Psychoeducational and Cognitive Behavioral Treatment Programs: Implementation and Evaluation From 1995 to 2015 in Kraepelin's Former Hospital

[Inpatient Psychiatric Treatment in the Corona-crisis by Psychologists and Psychiatrists in Home-office and in the Clinic]

Since the emergence of the new coronavirus (COVID-19) pandemic in March 2020, many people in Germany have become ill. This meant a challenge for the care of mentally ill hospitalized patients. There was a social shut-down in Bavaria with a decrease in social contacts. The present study deals with psychiatric care provided to these patients by psychologists and psychiatrists working in the home office and in the clinic. Psychologists from the Department of Psychiatry and Psychotherapy at LMU Munich, together with physicians working in the clinic, established telephone-based patient care for inpatients during the acute crisis in the home office during quarantine, in which 23 patients with depressive and schizophrenic disorders participated. Psychologists then worked in the hospital with 98 hospitalized patients. Current distress and its stresses were addressed and new therapeutic components were integrated into care. The feasibility of home office, its possibilities and limitations are presented. In this study, care concepts for hospitalized patients with affective and schizophrenic disorders as well as current stress factors and psychotherapeutic concepts will be addressed. The current approach was positively evaluated by patients and physicians and is thus promising in the current situation. With the exception of patients in the acute ward, all patients and even older ones benefited from this measure. During the crisis from March to August, all psychologists worked on full-time positions with the usual treatment frequency of 1-2 sessions a week, which was especially important for elderly individuals. During the acute COVID-19 crisis, there was a pause only in the treatment of ward-wide groups and family groups. Psychologists, like physicians and nurses, had a system-relevant role to play.

Special Supplement Introduction: The Fourth Kraepelin Symposium-Cognitive Dysfunction in Schizophrenia: Origins and Innovative Treatment

This Special Supplement presents reports from working groups meeting at the Fourth Kraepelin Symposium in Munich, Germany, in September 2014. It covers the origins and therapy of cognitive dysfunction in schizophrenia. Cognitive deficits are core symptoms of schizophrenia being decisive for the long-term prognosis only improved moderately by antipsychotic treatment, however, showing more evidence for cognitive remediation. The authors refer to neurobiological and psychological underpinnings of cognitive deficits and to innovative treatment interventions aimed at improving cognitive dysfunction in order to improve outcome and to support coping with the illness. Therapeutic approaches include aerobic exercise, cognitive training, psychoeducation, cognitive therapy, noninvasive brain stimulation and pharmacotherapy in acute to post-acute patients. The supplement also presents novel diagnostic tools for early recognition, such as biomarkers, as well as cognitive training to prevent worsening of symptoms in individuals at clinical high risk for psychosis. In recent years there has been progress in basic science and outcomes research as well as psychopharmacological and psychological treatment options. Despite of this, treatment of cognitive deficits needs significant improvement and further research is needed.