Abstract:
:Germany turned towards community-based mental health care in the mid seventies, during a general climate of social and political reform. The continuing deinstitutionalisation process and the implementation of community mental health services was considerably affected by the reunification of East and West Germany in 1990, which required dramatic changes in the structure and quality of the mental health care system of the former German Democratic Republic (GDR). Overall, German mental health care is organised as a subsidiary system, where planning and regulating mental health care is the responsibility of the 16 federal states. So German mental health care provision is spread among many sectors and characterised by considerable regional differences. A key characteristic is the particularly wide gap between inpatient and outpatient services, which are funded separately and staffed by different teams. In 2003 the total number of psychiatric beds was a mere two thirds of the overall bed capacity in 1991, the first year as a re-unified Germany, when psychiatric beds in East and West Germany totalled 80,275. From 1970 onwards the number of psychiatric beds was cut by roughly half. So the momentum of the reform has been strong enough to assimilate the completely different mental health care system of the former German Democratic Republic and, in the course of a decade, to re-structure mental health services for an additional 17-18 million new inhabitants. In an ongoing struggle to adapt to changing administrative set-ups, legal frameworks, and financial constraints, psychiatry in Germany in currently facing specific problems and is seriously challenged to defend to considerable achievements of the past. A major obstacle to achieving this aim lies in the fragmented system of mental health care provision and mental health care funding.
journal_name
Eur Arch Psychiatry Clin Neurosciauthors
Salize HJ,Rössler W,Becker Tdoi
10.1007/s00406-006-0696-9subject
Has Abstractpub_date
2007-03-01 00:00:00pages
92-103issue
2eissn
0940-1334issn
1433-8491journal_volume
257pub_type
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journal_title:European archives of psychiatry and clinical neuroscience
pub_type: 杂志文章
doi:10.1007/s00406-010-0109-y
更新日期:2010-10-01 00:00:00
abstract::Increases in seizure threshold (ST) over a course of brief pulse ECT can be predicted by decreases in EEG quality, informing ECT dose adjustment to maintain adequate supra-threshold dosing. ST increases also occur over a course of right unilateral ultrabrief (RUL UB) ECT, but no data exist on the relationship between ...
journal_title:European archives of psychiatry and clinical neuroscience
pub_type: 杂志文章,随机对照试验
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更新日期:2017-12-01 00:00:00
abstract::In recent studies, the glutamate (Glu) level has been quantified using the modified STEAM sequence on 3T MRI. We enrolled 15 healthy volunteers and a group of 51 patients who experienced stroke for the first time and had a good prognosis. The patients with infarction were divided into three groups according to their s...
journal_title:European archives of psychiatry and clinical neuroscience
pub_type: 杂志文章
doi:10.1007/s00406-011-0209-3
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abstract::In a single-blind, placebo-controlled crossover trial, the acute efficacy of the dopamine agonist pramipexole was investigated in 11 restless legs syndrome (RLS) patients by sleep laboratory methods, with a clinical follow-up for 4 weeks. In 3 nights (pre-treatment, placebo and drug night), objective sleep quality was...
journal_title:European archives of psychiatry and clinical neuroscience
pub_type: 临床试验,杂志文章
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abstract::Affective and non-affective psychoses are severe and frequent psychiatric disorders. Amongst others, they not only have a profound impact on affected individuals through their symptomatology, but also regarding cognition, brain structure and function. Cognitive impairment influences patients' quality of life as well a...
journal_title:European archives of psychiatry and clinical neuroscience
pub_type: 杂志文章,评审
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abstract::Altered neuroplasticity contributes to the pathophysiology of schizophrenia. However, the idea that antipsychotics may act, at least in part, by normalizing neurogenesis has not been consistently supported. Our study seeks to determine whether hippocampal cell proliferation is altered in adult rats pretreated with ket...
journal_title:European archives of psychiatry and clinical neuroscience
pub_type: 杂志文章
doi:10.1007/s00406-009-0033-1
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abstract::To assess the course of neuropsychological (NP) impairment in schizophrenia, 71 patients with first episode (FE) schizophrenia and 71 healthy controls were given a comprehensive battery of NP tests at index assessment, after a 2-year and after a 5-year follow-up period. By means of the z-score standardization, summary...
journal_title:European archives of psychiatry and clinical neuroscience
pub_type: 杂志文章
doi:10.1007/s00406-006-0667-1
更新日期:2006-10-01 00:00:00
abstract::This paper reports on psychiatric case identification by the application of the Structured Clinical Interview for DSM-III-R (SCID) in a sample of 198 Greek migrants repatriated from western europe in a northwestern province of Greece. The current (1 month) prevalence of psychiatric morbidity, based on the total number...
journal_title:European archives of psychiatry and clinical neuroscience
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/BF02191542
更新日期:1995-01-01 00:00:00
abstract::While the impact of mentally ill patients' perceptions of their key relatives' expressed emotion is well examined with regard to relapse, there is a paucity of evidence concerning the impact on their key relatives' burden. The present study aims to evaluate the relative prognostic value of expressed and perceived emot...
journal_title:European archives of psychiatry and clinical neuroscience
pub_type: 杂志文章
doi:10.1007/s00406-010-0178-y
更新日期:2011-08-01 00:00:00
abstract::Mutations in the presenilin-1 gene (PS-1 gene) on chromosome 14 have recently been identified as a cause of familial early-onset Alzheimer's disease (EOAD). To our knowledge, only two German EOAD patients with mutations in the PS-1 gene have been identified thus far. Herein we report the case of a German EOAD patient ...
journal_title:European archives of psychiatry and clinical neuroscience
pub_type: 杂志文章
doi:10.1007/s004060050028
更新日期:1998-01-01 00:00:00
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journal_title:European archives of psychiatry and clinical neuroscience
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/BF02191958
更新日期:1992-01-01 00:00:00
abstract::In clinical trials in psychiatry, changes in severity are usually measured with ordinal level scales which are applied repeatedly during the trial, showing a constant decline in psychopathology scores as treatment leads to improvement. Previous non-parametric tests for repeated measures in factorial designs did not te...
journal_title:European archives of psychiatry and clinical neuroscience
pub_type: 临床试验,杂志文章
doi:10.1007/s004060050061
更新日期:1999-01-01 00:00:00
abstract::Some studies suggest seasonality of suicide attempts in females, but not in males. The reasons for this gender difference remain unclear. Only few studies addressed the question whether gender differences in seasonality of suicide attempts reflect gender differences in the choice of method for suicide attempts, with i...
journal_title:European archives of psychiatry and clinical neuroscience
pub_type: 杂志文章
doi:10.1007/s00406-009-0086-1
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journal_title:European archives of psychiatry and clinical neuroscience
pub_type: 杂志文章
doi:10.1007/s00406-020-01158-3
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abstract::Decreased availability of serotonin in the central nervous system has been suggested to be a central factor in the pathogenesis of depression. Activation of indoleamine 2-3 dioxygenase following a pro-inflammatory state could reduce the amount of tryptophan converted to serotonin and increase the production of tryptop...
journal_title:European archives of psychiatry and clinical neuroscience
pub_type: 杂志文章
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更新日期:2018-03-01 00:00:00
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journal_title:European archives of psychiatry and clinical neuroscience
pub_type: 杂志文章
doi:10.1007/s00406-018-0975-2
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abstract::In this review, we discuss current structural and functional imaging data on ADHD in a neurological and neuroanatomical framework. At present, the literature on adult ADHD is somewhat sparse, and so results from imaging have to therefore be considered mainly from the childhood or adolescence perspective. Most work has...
journal_title:European archives of psychiatry and clinical neuroscience
pub_type: 杂志文章,评审
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journal_title:European archives of psychiatry and clinical neuroscience
pub_type: 杂志文章
doi:10.1007/s00406-018-0965-4
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journal_title:European archives of psychiatry and clinical neuroscience
pub_type: 杂志文章
doi:10.1007/s00406-018-0974-3
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journal_title:European archives of psychiatry and clinical neuroscience
pub_type: 杂志文章
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journal_title:European archives of psychiatry and clinical neuroscience
pub_type: 杂志文章
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journal_title:European archives of psychiatry and clinical neuroscience
pub_type: 杂志文章
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journal_title:European archives of psychiatry and clinical neuroscience
pub_type: 杂志文章
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journal_title:European archives of psychiatry and clinical neuroscience
pub_type: 杂志文章,随机对照试验
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更新日期:2012-12-01 00:00:00
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journal_title:European archives of psychiatry and clinical neuroscience
pub_type: 杂志文章
doi:10.1007/s00406-007-0763-x
更新日期:2008-03-01 00:00:00
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journal_title:European archives of psychiatry and clinical neuroscience
pub_type: 杂志文章
doi:10.1007/s00406-013-0428-x
更新日期:2014-03-01 00:00:00
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journal_title:European archives of psychiatry and clinical neuroscience
pub_type: 杂志文章
doi:10.1007/s00406-004-0510-5
更新日期:2004-10-01 00:00:00
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journal_title:European archives of psychiatry and clinical neuroscience
pub_type: 杂志文章
doi:10.1007/s00406-006-0608-z
更新日期:2006-08-01 00:00:00
abstract::Sustainable observations suggest that suicidal behaviour by itself may have biological correlates, among which those related to the serotonergic synapse hold the key position. Based on the association of suicide and serotonergic dysfunction, it was proposed that genetic mechanisms affecting suicidal behaviour could be...
journal_title:European archives of psychiatry and clinical neuroscience
pub_type: 杂志文章
doi:10.1007/s00406-004-0482-5
更新日期:2004-08-01 00:00:00
abstract::The aim of this study was to evaluate tardive dyskinesia (TD) (prevalence and possible risk factors, pharmacological and clinical), in a population of schizophrenic patients after prolonged institutionalization. A total of 148 patients (80 male, 68 female) aged between 28 and 87 years (mean 55, SD 11) diagnosed accord...
journal_title:European archives of psychiatry and clinical neuroscience
pub_type: 杂志文章
doi:10.1007/BF02190085
更新日期:1990-01-01 00:00:00