Roland von Känel

Roland von Känel
University of Zurich | UZH · Consultation-Liaison Psychiatry and Psychosomatic Medicine University Hospital Zurich

Professor (Full), MD

About

681
Publications
146,439
Reads
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14,721
Citations
Introduction
Roland von Känel, MD, is Chair of Consultation-Liaison Psychiatry and Psychosomatic Medicine at the University of Zurich and Director of the Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine at the University Hospital Zurich. He is an internist, psychiatrist and psychotherapist, specialized in psychosomatic medicine. His research interests include biobehavioral pathways linking psychological stress with the development and clinical manifestation of cardiovascular diseases.
Additional affiliations
February 2018 - present
University Hospital Zurich
Position
  • Head of Department
February 2018 - present
University of Zurich
Position
  • Chair
January 2016 - present
North-West University
Position
  • Extraordinary Professor
Education
January 1993 - June 2008
FMH Swiss Medical Association
Field of study
  • Specializied in Psychiatry and Psychotherapy
January 1993 - March 1999
FMH Swiss Medical Association
Field of study

Publications

Publications (681)
Article
Background: Acute coronary syndrome (ACS)-induced posttraumatic stress disorder (PTSD) and clinically significant PTSD symptoms (PTSS) are found in 4 and 12% of patients, respectively. We hypothesized that trauma-focused counseling prevents the incidence of ACS-induced PTSS. Methods: Within 48 h of hospital admission, 190 patients with high dist...
Article
Full-text available
BACKGROUND: Benzodiazepines and morphine are given during acute coronary syndromes (ACSs) to alleviate anxiety and pain, and β-blockers may also reduce pain. ACS may induce posttraumatic stress disorder (PTSD) symptoms (PTSS). When taken during trauma other than ACS, benzodiazepines increase the risk of PTSS, but it is unknown if benzodiazepines in...
Article
Background: Acute coronary syndrome (ACS) induces clinically significant posttraumatic stress symptoms (PTSS) in 12% of patients. Subjective sleep problems are a risk factor for the development of PTSS, but this is underexplored in patients with ACS. Purpose: To examine the association of insomnia symptoms with ACS-induced PTSS. Methods: In this lo...
Article
Full-text available
Acute coronary syndromes (ACS) induce posttraumatic stress symptoms (PTSS) in one out of eight patients. Effects of preventive interventions, the course and potential moderators of ACS-induced PTSS are vastly understudied. This study explored whether a preventive behavioral intervention leads to a decrease in myocardial infarction (MI)-induced PTSS...
Article
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Objective The traumatic experience of acute coronary syndrome (ACS) may induce symptoms of posttraumatic stress disorder (PTSD). We examined whether the ACS-triggered acute inflammatory response predicts the development of PTSD symptoms. Method Study participants were 70 patients (all Caucasian, 80% male, mean age 59 years) with myocardial infarct...
Article
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Background Little is known about the impact of ostomy formation in inflammatory bowel disease patients on course of disease, psychological well-being, quality of life and working capacity. Methods We analyzed patients over a follow-up of up to 16 years in the Swiss inflammatory bowel disease cohort study (SIBDCS) with prospective data collection....
Article
Aims Cardiac rehabilitation (CR) not only improves cardiovascular outcomes, but also health-related quality of life (HRQOL). Unfortunately, CR is still underutilized, especially among women and older patients. Aim of this study was to highlight age- and sex-specific effects of inpatient CR on HRQOL. Methods From 2012 to 2018, 18,459 patients were...
Article
Objective The distress thermometer (DT) is a well-established screening tool to detect clinically significant distress in cancer patients. It is often administered in combination with the problem list (PL), differentiating further between various (e.g., physical and emotional) sources of distress. The present study aimed to extend previous research...
Article
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Background The bidirectional “gut-brain axis” has been implicated in the pathogenesis of inflammatory bowel diseases (IBD). While the influence of stress and depressive symptoms on IBD is well-characterized, the role of personality remains insufficiently investigated. Methods Personality was assessed in 1154 Swiss IBD cohort study (SIBDCS) patient...
Article
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AimsEssential hypertension (EHT) is characterized by cardiovascular hyperreactivity to stress but underlying mechanism are not fully understood. Here, we investigated the role of α-adrenergic receptors (α-AR) in the cardiovascular reactivity to a norepinephrine (NE)-stress reactivity-mimicking NE-infusion in essential hypertensive individuals (HT)...
Article
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It is unknown whether the observed general physiological hyperreactivity to acute psychosocial stress in essential hypertension also extends to salivary alpha-amylase (sAA), a surrogate sympathetic nervous system marker. Here, we investigated sAA reactivity to acute psychosocial stress in essential hypertensive males (HT) as compared to normotensiv...
Article
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Background: Takotsubo syndrome (TTS) is an acute heart failure syndrome characterized by transient left ventricular dysfunction, increased myocardial biomarkers, and electrocardiographic changes. Symptoms of TTS are similar to those of acute coronary syndromes, but there is often no significant coronary stenosis. Although emotional and physical st...
Article
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Background Coercive measures continue to be an important topic in psychiatry. However, there is no proof of the effectiveness of the use of coercive measures, especially with suicidal people. For many years, attempts have been made to replace such measures with alternative noncoercive intervention options. This paper aims to clarify the situation o...
Article
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Background Sleep disturbance has been associated with poor prognosis in patients with acute coronary syndrome (ACS). This study examined the course of sleep disturbance and associated factors in patients with ACS who were followed for one year. Methods Study participants were 180 patients (mean age 59.6 years, 81.7% men) with ACS admitted to a ter...
Article
Objective After acute coronary syndrome (ACS), one in eight patients develops clinically significant symptoms of posttraumatic stress disorder (PTSD). We hypothesized that cardiac symptoms occurring in the post-hospital period would be associated with the development of ACS-induced PTSD symptoms up to 12 months after ACS. Methods Patients with ACS...
Article
Full-text available
Objective Psychological consequences of myocardial infarction (MI) are substantial, as 4% of all MI patients develop posttraumatic stress disorder (PTSD) and 12% clinically relevant posttraumatic stress symptoms (PTSS). The study investigated the course and development within 12 months of MI-induced PTSS to gain novel insights in potentially delaye...
Article
Ineffective stress-coping in Africans is associated with cardiac ischemia during acute mental stress. Ischemic conditions may be worsened by stress-induced release of glial-derived S100‑calcium-binding-protein β (S100B), which is pro-apoptotic for cardiomyocytes Whether estradiol as coping regulator and cardio-protective factor will protect against...
Article
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Background: Elevated levels of C-reactive protein (CRP) are associated with both an increased risk of cardiovascular disease (CVD) and depression. We aimed to test the hypothesis that a self-report history of depression is associated with a smaller decrease in CRP levels from hospital admission to 3-month follow-up in patients with acute myocardia...
Article
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Background After acute coronary syndrome (ACS), one in eight patients develops clinically significant symptoms of Post-traumatic stress disorder (PTSD). We hypothesized that changes in cardiac symptoms from 3 to 12 months after ACS are associated with changes in ACS-induced PTSD symptoms. Methods At 3 ( n = 154) and/or 12 months ( n = 106) post-AC...
Article
The opioid crisis in the United States (U.S.) is widespread and increasing in severity, and psychosocial exposures have been identified as potential risk factors. We examined associations of employment status with opioid misuse in a large, nationally representative, population-based sample in the U.S. Data were from the 2019 National Survey of Drug...
Article
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Background: A one-size-fits-all approach might explain why early psychological interventions are largely ineffective in preventing the development of posttraumatic stress disorder (PTSD) symptoms triggered by acute medical events. We examined the hypothesis that social and health care resources are moderators of an intervention effect. Methods: Wit...
Article
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Background Delirium in trauma surgery is common, especially post-operatively, but medical characteristics, risk factors and residence post-discharge have not comprehensively been investigated in all trauma patients. Methods Over 1 year, 2026 trauma patients were prospectively screened for delirium with the following tools: Delirium Observation scr...
Article
Background Higher trait anger has inconsistently been associated with hypertension and hypertension development, but social context in terms of recognition of other persons’ anger has been neglected in this context. Purpose Here, we investigated anger recognition of facial affect and trait anger in essential hypertensive and normotensive men in ad...
Article
Patients with both cancer and a severe mental illness (SMI) have a higher risk of advanced stage cancer at diagnosis and poorer survival in comparison to individuals with cancer alone. The present study explores if similar disparities exist in terms of psycho-oncological support. Latent class analysis (LCA) was used to group 10,945 patients with an...
Article
Background: . High-quality comprehensive data on short-/long-term physical/mental health effects of the COVID-19 pandemic are needed. Methods: . The Collaborative Outcomes study on Health and Functioning during Infection Times (COH-FIT) is an international, multi-language (n=30) project involving >230 investigators from 49 countries/territories/re...
Article
The prevalence and public health burden of chronic heart failure (CHF) in Europe is steadily increasing mainly caused by the ageing population and prolonged survival of CHF patients. Frequent hospitalizations, high morbidity and mortality rates, and enormous healthcare costs contribute to the health related burden. However, multidisciplinary framew...
Article
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Objective: In routine oncological treatment settings, psychological distress, including mental disorders, is overlooked in 30% to 50% of patients. High workload and a constant need to optimise time and costs require a quick and easy method to identify patients likely to miss out on psychological support. Methods: Using machine learning, factors...
Article
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Objectives Delirium is known to contribute to increased rates of institutionalization and mortality. The full extent of adverse outcomes, however, remains understudied. We aimed to systematically assess the discharge destinations and mortality risk in delirious patients in a large sample across all hospital services. Design Pragmatic prospective c...
Article
Background Knowledge on the impact of stoma formation surgery on course of disease, psychological well-being, quality of life (QoL) and working capacity in patients with IBD is scarce. Methods To investigate this, we analysed prospectively followed-up patients from the Swiss inflammatory bowel disease cohort study (SIBDCS), comparing ulcerative co...
Article
Background There is little guidance regarding the impact of alcohol and cannabis on the clinical course of inflammatory bowel disease. The aim of this study was to assess the prevalence, sociodemographic characteristics and impact of alcohol and cannabis use on the clinical course of the disease. Methods We performed a retrospective analysis of pr...
Conference Paper
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Dysfunctional thoughts about caregiving (DTAC) and familism (i.e. familistic obligation) were associated with worse caregiver emotional and cardiovascular health in cross-sectional studies. The aim of this study was to longitudinally examine the effects of familism and DTAC on cardiovascular health, considering caregiver kinship adjusting for well-...
Article
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Cross-sectional data show that caregivers’ ambivalent feelings are associated with psychological distress. The association of ambivalent feelings with caregivers’ cardiovascular risk has not been studied. For this purpose we analyzed preliminary data from the Spanish Longitudinal Caregiving Spanish Longitudinal Study (CUIDA-LONG). One-year follow-u...
Article
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Background: In a South African bi-ethnic cohort, defensive (DefS)/social support/avoidance coping strategies have been shown to influence cardiac troponin T (cTnT) levels through different stress signalling pathways. Personality traits (extra-version, neuroticism, conscientiousness, openness to experience , agreeableness) partially control stress c...
Article
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Objective The prevalence and effects of delirium in very old individuals aged ≥80 years have not yet been systematically evaluated. Therefore, this large single-center study of the one-year prevalence of delirium in 3,076 patients in 27 medical departments of the University Hospital of Zurich was conducted. Methods Patient scores on the Delirium O...
Article
Objective This study investigated the association between job burnout and quality of life (QoL) after acute coronary syndrome (ACS) in a Chinese sample. Methods This was a one-year longitudinal study. Participants included patients with a first episode of ACS who were still employed. The Copenhagen Burnout Inventory (CBI) assessed job burnout befo...
Article
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Background In patients with cancer, the routine recording of distress symptoms has been widely established in recent years. Psycho-oncological support has proven to reduce distress and increase quality of life. Despite high levels of distress as well as physical and emotional challenges in patients with cancer, a significant proportion forgoes psyc...
Article
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Background Fibromyalgia (FM) is a very prevalent and debilitating chronic pain disorder that is difficult to treat. Mindfulness-based techniques are regarded as a very promising approach for the treatment of chronic pain and in particular FM. The Mindfulness-Oriented Recovery Enhancement (MORE) intervention, a mindfulness-based group intervention,...
Article
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Background Due to ongoing political and social conflicts, the number of international refugees has been increasing. Refugees are exposed to severe mental and physical strain, as well as traumatic experiences during their flight. Therefore, the risk of psychiatric disorders is markedly increased among international refugees. International organizati...
Article
Full-text available
Objective Implantable cardioverter defibrillators (ICD) are successfully used to treat life-threatening arrhythmias and prevent sudden cardiac death. However, they are also known to have a major psychological impact leading to higher prevalence of depression and anxiety in a substantial proportion of patients. The aim of this study was to assess th...
Article
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Background Health care workers are often affected by burnout, resulting in reduced personal well-being and professional functioning. Although emotional exhaustion is considered a core component of burnout, little is known about the dynamics of emotions and their relation to burnout. We used network analysis to investigate the correlation between th...
Preprint
Full-text available
The heterogeneity of symptoms among individuals diagnosed with the same mental disorder complicates the identification of biomarkers and the development of targeted treatments. Yet, the characteristics of this heterogeneity remain largely unknown. We investigated the frequency of disorder-specific symptom combinations, a marker of symptom heterogen...
Article
Background: The COVID-19 pandemic has altered daily routines and family functioning, led to closing schools, and dramatically limited social interactions worldwide. Measuring its impact on mental health of vulnerable children and adolescents is crucial. Methods: The Collaborative Outcomes study on Health and Functioning during Infection Times (C...
Article
250/250 Background : The COVID-19 pandemic has altered daily routines and family functioning, led to closing schools, and dramatically limited social interactions worldwide. Measuring its impact on mental health of vulnerable children and adolescents is crucial. Methods : The Collaborative Outcome study on Health and Functioning during Infection...
Article
Full-text available
Background Exposure to childhood adversities (CHAD) has been found to be strongly associated with individuals' mental health and social development. Recently, it has been suggested that certain CHAD patterns exist in the population, which are more closely related to individuals' later mental health than the simple summation of adversities. The curr...
Article
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Aim: Although the risk factors for delirium in general medicine are well-established, their significance in cardiac diseases remains to be determined. Therefore, we evaluated the predisposing and precipitating risk factors in patients hospitalized with acute and chronic heart disease. Methods and Results: In this observational cohort study, 1,042 e...
Article
Full-text available
Unipolar depression is associated with insomnia and autonomic arousal. The aim of this study was to quantify the effect of a single bout of aerobic exercise on nocturnal heart rate variability and pre-sleep arousal in patients with depression. This study was designed as a two-arm, parallel-group, randomized, outcome assessor-blinded, controlled, su...
Article
Full-text available
It is well established that burnout in medical students is associated with depression and anxiety at a syndromal level. Moreover, there is an ongoing debate about the extent to which burnout overlaps with depression and anxiety. The emerging network approach to psychopathology offers a new perspective on the interrelations between mental disorders...
Article
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Summary Problem: Depression is a widespread disorder and among the leading causes of disability world-wide. In this article, we perform an umbrella review on the association between depression and excess mortality, cardiovascular disease (CVD), and cardiovascular risk factors. We also provide an overview of mechanisms that explain these association...
Article
Full-text available
Background and aims Anxiety and depression are prevalent in patients with inflammatory bowel diseases (IBD), especially during IBD flares. IBD therapies can profoundly affect the mood of patients with IBD. We aimed to determine the long-term impact of anti-tumor necrosis factor (anti-TNF) and immunomodulators (IM) on anxiety and depressive symptoms...
Article
Full-text available
Purpose: Psychological distress and manifest mental disorders are overlooked in 30 to 50% of patients with cancer. Accordingly, international cancer treatment guidelines recommend routine screening for distress in order to provide psychological support to those in need. Yet, institutional and patient related factors continue to hinder implementati...
Article
Full-text available
Anorexia nervosa (AN) is difficult to treat with up to half of patients failing to gain weight during treatment. Neurobiological factors predicting treatment response in AN are poorly understood. In this longitudinal study, we aimed to identify morphological characteristics in the grey matter which predict treatment success in patients with AN. Fif...
Article
Full-text available
Hyperreactivity to stress may be one explanation for the increased risk of cardiovascular disease (CVD) in individuals with essential hypertension. We investigated blood lipid reactivity to the Montreal Imaging Stress Task (MIST), a psychosocial stressor, in hypertensive and normotensive men and tested for prospective associations with biological r...
Article
Background: . High-quality comprehensive data on short-/long-term physical/mental health effects of the COVID�19 pandemic are needed. Methods: . The Collaborative Outcomes study on Health and Functioning during Infection Times (COH-FIT) is an international, multi-language (n=30) project involving >230 investigators from 49 countries/territories/r...
Article
Full-text available
Study objectives Insomnia increases the risk of negative disease trajectory, relapse, and suicide in patients with depression. We aimed at investigating the effects of a single bout of aerobic exercise, performed after 2 pm, on the subsequent night's sleep in patients with depression. Methods The study was designed as a two-arm parallel-group, ran...
Article
BACKGROUND AND PURPOSE: Delirium is a common severe complication of stroke. We aimed to determine the cost-of-illness and risk factors of poststroke delirium (PSD). METHODS: This prospective single-center study included n=567 patients with acute stroke from a hospital-wide delirium cohort study and the Swiss Stroke Registry in 2014. Delirium was de...
Article
Full-text available
Background: A prothrombotic tendency could partially explain the poor prognosis of patients with coronary heart disease and depression. We hypothesized that cognitive depressive symptoms are positively associated with the coagulation activation marker D-dimer throughout the first year after myocardial infarction (MI). Methods: Patients with acute M...