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Introduction
Additional affiliations
February 1992 - June 2016
Independent Researcher
Position
- Managing Director
April 1982 - August 1982
March 1979 - February 1992
Education
March 1979 - February 1992
Publications
Publications (187)
This article summarizes the current state of research with respect to the new obsessive-compulsive and related disorders (OCRD) grouping according to the International Statistical Classification of Diseases and Related Health Problems (ICD-11) and the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The ICD-11 grouping of OCRD is base...
In adult patients with obsessive-compulsive disorder (OCD), altered DNA methylation has been discerned in several candidate genes, while DNA methylation on an epigenome-wide level has been investigated in only one Chinese study so far. Here, an epigenome-wide association study (EWAS) was performed in a sample of 76 OCD patients of European ancestry...
Objective
Previous research has shown reduced interoceptive accuracy (IAcc) in depression. Attention deficit represents a key symptom of depression. Moreover, IAcc is positively correlated with attention. There is no study that investigates the effect of depression on IAcc and attention. The aim of this study is to examine the mediating effect of I...
Treatment resistance is common in obsessive-compulsive disorder (OCD) and associated with a significant burden for the individual patient. Accordingly, the identification of biomarkers as early predictors of the clinical response has become a central goal in the search for more efficacious and personalized treatments. Epigenetic mechanisms such as...
Introduction: Obsessive-compulsive disorder (OCD) is associated with high chronicity and treatment resistance, indicating the need for early therapy response markers enabling fast and personalized treatment adaptations. Although epigenetic mechanisms such as DNA methylation of the oxytocin receptor (OXTR) gene have previously been linked to OCD pat...
Background: Motor function is deficient in many patients with obsessive–compulsive disorder (OCD), especially in the face. To investigate subtle motor dysfunction, kinematical analysis of emotional facial expressions can be used. Our aim was to investigate facial movements in response to humorous film stimuli in OCD patients.; Method: Kinematical a...
Background:
Epigenetic markers such as DNA methylation of the monoamine oxidase A (MAOA) gene have previously been shown to be altered in anxiety- and stress-related disorders and to constitute a potential mechanism of action of psychotherapeutic interventions such as cognitive-behavioral therapy (CBT) in these disorders. The present study for the...
Interoception is impaired in different psychiatric disorders and is also associated with emotions. Only one study could show a higher interoceptive accuracy (IAcc) in patients with obsessive-compulsive disorder (OCD). Based on the predictive coding system we assume contrary results, indicating a decreased IAcc in patients with OCD. So far, there is...
Aims: It Is generally assumed but not sufficiently proved that burnout patients tend to have intense problems saying "no" and being exploited by others more easily. In this study, it is investigated whether higher scores of submissiveness and exploitability co-occur together with higher burnout scores. Thus, prevention and intervention could target...
Background:
Mounting evidence indicates the presence of structural brain alterations in individuals with obsessive-compulsive disorder (OCD). Findings are, however, rather heterogeneous, which may be partly because of differences in methodological approaches or clinical sample characteristics. The aim of the present study was to analyze the whole...
Objective
Previous studies report reduced interoceptive abilities in anorexia nervosa (AN) using various methods. Recent research suggests that different levels of interoceptive processes aiming at different subdomains of interoceptive abilities must be further distinguished as these levels can be differentially affected. Two important levels refer...
Background
Previous studies hypothesized that neurodevelopmental risk factors may play a role in the pathogenesis of obsessive-compulsive disorder (OCD). Cortical folding has been shown to be a reliable indicator for normal and altered neurodevelopment, but in OCD it has barely been investigated up to now. The present study investigates whether alt...
Background: The amygdala is known to be involved in anxiety processing, but its role in the psychopathology of obsessive-compulsive disorder (OCD) is still unclear.
Aims: In this MRI study we investigated potential alterations in structural and functional connectivity of the amygdala in 42 adult patients with OCD and 37 healthy subjects.
Method: Ps...
Background: Interoceptive abilities are known to be affected in anorexia nervosa (AN). Previous studies could show that private self-focus can enhance interoceptive accuracy (IAcc) in healthy participants. As body dissatisfaction is high in AN, confrontation with bodily features such as the own face might have a directly opposed effect in AN. Wheth...
Given the strong involvement of affect in obsessive-compulsive disorder (OCD) and recent findings, the current cortico-striato-thalamo-cortical (CSTC) model of pathophysiology has repeatedly been questioned regarding the specific role of regions involved in emotion processing such as limbic areas. Employing a connectomics approach enables us to cha...
Entspannungsverfahren sind Methoden, die vorwiegend dem klinischen Bereich entstammen und zur Behandlung verschiedener Störungsbilder dienen. Eine eindeutig nachweisbare Entwicklung der hier geschilderten Entspannungsverfahren ist erst im 19. und 20. Jahrhundert zu verzeichnen. Die Anwendung von Entspannungsverfahren ist immer auch eingebunden in d...
The issue of predicting treatment response and identifying, in advance, which patient will profit from treating obsessive-compulsive disorder (OCD) seems to be an elusive goal. This prospective study investigated brain electric activity [using Low-Resolution Brain Electromagnetic Tomography (LORETA)] for the purpose of predicting response to treatm...
When the early trials of Ginkgo biloba extract EGb 761® were conducted, different terms were used to denote ageing-associated neurocognitive disorders. With the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a taxonomy covering dementia and pre-dementia stages of such disorders became available. DSM-5 diagnostic...
In an overview the new alternative model for personality disorders in the fifth edition of the diagnostic and statistical manual of mental disorders (DSM-5) is presented. The change from a categorical to a dimensional diagnostic process and the development of a hybrid model is explained by the historical transformation of the term personality disor...
ICD-10-Symptom-Rating (ISR) - Das Handbuch zum Fragebogen
Das Handbuch zum lizenzfreien ICD-10-Symptomrating (ISR) für die schnelle syndrom-übergreifende Bewertung psychischer Symptomatik durch den Patienten. Es enthält Angaben zur Entstehung, Durchführung, Normierung und Studien zur Güte des ISR.
Das lizenzfreie „ICD-10-Symptomrating“ (ISR) ermö...
Neuropsychological assessments of participants with obsessive-compulsive disorder (OCD) indicate impaired verbal memory if to be remembered material has to be organized. People with OCD also tend to focus their attention on their thoughts (heightened cognitive self-consciousness). We tested the hypothesis that cognitive self-consciousness causes ve...
This review presents an overview of studies investigating white-matter integrity in patients with obsessive-compulsive disorder (OCD) using diffusion tensor imaging (DTI). There is increasing evidence for white matter alterations in OCD. In adult patients the majority of all studies reported abnormalities in terms of decreased fractional anisotropy...
Zusammenfassung
Der vorliegende Artikel beschreibt die aktuellen diagnostischen Entwicklungen im Bereich der Somatoformen Störung unter Zugrundelegung der aktuellen S3-Leitlinien für „Nichtspezifische funktionelle und somatoforme Körperbeschwerden“ und der historischen Entwicklung der Somatoformen Störungen (einschließlich der Hypochondrie). Neben...
The present article provides an overview concerning the comparison of ICD-10-/, DSM-IVTR- and DSM-5-criteria for somatization disorders (incl. hypochondria), now defined as somatic symptom and related disorders in DSM-5. Furthermore an over-view concerning definition, diagnosis and historical development of somatization disorders with special empha...
This study investigates neuronal activation patterns during the psychotherapeutic process, assuming that change dynamics undergo critical instabilities and discontinuous transitions. An internet-based system was used to collect daily self-assessments during inpatient therapies. A dynamic complexity measure was applied to the resulting time series....
Algorithm of dynamic complexity.
(DOCX)
Theoretischer Hintergrund: Die meisten diagnostischen Instrumente stellen bei Zwangsstörung, bzw. den Symptomkategorien Zwangsgedanken und -handlungen, in erster Linie den Schweregrad und nicht deren Generalisierung fest. Fragestellung: Sind Zwangsgedanken bzw. -handlungen situationsspezifisch oder generalisiert auf viele Bereiche? Methode: 142 Pat...
The concept of burnout is controversial, we prefer to define burnout
as a stressor-related process which results in the development
of axis I disorders like anxiety syndromes, depression etc. In our
own studies we could demonstrate that patients which suffered
from a long term burnout process developed in 98% a depressive
episode! Furthermore we co...
The burnout syndrome is not only a problem of professional stress,
but influenced by a variety of personality traits. The relation to
personality disorders (DSM-IV TR) or accentuated personalities is
yet unclear. In a sample of 151 inpatients of a psychosomatic
clinic the relation between burnout and personality disorders/accentuated
personalities...
Although the DSM-IV-TR suggests that obsessive-compulsive disorder (OCD) is a coherent syndrome, scientific evidence offers a compelling case that OCD is highly heterogeneous and possibly composed of many different subtypes. OCD can display completely distinct symptom patterns thus making it difficult to identify a single „textbook“ profile of OCD....
Although the DSM-IV-TR suggests that obsessive-compulsive disorder (OCD) is a coherent syndrome, scientific evidence offers a compelling case that OCD is highly heterogeneous and possibly composed of many different subtypes. OCD can display completely distinct symptom patterns thus making it difficult to identify a single "textbook" profile of OCD....
Da mehr als 80% der gefährdeten Älteren regelmäßig ihren Hausarzt konsultieren, nimmt dieser eine Schlüsselstellung in der Diagnostik und v.a. bei der Früherkennung dementieller Prozesse ein. Dies trifft in besonderem Maße auf die leichte kognitive Beeinträchtigung (LKB) zu, die ein besonders hohes Risiko für die Entwicklung einer Demenz darstellt....
This article reviews the present state of knowledge concerning obsessive-compulsive disorder (OCD) with respect to its classification, epidemiology, pathogenesis, and therapy. Epidemiological evidence has indicated that OCD may be one of the most prevalent and disabling psychiatric disorders. There is also a high comorbidity with depression and anx...
An abstract is unavailable. This article is available as HTML full text and PDF.
Zusammenfassung In dieser Arbeit wurden die Zusammenhänge zwischen den zwei Fragebogen ICD-10-Symptom-Rating (ISR) und der Symptom-Checkliste-90-R (SCL-90-R) anhand einer Stichprobe von N=3755 stationären psychosomatischen Patienten überprüft. Dabei reichten die Korrelationen zwischen den ISR-und SCL-90-R-Syndromskalen von r min =.18 (ISR-Essstörun...
Increasing attention has been given to subtyping OCD with respect to different clinical profiles, response to drug treatments, comorbidity and age of onset. There are a number of studies looking at predictors of treatment outcome in OCD, but so far not for OCD subtypes.
Prediction of outcome after cognitive-behavioural therapy was evaluated in 63 i...
Memory deficits in patients with obsessive-compulsive disorder (OCD) have been frequently reported but are not sufficiently accounted for by cognitive models of OCD. The aim of the study was to identify cognitive mechanisms that might be able to explain memory deficits in OCD. We hypothesized that a self-conscious meta-cognitive style might be resp...
Da mehr als 80% der gefährdeten Älteren regelmäßig ihren Hausarzt konsultieren, nimmt dieser eine Schlüsselstellung in der Diagnostik und v. a. bei der Früherkennung demenzieller Prozesse ein. Dies trifft in besonderem Maße auf die leichte kognitive Beeinträchtigung (LKB) zu, die ein besonders hohes Risiko für die Entwicklung einer Demenz darstellt...
This multicenter follow-up study examines the effectiveness of psychosomatic inpatient treatment under the conditions of routine practice.
We chose a naturalistic design with one pre- and two postmeasurements: admission, discharge, and 1-year follow-up with a follow-up sample of 935 patients from five psychosomatic hospitals.We assessed the effecti...
Background: New methods of internet-based real-time monitoring of psychotherapy processes allow for the documentation, analysis, and data-driven control of behaviour therapy. Daily ratings of the patient result in highly resolved time series of the change dynamics. Method and Patient: The Synergetic Navigation System was used in the treatment setti...
Neuroimaging studies in recent years suggest that cortical hyperactivity associated with more aroused cognitive processes and overfocussed attention is involved in the pathogenesis of obsessive-compulsive disorder (OCD), which was electrophysiologically supported by an own pilot-study in a small sample of stabilized OCD patients. To replicate this...
Objectives:
Construction of the newly developed "ICD-10 Symptom Rating" (ISR) is presented together with some statistical data. This questionnaire is founded on the well-known ICD-10, according to which symptoms are relevant for assessing psychological disorders. The ISR aims at a comprehensive evaluation of the severity of psychological disorders...
Entspannungsverfahren sind Methoden, die vorwiegend dem klinischen Bereich entstammen und zur Behandlung verschiedener Störungsbilder
entwickelt wurden. Obwohl die Wurzeln mancher der hier geschilderten Entspannungsverfahren bereits in der Antike andeutungsweise
beschrieben wurden, sind eindeutig nachweisbare Entwicklungen erst im 19. und 20. Jahrh...
Pathophysiologische Konzepte der Zwangsstorung postulieren funktionelle Beeintrachtigungen kortiko-subkortikaler Regelkreise, die den frontalen Kortex, die Basalganglien sowie den Thalamus umfassen. Neurophysiologische und funktionell-bildgebende Studien bei Patienten mit Zwangsstorung haben Veranderungen der kortikalen Aktivitat, insbesondere in d...
This study investigates if obsessive compulsive disorder with early onset differs in severity and symptomatology from that with late onset. Patients and Methods: A sample of 370 patients with obsessive compulsive disorder (OCD; ICD 10 F42) who received in-patient treatment at the psychosomatic clinic of Windach between 1998 and 2002 were divided in...
In clinical settings, neuropsychological tests and screening instruments are often used to measure cognitive change over time. However, the interpretation of changes in test scores is often difficult. For most instruments there is no information how much change occurs normally in cognitively healthy individuals.
To examine what is a reliable change...
Zusammenfassung: Mit dem SIDAM (Strukturiertes Interview fur die Diagnose einer Demenz vom Alzheimer Typ, der Multiinfarkt- Demenz und Demenzen anderer Atiologie nach DSM-III-R, DSM-IV und ICD-10) liegt ein standardisiertes Interview vor, welches Screening und Diagnose von Demenzen und leichten kognitiven Beeintrachtigungen ermoglicht. Alters- und...
Unter »übenden Verfahren« versteht man in der Regel die etablierten Entspannungsverfahren wie z. B. die progressive Muskelrelaxation, das autogene Training, Hypnose sowie in zweiter Linie Biofeedback, Meditation, imaginative Verfahren, funktionelle Entspannung und konzentrative Bewegungstherapie. Der Patient übt die o. g. Methoden zum Teil unter Mi...
Einleitung: Die vorliegende Untersuchung geht der Fragestellung nach, ob sich eine Zwangsstörung, die bereits
im Kindes- bzw. Jugendalter beginnt, von einer Zwangsstörung, die erst im Erwachsenenalter beginnt, hinsichtlich Schweregrad und Symptomatik unterscheidet. Patienten und Methoden: Eine Stichprobe von 370 Patienten
mit Zwangsstörung (ICD-10...
Neurophysiological studies in patients with obsessive-compulsive disorder (OCD) consistently revealed frontal alterations of cortical activity but otherwise showed inhomogeneous results, conceivably due to variable subgroups with diverse pathomechanisms involved. The aim of this study was to investigate quantitative electroencephalography (EEG) in...
Mild cognitive impairment is a syndrome defined as cognitive decline greater than expected for an individual's age and education level but that does not interfere notably with activities of daily life. Prevalence in population-based epidemiological studies ranges from 3% to 19% in adults older than 65 years. Some people with mild cognitive impairme...
Evidence has been accumulated suggesting that a dysfunction in pain inhibitory systems, i.e. in 'diffuse noxious inhibitory controls' (DNIC)-like mechanisms, might be-amongst other factors-responsible for the development of anatomically generalized chronic pain like fibromyalgia. The aim of the present study was to look for similar impairments in c...
IntroductionTerminology, Classification and Definition of MCIEpidemiologyDifferential DiagnosisDiagnostic BordersFollow-Up Studies of MCI and Rates of Conversion to ADAssessmentActivities of Daily Living (ADL)Asymptomatic ADSubjective Cognitive ImpairmentBiological MarkersNeuropathology and NeuroimagingManagement of MCIConclusions
References
Obsessive-compulsive disorder (OCD) is conceived as a disease that implicates dysfunctions in fronto-striatal brain systems. According to this model, performance deficits observed in patients with lesions in these brain areas are hypothesized to be present also in OCD patients. Implicit procedural learning, which refers to the acquisition of motor...
In a subgroup of patients with obsessive-compulsive disorder (OCD), motor soft signs, tics and other movement disorders can be observed, indicating a special pathogenetic involvement of basal ganglia.
The main objective of this study was to verify the hypothesis that such motor dysfunction characterises a subgroup of OCD patients with poor treatmen...
This review outlines the use of memantine in clinical practice and represents the output of a consensus group who met to consider the use of the drug. The main conclusions were: memantine, a glutamatergic agent, has a different mode of action to the other available agents, for the treatment of Alzheimer's disease, the anticholinesterases; is indica...
Brain monoaminergic function is involved in the pathophysiology of psychiatric disorders. The loudness dependence (LD) of the N1/P2 component of auditory evoked potentials has been proposed as a noninvasive indicator of central serotonergic function, whereas single photon emission computed tomography (SPECT) and [123I]beta-CIT can be used to visual...
Zusammenfassung Der vorliegende Artikel gibt neben einem Ruckblick auf die historische Entwicklung der psychosomatischen Krankenhausbehandlung (§ 108 SGB V) einen Uberblick uber die aktuellen Strukturen der Krankenhauspsychosomatik, Konzeptionen, statistische Daten zur Verweildauer, Hauptdiagnosen, Komorbiditat und Effizienz der Therapie. Aufgrund...
Movement disorders like disturbances of fine motor coordination are a frequent phenomenon in patients with obsessive-compulsive disorder (OCD) (1). Our aim was to investigate changes of hand motor dysfunction in OCD patients under the influence of ten-week treatment with sertraline and behaviour therapy.
We examined performance of 40 patients sati...
Movement disorders such as disturbances of fine motor co-ordination are a frequent phenomenon in patients with obsessive-compulsive disorder (OCD).
Our aim was to investigate changes of hand-motor dysfunction in OCD patients under the influence of 10-week treatment with sertraline and behaviour therapy.
We examined the performance of 40 patients sa...
This article is a review of the historical development of psychosomatic inpatient treatment form its first roots to present. The major focus of the article is a description of the present situation of psychosomatic hospitals in Germany, the kind of inpatient treatment in psychosomatic medicine, current concepts, data on lengths of stay, comorbidity...
In dieser Studie werden die Ergebnisse einer prospektiven 1-Jahres-Katamnese nach Behandlung von 30Patienten mit Zwangsstrungen (ICD-10; F42) in der Psychosomatischen Klinik Windach vorgestellt. Im Zentrum der Behandlung stand eine multimodale Verhaltenstherapie, die in Einzelfllen von Pharmakotherapie ergnzt wurde. Die Patienten konnten konsistent...
A central serotonergic dysfunction is considered to be involved in the pathophysiology of obsessive-compulsive disorder (OCD). The aim of this study was to investigate the serotonin transporter availability in patients with OCD as an in vivo marker of the central serotonergic system.
Nine unmedicated (7 drug-naive) patients with OCD and 10 healthy...
BACKGROUND; Motor function is deficient in many patients with obsessive-compulsive disorder (OCD), especially in the face. To investigate subtle motor dysfunction, kinematical analysis of emotional facial expressions can be used. Our aim was to investigate facial movements in response to humorous film stimuli in OCD patients.
Kinematical analysis o...
Current changes in the laws pertaining to mental disorders are mainly concerned with the redefinition in the Sozialgesetzbuch IX (SGB IX) [Social Law] of the term "disability", and the forthcoming introduction of the International Classification of Functioning, Disability and Health (ICF). Accordingly, the rehabilitation of the mentally disturbed w...
Context:
As public awareness of Alzheimer's disease increases, more people are asking for help and advice about memory problems. Memory complaints may be secondary to psychiatric, psychological, and physical conditions and is an almost universal early symptom of dementia. The concept of amnestic mild cognitive impairment attempts to describe those...
The SIDAM (Structured Interview for the diagnosis of Dementia of the Alzheimer type, Multi-infarct dementia and dementias of other etiology according to ICD-10 and DSM-IV) is a standardized interview for the diagnosis of dementia. It can also be used as a screening instrument for the diagnosis of different syndromes of dementia and mild cognitive i...
Psychiatrische Erkrankungen zählen zu den häufigsten Erkrankungen. Durch epidemiologische Studien begründet, weist die WHO darauf hin, dass diese weiter im Zunehmen sind. Insbesondere depressive Erkrankungen und Angsterkrankungen stellen ein großes Gesundheitsproblem der heutigen Gesellschaft dar. Aus Tabelle 14.1-1, in der die häufigsten Ursachen...