One-Year Randomized Controlled Trial and Follow-Up of Integrated Neurocognitive Therapy for Schizophrenia Outpatients

Objective: Cognitive remediation (CR) approaches have demonstrated to be effective in improving cognitive functions in schizophrenia. However, there is a lack of integrated CR approaches that target multiple neuro- and social-cognitive domains with a special focus on the generalization of therapy effects to functional outcome. Method: This 8-site randomized controlled trial evaluated the efficacy of a novel CR group therapy approach called integrated neurocognitive therapy (INT). INT includes well-defined exercises to improve all neuro- and social-cognitive domains as defined by the Measurement And Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative by compensation and restitution. One hundred and fifty-six outpatients with a diagnosis of schizophrenia or schizoaffective disorder according to DSM-IV-TR or ICD-10 were randomly assigned to receive 15 weeks of INT or treatment as usual (TAU). INT patients received 30 bi-weekly therapy sessions. Each session lasted 90min. Mixed models were applied to assess changes in neurocognition, social cognition, symptoms, and functional outcome at post-treatment and at 9-month follow-up. Results: In comparison to TAU, INT patients showed significant improvements in several neuro- and social-cognitive domains, negative symptoms, and functional outcome after therapy and at 9-month follow-up. Number-needed-to-treat analyses indicate that only 5 INT patients are necessary to produce durable and meaningful improvements in functional outcome. Conclusions: Integrated interventions on neurocognition and social cognition have the potential to improve not only cognitive performance but also functional outcome. These findings are important as treatment guidelines for schizophrenia have criticized CR for its poor generalization effect

"Das schnelle Date" - Internetgestützte Sexualkontakte und HIV-Infektionsrisiko: Ergebnisse einer 2006 durchgeführten Internetbefragung

Der seit Ende der 1990er Jahre diskutierten Frage, ob bei Sexualkontakten, die über Kontaktseiten im Internet hergestellt werden, in geringerem Umfang präventive Vorkehrungen in Hinblick auf HIV-Übertragungen erfolgen als bei andernorts angebahnten Kontakten, sollte in einer im Frühjahr 2006 durchgeführten Online-Umfrage nachgegangen werden. Die Umfrage erfolgte über vier Dating-Portale für heterosexuelle Frauen und Männer und über vier Portale für homound bisexuelle Männer. Von den berücksichtigten 5.050 Fragebögen entfielen 76 Prozent auf Männer, die ausschließlich gleichgeschlechtliche Sexualkontakte in den 12 Monaten vor der Befragung angaben, 11 Prozent der Männer wurden aufgrund ihrer Angaben als bisexuell und weitere 11 Prozent als heterosexuell definiert. Frauen stellten lediglich 2 Prozent der BefragungsteilnehmerInnen. Etwa drei Viertel aller Befragten schätzten an Kontaktseiten, das sie darüber Menschen mit gleichen Vorlieben kennenlernen können, dabei muss es sich nicht um sexuelle Vorlieben handeln: So haben etwa 22 Prozent der Frauen, 12 Prozent der homosexuellen, 9 Prozent der heterosexuellen und 6 Prozent der bisexuellen Männer überhaupt keine(n) Sexpartner(in) in den 12 Monaten vor der Befragung gesucht. Online gesucht aber keine(n) Partner(in) gefunden haben 18 Prozent der Frauen, 21 Prozent der homosexuellen, 24 Prozent der bisexuellen und 45 Prozent der heterosexuellen Männer. Etwa die Hälfte der homo- und bisexuellen Männer haben ihre SexualpartnerInnen mehrheitlich oder ausschließlich über das Internet kennengelernt, während dies nur auf 39 Prozent der heterosexuellen Männer zutrifft (zwei Drittel geben dies in der kleinen Gruppe der Frauen an). Dass heterosexuelle Männer die geringsten Erfolge beim Anbahnen von Sexualkontakten über das Internet haben, zeigen auch andere erhobene Daten. Unter den Befragungsteilnehmern erfolgte regelmäßiger Kondomgebrauch bei Vaginal- oder Analverkehr - je nach Gruppenzugehörigkeit - zu sehr unterschiedlichen Anteilen. 55 Prozent der homosexuellen und 47 Prozent der bisexuellen Männer benutzten grundsätzlich Kondome, 38 Prozent der heterosexuellen Männer und 34 Prozent der Frauen gaben dies an. Hinsichtlich des Risikos, sich mit HIV zu infizieren (ungeschützter Anal- oder Vaginalverkehr mit PartnerInnen mit unbekanntem oder diskordantem Serostatus - Expositionsrisiko), bestanden nur geringe Unterschiede zwischen homo- (27%), bi- (31%) und heterosexuellen Männern (26%) bzw. Frauen (27%). Ein Transmissionsrisiko konnte lediglich in der Teilgruppe der homosexuellen (8%) und bisexuellen (1%) Männer festgestellt werden, da in den anderen beiden Gruppen niemand HIV-positiv war. Es zeigt sich, dass bei der überwiegenden Mehrheit aller Befragten das HIV-bezogene sexuelle Risikoverhalten bei online- und offline-Dates gleich ist. -- Are people more likely to risk an HIV infection with sex partners they meet online as compared to those whom they meet offline? This question has been the subject of research since the late 1990s in several post-industrialized countries. This paper presents the results of a study conducted in Germany in 2006. A link to an anonymous, self-administered online questionnaire was posted on four dating websites for heterosexual men and women and on four dating websites for men who have sex with men. Of the 5,050 respondents included in the analysis, 76 per cent were men who reported sexual contacts in the previous twelve months exclusively with other men; 11 per cent could be classified as bisexual men (sexual contacts with men and women), and 11 per cent as heterosexual men (sexual contact with women only).. Two per cent of all respondents were women; because of the small number of respondents this group was not further stratified in the analysis. Finding persons with similar interests was the most frequently expressed positive aspect of dating websites (78% among homosexual men, 80% among bisexual men, 74% among heterosexual men, and 73% among women). This did not necessarily mean similar sexual interests: 22 per cent of the women, 12 per cent of the homosexual men, 6 per cent of the bisexual men, and 9 per cent of the heterosexual men claimed they had not been looking for sex partners during their visits to the sites in the previous twelve months. Many respondents reported being unsuccessful in finding a sex partner online: 18 per cent of the women, 21 per cent of the homosexual men, 24 per cent of the bisexual men, and 45 per cent of the heterosexual men. While during the previous twelve months half of the homo- and bisexual men found most (if not all) of their sex partners on the Internet, the respective proportions were 39 per cent among heterosexual men, and 67% in the small group of female respondents. Taken together, heterosexual men were the least successful in finding sex partners on the Internet. Regular use of condoms for every anal or vaginal intercourse was reported by 55 per cent of the homosexual men, 47 per cent of the bisexual men, 38 of the heterosexual men, and 34 per cent of the women. However, regarding unprotected anal or vaginal intercourse with a sex partner of unknown or discordant HIV serostatus, the proportions among the different subgroups were very similar (homosexual men: 27%; bisexual men: 31%; heterosexual men: 26%; women: 27%). The risk of transmitting a known HIV infection to sex partners was only present among homosexual (8%) and bisexual (1%) men, primarily because only respondents from these two subgroups identified as HIV-positive. For the large majority (83-86%) of men, HIV risk behaviours are the same, regardless if sex partners are met online or offline.

φ-Aromaticity in prismatic {Bi6_6}-based clusters

The occurrence of aromaticity in organic molecules is widely accepted, but its occurrence in purely metallic systems is less widespread. Molecules comprising only metal atoms (M) are known to be able to exhibit aromatic behaviour, sustaining ring currents inside an external magnetic field along M–M connection axes (σ-aromaticity) or above and below the plane (π-aromaticity) for cyclic or cage-type compounds. However, all-metal compounds provide an extension of the electrons’ mobility also in other directions. Here, we show that regular {Bi$_6$} prisms exhibit a non-localizable molecular orbital of f-type symmetry and generate a strong ring current that leads to a behaviour referred to as φ-aromaticity. The experimentally observed heterometallic cluster [{CpRu}$_3$Bi$_6$]–, based on a regular prismatic {Bi$_6$} unit, displays aromatic behaviour; according to quantum chemical calculations, the corresponding hypothetical Bi$_6$$^{2−}$ prism shows a similar behaviour. By contrast, [{(cod)Ir}$_3$Bi$_6$] features a distorted Bi$_6$ moiety that inhibits φ-aromaticity

WIRKSAMKEIT INTEGRIERTER THERAPIEANSÄTZEN BEI SCHIZOPHREN ERKRANKTEN

This article outlines two examples of cognitive-behavior group therapy approaches for an integrative treatment of psychosis: the Integrated Psychological Therapy (IPT) and the Integrated Neurocognitive Therapy (INT). We present their theoretical background, content and conceptualization as well as recent empirical evidence for their efficacy. The article concludes that adapting these approaches to early intervention for people with high risk of psychosis seems promising.Dieser Artikel stellt beispielhaft zwei kognitiv-behaviorale Gruppentherapieansätze für die integrierte Psychosebehandlung vor: Das Integrierte Psychologische Therapieprogramm (IPT) und die Integrierte Neurokognitive Therapie (INT). Ihr theoretischer Hintergrund, Inhalt und Konzeption sowie aktuelle Wirksamkeitsnachweise werden dargestellt. Der Artikel schließt mit dem Ausblick, dass eine Anpassung dieser Ansätze einen vielversprechenden Beitrag für die Frühintervention leisten könnte

"Das schnelle Date" - Internetgestützte Sexualkontakte und HIV-Infektionsrisiko: Ergebnisse einer 2006 durchgeführten Internetbefragung

"Der seit Ende der 1990er Jahre diskutierten Frage, ob bei Sexualkontakten, die über Kontaktseiten im Internet hergestellt werden, in geringerem Umfang präventive Vorkehrungen in Hinblick auf HIV-Übertragungen erfolgen als bei andernorts angebahnten Kontakten, sollte in einer im Frühjahr 2006 durchgeführten Online-Umfrage nachgegangen werden. Die Umfrage erfolgte über vier Dating-Portale für heterosexuelle Frauen und Männer und über vier Portale für homo- und bisexuelle Männer. Von den berücksichtigten 5.050 Fragebögen entfielen 76 Prozent auf Männer, die ausschließlich gleichgeschlechtliche Sexualkontakte in den 12 Monaten vor der Befragung angaben, 11 Prozent der Männer wurden aufgrund ihrer Angaben als bisexuell und weitere 11 Prozent als heterosexuell definiert. Frauen stellten lediglich 2 Prozent der BefragungsteilnehmerInnen. Etwa drei Viertel aller Befragten schätzten an Kontaktseiten, das sie darüber Menschen "mit gleichen Vorlieben" kennenlernen können, dabei muss es sich nicht um sexuelle Vorlieben handeln: So haben etwa 22 Prozent der Frauen, 12 Prozent der homosexuellen, 9 Prozent der heterosexuellen und 6 Prozent der bisexuellen Männer überhaupt keine(n) Sexpartner(in) in den 12 Monaten vor der Befragung gesucht. Online gesucht aber keine(n) Partner(in) gefunden haben 18 Prozent der Frauen, 21 Prozent der homosexuellen, 24 Prozent der bisexuellen und 45 Prozent der heterosexuellen Männer. Etwa die Hälfte der homo- und bisexuellen Männer haben ihre SexualpartnerInnen mehrheitlich oder ausschließlich über das Internet kennengelernt, während dies nur auf 39 Prozent der heterosexuellen Männer zutrifft (zwei Drittel geben dies in der kleinen Gruppe der Frauen an). Dass heterosexuelle Männer die geringsten Erfolge beim Anbahnen von Sexualkontakten über das Internet haben, zeigen auch andere erhobene Daten. Unter den Befragungsteilnehmern erfolgte regelmäßiger Kondomgebrauch bei Vaginal- oder Analverkehr - je nach Gruppenzugehörigkeit - zu sehr unterschiedlichen Anteilen. 55 Prozent der homosexuellen und 47 Prozent der bisexuellen Männer benutzten grundsätzlich Kondome, 38 Prozent der heterosexuellen Männer und 34 Prozent der Frauen gaben dies an. Hinsichtlich des Risikos, sich mit HIV zu infizieren (ungeschützter Anal- oder Vaginalverkehr mit PartnerInnen mit unbekanntem oder diskordantem Serostatus - Expositionsrisiko), bestanden nur geringe Unterschiede zwischen homo- (27%), bi- (31%) und heterosexuellen Männern (26%) bzw. Frauen (27%). Ein Transmissionsrisiko konnte lediglich in der Teilgruppe der homosexuellen (8%) und bisexuellen (1%) Männer festgestellt werden, da in den anderen beiden Gruppen niemand HIV-positiv war. Es zeigt sich, dass bei der überwiegenden Mehrheit aller Befragten das HIV-bezogene sexuelle Risikoverhalten bei online- und offline-Dates gleich ist." (Autorenreferat)"Are people more likely to risk an HIV infection with sex partners they meet online as compared to those whom they meet offline? This question has been the subject of research since the late 1990s in several post-industrialized countries. This paper presents the results of a study conducted in Germany in 2006. A link to an anonymous, self-administered online questionnaire was posted on four dating websites for heterosexual men and women and on four dating websites for men who have sex with men. Of the 5,050 respondents included in the analysis, 76 per cent were men who reported sexual contacts in the previous twelve months exclusively with other men; 11 per cent could be classified as bisexual men (sexual contacts with men and women), and 11 per cent as heterosexual men (sexual contact with women only). Two per cent of all respondents were women; because of the small number of respondents this group was not further stratified in the analysis. Finding persons 'with similar interests' was the most frequently expressed positive aspect of dating websites (78% among homosexual men, 80% among bisexual men, 74% among heterosexual men, and 73% among women). This did not necessarily mean similar sexual interests: 22 per cent of the women, 12 per cent of the homosexual men, 6 per cent of the bisexual men, and 9 per cent of the heterosexual men claimed they had not been looking for sex partners during their visits to the sites in the previous twelve months. Many respondents reported being unsuccessful in finding a sex partner online: 18 per cent of the women, 21 per cent of the homosexual men, 24 per cent of the bisexual men, and 45 per cent of the heterosexual men. While during the previous twelve months half of the homo- and bisexual men found most (if not all) of their sex partners on the Internet, the respective proportions were 39 per cent among heterosexual men, and 67% in the small group of female respondents. Taken together, heterosexual men were the least successful in finding sex partners on the Internet. Regular use of condoms for every anal or vaginal intercourse was reported by 55 per cent of the homosexual men, 47 per cent of the bisexual men, 38 of the heterosexual men, and 34 per cent of the women. However, regarding unprotected anal or vaginal intercourse with a sex partner of unknown or discordant HIV serostatus, the proportions among the different subgroups were very similar (homosexual men: 27%; bisexual men: 31%; heterosexual men: 26%; women: 27%). The risk of transmitting a known HIV infection to sex partners was only present among homosexual (8%) and bisexual (1%) men, primarily because only respondents from these two subgroups identified as HIV-positive. For the large majority (83-86%) of men, HIV risk behaviours are the same, regardless if sex partners are met online or offline." (author's abstract

Investigating emotion regulation and social information processing as mechanisms linking adverse childhood experiences with psychosocial functioning in young swiss adults: the FACE epidemiological accelerated cohort study.

BACKGROUND Adverse childhood experiences increase the risk for psychological disorders and lower psychosocial functioning across the lifespan. However, less is known about the processes through which ACE are linked to multiple negative outcomes. The aim of the FACE epidemiological study is to investigate emotion regulation (emotional reactivity, perseverative thinking and self-efficacy for managing emotions) and social information processing (rejection sensitivity, interpretation biases and social understanding) as potential mechanisms linking adverse childhood experiences and psychosocial functioning in a large population sample of young adults. It is embedded in a larger project that also includes an ecological momentary assessment of emotion regulation and social information processing and informs the development and evaluation of an online self-help intervention for young adults with a history of ACE. METHODS The study plans to recruit 5000 young adults aged 18 to 21 from the German-speaking Swiss population. Addresses are provided by Swiss Federal Statistical Office and participants are invited by mail to complete a self-report online survey. If the targeted sample size will not be reached, a second additional sample will be recruited via educational facilities such as universities or teacher training colleges or military training schools. Three follow-ups are planned after 1 year, 2 years and 3 years, resulting in ages 18-24 being covered. The main exposure variable is self-reported adverse childhood experiences before the age of 18, measured at the baseline. Primary outcomes are psychosocial functioning across the study period. Secondary outcomes are social information processing, emotion regulation and health care service use. Statistical analyses include a range of latent variable models to identify patterns of adverse childhood experiences and patterns and trajectories of psychosocial adaptation. DISCUSSION The results will contribute to the understanding of the underlying mechanisms that link ACE with psychosocial functioning which is crucial for an improved insight into risk and resilience processes and for tailoring interventions. Furthermore, the identification of factors that facilitate or hinder service use among young adults with ACE informs healthcare policies and the provision of appropriate healthcare services. TRIAL REGISTRATION NUMBER NCT05122988. The study was reviewed and authorized by the ethical committee of Northwestern and Central Switzerland (BASEC number 2021-01204)

GABA levels in left and right sensorimotor cortex correlate across individuals

Differences in -aminobutyric acid (GABA) levels measured with Magnetic Resonance Spectroscopy have been shown to correlate with behavioral performance over a number of tasks and cortical regions. These correlations appear to be regionally and functionally specific. In this study, we test the hypothesis that GABA levels will be correlated within individuals for functionally related regions—the left and right sensorimotor cortex. In addition, we investigate whether this is driven by bulk tissue composition. GABA measurements using edited MRS data were acquired from the left and right sensorimotor cortex in 24 participants. T1-weighted MR images were also acquired and segmented to determine the tissue composition of the voxel. GABA level is shown to correlate significantly between the left and right regions (r = 0.64, p < 0.03). Tissue composition is highly correlated between sides, but does not explain significant variance in the bilateral correlation. In conclusion, individual differences in GABA level, which have previously been described as functionally and regionally specific, are correlated between homologous sensorimotor regions. This correlation is not driven by bulk differences in voxel tissue composition