[Suicidality in schizophrenic psychosis: a current overview]. / Suizidalität bei schizophrenen Psychosen: eine aktuelle Übersicht.

BACKGROUND: Suicidality in schizophrenic psychosis is an important topic but stands in clinical everyday work behind the perception of suicide especially in affective disorders. Schizophrenic psychosis is recognized as an independent risk factor for suicide attempts and suicides, whereas it poses particular challenges to the clinical professional due to the frequent unpredictability, abruptness and brutality of the methods used. For this reason, the suicide of a psychotic patient often leaves the professional and non-professional environment disturbed. AIMS: An overview of the existing relevant literature on suicide in psychosis is given. Explanations on the psychodynamics, indications on pharmacotherapy and psychotherapy and considerations on prevention round off this article and provide an up to date overview of this topic for clinicians. MATERIAL AND METHODS: A search was carried out in PubMed and Google scholar using the terms "suicide", "suicidality", "schizophrenia", "suicide AND schizophrenia", "suicide AND psychosis", "suicidality AND schizophrenia", "suicidality AND psychosis", "suicidality AND psychosis AND prevention", "suicide AND psychosis AND prevention", "suicidality AND schizophrenia AND prevention", "suicide AND schizophrenia AND prevention". CONCLUSION: Clinicians must have knowledge of the specific risk factors for suicide in psychotic patients, the characteristics of suicide in terms of design and temporal connection with treatment. The exploration and assessment of suicidality is often more difficult in psychotic patients than in affective or personality disorder patients, as there are often impulsive suicide attempts that can be explained by (suddenly occurring) psychotic symptoms and are therefore difficult or even impossible to foresee.

[Two Years of Ward-Equivalent In-Patient Treatment (StaeB) in retrospect]. / Zwei Jahre stationsäquivalente Behandlung: Ein Werkstattbericht.

BACKGROUND: Since January 1, 2018, ward-equivalent treatment has been a service provided by health insurance companies and offers the possibility of treating acutely mentally ill people in their familiar social environment, a demand that has been made since long by various parties. In this essay, four case vignettes will be used to critically review two years of ward-equivalent treatment . MATERIAL AND METHODS: Four case vignettes of different disorders are presented and discussed. The selection represents as broad a spectrum as possible of the disturbance patterns treated so far. RESULTS: The ward-equivalent treatment represents a meaningful and long overdue expansion of the psychiatric treatment repertoire. It can be sensibly and successfully integrated into existing forms of treatment. This applies both to general psychiatric as well as addiction and geriatric psychiatric disorders. With ward-equivalent treatment affected persons are also reached who, for various reasons, have not sought or have not been able to seek contact with the psychiatric care system despite the need for inpatient treatment. However, the staff association needs further development of the regulations, e.g. with regard to the frequency of contacts, in order to take (even) better account of the living conditions of those affected. CONCLUSIONS: The structure of the staff associations is resource-intensive. It can be designed both for specific incidents and for incidents that span several incidents. The advantage of a cross-disturbance orientation is that a larger number of affected persons can be treated. It also contributes more to being included in the "standard repertoire" of psychiatric treatment. The staff association must be developed further.