Günter Niklewski

• Univ.- Prof. MD, PhD
• Managing Director at Klinikum Nürnberg

Non-communicable chronic diseases (NCDs) have become a major global health concern. They constitute the leading cause of disabilities, increased morbidity, mortality, and socio-economic disasters worldwide. Medical condition-specific digital biomarker (DB) panels have emerged as valuable tools to manage NCDs. DBs refer to the measurable and quanti...

Introduction: Indications for transcatheter aortic valve implantation (TAVI) are constantly expanding, including younger patients. Bicuspid aortic valves (BAV) often occur in this group. In order to achieve optimal treatment results in younger patients, it is necessary to develop an effective method for selecting the size of implanted valves. Aim...

Abstract Background Sleep disorders are very common in migrants and refugees, often as a comorbid disorder to different somatic or psychiatric diagnoses and psychological disturbances such as metabolic syndrome, post-traumatic stress disorder, depression, and anxiety disorders. Objectives To review published prevalence rates as well as possible pre...

Background Sleep disorders are very common in migrants and refugees, often as a comorbid disorder to different somatic or psychiatric diagnoses and psychological disturbances such as metabolic syndrome, post-traumatic stress disorder, depression, and anxiety disorders.Objectives To review published prevalence rates as well as possible predictors fo...

Sleep and chronobiology have decisive effects on human health and disease status. Chronobiology is relatively recently recognised as a prominent scientific area, particularly as in 2017 three American researchers received the Nobel Prize for their discoveries on molecular mechanisms behind the internal clocks and biological rhythms that govern huma...

Objective: The goal of this study was to evaluate whether symptoms are reduced and emotion regulation improves when patients with borderline personality disorder (BPD) receive a 5-week course of inpatient dialectical behavioral therapy (DBT) and if changes in emotion regulation are associated with changes in symptoms. Methods: Forty-four patient...

Introduction: The presence of coronary artery disease (CAD) in patients who underwent transcatheter aortic valve implantation (TAVI) may increase in-hospital and long-term mortality. Aim: To evaluate the impact of CAD in patients who underwent TAVI. Material and methods: The study group consisted of the first 142 patients treated with TAVI bet...

Introduction: The presence of coronary artery disease (CAD) in patients who underwent transcatheter aortic valve implantation (TAVI) may increase in-hospital and long-term mortality. Aim: To evaluate the impact of CAD in patients who underwent TAVI. Material and methods: The study group consisted of the first 142 patients treated with TAVI between...

Background: In women with multiple sclerosis (MS), depression and sexual dysfunction (SD) are common. Whether SD promotes depression or vice versa remains unclear despite therapeutic relevance. Therefore, we aimed to assess whether SD more likely triggers depression or vice versa. Methods: In 83 female MS patients and 21 age-matched healthy wome...

Background: In the study, the frequency and nature of asylum seekers' psychiatric diagnoses in a German admission center were examined. Additional aims were to identify changes in those diagnoses over time and to investigate health care utilization of mentally ill asylum seekers in the community. Methods: The sample for the study "Psychiatric Ex...

Associations between suicidal ideation and skill use were investigated during in-patient dialectical behavior therapy (DBT) for borderline personality disorder (BPD). Participants were N = 44 patients with BPD undergoing a 5-week in-patient DBT program in a psychiatric clinic. They filled in a diary card each treatment day resulting in 1,334 skill...

Abstract Background The year 2016 has marked the highest number of displaced people worldwide on record. A large number of these refugees are women, yet little is known about their specific situation and the hurdles they have to face during their journey. Herein, we investigated whether sociodemographic characteristics and traumatic experiences in...

Schlafstörungen nehmen im Alter zu. Ursächlich hierfür sind zunehmende körperliche und psychiatrische komorbide Erkrankungen sowie die Einnahme von Medikamenten. Darüber hinaus nimmt durch die Veränderung der Schlafarchitektur und vermehrt auftretende Schlafapnoe die Schlafqualität und damit die Erholsamkeit des Schlafes ab. Eine bestehende Schlafs...

Depression und Schlafapnoe haben eine Reihe gemeinsamer Symptome und kommen häufig zusammen vor. Bestimme Facetten der Erkrankungen betreffen Männer und Frauen unterschiedlich. Bei der alleinigen Verwendung diagnostischer Fragebögen besteht die Gefahr einer Verwechslung von Depressions- und Schlafsymptomatik, weshalb in jedem Fall eine psychiatrisc...

Introduction: Insomnia is the most frequent sleep disorder with prevalence rates between 6 and 10%. Typical symptoms of insomnia according to the ICD-10 classification include difficulties initiating and maintaining sleep with impaired mental state and daytime efficiency for at least 1 month. The PPP theory describes three groups of factors respons...

Aim and background: The role of the perceived social support in prevention of depression in adolescence still remains an insufficiently explored problem. By integrating the results of the previous studies of moderator role of perceived social support between negative life events and depression in adolescence we set up two goals. One is to determin...

Background This study aimed to determine the prevalence of clinical depression as defined by ICD-10 criteria in all patients with obstructive sleep apnea (OSA) referred to a sleep center. Methods Prospective general and sleep evaluations were conducted in 447 consecutive patients referred to our sleep center during the first quarter of 2008. Inclus...

In der Literatur werden verschiedene Geschlechtsunterschiede im Chronotypus berichtet, die sich über die Lebensspanne hinweg verändern. In Beziehungen können starke Unterschiedlichkeit in der Tageszeitpräferenz sowie andere schlafbezogene Parameter weit reichende Konsequenzen, etwa für das Sexualleben, mit sich bringen, die jedoch bisher nicht ausr...

It has been estimated that up to 80% of people will experience symptoms of tinnitus over the courses of their lives, with rates of comorbid sleeping problems ranging from 50 to 77%. Because of a potential connection between tinnitus and sleep disorders as well as high rates of comorbid psychiatric disorders, interdisciplinary approaches to treatmen...

(Article in German) Summary: Sleep disorders are widespread and can occur as an independent disease or as a comorbidity. The most common diseases are insomnia, sleep apnea syndrome, restless legs syndrome, narcolepsy and parasomnias.With the help of a brief guideline, including a sleep medical anamnesis, a differential diagnosis as well as effici...

Während Insomnie etwa 10 % der allgemeinen Bevölkerung betrifft, liegt die Prävalenz in der Population der über 65-Jährigen bei beinahe 50 %. Dieser Anstieg wird von einer Reihe verschiedener Faktoren, wie gesteigerter Medikamenteneinnahme, altersbedingten Veränderungen in Verhalten, Physiologie und zirkadianen Rhythmen, komorbiden Erkrankungen, od...

Sleep disorders are widespread and can occur as an independent disease or as a comorbidity. The most common diseases are insomnia, sleep apnea syndrome, restless legs syndrome, narcolepsy and parasomnias. With the help of a brief guideline, including a sleep medical anamnesis, a differential diagnosis as well as efficient sleep medical counselling...

Background Excessive fatigue and insomnia are common among shift workers and can lead to negative effects such as reduced work performance, processing errors, accidents at work, absenteeism, reduced quality of life, and symptoms of depression. Moreover, work in rotating shifts can be a risk factor for different somatic and psychiatric diseases and...

Background Vascular depression is regarded as a subtype of late-life depression characterized by a distinct clinical presentation and an association with cerebrovascular damage. Although the term is commonly used in research settings, widely accepted diagnostic criteria are lacking and vascular depression is absent from formal psychiatric manuals s...

Objective: To summarize research on couple sleeping with respect to gender-specific differences and chronotype. Methods: Systematic review of the literature. Results: Millions of adults around the world share their beds with a partner. This may be an expression of intimacy and attachment and tends to intensify romantic relationships. Yet, couple sl...

Plurality and individuality of hepatocellular carcinoma: PPPM perspectives Krishna Chander Sridhar, Olga Golubnitschaja Department of Radiology, Univeristy of Bonn, Bonn, Germany Correspondence: Olga Golubnitschaja (olga.golubnitschaja@ukb.uni-bonn.de) – Department of Radiology, Univeristy of Bonn, Bonn, Germany The EPMA Journal 2016, 7(Suppl 1)...

Einleitung: Im Laufe des Jahres 2014 sollten ca. 140 000 Asylbewerbern aufgenommen werden, wovon ca. 15% nach Bayern verteilt wurden. Das bayerische Staatsministerium für Arbeit und Soziales, Familie und Integration förderte ein Projekt in deren Rahmen erstens die Häufigkeit und die Art der psychiatrischen Diagnosen bei den Asylbewerbern in der ZAE...

Introduction: In 2014, 15% of about 140,000 asylum seekers were distributed to Bavaria. The Bavarian State Ministry of Labour and Social Affairs, Family and Integration promoted a project under which, first, the frequency and nature of psychiatric diagnoses among asylum seekers in the ZAE Zirndorf should be examined and, secondly, recommendations...

Einleitung: Durch Schichtarbeit verursachten Schlafstörungen und Müdigkeit können eine reduzierte Arbeitsleistung, Fehler bei der Arbeit sowie Arbeitsunfälle zur Folge haben. Absentismus, eine reduzierte Lebensqualität oder auch Depressionen sind weitere mögliche Konsequenzen. Außerdem kann Schichtarbeit in rotierenden Schichten einen Risikofaktor...

Chronotherapeutics for Affective Disorders. A Clinician's Manual for Light and Wake TherapyWirz-JusticeA, BenedettiF, TermanM (Eds) S.Karger AG, Basel, Switzerland, 2013. 124 pages. ISBN 978-3-318-02090-8. - Volume 26 Issue 3 - Kneginja Richter, Guenter Niklewski

Background: Insomnia occurs frequently in older adults. The underlying factors for the disorder are physiological changes of the sleep-wake cycle, comorbid diseases and drug treatment. Cognitive behavioural therapy (CBT I) combined with light therapy and physical activity can be effective in the treatment of comorbid insomnia in older adults. Metho...

Goal of the project The main goal of the program is prevention of suicide through early prediction and detection of depression. For the sustainability of the program a national centre for prevention and treatment of depression and suicide shell be established in the country. The Macedonian alliance against depression should be a network of experts...

Ein Manuel zur Behandlung von Ein-und Durchschlafstörungen bei Menschen über 65 J.

The specialty of psychooncology comprises the entire spectrum of psychosocial counselling up to a specialized psychotherapy including psychopharmacotherapy. In order to treat mental disorders in oncological patients, several special aspects have to be taken into account as follows: Many psychopharmaco- therapeutics have potential hematological side...

The specialty of psychooncology comprises the entire spectrum of psychosocial counselling up to a specialized psychotherapy including psychopharmacotherapy. In order to treat mental disorders in oncological patients, several special aspects have to be taken into account as follows: Many psychopharmacotherapeutics have potential hematological side e...

The German S3-Guidelines on Bipolar Disorders have been released online in May of 2012. S3 ("step 3") stands for the currently available highest evidence based methodology guidelines can have. This includes the systematic review and appraisal of the available international scientific literature on bipolar disorders and a consensus of all relevant g...

The proper functioning of the human body is regulated by the rhythmical change of the rest and activity cycle called sleep-wake activity. Suprachiasmatic nucleus (SCN) is responsible for the central generation of the biorhythm/circadian rhythm while the peripheral “Zeitgeber” as light, social contacts and time of meal modulate the rhythmical activi...

Introduction Some studies suggest seasonality of suicide attempts in females, but not males. Only few studies investigated whether gender differences in seasonality of suicide attempts reflect gender differences in the choice of method, with inconsistent results. Objectives/aims To analyze the association of gender with seasonality in suicide atte...

Introduction The clinic of psychiatry and psychotherapy and the clinic of otolaryngology of the clinic of Nuremberg offer an interdisciplinary consultation for patients suffering from tinnitus aurium and comorbid major depression and/or insomnia. Objectives Prediction variables are needed regarding the treatment of subjective ear noises by low fre...

The functioning of the human body is regulated by the rhythmical change between rest and activity. The SCN (suprachiasmatic nucleus) is responsible for the central control of the biorhythm and the genetic prediction of the individual chronotype, whereas peripheral time cues such as light, social contacts and times of meals modulate the rhythmical a...

In most countries worldwide suicide rates are higher for males whereas attempted suicide rates are higher for females. The aim is to investigate if the choice of more lethal methods by males explains gender differences in suicide rates. Data on completed and attempted suicides were collected (n=3235, Nuremberg and Wuerzburg, years 2000-2004). The r...

Objectives Patients with untreated obstructive sleep apnea often report depressive symptoms, such as low mood, loss of interest and reduction of drive. In this study we examined the frequency of significant depressive symptoms amongst patients with untreated obstructive sleep apnea over a one year period. Methods From January to December 2008 we s...

Objectives The Clinic of Psychiatry and Psychotherapy of Nuremberg established rTMS as a standard tool in the treatment of patients with depressive disorder since 2001. The stimulation protocol was modified in October 2008 to match the current standard procedure reported in the literature. The pulse number was heightened form 800 to 2000 per procee...

Objectives In the Federal Republic of Germany about 3 million people suffer from tinnitus/are hit by tinnitus, numerous of them depend on intensive medical care. The repetitive transcranial magnetic stimulation is considered to be an innovative and promising therapy in tinnitus treatment. Low frequency stimulation is meant to reduce the abnormal ne...