M Jänner

Heinrich-Heine-Universität Düsseldorf, Düsseldorf, North Rhine-Westphalia, Germany

Are you M Jänner?

Claim your profile

Publications (30)66.76 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: OBJECTIVE: The aim of this study was to examine the association of lay attributions about causes of depression with attitudes and prejudiced behaviour towards people with depression. METHOD: Subjects (1631 German-speakers aged 18 and over, randomly selected) were interviewed in two German cities by telephone using a standardized questionnaire. The survey assessed knowledge about depression, stereotypical attitudes and social distance towards persons with depression. RESULTS: The results indicate that a majority of the respondents holds predominantly non-pejorative attitudes towards persons with depression. The majority estimated psychosocial causes as being most important for the genesis of depression. Stronger social distance was linked to an estimation of personal causes as relevant. Subgroup differences were apparent with respect to age, sex and reported contact to people with depression. CONCLUSION: Improvements in the education of the public about depression should be based on a multifactorial model. Future interventions should promote contact with people with depression and place special emphasis on conveying information in a suitable manner depending on the needs of different target groups.
    Acta Psychiatrica Scandinavica 02/2013; · 4.86 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: In einem vom BMG geförderten 2-jährigen Projekt wurde anhand von insgesamt 1042 Behandlungsfällen an 4 psychiatrischen Kliniken unterschiedlicher Struktur in Nordrhein-Westfalen die Voraussetzung für eine externe Qualitätssicherung mit Hilfe der Tracer-Diagnose Schizophrenie geschaffen und durchgeführt. Ziele waren die Evaluation eines Erhebungsinstrumentariums, die Entwicklung von Qualitätsindikatoren und der Aufbau eines Rückmeldesystems zur Optimierung des internen Qualitätsmanagements. Anhand der erhobenen Daten ist es auf wissenschaftlich-statistischer Basis gelungen, Qualitätsindikatoren und eine vergleichende Art der Rückmeldung zu entwickeln, die neben Ergebnisvariablen auch Struktur-, Patienten- und Prozessvariablen beinhaltet. Diese Qualitätsprofile bilden einen wesentlichen Ausgangspunkt für krankheitsspezifische Problemanalysen im Rahmen eines internen Qualitätsmanagements. Due to legal regulations, external quality assurance is mandatory in Germany. Supported by the German Health Ministry (BMG),we present the results of a multicenter study in four hospitals with different structures on 1042 inpatients with the trace diagnosis of schizophrenia (ICD 10). We defined disease-specific indicators of structure, process, and outcome quality, developed an assessment instrument, and implemented a feedback system for quality comparison. The resulting quality profiles are useful as a starting point for internal quality management.
    Der Nervenarzt 04/2012; 71(5):364-372. · 0.80 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this randomized, controlled, multisite trial was to evaluate the efficacy of combined treatment with integrative behaviour therapy (IBT) and acamprosate on drinking behaviour in detoxified alcohol-dependent patients. A total of 371 patients were randomized to one of the three treatment conditions: IBT plus acamprosate, IBT plus placebo, or supportive counselling ('treatment as usual', TAU) plus acamprosate. The main outcome was success rate, i.e., rate of abstinence plus improvement according to the criteria of Feuerlein and Küfner (1989), at the end of the six-month treatment phase and at the subsequent six-month follow-up. Drinking status was validated by blood parameters (CDT, GGT, and MCV). Data were analyzed by an intent-to-treat model and missing data were classified as relapse. The success rates at the end of treatment under both TAU plus acamprosate (37.7%) and IBT plus placebo (48%) almost reached the levels derived from the literature. However, adding acamprosate to IBT did not result in the expected increase in success rate (IBT plus acamprosate: 47.6%), and success rates did not differ significantly between groups. Similarly, there was no significant difference between treatment success rates at follow-up. The results suggest that the combination of acamprosate and IBT is not more effective than treatment with either IBT or acamprosate alone. However, the two acamprosate conditions differed in success rate by about 10%, which might constitute a clinically relevant though statistically non-significant effect.
    Drug and alcohol dependence 05/2011; 118(2-3):417-22. · 3.60 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: We performed an Internet-based questionnaire survey of the opinions of German-speaking psychiatrists regarding the experiences with the 10th revision of the international classification of mental disorders (chapter F of ICD-10). We received 304 completed questionnaires including more than 500 free-text comments. The responding group was characterized by professionally experienced middle-aged psychiatrists. German-speaking psychiatrists were comparatively content with ICD-10. Most diagnostic categories received a "satisfied" or "very satisfied" rating by the majority of respondents. Negative "goodness of fit" ratings--a possible indicator of the need for revision--were not higher than 50% for any category. Based on free-text entries, neurasthenia was the single diagnostic category most often suggested for deletion in ICD-11. Changes were considered necessary mainly for dementias and personality disorders. Adult attention deficit disorder and narcissistic personality disorder were the two diagnostic categories most frequently suggested to be added as new categories. This study provides valuable information related to perceived clinical utility of the classification, though with a narrow sample. Information about clinicians' experiences should be combined with scientific evidence for the revision process of ICD-11.
    European Psychiatry 12/2010; 25(8):437-42. · 3.29 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The spatial and temporal relations between regional cerebral blood flow (rCBF) and brain volume (rVOL) changes in incipient and early Alzheimer's dementia (AD) are not fully understood. The participants comprised 30 subjects with mild cognitive impairment (MCI) and 15 with mild AD who were examined using structural and perfusion-weighted magnetic resonance imaging (MRI) at 1.5 Tesla. Hippocampus and amygdala volumes were measured by manual volumetry. A region-of-interest co-localisation method was used to calculate rCBF values. DNA samples were genotyped for apolipoprotein E (APO E). In comparisons of AD with MCI, rCBF was reduced in the posterior cingulum only, while profound rVOL reductions occurred in both right and left amygdala and in the right hippocampus, and as a trend, in the left hippocampus. Brain volumes of the hippocampus and the amygdala were uncorrelated with the respective rCBF variables in both MCI and AD. Hippocampal but not amygdalar volumes were associated with presence of one or two APOE epsilon4 alleles in MCI and mild AD, while there was no association of APOE epsilon4 allele with rCBF. These data support earlier indications that rCBF and rVOL changes are at least partly dissociated in the early pathogenesis of AD and heterogeneously associated with the APOE risk allele. The data also support the concept of functional compensatory brain activation and the diaschisis hypothesis as relevant in incipient and early AD.
    Psychiatry Research 07/2010; 183(1):44-51. · 2.68 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Earlier evidence indicates that regional cerebral volume (rVOL) and blood flow (rCBF) variables carry independent information on incipient and early Alzheimer's disease (AD) and combining these modalities may increase discriminant performance. We compared single variables and combinations regarding their power for optimizing diagnostic accuracy. Twelve cognitively normal elderly controls (CN), 30 subjects with mild cognitive impairment (MCI) and 15 with mild AD were examined by structural and perfusion-weighted magnetic resonance imaging (MRI) in single sessions at 1.5 Tesla. rVOLs were measured by manual volumetry, and rCBFs were calculated with a ROI-based co-localization technique. Applying single MRI variables for the differentiation of AD versus CN, the area under curve (AUC) of receiver operating characteristic curves (ROCCs) was highest for rVOL variables (maximum of 0.972 for right amygdala). A composite marker selected and weighted by logistic regression containing left amygdalar rCBF, left hippocampal and right amygdalar rVOLs gave a diagnostic accuracy for AD versus CN of 100%. Internal cross-validation revealed a reliability of 88.9%. Whilst external revalidation is mandatory employing a naturalistic sample containing disease controls, our phase I/II findings demonstrate that deducing composite markers from multimodal MRI acquisitions can optimize diagnostic accuracy for AD.
    European Journal of Neurology 04/2010; 17(12):1437-44. · 4.16 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Previous studies revealed some comorbidity of Alzheimer's disease and osteoporosis not only for advanced disease, but also for the incipient conditions cognitive decline and decline of bone mineral density. To detect comorbidity with osteoporosis at a subclinical level, we studied concentrations of biochemical osteoporosis markers in blood plasma of subjects with mild cognitive impairment and mild Alzheimer's disease compared to subjects with primary osteoporosis and age-matched cognitively normal controls in an explorative approach. Regarding disease-spanning molecular pathology we also studied osteoprotegerin, a decoy receptor of RANKL and TRAIL. Equally increased C-terminal collagen fragments, marking bone catabolism, were seen in osteoporosis and Alzheimer's disease (+68%) versus controls. Osteocalcin, marking bone remodelling and anabolism, was concomitantly increased in osteoporosis (+63%), as a trend, and significantly in Alzheimer's disease (+76%). Osteoprotegerin was unchanged between patient groups and controls. 25 (OH) vitamin D plasma levels were low normal and of equal amount in all groups except for the osteoporosis group. These results point to increased bone catabolism and concomitant remodelling/anabolism unrelated to vitamin D state in mild Alzheimer's disease, but not in mild cognitive impairment. This corroborates previous findings of comorbidity of Alzheimer's disease with osteoporosis in the early disease course at the level of biochemical blood markers. Regarding osteoprotegerin, previously reported plasma level increases in Alzheimer's disease were not observed in this study, which does not rule out subtle changes to be detected in larger samples or the possibility that other components of osteoprotegerin pathways are affected in Alzheimer's disease.
    Journal of Neural Transmission 08/2009; 116(7):905-11. · 3.05 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The utility of perfusion-weighted magnetic resonance imaging (PW-MRI) for detecting changes in regional cerebral blood flow (rCBF) in patients with mild cognitive impairment (MCI) and early Alzheimer's disease (AD) was evaluated. Thirteen cognitively normal (CN) elderly subjects, 35 mostly amnestic MCI subjects and 20 subjects with mild probable AD were enrolled. During i.v. injection of gadopentetate dimeglumine, a dynamic T2*-weighted single-shot EPI sequence was conducted using a 1.5-T scanner. Frontobasal (FROB), temporoparietal (TPAR), mesiotemporal (MTMP), anterior and posterior cingular (ACING, PCING), amygdala (AMYG), thalamus and cerebellar brain regions were studied. rCBF was computed from regional cerebral blood volume and arterial input function and normalised to white matter. Images were analysed by manually placed regions of interest using anatomical coregistration. Significant decreases of rCBF were detected in MCI vs. CN in MTMP (-23%), AMYG (-20%) and ACING (-15%) with no further decline in mild AD. In PCING hypoperfusion (-10%) was confined to AD. These hypoperfusional changes are a possible correlate of localised impairment of CNS function. In FROB no perfusion changes were observed between diagnostic groups, but hyperperfusion was observed in mild dementia stages, possibly reflecting functional compensatory mechanisms. These data suggest that PW-MRI detects specific changes in rCBF not only in AD, but also in amnestic MCI, a disorder suggested to largely represent a pre-dementia stage of AD. This method may thus be useful in both research and clinical applications to detect early functional brain changes in the pathogenesis of dementias.
    NeuroImage 05/2008; 40(2):495-503. · 6.25 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To evaluate a novel specific psychological intervention aimed at improving coping in patients with systemic lupus erythematosus (SLE). 34 community living SLE patients were recruited for the study. Intervention was undertaken in groups of up to eight patients and in two blocks over six months each. Eight patients were enrolled as a waiting list group. The 18 group sessions focused on information about the disease and specific problems of SLE patients, combining psychoeducative and psychotherapeutic elements. Psychological and medical evaluations were conducted at baseline and after three, six, and 12 months, using validated instruments. The 34 SLE patients (91% female, mean age 42 years) improved significantly over a six month period on most of the psychological measuring instruments applied, such as depression, anxiety, and overall mental burden. The waiting list group showed no significant changes. Conceptualised psychoeducational support may produce a significant and sustained improvement in coping skills of SLE patients and hence in their quality of life.
    Annals of the Rheumatic Diseases 12/2005; 64(11):1618-23. · 9.11 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Results of studies on intermittent neuroleptic treatment strategies in first episode (FE) schizophrenia have not been published. Aims of the present study were to elucidate the comparative efficacy of prodrome-based neuroleptic intervention in first vs multiple episode (ME) schizophrenia. As to the methods, three randomly assigned open neuroleptic treatment strategies were compared over 2 years in 363 schizophrenic outpatients (115 FE, 248 ME; ICD-9, RDC): maintenance medication vs two intermittent medication strategies (prodrome-based intervention and crisis intervention). Concerning relapse prevention, the results demonstrate that ME patients seemed to profit most from maintenance medication compared to both intermittent treatments, whereas FE patients did equally well under maintenance medication and prodrome-based intervention treatment. Psychopathology, social adjustment, subjective well-being, and side-effects after two years did not differ significantly between the FE and ME patients irrespective of treatment strategy. Concerning treatment adherence, FE patients complied better with prodrome-based intervention than with maintenance medication. Cumulative neuroleptic dosage was lowest in FE patients under intermittent treatment. In conclusion, maintenance medication is the best strategy for relapse prevention in ME patients. In FE patients, prodrome-based intermittent intervention seems to be equivalent or even better with respect to compliance and dosage applied.
    Schizophrenia Research 02/2002; 53(1-2):145-59. · 4.59 Impact Factor
  • M Haupt, A Karger, M Jänner
    [Show abstract] [Hide abstract]
    ABSTRACT: It has been convincingly demonstrated that in dementia, psychoeducative group intervention with caregivers positively impacts on motivation for care and satisfaction of the caregivers. It has, however, been neglected to examine the effect of psychoeducative group intervention on the behavioural and psychological symptoms of the demented patients. In a 3-month, expert-based and conceptualized group intervention with caregiving relatives of demented patients we investigated whether behavioural and psychological symptoms may improve and which of a set of independent variables may predict improvement. The 3-month group intervention yielded a significant improvement in agitation and anxiety of the demented patients. The presence of an additional somatic disease in the patients and male gender predicted a less positive outcome of the intervention related to the presence of agitation. This study demonstrated that psychoeducative group intervention with the caregivers of demented patients is helpful for the demented patients themselves. This evidence of a positive mediator effect of the group intervention on the behavioural and psychological symptoms of the patients underscores the importance of nonpharmacological strategies in the treatment of dementia.
    International Journal of Geriatric Psychiatry 01/2001; 15(12):1125-9. · 2.98 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Alzheimer's disease, the most frequent cause of dementia, progressively takes the ability of acting autonomously from the sufferers, makes them more and more dependent from their partners and eventually dissolves their personal identity. The present 2-year study which conducted a novel form of family-centered group therapy with demented patients and their primary caregivers investigated the effects of an open, uncontrolled group therapy approach in 32 families (demented patients and caregivers) over a five-months period with weekly sessions, by using the BEHAVE-AD and the NOSGER for the moderately demented patients and the Befindlichkeits-Skala (BfS) for the primary caregivers. In addition, a structured instrument to determine the patterns of interaction between patient and caregiver was administered prospectively at each of the weekly sessions. The results demonstrate a significant improvement of communication abilities among the patients and a significant reduction of coping problems and of care burden with respect to the caregivers. The present family-centered group therapy shows that over a period of 5 months functional and communication abilities of the moderately demented patients may be maintained and caregiver burden may be significantly reduced.
    Fortschritte der Neurologie · Psychiatrie 12/2000; 68(11):503-15. · 0.85 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: It has been convincingly demonstrated that in dementia psycho-educative training of caregivers positively impacts on motivation for care and satisfaction of the caregivers. It has, however, been neglected to examine the effect of psycho-educative training on the behavioural and psychological symptoms of dementia sufferers. In a three-month, expert-based and conceptualized group intervention with caregiving relatives of demented patients we investigated, whether functional impairment and behavioural and psychological symptoms may improve, which of a set of independent variables may predict improvement, and how the group intervention will be appreciated by the caregivers. The group intervention yielded a significant improvement of memory-related functions in daily living and a significant decrease of agitation and anxiety of the demented patients. The presence of an additional somatic disease predicted worse outcome of the intervention with respect to the impairment of memory-related functions in daily living and of agitation. Anonymous inquiry of the caregivers with respect to their judgement of the intervention revealed high acceptance and appreciation. This study demonstrated that a psycho-educative group intervention with caregiving relatives of dementia sufferers is helpful for both the caregivers and the demented patient. This evidence of a positive mediate effect of the group intervention on the functional and behavioural impairment of the demented patients underscores the importance of nonpharmacological strategies in the treatment plan of dementia.
    Fortschritte der Neurologie · Psychiatrie 06/2000; 68(5):216-23. · 0.85 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Due to legal regulations, external quality assurance is mandatory in Germany. Supported by the German Health Ministry (BMG), we present the results of a multicenter study in four hospitals with different structures on 1042 inpatients with the tracer diagnosis of schizophrenia (ICD 10). We defined disease-specific indicators of structure, process, and outcome quality, developed an assessment instrument, and implemented a feedback system for quality comparison. The resulting quality profiles are useful as a starting point for internal quality management.
    Der Nervenarzt 06/2000; 71(5):364-72. · 0.80 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Neuropsychometric tests (for instance the Alzheimer's Disease Assessment Scale, ADAS) and the EEG are often used in the diagnostic procedure of dementia. The validity of the instruments is only poorly investigated. The study aimed to investigate the accuracy of the discrimination between healthy controls and patients with dementia of the Alzheimer type (DAT) by ADAS and EEG. Thirty-six patients with DAT and 44 healthy controls were included. In a discriminant analysis of the 21 ADAS items and 18 EEG parameters (6 frequency bands, 12 topographic parameters), 6 ADAS items turned out to discriminate both groups with 100% sensitivity and specificity (remembering instructions, depression, following commands, pacing, restlessness and word finding difficulties). Regarding EEG parameters, 4 (topography of beta- and delta-activity and amplitude of delta-activity) led to a sensitivity and specificity of over 90%. Thus, both methods demonstrated an excellent discrimination between healthy controls and DAT. The slightly higher discrimination with the ADAS may depend on its closer relation to clinical symptoms. However, the EEG measuring functional activity reached nearly the same result. Both methods provide complementary information. A combination of both methods in the diagnostic procedure to detect dementia is recommended.
    Neuropsychobiology 02/2000; 41(2):102-7. · 2.37 Impact Factor
  • M Haupt, A Kurz, M Jänner
    [Show abstract] [Hide abstract]
    ABSTRACT: The aim was to examine the longitudinal occurrence and persistence of behavioural and psychological symptoms of dementia (BPSD) in Alzheimer's disease (AD). Following 60 patients with mild to severe AD over a period of 2 years with annual evaluations, the prospective occurrence and persistence of BPSD in AD were determined by using the Behavioural Abnormalities in AD Rating scale (BEHAVE-AD). Clinical and demographic features of the AD patients were analysed for their association with course features of these symptoms. All of the 60 AD patients experienced BPSD at some point during the 2-year period, particularly agitation was present in every patient within this period. 2-year persistence of BPSD in AD was frequently observed in patients with agitation and with depressiveness, with less frequency in patients with anxiety and aggressiveness, but not in patients with delusions or hallucinations. 2-year persistent aggressiveness was associated with older age and more functional impairment. More functional impairment was also related to 2-year non-persistent hallucinations. Counselling AD patients and their families and tailoring therapeutic strategies should take into account the different modi of BPSD in AD occurring and persisting longitudinally and interacting with functional disturbances.
    Dementia and Geriatric Cognitive Disorders 01/2000; 11(3):147-52. · 2.79 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The vulnerability-stress-coping (VSC) model is the most influential heuristic concept in understanding the course of schizophrenia, whose prodromal status still offers unsolved conceptual and methodological issues. Improved knowledge about the prodromal phase would provide a better understanding of the developing psychopathology and psychophysiology of schizophrenia and could also be of predictive value to attune therapeutic actions to the course of the illness more precisely. To shed more light on the characteristics of prodromal states, data from a German multicenter study on intermittent versus maintenance neuroleptic long-term treatment in schizophrenia (ANI study) were reanalyzed with respect to the prevalence and profile, nature, time course, and predictive value of prodromal symptoms in impending relapse. The results demonstrate that prodromes are a category of symptoms on their own, but they share variance with other symptom domains. Treatment side effects, psychotic symptoms, dysphoric mood, and social dysfunction are all associated with prodromal states--the direction of this association, however, is still to be clarified. Prodromal symptoms are also related to the neuroleptic treatment strategy and its relapse-preventive efficacy--findings that underscore neuroleptic maintenance medication in preventing both overt and subthreshold psychotic morbidity in schizophrenia.
    Comprehensive Psychiatry 01/2000; 41(2 Suppl 1):76-85. · 2.38 Impact Factor
  • W. Gaebel, M. Jänner, N. Frommann
    European Psychiatry - EUR PSYCHIAT. 01/2000; 15.
  • Fortschritte Der Neurologie Psychiatrie - FORTSCHR NEUROL PSYCHIAT. 01/2000; 68(11):503-515.
  • Fortschritte Der Neurologie Psychiatrie - FORTSCHR NEUROL PSYCHIAT. 01/2000; 68(5):216-223.