[show abstract][hide abstract] ABSTRACT: This article is based on an evaluation carried out by the DGPPN in 2011 surveying 50 German university and non-university institutions about the scientific research output focussing on psychiatric and psychotherapeutic research. The results of the survey show that on average there are 1 to 2 professors with 12 assistants scientifically active per institution. According to self-disclosure an estimated 1.8 million Euros of external funds are raised each year.Compared to international standards regarding the illnesses major depression, schizophrenia and alcohol abuse, Germany ranks second and third place behind the USA and the UK or Canada in terms of publication output. In terms of authors and institutions, German scientists and universities rank in the upper third to upper tenth for these illnesses. These data show that psychiatric research in Germany is not only internationally competitive but outstanding in its excellent achievements in these fields. Unfortunately, many funding programmes are limited to a 3-6 year period. In view of this fact and in order to achieve a long-term improvement in the translation of funding structures, as in the US (NIMH) or the UK (MRC) to benefit the mentally ill the implementation of a German centre for mental disorders is inevitable.
[show abstract][hide abstract] ABSTRACT: Zusammenfassung Derzeit besteht im Fach Psychiatrie und Psychotherapie wie in anderen medizinischen Fachgebieten trotz zunehmender Arztzahlen
ein deutliches Ungleichgewicht zwischen offenen Arztstellen und Bewerbern. Um das Ausmaß des Defizits zu erfassen, hat die
Deutsche Gesellschaft für Psychiatrie, Psychotherapie und Nervenheilkunde (DGPPN) eine Befragung bei den Leiterinnen und Leitern
der Kliniken und Abteilungen für Psychiatrie und Psychotherapie in Deutschland durchgeführt. Es zeigten sich einige prägnante
Trends: Der Mangel an Bewerbern ist in Abhängigkeit von den Kontextbedingungen der jeweiligen Klinik sehr unterschiedlich
ausgeprägt. Von 2008 auf 2009 hat er deutlich zugenommen, er ist im Osten größer als im Westen, in kleinen Kliniken größer
als in großen und bei Assistenzärzten größer als bei Fachärzten. Der Mangel an Bewerbern wird wahrscheinlich erheblich maskiert
durch Kompensationsmaßnahmen wie die Einstellung von Psychologen auf ärztliche Stellen. Es wird angenommen, dass neben dem
allgemeinen Ärztemangel auch eine fachspezifische Komponente eine Rolle spielt: die überproportional wachsende Nachfrage nach
[show abstract][hide abstract] ABSTRACT: Patients with schizophrenia have semantic processing disturbances leading to expressive language deficits (formal thought disorder). The underlying pathology has been related to alterations in the semantic network and its neural correlates. Moreover, crossmodal processing, an important aspect of communication, is impaired in schizophrenia. Here we investigated specific processing abnormalities in patients with schizophrenia with regard to modality and semantic distance in a semantic priming paradigm. Fourteen patients with schizophrenia and fourteen demographically matched controls made visual lexical decisions on successively presented word-pairs (SOA = 350 ms) with direct or indirect relations, unrelated word-pairs, and pseudoword-target stimuli during fMRI measurement. Stimuli were presented in a unimodal (visual) or crossmodal (auditory-visual) fashion. On the neural level, the effect of semantic relation indicated differences (patients > controls) within the right angular gyrus and precuneus. The effect of modality revealed differences (controls > patients) within the left superior frontal, middle temporal, inferior occipital, right angular gyri, and anterior cingulate cortex. Semantic distance (direct vs. indirect) induced distinct activations within the left middle temporal, fusiform gyrus, right precuneus, and thalamus with patients showing fewer differences between direct and indirect word-pairs. The results highlight aberrant priming-related brain responses in patients with schizophrenia. Enhanced activation for patients possibly reflects deficits in semantic processes that might be caused by a delayed and enhanced spread of activation within the semantic network. Modality-specific decreases of activation in patients might be related to impaired perceptual integration. Those deficits could induce and increase the prominent symptoms of schizophrenia like impaired speech processing.
European Archives of Psychiatry and Clinical Neuroscience 07/2013; · 2.75 Impact Factor
[show abstract][hide abstract] ABSTRACT: The basis for different neural activations in response to male and female voices as well as the question, whether men and women perceive male and female voices differently, has not been thoroughly investigated. Therefore, the aim of the present study was to examine the behavioral and neural correlates of gender-related voice perception in healthy male and female volunteers. fMRI data were collected while 39 participants (19 female) were asked to indicate the gender of 240 voice stimuli. These stimuli included recordings of 3-syllable nouns as well as the same recordings pitch-shifted in 2, 4 and 6 semitone steps in the direction to the other gender. Data analysis revealed a) equal voice discrimination sensitivity in men and women but better performance in the categorization of opposite-sex stimuli at least in men, b) increased responses to increasing gender ambiguity in the mid cingulate cortex and bilateral inferior frontal gyri, and c) stronger activation in a fronto-temporal neural network in response to voices of the opposite sex. Our results indicate a gender specific processing for male and female voices on a behavioral and neuronal level. We suggest that our results reflect higher sensitivity probably due to the evolutionary relevance of voice perception in mate selection.
[show abstract][hide abstract] ABSTRACT: The German Association for Psychiatry and Psychotherapy (DGPPN) has committed itself to establish a prospective national cohort of patients with major psychiatric disorders, the so-called DGPPN-Cohort. This project will enable the scientific exploitation of high-quality data and biomaterial from psychiatric patients for research. It will be set up using harmonised data sets and procedures for sample generation and guided by transparent rules for data access and data sharing regarding the central research database. While the main focus lies on biological research, it will be open to all kinds of scientific investigations, including epidemiological, clinical or health-service research.
European Archives of Psychiatry and Clinical Neuroscience 04/2013; · 3.20 Impact Factor
[show abstract][hide abstract] ABSTRACT: Pavlovian fear conditioning has been thoroughly studied in the visual, auditory and somatosensory domain, but evidence is scarce with regard to the chemosensory modality. Under the assumption that Pavlovian conditioning relies on the supra-modal mechanism of salience attribution, the present study was set out to attest the existence of chemosensory aversive conditioning in humans as a specific instance of salience attribution. fMRI was performed in 29 healthy subjects during a differential aversive conditioning paradigm. Two odors (rose, vanillin) served as conditioned stimuli (CS), one of which (CS+) was intermittently coupled with intranasally administered CO2. On the neural level, a robust differential response to the CS+emerged in frontal, temporal, occipito-parietal and subcortical brain regions, including the amygdala. These changes were paralleled by the development of a CS+-specific connectivity profile of the anterior midcingulate cortex (aMCC), which is a key structure for processing salience information in order to guide adaptive response selection. Increased coupling could be found between key nodes of the salience network (anterior insula, neo-cerebellum) and sensorimotor areas, representing putative input and output structures of the aMCC for exerting adaptive motor control. In contrast, behavioral and skin conductance responses did not show significant effects of conditioning, which has been attributed to contingency unawareness. These findings imply substantial similarities of conditioning involving chemosensory and other sensory modalities, and suggest that salience attribution and adaptive control represent a general, modality-independent principle underlying Pavlovian conditioning.
[show abstract][hide abstract] ABSTRACT: BACKGROUND: Emotional and non-emotional Stroop are frequently applied to study major depressive disorder (MDD). The versions of emotional Stroop used in previous studies were not, unlike the ones employed in the present study, based on semantic incongruence, making it difficult to compare the tasks. METHODS: We used functional magnetic resonance imaging (fMRI) to study the neural and behavioral responses of 18 healthy subjects and 18 subjects with MDD to emotional and non-emotional word-face Stroop tasks based on semantic incompatibility between targets and distractors. RESULTS: In both groups, the distractors triggered significant amounts of interference conflict. A between-groups comparison revealed hypoactivation in MDD during emotional task in areas supporting conflict resolution (lateral prefrontal cortex, parietal and extrastriate cortices) paralleled by increased response in the right amygdala. Response in the amygdala, however, did not vary between conflicting and non-conflicting trials. While in the emotional (compared to non-emotional) task healthy controls showed considerably stronger involvement of networks related to conflict resolution, in patients, the processing differences between the two conflict types were negligible. LIMITATIONS: The patients group was inhomogeneous in terms of medication and clinical characteristics. The number of female participants was higher, due to which gender effects could not be studied or excluded. CONCLUSION: Whilst healthy controls seemed able to adjust the involvement of the network supporting conflict resolution based on conflict demand, patients appeared to lack this capability. The reduced cortical involvement coupled with increased response of limbic structures might underlie the maladjustment vis-à-vis new demands in depressed mood.
Journal of affective disorders 02/2013; · 3.76 Impact Factor
[show abstract][hide abstract] ABSTRACT: The therapeutic success of haloperidol in the treatment of Tourette syndrome (TS) put an end to the discussion about a "hysteric" or "neurotic" origin of TS. The cortico-striato-thalamo-cortical circuit has been identified as an underlying neurobiological correlate of TS. In this review we explore the main findings of structural alterations in TS including cortical areas, basal ganglia, hippocampus, amygdala, midbrain, and cerebellum. Based on the structural changes we examine the functional pattern described by the findings of fMRI and (15)O-PET/(18)FDG PET investigations. From the neuroimaging findings a cortical origin of the generation of tics is indicated. Future research on the neuronal footprint of TS should be directed towards addressing the question of which patterns of connectivity distinguish individuals in whom tics disappear during early adulthood from those in whom the tics persist. The understanding of this pathomechanism could provide a key on how to influence dysconnectivity in TS, for example, by more specific pharmaceutical intervention or by individually adopted EEG and/or fMRI neurofeedback.
International Review of Neurobiology 01/2013; 112:35-71. · 1.65 Impact Factor
[show abstract][hide abstract] ABSTRACT: Antisocial behavior and aggression are prominent symptoms in several psychiatric disorders including antisocial personality disorder. An established precursor to aggression is a frustrating event, which can elicit anger or exasperation, thereby prompting aggressive responses. While some studies have investigated the neural correlates of frustration and aggression, examination of their relation to trait aggression in healthy populations are rare. Based on a screening of 550 males, we formed two extreme groups, one including individuals reporting high (n=21) and one reporting low (n=18) trait aggression. Using functional magnetic resonance imaging (fMRI) at 3T, all participants were put through a frustration task comprising unsolvable anagrams of German nouns. Despite similar behavioral performance, males with high trait aggression reported higher ratings of negative affect and anger after the frustration task. Moreover, they showed relatively decreased activation in the frontal brain regions and the dorsal anterior cingulate cortex (dACC) as well as relatively less amygdala activation in response to frustration. Our findings indicate distinct frontal and limbic processing mechanisms following frustration modulated by trait aggression. In response to a frustrating event, HA individuals show some of the personality characteristics and neural processing patterns observed in abnormally aggressive populations. Highlighting the impact of aggressive traits on the behavioral and neural responses to frustration in non-psychiatric extreme groups can facilitate further characterization of neural dysfunctions underlying psychiatric disorders that involve abnormal frustration processing and aggression.
PLoS ONE 01/2013; 8(10):e78503. · 3.73 Impact Factor
[show abstract][hide abstract] ABSTRACT: Empathy is a rather elaborated human ability and several recent studies highlight significant impairments in patients suffering from psychiatric disorders, such as schizophrenia, bipolar disorder or major depression. Therefore, the present study aimed at comparing behavioral empathy performance in schizophrenia, bipolar and depressed patients with healthy controls. All subjects performed three tasks tapping the core components of empathy: emotion recognition, emotional perspective taking and affective responsiveness. Groups were matched for age, gender, and verbal intelligence. Data analysis revealed three main findings: First, schizophrenia patients showed the strongest impairment in empathic performance followed by bipolar patients while depressed patients performed similar to controls in most tasks, except for affective responsiveness. Second, a significant association between clinical characteristics and empathy performance was only apparent in depression, indicating worse affective responsiveness with stronger symptom severity and longer duration of illness. Third, self-report data indicate that particularly bipolar patients describe themselves as less empathic, reporting less empathic concern and less perspective taking. Taken together, this study constitutes the first approach to directly compare specificity of empathic deficits in severe psychiatric disorders. Our results suggest disorder-specific impairments in emotional competencies that enable better characterization of the patient groups investigated and indicate different psychotherapeutic interventions.
Schizophrenia Research 10/2012; · 4.59 Impact Factor
[show abstract][hide abstract] ABSTRACT: BACKGROUND: Tourette syndrome is a neuropsychiatric disorder characterized by motor and phonic tics. Deficient motor inhibition underlying tics is one of the main hypotheses in the pathophysiology of tics. Therefore the question arises whether this supposed deficient motor inhibition affects also voluntary movements. Despite severe motor tics, different personalities who suffer from Tourette perform successfully as neurosurgeon, pilot or professional basketball player. METHODS: For the investigation of fine motor skills we conducted a motor performance test battery in an adult Tourette sample and an age matched group of healthy controls. RESULTS: The Tourette patients showed a significant lower performance in the categories steadiness of both hands and aiming of the right hand in comparison to the healthy controls. A comparison of patients' subgroup without comorbidities or medication and healthy controls revealed a significant difference in the category steadiness of the right hand. CONCLUSIONS: Our results show that steadiness and visuomotor integration of fine motor skills are altered in our adult sample but not precision and speed of movements. This alteration pattern might be the clinical vignette of complex adaptations in the excitability of the motor system on the basis of altered cortical and subcortical components. The structurally and functionally altered neuronal components could encompass orbitofrontal, ventrolateral prefrontal and parietal cortices, the anterior cingulate, amygdala, primary motor and sensorimotor areas including altered corticospinal projections, the corpus callosum and the basal ganglia.
[show abstract][hide abstract] ABSTRACT: While impairments in emotion recognition are consistently reported in schizophrenia, there is some debate on the experience of emotion. Only few studies investigated neural correlates of emotional experience in schizophrenia. The present functional magnetic resonance imaging (fMRI) study compared a standard visual mood induction paradigm with an audiovisual method aimed at eliciting emotions more automatically. To investigate the interplay of sensory, cognitive and emotional mechanisms during emotion experience, we examined connectivity patterns between brain areas. Sixteen schizophrenia patients and sixteen healthy subjects participated in two different mood inductions (visual, audiovisual) that were administered for different emotions (happiness, sadness, neutral). Confirming the dissociation of behavioral and neural correlates of emotion experience, patients rated their mood similarly to healthy subjects but showed differences in neural activations. Sensory brain areas were activated less, increased activity emerged in higher cortical areas, particularly during audiovisual stimulation. Connectivity was increased between primary and secondary sensory processing areas in schizophrenia. These findings support the hypothesis of a deficit in filtering and processing sensory information alongside increased higher-order cognitive effort compensating for perception deficits in the affective domain. This may suffice to recover emotion experience in ratings of clinically stable patients but may fail during acute psychosis.
Social Cognitive and Affective Neuroscience 10/2012; · 5.04 Impact Factor
[show abstract][hide abstract] ABSTRACT: Background: Facial expressions, prosody, and speech content constitute channels by which information is exchanged. Little is known about the simultaneous and differential contribution of these channels to empathy when they provide emotionality or neutrality. Especially neutralised speech content has gained little attention with regards to influencing the perception of other emotional cues. Methods: Participants were presented with video clips of actors telling short-stories. One condition conveyed emotionality in all channels while the other conditions either provided neutral speech content, facial expression, or prosody, respectively. Participants judged the emotion and intensity presented, as well as their own emotional state and intensity. Skin conductance served as a physiological measure of emotional reactivity. Results: Neutralising channels significantly reduced empathic responses. Electrodermal recordings confirmed these findings. The differential effect of the communication channels on empathy prerequisites was that target emotion recognition of the other decreased mostly when the face was neutral, whereas decreased emotional responses attributed to the target emotion were especially present in neutral speech. Conclusion: Multichannel integration supports conscious and autonomous measures of empathy and emotional reactivity. Emotional facial expressions influence emotion recognition, whereas speech content is important for responding with an adequate own emotional state, possibly reflecting contextual emotion-appraisal.
Cognition and Emotion 09/2012; 26(6):995-1014. · 2.52 Impact Factor
[show abstract][hide abstract] ABSTRACT: Patients with first-episode schizophrenia (FES) are known to be notably sensitive for developing extrapyramidal adverse effects, but the relation of akathisia and suicidal ideation has rarely been studied.The current report is an ongoing analysis of an 8-week double-blind randomized controlled multicenter trial in 289 FES, comparing risperidone and haloperidol. Assessments were conducted weekly and included the Hillside Akathisia Scale and 21-item Hamilton Depression Rating Scale ratings.Suicidal ideation was significantly associated with clinician observed akathisia, depressed mood, younger age, and use of propranolol. The allocated treatment, anxiety, and nervousness had no influence.The present findings suggest a promoting effect of akathisia on suicidal ideation can not be ruled out in patients with FES.
Journal of clinical psychopharmacology 08/2012; 32(5):694-698. · 5.09 Impact Factor
[show abstract][hide abstract] ABSTRACT: According to the aberrant-salience hypothesis, attribution of motivational salience is severely disrupted in patients with schizophrenia. To provide a translational approach for investigating underlying mechanisms, neural correlates of salience attribution were examined in normal mice and in a MK-801 model of schizophrenia. Electrophysiological responses to standard and deviant tones were assessed in the medial prefrontal cortex (mPFC) using an auditory oddball paradigm. Motivational salience was induced by aversive conditioning to the deviant tone. Analysis of the auditory evoked potential (AEP) showed selective modulation of the late frontal negativity (LFN) by motivational salience, which persisted throughout a 4-week delay. MK-801, an N-methyl-D-aspartic acid receptor antagonist, abolished this differential response to motivational salience in conditioned mice. In contrast, a pronounced LFN response was observed towards the deviant, ie, perceptually salient tone, in nonconditioned mice. The finding of a selective modulation of a late frontal slow wave suggests increased top-down processing and emotional evaluation of motivationally salient stimuli. In particular, the LFN is discussed as the mouse analog to the human stimulus preceding negativity, which reflects preparatory processes in anticipation of reward or punishment. MK-801 led to a disruption of the normal response in conditioned and nonconditioned mice, including an aberrantly increased LFN in nonconditioned mice. This pattern of 'false-negative' and 'false-positive' responses suggests a degradation of salience attribution, which points to mPFC responses to be relevant for translational research on cognitive alterations in schizophrenia.Neuropsychopharmacology advance online publication, 22 August 2012; doi:10.1038/npp.2012.156.
Neuropsychopharmacology: official publication of the American College of Neuropsychopharmacology 08/2012; · 6.99 Impact Factor