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Gruber M, Alexopoulos J, Doering S, Feichtinger K, Friedrich F, Klauser M, Hinterbuchinger B, Litvan Z, Mossaheb N, Parth K, Wininger A, Blüml V. Personality functioning and self-disorders in individuals at ultra-high risk for psychosis, with first-episode psychosis and with borderline personality disorder. BJPsych Open 2023; 9:e150. [PMID: 37563768 PMCID: PMC10594090 DOI: 10.1192/bjo.2023.530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 04/21/2023] [Accepted: 06/01/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Assessment of personality functioning in different stages of psychotic disorders could provide valuable information on psychopathology, course of illness and treatment planning, but empirical data are sparse. AIMS To investigate personality functioning and sense of self in individuals at ultra-high risk (UHR) for psychosis and with first-episode psychosis (FEP) in comparison with a clinical control group of individuals with borderline personality disorder (BPD) and healthy controls. METHOD In a cross-sectional design, we investigated personality functioning (Structured Interview of Personality Organization, STIPO; Level of Personality Functioning Scale, LPFS) and disturbances of the basic self (Examination of Anomalous Self-Experience, EASE) in 107 participants, comprising 24 individuals at UHR, 29 individuals with FEP, 27 individuals with BPD and 27 healthy controls. RESULTS The UHR, FEP and BPD groups had moderate to severe deficits in personality organisation (STIPO) compared with the healthy control group. Self-functioning with its subdomain (facet) 'self-direction' (LPFS) was significantly worse in participants with manifest psychosis (FEP) compared with those at-risk for psychosis (UHR). The FEP group showed significantly worse overall personality functioning than the UHR group and significantly higher levels of self-disturbance (EASE) than the BPD group, with the UHR group lying between these diagnostic groups. Hierarchical cluster analysis based on the seven STIPO domains yielded three clusters differing in level of personality functioning and self-disturbances. CONCLUSIONS Our data demonstrate that psychotic disorders are associated with impaired personality functioning and self-disturbances. Assessment of personality functioning can inform treatment planning for patients at different stages of psychotic disorder.
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Affiliation(s)
- Maria Gruber
- Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria; and Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Johanna Alexopoulos
- Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Stephan Doering
- Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Karin Feichtinger
- Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Fabian Friedrich
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Miriam Klauser
- Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Barbara Hinterbuchinger
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Zsuzsa Litvan
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Nilufar Mossaheb
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Karoline Parth
- Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Antonia Wininger
- Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Victor Blüml
- Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria
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Hinterbuchinger B, Koch M, Trimmel M, Litvan Z, Baumgartner J, Meyer EL, Friedrich F, Mossaheb N. Correction to: Psychotic-like experiences in non-clinical subgroups with and without specific beliefs. BMC Psychiatry 2023; 23:495. [PMID: 37430203 DOI: 10.1186/s12888-023-04968-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/12/2023] Open
Affiliation(s)
- B Hinterbuchinger
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, 1090, Austria.
| | - M Koch
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, 1090, Austria
| | - M Trimmel
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, 1090, Austria
| | - Z Litvan
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, 1090, Austria
| | - J Baumgartner
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, 1090, Austria
| | - E L Meyer
- Section for Medical Statistics, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, 1090, Austria
| | - F Friedrich
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, 1090, Austria
| | - N Mossaheb
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, 1090, Austria
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Hinterbuchinger B, Koch M, Trimmel M, Litvan Z, Baumgartner J, Meyer EL, Friedrich F, Mossaheb N. Psychotic-like experiences in non-clinical subgroups with and without specific beliefs. BMC Psychiatry 2023; 23:397. [PMID: 37270507 DOI: 10.1186/s12888-023-04876-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 05/16/2023] [Indexed: 06/05/2023] Open
Abstract
BACKGROUND Assuming a transdiagnostic and extended psychosis phenotype, psychotic-like experiences (PLEs) and psychotic symptoms are on a phenomenological and temporal continuum between clinical and non-clinical populations. Recent research points towards differences in PLE proneness in different subgroups and clinical impact of different PLE subtypes. This study examines the prevalence of PLEs in three groups of individuals with and without specific sets of beliefs aiming to elucidate the question whether proneness to PLEs varies according to traditional versus less traditional supernatural beliefs. METHODS The anonymized 16-item version of the Prodromal Questionnaire (PQ-16) was used to assess PLEs in three groups including individuals with religious beliefs (RB), belief in esoterism and paranormal phenomena (EB), and those embedded in scientific evidence approach and scepticism towards para-scientific theories (non-believers, NB). Male and female participants between 18 and 90 years were eligible for participation. RESULTS The sample comprised 159 individuals including 41 RB individuals, 43 EB individuals, and 75 NB individuals. The mean PQ-16 score of the EB individuals (6.86 ± 4.13) was significantly higher compared to NB individuals (3.43 ± 2.99) and to RB individuals (3.38 ± 3.23) with almost twice the score (both p-values < 0.001). There was no significant difference between the PQ-16 scores of the NB group and the RB group (p = 0.935). No significant impact of age (p = 0.330) and gender (p = 0.061) was found on the PQ16-Score. Group affiliation to esoterism was associated with a higher PQ-16 score compared to group affiliation to religious beliefs (p < 0.001) and group affiliation to scepticism (p = 0.011), while the latter two did not differ significantly (p = 0.735). No significant difference was found between the three groups in the degree of distress related to the affirmatively answered PQ-16 items (p = 0.74). CONCLUSION Under the assumption of a transdiagnostic psychosis phenotype, our findings provide more insight which subgroups within non-clinical samples have a higher likelihood of reporting PLEs.
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Affiliation(s)
- B Hinterbuchinger
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
| | - M Koch
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - M Trimmel
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Z Litvan
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - J Baumgartner
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - E L Meyer
- Section for Medical Statistics, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, 1090, Vienna, Austria
| | - F Friedrich
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - N Mossaheb
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
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Fellinger M, Waldhör T, Serretti A, Hinterbuchinger B, Pruckner N, König D, Gmeiner A, Vyssoki S, Vyssoki B, Fugger G. Seasonality in Major Depressive Disorder: Effect of Sex and Age. J Affect Disord 2022; 296:111-116. [PMID: 34600171 DOI: 10.1016/j.jad.2021.09.051] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 08/21/2021] [Accepted: 09/16/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND Aside from the concept of seasonal affective disorder, the evidence for a seasonal pattern (SP) of major depressive disorder (MDD) is controversial. Furthermore, the effect of sex and age is still unclear. METHODS This is a nationwide, registry-based study assessing all inpatient admissions in mental health hospitals due to MDD episodes according to ICD-10 (moderate (F32/33.1), severe (F32/33.2) and severe with psychotic features (F32/33.3)) in Austria across 14 years. Calculations were based on deviations from expected monthly admissions. RESULTS The sample comprised 231,824 hospitalisations (36.8% men) for MDD. A significant SP (p=0.001) in moderate and severe depressive episodes in both women and men with decreased admission rates in the summer months and December was detected. In psychotic depression a significant SP was only evidenced in women (p = 0.002, men: p = 0.291). Patients older than 55 years had a reduced SP compared to those being younger. LIMITATIONS Only anonymised admission data of inpatient treatments were available. Hospitalization rates cannot fully be equated to the occurrence of MDD. CONCLUSIONS The current study indicates a seasonal variation in MDD symptoms that may go beyond seasonal affective disorder. Knowledge about the predictability of depressive symptoms in patients should encourage preventive strategies.
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Affiliation(s)
- Matthäus Fellinger
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
| | - Thomas Waldhör
- Centre for Public Health, Department of Epidemiology, Medical University of Vienna, Austria.
| | - Alessandro Serretti
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy
| | - Barbara Hinterbuchinger
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
| | - Nathalie Pruckner
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
| | - Daniel König
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
| | - Andrea Gmeiner
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
| | | | - Benjamin Vyssoki
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
| | - Gernot Fugger
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy; Clinical Division of General Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
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Abstract
Assuming a continuum between psychotic experiences and psychotic symptoms aligned between healthy individuals and patients with non-psychotic and psychotic disorders, recent research has focused on subclinical psychotic experiences. The wide variety of definitions, assessment tools, and concepts of psychotic-like experiences (PLEs) might contribute to the mixed findings concerning prevalence and persistence rates and clinical impact. In this narrative review, we address the panoply of terminology, definitions, and assessment tools of PLEs and associated concerns with this multitude. Moreover, the ambiguous results of previous studies regarding the clinical relevance of PLEs are described. In conclusion, we address clinical implications and highly suggest conceptual clarity and consensus concerning the terminology and definition of PLEs. The development of an agreed upon use of a "gold standard" assessment tool seems essential for more comparable findings in future research.
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Affiliation(s)
- Barbara Hinterbuchinger
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Nilufar Mossaheb
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
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Baumgartner J, Litvan Z, Koch M, Hinterbuchinger B, Friedrich F, Baumann L, Mossaheb N. Metacognitive beliefs in individuals at risk for psychosis: a systematic review and meta-analysis of sex differences. Neuropsychiatr 2020; 34:108-115. [PMID: 32338344 PMCID: PMC7467958 DOI: 10.1007/s40211-020-00348-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 03/30/2020] [Indexed: 11/11/2022]
Abstract
BACKGROUND Sex differences were found in several domains in individuals at ultra-high risk for psychosis, but no previous work has systematically reviewed and analysed possible sex differences in metacognition in this population. However, alterations in metacognitive beliefs have been shown in the at-risk mental state for psychosis population. Our aim was to qualitatively review and quantitatively analyse the existing literature for data on sex differences in metacognitive beliefs-mainly depicted by the Metacognitions Questionnaire (MCQ) and its short form (MCQ-30)-in individuals with at-risk mental states. METHODS We performed a systematic review of the literature on metacognition in help-seeking adolescents and young adults at ultra-high risk for psychosis. We included peer-reviewed articles that included a high-risk for psychosis group assessed with operationalised criteria and instruments. For the quantitative meta-analysis, only studies comparing MCQ data in high-risk individuals were included. A fixed-effect meta-model was used and forest plots drawn for each subscale and overall score. The studies were weighted according to the inverse variance method in order to calculate pooled confidence intervals and p values. RESULTS No article on metacognitive beliefs in individuals at increased risk for psychosis explicitly reported possible sex differences. Our meta-analysis of 234 (57% male) individuals' scores in the MCQ yielded no significant sex difference. CONCLUSIONS Currently, no sex differences in metacognition can be described in the at-risk population; however, data are insufficient and heterogeneous with regard to thoroughly answering the question whether sex differences in clinical high-risk populations are mirrored in the metacognitive domain.
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Affiliation(s)
- Josef Baumgartner
- Department of Psychiatry and Psychotherapy, Clinical Division for Social Psychiatry, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
| | - Zsuzsa Litvan
- Department of Psychiatry and Psychotherapy, Clinical Division for Social Psychiatry, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Marlene Koch
- Department of Psychiatry and Psychotherapy, Clinical Division for Social Psychiatry, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Barbara Hinterbuchinger
- Department of Psychiatry and Psychotherapy, Clinical Division for Social Psychiatry, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Fabian Friedrich
- Department of Psychiatry and Psychotherapy, Clinical Division for Social Psychiatry, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Lukas Baumann
- Center for Medical Statistics, Informatics and Intelligent Systems (CeMSIIS), Institute for Medical Statistics, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Nilufar Mossaheb
- Department of Psychiatry and Psychotherapy, Clinical Division for Social Psychiatry, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
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Fugger G, Waldhör T, Hinterbuchinger B, Pruckner N, König D, Gmeiner A, Vyssoki S, Vyssoki B, Fellinger M. Pattern of inpatient care for depression: an analysis of 232,289 admissions. BMC Psychiatry 2020; 20:375. [PMID: 32677945 PMCID: PMC7364660 DOI: 10.1186/s12888-020-02781-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Accepted: 07/08/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The prevalence of major depressive disorder (MDD) in women is up to 50% higher as compared to men. However, little is known about discrepancies in health care utilization between depressed female and male patients. Consequently, the aim of the present study was to elucidate gender differences regarding the frequency of hospital admissions and the length of inpatient treatment for MDD across the lifespan. METHODS This nationwide, registry-based study analyzed all inpatient admissions in psychiatric hospitals due to recurrent/non-recurrent MDD episodes according to ICD-10 (moderate (F32/33.1), severe (F32/33.2), severe with psychotic features (F32/33.3)) in Austria across 14 years. We calculated weekly admission rates per 100,000 patients by directly age-standardized rates. RESULTS Across 232,289 admissions (63.2% female) the population based admission rates in MDD were significantly higher in women (p < 0.001). Female to male ratios across subgroups were 1.65 (F32/33.1), 1.58 (F32/33.2), 1.73 (F32/33.3), and peaked around 65 years (ratio ≥ 2 for all subgroups). Length of hospital stay for women was significantly longer in all depression subtypes (p < 0.001). CONCLUSIONS Elevated rates of inpatient treatment in women cannot solely be explained by a higher MDD prevalence and are dependent on age and type of depressive episode. Irrespective of the type and severity of the mood episode, women exhibit longer hospitalisation times.
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Affiliation(s)
- Gernot Fugger
- grid.22937.3d0000 0000 9259 8492Clinical Division of General Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Thomas Waldhör
- grid.22937.3d0000 0000 9259 8492Centre for Public Health, Department of Epidemiology, Medical University of Vienna, Vienna, Austria
| | - Barbara Hinterbuchinger
- grid.22937.3d0000 0000 9259 8492Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Wien, Austria
| | - Nathalie Pruckner
- grid.22937.3d0000 0000 9259 8492Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Wien, Austria
| | - Daniel König
- grid.22937.3d0000 0000 9259 8492Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Wien, Austria
| | - Andrea Gmeiner
- grid.22937.3d0000 0000 9259 8492Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Wien, Austria
| | - Sandra Vyssoki
- grid.434096.c0000 0001 2190 9211St. Pölten University of Applied Sciences, Sankt Pölten, Austria
| | - Benjamin Vyssoki
- grid.22937.3d0000 0000 9259 8492Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Wien, Austria
| | - Matthäus Fellinger
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Wien, Austria.
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Hinterbuchinger B, König D, Gmeiner A, Listabarth S, Fellinger M, Thenius C, Baumgartner JS, Vyssoki S, Waldhoer T, Vyssoki B, Pruckner N. Seasonality in schizophrenia-An analysis of a nationwide registry with 110,735 hospital admissions. Eur Psychiatry 2020; 63:e55. [PMID: 32389135 PMCID: PMC7355169 DOI: 10.1192/j.eurpsy.2020.47] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background. Seasonal patterns in hospitalizations have been observed in various psychiatric disorders, however, it is unclear whether they also exist in schizophrenia. Previous studies found mixed results and those reporting the presence of seasonality differ regarding the characteristics of these patterns. Further, they are inconclusive whether sex is an influencing factor. The aim of this study was therefore to examine if seasonal patterns in hospitalizations can be found in schizophrenia, with special regard to a possible influence of sex, by using a large national dataset. Methods. Data on all hospital admissions within Austria due to schizophrenia (F20.0–F20.6) for the time period of 2003–2016 were included. Age standardized monthly variation of hospitalization for women and men was analyzed and the level of significance adjusted for multiple testing. Results. The database comprised of 110,735 admissions (59.6% men). Significant seasonal variations were found in the total sample with hospitalization peaks in January and June and a trough in December (p < 0.0001). No significant difference in these patterns was found between women and men with schizophrenia (p < 0.0001). Conclusion. Our study shows that schizophrenia-related hospitalizations follow a seasonal pattern in both men and women. The distribution of peaks might be influenced by photoperiod changes which trigger worsening of symptoms and lead to exacerbations in schizophrenia. Further research is necessary to identify underlying factors influencing seasonal patterns and to assess whether a subgroup of patients with schizophrenia is especially vulnerable to the impact of seasonal variations.
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Affiliation(s)
- B Hinterbuchinger
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - D König
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - A Gmeiner
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - S Listabarth
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - M Fellinger
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - C Thenius
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - J S Baumgartner
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - S Vyssoki
- Department of Health Sciences, University of Applied Sciences, St. Pölten, Austria
| | - T Waldhoer
- Center for Public Health, Department of Epidemiology, Medical University of Vienna, Vienna, Austria
| | - B Vyssoki
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - N Pruckner
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
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Baumgartner J, Hoeflich A, Hinterbuchinger B, Fellinger M, Graf I, Friedrich F, Frey R, Mossaheb N. Fulminant Onset of Valproate-Associated Hyperammonemic Encephalopathy. Am J Psychiatry 2019; 176:900-903. [PMID: 31672038 DOI: 10.1176/appi.ajp.2019.18040363] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Josef Baumgartner
- The Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry (Baumgartner, Hoeflich, Hinterbuchinger, Fellinger, Friedrich, Mossaheb), and the Department of Psychiatry and Psychotherapy, Clinical Division of General Psychiatry (Graf, Frey), Medical University of Vienna
| | - Anna Hoeflich
- The Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry (Baumgartner, Hoeflich, Hinterbuchinger, Fellinger, Friedrich, Mossaheb), and the Department of Psychiatry and Psychotherapy, Clinical Division of General Psychiatry (Graf, Frey), Medical University of Vienna
| | - Barbara Hinterbuchinger
- The Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry (Baumgartner, Hoeflich, Hinterbuchinger, Fellinger, Friedrich, Mossaheb), and the Department of Psychiatry and Psychotherapy, Clinical Division of General Psychiatry (Graf, Frey), Medical University of Vienna
| | - Matthaeus Fellinger
- The Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry (Baumgartner, Hoeflich, Hinterbuchinger, Fellinger, Friedrich, Mossaheb), and the Department of Psychiatry and Psychotherapy, Clinical Division of General Psychiatry (Graf, Frey), Medical University of Vienna
| | - Irene Graf
- The Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry (Baumgartner, Hoeflich, Hinterbuchinger, Fellinger, Friedrich, Mossaheb), and the Department of Psychiatry and Psychotherapy, Clinical Division of General Psychiatry (Graf, Frey), Medical University of Vienna
| | - Fabian Friedrich
- The Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry (Baumgartner, Hoeflich, Hinterbuchinger, Fellinger, Friedrich, Mossaheb), and the Department of Psychiatry and Psychotherapy, Clinical Division of General Psychiatry (Graf, Frey), Medical University of Vienna
| | - Richard Frey
- The Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry (Baumgartner, Hoeflich, Hinterbuchinger, Fellinger, Friedrich, Mossaheb), and the Department of Psychiatry and Psychotherapy, Clinical Division of General Psychiatry (Graf, Frey), Medical University of Vienna
| | - Nilufar Mossaheb
- The Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry (Baumgartner, Hoeflich, Hinterbuchinger, Fellinger, Friedrich, Mossaheb), and the Department of Psychiatry and Psychotherapy, Clinical Division of General Psychiatry (Graf, Frey), Medical University of Vienna
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König D, Fellinger M, Pruckner N, Hinterbuchinger B, Dorffner G, Gleiss A, Vyssoki S, Vyssoki B. Corrigendum to "Availability and Use of Mental Health Services in European Countries: Influence on National Suicide Rates" [Journal of Affective Disorders 239 (2018) 66-71]. J Affect Disord 2019; 257:599. [PMID: 31344527 DOI: 10.1016/j.jad.2019.05.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Daniel König
- Clinical Division of Social Psychiatry, Univ. Dept. of Psychiatry and Psychotherapy, Medical University of Vienna, Austria.
| | - Matthäus Fellinger
- Clinical Division of Social Psychiatry, Univ. Dept. of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
| | - Nathalie Pruckner
- Clinical Division of Social Psychiatry, Univ. Dept. of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
| | - Barbara Hinterbuchinger
- Clinical Division of Social Psychiatry, Univ. Dept. of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
| | - Georg Dorffner
- Institute of Artificial Intelligence and Decision Support, Medical University of Vienna, Austria
| | - Andreas Gleiss
- Institute of Clinical Biometrics, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Austria
| | - Sandra Vyssoki
- Clinical Division of Social Psychiatry, Univ. Dept. of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
| | - Benjamin Vyssoki
- Clinical Division of Social Psychiatry, Univ. Dept. of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
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11
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Pruckner N, Hinterbuchinger B, Fellinger M, König D, Waldhoer T, Lesch OM, Gmeiner A, Vyssoki S, Vyssoki B. Alcohol-Related Mortality in the WHO European Region: Sex-Specific Trends and Predictions. Alcohol Alcohol 2019; 54:593-598. [DOI: 10.1093/alcalc/agz063] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 06/14/2019] [Accepted: 07/04/2019] [Indexed: 12/17/2022] Open
Abstract
Abstract
Aims
Alcohol is an important risk factor for morbidity and mortality, especially within the European region. Differences in per capita consumption and drinking patterns are possible reasons for regional differences and diverging trends in alcohol-related health outcomes.
Methods
Twenty-nine countries within the World Health Organization (WHO) European region were evaluated for trends and predictions in alcohol-related deaths within the last four decades using data available from the WHO Health for All database.
Results
Between 1979 and 2015, age-standardised death rates due to selected alcohol-related causes decreased significantly for both sexes in all assessed countries of the WHO European region, but regional differences are still pronounced. Assuming a similar trend in the future, the model predicted a further decrease until the year 2030.
Conclusion
Even though alcohol-related mortality may have decreased within the last decades, the detrimental effects of alcohol consumption and alcohol dependence remain a considerable burden of disease within Europe.
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Affiliation(s)
- Nathalie Pruckner
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Barbara Hinterbuchinger
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Matthäus Fellinger
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Daniel König
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Thomas Waldhoer
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria
| | - Otto M Lesch
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Andrea Gmeiner
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Sandra Vyssoki
- Department of Health Sciences, St. Pölten University of Applied Sciences, Fachhochschule St. Pölten GmbH Matthias Corvinus - Straße 15, 3100 St. Pölten, Austria
| | - Benjamin Vyssoki
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
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12
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Pruckner N, Baumgartner J, Hinterbuchinger B, Glahn A, Vyssoki S, Vyssoki B. Thiamine Substitution in Alcohol Use Disorder: A Narrative Review of Medical Guidelines. Eur Addict Res 2019; 25:103-110. [PMID: 30897571 DOI: 10.1159/000499039] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 02/15/2019] [Indexed: 11/19/2022]
Abstract
AIMS Patients with alcohol use disorder (AUD) frequently suffer from cognitive deficits ranging from mild symptoms to most severe forms. Wernicke encephalopathy (WE), caused by thiamine deficiency, is a potentially fatal syndrome characterized by the clinical triad of ophthalmoplegia, ataxia, and confusion. WE frequently presents in patients with AUD and, if left untreated, can progress to Wernicke-Korsakoff syndrome, which constitutes severe anterograde amnesia, confabulation, and behavioral abnormalities. Due to oftentimes indistinct clinical presentation, WE remains undiagnosed in up to 80% of cases. We conducted a review of current treatment guidelines for AUD in order to identify recommendations for the use of thiamine. METHODS Three different keyword combinations ("alcohol treatment guideline," "alcohol withdrawal guideline," and "alcohol treatment recommendation") were entered in PubMed and Scopus, additional guidelines were searched screening the online sites of the respective agencies or societies. In total, 14 guidelines were included. RESULTS Thiamine was mentioned in all but one of the reviewed publications. Specifications on application modalities and indications varied considerably. While the majority of reviewed guidelines recommended parenteral thiamine only for patients at high risk for WE, some gave no information regarding the application form or dosage. CONCLUSION Substitution of parenteral thiamine in individuals with suspected WE is a well-established treatment regimen. However, suggestions according to guidelines vary widely. Furthermore, hardly any evidence-based recommendations exist on a more general use of thiamine as a preventative intervention in individuals with AUD. Further research is of utmost importance to raise awareness for this potentially undervalued problem.
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Affiliation(s)
- Nathalie Pruckner
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria,
| | - Josef Baumgartner
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Barbara Hinterbuchinger
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Alexander Glahn
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Sandra Vyssoki
- Department of Health Sciences, St. Pölten University of Applied Sciences, Sankt Pölten, Austria
| | - Benjamin Vyssoki
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
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13
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Hinterbuchinger B, Kaltenboeck A, Baumgartner JS, Mossaheb N, Friedrich F. Do patients with different psychiatric disorders show altered social decision-making? A systematic review of ultimatum game experiments in clinical populations. Cogn Neuropsychiatry 2018; 23:117-141. [PMID: 29608131 DOI: 10.1080/13546805.2018.1453791] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Impairments in social functioning are a common feature of psychiatric disorders. Game paradigms pose a unique way for studying how people make decisions in interpersonal contexts. In the last decade, researchers have started to use these paradigms to study social decision-making in patients with psychiatric disorders. PURPOSE The aim of this systematic literature review is to summarise the currently available evidence on the behaviour of patients with psychiatric disorders in the commonly used Ultimatum Game (UG). METHOD A systematic literature search including MEDLINE, PsycINFO, PSYNDEXplus Tests, PSYNDEXPLUS Literature, EBM Reviews-Cochrane Central Register of Controlled Trials, Embase and PASCAL was performed via the Ovid interface. RESULTS We found evidence for alterations in UG behaviour for patients with frontotemporal dementia, schizophrenia, affective disorders, alcohol, cocaine, heroin and 3,4-methylenedioxymethamphetamine consumption, alcohol dependence, anxiety disorders, borderline personality disorder, autism, Tourette syndrome and oppositional defiant disorder. CONCLUSION There is some evidence that different psychiatric disorders might go along with alterations in social decision-making. However, in general, data are currently limited and studies are hard to compare due to differences in methodologies.
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Affiliation(s)
- Barbara Hinterbuchinger
- a Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy , Medical University of Vienna , Vienna , Austria
| | | | - Josef Severin Baumgartner
- a Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy , Medical University of Vienna , Vienna , Austria
| | - Nilufar Mossaheb
- a Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy , Medical University of Vienna , Vienna , Austria
| | - Fabian Friedrich
- a Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy , Medical University of Vienna , Vienna , Austria
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14
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Hinterbuchinger B, Litvan Z, Meyer EL, Friedrich F, Kaltenboeck A, Gruber M, König D, Sueßenbacher S, Mossaheb N. Psychotic-like experiences in esoterism: A twilight zone? Schizophr Res 2018; 193:240-243. [PMID: 28826998 DOI: 10.1016/j.schres.2017.08.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Revised: 08/03/2017] [Accepted: 08/07/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Over the past decades, research has suggested the existence of a psychosis continuum ranging from psychotic-like experiences (PLEs) in the general population to psychotic symptoms in patients with affective and schizophrenia spectrum disorders. Especially individuals interested in esoterism were more often reported having experienced PLEs. However, there is little information on the extent of PLEs in this subculture. The aim of this study was to assess the extent of PLEs in a non-clinical population with interest in esoterism by means of an anonymized clinically used screening questionnaire. PARTICIPANTS AND METHODS The 16-item version of the Prodromal Questionnaire (PQ-16), a self-report screening questionnaire assessing the presence of PLEs was administered to individuals with interest in esoterism (IE) and a control group without interest in esoterism (NI). RESULTS The sample included 402 individuals. 224 subjects (55.7%) reported interest in esoterism and 178 subjects (44.3%) showed no such interest. In an ANCOVA, interest in esoterism was shown to have a significant impact on the PQ-16 score (<0.001). Also, age (p=0.022) and the interaction between age and interest in esoterism had a significant impact on the PQ-16 score (p=0.004). Specifically, younger individuals interested in esoterism showed increased PQ-16 scores, whereas scores decreased with increasing age. In individuals without interest in esoterism, age had no relevant impact on the score. CONCLUSION Younger individuals interested in esoterism seem to be more prone to reporting psychotic-like experiences compared to individuals without interest in esoterism and compared to their older counterparts.
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Affiliation(s)
- Barbara Hinterbuchinger
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University of Vienna, Austria.
| | - Zsuzsa Litvan
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University of Vienna, Austria
| | - Elias Laurin Meyer
- Section for Medical Statistics, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Austria
| | - Fabian Friedrich
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University of Vienna, Austria
| | | | - Maria Gruber
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University of Vienna, Austria
| | - Daniel König
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University of Vienna, Austria
| | - Stefanie Sueßenbacher
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University of Vienna, Austria
| | - Nilufar Mossaheb
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University of Vienna, Austria
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15
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Missbach B, Hinterbuchinger B, Dreiseitl V, Zellhofer S, Kurz C, König J. When Eating Right, Is Measured Wrong! A Validation and Critical Examination of the ORTO-15 Questionnaire in German. PLoS One 2015; 10:e0135772. [PMID: 26280449 PMCID: PMC4539204 DOI: 10.1371/journal.pone.0135772] [Citation(s) in RCA: 125] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 07/24/2015] [Indexed: 12/28/2022] Open
Abstract
The characteristic trait of individuals developing a pathological obsession and preoccupation with healthy foods and a restrictive and avoidant eating behavior is described as orthorexia nervosa (ON). For ON, neither universal diagnosis criteria nor valid tools for large-scale epidemiologic assessment are available in the literature. The aim of the current study is to analyze the psychometric properties of a translated German version of the ORTO-15 questionnaire. The German version of the ORTO-15, a eating behavior and dieting habits questionnaire were completed by 1029 German-speaking participants (74.6% female) aged between 19 and 70 years (M = 31.21 ± 10.43 years). Our results showed that after confirmatory factor analysis, the best fitting model of the original version is a single-factor structure (9-item shortened version: ORTO-9-GE). The final model showed only moderate internal consistency (Cronbach's alpha = .67), even after omitting 40% of the original question. A total of 69.1% participants showed orthorectic tendencies. Orthorectic tendencies are associated with special eating behavior features (dieting frequency, vegetarian and vegan diet). Education level did not influence ON tendency and nutritional students did not show higher ON tendency compared to students from other disciplines. This study is the first attempt to translate and to evaluate the psychometric properties of a German version of the ORTO-15 questionnaire. The ORTO-9-GE questionnaire, however, is only a mediocre tool for assessing orthorectic tendencies in individuals and shows moderate reliability and internal consistency. Our research suggests, that future studies are needed to provide more reliable and valid assessment tools to investigate orthorexia nervosa.
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Affiliation(s)
- Benjamin Missbach
- Department of Nutritional Sciences, University of Vienna, Vienna, Austria
| | - Barbara Hinterbuchinger
- Department of Psychiatry and Psychotherapy, Division of Social Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Verena Dreiseitl
- Department of Nutritional Sciences, University of Vienna, Vienna, Austria
| | - Silvia Zellhofer
- Department of Nutritional Sciences, University of Vienna, Vienna, Austria
| | - Carina Kurz
- Department of Nutritional Sciences, University of Vienna, Vienna, Austria
| | - Jürgen König
- Department of Nutritional Sciences, University of Vienna, Vienna, Austria
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