Fit for Work and Life-an eight-week program for improvement of functionality and quality of life : A two-stage study

Background: The current two-stage study focused on work integration and quality of life of patients in an acute psychiatric day care unit. There is evidence that a longer absence from work due to illness negatively affects job retention, life satisfaction and clinical prognosis. Furthermore, there are individual supportive methods that proved to be effective in work integration. We therefore developed a specific group program Fit for Work and Life (FWL) for patients in an acute psychiatric day care unit focusing on work integration in the first labor market (in contrast to work in institutions for people with disabilities/second labor market). Methods: Between 2018 and 2020, 62 patients (intervention group; IG) were enrolled in an 8‑week prospective job integration program and compared to 74 patients (control group; CG) who received treatment as usual (partly retrospective survey). Patients of both groups held a job when entering treatment. Main outcome was defined as their working status 4 weeks after the end of treatment as well as self-reported life satisfaction. Results: At the end of treatment (i.e. the week prior to discharge), the IG participants reported higher overall life satisfaction as well as higher health-, self- and living condition-related satisfaction than controls. Functional and clinical improvement during treatment was linked to subsequently returning to work. Functional improvement was further linked to higher life satisfaction. Mediational analysis revealed an indirect path from functional improvement on life satisfaction via working status, i.e. the higher functional improvement during treatment, the higher the chance of successfully returning to work, which in turn increased life satisfaction. Conclusion: Our findings suggest that programs such as FWL are useful interventions for employed patients to improve reintegration into work and life and to help to increase life satisfaction. Keywords: First labor market; Healthcare research; Psychiatric patients; Quality of life; Work integration. = Zusammenfassung: HINTERGRUND: Im Fokus der aktuellen 2‑stufigen Studie standen die berufliche Integration und Lebensqualität von Patienten einer akutpsychiatrischen Tagesklinik. Es gibt Evidenz dafür, dass eine krankheitsbedingte längere Abwesenheit von der Arbeit sich negativ auf den Erhalt des Arbeitsplatzes, die Lebenszufriedenheit und die klinische Prognose auswirkt. Außerdem stehen individuelle Unterstützungsmethoden zur Verfügung, die sich als für die berufliche Integration wirksam erwiesen haben. Daher entwickelten die Autoren eine spezielles Gruppenprogramm „Fit for Work and Life“ (FWL), das sich an Patienten in einer akutpsychiatrischen Tagesklinik richtet und den Schwerpunkt auf die berufliche Integration in den ersten Arbeitsmarkt (im Gegensatz zur Beschäftigung in Einrichtungen für Menschen mit Behinderungen/zweiter Arbeitsmarkt) legt. Methodik: Zwischen 2018 und 2020 wurden 62 Patienten (Interventionsgruppe, IG) in ein 8‑wöchiges prospektives berufliches Integrationsprogramm aufgenommen und mit 74 Patienten verglichen (Kontrollgruppe, KG), die in herkömmlicher Weise behandelt wurden (partiell retrospektive Erhebung). Bei Beginn der Behandlung hatten die Patienten beider Gruppen eine Arbeitsstelle inne. Als Hauptendpunkt wurden der berufliche Status 4 Wochen nach Behandlungsende sowie die Lebenszufriedenheit nach eigenen Angaben definiert. Ergebnisse: Am Ende der Behandlung (d. h. in der Woche vor der Entlassung) gaben die Teilnehmer der IG eine höhere Gesamtlebenszufriedenheit und eine höhere Zufriedenheit in Bezug auf die Gesundheit, die eigene Person und die Lebensbedingungen an als die Kontrollen. Die funktionelle und klinische Verbesserung während der Behandlung stand im Zusammenhang mit der anschließenden Wiederaufnahme der Arbeitstätigkeit. Darüber hinaus war die funktionelle Verbesserung mit einer höheren Lebenszufriedenheit verknüpft. Die Mediationsanalyse ergab einen indirekten Pfad von der funktionellen Verbesserung zur Lebenszufriedenheit über den beruflichen Status, d. h., je größer die funktionelle Verbesserung während der Behandlung war, umso größer war die Chance auf eine erfolgreiche Wiederaufnahme der Arbeitstätigkeit, was wiederum die Lebenszufriedenheit erhöhte. Schlussfolgerung: Die vorliegenden Ergebnisse sind ein Hinweis dafür, dass Programme wie FWL nützliche Interventionen für berufstätige Patienten darstellen, um die Reintegration ins Arbeitsleben zu verbessern und so zur Erhöhung der Lebenszufriedenheit beizutragen. Keywords: First labor market; Healthcare research; Psychiatric patients; Quality of life; Work integration

Abstracts from the 8th International Conference on cGMP Generators, Effectors and Therapeutic Implications

This work was supported by a restricted research grant of Bayer AG

LSD and ketanserin and their impact on the human autonomic nervous system

The interest in lysergic acid diethylamide (LSD) has sparked again due to its supposed positive effects on psychopathological conditions. Yet, most research focuses on the actions of LSD on the central nervous system. The interaction with the autonomic nervous system (ANS) has been neglected so far. Therefore, the aim was to assess the effects of LSD and the serotonin 2A receptor antagonist ketanserin on the ANS as assessed by heart rate variability (HRV) measures and their correlation with subjective drug-induced effects in a randomized, placebo-controlled crossover trial. Thus, ANS activity was derived from electrocardiogram recordings after intake of placebo, LSD or ketanserin, and LSD by calculating R-peak-based measures of sympathetic and parasympathetic activity. Repeated measure ANOVA and partial correlation for HRV measures and subjective experience questionnaires were performed. LSD predominantly increased sympathetic activity, while ketanserin counteracted this effect on the ANS via an increase of parasympathetic tone. Sympathetic activity was positively and parasympathetic activity negatively associated with psychedelic effects of LSD. Furthermore, Placebo HRV measures predicted subjective experiences after LSD intake. The association between trait ANS activity and LSD-induced subjective experiences may serve as a candidate biomarker set for the effectiveness of LSD in the treatment of psychopathological conditions

Do political parties play dirty in the discussion on gender balanced boards? Evidence from Germany

International audienc

Primary ciliary dyskinesia associated with normal axoneme ultrastructure is caused by DNAH11 mutations

Primary ciliary dyskinesia (PCD) is an inherited disorder characterized by perturbed or absent beating of motile cilia, which is referred to as Kartagener syndrome (KS) when associated with situs inversus. We present a German family in which five individuals have PCD and one has KS. PCD was confirmed by analysis of native and cultured respiratory ciliated epithelia with high-speed video microscopy. Respiratory ciliated cells from the affected individuals showed an abnormal nonflexible beating pattern with a reduced cilium bending capacity and a hyperkinetic beat. Interestingly, the axonemal ultrastructure of these respiratory cilia was normal and outer dynein arms were intact, as shown by electron microscopy and immunohistochemistry. Microsatellite analysis indicated genetic linkage to the dynein heavy chain DNAH11 on chromosome 7p21. All affected individuals carried the compound heterozygous DNAH11 mutations c.12384C>G and c.13552_13608del. Both mutations are located in the C-terminal domain and predict a truncated DNAH11 protein (p.Y4128X, p.A4518_A4523delinsQ). The mutations described here were not present in a cohort of 96 PCD patients. In conclusion, our findings support the view that DNAH11 mutations indeed cause PCD and KS, and that the reported DNAH11 nonsense mutations are associated with a normal axonemal ultrastructure and are compatible with normal male fertility