Hans-Ulrich Wittchen

Hans-Ulrich Wittchen
Technische Universität Dresden | TUD · Institute and Outpatient Clinics of Psychiatrics and Psychotherapy

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1,259
Publications
276,730
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Publications

Publications (1,259)
Article
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Social factors play a crucial role in moderating the impact of severe stressful events on mental health. Exposure to harassment, hence to unwanted negative behavior that is intended to cause harm and/or is perceived as harmful and hostile, is a social factor thought to have particularly strong negative effects on mental health, including depressive...
Article
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Late-life depression has multiple, heterogeneous clinical presentations. The aim of the study was to identify higher-order homogeneous clinical features (symptom complexes), while accounting for their potential causal interactions within the network approach to psychopathology. We analyzed cross-sectional data from community-dwelling adults aged 65...
Article
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Panic disorder (PD) has a lifetime prevalence of 2–4% and heritability estimates of 40%. The contributory genetic variants remain largely unknown, with few and inconsistent loci having been reported. The present report describes the largest genome-wide association study (GWAS) of PD to date comprising genome-wide genotype data of 2248 clinically we...
Presentation
In der Expositionstherapie gilt der Verzicht auf Sicherheitsverhalten als Voraussetzung für die Reduktion der Angstsymptomatik. Es wird erwartet, dass nur ohne Sicherheitsverhalten die Widerlegung negativer Erwartungen möglich sei. Andererseits wird argumentiert, dass ein begrenztes Maß an Sicherheitsverhalten die Konfrontation und Erwartungswiderl...
Article
Further developments of exposure-based therapy (EBT) require more knowledge about transfer of treatment to non-trained everyday contexts. However, little is known about transfer effects of EBT. Using a standardized EBT protocol in 275 patients with panic disorder and agoraphobia we investigated the transfer of EBT to a highly standardized context d...
Article
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Theoretically, panic disorder and agoraphobia pathology can be conceptualized as a cascade of dynamically changing defensive responses to threat cues from inside the body. Guided by this trans-diagnostic model we tested the interaction between defensive activation and vagal control as a marker of prefrontal inhibition of subcortical defensive activ...
Chapter
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Die Beiträge der Epidemiologie für die Klinische Psychologie und Psychotherapie sind breit und facettenreich. Sie reichen von der Bestimmung der Häufigkeit, der Verteilung und des Spontanverlaufs psychischer Störungen (deskriptive Epidemiologie), über die Evaluation des Versorgungssystems sowie der Abschätzung des Versorgungsbedarfs (Versorgungsepi...
Article
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While DNA methylation patterns have been studied for a role in the pathogenesis of anxiety disorders, the role of the enzymes establishing DNA methylation—DNA methyltransferases (DNMTs)—has yet to be investigated. In an effort to investigate DNMT genotype-specific effects on dimensional anxiety traits in addition to the categorical phenotype of pan...
Article
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Background: Meta-analyses suggest an increased prevalence of paternal depression during the perinatal period of around 10%. The relationship between paternal and maternal symptoms, however, has received little attention. Objective: To determine pooled estimates pertaining to the relationship between paternal and maternal depression during the perin...
Preprint
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Adapting threat-related memories towards changing environments is a fundamental ability of organisms. One central process of fear reduction is suggested to be extinction learning, experimentally modeled by extinction training that is repeated exposure to a previously conditioned stimulus (CS) without providing the expected negative consequence (unc...
Article
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Depression is widely acknowledged to be a heterogeneous entity, and the need to further characterize the individual patient who has received this diagnosis in order to personalize the management plan has been repeatedly emphasized. However, the research evidence that should guide this personalization is at present fragmentary, and the selection of...
Article
Background Cognitive preparation plays a crucial role in CBT with exposure for panic disorder and agoraphobia. High emotional arousal while developing the exposure rationale might impair patients’ cognitive capacities for processing information about treatment and impede therapeutic outcome. Objective This study investigates whether patients’ voca...
Article
A dimensional approach in psychiatry aims to identify core mechanisms of mental disorders across nosological boundaries. We compared anticipation of reward between major psychiatric disorders, and investigated whether reward anticipation is impaired in several mental disorders and whether there is a common psychopathological correlate (negative moo...
Article
Full-text available
Background The role of maternal personality and perceived social support for peripartum changes in psychopathological symptoms remains unresolved. Methods In a regional-epidemiological sample of 306 women, depressive, anxiety, and stress symptoms were assessed three times during pregnancy and three times after delivery with the 21-item version of...
Article
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Cigarette smoking increases the likelihood of developing anxiety disorders, among them panic disorder (PD). While brain structures altered by smoking partly overlap with morphological changes identified in PD, the modulating impact of smoking as a potential confounder on structural alterations in PD has not yet been addressed. One-hundred forty-thr...
Article
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An amendment to this paper has been published and can be accessed via the original article.
Article
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Background: There is a need of comprehensive standardized diagnostic assessment tools of psychopathology that match recent changes in diagnostic classification systems, such as the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Therefore, the computer-assisted DIA-X-5 was developed and its test-retest reliability...
Article
Background Evidence suggests that maternal anxiety is associated with adverse pregnancy and delivery outcomes, such as preterm birth, vaginal bleedings and low birth weight. Aims To examine the association of lifetime anxiety disorders and pregnancy-related anxiety and complications during pregnancy and delivery. Study design Prospective-longitud...
Article
Background Panic disorders during pregnancy and after delivery may have detrimental effects for mother and child, but no firm conclusions regarding the course and outcomes of peripartum panic disorders can be drawn from previous studies. Methods N = 306 women were repeatedly interviewed with the Composite International Diagnostic Interview for Wom...
Article
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Neuronal nitric oxide synthase (NOS-I) impacts on fear/anxiety-like behavior in animals. In humans, the short (S) allele of a functional promotor polymorphism of NOS1 (NOS1 ex1f-VNTR) has been shown to be associated with higher anxiety and altered fear conditioning in healthy subjects in the amygdala and hippocampus (AMY/HIPP). Here, we explore the...
Article
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An amendment to this paper has been published and can be accessed via a link at the top of the paper.
Article
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Background: An ageing population worldwide needs to investigate quality of life (QoL) and level of functioning (LoF) in the elderly and its associated variables. We aimed to study the relationship between Quality of Life (QoL) and Level of Functioning (LoF) in an elderly population in Europe. Method: As part of the Ment_Dis65+ European Project,...
Chapter
This chapter describes the prevalence, onset, course, persistence, comorbidity, and outcome, as well as correlates and risk factors of anxiety disorders, namely separation anxiety disorder, specific phobia, social anxiety disorder, agoraphobia, panic disorder, and generalized anxiety disorder. The focus is laid upon the early years of life (childho...
Article
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Traumatic events (TEs) have been associated with suicide attempts (SAs). However, the empirical status of some TEs is inconclusive. This also concerns community adolescents and young adults, known to be a high-risk group for SAs. We examined associations between (a) a range of prior TEs (physical attack, rape/sexual abuse, serious accident, and wit...
Article
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Individuals differ in how they learn from experience. In Pavlovian conditioning models, where cues predict reinforcer delivery at a different goal location, some animals—called sign-trackers—come to approach the cue, whereas others, called goal-trackers, approach the goal. In sign-trackers, model-free phasic dopaminergic reward-prediction errors un...
Article
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With progress in magnetic resonance imaging technology and a broader dissemination of state-of-the-art imaging facilities, the acquisition of multiple neuroimaging modalities is becoming increasingly feasible. One particular hope associated with multimodal neuroimaging is the development of reliable data-driven diagnostic classifiers for psychiatri...
Article
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...
Article
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Background IgG-class autoantibodies to N-Methyl-D-Aspartate (NMDA)-type glutamate receptors define a novel entity of autoimmune encephalitis. Studies examining the prevalence of NMDA IgA/IgM antibodies in patients with Parkinson disease with/without dementia produced conflicting results. We measured NMDA antibodies in a large, well phenotyped sampl...
Article
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Background: Over the last decade Russia has introduced various policy measures to reduce alcohol consumption and alcohol-related harm at the population level. Several of these policies, such as higher pricing and taxation or restrictions of availability, may not work in the case of unrecorded alcohol consumption; they may encourage consumers to sw...
Article
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Objectives Affective disorders are among the most prevalent disorders in the elderly. The present study aims to examine the sociodemographic and clinical correlates of major depressive disorder (MDD) and dysthymia in different European and Associated countries using standardized interview techniques. Furthermore, service utilization for the elderly...
Article
Background: The use of machine learning (ML) algorithms to study suicidality has recently been recommended. Our aim was to explore whether ML approaches have the potential to improve the prediction of suicide attempt (SA) risk. Using the epidemiological multiwave prospective-longitudinal Early Developmental Stages of Psychopathology (EDSP) data se...
Article
Background: The role of anxiety and depressive disorders prior to pregnancy for changes in peripartum psychopathological symptoms has not been resolved yet. Methods: A regional-epidemiological sample of 306 women was prospectively followed in seven waves from early pregnancy until 16 months postpartum. Lifetime DSM-IV anxiety and depressive diso...
Article
d-cycloserine (DCS), a partial NMDA-receptor agonist, seems to be a promising enhancer for exposure therapy in anxiety disorders. It has been tested successfully in animal models of fear extinction, where DCS enhanced extinction learning. Applied in clinical studies, results of DCS-augmented exposure therapy remain ambiguous, calling for a deeper u...
Article
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Introduction: The neurobiological mechanisms behind panic disorder with agoraphobia (PD/AG) are not completely explored. The functional A/T single nucleotide polymorphism (SNP) rs324981 in the neuropeptide S receptor gene (NPSR1) has repeatedly been associated with panic disorder and might partly drive function respectively dysfunction of the neur...
Conference Paper
Einleitung: Die Häufigkeit (Frequenz) des Alkoholkonsums wird bei verschiedenen Instrumenten mittels kategorialer Antwortmöglichkeiten erfragt. Derzeit liegen keine empirischen Studien vor, die für solche Frequenzkategorien tagesgenaue Umrechnungsvorgaben ableiten. Diese Lücke soll durch den Vergleich von theoriegeleiteten und datengeleiteten Trink...
Article
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In animals and humans, behavior can be influenced by irrelevant stimuli, a phenomenon called Pavlovian-to-instrumental transfer (PIT). In subjects with substance use disorder, PIT is even enhanced with functional activation in the nucleus accumbens (NAcc) and amygdala. While we observed enhanced behavioral and neural PIT effects in alcohol-dependen...
Article
The gene coding for glycine receptor β subunits (GLRB) has been found to be related to panic disorder and agoraphobia (PD/AG) and to be associated with altered insular BOLD activation during fear conditioning, as an intermediate phenotype of defensive system reactivity in healthy subjects. In a multicenter clinical trial on PD/AG patients we invest...
Article
Introduction: Suicide belongs to the leading causes of maternal perinatal mortality and suicidal ideation is one of the strongest predictors for suicide attempt and completion and thus represents an opportunity for early intervention prior to self and infant harm. This post-hoc analysis aims to investigate predictors of peripartum suicidality (PS)...
Article
Background: Pavlovian-to-instrumental transfer (PIT) describes the influence of conditioned stimuli on instrumental behaviors and is discussed as a key process underlying substance abuse. Here, we tested whether neural responses during alcohol-related PIT predict future relapse in alcohol-dependent patients and future drinking behavior in adolesce...
Article
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Background The Diagnostic and Statistical Manual of Mental Disorders, version 5 (DSM‐5) definition of agoraphobia (AG) as an independent diagnostic entity makes it timely to re‐examine the epidemiology of AG. Study objective was to present representative data on the characteristics of individuals who meet DSM‐IV criteria for AG (AG without a histor...
Poster
Angststörungen zählen zu den häufigsten psychischen Störungen und sind gut behandelbar. Dennoch sind die Inanspruchnahmeraten unter den geringsten bei psychischen Störungen. Wir untersuchen, welche Barrieren Betroffene davon abhalten Kontakt mit den Versorgungssystem zu suchen. Wir untersuchen N=650 Teilnehmer des bevölkerungsrepräsentativen Deutsc...
Article
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Major depressive disorder and the anxiety disorders are highly prevalent, disabling and moderately heritable. Depression and anxiety are also highly comorbid and have a strong genetic correlation (rg ≈ 1). Cognitive behavioural therapy is a leading evidence-based treatment but has variable outcomes. Currently, there are no strong predictors of outc...
Article
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The influence of Pavlovian conditioned stimuli on ongoing behavior may contribute to explaining how alcohol cues stimulate drug seeking and intake. Using a Pavlovian-instrumental transfer task, we investigated the effects of alcohol-related cues on approach behavior (i.e., instrumental response behavior) and its neural correlates, and related both...
Article
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Background Although cognitive behavioral therapy (CBT) is highly effective in the treatment of anxiety disorders, many patients still do not benefit. This study investigates whether a history of traumatic event experience is negatively associated with outcomes of CBT for panic disorder. The moderating role of the monoamine oxidase A (MAOA) gene and...
Article
Full-text available
Preclinical studies point to a pivotal role of the orexin 1 (OX1) receptor in arousal and fear learning and therefore suggest the HCRTR1 gene as a prime candidate in panic disorder (PD) with/without agoraphobia (AG), PD/AG treatment response, and PD/AG-related intermediate phenotypes. Here, a multilevel approach was applied to test the non-synonymo...
Article
Optimism is associated with better health, and inflammatory activity has been proposed as a potential biological pathway. However, the evidence implicating inflammation has been adduced by cross-sectional studies, and the directionality of the optimism-inflammation relationship has remained unclear. The present longitudinal analyses therefore teste...
Article
Dispositional optimism and depression have each been independently linked to inflammation. The current study investigated possible independent and interactive (i.e. additive or moderating) associations with inflammation. Analyses explored if such associations varied by health status. Plasma CRP, dispositional optimism, and current depressive sympto...
Article
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Guidelines for prevention of cardiovascular diseases use risk scores to guide the intensity of treatment. A comparison of these scores in a German population has not been performed. We have evaluated the correlation, discrimination and calibration of ten commonly used risk equations in primary care in 4044 participants of the DETECT (Diabetes and C...
Article
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Background: Previous experimental research on testosterone (T) and psychological traits is inconclusive. Thus, we performed the first large-scale observational study of the association between T and dispositional optimism / pessimism. Methods: We used prospective data from 6,493 primary-care patients (3,840 women) of the DETECT study (Diabetes C...
Article
Background:: Depressive disorders are a frequent comorbidity of panic disorder with agoraphobia (PD/AG). Cognitive-behavioral therapy (CBT) for PD/AG effectively reduces anxiety and depressive symptoms, irrespective of comorbidities. However, as depressive comorbidities can confound fear circuitry activation (i.e. amygdalae, insulae, anterior cingu...
Article
Objectives Although clinical evidence suggests important differences between unipolar mania and bipolar‐I disorder (BP‐I), epidemiological data are limited. Combining data from 9 population‐based studies, we compared subjects with mania (M) or mania with mild depression (Md) to those with BP‐I with both manic and depressive episodes with respect to...
Article
Emotional-associative learning represents a translational model for the development, maintenance and treatment of anxiety disorders such as panic disorder (PD). The exact nature of the underlying fear learning and extinction deficits however, remains under debate. Using a three-day paradigm to separate the distinct learning and consolidation proces...
Article
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Increased sympathetic noradrenergic signaling is crucially involved in fear and anxiety as defensive states. MicroRNAs regulate dynamic gene expression during synaptic plasticity and genetic variation of microRNAs modulating noradrenaline transporter gene (SLC6A2) expression may thus lead to altered central and peripheral processing of fear and anx...
Article
Full-text available
Objectives Parkinson’s disease (PD) is the second most common neurodegenerative disorder and is further associated with progressive cognitive decline. In respect to motor phenotype, there is some evidence that akinetic-rigid PD is associated with a faster rate of cognitive decline in general and a greater risk of developing dementia. The objective...
Article
The role of behavioral inhibition (BI), parental rearing, and adverse life events in the development of obsessive–compulsive disorder (OCD) is unresolved. We prospectively examined whether BI and perceived parental rearing predicted the subsequent first onset of OCD and whether BI moderated the association between perceived parental rearing/adverse...