[The CIMH Track Concept in Psychiatry: Syndrome-specific Treatment across Modalities - Part 2 - Practical implementation]. / Das ZI-Track-Konzept in der modernen Psychiatrie: Eine syndromspezifische sektorenübergreifende Behandlung.

Modern psychiatry needs to implement novel mental health care systems in order to address recent developments in diagnostics and treatment of psychiatric patients. In this context, it is necessary to take into account recent ethical and certain legal aspects which explicitly seek to reduce coercive treatment. The so-called "track-unit" is a promising strategy in order to achieve these goals. The "track-unit" seeks to enhance and improve patients' autonomy, setting-overlapping team continuity, compliance and adherence to treatment as well as to reduce time of patients in hospital as inpatients by more flexible intervention. Although there are many interfaces between normal wards and the "track-unit", implementation into daily routine should be done gradually. The first part of this paper will focus on required changes taking as an example the Department of Psychiatry and Psychotherapy at the Central Institute of Mental Health in Mannheim. In the second part, we will describe corresponding helpful constructional measures. In part three, we will discuss the socio-economic aspects and benefits of "track-units". In conclusion, the implementation of "track-units" in a German psychiatric department is a personnel and economic endeavor to improve the link and coordination between diagnostics and treatment throughout all stages of mental illness.

[The CIMH Track Concept in Psychiatry: Syndrome-specific Treatment across Modalities - Part 1 - Theoretical background]. / Das ZI-Track-Konzept in der modernen Psychiatrie: Eine syndromspezifische sektorenübergreifende Behandlung.

During the past decades, important progress was made in the treatment of patients with mental disorders. Nevertheless, the guideline-based treatment still represents a significant challenge that must take into account novel diagnostic and therapeutic possibilities as well as recent social development and the economic framework. Therefore, there is a need for further improvement of care in inpatient, day-care and outpatient hospital units. An effective and economic over-arching treatment setting may be the so called "Track-unit". This is a symptom- and syndrome-based, decentralised, and modular constructed unit adjusted to the patient's individual stage-specific needs for his / her treatment across in- and outpatient sectors. This concept allows a team of clinicians to accompany a patient from acute (even coercive) admission through to discharge and outpatient department in order to ensure the best-fitted treatment providing a maximum continuity of care without break-points in responsibilities and information flow. The Track-unit may improve the quality of mental health care while at the same time meeting economic and social interests. However, its implementation is challenging for both staff and internal processes. Here, we focus on underlying principles of the Track-concept in a German psychiatric department emphasizing ethical, therapeutic, personnel, and educational benefits of this alternative and promising setting in modern psychiatry.

Pediatric psychopharmacological research in the post EU regulation 1901/2006 era.

Although the use of psychotropic medications in child and adolescent psychiatry in Germany is on the increase, most compounds are in fact prescribed "off-label" because of a lack of regulatory approval in these age groups. In 2007, the European Parliament introduced Regulation 1901/2006 concerning medicinal products in pediatric populations, with a subsequent amendment in the form of Regulation 1902/2006. The main aim of this legislation was to encourage research and clinical trials in children and adolescents, and thus promote the availability of medications with marketing authorization for these age groups. Furthermore, initiatives such as the European 7th Framework Program of the European Union now offer substantial funding for pediatric pharmacological research. At a recent Congress of the German Society for Child and Adolescent Psychiatry and Psychotherapy (DGKJP), experts from the field and the pharmaceutical industry held a symposium with lay representatives in order to discuss attitudes toward, and experience with, pediatric psychopharmacology research in Germany since 2007. Several areas of concern were identified. The present paper derives from that symposium and provides an overview of these opinions, which remain crucial to the field. A wider discussion of how to facilitate psychopharmacological research in Germany in order to optimize the treatment and welfare of children and adolescents with psychiatric disorders is now warranted.