Martin Hautzinger

• University of Tübingen

Objective Establishing robust evidence for psychotherapeutic treatment efficacy is crucial in evidence‐based medicine for mental disorders. Randomized controlled trials (RCTs) are key to minimizing biases such as selection effects and baseline imbalances between study groups. However, another challenge to robust evidence in psychotherapy research i...

Bipolar disorder is a leading contributor to the global burden of disease¹. Despite high heritability (60–80%), the majority of the underlying genetic determinants remain unknown². We analysed data from participants of European, East Asian, African American and Latino ancestries (n = 158,036 cases with bipolar disorder, 2.8 million controls), combi...

Psychotherapies are efficacious in the treatment of depression, albeit only with a moderate effect size. It is hoped that personalization of treatment can lead to better outcomes. The network theory of psychopathology offers a novel approach suggesting that symptom interactions as displayed in person‐specific symptom networks could guide treatment...

Background The German multicenter research consortium BipoLife aims to investigate the mechanisms underlying bipolar disorders. It focuses in particular on people at high risk of developing the disorder and young patients in the early stages of the disease. Functional and structural magnetic resonance imaging (MRI) data was collected in all partici...

Background: Child maltreatment is a broadly confirmed risk factor for mental and physical illness. Some psychological treatments specifically target mental health conditions associated with child maltreatment. For example, the Cognitive Behavioral Analysis System of Psychotherapy (CBASP) focuses on maladaptive interpersonal behaviours in chronic de...

Background Childhood trauma is a major risk factor for chronic depression. It has been suggested that adults with chronic depression who have experienced childhood trauma may require long-term treatment owing to a breakdown of basic trust and related difficulties in developing a productive therapeutic relationship. Aims As empirical studies have b...

In post war regions, especially in low-income countries, the health care systems often require immediate support. For example, after the terror of the so-called Islamic State of Iraq and Syria (ISIS) in 2014, many internally displaced persons took refuge in the Kurdistan Region of Iraq (KRI). Those displaced by war have had to face the reality that...

Das Lehrbuch stellt die zentralen Inhalte des reformierten Masterstudiengangs Klinische Psychologie und Psychotherapie dar. Eingegangen wird dabei auf alle psychotherapeutischen Richtlinienverfahren, also die Kognitive Verhaltenstherapie, die Systemische Therapie, die Tiefenpsychologisch fundierte Therapie und die Analytische Psychotherapie, sowie...

Background Individuals at risk for bipolar disorder (BD) have a wide range of genetic and non-genetic risk factors, like a positive family history of BD or (sub)threshold affective symptoms. Yet, it is unclear whether these individuals at risk and those diagnosed with BD share similar gray matter brain alterations. Methods In 410 male and female p...

Effect sizes of psychotherapies currently stagnate at a low‐to‐moderate level. Personalizing psychotherapy by algorithm‐based modular procedures promises improved outcomes, greater flexibility, and a better fit between research and practice. However, evidence for the feasibility and efficacy of modular‐based psychotherapy, using a personalized trea...

Background Globally, mental health conditions pose a substantial burden of disease. Despite the availability of evidence-based pharmacological and psychological treatments, the symptoms of a substantial subgroup of patients do not respond to these interventions, and only a minority of patients have access to them. This study aimed to assess the eff...

Importance Physical diseases co-occur with late-life depression (LLD). The influence of physical diseases and the subjective perception of physical health (PPH) on treatment outcome in LLD, however, is not well understood. Objective To assess the association of physical diseases and PPH with the outcomes of 2 different types of psychotherapy in LL...

Structural changes in chronically depressed patients in psychoanalyses compared to cognitive-behavioral longterm psychotherapy

Introduction: In clinical trials, mostly group-level treatment effects of repeated cross-sectional measures are analyzed. However, substantial heterogeneity regarding individual symptom profiles and the variability of treatment effects are often neglected, especially over the long-term course. To provide effective personalized treatments, investiga...

Background: This study aimed to assess the efficacy of ImPuls, a transdiagnostic group exercise intervention, plus treatment as usual (TAU) compared to TAU alone in outpatients with various mental disorders. Methods: In this pragmatic, two-arm, multi-site randomised controlled trial in Germany, 10 outpatient rehabilitative and medical care faciliti...

Background The German multicenter research consortium BipoLife aims to investigate the mechanisms underlying bipolar disorders. It focuses in particular on people at high risk of developing the disorder and young patients in the early stages of the disease. Functional and structural magnetic resonance imaging (MRI) data was collected in all partici...

Verstärkerverlust, dysfunktionale Überzeugungen sowie fehlende Möglichkeiten zur Selektion, Kompensation und Optimierung im Alter können die Entwicklung einer Altersdepression (engl: late-life depression, LLD) begünstigen. Die kognitive Verhaltenstherapie (KVT) bietet durch behaviorale und kognitive Umstrukturierung zahlreiche Möglichkeiten, um Dep...

Importance: Conceptualizing mental disorders as latent entities has been challenged by the network theory of mental disorders, which states that psychological problems are constituted by a network of mutually interacting symptoms. While the implications of the network approach for planning and evaluating treatments have been intensively discussed,...

Background The reduced ability to adaptively respond to stressors (coping) has been proposed as an underlying mechanism across psychopathology. It is associated with a reduced vagally-mediated heart rate variability (vmHRV) at rest and increased perceived stress. The present study investigated the increase in vmHRV and the reduction in perceived s...

Background: Evidence suggests that patients suffering from different mental disorders benefit from exercise pro‑ grams combined with behavior change techniques. Based on this evidence, we have developed an exercise program (ImPuls) specifically designed to provide an additional treatment option in the outpatient mental health care system. The imple...

Introduction: Different psychotherapeutic interventions for late-life depression (LLD) have been proposed, but their evaluation in large, multicenter trials is rare. Objective: The present study evaluated the efficacy of a specific cognitive behavioral therapy (CBT) for LLD (LLD-CBT) in comparison with a supportive unspecific intervention (SUI), bo...

Introduction: In randomized trials, mostly group-level treatment effects of repeated cross-sectional measures are analyzed. However, substantial heterogeneity regarding individual symptom profiles and variability of treatment effects are often neglected, particularly over the long-term course.Objective: Ratings of depression severity over 104 weeks...

By age 18, 22-27% of adolescents have experienced depressive symptoms increasing their risk of peripheral mental health and social issues. Despite the development of effective depression prevention programs, issues related to dissemination persist. This study aims to identify ways of increasing the likelihood of dissemination by a) investigating ho...

Objectives: In bipolar disorder (BD), the alternation of extreme mood states indicates deficits in emotion processing, accompanied by aberrant neural function of the emotion network. The present study investigated the effects of an emotion-centered psychotherapeutic intervention on amygdala responsivity and connectivity during emotional face proce...

Die Erkennung und Behandlung der Depression im höheren Lebensalter (Late-Life Depression, LLD) gewinnt aufgrund der alternden Gesellschaft immer mehr an Bedeutung. Aufgrund der altersspezifischen psychopathologischen Besonderheiten erweist sich die Diagnostik und die Behandlung der Altersdepression mitunter als komplex und herausfordernd. Auch Voru...

Background: Exercise interventions are efficacious in reducing disorder-specific symptoms in various mental disorders. However, little is known about long-term transdiagnostic efficacy of exercise across heterogenous mental disorders and the potential mechanisms underlying treatment effects. Methods: Physically inactive outpatients, with depressiv...

Objectives: In bipolar disorder (BD), the alternation of extreme and sustained positive and negative mood states indicates deficits in emotion processing. These alterations in emotion processing are accompanied by aberrant neural function of the emotion network. Focusing on the amygdala as the central node of this network, the present study aimed t...

Overweight with and without comorbid binge-eating disorder (BED) has been associated with increased reward sensitivity, though evidence is heterogeneous. To disentangle this heterogeneity and gain insights into mechanisms of impaired reward processing, this study applied multi-method neuro-behavioural techniques. Reward sensitivity was investigated...

Objective Psychotherapy of chronic depression has remained a challenge due to limited prognosis and high rates of recurrence. We present 5‐year outcome data from a multicentre trial comparing psychoanalytic (PAT) and cognitive‐behavioural (CBT) long‐term treatments with randomized and preferred allocations analysing symptom (N = 227) and structural...

Zusammenfassung. Theoretischer Hintergrund: Das BDI-II ist ein Selbstbeurteilungsinstrument zur Erfassung des Schweregrads einer Depression. Es liegen kaum Analysen mit Modellen aus der Item-Response-Theorie (IRT) vor. Fragestellung: Wie hoch ist die Messgenauigkeit des BDI-II über die unterschiedlichen Ausprägungen des latenten Traits (Depressivit...

Bipolar disorder (BD) is a complex mood disorder with a strong genetic component. Recent studies suggest that microRNAs contribute to psychiatric disorder development. In BD, specific candidate microRNAs have been implicated, in particular miR-137 , miR-499a , miR-708 , miR-1908 and miR-2113 . The aim of the present study was to determine the contr...

Die aus dem englischen adaptierten Kurzversionen, DAS-18A und DAS-18B, erfassen dysfunktionaler Einstellungen bei depressiv Erkrankten. Sie bestehen aus jeweils 18 Items mit den zwei Subskalen (1) Leistungsbewertung und (2) Anerkennung durch Andere beinhalten. Reliabilität: Die interne Konsistenz beträgt zwischen α = .80 und α = .89 für beide Versi...

Enthält die Fragebögen nebst Auswertungsanleitung. Weitere Informationen in der Dokumentation mit dem gleichlautenden Titel

Objectives In BD, impaired affective theory of mind (aToM) performance and aberrant neural activation in the ToM brain network partly explain social functioning impairments. However, it is not yet known whether psychotherapy of BD influences neuroimaging markers of aToM. Methods In the present study conducted within the multicentric randomized con...

Introduction: In depression treatment, most patients do not reach response or remission with current psychotherapeutic approaches. Major reasons for individual non-response are interindividual heterogeneity of etiological mechanisms and pathological forms, and a high rate of comorbid disorders. Personalised treatments targeting comorbidities as wel...

Background Stressful event exposure, dysfunctional attitudes (DA), negative automatic thoughts (NAT), and declining positive automatic thoughts (PAT) have been associated with depressive relapse/recurrence. Few studies have investigated the course of these variables and their relevance for relapse/recurrence in remitted depression. Methods Followi...

A mindfulness intervention was conducted during the critical and formative phase of teacher training in Germany. This study aims to investigate whether early career teachers benefit from this by better coping with occupational stress and improving their practical teaching skills. In a quasi-experimental design, 42 participants’ stress, mindfulness,...

Background: COVID-19-related confinements pose a threat to mental health. We investigated prevalence rates of symptoms of depression, generalized anxiety and insomnia in German adults. Furthermore, we explored associations of exercise behavior with disorder-specific symptoms and assessed whether specific affect regulation skills enhance the effect...

A mindfulness intervention was conducted during the critical and formative phase of teacher training in Germany. This study aims to investigate whether early career teachers benefit from this by better coping with occupational stress and improving their practical teaching skills. In a quasi-experimental design, 42 participants' stress, mindfulness,...

Background This systematic review and meta-analysis assesses the efficacy of regular, moderate to vigorous physical activity (MVPA) for attention deficit hyperactivity disorder (ADHD) in children and adolescents in randomized controlled trials (RCTs). Methods RCTs including children and adolescents with clinically diagnosed ADHD, implementing regu...

Adolescent girls, independent of their migration background, and adolescent boys, specifically with a migration background, experience more depressive symptoms than boys without a migration background. Adolescent girls also benefit more from depression prevention programs than boys. However, no studies have examined the role of migration background...

Objectives: Impairments in social cognitive processes are discussed as a vulnerability factor for bipolar disorder (BD). Previous studies demonstrated aberrant neural activation in brain areas related to theory of mind (ToM) and impaired affective ToM (aToM) task performance in BD. However, it is yet unknown whether successful psychotherapy of BD i...

Background Bipolar disorder is one of the most severe mental disorders. Its chronic course is associated with high rates of morbidity and mortality, a high risk of suicide and poor social and occupational outcomes. Despite the great advances over the last decades in understanding mental disorders, the mechanisms underlying bipolar disorder at the n...

Background Mental disorders are prevalent and cause considerable burden of disease. Exercise has been shown to be efficacious to treat major depressive disorders, insomnia, panic disorder with and without agoraphobia and post traumatic stress disorder (PTSD). Methods This pragmatic, two arm, multi-site randomised controlled trial will evaluate the...

Introduction: In depression treatment, most patients do not reach response or remission with current psychotherapeutic approaches. Major reasons for individual non-response are interindividual heterogeneity of etiological mechanisms and pathological forms, and a high rate of comorbid disorders. Personalised treatments targeting comorbidities as wel...

The founder of CBASP, James McCullough assumed that the interpersonal problems, which chronically depressed patients often experience, and which can fuel into the severity of the depression, have their roots in childhood maltreatment. These interpersonal problems also impair the relationship between patient and therapist and thereby impede effectiv...

Successful emotion regulation plays a key role in psychological health and well-being. This study examines (1) whether cognitive control and corresponding neural connectivity are associated with emotion regulation and (2) to what extent external instructions can improve emotion regulation in individuals with low vs. high cognitive control capacity....

Abstract Background Exercise efficaciously reduces disorder-specific symptoms of psychiatric disorders. The current study aimed to examine the efficacy of a group exercise intervention on global symptom severity and disorder-specific symptoms among a mixed outpatient sample. Methods Groups of inactive outpatients, waiting for psychotherapy, with de...

Mind-body exercises such as Yoga or Qi Gong have demonstrated a wide range of health benefits and hold great promise for employment in clinical practice. However, the psychophysiological mechanism underlying these effects remains unclear. Theoretical frameworks highlight regulation as a characteristic and specific mechanism of mind-body exercise fo...

Bipolar disorder is a heritable mental illness with complex etiology. We performed a genome-wide association study of 41,917 bipolar disorder cases and 371,549 controls of European ancestry, which identified 64 associated genomic loci. Bipolar disorder risk alleles were enriched in genes in synaptic signaling pathways and brain-expressed genes, par...

Zusammenfassung: Das Cognitive Behavioral Analysis System of Psychotherapy (CBASP) ist einer der vielversprechendsten Ansätze als störungsspezifisches Psychotherapieverfahren für chronische Depression. Um die kurz-und langfristige Wirksamkeit von CBASP beurteilen zu können, liegen bislang jedoch nicht genügend Studienergebnisse mit ausreichend lang...

Background: Bipolar disorder is one of the most severe mental disorders. Its chronic course is associated with high rates of morbidity and mortality, a high risk of suicide and poor social and occupational outcomes. Despite the great advances over the last decades in understanding mental disorders, the mechanisms underlying bipolar disorder at the...

Objective This study explored whether treatment outcomes in a trial on the Cognitive Behavioral Analysis System of Psychotherapy (CBASP) vs. Supportive Psychotherapy (SP) for patients with early-onset chronic depression differ between alliance patterns. Method Session-to-session ratings of the therapeutic alliance (Helping Alliance Questionnaire (...

Importance: In the treatment of persistent depressive disorder (PDD), disorder-specific Cognitive Behavioral Analysis System of Psychotherapy (CBASP) has been shown to be superior to Supportive Psychotherapy (SP) in outpatients. It remains to clear which subgroups of patients benefit equally and differentially from both psychotherapies. Objective:...

Background Bipolar disorders are serious illnesses with a chronic course and a high rate of relapse. Typically, bipolar disorders onset during adolescence or early adulthood, with patients experiencing significant personal and social costs as a consequence of their illness. Despite this, to date, there is limited (controlled) evidence regarding the...

Bipolar disorder (BD) is a heritable mental illness with complex etiology. We performed a genome-wide association study (GWAS) of 41,917 BD cases and 371,549 controls, which identified 64 associated genomic loci. BD risk alleles were enriched in genes in synaptic and calcium signaling pathways and brain-expressed genes, particularly those with high...

Background: fear of falling and reduced fall-related self-efficacy are frequent consequences of falls and associated with poorer rehabilitation outcomes. To address these psychological consequences, geriatric inpatient rehabilitation was augmented with a cognitive behavioural intervention ("Step by Step") and evaluated in a RCT. Methods: one hun...

Objective Physical exercise is associated with many health benefits. Especially for older adults it is challenging to achieve an appropriate adherence to exercise programs. The outcome expectations for exercise scale 2 (OEE-2) is a 13-item self-report questionnaire to assess negative and positive exercise outcome expectations in older adults. The a...

Introduction: Social distancing and quarantine measures applied during the COVID-19 pandemic might result in mental health problems. In this cross-sectional study we examined if perceived social support, exercise in minutes per week and change in exercise are protective factors regarding symptoms of depression, anxiety, and sleeping disorders. Meth...

Background: Looking back at more than 40 years of depression research including over 500 randomized trials, the efficacy of depression treatment is still unsatisfactory with less than half of the patients meeting criteria for response / remission (e.g. Cuijpers et al., 2014), and a high chronicity rate of up to 30% (e.g. Murphy & Byrne, 2012). In o...

Regelmäßige sportliche Aktivität wirkt sich nicht nur auf das körperliche Wohlbefinden aus, sondern hat auch positive Effekte auf die psychische Verfassung. Sport verringert bei Depressionen, Angststörungen, Schlafstörungen und ADHS die Symptomatik deutlich. Trotz dieser klinisch relevanten Effekte gibt es bisher vor allem im ambulanten Versorgungs...

Background: Childhood maltreatment (CM) predicted poorer outcomes in acute depression treatment with CBT, IPT and Supportive Psychotherapy (SP). The Cognitive Behavioral Analysis System of Psychotherapy (CBASP) fared well in patients with chronic depression and CM during acute treatment, yet there is a considerable lack of empirical evidence for lo...

Dans le monde entier, la pression exercée sur la psychanalyse pour qu’elle prouve les résultats de ses traitements à l’aune des critères dits « fondés sur des preuves » ( evidence based medecine ) a augmenté. Tandis qu’un grand nombre d’études sur les résultats des thérapies psychanalytiques brèves est maintenant disponible, de telles études font g...

Since the first publication of the guideline in 2012, which included critically reviewed evidence up to 2010, several hundred articles with new evidence were published and some topics of the clinical consensus needed to be reconsidered. Therefore, it was urgently necessary to revise the guideline to bring them up to date. In this article important...

Background: Late-life depression (LLD) is one of the most prevalent mental disorders in old age. It is associated with various adverse outcomes and frequent use of health care services thereby remaining a serious public health concern. Compared with depression in early adulthood, most treatment options of LLD are less effective. Psychotherapy may...

Die Entgegnung auf den Beitrag von Kaiser et al. betrifft die erste kontrollierte Psychotherapiestudie, die psychoanalytische und kognitiv-verhaltenstherapeutische Langzeitpsychotherapien mit randomisierter und präferierter Zuweisung miteinander vergleicht. In 4 Behandlungszentren wurden 554 chronisch depressive Patienten interviewt, von denen 252...

Does the pre-treatment profile of individuals with persistent depressive disorder (PDD) moderate their benefit from disorder-specific Cognitive Behavioral System of Psychotherapy (CBASP) versus supportive psychotherapy (SP)? We investigated this question by analyzing data from a multi-center randomized clinical trial comparing the effectiveness of...

Objectives A recent trial comparing Cognitive Behavioral Analysis System of Psychotherapy (CBASP) and supportive psychotherapy in chronic depression found CBASP to be more effective in treating depressive symptoms. We aimed to evaluate adverse events that occurred during this trial. Materials and Method A randomized trial of chronically depressed...

Objectives: Reward sensitivity is suggested to be an influence on the onset and reoccurrence of bipolar disorder (BD) in observational longitudinal studies. The current study examined whether reward sensitivity predicted the recurrence of mood episodes in a treatment seeking sample. We also explored if reward sensitivity moderated treatment outcom...

Over the last decade, the concept of Subjective Vitality has gained popularity as one indicator of human well-being. However, today no valid instrument exists to measure Subjective Vitality in German speaking samples. To close this gap, we validated a German trait and state version of the Subjective Vitality Scale (Ryan and Frederick 1997). Study o...

Chronically depressed individuals have a high suicide risk. However, it is an open question whether previously observed risk factors for suicide attempts also apply to chronic depression or whether there are specific risk factors related to chronic-recurrent illness. We drew from a large group of chronically depressed individuals seeking psychother...

Background Depression often remains undiagnosed or treated inadequately. Web-based interventions for depression may improve accessibility of treatment and reduce disease-related costs. This study aimed to examine the potential of the web-based cognitive behavioral intervention “deprexis” in reducing disease-related costs. Methods Participants with...

Background: Evidence on the long-term efficacy of psychotherapeutic approaches for chronic depression is scarce. Objective: To evaluate the effects of the Cognitive Behavioral Analysis System of Psychotherapy (CBASP) compared to Supportive Psychotherapy (SP) 1 year and 2 years after treatment termination. Methods: In this study, we present 1-...

Bipolar disorder is a highly heritable psychiatric disorder. We performed a genome-wide association study (GWAS) including 20,352 cases and 31,358 controls of European descent, with follow-up analysis of 822 variants with P < 1 × 10−4 in an additional 9,412 cases and 137,760 controls. Eight of the 19 variants that were genome-wide significant (P <...

High levels of expressed emotions (EE) reflect the amount of criticism and/or over-involvement in families and has been linked to relapse risk in various psychiatric disorders including bipolar disorder (BD). Less clear is which factors contribute to the development and/or maintenance of EE. Therefore, we tested whether patient characteristics, spe...

Zusammenfassung Nur etwa die Hälfte derjenigen, die an einer depressiven Störung leiden, sucht auch eine Behandlung auf. Selbstmanagement Interventionen sind eine Möglichkeit, diese Behandlungslücke zu reduzieren. Diese Interventionen basieren meist auf evidenzbasierten Techniken der Kognitiven Verhaltenstherapie, welche statt durch einen Therapeut...