30 results on '"Martin Zinkler"'
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2. The WHO QualityRights initiative: building partnerships among psychiatrists, people with lived experience and other key stakeholders to improve the quality of mental healthcare
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Soumitra Pathare, Akwasi Osei, Dainius Puras, Rodelen C. Paccial, Maria Francesca Moro, Mauro Giovanni Carta, and Martin Zinkler
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Mental healthcare ,Psychiatry and Mental health ,Nursing ,media_common.quotation_subject ,Lived experience ,Key (cryptography) ,Quality (business) ,Psychology ,media_common - Abstract
SummaryPsychiatrists have an essential role to play in promoting human rights in mental healthcare. The World Health Organization's QualityRights initiative, in partnership with different stakeholders, is improving the quality of psychiatric care in different countries.
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- 2021
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3. Offene Psychiatrie und gemeindepsychiatrische Arbeit
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Martin Zinkler and Peter W Nyhuis
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medicine.medical_specialty ,Psychosomatic medicine ,General Medicine ,Mental health ,030227 psychiatry ,03 medical and health sciences ,Psychiatry and Mental health ,0302 clinical medicine ,Neurology ,medicine ,Neurology (clinical) ,Home treatment ,Psychology ,Psychiatry ,030217 neurology & neurosurgery - Abstract
Im Zusammenhang mit der UN-Konvention uber die Rechte von Menschen mit Behinderungen konzentriert sich die Diskussion uber psychiatrische Versorgungskonzepte auf die Vermeidung von Gewalt und Zwangsmasnahmen. Offen gefuhrte psychiatrische Kliniken berichten uber weniger Gewalt und weniger haufige Zwangsmasnahmen. Dadurch kann eine spezifische Milieugestaltung gelingen, die soziale Ressourcen fordert und institutionelle Exklusion minimiert. Das Konzept geht uber das Offnen von Stationsturen hinaus, wenn die Klinik intensiv und aufsuchend in der Gemeinde tatig wird. Die Modellvorhaben nach § 64b Sozialgesetzbuch V zur sektorubergreifenden Versorgung ermoglichen flexible bedarfsorientierte Behandlung und Home-Treatment.
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- 2019
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4. Auf Fixierungen kann in der klinischen Praxis verzichtet werden – ohne dass auf Zwangsmedikation oder Isolierungen zurückgegriffen wird
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Michael Waibel and Martin Zinkler
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Gynecology ,03 medical and health sciences ,Psychiatry and Mental health ,medicine.medical_specialty ,0302 clinical medicine ,Political science ,medicine ,030227 psychiatry ,Patient isolation - Abstract
ZusammenfassungAusgehend von der Situation der Heidenheimer Klinik beschreiben wir die notwendigen Veränderungen, um völlig auf Fixierungen in der Allgemeinpsychiatrie einschließlich Gerontopsychiatrie und Suchtbehandlung zu verzichten, ohne auf andere Zwangsmaßnahmen wie Isolierung oder Zwangsmedikation zurückzugreifen. Dabei werden die bisherigen Fixierungen durch 2:1- oder 3:1-Betreuungen ersetzt. Die Klinik erfasst die Fixierungshäufigkeit und -dauer minutengenau. Dies erlaubt die Bestimmung der Zeiten für intensive Einzelbetreuungen. Die Anlässe für die bislang durchgeführten Fixierungen und individuelle Besonderheiten bei der Begleitung erlauben eine Einschätzung der Betreuungsintensität und damit des erforderlichen Personalaufwands. Die Personalressourcen und dafür erforderlichen Kosten werden mit den üblichen Ausfallzeiten und Personalkosten für qualifiziertes Pflegepersonal errechnet und ergeben einen zusätzlichen Bedarf von 4 % des jährlichen Klinikbudgets. Problematisch für die Umsetzung erscheint der Fachkräftemangel in der Krankenpflege in Deutschland.
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- 2019
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5. Aggression and violence in psychiatric hospitals with and without open door policies: A 15-year naturalistic observational study
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Donald A Bux, Andres R. Schneeberger, Andreas Heinz, Christian G. Huber, Stefanie von Felten, Undine E. Lang, Karl H Beine, Stefan Borgwardt, Eva Kowalinski, Martin Zinkler, Katrin Schröder, and Daniela Fröhlich
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Adult ,Hospitals, Psychiatric ,Male ,Restraint, Physical ,Safety Management ,medicine.medical_specialty ,Poison control ,Violence ,Suicide prevention ,Patient Isolation ,03 medical and health sciences ,0302 clinical medicine ,Germany ,Mentally Ill Persons ,Injury prevention ,Humans ,Medicine ,Psychiatry ,Biological Psychiatry ,Aged ,Inpatients ,business.industry ,Aggression ,Middle Aged ,Open door policy (business) ,Organizational Policy ,030227 psychiatry ,Psychiatry and Mental health ,Propensity score matching ,Female ,Observational study ,medicine.symptom ,business ,Seclusion ,030217 neurology & neurosurgery - Abstract
Aggressive behavior and violence in psychiatric patients have often been quoted to justify more restrictive settings in psychiatric facilities. However, the effects of open vs. locked door policies on aggressive incidents remain unclear. This study had a naturalistic observational design and analyzed the occurrence of aggressive behavior as well as the use of seclusion or restraint in 21 German hospitals. The analysis included data from 1998 to 2012 and contained a total of n = 314,330 cases, either treated in one of 17 hospitals with (n = 68,135) or in one of 4 hospitals without an open door policy (n = 246,195). We also analyzed the data according to participants' stay on open, partially open, or locked wards. To compare hospital and ward types, we used generalized linear mixed-effects models on a propensity score matched subset (n = 126,268) and on the total dataset. The effect of open vs. locked door policy was non-significant in all analyses of aggressive behavior during treatment. Restraint or seclusion during treatment was less likely in hospitals with an open door policy. On open wards, any aggressive behavior and restraint or seclusion were less likely, whereas bodily harm was more likely than on closed wards. Hospitals with open door policies did not differ from hospitals with locked wards regarding different forms of aggression. Other restrictive interventions used to control aggression were significantly reduced in open settings. Open wards seem to have a positive effect on reducing aggression. Future research should focus on mental health care policies targeted at empowering treatment approaches, respecting the patient's autonomy and promoting reductions of institutional coercion.
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- 2017
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6. Scenarios for the future of mental health care: a social perspective
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Giuseppe Ducci, Victoria Bird, Georg Schomerus, Jürgen Gallinat, Matthijs Muijen, Tim Greacen, Domenico Giacco, Nikolina Jovanović, Sonia Johnson, Phil Hadridge, Martin Zinkler, Simon Wessely, Tom K. J. Craig, Richard Laugharne, Michaela Amering, Stefan Priebe, Steven Gillard, and Craig Morgan
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medicine.medical_specialty ,Social Values ,Social perspective ,Allied Health Personnel ,MEDLINE ,Social value orientations ,Vulnerable Populations ,Health Services Accessibility ,User-Computer Interface ,03 medical and health sciences ,Professional Role ,0302 clinical medicine ,Surveys and Questionnaires ,medicine ,Humans ,030212 general & internal medicine ,Scenario planning ,Psychiatry ,Biological Psychiatry ,business.industry ,Social environment ,Public relations ,Mental health ,030227 psychiatry ,Psychiatry and Mental health ,Mental Health ,Mental health care ,Social disadvantage ,business ,Psychology ,Delivery of Health Care ,Forecasting - Abstract
Social values and concepts have played a central role in the history of mental health care. They have driven major reforms and guided the development of various treatment models. Although social values and concepts have been important for mental health care in the past, this Personal View addresses what their role might be in the future. We (DG, PH, and SP) did a survey of professional stakeholders and then used a scenario planning technique in an international expert workshop to address this question. The workshop developed four distinct but not mutually exclusive scenarios in which the social aspect is central: mental health care will be patient controlled; it will target people's social context to improve their mental health; it will become virtual; and access to care will be regulated on the basis of social disadvantage. These scenarios are not intended as fixed depictions of what will happen. They could, however, be useful in guiding further debate, research, and innovation.
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- 2017
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7. Supported Decision Making in the Prevention of Compulsory Interventions in Mental Health Care
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Martin Zinkler
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Psychiatry ,Opinion ,Human Rights ,Human rights ,lcsh:RC435-571 ,supported decision-making ,media_common.quotation_subject ,Psychological intervention ,Psychiatry and Mental health ,Nursing ,lcsh:Psychiatry ,Compulsory detention ,Coercive treatment ,Mental health care ,Psychology ,media_common - Published
- 2019
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8. Zwangsmaßnahmen in deutschen Kliniken für Psychiatrie und Psychotherapie
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Martin Zinkler, Karl H Beine, S. Häfner, F. Hohl-Radke, Manfred Koller, Peter Falkai, A. Deister, Thomas Pollmächer, Kristina Adorjan, Tilman Steinert, Erich Flammer, Oliver Pogarell, G. Gerlinger, and Sabine C. Herpertz
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medicine.medical_specialty ,Main diagnosis ,Penal code ,Psychosomatics ,General Medicine ,language.human_language ,030227 psychiatry ,German ,03 medical and health sciences ,Psychiatry and Mental health ,0302 clinical medicine ,Neurology ,language ,medicine ,In patient ,Neurology (clinical) ,Psychology ,Psychiatry ,030217 neurology & neurosurgery - Abstract
A simple instrument to record case-related coercive measures was tested as part of a pilot project of the German Association for Psychiatry, Psychotherapy and Psychosomatics (DGPPN). To assess coercive measures data were collected for 3 months in 8 German hospitals for psychiatry and psychotherapy. The type of measures used, the main diagnosis and the legal basis for the coercive measures were documented. In the sample studied, coercive measures were applied in 8% of cases. Coercive measures were most commonly used in patients with a schizophrenic disorder. The principle of justifiable necessity according to A A 34 of the German Penal Code was used particularly often as the legal basis for justifying the coercive measures. Suitable measurement instruments and reliable data that enable the learning of best practices represent the basis for a reduction of coercive measures.
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- 2016
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9. Was ist ein 'erheblicher gesundheitlicher Schaden' im Sinne des § 1906 BGB?
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Manfred Koller, Felix Hohl-Radke, Tilman Steinert, Andreas Heinz, Juergen Mueller, Martin Zinkler, and Sabine Mueller
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Task force ,Statement (logic) ,media_common.quotation_subject ,Association (object-oriented programming) ,language.human_language ,030227 psychiatry ,3. Good health ,German ,03 medical and health sciences ,Psychiatry and Mental health ,0302 clinical medicine ,Law ,Legal guardian ,language ,Psychology ,030217 neurology & neurosurgery ,Autonomy ,media_common - Published
- 2016
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10. Suicide risk and absconding in psychiatric hospitals with and without open door policies: a 15 year, observational study
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Christian G. Huber, Undine E. Lang, Martin Zinkler, Stefan Borgwardt, Karl H Beine, Stefanie von Felten, Daniela Fröhlich, Andreas Heinz, Eva Kowalinski, Marc Walter, and Andres R. Schneeberger
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Adult ,Hospitals, Psychiatric ,Male ,Risk ,medicine.medical_specialty ,MEDLINE ,Poison control ,Suicide prevention ,Security Measures ,Occupational safety and health ,03 medical and health sciences ,0302 clinical medicine ,Germany ,Injury prevention ,medicine ,Humans ,Psychiatry ,Biological Psychiatry ,business.industry ,Mental Disorders ,Human factors and ergonomics ,Middle Aged ,Organizational Policy ,030227 psychiatry ,Suicide ,Psychiatry and Mental health ,Treatment Outcome ,Emergency medicine ,Propensity score matching ,Female ,Observational study ,business ,030217 neurology & neurosurgery - Abstract
Inpatient suicide and absconding of inpatients at risk of self-endangering behaviour are important challenges for all medical disciplines, particularly psychiatry. Patients at risk are often admitted to locked wards in psychiatric hospitals to prevent absconding, suicide attempts, and death by suicide. However, there is insufficient evidence that treatment on locked wards can effectively prevent these outcomes. We did this study to compare hospitals without locked wards and hospitals with locked wards and to establish whether hospital type has an effect on these outcomes.In this 15 year, naturalistic observational study, we examined 349 574 admissions to 21 German psychiatric inpatient hospitals from Jan 1, 1998, to Dec 31, 2012. We used propensity score matching to select 145 738 cases for an analysis, which allowed for causal inference on the effect of ward type (ie, locked, partly locked, open, and day clinic wards) and hospital type (ie, hospitals with and without locked wards) on suicide, suicide attempts, and absconding (with and without return), despite the absence of an experimental design. We used generalised linear mixed-effects models to analyse the data.In the 145 738 propensity score-matched cases, suicide (OR 1·326, 95% CI 0·803-2·113; p=0·24), suicide attempts (1·057, 0·787-1·412; p=0·71), and absconding with return (1·288, 0·874-1·929; p=0·21) and without return (1·090, 0·722-1·659; p=0·69) were not increased in hospitals with an open door policy. Compared with treatment on locked wards, treatment on open wards was associated with a decreased probability of suicide attempts (OR 0·658, 95% CI 0·504-0·864; p=0·003), absconding with return (0·629, 0·524-0·764; p0·0001), and absconding without return (0·707, 0·546-0·925; p=0·01), but not completed suicide (0·823, 0·376-1·766; p=0·63).Locked doors might not be able to prevent suicide and absconding.None.
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- 2016
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11. Zwangsmaßnahmen in psychiatrischen Kliniken – einer von vielen Indikatoren der Behandlungsqualität
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Volkmar Aderhold, Martin Kleinschmidt, Sebastian von Peter, Stefan Weinmann, and Martin Zinkler
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Psychiatry and Mental health ,medicine.medical_specialty ,Neurology ,Psychotherapist ,business.industry ,Medicine ,Psychosomatic medicine ,Neurology (clinical) ,General Medicine ,business - Published
- 2019
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12. Soziale Kontrolle, Influencer und Interessenkonflikte
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Martin Zinkler
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Psychiatry and Mental health - Published
- 2019
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13. Langzeittendenzen in der Anwendung von Fixierungen und Isolierungen in fünf psychiatrischen Kliniken
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Sandra Hoppstock, Hans-Peter Elsässer-Gaißmaier, Martin Zinkler, Erich Flammer, Axel Starrach, and Tilman Steinert
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Gynecology ,Psychiatry and Mental health ,medicine.medical_specialty ,Political science ,medicine - Abstract
Anliegen: Langsschnittbeobachtung der Anwendung von Zwangsmasnahmen in deutschen psychiatrischen Kliniken. Methode: Der Arbeitskreis zur Pravention von Gewalt und Zwang fuhrt seit 2000 Klinikvergleiche zur Anwendung von Zwangsmasnahmen durch und versucht die Anwendung von Zwangsmasnahmen zu reduzieren. Wir verglichen die 5 Kliniken, von denen uber 9 Jahre durchgangig Vollerhebungsdaten mit gleicher Methode vorlagen. Ergebnisse: Der Anteil der betroffenen Patienten sank zwischen 2004 und 2012 von 8,2 % auf 6,2 %. Die Standardabweichung der Ergebnismase der einzelnen Kliniken nahm um 20 % ab. Schlussfolgerungen: Die durchgefuhrten Masnahmen zur Reduzierung von Zwangsmasnahmen sind insgesamt wirksam, aber deutlich weniger als in klinischen Studien.
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- 2014
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14. Zwangsbehandlung mit Elektrokrampftherapie – wissenschaftlich ungesichert und menschenrechtlich fragwürdige Therapie
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M. Kaiser, K. H. Beine, Stefan Weinmann, M. von Cranach, Volkmar Aderhold, M. Osterfeld, and Martin Zinkler
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medicine.medical_specialty ,Psychotherapist ,Neurology ,Human rights ,business.industry ,medicine.medical_treatment ,media_common.quotation_subject ,Psychosomatic medicine ,Compulsory treatment ,General Medicine ,030227 psychiatry ,03 medical and health sciences ,Psychiatry and Mental health ,0302 clinical medicine ,Electroconvulsive therapy ,medicine ,Neurology (clinical) ,Neurosurgery ,business ,030217 neurology & neurosurgery ,media_common - Published
- 2018
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15. Grundsätzliche Ablehnung der EKT unter Zwang
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Martin Zinkler
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Psychiatry and Mental health - Published
- 2018
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16. Leserbrief zum Beitrag: Grempler J, Steinert T, Schmid P. Rauchverhalten bei Patienten und Beschäftigten einer psychiatrischen Klinik. Psychiat Prax 2019; 46: 20–26
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Michael Waibel and Martin Zinkler
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Psychiatry and Mental health - Published
- 2019
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17. Arbitrary classification of hospital policy regarding open and locked doors - Authors' reply
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Stefanie von Felten, Undine E. Lang, Karl H Beine, Martin Zinkler, Christian G. Huber, Stefan Borgwardt, Andreas Heinz, Marc Walter, Eva Kowalinski, Daniela Fröhlich, and Andres R. Schneeberger
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World Wide Web ,03 medical and health sciences ,Psychiatry and Mental health ,0302 clinical medicine ,business.industry ,MEDLINE ,Doors ,Medicine ,business ,030217 neurology & neurosurgery ,Biological Psychiatry ,030227 psychiatry - Published
- 2016
18. Contents Vol. 81, 2012
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Giuseppe Maina, Guy Chouinard, Mats Dahlin, Alessandra M.A. Nivoli, Anita Parena, Isabella Pacchiarotti, Jonas Almlöv, Giovanni Castellini, Christian Fazekas, Domenico Mastrangelo, Luca Cieri, Mario Maggi, Lorenzo Lelli, Per Bech, Angelo Di Masi, Emanuela Offidani, Marinella Daniele, Armin Hartmann, Barbara Saum, Linda Vignozzi, Carlotta Belaise, Lisa Georén, Carlo Faravelli, Stephen Bremner, Carolina Lo Sauro, Druck Reinhardt Druck Basel, Anna Norgren, Alessia Gatti, Farrell Silverberg, Virginie-Anne Chouinard, Björn Paxling, Loretta Salvati, Mark Zimmerman, Ludger Tebartz van Elst, Umberto Albert, Adriaan W. Hoogendoorn, Valdo Ricca, Amy Gaglia, Merijn Eikelenboom, Stefan Priebe, Johannes H. Smit, Pim Cuijpers, Nyla Bhatti, Domenico Laera, Francesc Colom, Elisabeth Breitholtz, Filippo Bogetto, Almut Zeeck, Elena Tomba, Per Carlbring, Andrea Aguglia, Kirsten Barnicot, Lucy Yardley, Roberta Necci, Iris Molosankwe, Patricia van Oppen, Piero Porcelli, Gerhard Andersson, Paul M. G. Emmelkamp, Pie Roch-Norlund, Anton Leitner, Oliver Tüscher, Andreas Joos, Gunnar Östman, Sarah Kirby, Anton J. L. M. van Balkom, Eduard Vieta, Satz Mengensatzproduktion, Paul McCrone, Christina Katsakou, Martin Zinkler, Andrea Murru, and Antonio Tundo
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Psychiatry and Mental health ,Clinical Psychology ,General Medicine ,Applied Psychology - Published
- 2012
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19. Community treatment orders and capacity to consent
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Martin Zinkler, Kevin De Sabbata, APH - Global Health, and Athena Institute
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Human Rights ,media_common.quotation_subject ,Medical law ,Community Treatment Orders ,Medical Law ,03 medical and health sciences ,Mental Health Law ,Supported Decision-Making ,0302 clinical medicine ,Plea ,030212 general & internal medicine ,Legal Capacity ,media_common ,Mental health law ,Human rights ,Mental health ,030227 psychiatry ,Legal capacity ,Psychiatry and Mental health ,Mental Health ,Law ,Convention on the Rights of Persons with Disabilities ,Psychology ,Social psychology - Abstract
We welcome Newton-Howes & Ryan's plea for a more restrictive use of community treatment orders (CTOs).[1][1] They have a heavy impact on patients' rights, are largely ineffective[2][2] and are likely to damage the trust between patients and treatment teams, which is vital for sustained success in
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- 2017
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20. Clozapine: national review of postcode prescribing
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Johnny Downs and Martin Zinkler
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medicine.medical_specialty ,business.industry ,Star rating ,Gold standard ,Nice ,Commission ,medicine.disease ,Mental health ,030227 psychiatry ,03 medical and health sciences ,Psychiatry and Mental health ,0302 clinical medicine ,Schizophrenia ,Health care ,medicine ,030212 general & internal medicine ,business ,Psychiatry ,computer ,Clozapine ,medicine.drug ,computer.programming_language - Abstract
Aims and MethodWe review the prescribing rates for clozapine among all mental health trusts in England and explore whether it has changed with the introduction of NICE guidelines, generic clozapine and the Healthcare Commission ratings. Data were collected from mental health trusts in 2005–2006 and compared with a previous study from 2000. Mental health star ratings of 2004–2005 were taken from the Healthcare Commission.ResultsWe found a reduced inter-trust variability from 34-fold variation in 2000 to 5-fold variation in 2005–2006. There was a significant inverse relationship between star rating and clozapine prescribing.Clinical ImplicationsNICE guidelines and generic clozapine seem to have improved access to gold standard therapy for treatment-resistant schizophrenia. Star ratings have little bearing on the implementation of NICE guidelines.
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- 2007
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21. Dialectical behaviour treatment: implementation and outcomes
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Martin Zinkler, Eldad Farhy, S. M. Rajagopal Arokiadass, and Amy Gaglia
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Dialectic ,Service (business) ,Psychotherapist ,Treatment implementation ,Dialectical behaviour therapy ,medicine.disease ,Mental health ,030227 psychiatry ,03 medical and health sciences ,Psychiatry and Mental health ,0302 clinical medicine ,medicine ,030212 general & internal medicine ,Psychology ,Borderline personality disorder ,Hospital use ,Clinical psychology - Abstract
Aims and MethodDialectical behaviour therapy is an evidence-based treatment for people with borderline personality disorder. We describe implementation and outcomes of a new service.ResultsHospital use and frequency of self-harm were reduced dramatically with dialectical behaviour therapy. Moreover, the therapy can be implemented successfully in a relatively short time at modest costs.Clinical ImplicationsDialectical behaviour therapy provides a useful model of treatment for people with borderline personality disorder and/or self-harm in community mental health settings.
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- 2007
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22. Kann auf Zwangsmedikation in der klinischen Praxis verzichtet werden? – Pro
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Martin Zinkler and Jose-M. Koussemou
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03 medical and health sciences ,Psychiatry and Mental health ,030505 public health ,0302 clinical medicine ,Political science ,0305 other medical science ,Humanities ,030227 psychiatry - Published
- 2016
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23. Detention of the mentally ill in Europe - a review
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Martin Zinkler and Stefan Priebe
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Government ,medicine.medical_specialty ,business.industry ,Public health ,Social environment ,Legislation ,Mental illness ,medicine.disease ,Mental health ,Psychiatry and Mental health ,Involuntary treatment ,medicine ,media_common.cataloged_instance ,European union ,business ,Psychiatry ,media_common - Abstract
Objective: The frequency of compulsory admission varies widely across Europe. Although there has been some research on a nation-wide level, no work has been done to compare mental health legislation in different countries in relation to detention rates and to patients' perception of hospital detention. Method: Databases and government statistics were searched for regional, national and European data. Legal frameworks were compared and reviewed in relation to patients' and professionals' views. Results: Nearly 20-fold variations in detention rates were found in different parts of Europe. Criteria for detention of the mentally ill are broadly similar when it comes to patients at risk to themselves or others. However different rules apply for involuntary treatment in the interest of the patient's health. Conclusion: Variations in detention rates across Europe appear to be influenced by professionals' ethics and attitudes, sociodemographic variables, the public's preoccupation about risk arising from mental illness and the respective legal framework.
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- 2002
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24. Polydipsie bei paranoider Schizophrenie mit tödlichem Ausgang
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Frank Thomas Bopp, Martin Zinkler, and Tanja Katharina Franziska Gaigalat
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Creatinine ,Pediatrics ,medicine.medical_specialty ,Paranoid schizophrenia ,business.industry ,Sedation ,medicine.disease ,Sudden death ,Psychiatry and Mental health ,chemistry.chemical_compound ,chemistry ,Schizophrenia ,medicine ,medicine.symptom ,Hyponatremia ,business ,Polydipsia ,Clozapine ,medicine.drug - Abstract
OBJECTIVE AND METHODS Polydipsia with hyponatraemia commonly occurs with chronic psychosis and is associated with a reduced life expectancy for individuals diagnosed with schizophrenia. We describe a 51 years old man who presented with polydipsia during a relapse of paranoid schizophrenia. While treated with Clozapine, and despite regular observation and daily control of creatinine and electrolytes, the man suddenly collapsed and died after drinking huge amounts of water. No sedation from psychotropic medication or drugs and alcohol was present in this case. Sodium levels on the day of death and the day before were within normal range. A post-mortem revealed aspiration of water and gastric content as the cause of asphyxiation and death. A literature search in Medline and Embase did not yield a description of a similar case. RESULTS AND CONCLUSIONS This case highlights the risk of aspiration associated with polydipsia in chronic schizophrenia. Daily control of electrolytes to identify hyponatremia and regular observation are recommended but may not be sufficient to prevent sudden death from drinking huge amounts of water.
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- 2011
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25. Allgemeine und forensische Psychiatrie – Wer kümmert sich um junge Menschen mit psychotischen Störungen?
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Martin Zinkler
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Psychiatry and Mental health - Published
- 2009
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26. Mitteilungen des Arbeitskreises der Chefärzte und Chefärztinnen von Kliniken für Psychiatrie und Psychotherapie an Allgemeinkrankenhäusern in Deutschland (ackpa)
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Martin Zinkler
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Psychiatry and Mental health - Published
- 2015
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27. Effectiveness and cost-effectiveness of dialectical behaviour therapy for self-harming patients with personality disorder: a pragmatic randomised controlled trial
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Iris Molosankwe, Nyla Bhatti, Martin Zinkler, Stephen Bremner, Paul McCrone, Amy Gaglia, Christina Katsakou, Kirsten Barnicot, and Stefan Priebe
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Adult ,Male ,medicine.medical_specialty ,Cost effectiveness ,media_common.quotation_subject ,Cost-Benefit Analysis ,Poison control ,Rate ratio ,Suicide prevention ,Personality Disorders ,law.invention ,Randomized controlled trial ,law ,Behavior Therapy ,Borderline Personality Disorder ,Injury prevention ,medicine ,Personality ,Humans ,Psychiatry ,Borderline personality disorder ,Applied Psychology ,media_common ,General Medicine ,medicine.disease ,Psychiatry and Mental health ,Clinical Psychology ,Treatment Outcome ,Costs and Cost Analysis ,Female ,Psychology ,Self-Injurious Behavior - Abstract
Background: A primary goal of dialectical behaviour therapy (DBT) is to reduce self-harm, but findings from empirical studies are inconclusive. The aim of this study was to assess the effectiveness and cost-effectiveness of DBT in reducing self-harm in patients with personality disorder. Methods: Participants with a personality disorder and at least 5 days of self-harm in the previous year were randomised to receive 12 months of either DBT or treatment as usual (TAU). The primary outcome was the frequency of days with self-harm; secondary outcomes included borderline personality disorder symptoms, general psychiatric symptoms, subjective quality of life, and costs of care. Results: Forty patients each were randomised to DBT and TAU. In an intention-to-treat analysis, there was a statistically significant treatment by time interaction for self-harm (incidence rate ratio 0.91, 95% CI 0.89–0.92, p < 0.001). For every 2 months spent in DBT, the risk of self-harm decreased by 9% relative to TAU. There was no evidence of differences on any secondary outcomes. The economic analysis revealed a total cost of a mean of 5,685 GBP (6,786 EUR) in DBT compared to a mean of 3,754 GBP (4,481 EUR) in TAU, but the difference was not significant (95% CI –603 to 4,599 GBP). Forty-eight per cent of patients completed DBT. They had a greater reduction in self-harm compared to dropouts (incidence rate ratio 0.78, 95% CI 0.76–0.80, p < 0.001). Conclusions: DBT can be effective in reducing self-harm in patients with personality disorder, possibly incurring higher total treatment costs. The effect is stronger in those who complete treatment. Future research should explore how to improve treatment adherence.
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- 2012
28. A typology of advance statements in mental health care
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Graham Thornicroft, Claire Henderson, Jeffrey W. Swanson, Martin Zinkler, and George Szmukler
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Mental Health Services ,medicine.medical_specialty ,medicine.medical_treatment ,Health Personnel ,Psychological intervention ,Documentation ,Germany ,Health care ,medicine ,Humans ,Crisis plan ,Psychiatry ,business.industry ,Public health ,Mental Disorders ,Convalescence ,Public relations ,Mental health ,United States ,Psychiatry and Mental health ,Health Planning ,Crisis Intervention ,Patient Satisfaction ,Involuntary treatment ,Facilitator ,Commitment of Mentally Ill ,business ,Psychology ,Advance Directives ,Crisis intervention - Abstract
Advance statements documenting mental health service consumers’ preferences for treatment during a future mental health crisis or period of incapacity have gained currency in recent years in the United States and some European countries. Several kinds of advance statements have emerged—some as legal instruments, others as treatment planning methods—but no formal comparison has been made among them. This article reviews the literature in English and German to develop a comparative typology of advance statements: joint crisis plans, crisis cards, treatment plans, wellness recovery action plans, and psychiatric advance directives (with and without formal facilitation). The features that distinguish them are the extent to which they are legally binding, whether health care providers are involved in their production, and whether an independent facilitator assists in their production. The differing nature of advance statements is related to the diverse models of care upon which they are based and the legislative and service contexts in which they have been developed. However, there is recent convergence between the United Kingdom and the United States with respect to research interventions that facilitate the production of advance statements, as evidence emerges for the effectiveness of facilitated psychiatric advance directives and joint crisis plans. Different types of advance statements can coexist and in some cases may interact in complementary ways. However, the relationship of advance statements to involuntary treatment is more problematic, as is their effective implementation in many mental health service settings. (Psychiatric Services 59:63–71, 2008)
- Published
- 2008
29. Neuregelung von Zwang - ein Auftrag für die Fachgesellschaft?
- Author
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Martin Zinkler
- Subjects
Psychiatry and Mental health ,Psychology - Published
- 2013
- Full Text
- View/download PDF
30. Advance directives and advance agreements
- Author
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Martin Zinkler
- Subjects
Psychiatry and Mental health ,Patient Rights ,Computer science ,business.industry ,Germany ,Internet privacy ,Humans ,Service user ,Patient Participation ,Advance Directives ,business ,Attitude to Health ,United Kingdom - Abstract
The paper by Amering et al ([2005][1]) adds to the growing literature on advance directives. The main difficulty with advance directives seems to be that with the available training programmes very few service users can be enthused to draft one. The authors recommend more training of service users
- Published
- 2005
- Full Text
- View/download PDF
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