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Müller JL, Koller M, Müller S, Pollmächer T. [The forensic addiction rehabilitation center-Not a Gallic village of paternalism]. DER NERVENARZT 2023; 94:463-465. [PMID: 37010590 DOI: 10.1007/s00115-023-01458-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Accepted: 02/10/2023] [Indexed: 04/04/2023]
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Pollmächer T. Sleep and Mental Disorders. Eur Psychiatry 2022. [PMCID: PMC9567091 DOI: 10.1192/j.eurpsy.2022.41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Since ancient times, the close connection between disturbed sleep and mental disorders has been well known. And yet, it was not until the middle of the 20th century that these connections could be studied in detail, after the EEG and REM sleep were discovered. Especially the study of the sleep EEG of depressed patients has brought to light alterations of SWS and REM sleep that could be of considerable clinical value, but at least in part still await broad confirmation. In the treatment of disturbed sleep in psychiatric patients, cognitive behavioral therapy in particular has become increasingly established in recent years, whereas only limited innovations have been recorded with regard to pharmacological treatment. Only in recent years it has become clear that psychiatric disorders are often accompanied by clinically relevant somatic disorders of sleep, such as obstructive sleep apnea syndrome, and that such comorbidities urgently require attention and treatment. It is becoming increasingly clear that detailed knowledge of sleep disorders is essential for the effective treatment of mental disorders. Moreover, it is likely that the scientific study of sleep in mentally ill people still has untapped potential in terms of understanding the pathophysiology.
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Himmerich H, Fulda S, Linseisen J, Seiler H, Wolfram G, Himmerich S, Gedrich K, Kloiber S, Lucae S, Ising M, Uhr M, Holsboer F, Pollmächer T. Depression, comorbidities and the TNF-α system. Eur Psychiatry 2020; 23:421-9. [DOI: 10.1016/j.eurpsy.2008.03.013] [Citation(s) in RCA: 137] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2007] [Revised: 03/18/2008] [Accepted: 03/22/2008] [Indexed: 12/31/2022] Open
Abstract
AbstractDepression has frequently been reported to be associated with other physical diseases and changes in the cytokine system. We aimed to investigate associations between a medical history of depression, its comorbidities and cytokine plasma levels in the Bavarian Nutrition Survey II (BVS II) study sample and in patients suffering from an acute depressive episode.The BVS II is a representative study of the Bavarian population aged 13–80 years. The disease history of its 1050 participants was assessed through face-to-face interviews. A sub-sample of 568 subjects and 62 additional acutely depressed inpatients of the Max Planck Institute of Psychiatry participated in anthropometric measurements and blood sampling. Tumor necrosis factor-α (TNF-α) and soluble TNF receptor (sTNF-R) p55 and sTNF-R p75 plasma levels were measured using enzyme-linked immunosorbent assays.A history of depression was associated with a higher incidence of high blood pressure, peptic ulcer, dyslipoproteinemia, osteoporosis, allergic skin rash, atopic eczema and thyroid disease.Within the BVS II sample, participants with a history of depression differed from subjects who had never had depression with regard to sTNF-R p55 and sTNF-R p75 levels even when controlling for age, BMI and smoking status. Acutely depressed inpatients showed even higher levels of sTNF-R p55 and sTNF-R p75 than subjects in the normal population. TNF-α levels were also significantly elevated in acutely depressed patients.These results confirm earlier studies regarding the comorbidities of depression and support the hypothesis that activation of the TNF-α system may contribute to the development of a depressive disorder.
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Gerlinger G, Deister A, Heinz A, Koller M, Müller S, Steinert T, Pollmächer T. [After the reform is before the reform : Results of the amendment processes of mental health law in German federal states]. DER NERVENARZT 2019; 90:45-57. [PMID: 30191253 DOI: 10.1007/s00115-018-0612-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND On the basis of mental health law, which differs between the federal states in Germany, courts can order the involuntary commitment of people with severe mental disorders in psychiatric hospitals, if they present a danger to themselves or to others. Due to decisions of the highest courts, these laws have been subject to revision since 2011. The aim of this paper is to analyze and compare the results of the revision processes in order to define the need for action for federal and state legislature. MATERIAL AND METHODS Research of the current status of the revision processes in the federal states and a comparative analysis. The state laws were compared on the basis of selected particularly relevant areas with respect to human rights and treatment. RESULTS In spite of the revisions the state laws are extremely heterogeneous and in many states do not fully comply with the requirements of the United Nations Convention on the Rights of Persons with Disabilities (UN-CRPD) or the highest courts' decisions. CONCLUSION The state laws should be harmonized, particularly where they restrict basic and human rights, e. g. regarding prerequisites and objectives of involuntary commitment and coercive measures.
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Behr M, Acker J, Cohrs S, Deuschle M, Danker-Hopfe H, Göder R, Norra C, Richter K, Riemann D, Schilling C, Weeß HG, Wetter TC, Wollenburg LM, Pollmächer T. [Prevalence of sleep-related breathing disorders of inpatients with psychiatric disorders]. DER NERVENARZT 2018; 89:807-813. [PMID: 29876601 DOI: 10.1007/s00115-018-0545-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Sleep-related breathing disorders seriously impair well-being and increase the risk for relevant somatic and psychiatric disorders. Moreover, risk factors for sleep-related breathing disorders are highly prevalent in psychiatric patients. The aim of this study was for the first time in Germany to study the prevalence of obstructive sleep apnea syndrome (OSAS) as the most common form of sleep-related breathing disorder in patients with psychiatric disorders. METHODS In 10 psychiatric hospitals in Germany and 1 hospital in Switzerland, a total of 249 inpatients underwent an 8‑channel sleep polygraphy to investigate the prevalence of sleep apnea in this group of patients. RESULTS With a conspicuous screening result of 23.7% of the subjects, a high prevalence of sleep-related breathing disorders was found to occur among this group of patients. Male gender, higher age and high body mass index (BMI) were identified as positive risk factors for the detection of OSAS. DISCUSSION The high prevalence indicates that sleep apnea is a common sleep disorder among psychiatric patients. Although OSAS can lead to substantial disorders of the mental state and when untreated is accompanied by serious somatic health problems, screening procedures are not part of the routine work-up in psychiatric hospitals; therefore, sleep apnea is presumably underdiagnosed in psychiatric patients. In view of the results of this and previous studies, this topic complex should be the subject of further research studies.
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Riemann D, Baum E, Cohrs S, Crönlein T, Hajak G, Hertenstein E, Klose P, Langhorst J, Mayer G, Nissen C, Pollmächer T, Rabstein S, Schlarb A, Sitter H, Weeß HG, Wetter T, Spiegelhalder K. S3-Leitlinie Nicht erholsamer Schlaf/Schlafstörungen. SOMNOLOGIE 2017. [DOI: 10.1007/s11818-016-0097-x] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Adorjan K, Steinert T, Flammer E, Deister A, Koller M, Zinkler M, Herpertz SC, Häfner S, Hohl-Radke F, Beine KH, Falkai P, Gerlinger G, Pogarell O, Pollmächer T. Zwangsmaßnahmen in deutschen Kliniken für Psychiatrie und Psychotherapie. DER NERVENARZT 2016; 88:802-810. [DOI: 10.1007/s00115-016-0261-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Bassetti CL, Ferini-Strambi L, Brown S, Adamantidis A, Benedetti F, Bruni O, Cajochen C, Dolenc-Groselj L, Ferri R, Gais S, Huber R, Khatami R, Lammers GJ, Luppi PH, Manconi M, Nissen C, Nobili L, Peigneux P, Pollmächer T, Randerath W, Riemann D, Santamaria J, Schindler K, Tafti M, Van Someren E, Wetter TC. Neurology and psychiatry: waking up to opportunities of sleep. : State of the art and clinical/research priorities for the next decade. Eur J Neurol 2015; 22:1337-54. [DOI: 10.1111/ene.12781] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 06/05/2015] [Indexed: 12/22/2022]
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Wolff-Menzler C, Maier B, Junne F, Löhr M, Große C, Falkai P, Pollmächer T, Salize HJ, Nitschke R, Hauth I, Deister A, Godemann F. Versorgungsindikatoren in der Psychiatrie und Psychosomatik (VIPP) – Ein Datenbank-Projekt. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2014; 82:394-400. [PMID: 25014202 DOI: 10.1055/s-0034-1366577] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Godemann F, Falkai P, Hauth I, Salize HJ, Pollmächer T, Wolff-Menzler C. [Lump sum payment system in psychiatry and psychosomatics: concomitant research - quo vadis?]. DER NERVENARZT 2014; 84:864-8. [PMID: 23695005 DOI: 10.1007/s00115-013-3795-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The new lump sum payment scheme for psychiatric and psychosomatic services is coming into force in 2013. This constitutes another step on the way to performance-based financial compensation of inpatient and day hospital treatment in psychiatric and psychosomatic hospitals in Germany. This fundamental change needs to be accompanied by scientific evaluation with regards to its effects. This article reflects on the legal foundations of such evaluations and the current progress of preparation. Furthermore, own approaches for analysing the effects of the new finance scheme are presented.
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Oertel W, Riemann D, Pollmächer T. [Sleep]. DER NERVENARZT 2014; 85:7-8. [PMID: 24441881 DOI: 10.1007/s00115-013-3847-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Pollmächer T, Wetter TC, Happe S, Richter K, Acker J, Riemann D. [Sleep medicine differential diagnostics in psychiatry and psychotherapy]. DER NERVENARZT 2013; 85:57-66. [PMID: 24356713 DOI: 10.1007/s00115-013-3895-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Complaints about disturbed sleep or increased daytime sleepiness are among the most frequent symptoms reported to psychiatrists by patients. Such complaints can be symptoms of an underlying psychiatric disorder or indicative of a separate or comorbid sleep disorder. Hence, basic knowledge in the differential diagnosis of sleep medicine pathologies is pivotal for psychiatrists and psychotherapists. In the present overview following a description of the diagnostic methods, the diagnostic work-up according to the major symptomatic clusters, namely disturbances in initiating and maintaining sleep, abnormal nocturnal movements and excessive daytime sleepiness will be presented.
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Maurovich-Horvat E, Keckeis M, Lattová Z, Kemlink D, Wetter T, Schuld A, Šonka K, Pollmächer T. Hypothalamo–pituitary–adrenal axis, glucose metabolism and TNF-α in narcolepsy. Sleep Med 2013. [DOI: 10.1016/j.sleep.2013.11.352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kluge M, Pollmächer T, Schuld A. O-27 - Sleep propensity at daytime as assessed by multiple sleep latency tests (MSLT) in patients with schizophrenia increases with clozapine and olanzapine. Eur Psychiatry 2012. [DOI: 10.1016/s0924-9338(12)74127-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Hauth I, Pollmächer T. [10 topic paper of the BDK on the new payment system in psychiatry and psychotherapy]. PSYCHIATRISCHE PRAXIS 2011; 38:103. [PMID: 21394695 DOI: 10.1055/s-0031-1275226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Riemann D, Spiegelhalder K, Espie C, Pollmächer T, Léger D, Bassetti C, van Someren E. Chronic insomnia: clinical and research challenges--an agenda. PHARMACOPSYCHIATRY 2010; 44:1-14. [PMID: 21161882 DOI: 10.1055/s-0030-1267978] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Chronic insomnia afflicts up to 10% of the population in Western industrialized countries. It is characterized by delayed sleep onset, problems in maintaining sleep, early morning awakening or the feeling of non-restorative sleep coupled with significant daytime impairments on an emotional, social or professional level. It can occur as a co-morbid condition in any other medical or mental disorder, but also as a primary condition. Within the last decade new diagnostic and differential diagnostic approaches have been suggested that enhance diagnostic precision. Epidemiological data and data relating to the health care and cost situation of chronic insomnia suggest a huge burden for society. Chronic insomnia leads to a clear-cut increased risk for psychopathology (i. e., affective disorders) and probably also for cardiovascular and metabolic dysfunction. The pathophysiology of the condition is still poorly understood and will profit from integrating modern neuroscientific approaches (animal studies, molecular biology, neuroimaging, neurophysiology, etc.). Current treatment strategies are mainly based on cognitive behavioural interventions (CBT-I) and hypnotic treatment with benzodiazepine receptor agonists and sedating antidepressants. Although the effectiveness of these treatments has been clearly demonstrated, a substantial proportion of patients proves to be treatment-resistant or profits only poorly. The question of long-term pharmaceutical treatment of chronic insomnia, at least in Europe, is unresolved and urgently needs answers. Novel rational treatment avenues require clues on causes and mechanisms from integrated neuroscientific approaches. The important issues concerning insomnia treatment in the future especially in Europe will be reviewed and discussed critically.
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Beitinger PA, Fulda S, Dalal MA, Wehrle R, Keckeis M, Wetter TC, Pollmächer T, Schuld A. Glucose tolerance in patients with narcolepsy. Exp Clin Endocrinol Diabetes 2010. [DOI: 10.1055/s-0030-1267025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Hennings JM, Ising M, Grautoff S, Himmerich H, Pollmächer T, Schaaf L. Glucose Tolerance in Depressed Inpatients, under Treatment with Mirtazapine and in Healthy Controls. Exp Clin Endocrinol Diabetes 2009; 118:98-100. [DOI: 10.1055/s-0029-1237361] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Hennings JM, Owashi T, Binder EB, Horstmann S, Menke A, Kloiber S, Messer T, Pollmächer T, Nickel T, Sonntag A, Uhr M, Ising M, Holsboer F, Lucae S. Clinical characteristics and treatment outcome in a representative sample of depressed inpatients – Findings from the Munich Antidepressant Response Signature project. PHARMACOPSYCHIATRY 2009. [DOI: 10.1055/s-0029-1240131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Pollmächer T. [Overweight and obesity in schizophrenia--much more than a life-style issue!]. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2008; 76:697. [PMID: 19053011 DOI: 10.1055/s-0028-1100834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Penzel T, Hajak G, Hoffmann R, Lund R, Podszus T, Pollmächer T, Schäfer T, Schulz H, Sonnenschein W, Spieweg I. Empfehlungen zur Durchführung und Auswertung polygraphischer Ableitungen im diagnostischen Schlaflabor. KLIN NEUROPHYSIOL 2008. [DOI: 10.1055/s-2008-1060281] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Wehrle R, Beitinger P, Dalal M, Schuld A, Wetter TC, Pollmächer T. Daytime sleep after glucose intake in patients with narcolepsy. PHARMACOPSYCHIATRY 2007. [DOI: 10.1055/s-2007-991847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Beitinger PA, Wehrle R, Fulda S, Himmerich H, Pollmächer T, Wetter TC. Metabolic and cardiovascular risk factors in narcolepsy. PHARMACOPSYCHIATRY 2007. [DOI: 10.1055/s-2007-991834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Rathgeb-Fuetsch M, Beer U, Urmann I, Pollmächer T, Schuld A. Long-term efficacy of cognitive-behavioral therapy of patients with anxiety disorders in a hospital setting – influence of continuing psychotherapy and pharmacotherapy. PHARMACOPSYCHIATRY 2007. [DOI: 10.1055/s-2007-991804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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