Borwin Bandelow

University of Göttingen | GAUG · Psychiatry and Psychotherapy

Background It is a widespread opinion that after treatment with psychotherapy, patients with anxiety disorders maintain their gains beyond the active treatment period, whereas patients treated with medication soon experience a relapse after treatment termination. Aims We aimed to provide evidence on whether enduring effects of psychotherapy differ...

To our knowledge, no previous meta-analysis has attempted to compare the efficacy of pharmacological, psychological and combined treatments for the three main anxiety disorders (panic disorder, generalized anxiety disorder and social phobia). Pre-post and treated versus control effect sizes (ES) were calculated for all evaluable randomized-controll...

Objectives: Biomarkers are defined as anatomical, biochemical or physiological traits that are specific to certain disorders or syndromes. The objective of this paper is to summarise the current knowledge of biomarkers for anxiety disorders, obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD). Methods: Findings in bioma...

Objective: Biomarkers are defined as anatomical, biochemical or physiological traits that are specific to certain disorders or syndromes. The objective of this paper is to summarise the current knowledge of biomarkers for anxiety disorders, obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD). Methods: Findings in biomarker...

Around half the inmates in prison institutions have antisocial personality disorder (ASPD). A recent theory has proposed that a dysfunction of the endogenous opioid system (EOS) underlies the neurobiology of borderline personality disorder (BPD). In the present theoretical paper, based on a comprehensive database and hand search of the relevant lit...

Background: Anxiety is a common and disabling condition that significantly impacts quality of life. Subsyndromal anxiety (SSA) refers to anxiety symptoms that do not meet the full diagnostic criteria for an anxiety disorder but pose a risk for developing such disorders. We aimed to provide practical recommendations for the treatment of SSA in prim...

Anxiety disorders are very prevalent and often persistent mental disorders, with a considerable rate of treatment resistance which requires regulatory clinical trials of innovative therapeutic interventions. However, an explicit definition of treatment‐resistant anxiety disorders (TR‐AD) informing such trials is currently lacking. We used a Delphi...

Aim: This study aimed to investigate whether separation anxiety (SA) constitutes a dimension related to age at onset of panic disorder (PD), in homogeneous subgroups of outpatients with PD, based on their age of onset and symptom severity. Methods: A sample of 232 outpatients with PD was assessed with the Panic Disorder Severity Scale (PDSS) and...

Seit 2019 hat eine Leitliniengruppe mit 35 Expert*innen die 2014 erschienenen deutschen Leitlinien zur Behandlung von Angststörungen überarbeitet 1, 2, 3. Vertreten waren insgesamt 29 deutsche Fachgesellschaften und Berufsverbände sowie Patientenselbsthilfeorganisationen. Dieser Beitrag fasst die wichtigsten Empfehlungen sowie die Neuerungen der üb...

Die umfassende Neubearbeitung des Handbuches liefert kompakte und klare Informationen zu allen in Deutschland, Österreich und der Schweiz erhältlichen Psychopharmaka. Die Einteilung der Psychopharmaka erfolgt nach dem jeweiligen Anwendungsbereich. So werden u.a. Antidepressiva, Antipsychotika, Anxiolytika, Hypnotika, Phasenprophylaktika, Substanzen...

Aim: This is the third version of the guideline of the World Federation of Societies of Biological Psychiatry (WFSBP) Task Force for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Posttraumatic Stress Disorders (published in 2002, revised in 2008). Method: A consensus panel of 33 international experts representing 22 countrie...

Aim: This is the third version of the guideline of the World Federation of Societies of Biological Psychiatry (WFSBP) Task Force for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Posttraumatic Stress Disorders which was published in 2002 and revised in 2008.Method: A consensus panel of 34 international experts representing 22 c...

Background During the COVID-19 pandemic, internet-delivered psychotherapeutic interventions (IPI) move increasingly into the focus of attention. Method We reviewed 39 randomized controlled studies of IPIs with 97 study arms (n = 4122 patients) for anxiety disorders (panic disorder/agoraphobia, generalized anxiety disorder, and social anxiety disor...

Starting in 2019, the 2014 German Guidelines for Anxiety Disorders (Bandelow et al. Eur Arch Psychiatry Clin Neurosci 265:363–373, 2015) have been revised by a consensus group consisting of 35 experts representing the 29 leading German specialist societies and patient self-help organizations. While the first version of the guideline was based on 40...

Anxiety disorders (generalized anxiety disorder, panic disorder/agoraphobia, social anxiety disorder, and others) are the most prevalent psychiatric disorders, and are associated with a high burden of illness. Anxiety disorders are often underrecognized and undertreated in primary care. Treatment is indicated when a patient shows marked distress or...

The development of a high-end cannabinoid-based therapy is the result of intense translational research, aiming to convert recent discoveries in the laboratory into better treatments for patients. Novel compounds and new regimes for drug treatment are emerging. Given that previously unreported signaling mechanisms for cannabinoids have been uncover...

Objective The endogenous opioid system is assumed to be involved in the pathophysiology of borderline personality disorder (BPD), and opioid antagonists may improve core features of BPD. The aim of this retrospective chart analysis was to evaluate the relative contribution of the opioid antagonist naltrexone and other psychotropic drugs in the impr...

Background: Separation anxiety disorder may be important when considering risk of suicide. The aim of this study was to examine the association between both childhood and adult separation anxiety (disorder) and measures of suicide risk in a large cohort of outpatients with anxiety and mood disorders. Methods: The sample included 509 consecutive...

Besides cognitive behavioral therapy (CBT), psychopharmacotherapy belongs to the first-line treatment approaches for anxiety disorders according to all national and international guidelines. According to studies and meta-analyses, modern antidepressants in particular have been proven to be effective. Depending on the substance, there are approvals...

The mean age and gender distribution of patients seeking help for mental disorders have not yet been investigated systematically. Epidemiological surveys can provide data on gender distribution of disorders and an age range in which a disorder is most frequent, but do not offer data on the average help-seeking patient, and they are usually conducte...

In the DSM-5, separation anxiety disorder (SAD) is newly classified in the chapter on anxiety, renewing research efforts into its etiology. In this narrative review, we summarize the current literature on the genetic, endocrine, physiological, neural and neuropsychological underpinnings of SAD per se, SAD in the context of panic disorder, separatio...

Anxiety disorders, including panic disorder/agoraphobia (PDA), generalized anxiety disorder (GAD), social anxiety disorder (SAD), and others, are the most prevalent mental disorders. In this paper, recommendations are given for the psychopharmacological treatment of these disorders which are based on comprehensive treatment guidelines, meta-analyse...

Background: The purpose of this study was to assess the pharmacological treatment strategies of inpatients with borderline personality disorder between 2008 and 2012. Additionally, we compared pharmacotherapy during this period to a previous one (1996 to 2004). Methods: Charts of 87 patients with the main diagnosis of borderline personality diso...

Die deutsche S3 Leitlinie „Zahnbehandlungsangst beim Erwachsenen“ befasst sich mit der Epidemiologie, der Diagnostik und der Therapie der Zahnbehandlungsangst mit Krankheitswert bei Erwachsenen und wurde unter Beratung und Moderation durch die Arbeitsgemeinschaft der wissenschaftlichen Medizinischen Fachgesellschaften (AWMF) von einem Gremium erste...

Although depression and anxiety disorders are common comorbid conditions in alcohol dependence, few structural brain imaging studies have compared alcohol-dependent subjects with and without such comorbidity. In the current study, brain scans of 35 alcohol-dependent with and 40 individuals without diagnosis of a comorbid ICD-10 depressive or anxiet...

Effects of baseline anxiety on the efficacy of venlafaxine extended release versus placebo were examined in a post hoc pooled subgroup analysis of 1573 patients enrolled in eight short-term studies of major depressive disorder. Anxiety subgroups were defined based on baseline 17-item Hamilton Rating Scale for Depression Item 10 score <3 (low) versu...

Augmentation therapies for treatment-resistant depression: systematic review and meta-analysis – CORRIGENDUM - Rebecca Strawbridge, Ben Carter, Lindsey Marwood, Borwin Bandelow, Dimosthenis Tsapekos, Viktoriya L. Nikolova, Rachael Taylor, Tim Mantingh, Valeria de Angel, Fiona Patrick, Anthony J. Cleare, Allan H. Young

Objective and methods: This paper reviews sources of data typically used in guideline development, available grading systems, their pros and cons, and the methods for evaluating risks of bias in publications, and proposes a revised method for grading evidence and recommendations for use in development of clinical treatment guidelines. Results: The...

Background Depression is considered to have the highest disability burden of all conditions. Although treatment-resistant depression (TRD) is a key contributor to that burden, there is little understanding of the best treatment approaches for it and specifically the effectiveness of available augmentation approaches. Aims We conducted a systematic...

Anxiety disorders are the most prevalent mental disorders and are associated with substantial healthcare costs and a high burden of disease. In this article, changes in the new Diagnostic and Statistical Manual for Mental Disorders (the DSM–5) with respect to panic disorder/agoraphobia, generalized anxiety disorder, social anxiety disorder, specifi...

According to ICD-10 criteria, mixed anxiety and depressive disorder (MADD) is characterized by co-occurring, subsyndromal symptoms of anxiety and depression, severe enough to justify a psychiatric diagnosis, but neither of which are clearly predominant. MADD appears to be very common, particularly in primary care, although prevalence estimates vary...

There is evidence that besides limbic brain structures, prefrontal and insular cortical activations and deactivations are involved in the pathophysiology of panic disorder. This study investigated activation response patterns to stimulation with individually selected panic-specific pictures in patients with panic disorder with agoraphobia (PDA) and...

Patients with neurological or psychiatric disorders often require for their treatment expertise from both disciplines. Numerous examples are known in which it was necessary to initiate multidisciplinary therapy facilitating further treatment. These include, for example, neurodegenerative diseases, CNS disorder with comorbid psychiatric symptoms (e....

{\bf Objective:}$ Biomarkers are defined as anatomical, biochemical or physiological traits that are specific to certain disorders or syndromes. The objective of this paper is to summarise the current knowledge of biomarkers for anxiety disorders, obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD). ${\bf Methods:}$ Finding...

Background/objectives The reimbursement of inpatient psychiatric psychotherapeutic/psychosomatic hospital treatment in Germany is regulated by the German personnel ordinance for psychiatric hospitals (Psych-PV), which has remained unchanged since 1991. The aim of this article was to estimate the personnel requirements for guideline-adherent psychia...

Es existieren zahlreiche kontrollierte Studien zur Behandlung der Angsterkrankungen (Panikstörung/Agoraphobie, generalisierte Angststörung, soziale Phobie und spezifische Phobie) bei Erwachsenen. Durch eine frühzeitige leitliniengerechte Behandlung kann die Lebensqualität von Patienten mit Angststörungen deutlich gebessert werden. Erfahrungen zeige...

Das Kapitel beschreibt die Ziele der Leitlinie, die Zusammensetzung des Leitliniengremiums, die Prinzipien der Erstellung und Konzepte zur Implementierung.

Das Kapitel beschreibt die Theorie und Praxis der Psycho- und Pharmakotherapie bei Angststörungen sowie die Versorgungsstrukturen.

Das Kapitel enthält die Kurzfassung der Empfehlungen der Leitlinie sowie eine übersichtliche Zusammenfassung in Tabellenform.

In diesem Kapitel werden alle auswertbaren randomisierten kontrollierten Studien zur Behandlung von Angststörungen mit Psycho- und Pharmakotherapie einem systematischen Review unterzogen. Die Empfehlungen vorbestehender Leitlinien werden ausgewertet. Das Kapitel begründet ausführlich die Empfehlungen der Leitliniengruppe.

In this article, the co-occurrence of anxiety disorders (in particular generalized anxiety disorder) and pain conditions is described, characteristics of chronic pain are explained, and data on the prevalence of co-comorbidity of both conditions are reviewed. Further, hypotheses on the possible psychosocial and neurobiological backgrounds of the hi...

Anxiety disorders, including panic disorder with or without agoraphobia, generalized anxiety disorder, social anxiety disorder, specific phobias, and separation anxiety disorder, are the most prevalent mental disorders and are associated with immense health care costs and a high burden of disease. According to large population-based surveys, up to...

Accumulating evidence from mouse models points to the G protein-coupled receptor RGS2 (regulator of G-protein signaling 2) as a promising candidate gene for anxiety in humans. Recently, RGS2 polymorphisms were found to be associated with various anxiety disorders, e.g., rs4606 with panic disorder (PD), but other findings have been negative or incon...

Introduction Although 85% of inpatients with Borderline Personality Disorder (BPD) receive psychotropic drug treatment, no drug is approved for this indication so far. A dysregulation of the endogenous opioid system (EOS) has been posed to underly the neurobiology of BPD. Accordingly, the opioid antagonist naltrexone might be helpful to treat sympt...

Like other anxiety disorders, panic disorder (PD) with/without agoraphobia is more frequent in women than in men. Identification of the psychosocial contributors to and biological substrates of gender-specific susceptibility for PD may allow a better understanding of the etiology of anxiety disorders in general and would have important implications...

Das Kapitel beschreibt die Diagnostik, Differenzialdiagnose und Schweregradbestimmung.

Das Kapitel gibt einen Überblick über Definitionen, Prävalenzen, Komorbiditäten, Kosten für das Gesundheitssystem, Ätiopathogenese, Risikofaktoren sowie über den Verlauf von Angststörungen.

Die deutsche S3-Leitline zur Behandlung von Angststörungen (Panikstörung/Agoraphobie, generalisierte Angststörung, soziale Phobie, spezifische Phobie) bei Erwachsenen wurde unter Beratung und Moderation durch die Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF) von einem Gremium erstellt, das 20 Fachverbände und an...

A consensus group consisting of 36 experts representing 20 leading German specialist societies and patient self-help organizations developed evidence-based recommendations for the treatment of anxiety disorders in Germany. These were based on a systematic review of randomized controlled trials on anxiety disorders (n = 403) and on preexisting Germa...

Part 1 of this paper discussed several more general aspects of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and offered a detailed, paradigmatic analysis of changes made to the chapter on depressive disorders. This second part focusses on several other disorders, including bipolar and schizophrenia spectrum disorders. The respectiv...

DSM-5 was published in 2013 after about 10 years of preparation. Part 1 of this paper discusses several more general aspects of DSM-5 and offers a detailed, paradigmatic analysis of changes made to the chapter on depressive disorders. The background for the changes is analysed on the basis of a PubMed search and review papers on the classification...

Background: Anxiety disorders (panic disorder/agoraphobia, generalized anxiety disorder, social phobia, and specific phobias) are the most common mental illnesses. For example, the 12-month prevalence of panic disorder/agoraphobia is 6%. Method: This guideline is based on controlled trials of psychotherapy and pharmacotherapy, retrieved by a sys...

With a lifetime prevalence of 13 % social phobia (social anxiety disorder) is a common and serious condition that should not be played down because of the burden associated with the disorder, an increased suicide rate and the frequent comorbidity with substance abuse disorders. Social phobia is characterized by the excessive and unrealistic fear of...

This revision of the 2005 British Association for Psychopharmacology guidelines for the evidence-based pharmacological treatment of anxiety disorders provides an update on key steps in diagnosis and clinical management, including recognition, acute treatment, longer-term treatment, combination treatment, and further approaches for patients who have...

Abstract Objectives. To evaluate quetiapine XR in patients with anxious depression, as defined by HAM-A total and HAM-D anxiety/somatisation factor scores. Methods. Post hoc analyses of pooled data from two 6-week, double-blind, randomised, placebo-controlled studies of adjunctive quetiapine XR (150 or 300 mg/day) in patients with MDD and inadequat...

Panic disorder is characterized by sudden, unexpected attacks of intense fear and anticipatory anxiety. Panic attacks include symptoms such as palpitations, dyspnoea, dizziness, trembling, gastrointestinal discomfort and fear of dying. Therefore, patients with panic disorder often assume physical illnesses may underly their symptoms. They frequentl...

Die deutsche S3-Leitline zur Behandlung von Angststörungen (Panikstörung/Agoraphobie, generalisier- te Angststörung, soziale Phobie, spezifische Phobie) bei Erwachsenen wurde unter Beratung und Mode- ration durch die Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF) von einem Gremium erstellt, das 20 Fachverbände un...

Ängste gehören zu den normalen Bestandteilen menschlichen Lebens. Jeder Mensch kennt dieses Gefühl, es erfüllt bestimmte Schutzfunktionen, es kann sogar lebensrettend sein. Bei manchen Menschen entsteht aber etwas, was man als Angststörung bezeichnet. Angststörungen sind in erster Linie dadurch gekennzeichnet, dass Menschen in bestimmten Lebenssitu...

Die deutsche S3-Leitline zur Behandlung von Angststörungen (Panikstörung/Agoraphobie, generalisier- te Angststörung, soziale Phobie, spezifische Phobie) bei Erwachsenen wurde unter Beratung und Mode- ration durch die Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF) von einem Gremium erstellt, das 20 Fachverbände un...

A comprehensive database has developed and precise recommendations can be provided for treating patients with panic disorder. Selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors are standard treatments for panic disorder. Tricyclic antidepressants are as effective as modern antidepressants, but less well tolerat...

Schwere psychische Krankheit mit oft chronischem Verlauf und gelegentlich tödlichem Ausgang. Die Patientinnen haben die tief verwurzelte Überzeugung, zu dick zu sein und führen das Untergewicht absichtlich herbei – trotz schädlicher körperlicher Folgen. Sie sind extrem dünn (30–40 kg).

Die Symptomatik wird auch dadurch bestimmt, ob die Schädigung diffus (z. B. Meningitis) oder lokal (Tumor) ist. Außerdem wird zwischen akutem und chronischem Verlauf unterschieden: Akutes organisches Psychosyndrom : Die Störung tritt innerhalb von Stunden bis Wochen ein. Meist reversibel, wenn die Grunderkrankung behandelt werden kann. Hierzu gehör...

Zum psychiatrischen Aufnahmebefund

Psychisch kranke Patienten können unter bestimmten Voraussetzungen gegen ihren Willen in einer geschlossenen psychiatrischen Station aufgenommen werden. Diese Unterbringung wird durch das PsychKG (Gesetz über Hilfen und Schutzmaßnahmen bei psychischen Krankheiten) geregelt. Die gesetzlichen Bestimmungen sind in den deutschen Bundesländern unterschi...

Psychiatrische Krankheitsbilder unterliegen einem starken Placeboeffekt . So zeigt sich regelmäßig, dass sich Patienten mit Depression oder Angststörungen unter Placebobehandlung bis zu 50–60 % bessern. Es wird vermutet, dass die Placebowirkung durch eine Ausschüttung von Endorphinen vermittelt wird.

Nach internistischen und chirurgischen Notfällen sind psychiatrische Notfälle der dritthäufigste Grund für Notarzteinsätze (15–20% aller Einsätze). Die häufigsten Fälle

Psychose mit „positiven“ (Verfolgungswahn, Stimmenhören) und „negativen“ Symptomen (sozialer Rückzug, affektive Verflachung und mangelnde Selbstversorgung).

Was ist der Unterschied zwischen einer Persönlichkeitsstörung und einer Krankheit? Während Krankheiten kommen und gehen, geht man davon aus, dass eine Persönlichkeitsstörung mehr oder weniger das ganze Leben lang besteht. Allerdings ist diese Einteilung künstlich. So wird diskutiert, ob es sich bei der „emotional instabilen Persönlichkeitsstörung (...

Intelligenzminderung: Unvollständige geistige Entwicklung mit IQ < 70 (definitionsgemäß entspricht ein IQ von 100 dem Durchschnittswert der Normalbevölkerung). Andere Begriffe: „Geistige Behinderung“, „Oligophrenie“.

Störungen der Entwicklung – meist in Hinblick auf

Part of the Oxford Psychiatry Library series, this resource serves as a concise and practical manual for the clinical management of patients with panic disorder, which is characterized by sudden, unexpected attacks of intense fear and anticipatory anxiety. Panic attacks include symptoms such as palpitations, dyspnoea, dizziness, trembling, gastroin...

• First-line treatment should be with selective serotonin reuptake inhibitors (SSRIs) or serotonin norepinephrine reuptake inhibitors (SNRIs) • The treatment effect of antidepressants emerges slowly, over 2-4 weeks • Treatment should be continued for one year or more • Second-line treatments include TCAs or MAOIs • Benzodiazepines may be u...