Main research results in simple words...
The following description of the most important research results should provide a clear overview, of course not without loss of a scientific precision. The exact results can be found in the original publications.
- Weight gain among antipsychotics is largely due to a genetic predisposition. The following clinical predictors of antipsychotic-induced weight gain could be identified: increased BMI before the onset of disease / treatment, increased BMI values of the parents, young age, female sex, non-smoker, schizophrenic disorder (the latter, presumably due to the long treatment duration). A low BMI merely results in accelerated weight gain (but not overall high levels of weight gain), probably in the sense of catching up with previously lost weight loss as the onset of psychosis begins. Thus, the over decades existing error of research state derived from short-term studies could be cleared out of the way that a low body weight would lead to an antipsychotic-induced weight gain. Patients with a history of eating disorders also tend to get symptoms of eating disorders, even with antipsychotics that stimulate appetite.
- Motor side effects of atypical antipsychotics also occur in adolescents, but are significantly reduced in severity than under typical antipsychotics. Nevertheless, a young age and a strong manifestation of psychopathology with highly potent, high-dose, predominantly typical antipsychotics are risk factors for the development of motor side effects, which mostly correlate with schizophrenic negative symptoms. In contrast to parkinson or akathiform motor symptoms, tardive dyskinesia appear to have an increased morbogenic (genetic) component triggered by antipsychotics.
- The results of a pathway analysis suggest that a long prodromal stage increases the risk of negative symptoms, while a delayed onset of antipsychotic treatment after onset of psychotic symptoms leads in the long term to an increased manifestation and severity of positive symptoms.
- A psychosis model was developed that describes the psychotic symptoms as a pattern recognition disorder at the neurobiological level in the sense of a failure of the adjustment of real and requested output patterns.
Depression and pain
- Patients with pain symptoms related to a depressive disorder relieve pain as depression improves. A treatment of the pain symptoms is not necessary, but especially a treatment of depression, which may not necessarily be just medicated. Above all, the effectiveness of the treatment of depression is decisive, not certain antidepressant substance groups. For the individual patient, this means that the choice of antidepressant is based on the individual effect / side effect profile, not on a supposedly better analgesic effect. (No statement is made on patients with chronic pain and secondary depression.)
- Antidepressants lead to a normalization of cytokines.
- Music can reduce pain perception in depressive patients under the simulation condition of chronic pain
- For the treatment satisfaction of psychiatric patients the therapeutic effect has the main impact as well as the drug compatibility and the diagnosis (not variables such as age and gender, as in previous studies). As for the diagnosis, patients with a personality disorder have lower treatment satisfaction in a general psychiatric treatment setting; in these patients, satisfaction is particularly associated with symptom improvement in treatment, while the importance of psychotropic drugs is low.
Music and health
- People use music in everyday life for emotion modulation. While individuals from the general population use music in everyday life primarily to feel joy, patients with mental disorders use music in everyday life rather to reduce negative emotions. The more severe the impairment of the disease in everyday life is, the more they use music for emotion modulation, especially in young adults. Patients who expect music to have a positive meaning usually have a higher level of functioning and can perceive more that music helps them. However, only symptom reduction occurs in the patients who use the music for emotion modulation, regardless of the severity of the disease or of certain personality dimensions. Especially patients who do not have positive access to music could benefit from according instructions. Patients who have relatively high (self-) confidence can use music more to enjoy themselves. Patients with addiction disorders and personality disorders increasingly use music to relax, to solve problems and to reduce negative emotions, while patients with schizophrenia and depressive disorders are increasingly using music for relaxation. Patients with reduced ego strength tend to change their music preference at the onset of the disease. Patients with personality disorders prefer complex music (such as classical music), but can use it less than healthy control subjects to enjoy. Patients with obsessive-compulsive spectrum symptoms are in the "midfield" between patients with other mental disorders, who use music partly excessive to reduce negative emotions, and healthy controls, who use music rather for positive stimulation. Women seem to use music a bit more for emotional modulation than men, especially for relaxation and problem solving, but also increasingly in healthy controls to enjoy it. Mentally ill women with a negative self-esteem also seem to use music more often, even if their mood is getting more and more depressed by music. Patients who perceive themselves as musical individuals experience themselves more favorable in their self-image and use music more for relaxation and to reduce negative affectivity. In addition, they do not abandon such emotion modulation strategies when they become ill with a mental disorder, suggesting a higher level of self-efficacy, which in turn should be helpful for therapeutic success.
- Initial pilot results indicate that music therapy helps mental health patients to further develop their personality resources in order to solve everyday problems with music that patients find extremely helpful. Whereas patients without music therapy tend to use music as a means of venting of negative emotions, music therapy patients can deal with everyday music in a more situational, mindful, and independent way from previous patterns of attachment, thereby influencing their personal dimensions.
- In patients with mental disorders, ego strength in adulthood is positively associated with parental (especially maternal) caring for children, while there is a reciprocal relation of ego strength to parental controls in infancy.
- Patients with personality disorders most commonly described a "little lovingly, restrictive“ attachment style (little care, much control) with significantly less maternal care in childhood and lower ego strength in adulthood.
- Constructive attachment behavior at the grandparent level correlated significantly with constructive attachment behavior at the maternal level, which in turn correlated with a reduction of internal and external mental abnormalities at the child level. As a central element, caring emerged across the generations.
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