Pathways to care in subjects at high risk for psychotic disorders — A European perspective

Evidence-based decisions on indicated prevention in early psychosis require large-scale studies on the pathways to care in high-risk subjects. EPOS (The European Prediction of Psychosis Study), a prospective multi-center, naturalistic field study in four European countries (Finland, Germany, The Netherlands and England), was designed to acquire accurate knowledge about pathways to care and delay in obtaining specialized high risk care. Our high risk sample (n=233) reported on average 2.9 help-seeking contacts, with an average delay between onset of relevant problems to initial help-seeking contact of 72.6 weeks, and between initial help-seeking contact and reaching specialized high risk care of 110.9 weeks. This resulted in a total estimated duration of an unrecognized risk for psychosis of 3 ½ years. Across EPOS EU regions, about 90% of care pathway contacts were within professional health care sectors. Between EPOS regions, differences in the pathways parameters including early detection and health-care systems were often very pronounced. High-risk participants who later made transition to a full psychotic disorder had significantly longer delays between initial help-seeking and receiving appropriate interventions. Our study underlines the need for regionally adapted implementation of early detection and intervention programs within respective mental health and health care networks, including enhancing public awareness of early psychosis.

Das Judentum und sein Verhältnis zu anderen Religionen : nach christlichen und jüdischen Quellen bearb.

von A. Franz

Das Eine Nothwendige zur wahren Freiheit und zum rechten Fortschritte in christlicher Gerechtigkeit die öftere Kommunion oder Sakramentale Vereinigung mit Christo Jesu dem Lichte der Welt : Dargestellt gegen den Jansenismus der Zeit

von Anton Franz Salesius Edmund Rost

Deutschland's Zolleinigung : Schutz- und Differentialzölle

Boberach: Das in Preußen weit entwickelte Prinzip, die verschiedenen Wirtschaftszweige gleichmäßig zu fördern, soll bestehen bleiben. Handelsfreiheit und mäßiger Schutz des inländischen Gewerbes, weiterer Zusammenschluß im Deutschen Zollverein sollen der deutschen Einheit dienen und Voraussetzung für einen größeren Binnenmarkt sein, insbesondere durch Einschluß der Nordseehäfen. Differentialzölle sollen die Schiffahrt fördern

Die Preussische National-Versammlung und die Verfassung vom 5. Dezember : Beleuchtung der Ansprache des Abgeordneten Rodbertus an seine Wähler

Boberach: Gegen Rodbertus wird das Recht des Königs zur Verlegung der Nationalversammlung anerkannt und die Oktroyierung der Verfassung gebilligt, weil die Revision durch die Kammern vorgesehen ist

Circulare der Nieder-Oester. Landesregierung über die Verwechslung der Noten der öster. Nationalbank, und deren Verwendung als Zahlungsmittel: Wiewohl die österreichische Nationalbank wirksame Vorkehrungen getroffen hat ...

Welsch (Projektbearbeiter): Ermächtigung der Österreichischen National-Bank durch die niederösterreichische Landesregierung, die Einwechslung von Banknoten auf ein Minimum zu beschränken. Verpflichtung der Kunden zur Annahme von Banknoten

Da eine Deputation die Besorgniß ausspricht, es könne sich das böswillige Gerücht verwirklichen ...

Welsch (Projektbearbeiter): Zurückweisung von Gerüchten über ein bevorstehendes Einrücken von vier böhmischen Regimentern in Wien

Zuschrift des Kriegsministeriums an den Verwaltungsrath der Nationalgarde zu Wien ddo. 17. Juni 1848, Nr. 2598-M. K.: Gleichwie mich persönlich der in dem Aufrufe des Verwaltungsrathes der gesammten Nationalgarde Wiens ...

Welsch (Projektbearbeiter): Positive Reaktion des Kriegsministeriums auf einen Aufruf der Wiener Nationalgarde an das Heer. Die in der fraglichen Manifestation ausgesprochenen "loyalen Gesinnungen" werden ihren günstigen Eindruck auf die Armee nicht verfehlen

Depression predicts persistence of paranoia in clinical high-risk patients to psychosis: results of the EPOS project.

BACKGROUND The link between depression and paranoia has long been discussed in psychiatric literature. Because the causality of this association is difficult to study in patients with full-blown psychosis, we aimed to investigate how clinical depression relates to the presence and occurrence of paranoid symptoms in clinical high-risk (CHR) patients. METHODS In all, 245 young help-seeking CHR patients were assessed for suspiciousness and paranoid symptoms with the structured interview for prodromal syndromes at baseline, 9- and 18-month follow-up. At baseline, clinical diagnoses were assessed by the Structured Clinical Interview for DSM-IV, childhood adversities by the Trauma and Distress Scale, trait-like suspiciousness by the Schizotypal Personality Questionnaire, and anxiety and depressiveness by the Positive and Negative Syndrome Scale. RESULTS At baseline, 54.3 % of CHR patients reported at least moderate paranoid symptoms. At 9- and 18-month follow-ups, the corresponding figures were 28.3 and 24.4 %. Depressive, obsessive-compulsive and somatoform disorders, emotional and sexual abuse, and anxiety and suspiciousness associated with paranoid symptoms. In multivariate modelling, depressive and obsessive-compulsive disorders, sexual abuse, and anxiety predicted persistence of paranoid symptoms. CONCLUSION Depressive disorder was one of the major clinical factors predicting persistence of paranoid symptoms in CHR patients. In addition, obsessive-compulsive disorder, childhood sexual abuse, and anxiety associated with paranoia. Effective pharmacological and psychotherapeutic treatment of these disorders and anxiety may reduce paranoid symptoms in CHR patients.

Psychometric properties of the Trauma and Distress Scale, TADS, in an adult community sample in Finland

BACKGROUND: There is increasing evidence that a history of childhood abuse and neglect is not uncommon among individuals who experience mental disorder and that childhood trauma experiences are associated with adult psychopathology. Although several interview and self-report instruments for retrospective trauma assessment have been developed, many focus on sexual abuse (SexAb) rather than on multiple types of trauma or adversity. METHODS: Within the European Prediction of Psychosis Study, the Trauma and Distress Scale (TADS) was developed as a new self-report assessment of multiple types of childhood trauma and distressing experiences. The TADS includes 43 items and, following previous measures including the Childhood Trauma Questionnaire, focuses on five core domains: emotional neglect (EmoNeg), emotional abuse (EmoAb), physical neglect (PhyNeg), physical abuse (PhyAb), and SexAb.This study explores the psychometric properties of the TADS (internal consistency and concurrent validity) in 692 participants drawn from the general population who completed a mailed questionnaire, including the TADS, a depression self-report and questions on help-seeking for mental health problems. Inter-method reliability was examined in a random sample of 100 responders who were reassessed in telephone interviews. RESULTS: After minor revisions of PhyNeg and PhyAb, internal consistencies were good for TADS totals and the domain raw score sums. Intra-class coefficients for TADS total score and the five revised core domains were all good to excellent when compared to the interviewed TADS as a gold standard. In the concurrent validity analyses, the total TADS and its all core domains were significantly associated with depression and help-seeking for mental problems as proxy measures for traumatisation. In addition, robust cutoffs for the total TADS and its domains were calculated. CONCLUSIONS: Our results suggest the TADS as a valid, reliable, and clinically useful instrument for assessing retrospectively reported childhood traumatisation.

Ignaz Brüll [Illustration] : Ölgemälde

Franz von Lenbach

Missalonghis Untergang : Predigt über Röm. XII. v. 15. Ende ; gehalten Sonntags den 4. Juni 1826

von Conrad von Orell

Soliman der Zweyte, oder die drey Sultaninnen : Ein Singspiel in zwey Aufzügen ; für die k. k. Hoftheater

nach dem Französischen des Herrn Favart bearbeitet von Franz Xaver Huber. Die Musik ist von Hrn. Franz Xav. Süßmayer, Kapellmeister in wirklichen Diensten der k. k. Theatral-Hof-Direktion

Conomitrium julianum (Savi) Montg. ante portas

von Dr. Franz Blonski

Die Eigenart der biblischen Religion

von Konrad von Orelli