Marc Walter

University of Basel | UNIBAS

Background To date, there are no official diagnostic criteria for the frequently reported phenomenon of exercise addiction. Therefore, the aim of the present study was to investigate how mental disorders, specifically depression and attention-deficit hyperactivity disorder (ADHD), are related to exercise addiction (EA). Methods A total of 173 part...

Background Exercise dependence (ED) is characterised by behavioural and psychological symptoms that resemble those of substance use disorders. However, it remains inconclusive whether ED is accompanied by similar brain alterations as seen in substance use disorders. Therefore, we investigated brain alterations in individuals with ED and inactive co...

Background As the most commonly used illicit substance, cannabis is gaining global acceptance through increasing legalization efforts. This shift intensifies the need for research to guide policymakers and healthcare providers in harm reduction and treatment strategies. Nonetheless, the relationship between psychopathological symptoms and cannabis...

Background Clinical data are usually analyzed with the assumption that knowledge gathered from group averages applies to the individual. Doing so potentially obscures patients with meaningfully different trajectories of therapeutic change. Needed are “idionomic” methods that first examine idiographic patterns before nomothetic generalizations are m...

The Self and Interpersonal Functioning Scale (SIFS) is a 24-item self-report questionnaire assessing personality functioning according to the alternative DSM-5 model for personality disorders. We evaluated the German SIFS version in a total sample of 886 participants from Germany and Switzerland. Its factor structure was investigated with confirmat...

In Europe, the annual prevalence of cannabis use was most recently 7,7 %. A bidirectional relationship is known for depression and cannabis use. In order to be prepared for the potential impact of regulated access to cannabis, there is a high need to better understand its links with psychological disorders. The following study addresses the questi...

Background: People at risk of exercise addiction report increased symptoms of psychopathology. The aim of this study was to clinically assess the lifetime prevalence of depressive disorders in individuals at risk of exercise addiction and to determine whether depressive symptoms tend to precede or follow excessive exercising. Methods: Based on the...

Das gleichzeitige Auftreten psychischer Störungen bei Personen mit einer Suchterkrankung beziehungsweise «Doppeldiagnosen» ist eine besondere klinische Problemstellung bei der Behandlung von Suchterkrankungen (15). Da der Substanzkonsum in der Regel im Jugendalter beginnt und dort seinen Höhepunkt erreicht, geht die Behandlung dieser Patientengrupp...

Objective: Patients suffering from psychological disorders report decreased quality of life and low mood. The relationship of these symptoms to daily upsetting events or environments, and in the context of active coping mechanisms is poorly understood. The present study thus investigates the association between mood, psychological flexibility, ups...

Introduction: There is considerable effort in legalizing recreational use of cannabis globally. The successful implementation of a program of regulated access to recreational cannabis (PRAC) depends on the consumers' engagement. The aim of this study was to examine the acceptability of twelve different regulatory aspects by cannabis users includin...

Introduction: Treatment non-response occurs regularly, but psychotherapy is seldom examined for such patients. Existing studies targeted single diagnoses, were relatively small, and paid little attention to treatment under real-world conditions. Objective: The Choose Change trial tested whether psychotherapy was effective in treating chronic pat...

Impulsivity transcends psychiatric diagnoses and is often related to anhedonia. This ad hoc cross-sectional investigation explored 1) whether self-reported trait impulsivity mapped onto a common structural brain substrate across healthy controls (HCs) and psychiatric patients, and 2) in a more exploratory fashion, whether impulsivity and anhedonia...

Background: Clinical data are usually analyzed with the assumption that knowledge gathered from group averages applies to the individual. Doing so potentially obscures patients with meaningfully different trajectories of therapeutic change. Needed are “idionomic” methods that first examine idiographic patterns before nomothetic generalizations are...

Background Cannabis is the most widely used illicit substance. Various countries have legalized cannabis for recreational use. Evidence on the health effects of cannabis regulation remains unclear and is mainly based on observational studies. To date, there is no randomized controlled study evaluating the impact of cannabis regulation for recreatio...

New treatment approaches for opioid-dependent patients include injectable opioid agonist treatment with diacetylmorphine. While evidence has shown beneficial clinical effects of diacetylmorphine, it is still not clear how long-term diacetylmorphine treatment affects the brain and whether functional brain changes are accompanied by clinical improvem...

Trotz des vorherrschenden Verbots ist der Cannabiskonsum weit verbreitet, die Sicherheit der Konsumierenden nicht gewährleistet und der Schwarzmarkt blüht. Angesichts dieser unbefriedigenden Situation haben vereinzelte Länder alternative Modelle im Umgang mit Cannabis eingeführt. Bisherige Forschungsarbeiten zu den Auswirkungen einer Cannabisreguli...

Zusammenfassung In der Klinik kommen Suchterkrankungen bei Patient:innen mit Persönlichkeitsstörungen häufig vor. Bei etwa jeder zweiten Persönlichkeitsstörung kann eine komorbide Suchterkrankung diagnostiziert werden. Bei Patient:innen mit einer Drogenabhängigkeit scheint eine komorbide Persönlichkeitsstörung etwas häufiger als bei der Alkoholabhä...

In der Schweiz sterben jeden Tag zwei bis drei Menschen infolge Suizid. Mehr als die Hälfte dieser Menschen haben kurz vor ihrem Tod Alkohol oder eine andere Substanz zu sich genommen, etwa ein Viertel hat im Lauf des Lebens aufgrund einer Suchterkrankung eine Behandlung erhalten. Es ist deshalb wichtig, dieser speziellen Risikogruppe mit besondere...

Der Zusammenhang von Alkoholkonsum und Einsamkeit ist mehrdimensional. Basierend auf der qualitativen Auswertung von 20 Interviews mit Patient*innen mit Alkoholabhängigkeit wird gezeigt, dass dieser Zusammenhang erstens eine reziproke, kausale Beziehung von Einsamkeit und Alkoholkonsum umfasst und zweitens ohne Bezugnahme auf die Bedeutung des Alko...

People with alcohol use disorders (AUD) have a five to ten times higher risk of dying by suicide compared to the general population. Particularly critical is the fact that up to 20 % of patients show suicidal behaviour even after treatment. Suicidality is thus a significant clinical problem in this high-risk population that requires careful evaluat...

Background: Physical exercise has significant benefits for mental and physical health. The Federal Office of Public Health in Switzerland defined exercise as a medium-term treatment goal in the manual of heroin-assisted treatment. Methods: Sixty-four opioid agonist treatment providers and specialized psychosocial treatment centers across the German...

Meaningful relationships are centrally important for human functioning. It remains unclear, however, which aspects of meaningful relationships impact wellbeing the most and whether these differ between psychiatric patients and members of the community. Information about relationship attributes and functions were collected in community members (N =...

Der Wechsel vom stationären in das ambulante Setting stellt für Betroffene mit psychischen Störun- gen eine kritische Übergangszeit dar, in der es häufig zu Rückfällen, suizidalen Krisen oder Rehospitalisierungen kommt. Vielen Patienten steht nach einem stationären Aufenthalt nicht unmittelbar ein ambulanter Therapieplatz zur Verfügung, und Nachsor...

Background Heroin-assisted treatment has proven effective in reducing criminal offenses in opioid dependent individuals. Few studies attempted to explain the observed crime reduction and the reasons why these patients keep offending and getting incarcerated have to date not been explored. Methods Patients with a history of incarcerations during th...

Adolescence and emerging adulthood are often referred to as youth. Transitional psychiatry addresses this target group, which considers patients between 15 and 25 years of age. Substance use usually begins and peaks at this stage of life. Psychiatric disorders, foremost attention-deficit/hyperactivity disorder, and affective disorders, conduct diso...

Die unter dem Begriff Zwang subsumierten Störungsbilder gelten fälschlicherweise als seltene psychische Krankheiten. Tatsächlich leiden mehr als 3 % der Bevölkerung unter Zwangsstörungen. Nebst der ausgeprägten Scham von Betroffenen, die hohen Leidensdruck bedingt, wird diese Störung oftmals nicht oder falsch erkannt. Zudem hält sich auch in Fachkr...

Background Exercise addiction is increasingly being recognized as a psychologically and physically burdensome set of symptoms. However, little is known about the psychiatric profiles of individuals who are at risk. It is well-established that individuals affected by substance use disorders frequently suffer from depression, attention deficit hypera...

Zusammenfassung: Das Thema Hypersexualität (auch, bekannt als zwanghafte sexuelle Verhaltensstörung), hat in den letzten Jahren zunehmend Aufmerksamkeit erhalten. Insbesondere während der weltweiten Covid-19-Pandemie und den regionalen Lockdowns wurde ein Anstieg der Nutzung verschiedener Internetseiten mit pornografischem Inhalt und vermehrter pro...

Sind bei Notfällen Drogen oder Alkohol im Spiel und/oder ist der Patient verwirrt, erregt, desorientiert, traumatisiert oder suizidal, dann ist dies für den Arzt oder das Rettungsteam oft eine besonders schwierige Situation: Wie können Sie die zugespitzte Notfall-Situation deeskalieren und was können, müssen und dürfen Sie in der bedrohlichen Akuts...

Individuelle Persönlichkeitseigenschaften sind an der Entwicklung einer Suchterkrankung beteiligt. Gefährdet sind Personen mit Selbstwertproblemen und Schwierigkeiten in der Emotionsregulation, häufig geht damit auch eine Persönlichkeitsstörung einher. Die Diagnose einer Komorbidität von Persönlichkeitsstörung und Sucht hat Auswirkungen auf die The...

Introduction: Opioid agonist treatment (OAT) is the first-line treatment for opioid dependence. Currently available OAT options comprise oral (methadone and morphine) and sublingual (buprenorphine) routes of administration. In Switzerland and some other countries, severely opioid-dependent individuals with insufficient response to oral or sublingu...

The third edition of the Oxford Textbook of Endocrinology and Diabetes is an up-to-date, objective and comprehensive text that covers the full scope of endocrinology and diabetes. It contains wide ranging and pragmatic advice on diagnosis and clear guidelines for recommended management, while also covering the scientific principles that underlie th...

Background and Aims: Exercise addiction has not yet been designated as an addictive disorder in the DSM-5 due to a lack of detailed research. In particular, associations with other psychiatric diagnoses have received little attention. In this study, individuals with a possible exercise addiction are clinically assessed, in order to establish a prof...

Background Iboga and its primary alkaloids, ibogaine and noribogaine, have been of interest to researchers and practitioners, mainly due to their putative efficacy in treating substance use disorders (SUDs). For many SUDs, still no effective pharmacotherapies exist. Distinct psychoactive and somatic effects of the iboga alkaloids set them apart fro...

Heroin-assisted treatment comprises the use of diacetylmorphine (pharmaceutical heroin) for individuals with severe opioid use disorder. In Switzerland, take-home doses in heroin-assisted treatment are more strictly regulated as compared to conventional opioid agonist treatment. In light of the COVID-19 pandemic, the Swiss Federal Council provision...

Cannabis use is widespread in society and it is the most used illicit substance in Europe. Due to the ongoing public discourse about thepharmaceutical use of cannabis as well as continuing changes in the regulations of non-medical cannabis use current studies and literature on the subject become even more relevant. For this narrative review the Pub...

Cannabis law reform is subject to the current public discourse as cannabis use is a social reality in many countries. Cannabis prohibition has not been able to reduce cannabis consumption sustainably, while it is associated with high health and social costs. Therefore, various countries have begun to implement new forms of cannabis policies – movin...

Objective Difficulties in the assessments of Somatoform Disorders (SD) and Personality Disorders (PD) regarding operationalization, arbitrary thresholds, and reliability led to a shift from categorical to dimensional models in the DSM-5. Empirical research data postulates a continuous level of severity in both groups of diseases. The aim of this sy...

Psychological flexibility is increasingly studied in various contexts including clinical studies. The construct has been hypothesized to be a major determinant of mental health. Existing measures lack context-sensitivity (e.g, implicitly measuring it as a trait) and/or reference to a limited time frame. We developed a short self-report measure that...

Anhedonia has been associated with abnormal reward-related striatal dopamine functioning in patients with different psychiatric disorders. Here, we tested whether anhedonia expression mapped onto striatal volume across several psychiatric diagnoses. T1-weighted images from 313 participants including 89 healthy controls (HC), 22 patients with opioid...

Background: Recently proposed alternative dimensional models of personality disorder (PD) place the severity of impairments in self and interpersonal functioning at the core of personality pathology. However, associations of these impairments with disturbances in social, cognitive, and affective brain networks remain uninvestigated. Methods: The pr...

ZUSAMMENFASSUNG Dank verbesserter Behandlungsmöglichkeiten opioidabhängiger Menschen ist ein Anstieg der Zahl älterer Patienten in Opioid-Agonistentherapie (OAT) zu verzeichnen. Insgesamt verbesserte sich die Lebenserwartung dieser Patienten in den letzten Jahren deutlich und das Durchschnittsalter der Patienten in OAT nahm zu. Bei den über 50-jähr...

Seit über 25 Jahren existiert in der Schweiz die heroingestützte Behandlung für schwer opioidabhängige Patient*innen. Pharmazeutisches Heroin (Diacetylmorphin, DAM) wird dabei in spezialisierten Behandlungszentren in intravenöser und oraler Form verabreicht. Die Veränderung der Konsumformen von Straßenheroin und das steigende Durchschnittsalter her...

Shopping is and has long been an important part of everyday life. In the context of the current pandemic (COVID-19), shopping addiction is becoming an increasingly important topic in research. Its different forms make the topic so pervasive. The focus of this work is on shopping addiction as a behavioral addiction. This brief review focuses on diag...

The treatment of patients with schizophrenia and substance use disorder poses a challenge for clinicians. Continued use of cannabis and cocaine can exacerbate psychotic symptoms and worsen the course of disease. To date, no pharmacotherapy is available for patients with cannabis use disorder (CUD). Cannabidiol (CBD) and Δ9-tetrahydrocannabinol (THC...

Alcohol has widespread effects on the endocrine system, potentially impairing endocrine function. Endocrine dysfunction observed in alcoholism, not only results from hepatic failure or chronic malnutrition, but also from direct, toxic actions of alcohol on the endocrine organs themselves as well as interferences with endocrine regulation at the hyp...

Background: Despite increasing demand for treatment among cannabis users in many countries, most users are not in treatment. Internet-based self-help offers an alternative for those hesitant to seek face-to-face therapy, though low effectiveness and adherence issues often arise. Objective: Through adherence-focused guidance enhancement, we aimed to...

Background Movement is a basic component of health. Little is known about the spatiotemporal movement of patients with mental disorders. The aim of this study was to determine how spatiotemporal movement of patients related to their symptoms and wellbeing. Method A total of 106 patients (inpatients ( n = 69) and outpatients ( n = 37)) treated for...

Background Impulsivity is a central symptom of borderline personality disorder (BPD) and its neural basis may be instantiated in a frontoparietal network involved in response inhibition. However, research has yet to determine whether neural activation differences in BPD associated with response inhibition are attributed to attentional saliency, whi...

Background: The model of neuroinflammation has been proposed as a possible explanation of depression. Investigations of serum levels of tumor necrosis factor-α (TNF-α) in depressed patients have previously shown contradictory results of increased and decreased levels of TNF-α during the treatment of depression. Methods: We compared the serum lev...

Zusammenfassung Einleitung Die Alkoholabhängigkeit ist eine chronisch-rezidivierende Abhängigkeitserkrankung. Für verschiedene Behandlungsformen konnte eine positive Wirksamkeit auf den Verlauf der Erkrankung nachgewiesen werden. Die subjektive Sicht der Patienten auf ihre Erkrankung und die angebotenen Behandlungen ist bislang noch wenig untersuch...

Evidence suggests that narcissism and borderline personality disorder are associated with each other. This naturalistic study investigated the predictive value of grandiose and vulnerable narcissism on the development of the therapeutic alliance in short‐term psychodynamic treatment across 12 weeks. The sample consisted of 99 patients with borderli...

Online or internet gaming disorder (IGD) is currently not recognized as a mental disorder in the actual Diagnostic and Statistical Manual of Mental Disorders (DSM-5), although it is an emerging disease. Non-substance-related addictions often have similarities with substance addictions. It is therefore important to have a good understanding of the c...

Background: Individuals suffering from major depressive disorder (MDD) often describe workplace-related stress as one of the main causes of their disorder. Here, we present the story of a 33 year old “Bob” (a pseudonym) who suffered from a moderate (Hamilton-21 = 18) major depressive episode. Workplace-related stress seemed to be the main stressor...

Attention-deficit and hyperactivity disorder (ADHD) is a widespread neurodevelopmental disorder in children and adolescents, persisting into adulthood in a majority of them. ADHD and substance use disorders (SUDs) commonly co-occur in the clinical adult population. The higher-than-normal prevalence rates of SUDs in people with ADHD indicate increas...

BACKGROUND Despite increasing demand for treatment among cannabis misusers in many countries, most misusers are not in treatment. Internet-based self-help offers an alternative for those hesitant to seek face-to-face therapy, though low-effectiveness and adherence issues often arise. Through adherence-focused guidance enhancement (AFGE), we aimed t...

Background Despite increasing demand for treatment among cannabis users in many countries, most users are not in treatment. Internet-based self-help offers an alternative for those hesitant to seek face-to-face therapy, though low effectiveness and adherence issues often arise. Objective Through adherence-focused guidance enhancement, we aimed to i...

Background Many individuals with borderline personality disorder (BPD) perceive emotional expressions in faces intended to convey no emotion and display a heightened sensitivity to facial expressions conveying threat, such as fear. In BPD, the amygdala activates in response to ambiguous and threatening facial expressions, although the differential...

Zusammenfassung Einleitung: Die Alkoholabhängigkeit ist eine chronisch-rezidivierende Abhängigkeitserkrankung. Die Mehrheit der alkoholabhängigen Patientinnen und Patienten wird aber durch die derzeit verfügbaren Therapien nicht ausreichend erreicht. Insgesamt ist die subjektive Sicht der Betroffenen auf den Alkohol und die verschiedenen Therapien...

Background and Aims: While a number of studies have reported on individuals who exercise excessively, and feel unable to stop despite negative consequences, there is still insufficient evidence to categorize exercise as an addictive disorder. The aim of this meta-review is to summarize the published articles and to compile a list of symptoms report...

Introduction Exercise addiction is one of several behavioral addictions which has not yet been designated as an addictive disorder in the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5). This is in part due to a lack of clarity concerning co-occurring mental disorders of individuals at risk for exercise addiction. The aim of this re...

Despite the preponderance of treatment outcome predictors in patients with borderline personality disorder (BPD), the predictive value of measures of impulsiveness is inconclusive. This naturalistic study consecutively included hospitalized patients with BPD (N = 99) who underwent a standardized and structured 12-week inpatient treatment program, w...

A 39-year-old female patient suffering from severe, treatment-resistant depression and other symptoms associated with a complex personality disorder was admitted to our open psychiatric ward for an experimental treatment with lysergic acid diethylamide (LSD). The substance was administered in repeated weekly and ascending doses. Curiously, there we...

Clinical research has demonstrated the efficacy of injectable opioid treatment for long-term, treatment-refractory opioid-dependent patients. It has been hypothesized that compulsive drug use is particularly associated with neuroplasticity changes in the networks corresponding to withdrawal/negative affect and preoccupation/antici-pation rather tha...

Background In this controlled naturalistic study performed in healthcare workers we examined the effect of a two-day acceptance commitment therapy (ACT) workshop on work presence and productivity, i.e. the influence the workshop had on treatment efficacy in a routine hospital care setting. Aim To examine the influence of ACT on productivity and pr...

Open doors in psychiatry have been a subject of controversy in recent years. While some studies postulate the clinical necessity of closed doors, others challenge the theoretical advantages of this setting, mention numerous drawbacks of closed wards, and focus on the advantages of open-door settings. With regard to patients diagnosed with substance...

Background The purpose of the present study was threefold: first, to investigate the facial affective behavior in patients with a borderline personality disorder (BPD); second, to examine whether these patients could be divided into clusters according to facial affective behavior; and third, to test whether these clusters would influence the inpati...

Einleitung: Bewegungssucht, wie auch andere Verhaltenssüchte, gewinnt aktuell an Bedeutung in der wissenschaftlichen Literatur. Aufgrund mangelnder aussagekräftiger Studien ist das Phänomen jedoch noch nicht als psychische Störungen definiert; neue Erkenntnisse werden aber schrittweise generiert. Der vorliegende Übersichtsartikel fasst die Forschun...

Narzisstische Phänomene erregen seit langer Zeit großes wissenschaftliches und gesellschaftliches Interesse. In diesem Buch wird der Narzissmus von seinen normalen Ausdrucksformen bis hin zu den schweren narzisstischen Störungen nachgezeichnet. Dabei wird auf den beachtlichen Wandel fokussiert, dem der Narzissmus unterworfen war und ist. Dieser Wan...

Aims: Childhood trauma is of importance for the manifestation of substance-related disorders and maintenance of hypothalamic-pituitary-adrenal (HPA)-axis disorders. Since stress plays a crucial role in opioid compliance and craving, we investigated the immediate effects of diacetylmorphine application on the HPA axis. In particular, adrenocorticot...

Die MBT ist ein evidenzbasiertes, schulenübergreifendes Psychotherapieverfahren, das in ambulanter Einzel- und Gruppentherapie sowie stationärer und teilstationärer Psychotherapie Anwendung findet. Sie wurde für Borderline-und andere Persönlichkeitsstörungen entwickelt, eignet sich aber auch für die Behandlung von Patienten mit Depressionen, Essstö...

Background/Objective The manifestation of functional impairment in patients’ daily lives and interference with things they value is poorly understood. If values are compromised in patients, as theory suggests, social contexts (and the lack thereof) are especially important – though this is currently unexplored. We therefore examined whether daily v...