Carsten Konrad

Philipps University of Marburg | PUM

Biological research and clinical management in psychiatry face two major impediments: the high degree of overlap in psychopathology between diagnoses and the inherent heterogeneity with regard to severity. Here, we aim to stratify cases into homogeneous transdiagnostic subgroups using psychometric information with the ultimate aim of identifying in...

Humans are unconditionally confronted with social expectations and norms, up to a degree that they or some of them have a hard time recognizing what they actually want. This renders them susceptible for introjection, that is, to unwittingly mistake social expectations about doing relatively unpleasant activities for self-selected goals. Such introj...

Although abnormal resting state connectivity within several brain networks has been repeatedly reported in depression, little is known about connectivity in patients with early onset chronic depression. We compared resting state connectivity in a homogenous sample of 32 unmedicated patients with early onset chronic depression and 40 healthy control...

Introduction According to the World Health Organization, medication adherence is defined as the extent to which a person's behavior corresponds with an agreed recommendation from a healthcare provider. Approximately 50% of patients do not take their medication as prescribed, and non-adherence can contribute to the progress of a disease. For patient...

As early detection of symptoms in the subclinical to clinical psychosis spectrum may improve health outcomes, knowing the probabilistic susceptibility of developing a disorder could guide mitigation measures and clinical intervention. In this context, polygenic risk scores (PRSs) quantifying the additive effects of multiple common genetic variants...

Background The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, with its impact on our way of life, is affecting our experiences and mental health. Notably, individuals with mental disorders have been reported to have a higher risk of contracting SARS-CoV-2. Personality traits could represent an important determinant of preven...

Emotion regulation ability (ERA) enables individuals to disengage from negative stimuli. In this study, we investigated the role of ERA in the depression-related negativity bias. Seventy-four individuals with major depressive disorder and eighty-three nonclinical individuals were screened for depressiveness using the Beck Depression Inventory. ERA...

Background The SARS-CoV-2 pandemic, with all its impacts on our way of life, is affecting our experiences and mental health. Notably, individuals with mental disorders have been reported to have a higher risk of contracting SARS-CoV-2. Personality traits could represent an important determinant of preventative health behavior and, therefore, the ri...

Executive functions are metacognitive capabilities that control and coordinate mental processes. In the transdiagnostic PsyCourse Study, comprising patients of the affective-to-psychotic spectrum and controls, we investigated the genetic basis of the time course of two core executive subfunctions: set-shifting (Trail Making Test, part B (TMT-B)) an...

Background In contrast to cisgender persons, transgender persons identify with a different gender than the one assigned at birth. Although research on the underlying neurobiology of transgender persons has been accumulating over the years, neuroimaging studies in this relatively rare population are often based on very small samples resulting in dis...

There is a need for interventions supporting patients with mental health conditions in coping with stigma and discrimination. A psycho-educational group therapy module to promote stigma coping and empowerment (STEM) was developed and tested for efficacy in patients with schizophrenia or depression. 30 clinical centers participated in a cluster-rand...

Objectives: Brain morphology and its relation to endocrine parameters was examined, in order to determine the link of these parameters to treatment outcome to psychopharmacological treatment in depressed patients. Methods: We examined the potentially predictive value of Magnetic Resonance Imaging (MRI) parameters related to mineralocorticoid recept...

Transgender individuals (TIs) show brain-structural alterations that differ from their biological sex as well as their perceived gender. To substantiate evidence that the brain structure of TIs differs from male and female, we use a combined multivariate and univariate approach. Gray matter segments resulting from voxel-based morphometry preprocess...

Background: Stressful life events influence the course of affective disorders, however, the mechanisms by which they bring about phenotypic change are not entirely known. Methods: We explored the role of DNA methylation in response to recent stressful life events in a cohort of bipolar patients from the longitudinal PsyCourse study (n = 96). Per...

Importance Identifying psychosis subgroups could improve clinical and research precision. Research has focused on symptom subgroups, but there is a need to consider a broader clinical spectrum, disentangle illness trajectories, and investigate genetic associations. Objective To detect psychosis subgroups using data-driven methods and examine their...

Objective: Cognitive-behavioral therapy (CBT) has been hypothesized to act by reducing the pathologically enhanced semantic, anxiety-related associations of patients with panic disorder. This study investigated the effects of CBT on the behavioral and neural correlates of the panic-related semantic network in patients with panic disorder. Methods...

Transgender individuals show brain structural alterations that differ from their biological sex as well as their perceived gender. To substantiate evidence that the brain structure of transgender individuals differs from male and female, we use a combined multivariate and univariate approach. Gray matter segments resulting from voxel-based morphome...

Hintergrund. Polypharmazie ist trotz relevanter Risiken weit verbreitet, insbesondere in der Therapie schwer behandelbarer Erkrankungen wie z.B. der therapieresistenten Depression (TRD). Die Elektrokonvulsionstherapie (EKT) wird aufgrund ihrer hohen Wirksamkeit gemäß zahlreichen Leitlinien bei TRD empfohlen. Wenig untersucht ist jedoch, ob und wie...

Cognitive deficits are a core feature of psychiatric disorders like schizophrenia and bipolar disorder. Evidence supports a genome-wide polygenic score (GPS) for educational attainment (GPSEDU) can be used to explain variability in cognitive performance. We aimed to identify different cognitive domains associated with GPSEDU in a transdiagnostic cl...

Background: Religious delusions are a common symptom in patients experiencing psychosis, with varying prevalence rates of religious delusions across cultures and societies. To enhance our knowledge of this distinct psychotic feature, we investigated the mutually-adjusted association of genetic and environmental factors with occurrence of religious...

Background Childhood maltreatment (CM) plays an important role in the development of major depressive disorder (MDD). The aim of this study was to examine whether CM severity and type are associated with MDD-related brain alterations, and how they interact with sex and age. Methods Within the ENIGMA-MDD network, severity and subtypes of CM using t...

The cover image is based on the Research Article A longitudinal approach to biological psychiatric research: The PsyCourse study by Monika Budde et al., DOI: 10.1002/ajmg.b.32639.

Depressionen beeinträchtigen nicht nur das Befinden des Patienten, sondern auch dessen Interaktion mit anderen Menschen. Auch die therapeutische Beziehung ist eine Interaktion, innerhalb derer sich die depressive Symptomatik auf unterschiedliche Weise zeigen kann. Zu Beginn der Behandlung verhalten sich Patienten häufig hilflos und inaktiv, sodass...

Die in diesem Kapitel vorgeschlagenen Therapiemodule sind für die Behandlung von Patienten mit einer hypomanen Episode oder einer leichten bis mittelschweren depressiven Episode im Rahmen einer bipolar affektiven Störung vorgesehen. Der Schwerpunkt des Kapitels liegt auf der Behandlung von Patienten mit einer Hypomanie und der Rückfallprophylaxe be...

The Cognitive Behavioral Analysis System of Psychotherapy (CBASP) is a relatively new approach in the treatment of chronic depression (CD). Adapted as group psychotherapy for inpatients, CBASP is attracting increasing attention. In this naturalistic multicenter trial, we investigated its feasibility after 10 sessions of CBASP group therapy over a t...

Einleitung: Bei 20-30% der Patienten, die an einer Depression erkrankt sind, liegt ein chronischer Verlauf über mindestens zwei Jahre vor. Daraus ergibt sich eine Lebenszeitprävalenz der chronischen Depression (CD) von 3-6%. Patienten mit CD sind häufiger von Komorbiditäten und Suizidalität betroffen und sind häufiger arbeitslos als Patienten mit e...

Patients with major depressive disorder (MDD) exhibit gray matter volume (GMV) reductions in limbic regions. Clinical variables-such as the number of depressive episodes-seem to affect volume alterations. It is unclear whether the observed cross-sectional GMV abnormalities in MDD change over time, and whether there is a longitudinal relationship be...

The renin-angiotensin-aldosterone system and its hormone receptors, i.e. the angiotensin and mineralocorticoid receptor (MR), have emerged as important targets for central nervous system disorders and in particular for major depression. We have recently characterized baseline MR function as a predictor for treatment outcome with standard antidepres...

In current diagnostic systems, schizophrenia and bipolar disorder are still conceptualized as distinct categorical entities. Recently, both clinical and genomic evidence have challenged this Kraepelinian dichotomy. There are only few longitudinal studies addressing potential overlaps between these conditions. Here, we present design and first resul...

Objectives Bipolar disorder (BD) with early disease onset is associated with an unfavorable clinical outcome and constitutes a clinically and biologically homogenous subgroup within the heterogeneous BD spectrum. Previous studies have found an accumulation of early age at onset (AAO) in BD families and have therefore hypothesized that there is a la...

The amygdala plays a crucial role in the pathogenesis of major depressive disorder (MDD). While robust findings support a negative impact of illness duration on hippocampal volume in MDD, morphometric studies of the amygdala have yielded inhomogeneous results. Considering the methodical problems of automatic segmentation methods, a standardized seg...

Background: Patients suffering from major depressive disorder (MDD) show deficits in working memory (WM) performance accompanied by bilateral fronto-parietal signal changes. It is unclear whether patients with a first depressive episode (FDE) exhibit the same BOLD signal changes as patients with recurrent depressive episodes (RDE). Methods: We i...

Das Cognitive Behavioral Analysis System of Psychotherapy (CBASP) wurde von James P. McCullough Jr. als spezielles Behandlungsverfahren für chronisch depressive Patienten entwickelt. Es bedient sich kognitiv-verhaltenstherapeutischer, psychodynamischer und interpersoneller Aspekte und geht im Wesentlichen auf die Interaktion von Person und Umwelt e...

Das vorliegende Kapitel beschäftigt sich mit der Psychoedukation von depressiven Patienten und ihren Angehörigen. Im ersten Teil werden die Bedeutung und Ziele der Psychoedukation dargestellt. Im zweiten Teil wird die Durchführung von Psychoedukation im stationären Setting praxisnah beschrieben. Viele Patientenbeispiele, Formulierungshilfen und Arb...

Da viele Patienten, die einmal unter einer depressiven Episode gelitten haben, im Verlauf ihres Lebens weitere depressive Episoden erleiden, die oft mit erheblichen gesundheitlichen und sozialen Einschränkungen für die Patienten einhergehen, ist es wichtig, nach dem Abschluss der Akutbehandlung eine Erhaltungstherapie und ggf. eine längerfristige R...

Nach einer kurzen Einführung in die kognitive Verhaltenstherapie (KVT) und Modelle zur Entstehung und Aufrechterhaltung der Depression werden Therapiebausteine zur praktischen Durchführung der KVT dargestellt, insbesondere die Einführung in die KVT, das „Zustandsbarometer“, Aktivitätenaufbau und Tagesstrukturierung, kognitive Umstrukturierung sowie...

Objective of the study was to compare two commonly used anesthetic drugs, S-ketamine and etomidate, regarding their influence on seizure characteristics, safety aspects, and outcome of electroconvulsive therapy (ECT) in major depression. Treatment data of 60 patients who underwent a total number of 13 ECTs (median) because of the severe or treatmen...

In current diagnostic systems, schizophrenia and bipolar disorder are still conceptualized as distinct categorical entities. Recently, both clinical and genetic evidence have challenged this Kraepelinian dichotomy. There are only few longitudinal studies addressing the potential overlaps between these conditions. Here, we present design and first r...

Introduction: Major depressive disorder (MDD) patients show impairments of cognitive functioning such as working memory (WM), and furthermore alterations during WM-fMRI tasks especially in frontal and parietal brain regions. The calculation of a polygenic risk score (PRS) can be used to describe the genetic influence on MDD, hence imaging genetic...

Background The approach to apply multivariate pattern analyses based on neuro imaging data for outcome prediction holds out the prospect to improve therapeutic decisions in mental disorders. Patients suffering from panic disorder with agoraphobia (PD/AG) often exhibit an increased perception of bodily sensations. The purpose of this investigation w...

Schizophrenia is a devastating disease that arises on the background of genetic predisposition and environmental risk factors, such as early life stress (ELS). In this study, we show that ELS-induced schizophrenia-like phenotypes in mice correlate with a widespread increase of histone-deacetylase 1 (Hdac1) expression that is linked to altered DNA m...

The aetiology of suicidal behaviour is complex, and knowledge about its neurobiological mechanisms is limited. Neuroimaging methods provide a noninvasive approach to explore the neural correlates of suicide vulnerability in vivo. The ENIGMA-MDD Working Group is an international collaboration evaluating neuroimaging and clinical data from thousands...

Dieses Buch stellt Behandlungsmöglichkeiten der unipolaren Depression schulenübergreifend dar und kombiniert Praxistauglichkeit mit sehr gut evidenzbasierten Verfahren, die Bestandteil nationaler und internationaler Leitlinien sind. Der Herausgeber legt großen Wert auf eine sehr praxisnahe Darstellung. Zahlreiche Fallbeispiele, die sich durch das B...

Current research suggests functional (e.g. Backes et al., 2014 1) and structural (e.g. McKinnon et al., 2009 2) brain abnormalities in major depressive disorder (MDD). Especially brain volume reductions measured by voxel based morphometry (VBM) in areas comprising the hippocampus, frontal cortex, orbitofrontal cortex, cingulate cortex, and striatum...

Childhood adversity plays an important role for development of major depressive disorder (MDD). There are differences in subcortical brain structures between patients with MDD and healthy controls, but the specific impact of childhood adversity on such structures in MDD remains unclear. Thus, aim of the present study was to investigate whether chil...

The neuro-anatomical substrates of major depressive disorder (MDD) are still not well understood, despite many neuroimaging studies over the past few decades. Here we present the largest ever worldwide study by the ENIGMA (Enhancing Neuro Imaging Genetics through Meta-Analysis) Major Depressive Disorder Working Group on cortical structural alterati...

Background: Cytokines such as interleukin 6 (IL-6) have been implicated in dual functions in neuropsychiatric disorders. Little is known about the genetic predisposition to neurodegenerative and neuroproliferative properties of cytokine genes. In this study the potential dual role of several IL-6 polymorphisms in brain morphology is investigated. M...

Individuals with high anxiety sensitivity (AS) have an increased risk of developing anxiety disorders and are more biased in how they process fear-related stimuli. This study investigates the neural correlates of fear-related words and word associations in high- and low-AS individuals. We used a semantic priming paradigm during functional magnetic...

Molecular Psychiatry publishes work aimed at elucidating biological mechanisms underlying psychiatric disorders and their treatment

Major depressive disorder (MDD) is one of the most impairing and widespread mental disorders. According to ICD-10, MDD can be divided into a recurrent depressive disorder (RDE) or a single episode, which is rather the first depressive episode (FDE). MDD patients show deficits in various cognitive domains such as working memory (WM) functions accomp...

In current studies, genetic factors and their influence on the genesis and evolution of psychiatric disorders-for example major depressive disorder (MDD)-are discussed more frequently. Genome-wide association studies (GWAS) revealed single nucleotide polymorphisms (SNPs) associated with psychiatric disorders, respectively, but former studies often...

Corticotropin-releasing hormone (CRH) is a major regulator of the hypothalamic-pituitary-adrenal axis. Binding to its receptor CRHR1 triggers the downstream release of the stress response-regulating hormone cortisol. Biochemical, behavioral and genetic studies revealed CRHR1 as a possible candidate gene for mood and anxiety disorders. Here we aimed...