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Mental illness increases risk for obesity which is often attributed to medications. We assessed the impact of childhood maltreatment on body-mass-index (BMI) and obesity in N = 261 adult psychiatric inpatients and N = 81 controls. There was an increased risk for obesity in psychiatric inpatients compared to controls. Conditioned random forest regression revealed parental abuse at ages 4-5 and peer-related violence at 7-13 as crucial factors in BMI elevation among individuals with mental illness, while type of psychiatric diagnoses, and use of psychotropics were not. Recognizing this link may aid in understanding the mechanisms and the development of strategies to mitigate the risk., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

Purpose: If COVID-19 disease sequelae also (co-)affect the respiratory organs, national and international guidelines recommend pulmonary rehabilitation (PR). So far, however, no studies are available from Germany on the course after PR, nor on possible course differences between the two Long COVID subgroups "Ongoing symptomatic COVID-19" and "Post-COVID-19 syndrome" (PCS)., Methods:   In a prospective observational study, patient-reported outcomes (PROs) regarding exertional dyspnea, quality of life, pain, fatigue, depression, and anxiety were assessed at the beginning of PR (T1), end of PR (T2), and after 3 (T3) and 6 months (T4). Statistical analyses were performed using latent difference models., Results:   There were 224 rehabilitation patients (M Age =54.4; SD Age =10.4; 42.0% female) included in the study. During PR, all PROs improved significantly. After PR, improvements either persisted with large pre-post effect sizes (exertional dyspnea, quality of life), decreased slightly to small pre-post effect sizes (depression, fatigue), or decreased to baseline levels (anxiety, pain). PCS patients had greater burdens in depression, fatigue, and pain at baseline, but did not differ in trajectories. Indicators of the severity of the preceding acute phase (oxygen therapy, ICU treatment, ventilation) were associated with higher burdens at T0 in depression, fatigue, and pain, but not with the courses during and after PR. In contrast, female patients showed higher burdens in both depression and fatigue at T1 and higher pre-post effects than male patients., Conclusion:   The fact that improvements in PROs occurred in both subgroups only during PR, but not during the follow-up period suggests that the changes are not due to the natural healing process but at least partly due to PR. Moreover, the results suggest that both patient groups may benefit from PR. Persisting improvements in exertional dyspnea and quality of life and, to a reduced extent, in depression and fatigue until 6 months after PR, but not in pain and anxiety warrant study of additional multimodal interventions that may be needed to maintain these effects., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Picture-story exercises (PSE) form a popular measurement approach that has been widely used for the assessment of implicit motives. However, current theorizing offers two diverging perspectives on the role of pictures in PSEs: either to elicit stories or to arouse motives. In the current study, we tested these perspectives in an experimental design. We administered a PSE either with or without pictures. Results from N = 281 participants revealed that the experimental manipulation had a medium to large effect for the affiliation and power motive domains, but no effect for the achievement motive domain. We conclude that the herein chosen pictures cues function differentially across motives, as they aroused the affiliation and power motives, but not the achievement motive.

Background: Over the last decade, researchers have sought for alternative interventions that have better treatment effects than Cognitive Behavioral Therapy (CBT) when treating psychotic symptoms. Mindfulness-based interventions have been a proposed alternative to CBT, yet research regarding its feasibility, acceptance and effectiveness is lacking when treating individuals with early psychosis in inpatient settings., Objective: Before conducting a large-scale randomized-controlled trial (RCT), this pilot study evaluated the feasibility and the potential efficacy of a mindfulness-based inpatient group intervention that targets emotion regulation in patients with early psychosis, and thus indirectly improving psychotic symptoms., Methods: A pre-post study was performed. Thirty-six patients with early psychosis treated at the specialized inpatient treatment "Frühinterventions- und Therapiezentrum; FRITZ" (early intervention and therapy center) received eight group therapy sessions. Assessments were performed at baseline, after 8 weeks post treatment and at follow-up after 16 weeks., Results: Rates of patients who participated in the study suggests that a mindfulness-based group therapy is highly accepted and feasible for patients with early psychosis being treated in an inpatient ward. Friedman analyses revealed significant changes in the primary outcomes of emotional goal attainment (Goal 1: W = 0.79; Goal 2: W = 0.71) and psychotic symptoms (PANSS-T: W = 0.74). Significant, albeit small, effect sizes were found in patients' self-perception of emotion regulation skills (ERSQ: W = 0.23)., Discussion: We found favorable findings regarding the feasibility and acceptance of the Feel-Good mindfulness-based intervention. Results of the study provide a basis for an estimation of an adequate sample size for a fully powered RCT that needs to be conducted to test whether Feel-Good is effective in the inpatient treatment of psychotic symptoms for individuals with early psychosis., Clinical Trial Registration: [https://clinicaltrials.gov/ct2/show/NCT04592042], identifier [NCT04592042]., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 von Hardenberg, Leopold, Stenzel, Kallenbach, Aliakbari, Bechdolf and Mehl.)

In the light of missing randomised controlled trials, some arguments suggest that pulmonary rehabilitation has beneficial effects beyond natural recovery https://bit.ly/3ze2xvw., Competing Interests: Conflict of interest: R. Gloeckl has nothing to disclose. Conflict of interest: D. Leitl has nothing to disclose. Conflict of interest: I. Jarosch has nothing to disclose. Conflict of interest: T. Schneeberger has nothing to disclose. Conflict of interest: C. Nell has nothing to disclose. Conflict of interest: N. Stenzel has nothing to disclose. Conflict of interest: A. Daher has nothing to disclose. Conflict of interest: M. Dreher has nothing to disclose. Conflict of interest: C.F. Vogelmeier has nothing to disclose. Conflict of interest: K. Kenn has nothing to disclose. Conflict of interest: A.R. Koczulla has nothing to disclose., (Copyright ©The authors 2021.)

Background: Coronavirus disease 2019 (COVID-19) can result in a large variety of chronic health issues such as impaired lung function, reduced exercise performance and diminished quality of life. Our study aimed to investigate the efficacy, feasibility and safety of pulmonary rehabilitation in COVID-19 patients and to compare outcomes between patients with a mild/moderate and a severe/critical course of the disease., Methods: Patients in the post-acute phase of a mild to critical course of COVID-19 admitted to a comprehensive 3-week inpatient pulmonary rehabilitation programme were included in this prospective, observational cohort study. Several measures of exercise performance (6-min walk distance (6MWD)), lung function (forced vital capacity (FVC)) and quality of life (36-question short-form health survey (SF-36)) were assessed before and after pulmonary rehabilitation., Results: 50 patients were included in the study (24 with mild/moderate and 26 with severe/critical COVID-19). On admission, patients had a reduced 6MWD (mild: median 509 m, interquartile range (IQR) 426-539 m; severe: 344 m, 244-392 m), an impaired FVC (mild: 80%, 59-91%; severe: 75%, 60-91%) and a low SF-36 mental health score (mild: 49 points, 37-54 points; severe: 39 points, 30-53 points). Patients attended a median (IQR) 100% (94-100%) of all provided pulmonary rehabilitation sessions. At discharge, patients in both subgroups improved in 6MWD (mild/moderate: +48 m, 35-113 m; severe/critical: +124 m, 75-145 m; both p<0.001), FVC (mild/moderate: +7.7%, 1.0-17.8%, p=0.002; severe/critical: +11.3%, 1.0-16.9%, p<0.001) and SF-36 mental component (mild/moderate: +5.6 points, 1.4-9.2 points, p=0.071; severe/critical: +14.4 points, -0.6-24.5, p<0.001). No adverse event was observed., Conclusion: Our study shows that pulmonary rehabilitation is a feasible, safe and effective therapeutic option in COVID-19 patients independent of disease severity., Competing Interests: Conflict of interest: R. Gloeckl has nothing to disclose. Conflict of interest: D. Leitl has nothing to disclose. Conflict of interest: I. Jarosch has nothing to disclose. Conflict of interest: T. Schneeberger has nothing to disclose. Conflict of interest: C. Nell has nothing to disclose. Conflict of interest: N. Stenzel has nothing to disclose. Conflict of interest: C.F. Vogelmeier has nothing to disclose. Conflict of interest: K. Kenn has nothing to disclose. Conflict of interest: A.R. Koczulla has nothing to disclose., (Copyright ©The authors 2021.)

The German Respiratory Society (DGP) has commissioned Assembly 12 "Rehabilitation, Prevention and Tobacco Control" to develop recommendations for the implementation of pulmonary rehabilitation in COVID-19 patients. This position paper is based on the current state of knowledge, which develops daily. This position paper describes the health consequences in COVID-19 as well as the indications for pulmonary rehabilitation. Rehabilitative therapies in COVID-19 are already indicated on the ward or intensive care unit, continue as early pulmonary rehabilitation in the acute hospital and as pulmonary rehabilitation in pulmonary rehabilitation centers. The main focus of this position paper is to propose recommendations for the content-related implementation of a multimodal, interdisciplinary pulmonary rehabilitation in COVID-19 patients., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (© Georg Thieme Verlag KG Stuttgart · New York.)

The quality of life can be severely impaired in patients with COPD. In addition to physical restraints, they often suffer from psychological comorbidities (e. g. anxiety, depression). Psychological comorbidities are often associated with dysfunctional beliefs about the illness and its treatment. Such dysfunctional beliefs, in turn, are likely to negatively affect patients' quality of life as well as their communication with physicians and their illness behavior in general. It is therefore important for physicians to adapt their communication to account for patients' dysfunctional beliefs. This paper will review the role of dysfunctional beliefs and psychological comorbidities in COPD. It will also elaborate on potential ways to adjust communication between physicians and patients accordingly., Competing Interests: Interessenkonflikt: Dieses Manuskript basiert auf einem Vortrag bei der Expertentagung „Luftschlösser“ zum Thema „Exazerbation der COPD“ am 17. Februar 2017 in Wiesbaden (Sponsor: Boehringer Ingelheim). Von Seiten des Sponsors erfolgte keine Einflussnahme auf den Inhalt dieses Manuskriptes., (© Georg Thieme Verlag KG Stuttgart · New York.)

Objective: Individuals with chronic obstructive pulmonary disease (COPD) exhibit low physical and mental health-related quality of life (HRQL) and high susceptibility to disability. We investigated the influence of psychological factors on HRQL and disability in COPD individuals recruited from the general population. In line with Leventhal's common sense model, we expected psychological factors to be associated with HRQL and disability even after controlling for medical status., Methods: Individuals with COPD (n = 502; 59.7 years old; GOLD grades were I: 3%, II: 17%, III: 34%, IV: 46%) were assessed through an online survey administered via COPD patient organisations in Germany. Individuals filled in the Short Form Health Survey (SF-12), COPD Assessment Test, Patient Health Questionnaire (modules: GAD-2, PHQ-15, PHQ-9), Brief Illness Perception Questionnaire, a questionnaire that assesses causal illness attributions, and the internal illness-related locus of control scale of the 'KKG questionnaire for the assessment of control beliefs about illness and health'. Multiple linear regressions were calculated., Results: The investigated factors explained high variances (disability = 56%, physical HRQL = 28%, mental HRQL = 63%, p ≤ .001). Better mental health, more optimistic illness perceptions, attribution to psychological causes, and stronger internal locus of control were associated with lower disability and better HRQL. Comorbid somatic symptoms contributed to high disability and low quality of life., Conclusion: Psychological factors, such as illness perception, attribution and internal locus of control, were associated with disability and HRQL. These factors should be considered when designing treatments for individuals with COPD, and adequate interventions should be provided to enhance illness understanding and self-management skills.

Objective: Transdiagnostic skills (e.g., emotion regulation, stress management) and related self-concepts (e.g., self-esteem) are associated with the pathogenesis and course of different mental disorders. Evidence suggests that skill deficits coincide with not only specific psychopathology but also psychological strain and disability. So far, studies examining the relevance of several skills for a patient's disability are lacking. The aim of the present study was the combined assessment of 7 skills and self-concept variables to simultaneously analyze their relevance for disability., Method: We interviewed inpatients (N = 183) both on admission and discharge to assess 7 specific skills, 7 areas of daily living disability, and psychopathological distress., Results: Results support a relationship between several skills and disability (especially stress management), even while controlling for psychopathology. The improvement of skills and related self-concepts during therapy contributed substantially to the improvement of disability ratings., Conclusion: This study highlights the transdiagnostic importance of skills as well as the improvement of skills and related self-concepts as major determinants of disability. Parts of these effects are robust, even while controlling for psychopathology., (© 2015 Wiley Periodicals, Inc.)

Objective: Patients' beliefs about their disease have been associated with emotional adjustment and outcomes in several severe illnesses. The aim of the present study was to investigate whether illness perceptions before pulmonary rehabilitation influence exercise capacity and quality of life after rehabilitation in patients suffering from chronic obstructive pulmonary disease (COPD)., Methods: Ninety-six patients with COPD (GOLD III/IV) were approached on admission to rehabilitation and reassessed before discharge. Assessment included medical measures of FEV% predicted, and exercise capacity (6 min walk test). Additionally, depressive symptoms (Hospital Anxiety and Depression scale), anxiety (COPD specific anxiety questionnaire) and quality of life (Short Form 36 health survey (SF-36)) were assessed. Illness beliefs were measured by the Revised Illness Perception Questionnaire (IPQ-R)., Results: Exercise capacity and psychological well-being (SF-36) of patients improved after rehabilitation programme, while physical functioning (SF-36) did not change. Additionally, patients showed significantly lower levels of depressive symptoms, COPD specific anxiety and negative perceptions of their illness after pulmonary rehabilitation compared to baseline. In the hierarchical multiple regression analyses, after controlling for socio-demographic data, psychological variables, illness severity and baseline scores of the corresponding variables, it was shown that illness perceptions before rehabilitation predicted exercise capacity and psychological well-being, both assessed at the end of treatment., Conclusion: COPD patients' perceptions about their illness before rehabilitation influence exercise capacity and quality of life (psychological well-being) after treatment. Therefore it might be relevant to identify and change maladaptive illness perceptions in order to improve medical and psychological outcome in COPD., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Unlabelled: Recent research on psychotherapy has focused on the development and evaluation of disorder-specific treatments. Even though much progress has been made, treatments have not yet reached an ideal level of effectiveness. One reason for this could be the systematic overlap and high comorbidity between mental disorders. Consequently, a new trend has been the examination of transdiagnostic factors in order to conceptualize psychopathology and develop treatment tools. One approach is to strengthen skills (e.g., emotion regulation) that are relevant in different mental disorders. The unique feature of this study is the simultaneous examination of several skills and their relation to psychopathology. Therefore, the current study investigated the skill levels of different groups of inpatients (tinnitus, tinnitus/unipolar mood disorder and anxiety/unipolar mood disorder) and normal controls (n = 124). Participants were evaluated with the 'operationalized assessment of skills interview'. This interview allows the simultaneous assessment of seven skills (problem solving, social competence, stress management, emotion regulation, relaxation ability, self-efficacy and self-esteem) that are relevant for treatment planning. The results confirm negative correlations between skills and the number of comorbid diagnoses. Multivariate analyses identified significant differences in skill levels between clinical sample and normal controls. Furthermore, within the clinical sample, there were significant differences in skill levels and skill profiles between the different clinical subsamples. To conclude, the improvement of skills that can support recovery from mental disorders is especially relevant for patients with multiple diagnoses. The authors suggest assessing the different skills prior to treatment and considering the skill profiles when planning interventions., Key Practitioner Message: Lower skill levels are associated with higher comorbidity and higher level of psychopathology of patients. There is evidence for specific skill profiles within different clinical subsamples. The improvement of skills that can impact recovery from mental disorders is especially relevant for patients with multiple diagnoses. It makes sense to assess the different skills independently and consider them separately when planning interventions., (Copyright © 2012 John Wiley & Sons, Ltd.)

Background: For decades, research has shown that various skills (e.g., social skills) are associated with depressive symptoms. In recent years, much work has focused on skills for regulating emotion. Unfortunately, nearly all of these studies have investigated isolated skills. By contrast, the aim of the present study was the combined assessment of multiple skills in order to simultaneously analyze their relevance for depressive symptomatology. The authors wanted to identify skill domains that are essential for improving depressive symptoms., Methods: The sample consisted of N=124 inpatients assessed at admission and discharge. Seven different skills were measured using a structured multidimensional interview. In addition, the severity of depressive symptoms was assessed., Results: Correlations between the improvements in skills and depressive symptoms reached significance for every skill domain ranging from r=.21 to r=.54. A multiple hierarchical regression analysis was conducted with pre-treatment scores of skills. Compared to other domains, only emotion regulation significantly predicted the improvement of depressive symptomatology. Moreover, emotion regulation at pre-treatment turned out to be a moderator of the association between improvements in skills and the reduction of depressive symptoms., Limitations: Because this study primarily focused on skills, no conclusions can be drawn regarding the relevance of these skills in relation to other predictors of therapy outcome., Conclusions: Even when various skills are tested simultaneously, emotion regulation appears to be the essential skill influencing depressive symptom improvement. Therefore, a targeted enhancement of this skill may help to optimize the outcome regarding the treatment of depressive symptomatology., (Copyright © 2012 Elsevier B.V. All rights reserved.)

Anxiety and depression are prevalent comorbid conditions in COPD. Furthermore, diseases related anxieties (fear of progression, end-of-life fear) occur very often. Anxiety can have a negative impact on patients' quality of life and is sometimes even considered as a risk factor for re-hospitalisation. There are only a few studies that focus on disease related anxieties in COPD. The aim of our study was to investigate the associations between disease related anxieties (fear of progression, end-of-life fear), psychological health status and quality of life in COPD patients. 132 patients with COPD (GOLD II-IV) participated in the study. Results of a MANOVA showed no differences between diseases related anxieties among patients with different disease severity (GOLD II-IV). Furthermore, the results showed significant associations between end-of-life fear, fear of progression, depression and quality of life. Further analyses showed that there is a need for managing end-of-life fears and improving end-of-life care. Overall, our study showed, that health disease related anxieties play an important role in COPD and still do not receive enough attention., (© Georg Thieme Verlag KG Stuttgart · New York.)

Multi-PDZ (PSD-95/Discs large/Zonula-occludens-1) domain proteins play a crucial role in the establishment and maintenance of cell polarization. The novel multi-PDZ domain protein FRMPD2 is a potential scaffolding protein consisting of an N-terminal KIND domain, a FERM domain and three PDZ domains. Here we show that FRMPD2 is localized in a polarized fashion in epithelial cells at the basolateral membrane and partially colocalizes with the tight-junction marker protein Zonula-occludens-1. Downregulation of FRMPD2 protein in Caco-2 cells is associated with an impairment of tight junction formation. We find that the FERM domain of FRMPD2 binds phosphatidylinositols and is sufficient for membrane localization. Moreover, we demonstrate that recruitment of FRMPD2 to cell-cell junctions is strictly E-cadherin-dependent, which is in line with our identification of catenin family proteins as binding partners for FRMPD2. We demonstrate that the FERM domain and binding of the PDZ2 domain to the armadillo protein p0071 are required for basolateral restriction of FRMPD2. Moreover, the PDZ2 domain of FRMPD2 is sufficient to partially redirect an apically localized protein to the basolateral membrane. Our results provide novel insights into the molecular function of FRMPD2 and into the targeting mechanism of peripheral membrane proteins in polarized epithelial cells.