Daniel Schöttle

• MD, PD Dr. med.
• Head of Department at Asklepios Klinik Harburg

Introduction: Schizophrenia is among the most debilitating mental health conditions. While antipsychotic medication represents the primary pillar of treatment, guidelines now also recommend psychotherapy. Metacognitive Training (MCT) has emerged over the past 20 years as a novel approach that addresses the cognitive biases involved in the pathogen...

Autism spectrum condition is a neurodevelopmental condition with difficulties in social interaction, communication and repetitive behaviours. Autistic individuals often exhibit difficulties in non‐social cognitive processing, such as grouping items into meaningful categories based on their holistic visual appearance. Underlying mechanisms might be...

Patients with acute psychosis are often confronted with the prejudice that they refuse all treatment due to lack of insight. This study examined and compared the aims and preferences for treatment of patients with acute psychosis and of psychiatric inpatient staff. A total of 142 inpatients being treated for a psychotic disorder on either a locked...

Autistic adults frequently show increased physical or mental health conditions and impairments in social, occupational, and other life domains. Accordingly, they often report reduced health-related quality of life. Yet, numerous barriers prevent effective healthcare for autistic adults. To date, the impact of healthcare barriers on health-related q...

Introduction The role of emotional dysregulation (ED) in attention-deficit/hyperactivity disorder (ADHD) has become an important issue. This study, in which we analyzed data from a predictive pharmaco-EEG-trial, aimed to examine whether symptoms of ED in adult ADHD affect ADHD symptom severity, brain arousal regulation as measured by resting EEG, a...

Introduction: The role of emotional dysregulation (ED) in attention-deficit/ hyperactivity disorder (ADHD) has become an important issue. This study, in which we analyzed data from a predictive pharmaco-EEG-trial, aimed to examine whether symptoms of ED in adult ADHD affect ADHD symptom severity, brain arousal regulation as measured by resting EEG,...

Introduction Schizophrenia-Spectrum-Disorders are associated with poor long-term outcome as well as disability and often severely affect the lives of patients and their families often from symptom onset. Up to 70% of first episode psychosis (FEP) patients suffer from comorbid substance use disorders (SUD). We aimed at studying the course of illness...

Introduction Psychotic disorders have a significant impact on patients’ lives and their families, and long-term treatment with individually tailored multimodal combinations of therapies is often required. Integrated care (IC) concepts such as the “Hamburg Model (ACCESS)” with a focus on psychotic disorders, includes different (therapeutic) componen...

Introduction Family members of autistic individuals often provide support for their autistic relative throughout the lifespan which can lead to massive burden themselves. Reduced health-related Quality of Life (HRQoL) in family caregivers is assumed; however, only a handful studies on the HRQoL of family caregivers providing care to adult relatives...

Patients on acute psychiatric wards desire more psychosocial treatment than they receive, according to recent studies, but evidence-based interventions tailored to this setting are currently lacking. Metacognitive Training for psychosis (MCT) is a flexible, easy-to-administer group therapy that has been adapted to meet this demand (MCT-Acute). Thir...

Family caregivers often play a critical role in supporting their relative(s) with autism spectrum disorder (ASD) across the lifespan. This can lead to great burdens on family caregivers themselves. However, to date, the potential burden on family caregivers has not been in the focus of research, particularly, with respect to caregiver burden as rel...

Objectives The main objective of the present study was to investigate whether assessments of psychopathology vs. character strengths were associated with systematic differences concerning transient psychological states (i.e., cognitive performance, state mood, optimism, therapy motivation, perceived stigma) in individuals with psychotic disorders....

Background Autism refers to a neurodevelopmental condition with characteristic impairments in social interaction and communication, restrictive and repetitive behaviors, as well as difficulties in sensory information processing and daily living skills. Even though symptoms persist from early childhood throughout the lifespan and often require long-...

Objective: Despite guidelines providing detailed recommendations for the assessment of ADHD in adults and increasing clinician awareness of the persistence of ADHD into adulthood, ADHD remains under diagnosed in many countries. Method: A survey of 178 clinicians who regularly perform assessments for adult ADHD was conducted between February 2015 an...

Background Functional impairment affects many patients with schizophrenia. Treatment with the long-acting injectable antipsychotic aripiprazole once-monthly (AOM) may help improve functioning. Objectives To explore changes in functioning in patients with schizophrenia who received AOM treatment in observational studies. Methods Here we report fun...

Background Patients with schizophrenia may benefit from treatment with long-acting injectable (LAI) formulations of antipsychotics. Aripiprazole once-monthly (AOM) is an LAI that was tested in two non-interventional studies in Germany and Canada. Methods Here, we report on analyses of pooled data from the two non-interventional studies. Patients w...

Background: Functional impairment affects many patients with schizophrenia. Treatment with the long-acting injectable antipsychotic aripiprazole once-monthly (AOM) may help improve functioning. Methods: Here we report functional outcomes in the form of Global Assessment of Functioning (GAF) scores in a pooled analysis of data from two non-intervent...

Purpose Studies on outcomes mapping Quality of Life (QoL) as patient-reported outcome over a longer period in severe psychotic disorders are scarce. However, such data would be particularly important for structuring, implementing and operating effective and efficient care models and for promoting satisfaction with care, service engagement and adher...

Autism refers to an early-onset neurodevelopmental condition with characteristic impairments and difficulties in practical living skills, which persist across the lifespan such that adults with autism often require substantial support and comprehensive care. Yet, mental health and other services are frequently unavailable for adults with autism des...

Background: Noninterventional naturalistic studies are an important complement to randomized controlled trials. Aripiprazole once-monthly (AOM) is an atypical antipsychotic in a long-acting injectable formulation. Methods: A pooled analysis of two noninterventional studies was undertaken to validate previous results on AOM effectiveness and safe...

Attention deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder, characterized by core symptoms of inattention, hyperactivity and impulsivity. Comorbid depression is commonly observed in ADHD-patients. Psychostimulants are recommended as first-line treatment for ADHD. Aberrant long-range temporal correlations (LRTCs) of neuronal ac...

Introduction The COVID-19 pandemic had numerous consequences for general, mental and sexual health. As gender differences in sexual compulsivity (SC) have been reported in the past and SC has been connected to adverse events and psychological distress, the current study aims at investigating associations between these factors in the context of cont...

Establishing a secure sexual identity is a major developmental goal of an individual's transition from childhood to adolescence and the years that follow. Attention deficit/hyperactivity disorder (ADHD) as a neurodevelopmental disorder defined by the core symptoms of inattention, hyperactivity, and impulsivity, but also with emotional dysregulation...

Purpose: Studies on outcomes mapping Quality of Life (QoL) as patient-reported outcome over a longer period in severe psychotic disorders are scarce. However, such data would be particularly important for structuring, implementing and operating effective and efficient care models and for promoting satisfaction with care, service engagement and adhe...

Background Integrated care according to the Hamburg model combines therapeutic assertive community treatment (TACT) with initiatives for early detection and early treatment of schizophrenia and affective psychoses. The aim of this study was to identify the clinical characteristics of adolescents in comparison to adult patients and to derive knowled...

Zusammenfassung Hintergrund Die Kontaktbeschränkungen zur Eindämmung der durch die „coronavirus disease 2019“ (COVID-19) ausgelösten Pandemie beeinflussen das soziale Leben der Menschen auf vielen Ebenen, so auch die psychische und sexuelle Gesundheit. Fragestellung Ziel der Studie war es, Veränderungen sexueller Interessen und Erfahrungen in Deu...

Zusammenfassung Menschen mit einer Autismus-Spektrum-Störung zeigen die gesamte Vielfalt sexueller Fantasien und sexuellen Verhaltens ebenso wie ihre nichtbetroffenen Peers. Dennoch finden sich auch einige Besonderheiten in sexuellem Erleben und Verhalten bei Menschen mit einer Autismus-Spektrum-Störung, die größtenteils auf die störungsspezifische...

Introduction Major depressive disorder (MDD) and obesity are both common disorders associated with significant burden of disease worldwide. Importantly, MDD and obesity often co-occur, with each disorder increasing the risk for developing the other by about 50%–60%. Statins are among the most prescribed medications with well-established safety and...

EEG studies have shown that adult ADHD patients have less stable brain arousal regulation than age and gender matched controls. Psychostimulants have brain arousal stabilising properties evident in EEG patterns. The aim of this study was to investigate whether the stability of brain arousal regulation has prognostic value in predicting response to...

Autismus-Spektrum-Störungen (ASS) werden in den letzten Jahren immer häufiger auch im Erwachsenenalter diagnostiziert. Gerade bei hochfunktionalen Menschen mit ASS und einer durchschnittlichen oder überdurchschnittlichen Intelligenz wird die Diagnose häufig übersehen oder durch die augenscheinlichen Komorbiditäten überdeckt 1. Entgegen der vorherrs...

Zusammenfassung Ziel Die Literatur zum gemeinsamen Auftreten von Geschlechtsdysphorie/Gendervarianz und Autismus-Spektrum-Störungen wird für das Kindes- und Jugendalter systematisch aufbereitet. Methodik Für den Zeitraum 1946 bis Dezember 2018 wurde eine systematische Literaturrecherche durchgeführt. Ergebnisse Von insgesamt 144 identifizierten Pub...

Objectives People with psychotic disorders have a high prevalence of comorbid mental disorders, especially if severe mental illness (SMI) criteria are fulfilled. Substance Use Disorders (SUD) are the most common comorbidity. The aim of the study is to investigate whether SMI patients with and without comorbid SUD have a comparable course, remission...

Objectives Reward system dysfunctions are considered to be a pathophysiological mechanism in schizophrenia. Electrophysiological studies on reward system functions have identified frequency-specific brain networks for the processing of positive (high-beta frequency) and negative (theta frequency) events. Remarkably, midbrain dopaminergic signalling...

Background: In this non-interventional study, the functionality and well-being of patients with schizophrenia with aripiprazole once-monthly (AOM) was evaluated under real-life conditions in a naturalistic population. Methods: This non-interventional, prospective, multicenter 6-month study included 242 predominantly symptomatically stable patien...

Background: Health services research is of increasing importance in current psychiatry. Therefore, large datasets and aggregation of data generated by electronic routine documentation due to legal, financial, or administrative purposes play an important role. However, paper-based routine documentation is still of interest. It remains relevant in le...

Objective: To compare cost-effectiveness of integrated care with therapeutic assertive community treatment (IC-TACT) versus standard care (SC) in multiple episode psychosis. Method: 12-month IC-TACT in patients with schizophrenia-spectrum and bipolar I disorders were compared with a historical control group. Primary outcomes were entropy-balance...

Objective: The ACCESS treatment model offers assertive community treatment (ACT) embedded in an integrated care program to patients with severe psychotic disorders. Compared to standard care, it proved to be more effective in terms of service disengagement and other outcomes in patients with psychotic disorders over 12, 24, and 48 months. Many pati...

ZUSAMMENFASSUNG ADHS und ASS sind früh beginnenden neuronale Entwicklungsstörungen, die häufig gemeinsam vorkommen. Sie haben anteilig eine gemeinsame genetische Grundlage, die sich sowohl in der Auftretenswahrscheinlichkeit beim selben Individuum als auch in den Familien der Betroffenen zeigt. Die Unterscheidung, um welche Störung es sich handelt...

Adults with an Autism Spectrum Disorder (ASD) are characterized by impairments in social interaction and communication, repetitive and stereotyped interests and behaviours as well as hyper-and/or hyposensitivities. These disorder specific symptoms could be associated with the development of sexual disorders. The Dual Control Model of Sexual Respons...

Zusammenfassung Zwangsmaßnahmen sind trotz der Bemühungen um deren Vermeidung Teil des Alltags auf psychiatrischen Akutstationen. Diese werden durch verschiedene Faktoren begünstigt, die den vor-, den stationären und poststationären Bereich betreffen. Es werden in diesem Artikel, basierend auf der klinischen Erfahrung auf unserer Akutstation, Lösun...

Schizophrenia is a complex mental disorder. Hence, the mental health system faces enormous structural, therapeutic, and health-economic challenges. Innovative models of healthcare can facilitate making treatment more efficient and effective.This paper aims to give an overview of evidence-based and innovative models of care and treatment for schizop...

Following publication of the original article

Background In this study, the treatment of schizophrenia patients with aripiprazole once-monthly (AOM) was evaluated under real-life conditions in a naturalistic setting. Methods This multicenter, prospective, non-interventional study included 242 patients (age = 43.1 ± 15.1 years, 55.0% male) who were monitored during 6 months of AOM treatment. E...

Assertive community treatment (ACT) has shown to be effective in improving both functional deficits and quality of life (QoL) in patients with severe mental illness. However, the mechanisms of this beneficial effect remained unclear. We examined mechanisms of change by testing potential mediators including two subdomains of negative symptoms, i.e....

The ACCESS-model offers integrated care including assertive community treatment to patients with psychotic disorders. ACCESS proved more effective compared to standard care (ACCESS-I study) and was successfully implemented into clinical routine (ACCESS-II study). In this article, we report the 4-year outcomes of the ACCESS-II study. Between May 200...

Table A time to service-disengagement (non-practical reasons) and table B time to service-disengagement (practical reasons). (DOCX)

Translated study information. (PDF)

Mirror neuron system (MNS) dysfunctions might underlie deficits in autism spectrum disorders (ASD). Diffusion tensor imaging based probabilistic tractography was conducted in 15 adult ASD patients and 13 matched, healthy controls. Fractional anisotropy (FA) was quantified to assess group differences in tract-related white matter microstructure of b...

Like nonaffected adults, individuals with autism spectrum disorders (ASDs) show the entire range of sexual behaviors. However, due to the core symptoms of the disorder spectrum, including deficits in social skills, sensory hypo- and hypersensitivities, and repetitive behaviors, some ASD individuals might develop quantitatively above-average or nonn...

Purpose of review: The combination of the core symptoms, characterizing individuals with autism-spectrum disorder (ASD), can lead to problems in romantic relationships and sexual functioning. The purpose of this article is to review studies on sexuality in individuals with ASD published since January 2016. Recent findings: Individuals with ASD a...

TO THE EDITOR: Individuals suffering from psychotic disorders and substance use disorders (SUDs) are at heightened risk of experiencing episodes of agitation and violent behavior. Aggression and violence are major reasons for compulsory treatment to protect patients and staff. While a higher incidence of SUDs in transgender individuals has been des...

Background: People with psychotic disorders fulfilling criteria of a severe and persistent mental illness (SPMI) display a high risk of somatic comorbidity (SC). Methods: ACCESS II is a prospective, long-term study examining the effectiveness of Integrated Care for people with psychotic disorders fulfilling SPMI criteria. Chronic comorbid somati...

Objective: The objective of the study was to investigate whether a combined intervention composed of early detection plus integrated care (EDIC) enhances outcomes in patients with early psychosis compared to standard care (SC). Methods: ACCESS III is a prospective non-randomized historical control design 1-year study examining the efficacy of ED...

Altered sensory perception has been found in patients with autism spectrum disorders (ASD) and might be related to aberrant sensory perception thresholds. We used the well-established, standardized Quantitative sensory testing (QST) protocol of the German Research Network on Neuropathic Pain to investigate 13 somatosensory parameters including ther...

Aim: The Integrated Care in Early Psychosis (ACCESS III) Study examined the efficacy and cost-effectiveness of a combined intervention consisting of strategies to improve early detection and quality of care (integrated care including therapeutic assertive community treatment) in adolescents and young adults in the early phase of a severe psychotic...

This chapter provides an up-to-date review of olanzapine long-acting injection (OLAI). This is a crystalline salt formulation, olanzapine pamoate monohydrate, composed of olanzapine and pamoic acid. The authors review the drug’s pharmacology before considering the key RCTs that established clinical efficacy in the acute and maintenance treatment in...

Significance statement: The weak central coherence account proposes a tendency of individuals with autism spectrum disorders (ASDs) to focus on details at the cost of an integrated coherent whole. Here, we provide evidence, at the behavioral and the neural level, that visual integration in object recognition is impaired in ASD, when details had to...

Theories of autism spectrum disorders (ASD) have focused on altered perceptual integration of sensory features as a possible core deficit. Yet, there is little understanding of the neuronal processing of elementary sensory features in ASD. For typically developed individuals, we previously established a direct link between frequency-specific neural...

This is a prospective 1-year follow-up study comparing a combined intervention consisting of multidimensional early detection strategies with age- and interdisciplinary integrated care (intervention group, n = 120) with standard care (historical control group, n = 105) in adolescents and young adults within the early phase of psychosis. Data at stu...

Background: Tics are common in people with autism spectrum disorder (ASD). However, their phenomenology and characteristics have not been studied in detail. Methods: Based on video sequences of 21 adults with ASD without intellectual disability and 16 adults with Gilles de la Tourette syndrome (GTS), tic severity, tic repertoires, and tic awarene...

Gamma-band oscillations (e.g., the early auditory evoked gamma-band response, aeGBR) have been suggested to mediate cognitive and perceptual processes by driving the synchronization of local neuronal populations. Reduced aeGBR is a consistent finding in patients with schizophrenia and high-risk subjects, and has been proposed to represent an endoph...

Dysfunctions of the human mirror neuron system have been postulated to underlie some deficits in autism spectrum disorders including poor imitative performance and impaired social skills. Using three reaction time experiments addressing mirror neuron system functions under simple and complex conditions, we examined 20 adult autism spectrum disorder...

Hintergrund Das „Hamburger Modell“ ist ein Integriertes Versorgungsmodell (IV) nach § 140 SGB V für Psychosebetroffene, welche die Kriterien für eine schwere psychische Erkrankung erfüllen. Ziele der Arbeit Darstellung des Behandlungsmodells und Evaluation der Effektivität für alle Patienten, die ≥3 Jahre in der IV behandelt werden. Material un...

Traumatic brain injury (TBI) is one of the leading causes of permanent disability in young adults and is frequently accompanied by changes in sexual behaviors. Satisfying sexuality is an important factor for overall quality of life in people with disabilities. The purpose of this article is to review the studies evaluating the assessment, correlate...

Treatment models like "Crisis Resolution and Hometreatment (CRHT)" or "Assertive Community Treatment" (ACT), were found to be effective, enhancing the qualitative level of treatment for patients with severe mental disorders. In Germany, these are implemented only sporadically until today, often as part of a cross-sectoral Integrated Care (IC) treat...

Second-generation antipsychotics (SGAs) are a mainstay in the treatment of patients with schizophrenia. However, continuity in intake of the prescribed medication has been one of the greatest challenges in these patients. One option to improve medication adherence is to prescribe depot or long-acting injectable formulations (LAIs) of antipsychotics...

Purpose of review: The recent implementation of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition introduced some important changes in the conceptualization of hypersexuality and paraphilic disorders. The destigmatization of nonnormative sexual behaviors could be viewed as positive, However, other changes are more controvers...

Objective: The ACCESS treatment model offers assertive community treatment embedded in an integrated care program to patients with psychoses. Compared to standard care and within a controlled study, it proved to be more effective in terms of service disengagement and illness outcomes in patients with schizophrenia spectrum disorders over 12 months...

The aim of the present article is to review QoL scales used in studies investigating patients with schizophrenia over the past 5 years, and to summarize the results of QoL assessment in clinical practice in these patients. Literature available from January 2009 to December 2013 was identified in a PubMed search using the key words “quality of life”...

The aim of the present article is to review QoL scales used in studies investigating patients with schizophrenia over the past 5 years, and to summarize the results of QoL assessment in clinical practice in these patients. Literature available from January 2009 to December 2013 was identified in a PubMed search using the key words “quality of life”...