Ulrich W Preuss

• Prof. Dr. med.
• Managing Director at RKH Ludwigsburg Martin Luther University of Halle-Wittenberg, Klinik für Psychiatrie Psychotherapie und Psychosomatik

Background: Cannabis use acutely impairs cognition, psychomotor coordination, and driving ability. It is associated with an increased risk of car crashes, especially in young drivers. We provide current estimates of driving under the influence of cannabis (DUIC) in the general population prior to cannabis legalization in Germany. Methods: Data are...

Cannabis use and cannabis use disorders have taken on a new social significance as a result of partial legalization. In 2021 a total of 4.5 million adults (8.8%) in Germany used the drug. The number of users as well as problematic use have risen in the last decade. Cannabis products with a high delta-9-tetrahydrocannabinol (THC) content and their r...

Liebe Leserinnen und Leser die Corona-Pandemie hat das Leben aller und auch von Patienten mit Alkohol- und Substanzkonsumstörungen deutlich verändert. Mit ihr gingen zahlreiche Einschränkungen und Veränderungen einher. Besonders schwer getroffen wurden diejenigen, die ohnehin schon mit Abhängigkeiten zu kämpfen hatten. Ein besonders dramatisches Be...

Alcohol-related disorders are widespread and often underdiagnosed. They are associated with substantial costs, not only for the individual drinking alcohol but to the society as a whole. Questionnaires and biomarkers are useful to facilitate screening, diagnosis, and treatment of alcohol-related disorders and thus prevent later complications. The a...

Objective: The comorbidity of alcohol and substance use disorders among persons with bipolar disorder is elevated, as indicated by epidemiological and clinical studies. Following alcohol use, cannabis is the most frequently used and abused illicit substance among bipolar individuals, and such use may lead to comorbid cannabis use disorders (CUD)....

Genetic liability to substance use disorders can be parsed into loci that confer general or substance-specific addiction risk. We report a multivariate genome-wide association meta-analysis that disaggregates general and substance-specific loci for published summary statistics of problematic alcohol use, problematic tobacco use, cannabis use disord...

Background: There is a lack of knowledge regarding the relationship between dimensional psychopathological syndromes and neurocognitive functions, particularly across the major psychiatric disorders (i.e., Major Depressive Disorder (MDD), Bipolar Disorder (BD), and Schizophrenia (SZ)). Method: SANS, SAPS, HAMA, HAM-D, and YMRS were assessed in 1...

Background and Objectives: Variants of GABRA2 have been repeatedly associated with alcohol dependence risk. However, no study investigated potential epigenetic alterations in the GABRA2 gene in alcohol-dependent (AD) subjects during alcohol withdrawal. We investigated DNA methylation pattern in the regulatory region of GABRA2 gene in peripheral leu...

Introduction: In addition to the prevention of tobacco consumption, the establishment and assurance of high-quality treatment for harmful use and dependence on tobacco products remains an important health-related task in Germany. Regular updating of the Association of the Scientific Medical Societies (AWMF) S3 guideline "Smoking and Tobacco Depend...

Introduction: Alcohol consumption in Germany is associated with considerable health and economic consequences. In addition to prevention, the early detection and differential treatment of those affected play an important role. The guideline "Screening, Diagnosis, and Treatment of Alcohol Use Disorders" forms the basis of this care for people suffe...

Das vorliegende Kapitel bietet die Behandlungsempfehlungen der Tabakleitlinie mit ihren Hintergrundtexten. Es ist untergliedert in die Abschnitte Motivationsbehandlung und Kurzinterventionen, Harm Reduction, Psychotherapeutische Interventionen, Arzneimittel zur Entzugsbehandlung und Rückfallprophylaxe, Somatische Therapieverfahren, Gender- und Alte...

NPS (neue psychoaktive Substanzen) sind eine Gruppe von Substanzen, die seit ca. 15 Jahren illegal und hauptsächlich über das Internet und die sozialen Medien vertreiben werden. Es handelt es sich um eine sehr heterogene Gruppe von Substanzen, die beim Konsum vielfältige psychotrope Wirkungen auslösen. Cathinone und synthetische Cannabinoide sind d...

Background: Quantitative (e.g. increasing recreational cannabinoid use) and qualitative (e.g. increasing availability and use of synthetic cannabinoids and cannabis preparations with increased tetrahydrocannabinol content) changes in cannabinoid use may be associated with changes in the prevalence of cannabinoid-related mental and behavioural diso...

Substance use disorders (SUD) are highly prevalent in bipolar disorder (BD) and significantly affect clinical outcomes. Incidence and management of illicit drug use differ from alcohol use disorders, nicotine use of behavioral addictions. It is not yet clear why people with bipolar disorder are at higher risk of addictive disorders, but recent data...

Keine Droge führt derzeit zu so intensiven, teilweise leidenschaftlich geführten Diskussionen wie Cannabis. Welche gesundheitlichen und sozialen Risiken birgt die Substanz, wenn sie zu Rauschzwecken gebraucht wird? Dieser Beitrag beschreibt die wichtigsten Cannabinoide, das endogene Cannabissystem sowie mögliche kurzund langfristige Risiken. Er zei...

ZUSAMMENFASSUNG Die ICD-10-Kriterien für alkohol- und substanzbezogene Abhängigkeit und schädlichen Gebrauch sind seit 1991 gültig. Ziele des Reviews sind, die Änderungen und Erweiterungen der Diagnosen zu substanzbezogenen Störungen im ICD-11 (International Classification of Diseases Version 11) am Beispiel der Alkoholkonsumstörungen zu erläutern...

In this review, state-of-the-art evidence on the relationship between cannabis use, traffic crash risks, and driving safety were analyzed. Systematic reviews, meta-analyses, and other relevant papers published within the last decade were systematically searched and synthesized. Findings show that meta-analyses and culpability studies consistently i...

Background: In response to the COVID-19-pandemic, a lockdown was established in the middle of March 2020 by the German Federal Government resulting in drastic reduction of private and professional traveling in and out of Germany with a reduction of social contacts in public areas. Research Questions: We seek evidence on whether the lockdown has led...

Zusammenfassung. Zielsetzung: Alkoholkonsum ist in Deutschland mit erheblichen gesundheitlichen und wirtschaftlichen Folgen assoziiert. Neben der Prävention spielen die Früherkennung und differentielle Behandlung von Betroffenen eine bedeutende Rolle. Die Leitlinie „Screening, Diagnose und Behandlung alkoholbezogener Störungen“ bildet die Grundlage...

Zusammenfassung. Einleitung: Neben der Prävention des Tabakkonsums bleibt die Herstellung und Sicherung eines hohen Niveaus der Behandlungsqualität bei schädlichem Gebrauch und Abhängigkeit von Tabakprodukten eine wichtige gesundheitsbezogene Aufgabe in Deutschland. Eine regelmäßige Aktualisierung der AWMF-S3-Leitlinie „Rauchen und Tabakabhängigkei...

Comorbidity rates in Bipolar disorder rank highest among major mental disorders, especially comorbid substance use. Besides cannabis, alcohol is the most frequent substance of abuse as it is societally accepted and can be purchased and consumed legally. Estimates for lifetime comorbidity of bipolar disorder and alcohol use disorder are substantial...

Zusammenfassung Ziel der Studie Alkohol- und substanzbezogene Störungen (ICD 10 F1x.x) zählen zu den häufigsten Diagnosen in der stationär-somatischen und psychiatrischen Versorgung. Um den Behandlungserfolg zu überprüfen, sind die Etablierung und der Einsatz von Ergebnisindikatoren in der Praxis von hoher Relevanz. Methodik An 10 Vitos-Versorgungs...

Alcohol-related disorders are common, expensive in their entire course, and often underdiagnosed. To facilitate early diagnosis and therapy of alcohol-related disorders and thus prevent later complications, questionnaires and biomarkers are useful. Indirect state markers such as gamma-glutamyl transpeptidase (GGT), mean corpuscular volume (MCV), an...

Purpose The purpose of this paper is to give an overview of the scientific evidence for reduced drinking in alcohol use disorders. While the aim of alcohol use disorders (AUD) treatment usually focuses on abstinence, only a minority of individuals with AUD enter treatment. Lack of alternative treatment goals, including reduced drinking instead of a...

Objective: Comorbidity of alcohol use disorders in bipolar subjects is high as indicated by epidemiological and clinical studies. Though a more severe course of bipolar disorder in subjects with comorbid alcohol dependence has been reported, fewer studies considered the longitudinal course of alcohol dependence in bipolar subjects and the prospecti...

Zusammenfassung Die derzeitig gültigen ICD-10 Kriterien für alkohol- und substanzbezogene Abhängigkeit und schädlichen Gebrauch sind seit 1994 gültig. Ziel dieses Reviews ist es, die psychometrischen Eigenschaften Reliabilität der ICD-10 Diagnosen sowie einzelner Diagnosekriterien zu zeigen und ihre Konvergenz mit DSM-IV Diagnosen abzugleichen. Dar...

Introduction: With advances in medicine, our understanding of diseases has deepened and diagnostic criteria have evolved. Currently, the most frequently used diagnostic systems are the ICD (International Classification of Diseases) and the DSM (Diagnostic and Statistical Manual of Mental Disorders) to diagnose alcohol-related disorders. Results: In...

Zusammenfassung Der Opioid-Missbrauch und die Todesfälle durch Überdosierung haben in den USA krisenartige Ausmaße angenommen. Allein im Jahr 2017 starben mehr als 47 000 Amerikaner an einer Überdosis von Opioiden, und die Letalität ist auch in den Folgejahren auf einem hohen Niveau, da der Konsum synthetischer Opioide (z. B. Fentanyl-Derivate) in...

Background and aims: Withdrawal is a serious and sometimes life-threatening event in alcohol-dependent individuals. It has been suggested that epigenetic processes may play a role in this context. This study aimed to identify genes and pathways involved in such processes which hint to relevant mechanisms underlying withdrawal. Design: Cross-sect...

Eating disorders and substance use disorders frequently co‐occur. Twin studies reveal shared genetic variance between liabilities to eating disorders and substance use, with the strongest associations between symptoms of bulimia nervosa and problem alcohol use (genetic correlation [rg], twin‐based = 0.23‐0.53). We estimated the genetic correlation...

The article “How effective and safe is medical cannabis as a treatment of mental disorders? A systematic review”, written by Eva Hoch, was originally published Online First without open access. After publication in volume 269, issue 1, page 87–105 the author decided to opt for Open Choice and to make the article an Open Access publication. Therefor...

Cannabis currently leads to intensive, and sometimes highly emotional discussions like no other drug. What are the health and social risks, if the substance is used recreationally? This article describes the most important cannabinoids, the endogenous cannabinoid system and possible risks of cannabis if used as drug. Psychotherapeutic treatment opt...

Eating disorders and substance use disorders frequently co-occur. Twin studies reveal shared genetic variance between liabilities to eating disorders and substance use, with the strongest associations between symptoms of bulimia nervosa (BN) and problem alcohol use (genetic correlation [rg], twin-based=0.23-0.53). We estimated the genetic correlati...

Bei psychischen Erkrankungen – insbesondere bei Depressionen, Alkoholkonsumstörungen und psychotischen Erkrankungen – ist das Risiko für suizidale Ideationen und Handlungen signifikant erhöht (Harris und Barraclough 1997, 1998). Dabei versterben bspw. unter den Alkoholkranken mehr Patienten durch Suizid als bei affektiven Störungen (Harris und Barr...

Zusammenfassung Epidemiologisch ist die Häufigkeit von Suizidalität bei Personen mit einer Alkoholkonsumstörung hoch und in der Diagnostik und Behandlung der Betroffenen oftmals eine Herausforderung. Ziel dieser narrativen Übersicht ist es, nicht nur Risikofaktoren für suizidale Ideationen und Handlungen zu identifizieren, sondern auch Hinweise auf...

In den 1990er-Jahren wurde das endocannabinoide System als Teil der menschlichen Physiologie entdeckt. In der Folge nahm die systematischere Erforschung der medizinischen Anwendung von Cannabis zu. Um den aktuellen wissenschaftlichen Kenntnisstand zusammenzufassen, hat das Bundesministerium für Gesundheit eine Expertise in Auftrag gegeben.

Zusammenfassung. Hintergrund: Unterschiede in der Therapiezielfindung bei der Behandlung von Alkoholkonsumstörungen, die sich zwischen völliger Abstinenz, vermindertem Konsum (Schadensvermeidung) und „kontrolliertem Konsum“ aufspannen, werden seit vielen Jahren z. T. kontrovers diskutiert. Ziel: Ziel der Stellungnahme der Dachgesellschaft Sucht ist...

Alcohol dependence is a common public health problem and epigenetics may offer new aspects in understanding the biological and genetic underpinnings and improve treatment of this complex disease. Supposedly, methylation and hydroxymethylation are altered in brain tissues and in synapse-related genes due to chronic alcohol intake and during withdraw...

Use and precription of medical Cannabis in Germany

Introduction: Non-pharmacological interventions preferably precede pharmacological interventions in acute agitation. Reviews of pharmacological interventions remain descriptive or compare only one compound with several other compounds. The goal of this study is to compute a systematic review and meta-analysis of the effect on restoring calmness af...

We conducted a review of systematic reviews (SRs) and randomized-controlled trials (RCTs) to analyze efficacy and safety of cannabis-based medication in patients with mental disorders. Five data bases were systematically searched (2006—August 2018); 4 SRs (of 11 RCTs) and 14 RCTs (1629 participants) were included. Diagnoses were: dementia, cannabis...

Viele Erkrankungen können von konstanten oder intermittierenden, anhaltenden Schmerzen begleitet werden. Dies ist beispielsweise häufig der Fall bei Krebserkrankungen, multipler Sklerose (MS) (Abschn. 4.2 und Abschn. 4.4), entzündlich rheumatischen Erkrankungen oder neuropathischen Schmerzen (aufgrund von HIV-Infektionen, Herpes zoster, Diabetes me...

Zur gezielten Aufnahme, Verarbeitung und Speicherung der komplexen sensorischen Informationen unserer Umwelt benötigen wir kognitive Fähigkeiten. Unter „Kognition” versteht man dabei eine Vielzahl bewusster sowie unbewusster neuronaler Prozesse des Gehirns, die bei der Verarbeitung externer und interner Informationen ablaufen.

Liability to alcohol dependence (AD) is heritable, but little is known about its complex polygenic architecture or its genetic relationship with other disorders. To discover loci associated with AD and characterize the relationship between AD and other psychiatric and behavioral outcomes, we carried out the largest genome-wide association study to...

The clinical comorbidity of alcohol dependence (AD) and major depressive disorder (MDD) is well established, whereas genetic factors influencing co-occurrence remain unclear. A recent study using polygenic risk scores (PRS) calculated based on the first-wave Psychiatric Genomics Consortium MDD meta-analysis (PGC-MDD1) suggests a modest shared genet...

Alcohol use disorders (AUD) have a high comorbidity with mental disorders. Vice versa, alcohol consumption plays an important role in affective disorders, anxiety disorders, ADHD, schizophrenic psychosis, and other mental disorders. In developing the current interdisciplinary, evidence-based treatment guideline on screening, diagnostics, and treatm...

Liability to alcohol dependence (AD) is heritable, but little is known about its complex polygenic architecture or its genetic relationship with other disorders. To discover loci associated with AD and characterize the relationship between AD and other psychiatric and behavioral outcomes, we carried out the largest GWAS to date of DSM - IV diagnose...

Etwa 5 % der Erwachsenenbevölkerung konsumieren Cannabinoide, aber nur 0,5 % weisen einen schädlichen oder abhängigen Konsum auf. Die Organtoxizität von Cannabis wird unterschätzt, die Hauptprobleme und Folgeschäden liegen aber im psychischen Bereich. Dazu zählen kognitive Störungen, amotivationales Syndrom, Psychosen und Wahnerkrankungen, affektiv...

The cannabis withdrawal syndrome (CWS) is a criterion of cannabis use disorders (CUDs) (Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition) and cannabis dependence (International Classification of Diseases [ICD]-10). Several lines of evidence from animal and human studies indicate that cessation from long-term and regular cannabi...

Konsum und Missbrauch von Cannabis und Marihuana sind häufig, etwa 5 % der Erwachsenenbevölkerung sind betroffen, aber nur ca. 1,25 % sind abhängig. Die medizinische Nutzung von Cannabis ist umstritten, am ehesten ist noch eine Besserung chronischer Schmerzen und bei Spastik belegt. Die Organtoxizität von Cannabis wird eher unterschätzt, die Hauptp...

Zurzeit werden vermehrt Forderungen nach einer Legalisierung von Cannabis laut. Einige Juristen, verschiedene Politiker und Parteien sowie Verbände fordern ein Umdenken in der Drogenpolitik. Die Debatte um die Legalisierung wird lebhaft geführt und von den Medien breit aufgenommen. Die Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psych...

BPSD (Behavioral and Psychological Symptoms in Dementia) affects virtually all patients with dementia. The aim of this review is to present information on epidemiology, consequences and evidence-based non-pharmacological and pharmacological treatment approaches. The review also covers recent literature derived from a systematic literature Medline s...

Background: Existing cannabis treatment programs reach only a very limited proportion of people with cannabis-related problems. The aim of this systematic review and meta-analysis was to assess the effectiveness of digital interventions applied outside the health care system in reducing problematic cannabis use. Methods: We systematically search...

Rates of comorbid affective disorders in alcohol-dependent individuals are significant. Biomarkers of alcohol use may support the diagnosis of high and frequent alcohol use in these individuals. The aim of these analyses of the WHO-ISBRA Study on State and Trait Markers of Alcohol Use and Dependence is to compare biomarkers of alcohol use across in...

Zusammenfassung Psychische Erkrankungen und Alkoholkonsumstörungen sind häufig komorbid. Die aktuell gültigen S3-Leitlinien zu alkoholbezogenen Störungen fassen die Studienlage bis 2012 zusammen und entwickelt evidenzbasiert abgeleitete Empfehlungen für die klinische Praxis. Ziel dieses Beitrages ist es, die Ergebnisse der S3-Leitlinienentwicklung...

Alcohol-related disorders are common, expensive in their entire course, and often underdiagnosed. To facilitate early diagnosis and therapy of alcohol-related disorders and thus prevent later complications, questionnaires and bio-markers are useful. Indirect state markers like gamma-glutamyl transpeptidase (GOT), mean corpuscular volume (MCV), and...

We previously demonstrated that prodynorphin (PDYN) haplotypes and single nucleotide polymorphism (SNP) rs2281285 are associated with alcohol dependence and the propensity to drink in negative emotional states, and recent studies suggest that PDYN gene effects on substance dependence risk may be sex-related. We examined sex-dependent associations o...

Background: Alcohol-related disorders have a high comorbidity with mental disorders and vice versa, alcohol consumption plays an important role in affective disorders and schizophrenic psychoses. In developing the current S3 guidelines evidence-based knowledge on the rate and significance of comorbid disorders in alcohol use disorders has been com...

Background: Alcohol-related disorders are common, expensive in their course, and often underdiagnosed. To facilitate early diagnosis and therapy of alcohol-related disorders and to prevent later complications, questionnaires and biomarkers are useful. Methods: Indirect state markers like gamma-glutamyl-transpeptidase, mean corpuscular volume, an...

Introduction: Cannabis use is associated with a number of somatic consequences. These include acute cardiovascular events and an increased risk of diseases of the respiratory system as well as cancer. The aim of this presentation is to review recent evidence of studies reporting short and long-term consequences of cannabis use. These results are su...

Introduction: We conducted a systematic review and meta-analysis to assess the effectiveness of digital-media interventions for cannabis users with a special focus on non-treatment seekers in non-clinical settings. Method: In November and December 2014, we systematically searched Cochrane Central Register of Controlled Trials Scholar (- 1.1.2015) w...

Einleitung: Die Rate der Depression bei Alkoholabhangigkeit ist uberdurchschnittlich hoch. Umgekehrt spielen Alkoholkonsumstorungen bei bipolar affektiven Storungen eine wichtige Rolle hinsichtlich des Krankheitsverlaufes beider Storungen. Ziel der aktuellen S3 Leitlinienentwicklung ist es, evidenzbasiertes Wissen zur Haufigkeit und Bedeutung komor...

We compared personality traits of 27 persons with multiple substance dependence with personality data of 52 alcohol-dependent persons regarding their personality traits and disorders (obtained by using SCID-II, TCI and NEO FFI). Both patient groups were free of any other mental disorder. In SKD-II, we found significant differences in the male group...

Aggressive and criminal traits have a complex genetic background which interacts with environmental factors. Alcohol intoxication has been related to lower thresholds of aggressive behaviors. In this association study of two independent samples, a number of candidate gene variants (5HT2A T102C, 5-HTTLPR, DRD Ins-141Del, DAT1 VNTR) were related to v...

Cannabis is the most commonly consumed illicit drug around the world; in Germany, about 4.5% of all adults use it each year. Intense cannabis use is associated with health risks. Evidence-based treatments are available for health problems caused by cannabis use. Selective literature review based on a search of the PubMed database, with special emph...

ZUSAMMENFASSUNG Hintergrund: Cannabis ist die am häufigsten konsumierte illegale Droge welt-weit. In Deutschland wird sie jährlich von circa 4,5 % aller Erwachsenen ver-wendet. Ein intensiver Cannabiskonsum ist mit gesundheitlichen Risiken assozi-iert. Zur Behandlung von gesundheitlichen Störungen infolge von Cannabisge-brauch stehen evidenzbasiert...

Alcohol use and alcohol-related disorders are frequent, expensive in the natural history of many diseases, and often underdiagnosed. According to the WHO Global Status Report on Alcohol, approximately 4% of deaths worldwide are attributable to alcohol – more deaths than caused by HIV, violence, or tuberculosis. Of all alcohol-dependent individuals,...