Steffen Moritz

• PhD
• Head of Department at University Medical Center Hamburg - Eppendorf

Der Krankheitsbegriff “Schizophrenie”, abgeleitet aus den altgriechischen Wörtern schizein („spalten, zersplittern“) und phrēn („Geist, Seele“), geht auf den Schweizer Psychiater Eugen Bleuler (1911) zurück, der genaugenommen bereits den Plural Schizophrenien vorschlug. Im Vergleich zu dem zuvor von Emil Kraepelin (1896) verwendeten Begriff „Dement...

The high prevalence of chronic pain and comorbid depression, along with their negative impacts on individuals and society, highlights the need for accessible and effective interventions. This study examined the feasibility, efficacy, and acceptability of Lenio, an Internet-based self-help intervention, combined with the COGITO smartphone applicatio...

Introduction Patients with borderline personality disorder (BPD) commonly display psychotic symptoms such as hallucinations or delusional/paranoid ideas. We used the fish task to investigate cognitive biases (jumping to conclusions and overcorrection) implicated in the aetiology of psychotic symptoms in patients with BPD. Methods Participants rece...

Background and objectives: Increasing evidence confirms the significant involvement of disgust in contamination-related obsessive-compulsive disorder (C-OCD). More insights into the role of disgust within cognitive biases in OCD may illuminate the psychopathology and corresponding subdimensions or subtypes. The present study introduces a new approa...

Treatment efficacy for patients with obsessive‐compulsive disorder (OCD) with poor insight is low. Insight refers to a patient's ability to recognize that their obsessions are irrational and that their compulsions are futile attempts to reduce anxiety. This case study presents the first application of virtual reality‐assisted avatar therapy for OCD...

Objective. Clinical care and research need to improve treatment availability for auditory verbal hallucinations (AVH). To provide further evidence, we examined the efficacy of an unguided six-weeks self-help intervention for AVH (SH-MCTAVH) based on metacognitive training. Methods. N = 78 participants with distressing AVH were recruited from clinic...

Background: Psychological interventions are increasingly discussed as a method to prevent major depressive disorder (MDD) in adults who already experience subthreshold depressive symptoms. In this individual participant data metaanalysis, we quantify the effect of preventive interventions against control on MDD onset in this population, and explore...

Patients with acute psychosis are often confronted with the prejudice that they refuse all treatment due to lack of insight. This study examined and compared the aims and preferences for treatment of patients with acute psychosis and of psychiatric inpatient staff. A total of 142 inpatients being treated for a psychotic disorder on either a locked...

Objectives Metacognitive training (MCT) for psychosis is a group intervention that combines cognitive‐behavioural therapy and psychoeducation. It has proven efficacy in reducing psychotic symptoms and correcting cognitive biases implicated in the development and maintenance of psychotic symptoms. However, other outcomes, such as patient satisfactio...

Hintergrund: Die körperbezogenen repetitiven Verhaltensweisen (body focused repetitive behaviors; BFRBs) subsumieren eine Gruppe von Störungsbildern an der Schnittstelle von klinischer Psychologie/Psychiatrie, Dermatologie und Zahnheilkunde. Ohne entsprechende Behandlung neigen BFRBs zur Chronizität und können zu gravierenden körperlichen und psych...

Background: Cognitive models emphasise that source monitoring, top-downprocesses, and inhibitory control are mechanisms of perceptual anomalies, particularlyauditory hallucinations (AHs) and hallucinatory-like experiences (HLEs). Nonetheless,limited research integrates clinical and non-clinical perceptual anomalies to examinethese cognitive mechani...

Even during the third wave of the COVID-19 pandemic health professionals were facing mental health challenges. The aim of this study was to examine the mental health of doctors, nurses and other professional groups in Europe and to identify differences between the professional groups. We conducted a cross-sectional online survey in 8 European count...

Despite the lack of studies, the influence of social cognition and metacognition on personal stigma can be better understood by investigating the social components involved in this construct, as well as by the influence of self-esteem and quality of life (QOL) found in previous studies. The aims of the present study were (a) to study the relationsh...

BACKGROUND One in eight people worldwide experiences mental health disorders, with depression and anxiety being the most common. E-mental health programs are gaining momentum in modern mental health care. OBJECTIVE The study aimed to investigate factors influencing knowledge gain in low-threshold e-mental health programs focusing on sleep and soci...

Introduction Deficits in social functioning and decision-making are well-documented in schizophrenia, but their relationship with positive symptoms and social conflicts is poorly understood. We created a new paradigm based on the Dictator Game (DG) to explore differences in social decision-making between individuals experiencing high levels of psyc...

Background: The effectiveness of psychological interventions is undisputed. But while in other fields of health care, safety of interventions is studied alongside effectiveness, adverse events (AEs) have only recently been assessed in clinical studies of psychological interventions. This critical review summarizes the definition, assessment and cur...

Identifying components of modularized psychological interventions that contribute to symptom reduction is essential to improving depression treatment. In a secondary analysis of a randomized controlled trial (RCT), session-specific effects of Metacognitive Training-Silver, a group intervention for older adults with depression, were investigated. Th...

Background In the DSM-5, body-focused repetitive behaviors (BFRBs) are now classified in the obsessive-compulsive and related disorders section. Differential diagnosis is complicated by the overlap of BFRBs with other disorders, especially non-suicidal self-injurious behavior (NSSI) and stereotypic movement behavior (SMB). The present study examine...

Web-based interventions can be effective in treating depressive symptoms. Patients with risk not responding to treatment have been identified by early change patterns. This study aims to examine whether early changes are superior to baseline parameters in predicting long-term outcome. In a randomized clinical trial with 409 individuals experiencing...

BACKGROUND Cognitive impairments are a key aspect of schizophrenia-spectrum disorders (SSD), significantly affecting clinical and functional outcomes. The COVID-19 pandemic has heightened concerns about mental health services and cognitive stimulation opportunities. Despite evidence-based interventions like action-based cognitive remediation (ABCR)...

Importance Most individuals with problem gambling or gambling disorder remain untreated due to barriers to treatment. Limited research exists on alternative treatments. Objective To investigate the efficacy of a self-guided internet-based intervention for individuals with gambling problems and to identify potential outcome moderators. Design, Set...

Even during the third wave of the COVID-19 pandemic health professionals were facing mental health challenges. The aim of this study was to examine the mental health of doctors, nurses and other professional groups in Europe and to identify differences between the professional groups. We conducted a cross-sectional online survey in 8 European count...

Imaginal retraining (IR) is an approach‐avoidance procedure that has shown promising results in previous studies. The aim of the present study was to dismantle the efficacy of IR's components in a randomized controlled trial (RCT). We conducted a RCT with nine conditions comprising eight intervention groups and a waitlist control group (WLC). Alcoh...

Background Diagnostic criteria for mental disorders are subject to change. This is particularly true for schizophrenia, whose diagnostic criteria in the current DSM-5 bear little resemblance to what Kraepelin once named “dementia praecox” and Bleuler termed “the schizophrenias.” The present study reports results from a survey of experts on two core...

Background and aim Problematic pornography use (PPU) can be a manifestation of compulsive sexual behavior disorder (CSBD). Studies investigating PPU confirm approach-avoidance tendencies in response to pornographic stimuli in this population. This study show indications of the significance of the efficacy of imaginal retraining, a variant of approa...

Negative attitudes and stigmatization toward sexual minorities is a cause of minority stress of non-heterosexual persons on an individual level and has a negative impact on democratic coexistence in postmodern, plural society on a societal level. Derived from clinical research, we developed a short metacognitive training (MCT) intended to induce do...

Background Body‐focused repetitive behaviours (BFRBs), such as skin picking and trichotillomania, are conditions at the interface of dermatology and psychiatry. Objectives We asked individuals with various BFRBs about their habits and preferences preceding the onset of their BFRB(s). We also inquired about the emotions (positive, negative or mixed...

Increased hygiene behavior may be a factor in the development of contamination-related obsessive-compulsive symptoms (C-OCS). We aimed at investigating (1) the course of C-OCS over 1 year after the start of the COVID-19 pandemic and (2) the effects of changes in hand hygiene (i.e., duration and frequency of handwashing) and related distress regulat...

Body-focused repetitive behaviors (BFRBs) are common but under-recognized mental disorders. The present study aimed to examine the efficacy of a video presentation of self-help techniques for BFRBs compared to a web-based intervention containing psychoeducation and comprehensive self-help treatment information on BFRBs to reduce symptomatology as w...

Self-help may help fill the large treatment gap in individuals with body-focused repetitive behaviors (BFRBs). We examined the efficacy of three self-help techniques for BFRBs: habit reversal training (HRT), decoupling (DC), and decoupling in sensu (DC-is) and also tested whether a video demonstration is more efficacious to written instructions. A...

Background Prevalence estimates for body-focused repetitive behaviors (BFRBs) such as trichotillomania differ greatly across studies owing to several confounding factors (e.g. different criteria). For the present study, we recruited a diverse online sample to provide estimates for nine subtypes of BFRBs and body-focused repetitive disorders (BFRDs)...

The Comparative Psychotherapy Process Scale (CPPS) is a 20-item scale which aims to capture technical features distinguishing cognitive behavioral (CBT) from psychodynamic (PD) psychotherapy (and vice versa) in two corresponding subscales (CBT and PD Subscale). Our objective was to validate a German self-report version of the CPPS regarding a previ...

Patients on acute psychiatric wards desire more psychosocial treatment than they receive, according to recent studies, but evidence-based interventions tailored to this setting are currently lacking. Metacognitive Training for psychosis (MCT) is a flexible, easy-to-administer group therapy that has been adapted to meet this demand (MCT-Acute). Thir...

Background: Body-focused repetitive behaviors (BFRBs) are highly prevalent conditions at the border of psychiatry and dermatology. Using a newly developed scale, the Generic BFRB scale (GBS-36), we aimed to compare 4 prominent BFRBs in terms of phenomenology, age at onset, and other illness-related aspects. Methods: A sample of 391 individuals w...

Introduction Depression is one of the most common psychological disorders in later life. Although psychological interventions are recommended by treatment guidelines, most older adults with depression remain untreated. The aim of this study is to evaluate the efficacy of the Portuguese version of Metacognitive Training for Depression in later life...

Self-help habit reversal training and decoupling are effective in improving body-focused repetitive behaviors (BFRBs). However, most studies to date on self-help techniques have assessed short-term effects only. The present study aimed to elucidate whether treatment effects would be sustained over a longer period of time. We conducted a 2-year foll...

Background Individuals with schizophrenia spectrum and related psychotic disorders (SSD) experience significant impairments in social cognition that impede functioning. Social cognition is a multidimensional construct consisting of four domains: 1. theory of mind, 2. emotion processing, 3. attributional style and 4. social perception. Metacognitive...

Kurt Schneider has played a leading role in shaping our current view of schizophrenia, placing certain manifestations of delusions and hallucinations at the center of the disorder, especially ideas of persecution and voice-hearing. The first part of this review summarizes Schneider’s original ideas and then traces how the different editions of the...

Background The COVID-19 pandemic severely affected everyday life and working conditions for most Europeans, particularly health care professionals (HCPs). Over the past 3 years, various policies have been implemented in various European countries. Studies have reported on the worsening of mental health, work-related stress, and helpful coping strat...

Introduction: Contemporary models of psychosis imply that cognitive biases such as the jumping to conclusions (JTC), the bias against disconfirmatory evidence (BADE), and the liberal acceptance (LA) bias play a role in the pathogenesis of delusions. Most of the studies investigating the role of cognitive biases, however, have been conducted with s...

Background Due to several treatment barriers, many individuals with panic disorder do not receive evidence-based treatment. One promising option to narrow this treatment gap is Internet-based psychotherapy, which has been shown particularly effective in guided formats. Still, there remains room for improvement to make these digital therapies more a...

Objectives The main objective of the present study was to investigate whether assessments of psychopathology vs. character strengths were associated with systematic differences concerning transient psychological states (i.e., cognitive performance, state mood, optimism, therapy motivation, perceived stigma) in individuals with psychotic disorders....

Importance: Body-focused repetitive behaviors (BFRBs; eg, skin picking) encompass a set of conditions at the interface of dermatology and psychiatry/psychology. The disorder is prevalent but currently underdiagnosed and undertreated. Objective: To compare a new self-help intervention, habit replacement, against a wait-list control condition for...

Background Despite the existence of evidence-based therapy options for the treatment of chronic pain and comorbid depressive symptoms (e.g., CBT), many individuals remain untreated. Treatment gaps result from a lack of specialists, patient fear of stigmatization, or patient immobility. Internet-based self-help interventions could serve as an anonym...

Dysfunctional beliefs are central in the development and maintenance of obsessive–compulsive disorder (OCD) as well as its treatment. Yet, research suggests that not all dysfunctional beliefs are equally important for each of the symptom dimensions of OCD. However, results are inconsistent in that studies contradict each other regarding the associa...

Objective: Despite guidelines providing detailed recommendations for the assessment of ADHD in adults and increasing clinician awareness of the persistence of ADHD into adulthood, ADHD remains under diagnosed in many countries. Method: A survey of 178 clinicians who regularly perform assessments for adult ADHD was conducted between February 2015 an...

###Background### Depressed patients report more severe cognitive impairment than is detectable by neuropsychological tests because they may underestimate their cognitive performance. Alternatively, it is possible that cognitive impairment primarily occurs under everyday life conditions as referred to in most questionnaires. The aim of the present s...

Introduction: Technology-supported exposure and response prevention (ERP) for patients with obsessive-compulsive disorder (OCD) as tested in clinical research, holds promise but also has limitations. The present study aims to overcome these limitations by using mixed reality for ERP (MERP). The objectives of this pilot study were to evaluate the s...

Aims: Tourette syndrome (TS) is a neurological condition; its etiology is not yet fully understood. Cognitive behavioural therapy with habit reversal training is the recommended first-line treatment, but is not effective in all patients. This is the first report examining the usefulness of decoupling, a behavioural self-help treatment originally d...

Background: Adherence to internet-based cognitive-behavioral therapy (iCBT) is often low, potentially reducing its potential. The current study set out to test whether adherence and effects of unguided iCBT for obsessive-compulsive disorder (OCD) could be improved by varying the degree of autonomy in which modules are completed (free choice vs. fi...

Many patients with obsessive-compulsive disorder (OCD) do not receive cognitive behavioral therapy with exposure and response prevention (first line treatment for OCD), for example, due to patients’ fear of the exposure and reservations of the therapists. Technology-supported exposure (e.g., exposure therapy with response prevention in mixed realit...

Many patients with obsessive-compulsive disorder (OCD) do not receive cognitive behavioral therapy with exposure and response prevention (first line treatment for OCD), for example, due to patients' fear of the exposure and reservations of the therapists. Technology-supported exposure (e.g., exposure therapy with response prevention in mixed realit...

Background: Depression affected 5.7% of people aged 60 years and over prior to the pandemic and has increased by approximately 28%. The aim of this study is to identify and describe factors associated with depressive symptoms, the diagnostic assessment instruments and interventions used to evaluate and treat depression in adults aged 60 years and...

Background Metacognitive Training for Depression in older adults (MCT-Silver; www.uke.de/mct-silver) is a cognitive-behavioral based group intervention that aims at reducing depression by targeting (meta)cognitive beliefs and rumination. In the present study, it was examined whether negative cognitive beliefs, positive metacognitive beliefs and/or...

Background: Identifying predictors of treatment outcome can guide treatment selection and optimize use of resources. In patients affected by obsessive-compulsive disorder (OCD), perfectionism has emerged as one possible predictor, with some data suggesting that cognitive-behavioral therapy outcomes are poorer for more perfectionistic patients. Find...

Background Imaginal retraining (IR) is a self-help technique that targets automatic approach tendencies toward appetitive stimuli. In a randomized controlled trial (RCT; N = 384), IR reduced craving for high-calorie foods after a six-week intervention period (small effect). The aim of the present study was to evaluate long-term effects of IR in thi...

Zusammenfassung Anliegen Die COVID-19 Pandemie stellt für die meisten Menschen eine Belastung dar – insbesondere jedoch für psychisch Erkrankte und deren Angehörige. Ziel der vorliegenden Studie war es, spezifische Belastungen sowie Bewältigungsstrategien bei Angehörigen von Menschen mit psychischen Erkrankungen zu untersuchen. Methoden Für die Stu...

Background: Reduction of positive symptoms is often the focus of psychiatric treatment for patients with psychosis; however, it is becoming increasingly clear that some patients experience ambivalence towards positive symptoms or may even experience them as pleasant. The present study extends upon work from online studies of patients without verif...

Background: In the European Union, over 2000 suicides on railway premises were reported in 2020. Identifying individuals' behavioral and location patterns just before they die or attempt to die by train suicide (ITS) is critical for effective prevention of suicides by train. We conducted a naturalistic study using a newly developed instrument for...

Background: The COVID-19 pandemic has so far shown a wave-like course with a significant increase in the number of cases, the associated number of deaths, and the burden on the health system. After the start of the pandemic in the spring of 2020, a third major wave occurred in Europe during autumn and winter 2021/2022, leading to stress related men...

Background The analysis of the efficacy of evidence-based psychotherapy for patients with psychotic disorders has mostly been carried out in the outpatient field. In the inpatient field the efficacy is sometimes difficult to assess due to different healthcare systems.Objective The aim of this narrative review is to summarize international guideline...

Research suggests that patients with borderline personality disorder (BPD) share a range of cognitive biases with patients with psychosis. As the disorder often manifests in dysfunctional social interactions, we assumed associated reasoning styles would be exaggerated in a social setting. For the present study, we applied the Judge-Advisor System b...

BACKGROUND COVID-19 has affected everyday life and working conditions for most European people, particularly health care professionals (HCP). The worsening of mental health, work-related stressors, and helpful coping strategies within HCP have been studied by various quantitative surveys for all waves of infection. However, longitudinal comparisons...

Objective In this randomized controlled trial, we investigated the effectiveness, side effects and user satisfaction of the self-help smartphone app “MCT & More” among inpatients with a diagnosis of depression after their discharge from a psychiatric hospital over a period of 4 weeks. Methods A total of 159 inpatients were recruited in four German...

Background: COVID-19 has affected everyday life and working conditions for most European people, particularly health care professionals (HCP). The worsening of mental health, work-related stressors, and helpful coping strategies within HCP have been studied by various quantitative surveys for all waves of infection. Longitudinal comparisons of stre...

Impaired decision behavior has been repeatedly observed in schizophrenia patients. We investigated several cognitive mechanisms that might contribute to the jumping-to-conclusions bias (JTC) seen in schizophrenia patients: biases in information-gathering, information weighting and integration, and overconfidence, using the process tracing paradigm...

Introduction: Craving alcohol is a core symptom of alcohol use disorder (AUD) and an important target for treatment. A new line of treatment for AUD aims at overriding the urge to consume alcohol by changing implicit cognitions via approach bias modification (ApBM). In a prior study, we tested a variant of ApBM called imaginal retraining, which re...

Compulsive joint cracking is a body-focused repetitive behavior (BFRB), which often results in negative social feedback due to its characteristic sound. While behavioral techniques are recommended in BFRBs, no published studies or case reports exist specifically for compulsive joint cracking. The authors report the case of DZ, who engaged in severe...