TY - JOUR A1 - Spiegelhalder, Kai A1 - Baumeister, Harald A1 - Al-Kamaly, Abdulwahab A1 - Bader, Martina A1 - Bauereiss, Natalie A1 - Benz, Fee A1 - Braun, Lina A1 - Buntrock, Claudia A1 - Burkhardt, Maike A1 - Cuijpers, Pim A1 - Domschke, Katharina A1 - Dülsen, Patrick A1 - Franke, Marvin A1 - Frase, Lukas A1 - Heber, Elena A1 - Helm, Kathrin A1 - Jentsch, Terry A1 - Johann, Anna A1 - Küchler, Ann-Marie A1 - Kuhn, Michael A1 - Lehr, Dirk A1 - Maun, Andy A1 - Morin, Charles M A1 - Moshagen, Morten A1 - Richter, Kneginja A1 - Schiel, Julian A1 - Simon, Laura A1 - Spille, Lukas A1 - Weeß, Hans-Günter A1 - Riemann, Dieter A1 - Ebert, David Daniel T1 - Comparative effectiveness of three versions of a stepped care model for insomnia differing in the amount of therapist support in internet-delivered treatment: study protocol for a pragmatic cluster randomised controlled trial (GET Sleep) JF - BMJ Open N2 - IntroductionIt is unclear how internet-delivered cognitive-behavioural therapy for insomnia (CBT-I) can be integrated into healthcare systems, and little is known about the optimal level of therapist guidance. The aim of this study is to investigate three different versions of a stepped care model for insomnia (IG1, IG2, IG3) versus treatment as usual (TAU). IG1, IG2 and IG3 rely on treatment by general practitioners (GPs) in the entry level and differ in the amount of guidance by e-coaches in internet-delivered CBT-I.Methods and analysisIn this randomised controlled trial, 4268 patients meeting International Classification of Diseases, Tenth Revision (ICD-10) criteria for insomnia will be recruited. The study will use cluster randomisation of GPs with an allocation ratio of 3:3:3:1 (IG1, IG2, IG3, TAU). In step 1 of the stepped care model, GPs will deliver psychoeducational treatment; in step 2, an internet-delivered CBT-I programme will be used; in step 3, GPs will refer patients to specialised treatment. Outcomes will be collected at baseline, and 4 weeks, 12 weeks and 6 months after baseline assessment. The primary outcome is insomnia severity at 6 months. An economic evaluation will be conducted and qualitative interviews will be used to explore barriers and facilitators of the stepped care model.Ethics and disseminationThe study protocol was approved by the Ethics Committee of the Medical Centre—University of Freiburg. The results of the study will be published irrespective of the outcome.Trial registration numberDRKS00021503. Y1 - 2022 U6 - https://doi.org/10.1136/bmjopen-2021-058212 SN - 2044-6055 VL - 12 IS - 8 PB - BMJ ER - TY - JOUR A1 - Frase, Lukas A1 - Acker, Jens A1 - Cohrs, Stefan A1 - Danker-Hopfe, Heidi A1 - Frohn, Corinna A1 - Göder, Robert A1 - Mauche, Nicole A1 - Norra, Christine A1 - Pollmächer, Thomas A1 - Richter, Kneginja A1 - Riemann, Dieter A1 - Schilling, Claudia A1 - Weeß, Hans-Günter A1 - Wetter, Thomas C. A1 - Nissen, Christoph T1 - Empfehlungen zur Durchführung einer Polygraphie oder Polysomnographie im Bereich Psychiatrie und Psychotherapie BT - Positionspapier des DGPPN-Referats Schlafmedizin JF - Der Nervenarzt N2 - Ein- und Durchschlafstörungen, nichterholsamer Schlaf oder erhöhte Tagesmüdigkeit sind unspezifische Symptome von heute ca. 100 unterscheidbaren Störungsbildern, die in der kommenden 11. Revision der Internationalen statistischen Klassifikation der Krankheiten (ICD-11) erstmals als eigenes Kapitel 7 „Schlaf-Wach-Störungen“ zusammengefasst werden. Mit Blick auf den Fachbereich Psychiatrie und Psychotherapie besteht ein bidirektionaler Zusammenhang zwischen Schlaf-Wach-Störungen und psychischen Erkrankungen. Schlaf-Wach-Störungen können einen unabhängigen Risikofaktor für das Entstehen einer psychischen Erkrankung darstellen und den Erkrankungsverlauf ungünstig beeinflussen. Zudem können Schlaf-Wach-Störungen einer psychischen Erkrankung auch als Frühsymptom vorausgehen und damit ein wichtiger Hinweis bei der Früherkennung sein. Zahlreiche Schlaf-Wach-Störungen können anhand der Anamnese und üblicher klinischer Untersuchungen diagnostiziert werden. Bei spezielleren Fragestellungen können die Untersuchung in einem speziali-sierten Schlaflabor und die Behandlung in einem schlafmedizinischen Zentrum im Sinne einer gestuften Versorgung notwendig sein. Hier ist die Polysomnographie die wichtigste Untersuchungsmethode für die Differenzialdiagnostik, für deren Abrechnung über die Kostenträger heute in Deutschland jedoch keine gesetzliche Grundlage im Bereich neuro-psychiatrischer Störungen besteht. Die vorliegende Arbeit fasst die aktuellen Leitlinien hinsichtlich der Kriterien für eine Untersuchung im Schlaflabor aus Sicht des Fachgebiets Psychiatrie und Psychotherapie zusammen und stellt daraus abgeleitet Forderungen für eine leitliniengerechte Diagnostik und Behandlung. N2 - Difficulties in falling asleep and maintaining sleep, nonrestorative sleep and decreased daytime wakefulness represent very common but relatively unspecific health complaints. Around 100 specific sleep-related disorders will be classified in their own major chap. 7 (sleep wake disorders) for the first time in the upcoming 11th version of the International Classification of Diseases (ICD 11). With respect to the disciplines of psychiatry and psychotherapy there is a bidirectional relationship between mental health and sleep wake disorders. Sleep wake disorders can be an independent risk factor for the onset of a mental disorder and have a negative influence on the course of the disease. In addition, sleep wake disorders can also precede a mental disease as an early symptom and therefore be an important indication for early recognition. Many sleep wake disorders can be diagnosed based on the anamnesis and routine clinical investigations. In special cases, examination in a specialized sleep laboratory and treatment in a sleep medicine center following a staged care approach can be mandatory. Polysomnography represents the gold standard for the differential diagnostics; however, there is no legal foundation in the field of neuro-psychiatric disorders for remuneration in the German healthcare system. This review summarizes the current guidelines with respect to the criteria for an investigation in a sleep laboratory from the perspective of the disciplines of psychiatry and psychotherapy. From this the requirements for guideline-conform diagnostics and treatment are derived. T2 - Recommendations on performing polygraphy or polysomnography in the fields of psychiatry and psychotherapy Y1 - 2019 U6 - https://doi.org/10.1007/s00115-019-00855-2 SN - 0028-2804 VL - 91 IS - 9 SP - 843 EP - 853 PB - Springer Science and Business Media LLC ER - TY - JOUR A1 - Spiegelhalder, Kai A1 - Acker, Jens A1 - Baumeister, Harald A1 - Büttner-Teleaga, Antje A1 - Danker-Hopfe, Heidi A1 - Ebert, David D. A1 - Fietze, Ingo A1 - Frase, Lukas A1 - Klein, Sarah A1 - Lehr, Dirk A1 - Maun, Andy A1 - Mertel, Isabella A1 - Richter, Kneginja A1 - Riemann, Dieter A1 - Sauter, Cornelia A1 - Schilling, Claudia A1 - Schlarb, Angelika A. A1 - Specht, Markus A1 - Steinmetz, Lisa A1 - Weeß, Hans G. A1 - Crönlein, Tatjana T1 - Digitale Behandlungsangebote für Insomnie – eine Übersichtsarbeit JF - Somnologie N2 - ZusammenfassungDigital angebotene psychologische Interventionen gegen Schlafstörungen sind aktuell ein sehr intensiv bearbeitetes Forschungsthema. In dieser Übersichtsarbeit werden Originalarbeiten und Metaanalysen zu diesem Thema zusammengefasst. Hierbei zeigt sich, dass die internetbasierte kognitive Verhaltenstherapie für Insomnie (KVT-I) bei Erwachsenen durchweg sehr effektiv ist mit allenfalls leicht geringeren Effektstärken als die gleiche Behandlung mit physischer Präsenz von Therapeuten und Patienten. Behandlungseffekte zeigen sich dabei auch für sekundäre Outcome-Parameter wie Depressivität, Angst, Fatigue und Lebensqualität. Hingegen lassen die Forschung zur Wirksamkeit der internetbasierten KVT‑I bei Erwachsenen mit komorbiden psychischen Störungen oder körperlichen Erkrankungen sowie die Forschung zur Frage, wieviel Therapeutenkontakt in die Behandlung integriert werden sollte, anscheinend noch keine abschließenden Antworten zu. In diesen Bereichen scheint weitere Forschung notwendig zu sein scheint. Y1 - 2020 U6 - https://doi.org/10.1007/s11818-020-00238-9 SN - 1432-9123 VL - 24 IS - 2 SP - 106 EP - 114 PB - Springer Science and Business Media LLC ER - TY - JOUR A1 - Weber, Franziska C. A1 - Danker-Hopfe, Heidi A1 - Dogan-Sander, Ezgi A1 - Frase, Lukas A1 - Hansel, Anna A1 - Mauche, Nicole A1 - Mikutta, Christian A1 - Nemeth, Diana A1 - Richter, Kneginja A1 - Schilling, Claudia A1 - Sebestova, Martina A1 - Spath, Marian M. A1 - Nissen, Christoph A1 - Wetter, Thomas C. T1 - Restless Legs Syndrome Prevalence and Clinical Correlates Among Psychiatric Inpatients BT - a multicenter study JF - Frontiers in Psychiatry N2 - BackgroundThere are only limited reports on the prevalence of restless legs syndrome (RLS) in patients with psychiatric disorders. The present study aimed to evaluate the prevalence and clinical correlates in psychiatric inpatients in Germany and Switzerland.MethodsThis is a multicenter cross-sectional study of psychiatric inpatients with an age above 18 years that were diagnosed and evaluated face-to-face using the International RLS Study Group criteria (IRLSSG) and the International RLS severity scale (IRLS). In addition to sociodemographic and biometric data, sleep quality and mood were assessed using the Pittsburgh Sleep Quality Index (PSQI), the Insomnia Severity Index (ISI), the Epworth Sleepiness Scale (ESS), and the Patient Health Questionnaire (PHQ-9). In addition to univariate statistics used to describe and statistically analyze differences in variables of interest between patients with and without RLS, a logistic model was employed to identify predictors for the occurrence of RLS.ResultsThe prevalence of RLS in a sample of 317 psychiatric inpatients was 16.4%, and 76.9% of these were diagnosed with RLS for the first time. RLS severity was moderate to severe (IRLS ± SD: 20.3 ± 8.4). The prevalences in women (p = 0.0036) and in first-degree relatives with RLS (p = 0.0108) as well as the body mass index (BMI, p = 0.0161) were significantly higher among patients with RLS, while alcohol consumption was significantly lower in the RLS group. With the exception of atypical antipsychotics, treatment with psychotropic drugs was not associated with RLS symptoms. Regarding subjective sleep quality and mood, scores of the PSQI (p = 0.0007), ISI (p = 0.0003), and ESS (p = 0.0005) were higher in patients with RLS, while PHQ-9 scores were not different. A logistic regression analysis identified gender (OR 2.67; 95% CI [1.25; 5.72]), first-degree relatives with RLS (OR 3.29; 95% CI [1.11; 9.73], ESS score (OR 1.09; 95% CI [1.01; 1.17]), and rare alcohol consumption (OR 0.45; 95% CI [0.22; 0.94] as predictors for RLS.ConclusionsClinically significant RLS had a high prevalence in psychiatric patients. RLS was associated with higher BMI, impaired sleep quality, and lower alcohol consumption. A systematic assessment of restless legs symptoms might contribute to improve the treatment of psychiatric patients. Y1 - 2022 U6 - https://doi.org/10.3389/fpsyt.2022.846165 SN - 1664-0640 VL - 13 PB - Frontiers Media SA ER -