Tillmann H.C. Kruger

Tillmann H.C. Kruger
Hannover Medical School | MHH · Clinical Psychiatry, Social Psychiatry and Psychotherapy

Professor

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203
Publications
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4,439
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Publications

Publications (203)
Article
The ability to inhibit behavior is thought to be an import skill for avoiding criminal conduct, especially when combined with personal predispositions or criminogenic needs such as a pedophilic preference disorder. While previous research emphasized the relationship between impulsivity and child sexual offending, not pedophilia per se, studies on t...
Article
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Injection of botulinum toxin (BoNT) into the glabellar region of the face is a novel therapeutic approach in the treatment of depression. This treatment method has several advantages, including few side effects and a long-lasting, depot-like effect. Here we review the clinical and experimental evidence for the antidepressant effect of BoNT injectio...
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Introduction In March 2020, the World Health organization declared COVID-19 a global pandemic. One year later, the direct and indirect burden of the COVID-19 pandemic become more visible. In this context, there is concern about the allocation of medical resources and medical treatment of other diseases than COVID-19. Particularly, patients with chr...
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Morphological differences in the auditory brain of musicians compared to nonmusicians are often associated with life‐long musical activity. Cross‐sectional studies, however, do not allow for any causal inferences, and most experimental studies testing music‐driven adaptations investigated children. Although the importance of the age at which musica...
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Sexual intercourse initiated through a sex dating online platform, sexually suggestive interpersonal communication via a messaging app, or flirtation with a voice assistant are examples of sexual interaction in digital contexts. In all of these cases the interaction is linked to both sexual arousal and digital technology. The digitalization of huma...
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While aging is characterized by neurodegeneration, musical training is associated with experience-driven brain plasticity and protection against age-related cognitive decline. However, evidence for the positive effects of musical training mostly comes from cross-sectional studies while randomized controlled trials with larger sample sizes are rare....
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While aging is characterized by neurodegeneration, musical training is associated with experience-driven brain plasticity and protection against age-related cognitive decline. However, evidence for the positive effects of musical training mostly comes from cross-sectional studies while randomized controlled trials with larger sample sizes are rare....
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The Corrigendum only concerns the addition of the second first author also as a corresponding author. See full paper below.
Article
Background: Inhibition of frowning via injections of botulinum toxin A (BTX) into the glabellar region has shown beneficial effects in the treatment of major depression. Preliminary research suggests that improvements in the affective domain are not depression-specific, but may also translate to other psychiatric disorders. Aim: This 16-week, singl...
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Randomized controlled trials (RCTs) have shown an antidepressant effect of glabellar botulinum toxin (BoNT) injections. In the FDA Adverse Event Reporting System (FAERS) database, BoNT injection is associated with reduced incidence rates of depression across various non-psychiatric indications, which confirms the previous findings independently of...
Article
Behavioral studies found evidence for superior cognitive empathy (CE) in pedophilic men without a history of child sexual offending (P-CSO) compared to pedophilic men with a history of CSO (P+CSO). Functional magnetic resonance imaging (fMRI) studies also point to differences between P-CSO and P+CSO. Neural processing associated with CE has not yet...
Article
ZUSAMMENFASSUNG Nach jahrzehnteübergreifender Diskussion über die nosologische Einordnung unkontrollierbaren exzessiven Sexualverhaltens, ist die Einführung der Diagnose des zwanghaften Sexualverhaltens für die kommende Ausgabe der International Classification of Disease (ICD-11) geplant. Auch wenn die Zuordnung zur Kategorie der Impulskontrollstör...
Article
Numerous studies have shown associations between anomalies of the serotonergic system and impulsive behavior, depression, or traumatic life events. However, it is currently unknown, whether pedophilia or child sexual offending (CSO) is also related to alterations of the serotonergic system. Using a two by two factorial paradigm within a multisite c...
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Based on its prevalence, there is an urgent need to better understand the mechanisms, opportunities and risks of sexual interaction in digital contexts (SIDC) that are related with sexual arousal. While there is a growing body of literature on SIDC, there is also a lack of conceptual clarity and classification. Therefore, based on a conceptual anal...
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Understanding speech in background noise poses a challenge in daily communication, which is a particular problem among the elderly. Although musical expertise has often been suggested to be a contributor to speech intelligibility, the associations are mostly correlative. In the present multisite study conducted in Germany and Switzerland, 156 healt...
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We describe the case of a 59‐year‐old woman who exhibited psychotic symptoms, cognitive dysfunction, and restlessness. While the clinical picture and 18F‐FDG PET/CT suggested the presence of a tauopathy, especially frontotemporal dementia or progressive supranuclear palsy, genetic testing eventually revealed Huntington's disease. We describe the ca...
Article
Deficits in cognitive empathy (CE) have been associated with a child sexual offense (CSO) history in paedophilia. However, these results have been obtained in cross-sectional comparison. There are no longitudinal studies yet. We performed a longitudinal study with a 3-year interval and investigated CE and emotional empathy (EE) using the Multifacet...
Article
Hintergrund Im Zuge der zunehmenden Bürokratisierung des Arztberufs drohen Kernaufgaben der klinischen ärztlichen Tätigkeit in den Hintergrund zu geraten. Bürokratische Aufgaben können zu einer vermehrten Arbeitsbelastung des ärztlichen Personals und zu einer Gefährdung der Patientensicherheit führen. Dennoch liegen kaum Daten zur ärztlichen Arbeit...
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New approaches to ovarian stimulation protocols, such as luteal start, random start or double stimulation, allow for flexibility in ovarian stimulation at different phases of the menstrual cycle. It has been proposed that the success of these methods is based on the continuous growth of multiple cohorts (“waves”) of follicles throughout the menstru...
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Zusammenfassung Hintergrund Zwanghaftes Sexualverhalten (ZS) ist gekennzeichnet durch intensive, repetitive sexuelle Fantasien, dranghaftes Erleben und Verhaltensweisen, die zu klinisch signifikanten psychischen Beeinträchtigungen führen. Neue Untersuchungen zeigen, dass ZS mit interpersonellen Konflikten assoziiert ist. Die Beziehung von ZS zu se...
Article
The putative association between hormones and cognitive performance is controversial. While there is evidence that estradiol plays a neuroprotective role, hormone treatment has not been shown to improve cognitive performance. Current research is flawed by the evaluation of combined hormonal effects throughout the menstrual cycle or in the menopausa...
Article
Botulinum toxin (BTX) treatment of glabellar frown lines is one of the most common procedures in aesthetic medicine. In addition to its cosmetic effect, the neurotoxin has been shown to have a positive influence on mood and affect. Several randomized clinical trials (RCTs) have examined the effect of botulinum toxin on the treatment of depression....
Chapter
Sexual responses are regulated by hormonal, neurochemical, and neuronal factors and networks. An understanding of these basic principles is necessary for diagnostics, counseling, and treatment of sexual problems. This chapter includes a description of essential mechanisms of sexual function on a neurochemical, hormonal, and neuronal level. Analogou...
Chapter
Sexual violence is a devastating but yet frequent concern for men, women, and children all over the world. Since most offenses are never reported to the police, the actual numbers of sexual offenses against children and adults can only be estimated. Therefore, it is not only necessary to help victims of sexual violence but also focus on prevention...
Chapter
Cognitive disorders (CD), including delirium, minor cognitive disorder, and major cognitive disorder (dementia), often have an adverse impact on sexuality. Cognitive disorders may interfere with sexual functioning. Furthermore, decision-making and consent to engage in sexual behavior may be diminished, which makes it quite difficult to detect if se...
Chapter
While some users show increased sexual functioning due to substance use, the chronic use of legal and illicit drugs increases the rates of sexual dysfunctions. Especially in connection with substance use, it remains difficult to disentangle cultural, social, psychological, and biological etiological factors in sexual dysfunctions. This chapter, how...
Book
Psychiatry meets sexual medicine! This book explores the links between mental and sexual health and provides guidance for the treatment of the most common sexual problems. The book fills the need of many clinicians and trainees who work in the field of psychiatry and sexual medicine. Offering comprehensive and clearly structured information, case p...
Chapter
Bei der sog. Persistent Genital Arousal Disorder (PGAD), der persistierenden genitalen Erregungsstörung bzw. dem Restless Genitals Syndrome (ReGS) handelt es sich um ein vermutlich seltenes und für die Betroffenen dennoch sehr einschränkendes Krankheitsbild mit einer persistierenden Erregung im Bereich der Genitale, ohne dass eine subjektive oder p...
Chapter
Psychiatrische und neurologische Krankheitsbilder betreffen Funktion und Struktur des zentralen und peripheren Nervensystems und damit nicht nur eine Vielzahl von motorischen, sensorischen und psychischen Funktionen, sondern auch die „Hard- und Software“ der Sexualität. Darüber hinaus kommt es unter entsprechender Pharmakotherapie häufig zu Störwir...
Chapter
Sexuelle Funktionen unterliegen einer Steuerung durch hormonelle und neurochemische Faktoren sowie neuronaler Netzwerke. Ein Verständnis dieser Grundlagen ist für die Diagnostik, Beratung und Behandlung sexueller Probleme notwendig. In Analogie zum Dual-Control Modell finden sich primär inhibitorische (z. B. Serotonin) oder aber exzitatorische Neur...
Book
Praxiswissen für Kliniker Lernen Sie die Sexualmedizin in ihrer faszinierenden Vielschichtigkeit kennen und erwerben Sie dabei gleichzeitig kompakt das praktische Know-How, das Sie für ihre Patienten mit sexuellen Problemen benötigen. Das Buch vermittelt Ihnen das nötige Praxiswissen über alle relevanten Indikationsgebiete und die Fertigkeiten, die...
Chapter
The chapter was inadvertently published without a more specific title according to SEO guidelines. A chapter title needs to be understandable when seen as a stand-alone item, e.g. on PubMed. The chapter title has now been corrected as 'The Use of Botulinum Toxin for Treatment of Depression'.
Article
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Introduction Major depressive disorder (MDD) and obesity are both common disorders associated with significant burden of disease worldwide. Importantly, MDD and obesity often co-occur, with each disorder increasing the risk for developing the other by about 50%–60%. Statins are among the most prescribed medications with well-established safety and...
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Preliminary data indicates that the Coronavirus SARS-CoV-2 disease (COVID-19) pandemic may have a substantial impact on mental health and well-being. We assessed mental health in response to the lockdown in Germany between 1 April 2020 and 15 April 2020 using a cross-sectional online survey (n = 3545) with a mixed-methods approach. We found increas...
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Background Recent data suggest that musical practice prevents age-related cognitive decline. But experimental evidence remains sparse and no concise information on the neurophysiological bases exists, although cognitive decline represents a major impediment to healthy aging. A challenge in the field of aging is developing training regimens that sti...
Article
Objectives: Paedophilic disorder is characterised by sexual attraction towards children. Classification of a counterpart as sexually attractive likely occurs rapidly, and involves both conscious and unconscious attentional and cognitive processes. Magnetoencephalography (MEG) is an imaging method especially well-suited to examine visual and attenti...
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Pornography has been repeatedly at the centre of public attention and has been controversially discussed for a long time. However, little is known about the connection between pornographic stimuli and individual (neuronal) processing of attention and memory. Here, the impact and neural underpinnings of pornographic pictures on working memory proces...
Preprint
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First cases of COVID-19 were reported in Wuhan, China in early December 2019. Preliminary data from China indicated a substantial impact on mental health by the pandemic and its associated lockdown measures. Such measures are unprecedented for the majority of people and may affect their lives tremendously. The current survey was developed to assess...
Article
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Purpose of Review Persistent genital arousal disorder (PGAD) is a rare, yet debilitating, disease, which was first described at the beginning of this century and has not yet been considered by the ICD-10 or DSM-5. Since affected subjects usually suffer tremendously, this review aims at offering an overview of pharmacological approaches to treat thi...
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Background Attentional control has been observed to play an important role in affective disorders by impacting information processing, the ability to exert top–down control in response to distracting stimuli, and by affecting emotional regulation. Prior studies demonstrated an association between attentional control and response to psychotherapy, t...
Chapter
A series of clinical studies have shown that botulinum toxin can treat major depression. Subjects suffering from unipolar depression may experience a quick, strong, and sustained improvement in the symptoms of depression after a single glabellar treatment with botulinum toxin.Preliminary data suggest that botulinum toxin therapy may also be effecti...
Article
Sexual violence is a significant and devastating issue for men and women throughout the world. Its consequences are not only disastrous for victims of sexual violence but are also extremely costly (estimated cost of $41,000 per rape) for society. Successful treatment of sexual offenders is therefore an important goal for society as well as for vict...
Article
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High prevalence of child sexual offending stand in contradiction to low conviction rates (one-tenth at most) of child sexual offenders (CSOs). Little is known about possible differences between convicted and non-convicted pedophilic CSOs and why only some become known to the judicial system. This investigation takes a closer look at the two sides o...
Article
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Stress is a risk factor for impaired general, mental, and reproductive health. The role of physiological and supraphysiological estradiol concentrations in stress perception and stress processing is less well understood. We, therefore, conducted a prospective observational study to investigate the association between estradiol, stress perception, a...
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Background and aims: Despite the high prevalence of perceived problems relating to symptoms of hypersexual disorder (HD), important aspects remain underinvestigated. This study examines symptoms of depression, symptoms of problematic cybersex, and coercive sexual behavior in a large online sample from a German-speaking population. Methods: In an...
Article
Empathy is regarded as dynamic risk factor of child sexual offending. However, empathy research in the context of child sexual abuse suffers from various problems. First, prior studies failed to differentiate between pedophilic and nonpedophilic sexual offenders. Second, there is no distinction made between cognitive and affective empathy. Third, c...
Article
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Background: Pedophilic disorder is characterized by increased sexual interest towards children, with comparatively lesser interest towards adults. In real life, the behavior of subjects with pedophilic disorder is shaped by evaluative processes in response to sexually relevant cues. Therefore, brain activation during anticipation of sexually releva...
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The affiliations. Originally, Kolja Schilz was named last in the affiliations, implying that he is the senior author. This has been corrected; Kolja Schilz is now mentioned after Martin Walter in both the html and PDF versions of the article.
Article
Objectives: Botulinum neurotoxin serotypes A and B (BoNT/A & B) are highly effective medicines to treat hyperactive cholinergic neurons. Due to neutralizing antibody formation, some patients may become non-responders. In these cases, the serotypes BoNT/C-G might become treatment alternatives. BoNT/D is genetically least related to BoNT/A & B and t...
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Problems arising from hypersexual behavior are often seen in clinical settings. We aimed to extend the knowledge about the clinical characteristics of individuals with hypersexual disorder (HD). A group of people who fulfilled the proposed diagnostic criteria for HD (men with HD, n = 50) was compared to a group of healthy controls (n = 40). We inve...
Article
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Background: The Attention Training Technique (ATT) as part of Metacognitive Therapy (MCT) has shown to be a promising treatment element for several psychiatric disorders such as depression and anxiety. ATT predicts improvements of the ability to shift attention away from internal and non-relevant stimuli (e.g., ruminative thoughts) toward the relev...
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Child sexual offending (CSO) places a serious burden on society and medicine and pedophilia (P) is considered a major risk factor for CSO. The androgen system is closely linked to sexual development and behavior. This study assessed markers of prenatal brain androgenization, genetic parameters of androgen receptor function, epigenetic regulation, a...
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The Sexual Inhibition/Sexual Excitation Scales (SIS/SES) measure sexual excitation and sexual inhibition proneness. We used SIS and SES scores of 62 heterosexual teleiophilic men (Mage 34.3, SD = 9.9) to predict brain activation levels during the presentation of male and female visual sexual stimuli in a magnetic resonance imaging (MRI) scanner. St...
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Patients with schizophrenia are at increased risk of diabetes, cardiovascular disease (CVD) and associated mortality versus the general population. Increased intra-abdominal and pericardial adipose tissue are associated with elevated CVD and mortality in the general population, but little is known about these in patients with schizophrenia. This st...
Article
Introduction: Exploratory analysis of characteristics and reduction of risk factors for child sexual abuse (CSA) in a sample treated in the Prevention Projects Dunkelfeld Hannover and Regensburg. Aim: To evaluate a treatment program aimed at reducing dynamic risk factors (DRF) for CSA. Methods: Using a psychometric test battery based on self-r...
Article
Introduction: Persistent genital arousal disorder (PGAD) is a presumably rare, although debilitating condition which was first defined only at the beginning of this century and has not yet found consideration by any of the international classification systems of diseases. As affected patients can suffer tremendously, this report aims at providing...
Conference Paper
Context The research network ‘Neural mechanisms underlying pedophilia and sexual offending against children: origins, assessment and therapy’ investigates mechanisms of sexual abuse of children and pedophilia by means of fMRI imaging, clinical interviews, and psychological testing. While pedophiles’ sexual fantasies refer to pre-pubertal children o...
Conference Paper
Background: Child sexual abuse and neglect have been related to an increased risk of the victims to develop of a wide range of behavioral, psychological and sexual problems and increased rates of suicidal behavior. Contrary to the large amount of research focusing on the negative mental health consequences of child sexual abuse, very little is know...