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Zusammenfassung. Ziel: Das Ziel dieser Studie war es, zu untersuchen, ob chronisch psychisch kranke Raucher an einer Tabakentwöhnung erfolgreich teilnehmen können. Methode: Bei allen 214 Heimbewohnern des Heims für psychisch Kranke in Göppingen (Christophsbad) wurde der Rauchstatus erhoben. Insgesamt waren 56,2 % (n = 120) der 214 Heimbewohner Raucher. 21 Patienten nahmen das Angebot einer verhaltenstherapeutischen Tabakentwöhnung in Kombination mit Vareniclin (n = 20) oder Nikotinersatz (n = 1) an. Erfolg der Intervention, Befindlichkeit und Nebenwirkungen sowie Kohlenmonoxidkonzentrationen in der Ausatemluft wurden bei 21 Probanden während der 26 Kurswochen der Tabakentwöhnung und des 3-monatigen Nachbeobachtungszeitraumes erfasst. Neben dem Raucherstatus und den Rauchercharakteristika wurden die Stärke der Nikotinabhängigkeit (FTND), die Motivation zur Abstinenz (Motivationsfragebogen), das Rauchverlangen (QSU-b), der Grad der Depressivität (BDI) und die Entzugssymptomatik (MNWS-revised) erhoben. Die Veränderung über die verschiedenen Untersuchungszeitpunkte (Baseline, Kurswoche (KW) 1, 5, 9, 13, 17, 21, 26, Katamnesewoche (Kat) 1, 3, 6, 9, 12) wurde mittels Varianzanalysen für Messwiederholung untersucht. Ergebnisse: Von den 21 Teilnehmern der Tabakentwöhnung waren 4 zum Ende der 3-monatigen Nachbefragung rauchfrei. Sie kamen bis dahin auf eine durchschnittliche rauchfreie Zeit von 6 Monaten. Weitere 4 Teilnehmer hatten eine abstinente Phase während des Studienverlaufs, konnten diese jedoch nicht bis zum Ende der Nachbefragung aufrechterhalten. Nur ein Proband war in der Lage, den Rauchstopp abrupt umzusetzen. Schlussfolgerung: Eine Tabakentwöhnung bei chronisch psychisch und somatisch erkrankten Heimbewohnern erscheint nach den vorliegenden Daten als durchführbar.

There is strong neuroimaging evidence that cortical alterations represent a core pathophysiological feature of major depressive disorder (MDD). Differential contributions of cortical features of neurodevelopmental origin, which may distinctly contribute to MDD vulnerability, disease-onset, or symptom expression, are unclear at present.We investigated distinct markers of cortical neurodevelopment, i.e. local cortical gyrification (LGI) and thickness (CT) in patients with MDD (n = 38) and healthy controls (HC, n = 22) using 3 T structural magnetic resonance imaging data and surface-based data analysis techniques. CT and LGI were computed using the Computational Anatomy Toolbox (CAT12). Analyses were performed for the entire cortical surface followed by a complementary regions-of-interest approach.MDD patients showed significantly greater LGI in frontal, cingulate, parietal, temporal, and occipital regions compared to HC (FDR-corrected at p 0.05 using threshold-free cluster enhancement). No significant differences of CT were found. In the MDD-group, correlations were found between duration of illness in years and number of depressive episodes and LGI of frontal, temporal, and parietal regions (p 0.05).Main limitations are the relatively modest sample size and a cross-sectional study design. We did not control for early environmental factors potentially influencing neurodevelopment, such as childhood trauma. We report associations uncorrected for multiple comparisons.The data suggest different local trajectories of cortical change in MDD. In addition, our data support the notion that aberrant cortical development may serve as a vulnerability marker of MDD, as well as a potential predictor of disease course.

The Brief Symptom Inventory 25 Forensic (BSI-25-F) is a screening instrument for measuring the psychophysical distress of prisoners and forensic patients. The aim of the study was to validate the i...

Zusammenfassung Einleitung Da die therapeutische Beziehung im Maßregelvollzug bzw. in der Forensischen Psychiatrie aufgrund des Zwangscharakters sowie der Doppelrolle des Therapeuten als Behandler und als Sachverständiger besonders belastet ist, wurde die therapeutische Beziehung im Maßregelvollzug mit der therapeutischen Beziehung in der Allgemeinpsychiatrie verglichen. Material & Methoden 52 Patienten des Maßregelvollzugs und 65 Patienten der Allgemeinpsychiatrie beantworteten das Psychopathy Personality Inventory – Revised (PPI-R), das Inventar zur Erfassung interpersonaler Probleme - Deutsche Version (IIP-D), den Fragebogen zur Erfassung der Psychotherapiemotivation (FPTM) sowie das Working Alliance Inventory – Short Revised (WAI-SR). Statistisch wurden deskriptive Analysen durchgeführt, univariate t-Tests, multivariate T-Tests sowie verallgemeinerte lineare Modelle gerechnet. Ergebnisse Die Qualität der therapeutischen Beziehung wird von den Patienten des Maßregelvollzugs genauso positiv wahrgenommen wie von den Patienten der Allgemeinpsychiatrie. Patienten des Maßregelvollzugs sind tendenziell sogar eher davon überzeugt, dass die in der Therapie angewandten Techniken der Erreichung ihrer Therapieziele dienen. Diskussion Die therapeutische Beziehung im Maßregelvollzug ist genauso tragfähig wie in der Allgemeinpsychiatrie. Dies könnte auf die längeren, zumeist mehrjährigen Unterbringungszeiten im Maßregelvollzug zurückgeführt werden, in deren Rahmen deutlich mehr Zeit auf den Beziehungsaufbau verwendet werden kann als im Rahmen einer zeitlich auf wenige Wochen begrenzten Therapie in der Allgemeinpsychiatrie.

It is widely recognized that substance abuse increases the general risk of delinquency and violent offenses in particular. Substance-related disorders are the primary cause of offenders being sente...

In schizophrenia temporal cortical volume loss differs between patients presenting with persistent auditory verbal hallucinations (pAVH) in contrast to those without hallucinatory symptoms (nAVH). However, it is unknown whether this deficit reflects a neural signature of neurodevelopmental origin or if abnormal temporal cortical volume is reflective of factors which may be relevant at later stages of the disorder. Here, we tested the hypothesis that local gyrification index (LGI) in regions of the temporal cortex differs between patients with pAVH (n=10) and healthy controls (n=14), and that abnormal temporal LGI discriminates between pAVH and nAVH (n=10). Structural magnetic resonance imaging at 3T along with surface-based data analysis methods was used. Contrary to our expectations, patients with pAVH showed lower LGI in Broca´s region compared to both healthy persons and nAVH. Compared to nAVH, those individuals presenting with pAVH also showed lower LGI in right Broca's homologue and right superior middle frontal cortex, together with increased LGI in the precuneus and superior parietal cortex. Regions with abnormal LGI common to both patient samples were found in anterior cingulate and superior frontal areas. Inferior cortical regions exhibiting abnormal LGI in pAVH patients were associated with overall symptom load (BPRS), but not with measures of AVH symptom severity. The pattern of abnormal cortical folding in this sample suggests a neurodevelopmental signature in Broca's region, consistent with current AVH models emphasizing the pivotal role of language circuits and inner speech. Temporal cortical deficits may characterize patients with pAVH during later stages of the disorder.

Patients with schizophrenia constitute a substantial proportion of patients hospitalized in forensic psychiatry. Antipsychotic medication is an essential part of evidence-based treatment and can significantly improve both the medical and legal prognosis. In this study, we compared psychopathological features, psychopharmacological treatment, and the neurologic and metabolic side effects of treatment in demographically comparable in-patients with schizophrenia being treated in either forensic or general psychiatry. Megalomanic ideations, animosity, affect flattening, weak will, social passivity, apathy, uncooperative behavior, and poor impulse control were more pronounced in the forensic psychiatry sample. Nevertheless, patients in the forensic setting were prescribed less antipsychotic medication than the general psychiatry patients. Polypharmacy was pronounced in both samples. There were no significant differences in prescription rates of depot antipsychotics, movement disorders, or metabolic par...

Child sexual offenders have been found to have a lower average IQ than the general population. Several studies indicate that they also exhibit executive dysfunction, but the specificity of this dysfunction is unclear; the inconclusive results have been attributed to methodological problems and the heterogeneity of the population. Our study aimed to describe the neuropsychological profiles of convicted child sexual offenders with pedophilia (n = 15). To control for IQ-related effects on neuropsychological performance, we compared the sample with an IQ-matched control group (n = 15). Test scores in both groups were significantly lower than the norms, but we did not find significant differences between the two study groups. The findings of our pilot study indicate that the neuropsychological deficits of pedophilic sexual offenders are unspecific rather than the result of a pedophilia-specific brain dysfunction.

Psychiatrists frequently find themselves faced with aggressive behavior on the part of their patients. A large body of literature indicates that traumatic experiences in the anamnesis might be a risk factor for violent behavior. But, not all maltreated children became perpetrators of violence themselves. The present review assembled actual behavioral studies that focus on factors which might influence the pathway from trauma to aggression. Substance use to cope, occurrence of post-traumatic stress disorder, depression, altered impulsivity and emotional dysregulation are some of the phenomena that seem to be of importance. Also, possible diagnostics and treatment implications for both general and forensic psychiatry are discussed.

Die Beziehung zwischen Patient und Therapeut hat einen wesentlichen Einfluss auf den Erfolg einer psychotherapeutischen Behandlung. Wahrend englischsprachige Instrumente zur Untersuchung der Qualitat der therapeutischen Beziehung erfolgreich im deutschsprachigen Raum im ambulant-psychiatrischen Setting eingesetzt werden, fehlen Untersuchungen an Patienten im Masregelvollzug, die den Besonderheiten dieser Patientengruppen und den spezifischen Rahmenbedingungen Rechnung tragen wurden. Wir berichten uber die Ergebnisse einer Pilotstudie zur Evaluation eines neu entwickelten Fragebogens zur Untersuchung der therapeutischen Beziehung in der Forensik („FTBF“). Die Daten wurden im Masregelvollzug und in den allgemeinpsychiatrischen Kliniken erhoben. Im Rahmen der Faktorenanalysen des angewandten Fragebogens differenzierten sich zwei wesentliche Faktoren, namlich „Positive emotionale Aspekte“ (12 Items, wesentliche Merkmale Vertrauen, Respekt, Hilfsbereitschaft, Harmonie, und Sympathie; interne Konsistenz mittels Cronbachs α = 0,933) und „Negative emotionale Aspekte“ (4 Items, wesentliche Merkmale Machtgefalle und Bestrafung; Cronbachs α = 0,805). Dabei nahmen die forensischen Patienten im Rahmen des Faktors „Negative emotionale Aspekte“ das bestehende Machtgefalle und Bestrafungstendenzen zwischen Patient und Therapeuten signifikant starker wahr als die Patienten der Allgemeinpsychiatrie (p

Die psychischen Langzeitfolgen der sexuellen Traumatisierungen in der Kindheit sind mit vielschichtigen Symptomen assoziiert, werden jedoch noch haufig nicht erkannt oder fehldiagnostiziert. Diagnostisch werden sie verstarkt unter dem Konzept der komplexen posttraumatischen Belastungsstorung (PTBS) subsumiert. Unter Einbeziehung eines prototypischen Falls wird eine Ubersicht uber dieses vielschichtige Krankheitsbild in unterschiedlichen Altersstufen gegeben, und die evidenzbasierten Therapieoptionen werden aufgezeigt. Es erfolgen die Darstellung eines prototypischen Falls, die narrative Ubersicht uber die aktuelle Literatur und eine vergleichende Analyse der diagnostischen Kriterien in den unterschiedlichen Klassifikationssystemen. Die Symptome einer komplexen Traumatisierung im Erwachsenenalter konnen auch wahrend der langeren und multiplen stationaren Behandlungen im multidisziplinaren Setting einer Universitatsklinik verkannt werden. Fur die Praxis erscheint die Erhebung einer spezifischen Traumaanamnese bei multiplen Beschwerden, wechselnden Diagnosen und gescheiterten Therapieansatzen in der Vergangenheit notwendig, da die richtige Bewertung und Einordnung von groser Bedeutung fur das weitere psychotherapeutische Vorgehen ist, das eine weitere Chronifizierung der Beschwerden verhindern kann.

This study examined whether the associations between self-aggression and different forms of externalized aggression (reactive and spontaneous aggression) are influenced by self-esteem and current psychopathological symptoms. For this purpose, we asked 681 participants from the general population (GP) and 282 general psychiatric patients (PPs) to answer the German versions of the Short Questionnaire for Assessing Factors of Aggression (K-FAF), the Multidimensional Self-Esteem Scale (MSWS), and the Brief Symptom Inventory 25 Forensic (BSI-25-F). Statistically, we performed descriptive and mediation analyses. Our findings indicated that in both samples the association between self-aggression and reactive aggression was mediated by self-esteem but not by current psychological problems. The association between self-aggression and spontaneous aggression was mediated by self-esteem in the GP sample and by psychopathological symptoms in the PP sample. We conclude that when examining the association between self-aggression and externalized aggression it is important to consider the various subtypes of externalized aggression and differences between populations.

Abnormal gray matter volume has been consistently reported in patients with major depressive disorder (MDD), but markers of cortical neurodevelopment have been rarely investigated. Also, it is unclear whether there exist common versus distinct spatial patterns of abnormal cortical development across different disorders presenting with negative emotions and deficient affective regulation. In this study, we used structural MRI at 3T to investigate the local gyrification index (LGI), a marker of fetal/infant neurodevelopment, in adult female patients with MDD (n = 22), in adult female patients with borderline personality disorder (BPD) (n = 17), and in controls (n = 22). Reduced cortical folding of the precuneus, the superior parietal gyrus and the parahippocampal gyrus was found in both MDD and BPD patients when compared to controls (p 0.05, cluster-wise probability [CWP] corrected). MDD patients showed additional hypogyrification of the middle frontal gyrus and the fusiform gyrus when compared to both controls and BPD patients (p 0.05, CWP corrected). In MDD patients, lower LGI of prefrontal regions was significantly associated with the age of disease onset and with the number of depressive episodes. In BPD patients, lower LGI of orbitofrontal regions was associated with impulsivity. Our findings suggest abnormal early cortical development in MDD, affecting brain regions that have been frequently implied in MDD pathophysiology. However, LGI abnormalities may not be specific for MDD, since MDD and BPD patients also exhibited common patterns of hypogyrification. Hypogyrification of cortical regions associated with higher-order cognition appears to be most pronounced in MDD. Abnormal early cortical neurodevelopment may mediate vulnerability to disorders of emotion.

Um die Diagnostik von Personlichkeitsstorungen zu objektivieren, werden in zunehmendem Mase strukturierte klinische Interviews und standardisierte Fragebogeninstrumente eingesetzt. Diese gelangen jedoch aufgrund unterschiedlicher methodischer Ansatze z. T. zu divergenten Ergebnissen. Folglich bestand das Ziel darin, die konvergente Validitat des Strukturierten Klinischen Interviews fur DSM-IV-Achse-II-Storungen (SKID-II) als Vertreter des kategorialen Ansatzes und des Temperament- und Charakterinventars (TCI) als Beispiel des dimensionalen Vorgehens zu ermitteln. Die diagnostischen Ubereinstimmungen wurden statistisch mithilfe von Cohens Kappa, Yules Y und Korrelationen abgebildet. Die Ergebnisse deuten darauf hin, dass die beiden Verfahren zu sehr unterschiedlichen Ergebnissen gelangen und dass mit dem SKID-II tendenziell eher eine PS diagnostiziert wird als mit dem TCI.

ZusammenfassungZiel: Die Zielsetzung war es, einen Überblick über die Vor- und Nachteile des “Strukturierten Klinischen Interviews für DSM-IV Achse- II-Störungen” (SKID-II) sowie des “Temperament- und Charakterinventars” (TCI) als jeweilige Vertreter der kategorialen bzw. dimensionalen Diagnostik von Persönlichkeitsstörungen zu geben und anhand dessen eine pragmatische Empfehlung für den Einsatz dieser Diagnoseinstrumente in der Begutachtungspraxis abzuleiten. Material und Methode: Es wurde eine Literaturrecherche hinsichtlich der Gütekriterien des TCI sowie des SKID-II durchgeführt. Die Ergebnisse werden narrativ referiert. Ergebnisse: Sowohl das SKID-II als auch das TCI weisen Stärken und Schwächen in Bezug auf Interrater-Reliabilität, Retest-Reliabilität und interne Konsistenz auf. Die konvergente Validität von SKID-II und TCI ist als unbefriedigend zu bezeichnen. Schlussfolgerung: Angesichts der Vor- und Nachteile beider Verfahren wird eine kombinierte, hintereinander geschaltete Anwendung von TCI und SKID-II vorgeschlagen, sodass eine optimale Ausnutzung der Stärken beider Instrumente ermöglicht wird.

Die Frage, wie mit Regelverletzungen und wie mit den einzelnen oder Gruppentatern, die Regeln verletzen, umzugehen sei, reicht bis in die Anfange der Bildung sozialer Gruppen zuruck. Im Laufe der raschen evolutionaren Entwicklung sozialer Fahigkeiten der Spezies Homo sapiens in den letzten 20.000 bis 30.000 Jahren wurden die geltenden inner- und ausergemeinschaftlichen Regeln immer differenzierter. Im vorliegenden Beitrag werden am Beispiel des Phanomens der Schuld die Verflechtung vielfaltiger Faktoren und ihre Wechselwirkungen aufgezeigt, die die Interaktion zwischen psychischen Storungen und Verletzung von – im weiteren Sinne – Normen und – im engeren Sinne – Gesetz bestimmen. Dabei zeigt die historische Darstellung, welche intensive Rolle juristische Konstrukte – wie beispielsweise verschiedene Schuldbegriffskonzepte –, theologische Vorstellungen und Vorsatze – betreffend z. B. das Verhaltnis zwischen Menschlichem und Gottlichem – sowie philosophische Grundauffassungen – z. B. im Rahmen der Philosophie des Geistes – spielen. Zu verschiedenen Zeiten waren die Antworten auf die Fragen nach Haftung, Verantwortung, Schuld oder Strafe immer entscheidend durch das jeweilige Grundverstandnis der Weltordnung und des Menschenbilds charakterisiert; gegenwartig ist es auch nicht anders. Die aktuellen Auffassungen sind der Endpunkt einer Entwicklung, wie anhand einer selektiven Darstellung mancher Aspekte der Geschichte forensisch-psychiatrisches Denkens darzustellen beabsichtigt ist. Die Zusammenhange dieser Themen zu den Kernbereichen des forensisch-psychiatrischen Denkens und Handelns wie der Schuldfrage werden naher erortert, um zur Reflexion der gegenwartigen Positionen anzuregen.

There is growing evidence that the cerebellum plays a crucial role in the pathophysiology of schizophrenia symptoms. Despite increasing evidence for cerebellar involvement in affective, attentive, and cognitive functions including language processing and perception, investigations of cerebellar contributions to auditory verbal hallucinations (AVH) in schizophrenia are lacking. Using structural magnetic resonance imaging at 3T, we investigated the data of 20 patients with schizophrenia and 14 matched healthy controls. Ten patients were classified as having chronic and treatment resistant AVH (pAVH), whereas the remaining ten patients either never had AVH in the past or were in full remission with regard to AVH (nAVH). Employing cerebellum-optimized segmentation techniques, i.e., the Spatially Unbiased Infratentorial Template (SUIT) toolbox, we investigated cerebellar gray matter volume (GMV) differences among the pAVH, nAVH, and a healthy control group, the magnitude of their expression between these groups and the relationship between GMV and schizophrenia symptom load. Lower GMV in pAVH patients compared to controls was found in lobules VIIb and VIIIa. Additionally, lower GMV in pAVH compared to nAVH patients was found in lobule VIIIa. A negative relationship between VIIIa GMV and overall positive symptoms was detected. Correlations with AVH-specific psychometric scores were not significant. This study shows that there are structural changes in the cognitive regions of the cerebellum that are linked to a clinical phenotype presenting with persistent positive symptoms such as AVH. The results suggest that the cerebellum and its associated neural circuits do play a role in the emergence of positive symptoms in schizophrenia, but probably not exclusively in AVH symptom expression.

Abnormal cortical cerebral blood flow and gray matter volume have been frequently reported in patients with major depressive disorder (MDD). In contrast, although the role of the cerebellum in MDD pathophysiology has attracted considerable interest more recently, studies investigating both functional and structural aspects of cerebellar integrity are scarce.In this study, we used structural and functional magnetic resonance imaging (MRI) to investigate cerebellar volume and regional cerebellar blood flow (rCBF) at rest in clinically acute MDD patients (n = 22) and healthy controls (n = 18). We acquired high-resolution structural images at 3 T together with perfusion images obtained with continuous arterial spin labeling. Cerebellar structure and function were investigated using cerebellum-optimized analysis techniques.Markedly increased rCBF was found in bilateral cerebellar areas VIIa and VIIIb (p0.05 family-wise-error [FWE] corrected). Significant differences in cerebellar volume between patients and controls were not found (p0.05, FWE-corrected). Left cerebellar area VIIa perfusion was significantly associated with depressive symptoms, as measured by the Hamilton Depression Rating Scale.Potential limitations of this study include the modest sample size, the cross-sectional design, the lack of task-related imaging and the heterogeneity of drug treatment.The data suggest contributions of "affective" cerebellar regions to MDD pathophysiology and symptom expression. While cerebellar perfusion at rest is compromised in MDD, cerebellar volume seems to be less affected.

Background:Previous research indicates that prisoners have severe psychological distress. To assess their distress level and potential need for treatment, the present study compared the subjective psychological distress of long- and short-term prisoners with that of psychiatric and forensic patients.Methods:Long- (n = 98) and short-term prisoners (n = 94) and forensic (n = 102) and psychiatric (n = 199) patients completed the German versions of the Symptom Checklist Revised (SCL-90-R) and Brief Symptom Inventory (BSI).Results:In general, long-term prisoners showed the same level of mental distress as psychiatric patients and more than that reported by forensic patients. Short-term prisoners reported the least level of distress. Long- but not short-term prisoners showed clinically significant results on the scales for depression, paranoid ideation, and psychosis.Conclusions:The improvements in psychiatric treatment for inmates demanded by many stakeholders need to differentiate between long- and short-term prisoners. Because depression seems to cause the most psychological distress among inmates, suicide prevention seems to be an important issue in prisons.

Executive functioning (EF) is associated with various aspects of school achievement and cognitive development in children and adolescents. There has been substantial research investigating associations between EF and other factors in young children, such as support processes and parenting, but less research has been conducted about external factors relating to EF in older children and adolescents. Therefore, the present study investigates one possible factor that could correlate with EF in school-age children and adolescents: parenting behavior. The cross-sectional study design gathered data from 169 children in primary schools, middle-schools, and Gymnasien, and their corresponding parents. All children underwent a standardized task to measure EF, the computer-based Erikson Flanker task, which evaluates EF as a function of error rates and response time. A self-report questionnaire was used to assess parenting behavior. Multilevel analysis was implemented to test the effects of parenting behavior on EF in school-age children. The results show significant associations between various parenting behaviors and children's EF: High scores on parental involvement or parental responsibility are associated with low error rates on the Erikson Flanker task, whereas high parental scores on inconsistent discipline are associated with high error rates. These correlations between parenting behavior and EF remained significant despite controlling for child age, maternal education, family income, and baseline performance (i.e., congruent trials on the Erikson Flanker task). No associations were found between parental behavior and reaction time on the Erikson Flanker task. These results indicate the important association between parenting behaviors and EF skills in school-age children, and foster the necessity to inform parents about ways in which they can optimally support their children's cognitive development.

Abnormal cortical volume is well-documented in patients with major depressive disorder (MDD), but cerebellar findings have been heterogeneous. It is unclear whether abnormal cerebellar structure relates to disease state or medication. In this study, using structural MRI, we investigated cerebellar volume in clinically acute (with and without psychotropic treatment) and remitted MDD patients. High-resolution structural MRI data at 3T were obtained from acute medicated (n=29), acute unmedicated (n=14) and remitted patients (n=16). Data from 29 healthy controls were used for comparison purposes. Cerebellar volume was investigated using cerebellum-optimized voxel-based analysis methods. Patients with an acute MDD episode showed increased volume of left cerebellar area IX, and this was true for both medicated and unmedicated individuals (p

Major depressive disorder (MDD) and borderline personality disorder (BPD) show substantial overlap in both affective symptom expression and in regional brain volume reduction. To address the specificity of structural brain change for the respective diagnostic category, we investigated structural networks in MDD and BPD to identify shared and distinct patterns of abnormal brain volume associated with these phenotypically related disorders. Using magnetic resonance imaging at 3 T, we studied 22 females with MDD, 17 females with BPD and without comorbid posttraumatic stress disorder, and 22 age-matched female healthy controls. We used “source-based morphometry” (SBM) to investigate naturally grouping patterns of gray matter volume variation (i.e. “structural networks”) and the magnitude of their expression between groups. SBM identified three distinct structural networks which showed a significant group effect (p b 0.05, FDR-corrected). A bilateral frontostriatal network showed reduced volume in MDD compared to both controls and BPD patients. A medial temporal/medial frontal network was found to be significantly reduced in BPD compared to both controls and MDD patients. Decreased cingulate and lateral prefrontal volume was found in both MDD and BPD when compared to healthy individuals. In MDD significant relationships were found between depressive symptoms and a cingulate/lateral prefrontal structural pattern. In contrast, overall BPD symptoms and impulsivity scores were significantly associated with medial temporal/medial frontal network volume. The data suggest both distinct and common patterns of abnormal brain volume in MDD and BPD. Alterations of distinct structural networks differentially modulate clinical symptom expression in these disorders.

Although previous studies in inmates, forensic and psychiatric samples suggest the relation between childhood trauma and suicide behavior as well as between childhood trauma and violent delinquency, the understanding of possible underlying mechanisms is still fragmentary. In a naturalistic study design, we tested if suicidal attempts and violent crimes are differently associated with adverse childhood experiences and levels of appetitive aggression in male forensic psychiatry inpatients. Adverse childhood experiences and appetitive aggression styles were collected by means of self-report measures, suicide attempts were taken from the medical history and violent crimes were appraised by official court records. The data were analyzed by the means of generalized linear models. Results revealed that appetitive aggression and adverse childhood experiences were significant predictors of suicide attempts, whereas violent crimes were associated solely with appetitive aggression. Suicide attempts and violent delinquency in forensic patients seem to be both positively associated with high levels of appetitive aggression, whereas their etiological pathways might differ with regard to adverse childhood experiences. Considering these interrelations to a greater extent might improve both diagnostics and treatment of forensic patients.

For the purpose of retrospective assessment and characterization of childhood trauma in adults, the factorial validity of the short form of the Childhood Trauma Questionnaire (CTQ–SF) in Germany was evaluated by conducting confirmatory factor analyses for three samples including 1,524 adult psychiatric patients, 224 inmates, and 295 university students. In addition, sex-specific confirmatory factor analyses were performed within each sample. Because several authors have suggested a different factor structure than that originally proposed in the manual, two competing models focusing on the Physical neglect subscale were examined. In psychiatric patients and inmates, the fit indices were reasonable to good. Among the students, factor loadings were markedly lower, and fit indices were poor. Sex-specific analyses did not indicate sex differences. Comparing the original and the alternative models revealed better fit indices of the original factor structure. The present findings indicate that the German version of the CTQ–SF has factorial validity in psychiatric patients and inmates, but not in students.

The study aimed to investigate the correlation between impulsiveness and the antisocial personality disorder among short-term prisoners.The impulsiveness was diagnosed by the Barratt Impulsiveness Scale (BIS).Short-term prisoners with antisocial personality disorder scored significant higher marks on the BIS total scale than those without any personality disorder. In detail, they scored higher marks on each subscale regarding attentional, motor and nonplanning impulsiveness. Moderate and high effects were calculated.It is to be considered to regard impulsivity as a conceptual component of antisociality.

Evidence from animal models and neuropathological data has revealed cerebellar pathology in Huntington's disease (HD). The extent of cerebellar dysfunction in preclinical stages and in early manifest HD is unclear. In this study, using MRI we investigated cerebellar changes in preclinical (preHD) and early manifest HD individuals. High-resolution structural MRI data at 3 Tesla were obtained from two independent preHD samples (n = 20/25 participants), from two independent cohorts of healthy controls (n = 20/24 participants) and from patients with early manifest HD (n = 20 participants). Resting-state functional MRI data were acquired from 20 healthy controls and 20 HD patients. Cerebellar volume was investigated using cerebellum-optimized voxel-based analysis methods. Corticocerebellar connectivity at rest was investigated by means of seed-region correlations. In both preHD samples, between-group analyses revealed no change of cerebellar volume. In contrast, early manifest HD patients exhibited lower right cerebellar lobule VIIa volume (p < 0.05 cluster-corrected). Within the control group regions functionally coupled to right cerebellar lobule VII comprised bilateral cerebellar regions, right prefrontal and cingulate areas, whereas within manifest HD, functional coupling was found in paracentral, lingual and inferior frontal areas. Paracentral connectivity strength in patients was associated with disease burden and motor symptoms. These data suggest intact cerebellar volume in preHD. In contrast, early manifest HD patients exhibit atrophy of specific cerebellar subregions and abnormal corticocerebellar functional coupling. In early HD, the association between paracentral lobule function and clinical parameters suggests that corticocerebellar connectivity strength is related to the evolution of HD biology and the severity of HD motor signs.

Abnormal brain volume has been frequently demonstrated in major depressive disorder (MDD). It is unclear if these findings are specific for MDD since aberrant brain structure is also present in disorders with depressive comorbidity and affective dysregulation, such as borderline personality disorder (BPD). In this transdiagnostic study, we aimed to investigate if regional brain volume loss differentiates between MDD and BPD. Further, we tested for associations between brain volume and clinical variables within and between diagnostic groups.22 Females with a DSM-IV diagnosis of MDD, 17 females with a DSM-IV diagnosis of BPD and without comorbid posttraumatic stress disorder, and 22 age-matched female healthy controls (HC) were investigated using magnetic resonance imaging. High-resolution structural data were analyzed using voxel-based morphometry.A significant (p0.05, cluster-corrected) volume decrease of the anterior cingulate cortex (ACC) was found in MDD compared to HC, as opposed to volume decreases of the amygdala in BPD compared to both HC and MDD. Sensitivity and specificity of regional gray matter volume for a diagnosis of MDD were modest to fair. Amygdala volume was related to depressive symptoms across the entire patient sample.Potential limitations of this study include the modest sample size and the heterogeneous psychotropic drug treatment.ACC volume reduction is more pronounced in MDD with an intermediate degree of volume loss in BPD compared to HC. In contrast, amygdala volume loss is more pronounced in BPD compared to MDD, yet amygdala volume is associated with affective symptom expression in both disorders.