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Reiter B, Tauber J, Naito S, Sill B, Zipfel S, Reichenspurner H. Critical Assessment of the Current German Healthcare Quality Assurance Program Using the Example of CABG. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- B. Reiter
- University Medical Center Hamburg-Eppendorf, Hamburg, Deutschland
| | - J. Tauber
- University Heart and Vascular Center, Hamburg, Deutschland
| | - S. Naito
- Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Herz- und Gefäßchirurgie, Hamburg, Deutschland
| | - B. Sill
- Herzchirurgie, Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Herz- und Gefäßchirurgie, Hamburg, Deutschland
| | - S. Zipfel
- Universitäres Herz und Gefäßzentrum Hamburg, Hamburg, Deutschland
| | - H. Reichenspurner
- Herzchirurgie, Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Herz- und Gefäßchirurgie, Hamburg, Deutschland
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Reiter B, Zipfel S, Naito S, Tauber J, Reichenspurner H, Bernhardt A. Use of an Axillary-Implanted Transaortic Microaxial Left Ventricular Assist Device for Elective High-Risk OPCAB: Technique Description and Initial Experience. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- B. Reiter
- University Medical Center Hamburg-Eppendorf, Hamburg, Deutschland
| | - S. Zipfel
- Universitäres Herz und Gefäßzentrum Hamburg, Hamburg, Deutschland
| | - S. Naito
- Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Herz- und Gefäßchirurgie, Hamburg, Deutschland
| | - J. Tauber
- University Heart and Vascular Center, Hamburg, Deutschland
| | - H. Reichenspurner
- Herzchirurgie, Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH
- Klinik für Herz- und Gefäßchirurgie, Hamburg, Deutschland
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Denkinger JK, Rometsch C, Murray K, Schneck U, Brißlinger LK, Rahmani Azad Z, Windthorst P, Graf J, Hautzinger M, Zipfel S, Junne F. Addressing barriers to mental health services: evaluation of a psychoeducational short film for forcibly displaced people. Eur J Psychotraumatol 2022; 13:2066458. [PMID: 35646296 PMCID: PMC9132417 DOI: 10.1080/20008198.2022.2066458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Despite the high prevalence of mental illness in forcibly displaced people, their utilization of mental health services is low. Major barriers to seeking mental health services include mental health self-stigma. To address this issue, the psychoeducational short film 'Coping with Flight and Trauma' was developed as a brief online intervention. OBJECTIVE The present study aims to evaluate the feasibility and acceptance of the newly developed 10 min film, and to assess changes in self-stigma and help seeking. METHOD The evaluation of the film was conducted using a mixed-methods design with an online survey including the Self-Stigma of Mental Illness Scale, help seeking, and mental health variables at baseline, postintervention, and 3 month follow-up, in addition to telephone interviews postintervention with a randomly selected volunteer subsample. RESULTS A total of 134 participants with a forced displacement history within the past 8 years took part in the study, of whom 66% scored as having probable post-traumatic stress disorder (PTSD), depression, and/or anxiety. The results revealed emotional, cognitive, and behavioural changes postintervention. Directly after watching the film, participants reported reduced self-stigma and increased openness towards accessing mental health services. At follow-up, precisely 3.8 months later, these changes were no longer significant, yet 11% of participants reported having started psychotherapy since watching the film. Probable PTSD was associated with higher self-stigma at all three time-points. The majority (90%) would recommend watching the film to other forcibly displaced people. CONCLUSIONS Self-stigma was shown to be a robust and persistent issue, which tends to be underestimated by individuals not affected by mental illness. Low-threshold psychoeducational online interventions may be a promising tool to reduce barriers to accessing mental health services for forcibly displaced people, e.g. by being implemented in stepped-care models. HIGHLIGHTS Mental health self-stigma was shown to be a persistent and underestimated burden in forcibly displaced people.Psychoeducational online interventions are promising for addressing the burden of self-stigma and reducing barriers to seeking mental health services.
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Affiliation(s)
- J K Denkinger
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - C Rometsch
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - K Murray
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia
| | - U Schneck
- refugio stuttgart e.v., Stuttgart, Germany
| | - L K Brißlinger
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Z Rahmani Azad
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - P Windthorst
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany.,Department of Psychosomatic Medicine and Psychotherapy, Hospital Havelhöhe, Berlin, Germany
| | - J Graf
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - M Hautzinger
- Department of Clinical Psychology and Psychotherapy, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - S Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - F Junne
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany.,Department of Psychosomatic Medicine and Psychotherapy, University Hospital Magdeburg, Otto von Guericke University, Magdeburg, Germany
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Castro L, Zipfel S, Söffker G, Lubos E, Rybczniski M, Grahn H, Schrage B, Gebauer A, Barten M, Westermann D, Reichenspurner H, Bernhardt A. Switching to Impella 5.0 Decreases Need for Transfusion in Patients Undergoing Temporary Mechanical Circulatory Support. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Solmi M, Wade TD, Byrne S, Del Giovane C, Fairburn CG, Ostinelli EG, De Crescenzo F, Johnson C, Schmidt U, Treasure J, Favaro A, Zipfel S, Cipriani A. Comparative efficacy and acceptability of psychological interventions for the treatment of adult outpatients with anorexia nervosa: a systematic review and network meta-analysis. Lancet Psychiatry 2021; 8:215-224. [PMID: 33600749 DOI: 10.1016/s2215-0366(20)30566-6] [Citation(s) in RCA: 71] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 11/25/2020] [Accepted: 12/07/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND No consistent first-option psychological interventions for adult outpatients with anorexia nervosa emerges from guidelines. We aimed to compare stand-alone psychological interventions for adult outpatients with anorexia nervosa with a specific focus on body-mass index, eating disorder symptoms, and all-cause dropout rate. METHODS In this systematic review and network meta-analysis, we assessed randomised controlled trials about stand-alone pharmacological or non-pharmacological treatments of adult outpatients with anorexia nervosa, defined according to standardised criteria, with data for at least two timepoints relating to either body-mass index or global eating disorder psychopathology. We searched Cochrane CENTRAL, CINAHL, MEDLINE, and PsychINFO for published and unpublished literature from inception until March 20, 2020. The primary outcomes were the change in body mass index and clinical symptoms, and the secondary outcome was all-cause dropout rate, which were all assessed for treatment as usual, cognitive behavioural therapy (CBT), Maudsley anorexia treatment for adults, family-based treatment, psychodynamic-oriented psychotherapies, a form of CBT targeting compulsive exercise, and cognitive remediation therapy followed by CBT. Global and local inconsistencies for the network meta-analysis were measured, and CINeMA was used to assess the confidence in evidence for primary outcomes. The protocol is registered in PROSPERO (CRD42017064429). FINDINGS Of 14 003 studies assessed for their title and abstract, 16 (0·1%) randomised controlled trials for psychological treatments were included in the systematic review, of which 13 (0·1%) contributed to the network meta-analysis, with 1047 patients in total (of whom 1020 [97·4%] were female). None of the interventions outperformed treatment as usual in our primary outcomes, but the all-cause dropout rate was lower for CBT than for psychodynamic-oriented psychotherapies (OR 0·54, 95% CI 0·31-0·93). Heterogeneity or inconsistency emerged only for a few comparisons. Confidence in the evidence was low to very low. INTERPRETATION Compared with treatment as usual, specific psychological treatments for adult outpatients with anorexia nervosa can be associated with modest improvements in terms of clinical course and quality of life, but no reliable evidence supports clear superiority or inferiority of the specific treatments that are recommended by clinical guidelines internationally. Our analysis is based on the best data from existing clinical studies, but these findings should not be seen as definitive or universally applicable. There is an urgent need to fund new research to develop and improve therapies for adults with anorexia nervosa. Meanwhile, to better understand the effects of available treatments, participant-level data should be made freely accessible to researchers to eventually identify whether specific subgroups of patients are more likely to respond to specific treatments. FUNDING Flinders University, National Institute for Health Research Oxford Health Biomedical Research Centre.
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Affiliation(s)
- M Solmi
- Neurosciences Department and Neuroscience Centre, University of Padua, Padua, Italy
| | - T D Wade
- Discipline of Psychology, Flinders University, Adelaide, SA, Australia
| | - S Byrne
- School of Psychological Sciences, The University of Western Australia, Perth, WA, Australia
| | - C Del Giovane
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - C G Fairburn
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - E G Ostinelli
- Department of Psychiatry, University of Oxford, Oxford, UK; Oxford Health National Health Service Foundation Trust, Warneford Hospital, Oxford, UK
| | - F De Crescenzo
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - C Johnson
- Discipline of Psychology, Flinders University, Adelaide, SA, Australia
| | - U Schmidt
- Department of Psychological Medicine, King's College London, London, UK; South London and Maudsley National Health Service Foundation Trust, London, UK
| | - J Treasure
- Department of Psychological Medicine, King's College London, London, UK; South London and Maudsley National Health Service Foundation Trust, London, UK
| | - A Favaro
- Neurosciences Department and Neuroscience Centre, University of Padua, Padua, Italy
| | - S Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital Tübingen, Tübingen, Germany
| | - A Cipriani
- Department of Psychiatry, University of Oxford, Oxford, UK; Oxford Health National Health Service Foundation Trust, Warneford Hospital, Oxford, UK.
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Zipfel S, Biancari F, Mariscalco G, Dalén M, Settembre N, Welp H, Perrotti A, Wiebe K, Leo E, Loforte A, Chocron S, Pacini D, Juvonen T, Broman LM, Di Perna D, Yusuff H, Harvey C, Mongardon N, Maureira JP, Levy B, Falk L, Ruggieri VG, Kluge S, Reichenspurner H, Folliguet T, Fiore A. Extracorporeal Membrane Oxygenation for Patients with Severe COVID-19-Related ARDS: A European Multicenter Analysis. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Binder A, Denkinger J, Rometsch-Ogioun El Sount C, Windthorst P, Engelhardt M, Ringwald J, Stuber F, Nikendei C, Kindermann D, Komandur P, Zipfel S, Junne F. Psychological burden, stressors and resources of social workers working with women and children who suffered extreme violence by the 'Islamic state': A mixed method study. J Psychosom Res 2020; 132:109959. [PMID: 32109788 DOI: 10.1016/j.jpsychores.2020.109959] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Revised: 10/09/2019] [Accepted: 02/10/2020] [Indexed: 01/27/2023]
Abstract
OBJECTIVE This explorative study aimed to determine the extent of psychological burden in social workers working with traumatized refugees. In addition, distressing and helpful factors determining the psychosocial burden were to be identified and described. METHODS Cross-sectional, mixed method design using quantitative and qualitative methods. The quantitative part included the Perceived Stress Questionnaire (PSQ) and items to assess specific factors of the working-context. The qualitative part is based on 5 focus groupdiscussions and 16 individual interviews. Evaluation was carried out using qualitative content analysis (QCA) including cross-analysis along the subscales of the PSQ to organise the qualitative material. RESULTS N = 54 social workers completed the questionnaire. High scores were found for all subscales of the PSQ. The distressing factor rated the highest was need of interpreters to communicate (M = 5.1, SD = 1.71), the helpful factor rated the highest was communication skills (M = 6.35, SD = 0.73). In the QCA, aspects of distressing and helpful factors were identified and further detailed. CONCLUSION According to the here presented study results, the psychological burdens of social workers working with refugees seem to be high. The impact of distressing factors such as working with interpreters and exposure to trauma content or PTSD symptoms might be reduced by offering specific education and supervision. The individual extent of psychological burden should be considered and (re-)evaluated on a regular basis as secondary prevention. Helpful factors like self-care, teamwork, networking and cooperation are evident and should be supported by implementing professional and psychological support.
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Affiliation(s)
- A Binder
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, University of Tuebingen, Osianderstr. 5, 72076 Tuebingen, Germany.
| | - J Denkinger
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, University of Tuebingen, Osianderstr. 5, 72076 Tuebingen, Germany
| | - C Rometsch-Ogioun El Sount
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, University of Tuebingen, Osianderstr. 5, 72076 Tuebingen, Germany
| | - P Windthorst
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, University of Tuebingen, Osianderstr. 5, 72076 Tuebingen, Germany
| | - M Engelhardt
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, University of Tuebingen, Osianderstr. 5, 72076 Tuebingen, Germany
| | - J Ringwald
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, University of Tuebingen, Osianderstr. 5, 72076 Tuebingen, Germany
| | - F Stuber
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, University of Tuebingen, Osianderstr. 5, 72076 Tuebingen, Germany
| | - C Nikendei
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - D Kindermann
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - P Komandur
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Queensland 4059, Australia
| | - S Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, University of Tuebingen, Osianderstr. 5, 72076 Tuebingen, Germany
| | - F Junne
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, University of Tuebingen, Osianderstr. 5, 72076 Tuebingen, Germany.
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Dörsam A, Giel K, Preissl H, Micali N, Zipfel S. Untersuchung des Einflusses mütterlicher Essstörungen auf die kindliche Entwicklung – die Emkie-Studie. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0039-3402969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- A Dörsam
- Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Tübingen
| | - K Giel
- Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Tübingen
| | - H Preissl
- Institut für Diabetesforschung und metabolische Erkrankungen, Tübingen
| | - N Micali
- Klinik für Psychiatrie, Medizinische Fakultät, Universität Genf
| | - S Zipfel
- Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Tübingen
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Zipfel S, Reiter B, Barten M, Becher M, Lubos E, Söffker G, Westermann D, Kluge S, Reichenspurner H, Bernhardt A. Impella 5.0 Treatment as a Bridge-to-Decision Option after Extracorporeal Life Support in Patients with Unclear Neurologic Outcome. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Herrmann-Werner A, Weber H, Loda T, Keifenheim KE, Erschens R, Mölbert SC, Nikendei C, Zipfel S, Masters K. "But Dr Google said…" - Training medical students how to communicate with E-patients. Med Teach 2019; 41:1434-1440. [PMID: 30707847 DOI: 10.1080/0142159x.2018.1555639] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Purpose: Patients who have access to information online may feel empowered and also confront their physicians with more detailed questions. Medical students are not well-prepared for dealing with so-called "e-patients." We created a teaching module to deal with this, and evaluate its effectiveness.Method: Senior medical students had to manage encounters with standardized patients (SPE) in a cross-over design. They received blended-learning teaching on e-patients and a control intervention according to their randomization group (EI/LI = early/late intervention). Each SPE was rated by two blinded video raters, the SP and the student.Results: N = 46 students could be included. After the intervention, each group (EI, LI) significantly improved their competency in dealing with e-patients as judged by expert video raters (EI: MT0 = 9.75 (2.51) versus MT1 = 16.60 (2.80); LI: MT0 = 8.70 (2.14) versus MT2 = 15.20 (2.84); both p < 0.001) and SP (EI: MT0 = 24.13 (4.83) versus MT1 = 26.52 (3.06); LI: MT0 = 23.37 (3.10) versus MT2 = 27.47 (4.38); both p < 0.001). Students' rating showed a similar non-significant trend.Conclusions: Students, SP and expert video raters determined that blended-learning teaching can improve students' competencies when dealing with e-patients. Within the study period, this effect was lasting; however, further studies should look at long-term outcomes.
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Affiliation(s)
- A Herrmann-Werner
- Medical Department VI/Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - H Weber
- Medical Department VI/Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - T Loda
- Medical Department VI/Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - K E Keifenheim
- Medical Department VI/Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - R Erschens
- Medical Department VI/Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - S C Mölbert
- Medical Department VI/Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - C Nikendei
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - S Zipfel
- Medical Department VI/Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - K Masters
- Medical Education & Informatics Unit, College of Medicine & Health Sciences SQU, Alkoudh, Sultanate of Oman
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Keifenheim KE, Velten-Schurian K, Fahse B, Erschens R, Loda T, Wiesner L, Zipfel S, Herrmann-Werner A. "A change would do you good": Training medical students in Motivational Interviewing using a blended-learning approach - A pilot evaluation. Patient Educ Couns 2019; 102:663-669. [PMID: 30448043 DOI: 10.1016/j.pec.2018.10.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 10/26/2018] [Accepted: 10/30/2018] [Indexed: 05/28/2023]
Abstract
Objectives This study aims to assess medical students' interest in a Motivational Interviewing (MI), the objective need for a special training, and students' satisfaction with and the effectiveness of such a course. Methods A mandatory MI course was implemented for sixth-semester medical students. Their interest in learning MI was evaluated, along with their satisfaction with the course, which was delivered in a blended-learning teaching approach. Participants' baseline MI skills and general communication skills were assessed. MI non-adherent behavior, like persuading and confronting patients, was noted. Successful learning was measured with a multiple-choice test administered before and after the course that assessed subjective knowledge and skills. Results Students were highly interested in learning MI. At baseline, they showed good communication skills but moderate MI skills. Satisfaction with the course was high. The course was effective, as subjective and objective knowledge and skills improved significantly. Conclusions This pilot study suggests that basic MI skills can be successfully taught in a blended-learning teaching approach. Further research should investigate sustainability and transfer to clinical practice. Practice implications Medical schools should consider providing students with special training in MI to help students counsel patients towards behavioral changes.
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Affiliation(s)
- K E Keifenheim
- Department for Psychosomatic Medicine and Psychotherapy, University Hospital of Tuebingen, Germany.
| | - K Velten-Schurian
- University Hospital for Psychiatry and Psychotherapy, Tuebingen, Germany
| | - B Fahse
- Department for Psychosomatic Medicine and Psychotherapy, University Hospital of Tuebingen, Germany
| | - R Erschens
- Department for Psychosomatic Medicine and Psychotherapy, University Hospital of Tuebingen, Germany
| | - T Loda
- Department for Psychosomatic Medicine and Psychotherapy, University Hospital of Tuebingen, Germany
| | - L Wiesner
- Department for Psychosomatic Medicine and Psychotherapy, University Hospital of Tuebingen, Germany
| | - S Zipfel
- Department for Psychosomatic Medicine and Psychotherapy, University Hospital of Tuebingen, Germany
| | - A Herrmann-Werner
- Department for Psychosomatic Medicine and Psychotherapy, University Hospital of Tuebingen, Germany
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Rometsch-Ogioun El Sount C, Windthorst P, Denkinger J, Ziser K, Nikendei C, Kindermann D, Ringwald J, Renner V, Zipfel S, Junne F. Chronic pain in refugees with posttraumatic stress disorder (PTSD): A systematic review on patients' characteristics and specific interventions. J Psychosom Res 2019; 118:83-97. [PMID: 30078503 DOI: 10.1016/j.jpsychores.2018.07.014] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 07/20/2018] [Accepted: 07/25/2018] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Chronic pain in patients with posttraumatic stress disorder (PTSD) is a frequent symptom and a complicating factor in the treatment of patients. The study' purpose is to systematically review the scientific literature on patients' characteristics and the effects of specific interventions implemented for the treatment of chronic pain in traumatized refugees. METHOD A systematic search of the current literature was conducted in PubMed and Web of Science, from 1996 to 2017. A structured screening process in accordance with the PRISMA-statement was used with eligibility criteria based on the modified PICOS-criteria including refugees with chronic pain and diagnosed PTSD to investigate sample size, gender, country of origin, residential status, pain locations, predictors and correlations and type and efficacy of specific interventions. RESULTS The initial search resulted in a total of 2169 references, leading to 15 included studies. Most frequently, patients reported headaches, backaches, and pain in the arms and legs. Pain symptoms were associated with higher age, female gender, general living difficulties and PTSD symptoms. Cognitive behavioral therapy (CBT) and, Narrative Exposure Therapy (NET) with biofeedback, manualized trauma psychotherapy, Traditional Chinese Medicine (TCM) and Emotional Freedom Techniques were evaluated as specific interventions, resulting in positive outcomes for both pain severity and PTSD symptoms. CONCLUSIONS To date, the existing literature shows scarce evidence evaluating specific interventions that address the needs of traumatized refugees with chronic pain. However, the current reported evidence allows for a preliminary evaluation of the characterizations of patient dimensions as well as promising results found in intervention studies.
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Affiliation(s)
- C Rometsch-Ogioun El Sount
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, University of Tuebingen, Osianderstr. 5, 72076 Tuebingen, Germany.
| | - P Windthorst
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, University of Tuebingen, Osianderstr. 5, 72076 Tuebingen, Germany
| | - J Denkinger
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, University of Tuebingen, Osianderstr. 5, 72076 Tuebingen, Germany
| | - K Ziser
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, University of Tuebingen, Osianderstr. 5, 72076 Tuebingen, Germany
| | - C Nikendei
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - D Kindermann
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - J Ringwald
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, University of Tuebingen, Osianderstr. 5, 72076 Tuebingen, Germany
| | - V Renner
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, University of Tuebingen, Osianderstr. 5, 72076 Tuebingen, Germany; Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - S Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, University of Tuebingen, Osianderstr. 5, 72076 Tuebingen, Germany
| | - F Junne
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, University of Tuebingen, Osianderstr. 5, 72076 Tuebingen, Germany
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Castro L, Zipfel S, Hakmi S, Reiter B, Söffker G, Lubos E, Rybczinski M, Grahn H, Schrage B, Westermann D, Barten M, Reichenspurner H, Bernhardt A. Impella 5.0 Therapy Decreases Bleeding Complications in Patients after Change from Extracorporeal Life Support. Thorac Cardiovasc Surg 2019. [DOI: 10.1055/s-0039-1678931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- L. Castro
- Universitäres Herzzentrum Hamburg, Klinik für Herzchirurgie, Hamburg, Germany
| | - S. Zipfel
- Universitäres Herzzentrum Hamburg, Klinik für Herzchirurgie, Hamburg, Germany
| | - S. Hakmi
- Universitäres Herzzentrum Hamburg, Klinik für Herzchirurgie, Hamburg, Germany
| | - B. Reiter
- Universitäres Herzzentrum Hamburg, Klinik für Herzchirurgie, Hamburg, Germany
| | - G. Söffker
- Universitätsklinik Hamburg-Eppendorf, Klinik für Intensivmedizin, Hamburg, Germany
| | - E. Lubos
- Universitäres Herzzentrum Hamburg, Klinik für Allgemeine und Interventionelle Kardiologie, Hamburg, Germany
| | - M. Rybczinski
- Universitäres Herzzentrum Hamburg, Klinik für Allgemeine und Interventionelle Kardiologie, Hamburg, Germany
| | - H. Grahn
- Universitäres Herzzentrum Hamburg, Klinik für Allgemeine und Interventionelle Kardiologie, Hamburg, Germany
| | - B. Schrage
- Universitäres Herzzentrum Hamburg, Klinik für Allgemeine und Interventionelle Kardiologie, Hamburg, Germany
| | - D. Westermann
- Universitäres Herzzentrum Hamburg, Klinik für Allgemeine und Interventionelle Kardiologie, Hamburg, Germany
| | - M. Barten
- Universitäres Herzzentrum Hamburg, Klinik für Herzchirurgie, Hamburg, Germany
| | - H. Reichenspurner
- Universitäres Herzzentrum Hamburg, Klinik für Herzchirurgie, Hamburg, Germany
| | - A. Bernhardt
- Universitäres Herzzentrum Hamburg, Klinik für Herzchirurgie, Hamburg, Germany
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14
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Graf J, Brucker SY, Wallwiener D, Wosnik A, Zipfel S, Simoes E. Akademisierung der Hebammenausbildung: Erweiterung der Kompetenzen als Beitrag zur interdisziplinären Versorgung bei Brustkrebs in der Schwangerschaft. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- J Graf
- Universitätsklinikum Tübingen, Department für Frauengesundheit, Tübingen, Deutschland
- Universitätsklinikum Tübingen, Department für Frauengesundheit, Forschungsinstitut für Frauengesundheit, Tübingen, Deutschland
- Medizinische Fakultät, Bereich Studium und Lehre, Universität Tübingen, Tübingen, Deutschland
| | - SY Brucker
- Universitätsklinikum Tübingen, Department für Frauengesundheit, Tübingen, Deutschland
- Universitätsklinikum Tübingen, Department für Frauengesundheit, Forschungsinstitut für Frauengesundheit, Tübingen, Deutschland
| | - D Wallwiener
- Universitätsklinikum Tübingen, Department für Frauengesundheit, Tübingen, Deutschland
| | - A Wosnik
- Medizinische Fakultät, Bereich Studium und Lehre, Universität Tübingen, Tübingen, Deutschland
| | - S Zipfel
- Medizinische Fakultät, Bereich Studium und Lehre, Universität Tübingen, Tübingen, Deutschland
- Universitätsklinikum Tübingen, Abteilung für Psychosomatische Medizin und Psychotherapie, Tübingen, Deutschland
| | - E Simoes
- Universitätsklinikum Tübingen, Department für Frauengesundheit, Tübingen, Deutschland
- Universitätsklinikum Tübingen, Department für Frauengesundheit, Forschungsinstitut für Frauengesundheit, Tübingen, Deutschland
- Universitätsklinikum Tübingen, Stabstelle Sozialmedizin, Tübingen, Deutschland
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15
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Zipfel S, Reiter B, Barten M, Rybczinski M, Schrage B, Westermann D, Blankenberg S, Kubik M, Kluge S, Reichenspurner H, Bernhardt A. Levosimendan Effects Benefit Weaning From Veno-Arterial Extracorporeal Life Support. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.986] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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16
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Rieger MA, Burgess S, Junne F, Rothermund E, Gündel H, Zipfel S, Michaelis M. 985 Prevention of common mental disorders in employees – attitudes of health care professionals, human resources managers, and employees in germany. Health Serv Res 2018. [DOI: 10.1136/oemed-2018-icohabstracts.525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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17
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Zipfel S, Hakmi S, Reiter B, Barten M, Rybczinski M, Kubik M, Kluge S, Reichenspurner H, Bernhardt A. Impella 5.0 as a Bridge-To Bridge Option after Extracorporeal Life Support. Lessons Learned from the First 15 Cases. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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18
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Mölbert SC, Thaler A, Mohler BJ, Streuber S, Romero J, Black MJ, Zipfel S, Karnath HO, Giel KE. Assessing body image in anorexia nervosa using biometric self-avatars in virtual reality: Attitudinal components rather than visual body size estimation are distorted. Psychol Med 2018; 48:642-653. [PMID: 28745268 PMCID: PMC5964466 DOI: 10.1017/s0033291717002008] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 06/20/2017] [Accepted: 06/21/2017] [Indexed: 12/01/2022]
Abstract
BACKGROUND Body image disturbance (BID) is a core symptom of anorexia nervosa (AN), but as yet distinctive features of BID are unknown. The present study aimed at disentangling perceptual and attitudinal components of BID in AN. METHODS We investigated n = 24 women with AN and n = 24 controls. Based on a three-dimensional (3D) body scan, we created realistic virtual 3D bodies (avatars) for each participant that were varied through a range of ±20% of the participants' weights. Avatars were presented in a virtual reality mirror scenario. Using different psychophysical tasks, participants identified and adjusted their actual and their desired body weight. To test for general perceptual biases in estimating body weight, a second experiment investigated perception of weight and shape matched avatars with another identity. RESULTS Women with AN and controls underestimated their weight, with a trend that women with AN underestimated more. The average desired body of controls had normal weight while the average desired weight of women with AN corresponded to extreme AN (DSM-5). Correlation analyses revealed that desired body weight, but not accuracy of weight estimation, was associated with eating disorder symptoms. In the second experiment, both groups estimated accurately while the most attractive body was similar to Experiment 1. CONCLUSIONS Our results contradict the widespread assumption that patients with AN overestimate their body weight due to visual distortions. Rather, they illustrate that BID might be driven by distorted attitudes with regard to the desired body. Clinical interventions should aim at helping patients with AN to change their desired weight.
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Affiliation(s)
- S. C. Mölbert
- Department of Psychosomatic Medicine and
Psychotherapy, Medical University Hospital
Tübingen, Tübingen, Germany
- Max Planck Institute for Biological
Cybernetics, Tübingen, Germany
- Graduate Training Centre of Neuroscience,
International Max Planck Research School, Universität Tübingen,
Tübingen, Germany
| | - A. Thaler
- Max Planck Institute for Biological
Cybernetics, Tübingen, Germany
- Graduate Training Centre of Neuroscience,
International Max Planck Research School, Universität Tübingen,
Tübingen, Germany
| | - B. J. Mohler
- Max Planck Institute for Biological
Cybernetics, Tübingen, Germany
| | - S. Streuber
- École Polytechnique Fédérale de Lausanne, Brain
Mind Institute, Lausanne,
Switzerland
| | - J. Romero
- Max Planck Institute for Intelligent
Systems, Tübingen, Germany
| | - M. J. Black
- Max Planck Institute for Intelligent
Systems, Tübingen, Germany
| | - S. Zipfel
- Department of Psychosomatic Medicine and
Psychotherapy, Medical University Hospital
Tübingen, Tübingen, Germany
| | - H.-O. Karnath
- Division of Neuropsychology,
Center of Neurology, Hertie-Institute for Clinical Brain Research, University
of Tübingen, Tübingen, Germany
| | - K. E. Giel
- Department of Psychosomatic Medicine and
Psychotherapy, Medical University Hospital
Tübingen, Tübingen, Germany
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19
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Zipfel S, Reichenspurner H, Brickwedel J. Right Atrial Metastasis Nine Years after Initial Hepatocellular Carcinoma: A Case Report. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1628014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- S. Zipfel
- Universitäres Herzzentrum Hamburg, Hamburg, Germany
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20
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Zipfel S, Reiter B, Sill B, Barten M, Rybczinski M, Kubik M, Kluge S, Reichenspurner H, Bernhardt A. Levosimendan Effects Benefit Weaning from Veno-Arterial Extracorporeal Life Support. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1628090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- S. Zipfel
- Universitäres Herzzentrum Hamburg, Hamburg, Germany
| | - B. Reiter
- Universitäres Herzzentrum Hamburg, Hamburg, Germany
| | - B. Sill
- Universitäres Herzzentrum Hamburg, Hamburg, Germany
| | - M. Barten
- Universitäres Herzzentrum Hamburg, Hamburg, Germany
| | | | - M. Kubik
- Universitäres Herzzentrum Hamburg, Hamburg, Germany
| | - S. Kluge
- Universitätsklinik Hamburg Eppendorf, Hamburg, Germany
| | | | - A. Bernhardt
- Universitäres Herzzentrum Hamburg, Hamburg, Germany
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21
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Bernhardt A, Reiter B, Zipfel S, Yildirim Y, Hakmi S, Barten M, Rybczinski M, Reichenspurner H. Secondary Interventions after Transportation in Patients after ECLS Implantation in Referring Centers. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1627873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- A. Bernhardt
- Herz- und Gefäßchirurgie, Universitäres Herzzentrum Hamburg, Hamburg, Germany
| | - B. Reiter
- Herz- und Gefäßchirurgie, Universitäres Herzzentrum Hamburg, Hamburg, Germany
| | - S. Zipfel
- Herz- und Gefäßchirurgie, Universitäres Herzzentrum Hamburg, Hamburg, Germany
| | - Y. Yildirim
- Herz- und Gefäßchirurgie, Universitäres Herzzentrum Hamburg, Hamburg, Germany
| | - S. Hakmi
- Herz- und Gefäßchirurgie, Universitäres Herzzentrum Hamburg, Hamburg, Germany
| | - M. Barten
- Herz- und Gefäßchirurgie, Universitäres Herzzentrum Hamburg, Hamburg, Germany
| | - M. Rybczinski
- Allgemeine und Interventionelle Kardiologie, Universitäres Herzzentrum Hamburg, Hamburg, Germany
| | - H. Reichenspurner
- Herz- und Gefäßchirurgie, Universitäres Herzzentrum Hamburg, Hamburg, Germany
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22
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Zipfel S, Reiter B, Yildirim Y, Hakmi S, Barten M, Rybczinski M, Westermann D, Reichenspurner H, Bernhardt A. Secondary LV Unloading after Out-of-hospital ECLS Implantation and Transportation Improved Survival and Probability of Successful Weaning. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1627877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- S. Zipfel
- Universitäres Herzzentrum Hamburg, Hamburg, Germany
| | - B. Reiter
- Universitäres Herzzentrum Hamburg, Hamburg, Germany
| | - Y. Yildirim
- Universitäres Herzzentrum Hamburg, Hamburg, Germany
| | - S. Hakmi
- Universitäres Herzzentrum Hamburg, Hamburg, Germany
| | - M. Barten
- Universitäres Herzzentrum Hamburg, Hamburg, Germany
| | | | | | | | - A. Bernhardt
- Universitäres Herzzentrum Hamburg, Hamburg, Germany
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23
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Linder M, Pecha S, Castro L, Zipfel S, Gosau N, Willems S, Reichenspurner H, Hakmi S. The Challenge of Aggressive Adhesions: Tool Combination for Successful Lead Extraction. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- M. Linder
- Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
| | - S. Pecha
- Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
| | - L. Castro
- Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
| | - S. Zipfel
- Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
| | - N. Gosau
- Department of Cardiology - Elektrophysiology, University Heart Center Hamburg, Hamburg, Germany
| | - S. Willems
- Department of Cardiology - Elektrophysiology, University Heart Center Hamburg, Hamburg, Germany
| | - H. Reichenspurner
- Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
| | - S. Hakmi
- Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
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24
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Castro L, Pecha S, Linder M, Zipfel S, Gosau N, Willems S, Reichenspurner H, Hakmi S. CRT Device Explantation: A Temporary Bridging Solution for Bi-Ventricular Pacing is Needed. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- L. Castro
- Universitäres Herzzentrum Hamburg, Klinik für Herzchirurgie, Hamburg, Germany
| | - S. Pecha
- Universitäres Herzzentrum Hamburg, Klinik für Herzchirurgie, Hamburg, Germany
| | - M. Linder
- Universitäres Herzzentrum Hamburg, Klinik für Herzchirurgie, Hamburg, Germany
| | - S. Zipfel
- Universitäres Herzzentrum Hamburg, Klinik für Herzchirurgie, Hamburg, Germany
| | - N. Gosau
- Universitäres Herzzentrum Hamburg, Klinik für Elektrophysiologie, Hamburg, Germany
| | - S. Willems
- Universitäres Herzzentrum Hamburg, Klinik für Elektrophysiologie, Hamburg, Germany
| | - H. Reichenspurner
- Universitäres Herzzentrum Hamburg, Klinik für Herzchirurgie, Hamburg, Germany
| | - S. Hakmi
- Universitäres Herzzentrum Hamburg, Klinik für Herzchirurgie, Hamburg, Germany
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25
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Seoudy H, Pecha S, Gosau N, Linder M, Zipfel S, Willems S, Treede H, Reichenspurner H, Hakmi S. Limitations in the Extraction of Active Fixation Coronary Sinus Leads. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- H. Seoudy
- UKE, Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
| | - S. Pecha
- UKE, Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
| | - N. Gosau
- UKE, Department of Cardiology-Electrophysiology, University Heart Center Hamburg, Hamburg, Germany
| | - M. Linder
- UKE, Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
| | - S. Zipfel
- UKE, Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
| | - S. Willems
- UKE, Department of Cardiology-Electrophysiology, University Heart Center Hamburg, Hamburg, Germany
| | - H. Treede
- Department of Cardiac and Thoracic Surgery, University Hospital Halle (Saale), Halle (Saale), Germany
| | - H. Reichenspurner
- UKE, Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
| | - S. Hakmi
- UKE, Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
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26
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Zipfel S, Pecha S, Braune S, Hakmi S, Kluge S, Kubik M, Bernhardt A, Deuse T, Reichenspurner H, Sill B. A Distal Limb Perfusion Cannula Is Mandatory in Extracorporeal Membrane Oxygenation with Femoral Access. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- S. Zipfel
- Universitäres Herzzentrum Hamburg, Hamburg, Germany
| | - S. Pecha
- Universitäres Herzzentrum Hamburg, Hamburg, Germany
| | - S. Braune
- Universitätsklinik Hamburg, Hamburg, Germany
| | - S. Hakmi
- Universitäres Herzzentrum Hamburg, Hamburg, Germany
| | - S. Kluge
- Universitätsklinik Hamburg, Hamburg, Germany
| | - M. Kubik
- Universitätsklinik Hamburg, Hamburg, Germany
| | - A. Bernhardt
- Universitäres Herzzentrum Hamburg, Hamburg, Germany
| | - T. Deuse
- Universitäres Herzzentrum Hamburg, Hamburg, Germany
| | | | - B. Sill
- Universitäres Herzzentrum Hamburg, Hamburg, Germany
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27
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Hinney A, Kesselmeier M, Jall S, Volckmar AL, Föcker M, Antel J, Heid IM, Winkler TW, Grant SFA, Guo Y, Bergen AW, Kaye W, Berrettini W, Hakonarson H, Herpertz-Dahlmann B, de Zwaan M, Herzog W, Ehrlich S, Zipfel S, Egberts KM, Adan R, Brandys M, van Elburg A, Boraska Perica V, Franklin CS, Tschöp MH, Zeggini E, Bulik CM, Collier D, Scherag A, Müller TD, Hebebrand J. Evidence for three genetic loci involved in both anorexia nervosa risk and variation of body mass index. Mol Psychiatry 2017; 22:192-201. [PMID: 27184124 PMCID: PMC5114162 DOI: 10.1038/mp.2016.71] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Revised: 02/22/2016] [Accepted: 03/17/2016] [Indexed: 02/06/2023]
Abstract
The maintenance of normal body weight is disrupted in patients with anorexia nervosa (AN) for prolonged periods of time. Prior to the onset of AN, premorbid body mass index (BMI) spans the entire range from underweight to obese. After recovery, patients have reduced rates of overweight and obesity. As such, loci involved in body weight regulation may also be relevant for AN and vice versa. Our primary analysis comprised a cross-trait analysis of the 1000 single-nucleotide polymorphisms (SNPs) with the lowest P-values in a genome-wide association meta-analysis (GWAMA) of AN (GCAN) for evidence of association in the largest published GWAMA for BMI (GIANT). Subsequently we performed sex-stratified analyses for these 1000 SNPs. Functional ex vivo studies on four genes ensued. Lastly, a look-up of GWAMA-derived BMI-related loci was performed in the AN GWAMA. We detected significant associations (P-values <5 × 10-5, Bonferroni-corrected P<0.05) for nine SNP alleles at three independent loci. Interestingly, all AN susceptibility alleles were consistently associated with increased BMI. None of the genes (chr. 10: CTBP2, chr. 19: CCNE1, chr. 2: CARF and NBEAL1; the latter is a region with high linkage disequilibrium) nearest to these SNPs has previously been associated with AN or obesity. Sex-stratified analyses revealed that the strongest BMI signal originated predominantly from females (chr. 10 rs1561589; Poverall: 2.47 × 10-06/Pfemales: 3.45 × 10-07/Pmales: 0.043). Functional ex vivo studies in mice revealed reduced hypothalamic expression of Ctbp2 and Nbeal1 after fasting. Hypothalamic expression of Ctbp2 was increased in diet-induced obese (DIO) mice as compared with age-matched lean controls. We observed no evidence for associations for the look-up of BMI-related loci in the AN GWAMA. A cross-trait analysis of AN and BMI loci revealed variants at three chromosomal loci with potential joint impact. The chromosome 10 locus is particularly promising given that the association with obesity was primarily driven by females. In addition, the detected altered hypothalamic expression patterns of Ctbp2 and Nbeal1 as a result of fasting and DIO implicate these genes in weight regulation.
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Affiliation(s)
- A Hinney
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - M Kesselmeier
- Clinical Epidemiology, Integrated Research and Treatment Center, Center for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany
| | - S Jall
- Institute for Diabetes and Obesity, Helmholtz Diabetes Center & German Diabetes Center (DZD), Helmholtz Zentrum München, Neuherberg, Germany
- Division of Metabolic Diseases, Department of Medicine, Technische Universität München, Munich, Germany
| | - A-L Volckmar
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - M Föcker
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - J Antel
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - I M Heid
- Department of Genetic Epidemiology, University of Regensburg, Regensburg, Germany
| | - T W Winkler
- Department of Genetic Epidemiology, University of Regensburg, Regensburg, Germany
| | - S F A Grant
- Department of Pediatrics, University of Pennsylvania, Philadelphia, PA, USA
- Divisions of Genetics and Endocrinology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- The Center for Applied Genomics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Y Guo
- The Center for Applied Genomics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | | | - W Kaye
- Department of Psychiatry, University of California, San Diego, San Diego, CA, USA
| | - W Berrettini
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - H Hakonarson
- The Division of Human Genetics, Department of Pediatrics, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - B Herpertz-Dahlmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of the RWTH Aachen, Aachen, Germany
| | - M de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - W Herzog
- Department of Internal Medicine II, General Internal and Psychosomatic Medicine, University of Heidelberg, Heidelberg, Germany
| | - S Ehrlich
- Translational Developmental Neuroscience Section, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU-Dresden, University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany
| | - S Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital, Tübingen, Germany
| | - K M Egberts
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - R Adan
- Brain Center Rudolf Magnus, Department of Translational Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands
- Altrecht Eating Disorders Rintveld, Zeist, The Netherlands
| | - M Brandys
- Brain Center Rudolf Magnus, Department of Translational Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands
- Altrecht Eating Disorders Rintveld, Zeist, The Netherlands
| | - A van Elburg
- Brain Center Rudolf Magnus, Department of Translational Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands
| | - V Boraska Perica
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
- University of Split School of Medicine, Split, Croatia
| | - C S Franklin
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
| | - M H Tschöp
- Institute for Diabetes and Obesity, Helmholtz Diabetes Center & German Diabetes Center (DZD), Helmholtz Zentrum München, Neuherberg, Germany
- Division of Metabolic Diseases, Department of Medicine, Technische Universität München, Munich, Germany
| | - E Zeggini
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
| | - C M Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Nutrition, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - D Collier
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK
- Eli Lilly and Company Ltd, Surrey, UK
| | - A Scherag
- Clinical Epidemiology, Integrated Research and Treatment Center, Center for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany
| | - T D Müller
- Institute for Diabetes and Obesity, Helmholtz Diabetes Center & German Diabetes Center (DZD), Helmholtz Zentrum München, Neuherberg, Germany
- Division of Metabolic Diseases, Department of Medicine, Technische Universität München, Munich, Germany
| | - J Hebebrand
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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Hinney A, Kesselmeier M, Jall S, Volckmar AL, Föcker M, Antel J, Heid IM, Winkler TW, Grant SFA, Guo Y, Bergen AW, Kaye W, Berrettini W, Hakonarson H, Herpertz-Dahlmann B, de Zwaan M, Herzog W, Ehrlich S, Zipfel S, Egberts KM, Adan R, Brandys M, van Elburg A, Perica VB, Franklin CS, Tschöp MH, Zeggini E, Bulik CM, Collier D, Scherag A, Müller TD, Hebebrand J. Evidence for three genetic loci involved in both anorexia nervosa risk and variation of body mass index. Mol Psychiatry 2017; 22:321-322. [PMID: 27457816 PMCID: PMC8477229 DOI: 10.1038/mp.2016.126] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Egger N, Wild B, Zipfel S, Junne F, Konnopka A, Schmidt U, de Zwaan M, Herpertz S, Zeeck A, Löwe B, von Wietersheim J, Tagay S, Burgmer M, Dinkel A, Herzog W, König HH. Cost-effectiveness of focal psychodynamic therapy and enhanced cognitive-behavioural therapy in out-patients with anorexia nervosa. Psychol Med 2016; 46:3291-3301. [PMID: 27609525 DOI: 10.1017/s0033291716002002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Anorexia nervosa (AN) is a serious illness leading to substantial morbidity and mortality. The treatment of AN very often is protracted; repeated hospitalizations and lost productivity generate substantial economic costs in the health care system. Therefore, this study aimed to determine the differential cost-effectiveness of out-patient focal psychodynamic psychotherapy (FPT), enhanced cognitive-behavioural therapy (CBT-E), and optimized treatment as usual (TAU-O) in the treatment of adult women with AN. METHOD The analysis was conducted alongside the randomized controlled Anorexia Nervosa Treatment of OutPatients (ANTOP) study. Cost-effectiveness was determined using direct costs per recovery at 22 months post-randomization (n = 156). Unadjusted incremental cost-effectiveness ratios (ICERs) were calculated. To derive cost-effectiveness acceptability curves (CEACs) adjusted net-benefit regressions were applied assuming different values for the maximum willingness to pay (WTP) per additional recovery. Cost-utility and assumptions underlying the base case were investigated in exploratory analyses. RESULTS Costs of in-patient treatment and the percentage of patients who required in-patient treatment were considerably lower in both intervention groups. The unadjusted ICERs indicated FPT and CBT-E to be dominant compared with TAU-O. Moreover, FPT was dominant compared with CBT-E. CEACs showed that the probability for cost-effectiveness of FTP compared with TAU-O and CBT-E was ⩾95% if the WTP per recovery was ⩾€9825 and ⩾€24 550, respectively. Comparing CBT-E with TAU-O, the probability of being cost-effective remained <90% for all WTPs. The exploratory analyses showed similar but less pronounced trends. CONCLUSIONS Depending on the WTP, FPT proved cost-effective in the treatment of adult AN.
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Affiliation(s)
- N Egger
- Department of Health Economics and Health Services Research,Hamburg Center for Health Economics (HCHE), University Medical Center Hamburg-Eppendorf,Hamburg,Germany
| | - B Wild
- Department of General Internal Medicine and Psychosomatics,Heidelberg University Hospital,Heidelberg,Germany
| | - S Zipfel
- Department of Psychosomatic Medicine and Psychotherapy,University Hospital Tübingen,Tübingen,Germany
| | - F Junne
- Department of Psychosomatic Medicine and Psychotherapy,University Hospital Tübingen,Tübingen,Germany
| | - A Konnopka
- Department of Health Economics and Health Services Research,Hamburg Center for Health Economics (HCHE), University Medical Center Hamburg-Eppendorf,Hamburg,Germany
| | - U Schmidt
- Section of Eating Disorders,Department of Psychological Medicine,King's College London,London,UK
| | - M de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy,Hannover Medical School,Hannover,Germany
| | - S Herpertz
- Department of Psychosomatic Medicine and Psychotherapy,LWL-University Clinic Bochum, Ruhr-University Bochum,Bochum,Germany
| | - A Zeeck
- Department of Psychosomatic Medicine and Psychotherapy,University Hospital Freiburg,Freiburg,Germany
| | - B Löwe
- Department of Psychosomatic Medicine and Psychotherapy,University Medical Center Hamburg-Eppendorf, and Schön Klinik Hamburg-Eilbek,Hamburg,Germany
| | - J von Wietersheim
- Department of Psychosomatic Medicine and Psychotherapy,University Hospital of Ulm,Ulm,Germany
| | - S Tagay
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR Hospital Essen, University of Duisburg-Essen,Essen,Germany
| | - M Burgmer
- Department of Psychosomatics and Psychotherapy,University Hospital Münster,Münster,Germany
| | - A Dinkel
- Department of Psychosomatic Medicine and Psychotherapy,Klinikum rechts der Isar, Technische Universität München,Munich,Germany
| | - W Herzog
- Department of General Internal Medicine and Psychosomatics,Heidelberg University Hospital,Heidelberg,Germany
| | - H-H König
- Department of Health Economics and Health Services Research,Hamburg Center for Health Economics (HCHE), University Medical Center Hamburg-Eppendorf,Hamburg,Germany
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Zeeck A, Hartmann A, Wild B, De Zwaan M, Herpertz S, Burgmer M, von Wietersheim J, Resmark G, Friederich HC, Tagay S, Dinkel A, Loewe B, Teufel M, Orlinsky D, Herzog W, Zipfel S. How do patients with anorexia nervosa "process" psychotherapy between sessions? A comparison of cognitive-behavioral and psychodynamic interventions. Psychother Res 2016; 28:873-886. [PMID: 27808005 DOI: 10.1080/10503307.2016.1252866] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE Patients' processing of psychotherapy between sessions ("inter-session process" (ISP)) has been repeatedly shown to be related to outcome. The aim of this study was to compare ISP characteristics of cognitive-behavioral vs. psychodynamic psychotherapy in the treatment of anorexia nervosa (AN) and their relation to outcome. METHODS Data of 106 patients participating in a randomized-controlled trial who received either 40 sessions of enhanced cognitive-behavioral therapy (CBT-E) or focal psychodynamic therapy (FPT) were analyzed. The ISP was measured with the Inter-session Experience Questionnaire (IEQ). Three outcome classes were distinguished: full recovery, partial recovery, and still fulfilling all AN criteria. RESULTS Patients receiving CBT-E reported more on "applying therapy" in the initial and the final treatment phase compared to FPT patients. In terms of process-outcome relations, higher levels of "recreating the therapeutic dialogue between sessions," "recreating the therapeutic dialogue with negative emotions" as well as "applying therapy with negative emotions" in the final phase of treatment predicted negative outcome in FPT, whereas overall higher levels of negative emotions predicted negative outcome in CBT-E. CONCLUSIONS In outpatient treatment in AN, the processing of therapy as measured by the IEQ showed surprisingly few differences between CBT-E and FPT. However, different ISP patterns were predictive of outcome, pointing to different mechanisms of change.
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Affiliation(s)
- A Zeeck
- a Department of Psychosomatic Medicine and Psychotherapy , University Medical Center Freiburg , Freiburg , Germany
| | - A Hartmann
- a Department of Psychosomatic Medicine and Psychotherapy , University Medical Center Freiburg , Freiburg , Germany
| | - B Wild
- b Center for Psychosocial Medicine, Department of General Internal Medicine and Psychosomatics , Heidelberg University Hospital , Heidelberg , Germany
| | - M De Zwaan
- c Department of Psychosomatic Medicine and Psychotherapy , University Medical Center Hannover , Hannover , Germany
| | - S Herpertz
- d Department of Psychosomatic Medicine and Psychotherapy , LWL-University Medical Center of the Ruhr-University Bochum , Bochum , Germany
| | - M Burgmer
- e Department of Psychosomatic Medicine and Psychotherapy , University Medical Center Münster , Münster , Germany
| | - J von Wietersheim
- f Department of Psychosomatic Medicine and Psychotherapy , University Medical Center Ulm , Ulm , Germany
| | - G Resmark
- g Department of Psychosomatic Medicine and Psychotherapy , University Medical Center Tübingen , Tübingen , Germany
| | - H-C Friederich
- h Department of Psychosomatic Medicine and Psychotherapy , University Medical Center Düsseldorf , Düsseldorf , Germany
| | - S Tagay
- i Department of Psychosomatic Medicine and Psychotherapy , University Duisburg-Essen , Duisburg , Germany
| | - A Dinkel
- j Department of Psychosomatic Medicine and Psychotherapy , University of Technology München , München , Germany
| | - B Loewe
- k Institute and Outpatient Clinic for Psychosomatic Medicine and Psychotherapy , University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - M Teufel
- g Department of Psychosomatic Medicine and Psychotherapy , University Medical Center Tübingen , Tübingen , Germany
| | - D Orlinsky
- l Department of Comparative Human Development , University of Chicago , Chicago , IL , USA
| | - W Herzog
- b Center for Psychosocial Medicine, Department of General Internal Medicine and Psychosomatics , Heidelberg University Hospital , Heidelberg , Germany
| | - S Zipfel
- g Department of Psychosomatic Medicine and Psychotherapy , University Medical Center Tübingen , Tübingen , Germany
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- a Department of Psychosomatic Medicine and Psychotherapy , University Medical Center Freiburg , Freiburg , Germany
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Shiozawa T, Griewatz J, Hirt B, Zipfel S, Lammerding-Koeppel M, Herrmann-Werner A. Development of a seminar on medical professionalism accompanying the dissection course. Ann Anat 2016; 208:208-211. [PMID: 27497713 DOI: 10.1016/j.aanat.2016.07.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 06/25/2016] [Accepted: 07/04/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Medical professionalism is an increasingly important issue in medical education. The dissection course represents a profound experience for undergraduate medical students, which may be suitable to address competencies such as self-reflection and professional behavior. MATERIAL AND METHODS Based on a needs assessment, a seminar on medical professionalism was developed to parallel the dissection course. The conceptual framework for the teaching intervention is experiential learning. Specific learning goals and an interview guideline were formulated. After a pilot run, peer-teaching was introduced. RESULTS Over three terms (winter 2012/13, 2013/14, 2014/15), an average of 129 students voluntarily participated in the seminar, corresponding to 40% of the student cohort. The evaluation (n=38) shows a majority of students agreeing that the seminar offers support with this extraordinary situation in general and also that the seminar helps them to become first impressions on how to cope with death and dying in their later professional life as a doctor, and, that it also provides them the means to reflect upon their own coping mechanisms. CONCLUSION Although not yet implemented as an obligatory course, the seminar is appreciated and positively evaluated. Medical professionalism is an implicit aspect of the dissection course. To emphasize its importance, a teaching intervention to explicitly discuss this topic is advisable.
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Affiliation(s)
- T Shiozawa
- Institute of Clinical Anatomy and Cell Analysis, University of Tuebingen, Tuebingen, Germany.
| | - J Griewatz
- Competence Center for University Teaching in Medicine, University of Tuebingen, Tuebingen, Germany.
| | - B Hirt
- Institute of Clinical Anatomy and Cell Analysis, University of Tuebingen, Tuebingen, Germany.
| | - S Zipfel
- Medical Faculty, University of Tuebingen, Tuebingen, Germany; Department of Internal Medicine VI, Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany.
| | - M Lammerding-Koeppel
- Competence Center for University Teaching in Medicine, University of Tuebingen, Tuebingen, Germany.
| | - A Herrmann-Werner
- Department of Internal Medicine VI, Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany.
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Ritze Y, Schollenberger A, Hamze Sinno M, Bühler N, Böhle M, Bárdos G, Sauer H, Mack I, Enck P, Zipfel S, Meile T, Königsrainer A, Kramer M, Bischoff SC. Gastric ghrelin, GOAT, leptin, and leptinR expression as well as peripheral serotonin are dysregulated in humans with obesity. Neurogastroenterol Motil 2016; 28:806-15. [PMID: 26787056 DOI: 10.1111/nmo.12773] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Accepted: 12/19/2015] [Indexed: 01/01/2023]
Abstract
BACKGROUND Gastrointestinal hormone release and the regulation of appetite and body weight are thought to be dysbalanced in obesity. However, human data investigating the expression of gastrointestinal hormones in the obese are rare. We studied the expression of ghrelin, leptin, and the serotonergic system in stomach tissue and serum of obese and non-obese individuals. METHODS Gastric tissue and serum were collected from 29 adult obese (BMI 48.7 ± 10.6 kg/m(2) ; mean ± SD) who underwent laparoscopic sleeve gastrectomy. Gastric biopsies, surgery specimen or serum was obtained from 35 adult non-obese humans (BMI 22.7 ± 1.9 kg/m(2) ). Ghrelin, ghrelin O-acyl transferase (GOAT), leptin, leptin receptor, and tryptophan hydroxylase 1 (TPH1) mRNA expression were measured by qRT-PCR. Serotonin (5HT) and leptin protein concentration were quantified in tissue extracts and serum; GOAT and ghrelin-positive cells were immunohistologically quantified in tissue. Additionally, 21 blood immune markers were analyzed. KEY RESULTS In gastric tissue, GOAT-positive cells were reduced (p < 0.01), but ghrelin-positive cells and mRNA were increased (both p < 0.05) in obese compared with non-obese individuals. Gastric leptin (p < 0.001) and leptin receptor (p < 0.001) mRNA expression, as well as leptin concentrations in serum (p < 0.001), were increased in obese compared with non-obese individuals. Serum 5HT was reduced (p < 0.05), while tissue 5HT and TPH1 mRNA were reduced only by trend. Interleukin 1 receptor a (IL1Ra), IL-8, IL-12, and monocyte chemoattractant protein 1 (IL1Ra) were increased and IL1Ra correlated negatively with serum leptin. CONCLUSIONS & INFERENCES Our data indicate that obesity causes a dysregulation of gastrointestinal hormones at the tissue level and serum, including a negative correlation with an increased marker of subclinical inflammation.
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Affiliation(s)
- Y Ritze
- Department of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany.,Institute for Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
| | - A Schollenberger
- Department of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
| | - M Hamze Sinno
- Department of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
| | - N Bühler
- Department of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
| | - M Böhle
- Department of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
| | - G Bárdos
- Department of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
| | - H Sauer
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - I Mack
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - P Enck
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - S Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - T Meile
- Department of General and Transplant Surgery and Comprehensive Cancer Center, University of Tübingen, Tübingen, Germany
| | - A Königsrainer
- Department of General and Transplant Surgery and Comprehensive Cancer Center, University of Tübingen, Tübingen, Germany
| | - M Kramer
- Arabella Clinic, München, Germany
| | - S C Bischoff
- Department of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
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Rapps N, Skoda E, Overkamp D, Becker S, Teufel M, Zipfel S, Smolka R. [Spontaneous pneumomediastinum and soft tissue emphysema as rare somatic complication in anorexia nervosa]. Nervenarzt 2016; 87:556-557. [PMID: 26334353 DOI: 10.1007/s00115-015-4416-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- N Rapps
- Abteilung für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Tübingen, Osianderstr. 5, 72076, Tübingen, Deutschland.
| | - E Skoda
- Abteilung für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Tübingen, Osianderstr. 5, 72076, Tübingen, Deutschland
| | - D Overkamp
- Abteilung für Endokrinologie und Diabetologie, Angiologie, Nephrologie und Klinische Chemie, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - S Becker
- Abteilung für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Tübingen, Osianderstr. 5, 72076, Tübingen, Deutschland
| | - M Teufel
- Abteilung für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Tübingen, Osianderstr. 5, 72076, Tübingen, Deutschland
| | - S Zipfel
- Abteilung für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Tübingen, Osianderstr. 5, 72076, Tübingen, Deutschland
| | - R Smolka
- Abteilung für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Tübingen, Osianderstr. 5, 72076, Tübingen, Deutschland
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Zipfel S, Pecha S, Braune S, Kluge S, Bernhardt A, Sill B, Hakmi S, Kubik M, Reichenspurner H, Deuse T. Cardiopulmonary Resuscitation - Is Veno-Arterial Extracorporeal Membrane Oxygenation an Option? J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.1078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Linder M, Pecha S, Zipfel S, Castro L, Gosau N, Willems S, Reichenspurner H, Hakmi S. Lead Extraction with High-Frequency Laser Sheaths: A Single-Center Experience. Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Castro L, Pecha S, Linder M, Zipfel S, Gosau N, Willems S, Reichenspurner H, Hakmi S. The Wearable Defibrillator as a Bridge to Reimplantation in Patients with ICD or CRT-D Infections. Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Teufel M, Zipfel S. Somatoforme Körperbeschwerden und umweltbezogene Gesundheitsstörung. ALLERGOLOGIE 2016. [DOI: 10.1007/978-3-642-37203-2_41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Thiel A, Schubring A, Schneider S, Zipfel S, Mayer J. Health in Elite Sports – a “Bio-Psycho-Social” Perspective. Dtsch Z Sportmed 2015. [DOI: 10.5960/dzsm.2015.194] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Schaeffeler N, Pfeiffer K, Ringwald J, Brucker S, Wallwiener M, Zipfel S, Teufel M. Assessing the need for psychooncological support: screening instruments in combination with patients' subjective evaluation may define psychooncological pathways. Psychooncology 2015; 24:1784-91. [PMID: 26042392 DOI: 10.1002/pon.3855] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 03/05/2015] [Accepted: 04/28/2015] [Indexed: 11/12/2022]
Abstract
BACKGROUND Cancer patients suffer from severe distress. About one third show mental comorbidities. Nevertheless, there is no common agreement on how to measure distress or identify patients in need for psychooncological services using screening questionnaires. PATIENTS AND METHODS A sample of N = 206 patients with confirmed breast cancer, being inpatient for surgical treatment, filled in distress assessment instruments: Distress Thermometer, Hospital Anxiety and Depression Scale, Patient Health Questionnaire 2, Hornheider Screening Instrument and parts of the EORTC-QLQ-C30. Additionally, they were asked for their subjective need for psychooncological counselling. RESULTS The correlation between the assessment instruments is low to medium. The number of patients above the cut-off criteria varies quite a lot according to the instrument (10% to 66%). Therefore, the congruence between the instruments' indications is quite low. Patients with and without subjective need do not differ in personal data but in distress scores. CONCLUSIONS Recommended instruments for distress assessment in psychooncology measure different areas of distress. They do not sufficiently agree in indicating a patient's need for psychooncological treatment. Hence, one should neither compare results of studies using different assessment instruments nor implement a screening without reflecting the used instrument's characteristics compared to the others. The subjective need seems to provide additional information to the assessment. At present, the combination of an assessment instrument and patients' subjective need is seen as a best practice for identifying patients in need of psychooncological treatment.
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Affiliation(s)
- N Schaeffeler
- Department of Psychosomatic Medicine and Psychotherapy, Tuebingen University Hospital, Tuebingen, Germany.,Comprehensive Cancer Centre, Tuebingen University Hospital, Tuebingen, Germany
| | - K Pfeiffer
- Department of Psychosomatic Medicine and Psychotherapy, Tuebingen University Hospital, Tuebingen, Germany
| | - J Ringwald
- Department of Psychosomatic Medicine and Psychotherapy, Tuebingen University Hospital, Tuebingen, Germany.,Comprehensive Cancer Centre, Tuebingen University Hospital, Tuebingen, Germany
| | - S Brucker
- Department of Obstetrics and Gynaecology, Tuebingen University Hospital, Tuebingen, Germany
| | - M Wallwiener
- Department of Obstetrics and Gynaecology, Heidelberg University Hospital, Heidelberg, Germany
| | - S Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, Tuebingen University Hospital, Tuebingen, Germany
| | - M Teufel
- Department of Psychosomatic Medicine and Psychotherapy, Tuebingen University Hospital, Tuebingen, Germany.,Comprehensive Cancer Centre, Tuebingen University Hospital, Tuebingen, Germany
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Huhn D, Junne F, Zipfel S, Duelli R, Resch F, Herzog W, Nikendei C. International medical students--a survey of perceived challenges and established support services at medical faculties. GMS Z Med Ausbild 2015; 32:Doc9. [PMID: 25699112 PMCID: PMC4330639 DOI: 10.3205/zma000951] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Revised: 09/04/2014] [Accepted: 10/30/2014] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Medical students with a non-German background face several challenges during their studies. Besides support given by foreign student offices further specific projects for international students have been developed and are offered by medical faculties. However, so far, neither a systematic survey of the faculties' perceived problems nor of the offered support exists. METHOD All study deaneries of medical faculties in Germany were contacted between April and October 2013 and asked for their participation in a telephone interview. Interview partners were asked about 1.) The percentage of non-German students at the medical faculty; 2.) The perceived difficulties and problems of foreign students; 3.) The offers for non-German students; and 4.) The specification of further possibilities of support. Given information was noted, frequencies counted and results interpreted via frequency analysis. RESULTS Only 39% of the medical faculties could give detailed information about the percentage of non-German students. They reported an average share of 3.9% of students with an EU migration background and 4.9% with a non-EU background. Most frequently cited offers are student conducted tutorials, language courses and tandem-programs. The most frequently reported problem by far is the perceived lack of language skills of foreign students at the beginning of their studies. Suggested solutions are mainly the development of tutorials and the improvement of German medical terminology. DISCUSSION Offers of support provided by medical faculties for foreign students vary greatly in type and extent. Support offered is seen to be insufficient in coping with the needs of the international students in many cases. Hence, a better coverage of international students as well as further research efforts to the specific needs and the effectiveness of applied interventions seem to be essential.
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Affiliation(s)
- D. Huhn
- University Hospital Heidelberg, Centre for Psychosocial Medicine, Department of General Internal Medicine and Psychosomatics, Heidelberg, Germany
| | - F. Junne
- Eberhard-Karls-University Tubingen, Medical Clinic, Department of Psychosomatic Medicine and Psychotherapy, Tübingen, Germany
| | - S. Zipfel
- Eberhard-Karls-University Tubingen, Medical Clinic, Department of Psychosomatic Medicine and Psychotherapy, Tübingen, Germany
| | - R. Duelli
- Ruprecht-Karls-University of Heidelberg, Dean's Office of the Medical Faculty of Heidelberg, Heidelberg, Germany
| | - F. Resch
- Ruprecht-Karls-University of Heidelberg, Dean's Office of the Medical Faculty of Heidelberg, Heidelberg, Germany
| | - W. Herzog
- University Hospital Heidelberg, Centre for Psychosocial Medicine, Department of General Internal Medicine and Psychosomatics, Heidelberg, Germany
| | - C. Nikendei
- University Hospital Heidelberg, Centre for Psychosocial Medicine, Department of General Internal Medicine and Psychosomatics, Heidelberg, Germany,*To whom correspondence should be addressed: C. Nikendei, University Hospital Heidelberg, Centre for Psychosocial Medicine, Department of General Internal Medicine and Psychosomatics, Thibautstraße 2, D-69115 Heidelberg, Germany, Phone: +49 (0)6221/56-38663, Fax: +49 (0)6221/56-5330, E-mail:
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Yildirim Y, Pecha S, Hakmi S, Alassar Y, Zipfel S, Braune S, Kluge S, Reichenspurner H. Veno-venous Extracorporeal Membrane Oxygenation for Acute Respiratory Distress Syndrome. Thorac Cardiovasc Surg 2015. [DOI: 10.1055/s-0035-1544486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Reiter B, Schönebeck J, Zipfel S, Hakmi S, Reichenspurner H, Wagner F. Major Bleeding Events in Patients with Vacuum-Assisted Therapy of Post-Sternotomy Mediastinits. Thorac Cardiovasc Surg 2015. [DOI: 10.1055/s-0035-1544503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Diehl K, Thielmann I, Thiel A, Mayer J, Zipfel S, Schneider S. Possibilities to support elite adolescent athletes in improving performance: Results from a qualitative content analysis. Sci Sports 2014. [DOI: 10.1016/j.scispo.2014.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Boraska V, Franklin CS, Floyd JAB, Thornton LM, Huckins LM, Southam L, Rayner NW, Tachmazidou I, Klump KL, Treasure J, Lewis CM, Schmidt U, Tozzi F, Kiezebrink K, Hebebrand J, Gorwood P, Adan RAH, Kas MJH, Favaro A, Santonastaso P, Fernández-Aranda F, Gratacos M, Rybakowski F, Dmitrzak-Weglarz M, Kaprio J, Keski-Rahkonen A, Raevuori A, Van Furth EF, Slof-Op 't Landt MCT, Hudson JI, Reichborn-Kjennerud T, Knudsen GPS, Monteleone P, Kaplan AS, Karwautz A, Hakonarson H, Berrettini WH, Guo Y, Li D, Schork NJ, Komaki G, Ando T, Inoko H, Esko T, Fischer K, Männik K, Metspalu A, Baker JH, Cone RD, Dackor J, DeSocio JE, Hilliard CE, O'Toole JK, Pantel J, Szatkiewicz JP, Taico C, Zerwas S, Trace SE, Davis OSP, Helder S, Bühren K, Burghardt R, de Zwaan M, Egberts K, Ehrlich S, Herpertz-Dahlmann B, Herzog W, Imgart H, Scherag A, Scherag S, Zipfel S, Boni C, Ramoz N, Versini A, Brandys MK, Danner UN, de Kovel C, Hendriks J, Koeleman BPC, Ophoff RA, Strengman E, van Elburg AA, Bruson A, Clementi M, Degortes D, Forzan M, Tenconi E, Docampo E, Escaramís G, Jiménez-Murcia S, Lissowska J, Rajewski A, Szeszenia-Dabrowska N, Slopien A, Hauser J, Karhunen L, Meulenbelt I, Slagboom PE, Tortorella A, Maj M, Dedoussis G, Dikeos D, Gonidakis F, Tziouvas K, Tsitsika A, Papezova H, Slachtova L, Martaskova D, Kennedy JL, Levitan RD, Yilmaz Z, Huemer J, Koubek D, Merl E, Wagner G, Lichtenstein P, Breen G, Cohen-Woods S, Farmer A, McGuffin P, Cichon S, Giegling I, Herms S, Rujescu D, Schreiber S, Wichmann HE, Dina C, Sladek R, Gambaro G, Soranzo N, Julia A, Marsal S, Rabionet R, Gaborieau V, Dick DM, Palotie A, Ripatti S, Widén E, Andreassen OA, Espeseth T, Lundervold A, Reinvang I, Steen VM, Le Hellard S, Mattingsdal M, Ntalla I, Bencko V, Foretova L, Janout V, Navratilova M, Gallinger S, Pinto D, Scherer SW, Aschauer H, Carlberg L, Schosser A, Alfredsson L, Ding B, Klareskog L, Padyukov L, Courtet P, Guillaume S, Jaussent I, Finan C, Kalsi G, Roberts M, Logan DW, Peltonen L, Ritchie GRS, Barrett JC, Estivill X, Hinney A, Sullivan PF, Collier DA, Zeggini E, Bulik CM. A genome-wide association study of anorexia nervosa. Mol Psychiatry 2014; 19:1085-94. [PMID: 24514567 PMCID: PMC4325090 DOI: 10.1038/mp.2013.187] [Citation(s) in RCA: 241] [Impact Index Per Article: 24.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Revised: 11/21/2013] [Accepted: 11/25/2013] [Indexed: 02/06/2023]
Abstract
Anorexia nervosa (AN) is a complex and heritable eating disorder characterized by dangerously low body weight. Neither candidate gene studies nor an initial genome-wide association study (GWAS) have yielded significant and replicated results. We performed a GWAS in 2907 cases with AN from 14 countries (15 sites) and 14 860 ancestrally matched controls as part of the Genetic Consortium for AN (GCAN) and the Wellcome Trust Case Control Consortium 3 (WTCCC3). Individual association analyses were conducted in each stratum and meta-analyzed across all 15 discovery data sets. Seventy-six (72 independent) single nucleotide polymorphisms were taken forward for in silico (two data sets) or de novo (13 data sets) replication genotyping in 2677 independent AN cases and 8629 European ancestry controls along with 458 AN cases and 421 controls from Japan. The final global meta-analysis across discovery and replication data sets comprised 5551 AN cases and 21 080 controls. AN subtype analyses (1606 AN restricting; 1445 AN binge-purge) were performed. No findings reached genome-wide significance. Two intronic variants were suggestively associated: rs9839776 (P=3.01 × 10(-7)) in SOX2OT and rs17030795 (P=5.84 × 10(-6)) in PPP3CA. Two additional signals were specific to Europeans: rs1523921 (P=5.76 × 10(-)(6)) between CUL3 and FAM124B and rs1886797 (P=8.05 × 10(-)(6)) near SPATA13. Comparing discovery with replication results, 76% of the effects were in the same direction, an observation highly unlikely to be due to chance (P=4 × 10(-6)), strongly suggesting that true findings exist but our sample, the largest yet reported, was underpowered for their detection. The accrual of large genotyped AN case-control samples should be an immediate priority for the field.
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Affiliation(s)
- V Boraska
- 1] Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK [2] University of Split School of Medicine, Split, Croatia
| | - C S Franklin
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
| | - J A B Floyd
- 1] Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK [2] William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, John Vane Science Centre, Charterhouse Square, London, UK
| | - L M Thornton
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - L M Huckins
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
| | - L Southam
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
| | - N W Rayner
- 1] Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK [2] Wellcome Trust Centre for Human Genetics (WTCHG), University of Oxford, Oxford, UK [3] Oxford Centre for Diabetes, Endocrinology and Metabolism (OCDEM), Oxford, UK
| | - I Tachmazidou
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
| | - K L Klump
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - J Treasure
- Section of Eating Disorders, Institute of Psychiatry, King's College London, London, UK
| | - C M Lewis
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK
| | - U Schmidt
- Section of Eating Disorders, Institute of Psychiatry, King's College London, London, UK
| | - F Tozzi
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - K Kiezebrink
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - J Hebebrand
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Universitätsklinikum Essen, University of Duisburg-Essen, Essen, Germany
| | - P Gorwood
- 1] INSERM U894, Centre of Psychiatry and Neuroscience, Paris, France [2] Sainte-Anne Hospital (CMME), University of Paris-Descartes, Paris, France
| | - R A H Adan
- 1] Brain Center Rudolf Magnus, Department of Translational Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands [2] Altrecht Eating Disorders Rintveld, Zeist, The Netherlands
| | - M J H Kas
- Brain Center Rudolf Magnus, Department of Translational Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands
| | - A Favaro
- Department of Neurosciences, University of Padova, Padova, Italy
| | - P Santonastaso
- Department of Neurosciences, University of Padova, Padova, Italy
| | - F Fernández-Aranda
- 1] Department of Psychiatry and CIBERON, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain [2] Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - M Gratacos
- 1] Genomics and Disease Group, Centre for Genomic Regulation (CRG), Barcelona, Spain [2] Universitat Pompeu Fabra (UPF), Barcelona, Spain [3] Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain [4] Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - F Rybakowski
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - M Dmitrzak-Weglarz
- Department of Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - J Kaprio
- 1] Hjelt Institute, University of Helsinki, Helsinki, Finland [2] Institute of Molecular Medicine, University of Helsinki, Helsinki, Finland [3] Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland
| | | | - A Raevuori
- 1] Hjelt Institute, University of Helsinki, Helsinki, Finland [2] Department of Adolescent Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
| | - E F Van Furth
- 1] Center for Eating Disorders Ursula, Leidschendam, The Netherlands [2] Department of Psychiatry, Leiden University Medical Centre, Leiden, The Netherlands
| | - M C T Slof-Op 't Landt
- 1] Center for Eating Disorders Ursula, Leidschendam, The Netherlands [2] Molecular Epidemiology Section, Department of Medical Statistics, Leiden University Medical Centre, Leiden, The Netherlands
| | - J I Hudson
- Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - T Reichborn-Kjennerud
- 1] Department of Genetics, Environment and Mental Health, Norwegian Institute of Public Health, Oslo, Norway [2] Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - G P S Knudsen
- Department of Genetics, Environment and Mental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - P Monteleone
- 1] Department of Psychiatry, University of Naples SUN, Naples, Italy [2] Chair of Psychiatry, University of Salerno, Salerno, Italy
| | - A S Kaplan
- 1] Centre for Addiction and Mental Health, Toronto, ON, Canada [2] Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - A Karwautz
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - H Hakonarson
- 1] The Center for Applied Genomics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA [2] The Division of Human Genetics, Department of Pediatrics, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - W H Berrettini
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Y Guo
- The Center for Applied Genomics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - D Li
- The Center for Applied Genomics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - N J Schork
- Department of Molecular and Experimental Medicine and The Scripps Translational Science Institute, The Scripps Research Institute, La Jolla, CA, USA
| | - G Komaki
- 1] Department of Psychosomatic Research, National Institute of Mental Health, NCNP, Tokyo, Japan [2] School of Health Sciences at Fukuoka, International University of Health and Welfare, Fukuoka, Japan
| | - T Ando
- Department of Psychosomatic Research, National Institute of Mental Health, NCNP, Tokyo, Japan
| | - H Inoko
- Department of Molecular Life Sciences, Tokai University School of Medicine, Kanagawa, Japan
| | - T Esko
- Estonian Genome Center, University of Tartu, Tartu, Estonia
| | - K Fischer
- Estonian Genome Center, University of Tartu, Tartu, Estonia
| | - K Männik
- 1] Institute of Molecular and Cell Biology, University of Tartu, Tartu, Estonia [2] Center for Integrative Genomics, University of Lausanne, Lausanne, Switzerland
| | - A Metspalu
- 1] Estonian Genome Center, University of Tartu, Tartu, Estonia [2] Institute of Molecular and Cell Biology, University of Tartu, Tartu, Estonia
| | - J H Baker
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - R D Cone
- Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - J Dackor
- Department of Genetics, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - J E DeSocio
- Seattle University College of Nursing, Seattle, WA, USA
| | - C E Hilliard
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - J Pantel
- Centre de Psychiatrie et Neurosciences - Inserm U894, Paris, France
| | - J P Szatkiewicz
- Department of Genetics, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - C Taico
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - S Zerwas
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - S E Trace
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - O S P Davis
- 1] Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK [2] Department of Genetics, Evolution and Environment, University College London, UCL Genetics Institute, London, UK
| | - S Helder
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK
| | - K Bühren
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Clinics RWTH Aachen, Aachen, Germany
| | - R Burghardt
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité, Berlin, Germany
| | - M de Zwaan
- 1] Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany [2] Department of Psychosomatic Medicine and Psychotherapy, University of Erlangen-Nuremberg, Erlangen, Germany
| | - K Egberts
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Würzburg, Würzburg, Germany
| | - S Ehrlich
- 1] Department of Child and Adolescent Psychiatry, University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany [2] Athinoula A. Martinos Center for Biomedical Imaging, Psychiatric Neuroimaging Research Program, Massachusetts General Hospital/Harvard Medical School, Charlestown, MA, USA
| | - B Herpertz-Dahlmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Clinics RWTH Aachen, Aachen, Germany
| | - W Herzog
- Departments of Psychosocial and Internal Medicine, Heidelberg University, Heidelberg, Germany
| | - H Imgart
- Parklandklinik, Bad Wildungen, Germany
| | - A Scherag
- Institute for Medical Informatics, Biometry and Epidemiology, Universitätsklinikum Essen, University of Duisburg-Essen, Essen, Germany
| | - S Scherag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Universitätsklinikum Essen, University of Duisburg-Essen, Essen, Germany
| | - S Zipfel
- Department of Internal Medicine VI, Psychosomatic Medicine and Psychotherapy, University Medical Hospital Tübingen, Tübingen, Germany
| | - C Boni
- INSERM U894, Centre of Psychiatry and Neuroscience, Paris, France
| | - N Ramoz
- INSERM U894, Centre of Psychiatry and Neuroscience, Paris, France
| | - A Versini
- INSERM U894, Centre of Psychiatry and Neuroscience, Paris, France
| | - M K Brandys
- 1] Brain Center Rudolf Magnus, Department of Translational Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands [2] Altrecht Eating Disorders Rintveld, Zeist, The Netherlands
| | - U N Danner
- Altrecht Eating Disorders Rintveld, Zeist, The Netherlands
| | - C de Kovel
- Department of Medical Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - J Hendriks
- Brain Center Rudolf Magnus, Department of Translational Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands
| | - B P C Koeleman
- Department of Medical Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - R A Ophoff
- 1] Center for Neurobehavioral Genetics, University of California, Los Angeles, Los Angeles, CA, USA [2] Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - E Strengman
- Department of Medical Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - A A van Elburg
- 1] Altrecht Eating Disorders Rintveld, Zeist, The Netherlands [2] Department of Child and Adolescent Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
| | - A Bruson
- Clinical Genetics Unit, Department of Woman and Child Health, University of Padova, Padova, Italy
| | - M Clementi
- Clinical Genetics Unit, Department of Woman and Child Health, University of Padova, Padova, Italy
| | - D Degortes
- Department of Neurosciences, University of Padova, Padova, Italy
| | - M Forzan
- Clinical Genetics Unit, Department of Woman and Child Health, University of Padova, Padova, Italy
| | - E Tenconi
- Department of Neurosciences, University of Padova, Padova, Italy
| | - E Docampo
- 1] Genomics and Disease Group, Centre for Genomic Regulation (CRG), Barcelona, Spain [2] Universitat Pompeu Fabra (UPF), Barcelona, Spain [3] Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain [4] Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - G Escaramís
- 1] Genomics and Disease Group, Centre for Genomic Regulation (CRG), Barcelona, Spain [2] Universitat Pompeu Fabra (UPF), Barcelona, Spain [3] Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain [4] Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - S Jiménez-Murcia
- 1] Department of Psychiatry and CIBERON, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain [2] Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - J Lissowska
- M. Sklodowska-Curie Cancer Center and Institute of Oncology, Warsaw, Poland
| | - A Rajewski
- Department of Epidemiology, Institute of Occupational Medicine, Department of Epidemiology, Lodz, Poland
| | - N Szeszenia-Dabrowska
- Department of Epidemiology, Institute of Occupational Medicine, Department of Epidemiology, Lodz, Poland
| | - A Slopien
- Department of Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - J Hauser
- Department of Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - L Karhunen
- Department of Clinical Nutrition, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - I Meulenbelt
- Molecular Epidemiology Section, Department of Medical Statistics, Leiden University Medical Centre, Leiden, The Netherlands
| | - P E Slagboom
- 1] Molecular Epidemiology Section, Department of Medical Statistics, Leiden University Medical Centre, Leiden, The Netherlands [2] Netherlands Consortium for Healthy Ageing, Leiden University Medical Center, Leiden, The Netherlands
| | - A Tortorella
- Department of Psychiatry, University of Naples SUN, Naples, Italy
| | - M Maj
- Department of Psychiatry, University of Naples SUN, Naples, Italy
| | - G Dedoussis
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - D Dikeos
- 1st Department of Psychiatry, Athens University Medical School, Athens, Greece
| | - F Gonidakis
- Eating Disorders Unit, 1st Department of Psychiatry, Athens University Medical School, Athens, Greece
| | - K Tziouvas
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - A Tsitsika
- Adolescent Health Unit (A.H.U.), 2nd Department of Pediatrics - Medical School, University of Athens 'P. & A. Kyriakou' Children's Hospital, Athens, Greece
| | - H Papezova
- Department of Psychiatry, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - L Slachtova
- Department of Pediatrics, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - D Martaskova
- Department of Psychiatry, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - J L Kennedy
- 1] Centre for Addiction and Mental Health, Toronto, ON, Canada [2] Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - R D Levitan
- 1] Centre for Addiction and Mental Health, Toronto, ON, Canada [2] Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Z Yilmaz
- 1] Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA [2] Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - J Huemer
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - D Koubek
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - E Merl
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - G Wagner
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - P Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - G Breen
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK
| | - S Cohen-Woods
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK
| | - A Farmer
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK
| | - P McGuffin
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK
| | - S Cichon
- 1] Department of Genomics, Life & Brain Center, Institute of Human Genetics, University of Bonn, Bonn, Germany [2] Institute of Neuroscience and Medicine (INM-1), Research Center Jülich, Jülich, Germany [3] Division of Medical Genetics, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - I Giegling
- Klinikum der Medizinischen Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle/Saale, Germany
| | - S Herms
- 1] Department of Genomics, Life & Brain Center, Institute of Human Genetics, University of Bonn, Bonn, Germany [2] Division of Medical Genetics, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - D Rujescu
- Klinikum der Medizinischen Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle/Saale, Germany
| | - S Schreiber
- Institute of Clinical Molecular Biology, University of Kiel, Kiel, Germany
| | - H-E Wichmann
- 1] Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany [2] Institute of Medical Informatics, Biometry and Epidemiology, Ludwig-Maximilians-University, Munich, Germany
| | - C Dina
- CNRS 8090-Institute of Biology, Pasteur Institute, Lille, France
| | - R Sladek
- McGill University and Genome Quebec Innovation Centre, Montreal, QC, Canada
| | - G Gambaro
- Division of Nephrology, Department of Internal Medicine and Medical Specialties, Columbus-Gemelly Hospitals, Catholic University, Rome, Italy
| | - N Soranzo
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
| | - A Julia
- Unitat de Recerca de Reumatologia (URR), Institut de Recerca Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - S Marsal
- Unitat de Recerca de Reumatologia (URR), Institut de Recerca Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - R Rabionet
- 1] Genomics and Disease Group, Centre for Genomic Regulation (CRG), Barcelona, Spain [2] Universitat Pompeu Fabra (UPF), Barcelona, Spain [3] Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain [4] Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - V Gaborieau
- Genetic Epidemiology Group, International Agency for Research on Cancer (IARC), Lyon, France
| | - D M Dick
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - A Palotie
- 1] Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK [2] The Finnish Institute of Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland [3] The Program for Human and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - S Ripatti
- 1] The Finnish Institute of Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland [2] Finnish Institute of Occupational Health, Helsinki, Finland
| | - E Widén
- 1] The Finnish Institute of Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland [2] Finnish Institute of Occupational Health, Helsinki, Finland
| | - O A Andreassen
- NORMENT, K.G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - T Espeseth
- 1] NORMENT, K.G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway [2] Department of Psychology, University of Oslo, Oslo, Norway
| | - A Lundervold
- 1] Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway [2] Kavli Research Centre for Aging and Dementia, Haraldsplass Deaconess Hospital, Bergen, Norway [3] K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, University of Bergen, Bergen, Norway
| | - I Reinvang
- Department of Psychology, University of Oslo, Oslo, Norway
| | - V M Steen
- 1] Department of Clinical Science, K.G. Jebsen Centre for Psychosis Research, Norwegian Centre For Mental Disorders Research (NORMENT), University of Bergen, Bergen, Norway [2] Dr Einar Martens Research Group for Biological Psychiatry, Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, Norway
| | - S Le Hellard
- 1] Department of Clinical Science, K.G. Jebsen Centre for Psychosis Research, Norwegian Centre For Mental Disorders Research (NORMENT), University of Bergen, Bergen, Norway [2] Dr Einar Martens Research Group for Biological Psychiatry, Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, Norway
| | - M Mattingsdal
- NORMENT, K.G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - I Ntalla
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - V Bencko
- Institute of Hygiene and Epidemiology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - L Foretova
- Department of Cancer Epidemiology and Genetics, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - V Janout
- Palacky University, Olomouc, Czech Republic
| | - M Navratilova
- Department of Cancer Epidemiology and Genetics, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - S Gallinger
- 1] University Health Network, Toronto General Hospital, Toronto, ON, Canada [2] Mount Sinai Hospital, Samuel Lunenfeld Research Institute, Toronto, ON, Canada
| | - D Pinto
- Departments of Psychiatry, and Genetics and Genomic Sciences, Seaver Autism Center, and the Mindich Child Health and Development Institute, Mount Sinai School of Medicine, New York, NY, USA
| | - S W Scherer
- The Centre for Applied Genomics and Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON, Canada
| | - H Aschauer
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - L Carlberg
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - A Schosser
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - L Alfredsson
- The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - B Ding
- The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - L Klareskog
- Rheumatology Unit, Department of Medicine at the Karolinska University Hospital, Solna, Sweden
| | - L Padyukov
- Rheumatology Unit, Department of Medicine at the Karolinska University Hospital, Solna, Sweden
| | - P Courtet
- 1] Inserm, U1061, Université Montpellier 1, Montpellier, France [2] Department of Emergency Psychiatry, CHU Montpellier, Montpellier, France
| | - S Guillaume
- 1] Inserm, U1061, Université Montpellier 1, Montpellier, France [2] Department of Emergency Psychiatry, CHU Montpellier, Montpellier, France
| | - I Jaussent
- 1] Inserm, U1061, Université Montpellier 1, Montpellier, France [2] Department of Emergency Psychiatry, CHU Montpellier, Montpellier, France
| | - C Finan
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
| | - G Kalsi
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK
| | - M Roberts
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK
| | - D W Logan
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
| | - L Peltonen
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
| | - G R S Ritchie
- 1] Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK [2] European Molecular Biology Laboratory, European Bioinformatics Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge
| | - J C Barrett
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
| | - X Estivill
- 1] Genomics and Disease Group, Centre for Genomic Regulation (CRG), Barcelona, Spain [2] Universitat Pompeu Fabra (UPF), Barcelona, Spain [3] Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain [4] Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - A Hinney
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Universitätsklinikum Essen, University of Duisburg-Essen, Essen, Germany
| | - P F Sullivan
- 1] Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA [2] Department of Genetics, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - D A Collier
- 1] Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK [2] Eli Lilly and Company, Erl Wood Manor, Windlesham, UK
| | - E Zeggini
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
| | - C M Bulik
- 1] Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA [2] Department of Nutrition, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Lender N, Talley NJ, Enck P, Haag S, Zipfel S, Morrison M, Holtmann GJ. Review article: Associations between Helicobacter pylori and obesity--an ecological study. Aliment Pharmacol Ther 2014; 40:24-31. [PMID: 24832176 DOI: 10.1111/apt.12790] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Revised: 09/18/2013] [Accepted: 04/21/2014] [Indexed: 02/06/2023]
Abstract
BACKGROUND There is emerging debate over the effect of Helicobacter pylori infection on body mass index (BMI). A recent study demonstrated that individuals who underwent H. pylori eradication developed significant weight gain as compared to subjects with untreated H. pylori colonisation. AIM To elucidate the association between H. pylori colonisation and the prevalence of overweight and obesity in developed countries. METHODS The literature was searched for publications reporting data on H. pylori prevalence rates and obesity prevalence rates. Studies selected reported H. pylori prevalence in random population samples with sample sizes of more than 100 subjects in developed countries (GDP >25,000 US$/person/year). Corresponding BMI distributions for corresponding countries and regions were identified. Nonparametric tests were used to compare the association between H. pylori and overweight and obesity rates. RESULTS Forty-nine studies with data from 10 European countries, Japan, the US and Australia were identified. The mean H. pylori rate was 44.1% (range 17-75%), the mean rates for obesity and overweight were 46.6 (± 16)% and 14.2 (± 8.9)%. The rate of obesity and overweight were inversely and significantly (r = 0.29, P < 0.001) correlated with the prevalence of H. pylori infection. CONCLUSIONS There is an inverse correlation between H. pylori prevalence and rate of overweight/obesity in countries of the developed world. Thus, the gradual decrease of the H. pylori colonisation that has been observed in recent decades (or factors associated with decrease of) could be causally related to the obesity endemic observed in the Western world.
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Affiliation(s)
- N Lender
- Department of Gastroenterology & Hepatology, Princess Alexandra Hospital, Woolloongabba, Qld, Australia; Faculty of Medicine and Biomedicine & Faculty of Health and Behavioural Sciences, University of Queensland, St Lucia, Qld, Australia
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Kullmann S, Giel K, Teufel M, Thiel A, Zipfel S, Preissl H. P24: Aberrant connectivity of the inferior frontal cortex in anorexia nervosa. Clin Neurophysiol 2014. [DOI: 10.1016/s1388-2457(14)50188-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Schönenberg M, Mares L, Smolka R, Jusyte A, Zipfel S, Hautzinger M. Facial affect perception and mentalizing abilities in female patients with persistent somatoform pain disorder. Eur J Pain 2014; 18:949-56. [PMID: 24395204 DOI: 10.1002/j.1532-2149.2013.00440.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2013] [Indexed: 11/09/2022]
Abstract
BACKGROUND Numerous studies have demonstrated a robust link between alexithymic traits and somatic complaints in patients suffering from psychosomatic disorders, while less is known about disease-related impairments in the processing of affective social information. Deficits in emotion recognition can lead to misinterpretations of social signals and induce distress in interpersonal interactions. This, in turn, might contribute to somatoform symptomatology in affected individuals. The aim of the present study was to investigate basal facial affect recognition as well as higher-order cognitive mind-reading skills in order to further clarify the association between alexithymia and the processing of social affective information in a homogenous sample of patients suffering from somatoform pain. METHODS We employed a series of animated morph clips that gradually displayed the onset and development of the six basic emotional expressions to investigate facial affect perception in a female sample of patients diagnosed with persistent somatoform pain disorder (PSPD) and matched healthy controls. In addition, all participants were presented with the Movie for the Assessment of Social Cognition to explore mind-reading abilities. RESULTS Specifically impaired mentalizing skills and increased alexithymic traits were observed in PSPD, while emotional facial expression recognition appeared to be intact in these patients. CONCLUSIONS PSPD subjects tend to overattribute inappropriate affective states to others, which could be the consequence of the inability to adequately experience and express their own emotional reactions. This cognitive bias might lead to the experience of poor psychosocial functioning and has the potential to negatively impact the course and outcome of this psychopathology.
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Affiliation(s)
- M Schönenberg
- Department of Clinical Psychology and Psychotherapy, University of Tübingen, Germany
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Horing B, Kugel H, Brenner V, Zipfel S, Enck P. Perception and pain thresholds for cutaneous heat and cold, and rectal distension: associations and disassociations. Neurogastroenterol Motil 2013; 25:e791-802. [PMID: 23937429 DOI: 10.1111/nmo.12207] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 07/18/2013] [Indexed: 02/08/2023]
Abstract
BACKGROUND Hypersensitivity to somatic or visceral pain has been reported in numerous clinical conditions such as fibromyalgia or the irritable bowel syndrome, and general hypersensitivity has been proposed to be the underlying mechanism. However, cross-modal relationships especially between somatic and visceral pain have rarely been investigated even in healthy volunteers. Furthermore, psychological influences on pain have rarely been characterized across modalities. METHODS Sixty-one healthy participants underwent testing of perception and pain thresholds for cutaneous thermode heat and cold, as well as for rectal balloon distension. Psychological testing for anxiety, depression, and pain experience (including catastrophizing and coping) as well as cardiac interoception was performed. Measurement quality and the correlations between the different modalities were examined. KEY RESULTS Significant correlations existed between the perception thresholds for cold/heat (τB = -0.28, p = 0.002) and cold/distension (τB = -0.21, p = 0.03) and for the pain thresholds for cold/heat (r = -0.61, p < 0.001) and heat/distension (r = 0.33, p = 0.01). No association was found between pain thresholds and anxiety, depression, psychological experience with and processing of pain, or cardiac interoception. Retest reliabilities for pain measurements were satisfying after short intertrial intervals (all intraclass correlation coefficients >0.8), but less so after longer intervals. The individuals contributing to the respective correlations differ between measurements. CONCLUSIONS & INFERENCES Moderate associations were found for pain thresholds across modalities. The strength of the associations and their stability over time warrants further investigation and might serve to increase the understanding of conditions affecting multiple pain modalities.
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Affiliation(s)
- B Horing
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
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Stiegler A, Rosenkranz T, Abele H, Zipfel S, Batra A. IRIS I - Ein Pilotprojekt zur Entwicklung einer individualisierten, risikoadaptierten Intervention zur Verringerung des Alkohol- und Tabakkonsums bei Schwangeren. Suchttherapie 2013. [DOI: 10.1055/s-0033-1351648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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