Retention Management für Assistenzärzte in einer psychiatrischen Klinik (German Edition)


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In , a new center for biomedical research was opened on the Hubland, which today brings together members of ten different institutions, from the faculties of medicine, chemistry and pharmacy as well as biology. Professor Dr. The research at the Department of Anatomy and Cell Biology I is carried out by 3 postdocs, 5 doctoral candidates and 2 technical assistants. Focus of research The B cell-dependent immunopathology of multiple sclerosis S.

Wagner Professor Dr. While its dependence on T cells is widely acknowledged, the contribution of B cells to the pathogenesis of MS is still questionable. Next to the production of autoantibodies and the pre- sentation of antigens B cells could be involved in the disease through the formation of ectopic lymphoid structures in the CNS. The focus of our group is to study the mechanisms underlying B cell autoimmunity in MS. On the one hand, we have established a model of experimental autoimmune encephalomyelitis EAE that is based upon active immunization of mice with the myelin basic protein MBP -proteolipid PLP fusion protein MP4.

One of the unique features of MP4-induced EAE compared to other commonly employed models is its dependence on B cells. On the other hand, following a translational approach our group is also devoted to developing strategies for monitoring the B cell dependence of MS in individual patients. The neuroimmunological research group Head: Prof. The focus of the research group tumor angiogenesis and drug delivery Head: Dr. Erik Henke; Prof. Central to our understanding of these pharmacological effects are the blood vessels that supply the tumor with Fig.

A Immune cell infiltrates in the CNS. C, D Deposition of myelin-reactive antibodies on spinal cord nerve fibers.

E Demyelination and axonal damage in the spinal cord. Wager, V. Gorboulev Currently available treatment options for multiple sclerosis MS mainly target the inflammatory component of the disease. However, it is known that neurodegeneration occurs already early on in the disease and leads to the irreversible loss of axons. Studying an animal model for MS, our initial analyses have shown that treatment with the calcium channel antagonist nimodipine leads to a decrease in axonal damage and demyelination while supporting remyelination.

This project aims to further study the mechanisms underlying the neuroprotective effects of nimodipine. Development of microglia cells from the walls of CNS blood vessels S. Macrophages and microglia occur in two subtypes. Whereas the subtype M1 asserts a pro-inflammatory role, an anti-inflammatory role is assigned to the subtype M2.

Here, we would like to investigate whether microglia cells can develop from the walls of CNS blood vessels. Subsequently, we are going to study the role of these microglia cells in neuroinflammation. A local neogenesis of microglia cells in patients with MS would underline the need for treatment strategies that pass the blood-brain-barrier, are effective in the CNS itself and also target the innate immune system.

B: Density, shape and size of blood vessels differ significantly in different tumors. Immunohistological staining for CD31 for visualization of blood vessels in two different tumors. Re-engineering of the tumor vasculature for improved drug delivery E. Henke, S. This is at least partially caused by the constant overstimulation of the vasculature in the permanently remodeling tumor microenvironment.

As a result the re-engineered vasculature was more mature and better organized, and was able to supply the tumors with increased levels of anti-tumor agents. In individual tumors the vessel phenotype can vary strongly, because different cellular pathways that are involved in generating the defective tumor vessel phenotype are variably activated. A large variety of regulating proteins have been identified as potential targets to improve vessel quality. To identify the most promising targets for changing the vessel structure, we established methods to assess the various defects in the tumor vessels and correlate them with expression profiles of key mediators in these pathways.

Teaching activity Courses in microscopic and macroscopic anatomy, neuroanatomy and cell biology are held for medical, biomedical and dentistry students a total of about students a year. It is our ultimate goal to develop novel therapeutic strategies for MS that target the B cell component of the disease. Acta Neuropathol. Cancer Res. In a further project we want to explore the contribution of local progenitor and stem cells to tumor vascularization, particularly those resident in the wall of pre-existing blood vessels. The stem cell and regenerative medicine group Head: Prof.

Edenhofer; Prof. The research of neuromorphology group Head: Prof. Asan; Prof. Kugler studies structural basis of complex functions in the nervous systems such as monoaminergic and peptidergic systems and their interactions on neuronal networks in the amygdala. The research work at the Department II is carried out by 10 postdocs, 6 doctoral candidates and 5 technical assistants. Wagner, H. Bauer Cardiovascular diseases are leading among the deadly ending disorders worldwide. The research of the cardiovascular group is aiming on exploration of mechanisms governing the endothelial barrier, formation of neointima and atherosclerosis and regeneration of blood vessels using in vitro- endothelial migration, proliferation and tube formation assays , ex vivo- arterial ring assays and in vivo models mouse models.

In particular, the contribution of vessel wall-resident progenitor and stem cells to the formation of neointima and atherosclerosis, as well as the mechanistic role of CEACAM1 and CEACAM1-Isoprostan interaction in these processes and in the regulation of the endothelial barrier, will be studied in vitro and in vivo using mouse models as Ceacam1-KO, Ceacam1 endothelial transgene and thromboxane receptor-KO. Tumorangiogenesis, Lymphangiogenesis and Tumor Metastasis S. Allmannritter, M.

Veyhl-Wichmann, V. Pfeiffer Cancer is the second leading cause of death worldwide. Tumor growth and metastasis require new blood vessels. The cardiovascular group Head: Prof. The damage of this barrier is one of the leading causes of vascular disease such as endothelial dysfunction, vascular inflammation and atherosclerosis. The tumor angiogenesis group Head: Prof. As shown in this figure, VW-SCs can be mobilized in both directions: i toward the outside of the vessel wall, for example, by signals released from tumor cells, inflammatory processes, and tissue ischemia, and ii toward the vessel lumen, for example, hypoxia of the vessel wall, endothelial injury, and atherosclerotic plaque development pl.

In these processes, VWSCs may contribute to new vessel formation and also to accumulation of inflammatory cells. Finally, VW-SCs hypothetically can be mobilized from their niche into the vasa vasorum and thus may contribute to the pool of circulating stem and progenitor cells. A plethora of nuclear proteins play an important role in the integrity of the nucleus. We investigate such proteins e. Kanadaptin, Lamins in the context of fundamental and pathophysiological processes e. Our group is working on molecular and cellular mechanisms of tumor vessel formation via angiogenesis and postnatal vasculogenesis using in vitro-, ex vivo und in vivo models.

A particular focus of our research lies in understanding of the role of the cell adhesion molecule CEACAM1 in tumor new vessel formation. In a project granted by the DFG, we focus on the role of this molecule in lymphangiogenesis and lymphatic metastasis of prostate cancer. Furthermore, we are studying the mechanisms of vascular remodeling under anti-angiogenic therapy, e. In this context also the role of stem and progenitor cells resident in the adventitia of pre-existing blood vessels will be investigated. Stem Cells and Regenerative Medicine F. Edenhofer, P. Stoll, S. Patient-derived reprogrammed cells, such as induced pluripotent iPS cells, represent an attractive platform for both, the modeling of diseases in the cell culture dish and the development of cell and tissue repair strategies.

For the first time, our group was able to derive artificially induced neural stem iNS cells from mouse fibroblasts. Additionally, we showed that transplanted iNS cells yield in partial recovery in animal models for demyelinating diseases. In a second line of research we identified in the adventitia of human blood vessels a niche which we termed vasculogenic zone harboring stem and progenitor cells that are able to differentiate beyond the vascular lineage.

Our research activities aim at the reprogramming and recruitment of endogenous stem cells, respectively, of the cardiovascular system for cell replacement therapy. Neuromorphology E. Asan, P. Kugler Research of the neuromorphological groups is focused on analyses of the structural basis of complex functions in the nervous system. Investigations are, for instance, carried out on the influence of monoaminergic and peptidergic systems and of their interactions on neuronal networks in the amygdala, a brain area with key functions for emotional processes.

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Another central project is aimed at elucidating the subcellular localization and translocation of transport molecules for glutamate in glutamatergic neurons. Glutamate is the most important excitatory neurotransmitter and has to be eliminated after being released from the synapse by glutamate transporters to prevent neurotoxic effects. Further lightand electron microscopic studies are carried out in cooperation with clinical groups, for instance as contributions to investigations into alterations of specific neurons in genetic mouse models for disorders of the nervous system, into the exact morphology of specific projection systems in the basal ganglia, and into the cellular and subcellular localization of molecules involved in various signal transduction processes in the central and peripheral nervous system.

The Department II organizes an annual workshop of the Anatomical Society every two years next event in the last week of September Right figure panel: induced neuronal stem cells iNS cells directly converted from mouse fibroblasts differentiate into astrocytes in an in vivo model. Sci Rep. Am J Physiol Endocrinol Metab. Int J Cancer Cell Stem Cell Brain Struct Funct. The building accomodates the research laboratories and offices, a lecture hall seating students, course laboratories, seminar rooms, and a library.

Facilities for animal husbandry, for work with radioactive isotopes and a repair shop are also available. The research at Vegetative Physiology is focused on Cardiovascular Physiology and three research groups are led by the University Professors Dr. Michaela Kuhn, Dr. Andreas Friebe and Dr. Kai Schuh. To dissect the regulation, pleiotropic functions and disease relevant alterations of these hormones and of cGMP, we generate and characterize genetic mouse models with conditional, cell-specific deletion of these receptors or of regulatory proteins involved in their signal transduction.

Kuhn, B. Oberwinkler, W. Chen, F. Werner, T. Premsler, S. Hupp, H. Nakagawa, M. Klaiber and coworkers teract pathological cardiac remodelling. CNP influences electromechanical coupling, for instance by stimulating cGKI-mediated phosphorylation of phospholamban and troponin I, ultimately enhancing inotropy and lusitropy.

The role of these signaling pathways in cardiac homeostasis is emphasized by the phenotype of mice with cardiomyocyte-restricted inactivation of cGKI, which develop severe dilatative cardiomyopathy in response to enhanced cardiac afterload Frantz et al. Our research demonstrates interesting similarities of ANP signal transduction in cardiomyocytes and endothelial cells. Thereby ANP stabilizes the endothelial barrier and attenuates an acute inflammation.

Instead, this hormone, which is made by chondrocytes and endothelia, critically stimulates long bone growth. In collaboration with Dutch colleagues we characterized an heterozygous activating mutation of the GC-B receptor in a patient with skeletal All cardiovascular cell types express both particulate GC-receptors, GC-A and GC-B, although at very different densities.


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Friebe, D. Groneberg, R. Lies, N. Bettaga, S. As the most important receptor for the signaling molecule nitric oxide NO NO-GC is involved in many physiological regulatory processes. We have generated transgenic mice with global deletion of NO-GC. These mice show increased blood pressure, gastrointestinal dysmotility, early postnatal lethality and shortened bleeding time. The identities of the individual cell types and tissues responsible for the respective phenotypes are not yet clear. To characterize the role of NO-GC in gastrointestinal motility and lower urinary tract function, we generated mouse KO lines in which NO-GC is specifically ablated in smooth muscle cells or interstitial cells of Cajal or both.

Our observations in these mice showed that both smooth muscle cells and interstitial cells of Cajal mediate gastrointestinal nitrergic relaxation Groneberg et al. Physiological characterization of EVH1 domain-containing proteins K. Schuh, M. Ullrich, M. Benz and co-workers Gene trapping is an elegant tool to combine the ablation of a specific gene with parallel analyses of promoter activity of the trapped gene. We used this technique to characterize the relevance of various EVH1 domaincontaining proteins in vivo.

Of particular interest are the involved intracellular signalling pathways and the regulation of the cytoskeleton. Teaching The chairs of Vegetative Physiology and Neurophysiology offer a broad spectrum of lectures, integrative seminars and practical courses for students of Medicine, Dentistry, Pharmacy, Biology, and Biomedicine. A major focus is the intensive teaching of Vegetative Physiology and Pathophysiology to students of Medicine 3rd - 4th term. These university fundings must be dedicated to improve teaching. The role of the KHD is uncertain.

Our observations unravel a new potential molecular target for the treatment of achondroplasia Type Maroteaux. Cell Commun Signal. Eur Heart J. Gastroenterology J Clin Endocrinol Metab E J Physiol. We use the mouse and the fruit fly Drosophila melanogaster as prime model organisms and combine electrophysiological methods, molecular biological and genetic tools with high-end microscopy.

Neuser, M. Heckmann Intelligent behaviour is based on learning and usage of memorized contents. Drosophila melanogaster flies show intelligent behaviour as well. For example, they possess a spatial working memory. That is, they are able to store the position of visual objects and to use that memory content to show goal-directed movement even if the object has disappeared.

This project aims to test whether the neuronal correlate of working memory can be linked to the molecular organisation of presynaptic proteins. Distinct sets of necessary neurons will be identified and the learning performance of transgenic fruit flies with altered compositions of presynaptic active zone proteins will be tested.

Nanoscopy of endplate active zones M. Pauli, M. Heckmann Presynaptic active zones are too small to be resolved by conventional light microscopy. In electron micrographs active zones of neuromuscular endplates appear as ordered structures. We study endplate active zones using super-resolution dSTORM light microscopy together with the Sauer laboratory Department of Biotechnology and Biophysics with the aim to identify the molecular components of this ordered structure. Molecular mechanisms of synaptic differentiation M. Paul, M. Heckmann Information processing in the nervous system is regulated by interaction of numerous proteins.

Electrophysiological techniques as well as confocal and super-resolution microscopy are used to investigate the mo- 20 lecular mechanisms of functional and structural differentiation of active zones. Langenhan Adhesion-GPCRs are evolutionarily highly conserved receptors that are present on cell surfaces of all major tissue types from earliest developmental stages onwards until adulthood. Several physiological functions of Adhesion-GPCRs have been determined including their contribution to tissue polarity, cell fate induction and the facilitation of specific cell-cell interactions.

We are specifically interested in the processes involved in Adhesion-GPCRs signal perception and transduction. Regulation of cellular excitability by potassium background currents E. Wischmeyer, F. The activity of K2P channels is modulated by various physical and chemical stimuli as well as by G-protein coupled receptors. Therefore, we address the question whether excitable processes of nociception and inhibitory effects of K2P channels are regulated by identical signaling cascades. These properties may explain the beneficial antidepressive effects in brain as well as unwanted arrhythmias in heart.

The importance of K2P channels for heart action and cardiac side effects of antidepressants are currently investigated in knockout mouse models. Changes in serotonin metabolism substantially interfere with emotional states such as mood and anxiety. Neuronal potassium channels are controlled by the activation of different serotonin receptors and thus are molecular targets for changes in emotions. Teaching Fig. Investigations by the Kittel Emmy-Noether group in collaboration with the Sauer laboratory Department of Biotechnology and Biophysics concerning the spatial distribution of the Bruchpilot Brp protein in active zones.

A and B from Kittel et al. Physiology and plasticity of the active zone in vivo R. Kittel, DFG Emmy-Noether research group leader Synapses are specialised intercellular contact sites, which serve as the communication link between neurons and their partner cells. Transmitter substances released by this process then diffuse across the synaptic cleft and are sensed by postsynaptic receptors to convey signal transduction. A hallmark of synaptic transmission is its plasticity, which enables synapses to regulate complex brain processes by filtering, modifying, or integrating information.

The details of active zone physiology and how its modulation contributes to synaptic plasticity are, however, barely understood. The clinical aspect of human physiology is conveyed in integrated seminar series, which are held in collaboration with clinicians, which co-lecture on physiological topics. Cell Rep J Cell Sci: Curr Biol. All research groups at this unit use molecular methods to understand problems in Biology and Medicine on all levels of the biological organization. The multi-faceted approach is reflected in the fact that scientists of the department are developmental biologists, molecular biologists, biochemists and biomedical researchers and that the head of the institute is a member of the Medical Faculty as well as of the Biological Faculty.

The research focus is the molecular understanding of developmental processes and the pathobiochemistry of cancer. Major Research Interests Molecular analysis of melanoma formation M. Schartl Due to the enormous complexity and variety of human cancerous diseases, animal models are especially necessary because they are well suited to analyse basic mechanisms of tumor development and tumor progression on the genetic and molecular level.

Our group is mainly interested in the processes and mechanisms of melanoma development, which is studied in several elaborate model systems, including laboratory fish and mouse models, in vitro cell culture systems and patient material. One focus is traditionally the studies on the small aquarium model species, Xiphophorus and Medaka, which represent well established and useful melanoma models. During the last two years, we have performed DNA high throughput sequencing transcriptome analyses of different types of melanoma, induced by the oncogenic receptor tyrosine kinase Xmrk in both model systems.

We found a high level of similarity in expression regulation of known and novel tumor related genes in fish melanoma and human melanoma. These are now further investigated for their functional relevance for melanoma development. Recently, we have also included the analysis of microRNA and other non-coding RNA classes because those molecules are expected to play a role in tumor development.

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However, their function for the oncogenic processes are so far not understood. Fishes of the genus Xiphophorus are the oldest animal model for melanoma development. The system was first described in the twenties of the last century and the causative oncogene xmrk has been isolated more than twenty years ago. Many aspects of tumor development, however, are still not understood. Since we now have the full genome sequence of this animal model.

This is a milestone for our research because the availability of the genome and other genomic resources is a rare condition for ans- Fig. The picture above shows a control fish, the picture below shows the tumor fish. Blood vessels express GFP and therefore glow green. We have indication that secreted factors from vemurafenib treated melanoma cells contribute to resistance and we are currently testing this hypothesis. Gaubatz wering many open questions of melanoma development in this animal system and provide unique resources for the future to study cancer from the evolutionary and comparative pathobiochemical point of view.

The analysis of the Xmrk mediated signal transduction is another focus of our research. This leads to an extremely efficient and hypoxia-independent tumor angiogenesis, which can even be elicited from single xmrk expressing transformed pigment cells Figure 1. Similarly, human melanoma cells exhibit high intrinsic levels of NF-kB, which also display a strong angiogenic effect. However, if ROS levels are too high, this leads to senescence. We have found that the transsulfuration pathway, which is responsible for de novo synthesis of cysteine, can inhibit ROS mediated senescence. Melanoma cells show an enhanced ROS production.

Consequently the inhibition of the transsulfuration pathway caused the induction of senescence and apoptosis. A possible therapeutic use of this observation is currently studied in mouse models for human melanoma. The ROS induced senescence of melanoma cells is just one example for therapy induced senescence. In collaboration Our research focuses on E2F transcription factors, the retinoblastoma protein and related pocket proteins. These proteins play key roles in the regulation of cellular proliferation, differentiation and apoptosis and they have been implicated in tumorigenesis.

Genome wide expression studies have shown that DREAM mediates the activation of a cluster of genes required for entry into mitosis, spindle assembly and cytokinesis. It has been proposed that overactivity of these mitotic proteins contributes to chromosomal instability and thus promotes tumorigenesis. We are currently investigating the role of DREAM in an in vivo mouse model of lung cancer driven by oncogenic Ras and mutant p These studies could lead to the development of new therapeutic approaches for lung cancer.

We are also interested in the function of novel target genes of DREAM such as GAS2L3, an actin and microtubule-interacting protein that plays important roles in cytokinesis and genome stability. Immunohistochemistry staining of lung tumors and adjacent normal lung tissue from a mouse model of lung cancer 13 weeks after activation of oncogenic Ras and loss of p Nature Genetics Oncogene Cell Cycle J Cell Sci — Biochemistry and Molecular Biology teaches biochemistry for preclinical students in Medicine and Dentistry and for the Bachelor students of Biomedical sciences.

Five research groups work at BMB, two of which are headed by junior investigators Dr. Nikita Popov and Dr. Armin Wiegering; Dr. Daniel Murphy, a third junior group leader was promoted to a faculty position at the Beatson Institute, Glasgow, in The major research aim of BMB is to understand the function of the Myc family of nuclear oncoproteins, which contribute to the majority of all human cancers. A second research aim is to use mouse models and functional genomic tools to identify novel strategies for the therapy of human cancers.

Eilers The MYC family of proto-oncogenes participates in the genesis of the majority of all human tumors.

GianCarlo Molteni

The three genes of this family encode nuclear proteins that are central regulators of cell growth and cell proliferation. They exert this control at least in part by binding to specific DNA sequences and affecting the transcription of multiple genes involved in protein syn- thesis, metabolism and cell proliferation.

Many central questions about the basic function of Myc and the regulation of its multiple activities remain unanswered. The aim of our research is to unravel how Myc functions and to devise strategies to use this knowledge for the treatment of human disease. The junior group of Nikita Popov studies ubiquitination of Myc and its functional consequences; the clinically oriented junior group of Armin Wiegering investigates c-Myc interacting proteins and activating pathways in colorectal cancer to define new therapeutic strategy in co-operation with the Department of Surgery I ; the group of Daniel Murphy in Glasgow since develops novel mouse models to study the role of Myc in tumor progression.

Control of Cell Growth in Drosophila P. Gallant The fruit fly Drosophila melanogaster offers a unique model system that allows the genetic analysis of pathways controlling cellular growth, and of their effects on organismal growth and on cell proliferation. We use this system to investigate the evolutionarily conserved function of Myc in cellular growth. In addition, we characterize the systemic pathways that coordinate the rate of growth between different organs within the animal.

The left panel shows the survival of mice with neuroblastoma induced by N-Myc overexpression, after control treatment blue curve and after treatment with an inhibitor of Aurora-A red curve. The right panel explains the putative effect of Aurora-A on N-Myc stability. The data are taken from Brockmann et al. Upon systematic manipulation of individual genes in the fat body red tissue in the left panel , the resulting effect on imaginal disc size green tissue in the left panel is measured enzymatically.

The right panel shows an example of 20 tested genes that do not significantly affect the fat body derived systemic growth signal, and one that does marked by a yellow box. We also teach Biochemistry to the 24 annual students of Biomedicine B. Nature Communications PLoS One 8:e Cancer Cell Gallant P. Cold Spring Harbor Perspectives in Biology 3:a Nature The current focus is on the development of the cardiovascular system and the kidneys as well as on childhood kidney cancers, i. This is a prerequisite for the formation of precursor cells that are in turn needed to build the cardiac septum and valves.

This could be demonstrated through in vitro and in vivo analysis of cardiac precursors from knockout mouse embryos. Hey1 and Hey2 also appear to participate in the positioning of the atrio-ventricular canal as an organizing center. The target genes of Hey factors in these processes are still largely unknown.

Current efforts are directed towards their identificati- on through gene expression analyses and sequencing of binding sites in the genome based on ChIPseq analyses. For this we employ various cell types including embryonic stem cells, which can be differentiated in vitro into cardiomyocytes or endothelial cells.

In this way global as well as cell-type specific regulatory mechanisms of Hey proteins can be elucidated. These could be utilized to gain novel insight into cardiac electric activity and conduction, where Hey2 seems to play an important and previously unrecognized role. Hey genes are also important for embryonal angiogenetic remodeling and for arterialization of blood vessels.

A lack of Hey1 and Hey2 results in a lethal angiogenesis defect. Again, in vitro differentiation systems are employed to recapitulate these processes and to identify or to modulate corresponding target genes. Besides these cardiovascular functions we could identify first hints for a role of Hey2 in the development of the organ of Corti and for Hey1 in the activation macrophages.

While Hey2 functions in the inner ear appear to be independent of Notch signaling, the latter is essential in macrophages. Furthermore, Hey1 and HeyL are involved in bone homeostasis. This underscores that Hey genes can be activated by different stimuli in a variety of cell types and they likely regulate a multitude of physiological functions, as has been expected from their complex expression patterns in numerous organs. For Biology and Biochemistry students advanced modules with a focus on Biochemistry, Developmental Biology and Tumor Biology are offered.

Within the framework of the German Wilms tumor study we have established a tumor bank that by now includes more than tumors and corresponding control tissues. These are routinely screened for chromosomal alterations and mutations in known tumor genes like WT1 or CTNNB1 and they are used to identify novel biomarkers and target structures for improved diagnosis and treatment. All attempts to analyze the biology of Wilms tumors through in vitro experimentation have been hampered by the lack of suitable cell culture systems. We have now established and characterized a series of primary cultures that can be used for functional studies.

These cultures recapitulate critical features of these tumors, namely the stromal and epithelial components. We have not yet been able to establish conditions for the growth of the blastemal compartment. Several primary cultures could be immortalized through telomerase expression, yielding permanent stable lines. This now opens up the possibility to perform functional studies in vitro on standardized cells that are amenable to genetic manipulation and still represent typical Wilms tumors.

Our microarray analyses revealed that tumors which poorly respond to chemotherapy treatment are characterized by a decreased activity of the retinoic acid signaling pathway. Thus, activation of this pathway might in turn be beneficial for patients. This could be substantiated in experiments with primary tumor cell cultures. First therapeutic trials of individual cases have already been initiated based on these results.

Using our series of additional primary and immortalized cultures we could show that retinoic acid derivatives slow down the growth of tumor cells and induce their differentiation. We observed differences in the effects of individual retinoids that may become relevant for future therapeutic application. In cooperation with hipo Heidelberg Initiative for Personalized Oncology we could employ high-throughput methods for mutation screening and expression analysis in the high-risk group of blastemal-type Wilms tumors.

We were able to identify several novel candidate genes that currently undergo extensive validation. The pathways affected already now provide us with new and unexpected insights into the biology of these tumors and their genetic makeup. Teaching Together with the Chairs of Physiological Chemistry and Biochemistry and Molecular Biology we offer a broad spectrum of lectures, seminars and practical courses.

A focus is on the theoretical and practical training of more than students of Medicine and Dentistry in their curricular subjects Biochemistry and Molecular Biology. Montero Gonzalez, M. Fernandez, V. Feldman, Per A. Newcorn, J. Robert Mestel, Germany In pursuit of truth which therapies will determine the future? Aichberger, Germany. Servaas, Date C. Schroeter Postoperative delirium and postoperative cognitive dysfunction: is there relationship to dementia? Angermeyer, Tobias Luck, Steffi G. Verhagen, The Netherlands What happens if we solve our world's crisis with amygdala driven reactions social psychiatry perspectives Roy Abraham Kallivayalil, India How does the juridical system respond to world's crisis a diagnosis Sabine Koenig, Germany Religion and conflict what can we learn from comparative religion?

Peter J. Nordic approaches Marianne C. Two case studies denoting new conditions for partnership between psychiatrists and faith healers in Saudi Arabia Asmaa Ebraheem, Egypt Assabeyya, idiom of distress: an exploration of Egyptian women's suffering in contemporary Cairo Heba Allah Habib, Egypt Abdelwahed Mekki-Berrada Dangerous or vulnerable a genealogy of difficult and violent adolescents in France Yannis Gansel, France Tandems between professionals and lay experts towards sustainable mental health vs.

Lang, Christian G. Berner, Germany. Schatzberg, USA Translational research approaches focused on mechanisms underlying the risk to develop stress-related psychopathology Ned H. Kees Laban, The Netherlands Racism, discrimination and mental distress Carlos Zubaran, Australia Effective interventions to reduce mental health stigma and discrimination Graham Thornicroft, United Kingdom Xenophobia and mental health: discrimination, depression and the suffering of refugees in the new South Africa Jonathan Burns, United Kingdom Addressing racism and discrimination through culturally informed mental health policy and practice Laurence J.

Juan J. Kostas Fountoulakis, Greece Family educational and training programs in different psychiatric contexts Massimo Clerici, Italy Ester di Giacomo Biobanking, biomarkers, and multi-omics in psychiatry: a comprehensive perspective Thomas G. Asokan, India Highlights of psycho-legal issues in a prospective data of a tertiary care hospital in Pakistan Fareed A. Beine, Germany Hilf dir selbst, sonst tut es keiner Karl H.

Dan Rujescu, Germany Translational imaging evidence for functionality and mechanisms of GWA-identified genetic variants Andreas Meyer-Lindenberg, Germany Epigenetic processes in neuropsychiatry disorders Moshe Szyf, Canada S Symposium Hall A1 TOPIC 3: Psychotic disorders Symptom dimensions in schizophrenia brain correlates and personalised treatment options Chairs: Tilo Kircher, Germany Werner Strik, Switzerland A three dimensional symptom structure of schizophrenia is linked to specific structural and functional brain changes Werner Strik, Switzerland The neurobiology of formal thought disorder: specific for schizophrenia?

Tilo Kircher, Germany Speech graphs and brain graphs: can we improve outcomes of schizophrenia by targeting language? Lena K. You're making me sick! The controversial diagnosis of gender incongruence of childhood Annelou L. Krueger, USA Can clinicians tell the difference between mental disorders and private behaviours?

Menon, T. Grund Transgenerational cycle of maltreatment: biological effects in the peripheral organ system and its implications for psychotherapy research Christiane Waller, Germany S. Krause, R. Fegert, I. Kolassa, U. Gablonski, J. Reed, Switzerland. Montag, A. Matthey, Z. Strasser, T. Kaiser, A. Wullschleger, J. Berg, N. Alan F. Schatzberg, USA Using multimodal predictors for antidepressant treatment response from neuroimaging to genetics and epigenetics Elisabeth Binder, Germany Using a nonhuman primate model of anxiety to inform the development of personalized treatments Ned H.

Chairs: Maike Rotzoll, Germany Volker Roelcke, Germany Resources for each other the Society of German Neurologists and Psychiatrists and Nazi biopolitics Hans-Walter Schmuhl, Germany Give them back a part of their dignity research on the victims of patients' murder Euthanasia and its significance for understanding national socialist psychiatry Maike Rotzoll, Germany Brain tissues as a legacy of Nazi psychiatry and their post-war use, Paul Weindling, United Kingdom. Marie Spies, Germany The new proposed neuroscience-based nomenclature for psychotropic medications Thomas Baghai, Germany.

Margret Osterfeld, Germany. Was brauchen wir? Lymberis, USA. The association between suicidality and religion in depressed, religiously affiliated patients Matthias Jongkind, The Netherlands. Mirella Ruggeri, Italy Continuity of care or specialisation: what do clinicians prefer? Jacek Moskalewicz, Poland Marta Welbel, Justyna Klingemann Which service organisation model can reduce hospital admissions and improve clinical and social outcomes? Lee, USA The oxytocin system and social-cognitive functioning in schizophrenia is nasal oxytocin a potential treatment option?

Mohandas Warrier, India Gut microbiota a primer E. Naveen Kumar, V. Ramesh, Thirthalli Jagadisha, Bangalore N. Gangadhar Predictors of relapse among patients with psychosis and bipolar disorder from Eastern Crete Maria Anastasaki, Greece Emmanouil Pasparakis, Panagiotis Simos, Eirini Koutentaki, Alexandros Vgontzas, Konstantinos Faloutsos, Giorgos Mavroidis, Georgia Kalomoiri Increased densities of T- and B-lymphocytes and plasma cells in post mortem brains of schizophrenics and patients suffering from affective disorders indicate neuroinflammation in patient subgroups Konstantin Schlaaff, Germany Scarlett V.

Bhargavi Davar, India. Milan Latas, Serbia Culture and assessment of psychopathology: a focus on Australian Aboriginal people Aleksandar Janca, Australia Dimensional and categorical assessment of personality disorders: advantages and disadvantages Peter Tyrer, United Kingdom Assessment of transdiagnostic constructs: how helpful are worry, intolerance of uncertainty and dysphoria? Kalmady, Vijay Danivas, Janardhanan V. Narayanaswamy, Shivarama Varambally, Ganesan Venkatasubramanian The influence of task-irrelevant threat on the early electrocortical processing stages in individuals with schizophrenia and healthy controls Barbara Schulte Holthausen, Germany Christina Regenbogen, Thilo Kellermann, Frank Schneider, J.

Rao Medication and bipolar mixed states? Reed, Switzerland Symptom severity qualifiers and course specifiers in ICD primary psychotic disorders: could they contribute to adequate pay for performance? Stefan Borgwardt, Switzerland What can our knowledge about the brain contribute to psychopathology? Plaedoyer for a spatiotemporal psychopathology Georg Northoff, Canada Semantic processing and semantic experience in people with schizophrenia: a bridge between phenomenological psychopathology and neuroscience?

A randomised, double-blinded, placebo-controlled clinical trial Anders Fink-Jensen, Denmark. Meyer Is psychoeducational family intervention feasible in the Italian mental health centres? Shiroma, Subhagya Kulatunga, Tharaka Dassanayake. Austin Goethe's creative self- therapeutic strategies to overcome depressive episodes Rainer M. Cernovsky, Canada Jack R. Herpertz, Germany Current evidence for psychological interventions: updated Cochrane review Eric Simonsen, Denmark Socio-cultural aspects of the clinical management of personality disorders Renato Alarcon, USA Abnormal brain mechanisms as targets of psychotherapy in borderline Sabine C.

Thorup, Ole Mors. Corrigan, USA What can research contribute to anti-stigma work? Patrick W. Verhagen, The Netherlands Presentation of the position statement and its practical implications for research, education and clinical practice Alexander Moreira-Almeida, Brazil Position statement on spirituality and religion in psychiatry: a matter of attitude Peter J. Wai Lun Alan Fung, Canada Interfaith mental health alliance for holistic, cost effective, culturally sensitive health care delivery Avdesh Kumar Sharma, India Practical spirituality for mental health issues: some key concepts and principles of Brahmakumaris Rajyoga lifestyle Sujatha Devanathan Sharma, India Stigma and stigmata: the intersection of spirituality, stigma and mental health discrimination Alison J.

Quevenco, Anton F. Nitsch, Christoph Hock Are anxiety disorders associated with accelerated aging and cognitive decline? Baena Mures, J. Reed, Fareed A. Stanley, J. Lyketsos, USA. Schroeter, Germany Meta-analysis of cytokine alterations in psychiatric disorders: comparisons between schizophrenia, bipolar disorder, and depression David Goldsmith, USA C-reactive protein is increased in schizophrenia but is not altered by antipsychotics: meta-analysis and implications Brisa S.

A European perspective on care for patients with chronic disorders Stefan Priebe, United Kingdom Chances and challenges of working in partnership with users and family carers Michaela Amering, Austria Providing care for people with severe mental illness: what should the research focus be? Beine, Germany Ich will das auch! In 7 Schritten zur Resilienz Bodo K.

Wolfgang Fleischhacker, Austria Epi genetics new avenues towards personalized treatment in psychiatry? Chairs: Thomas G. Roland Freudenmann, Germany Duration of untreated psychosis and its impact on the outcome in delusional disorders including delusional infestation Dmitry V. Chairs: Rachid Bennegadi, France Roy Abraham Kallivayalil, India Differing perspectives from the developing and developed countries Roy Abraham Kallivayalil, India Providing care to people in precarious situations: social and cultural competence Rachid Bennegadi, France Social determinants of mental health: the universal and the local Fernando Lolas, Chile Social determinants of mental health: the role of psychiatric organisations Marianne C.

Marien-Hospital Eickel Peter W. A comparison to benzodiazepines with special regard to withdrawal reactions Tom Bschor, Germany The withdrawal of neuroleptics: When to do so? When not to do so? What then? McMahon, Thomas G. Schulze, Bernhard T. Peter C. Vladimir Carli, Sweden Utilization of clinical biomarkers for the evaluation of suicide risk Philippe Courtet, France Suicide risk assessment: where are we now?

Toshimasa Maruta, Japan The cooperation between attending physicians and occupational physicians in the support of employees with mental disorders in Japan Hisanori Hiro, Japan Who pays for what? Marc Masson, France Which biomarkers for lithium response? Frank Bellivier, France Is lithium therapy really at risk for kidney?

Pim Cuijpers, The Netherlands Is individualized psychotherapy a motor of innovation? Winston Shen, Taiwan From evidence-based medicine to precision medicine of depression in Korea Min-Soo Lee, Republic of Korea Is there a role for Chinese acupuncture in the treatment of depressive disorders? Roger Ng, People's Republic of China. Lagos-Grisales, Alfonso J. Domes, Sarah E. Fromme, Tracy M. Baune The watchdog won't stop barking! Decreased amygdala inhibition by prefrontal cortex in major depression: the influence of medication, genetic predisposition and childhood maltreatment Roman Kessler, Germany Igor Nenadic, Verena Schuster, Miriam H.

Bopp, Kristin M. Noethen, Stephanie H. Kastrup, Denmark Health care services for female refugees in Australia Kym Jenkins, Australia Results of a representative study: expectations of female refugees Meryam Schouler-Ocak, Germany S Symposium Hall Helsinki 1 TOPIC 6: Eating disorders, sleep disorders and other disorders of this category New developments in the treatment of eating disorders over the life span Chairs: Beate Herpertz-Dahlmann, Germany Ulrike Schmidt, United Kingdom Treatment setting matters advantages and disadvantages of inpatient, day patient and home treatment in young patients with AN Beate Herpertz-Dahlmann, Germany Repetitive transcranial magnetic stimulation: new hope for patients with severe and enduring anorexia nervosa?

Gillespie, Steven H. Aggen, Robert F. Krueger, Kenneth S. Marta Torrens, Spain Improving treatment for individuals with severe dual diagnosis: available evidence, current treatment models, and new directions Christian G. Schulze, Germany Raju M. The patient experience! Anil Thapliyal, New Zealand Can computer games treat anxiety? Sally Merry, New Zealand Web programs as add-on and alternative to conventional care? Schulze, Germany Dan Rujescu, Germany Molecular-genetic correlates of long-term outcome in psychoses: what can be done with a well-characterised cohort?

Herpertz, Romuald Brunner, Sibylle Maria Winter, Andreas Heinz, Stefan Roepke, Christine Heim, Felix Bermpohl A systematic review of depressive disorder and depressive symptoms amongst sexual minority youth: are gay kids really more likely to feel down? Asokan, G. Srinivasagopalan, C. Maikandaan OS Oral Presentation Session Room R5 TOPIC Stimulation methods and interdisciplinary interventions Stimulation methods and interdisciplinary interventions Chairs: Alexander Sartorius, Germany Oliver Gruber, Germany Promising results on treatment of prolonged and chronic depression through cross-sectorial and multi-professional collaboration Heidrun Faninger-Lund, Finland Study on effects of add-on transcranial direct current stimulation tdcs in patients with schizophrenia Premchand Karuppannan Chandrasekaran, India Samir Kumar Praharaj Efficacy of transcranial direct current stimulation tdcs in somatic symptom disorder, predominantly pain: a randomized, double-blind, sham-controlled study Prashanth Peethala, India Shripathy M.

Poyares, Ana E. Rui, Alberto O. Straube, N. Bausch-Becker, E. Narayanaswamy, Shivarama Varambally, Venkatasubramanian Ganesan Disparity of end-of-life care in cancer patients with and without schizophrenia: a nationwide population-based cohort study Huei-Kai Huang, Taiwan Ying-Wei Wang, Jyh-Gang Hsieh, Chia-Jung Hsieh Effects of transcranial direct current stimulation tdcs on working memory performance in patients with schizophrenia Tobias Schwippel, Germany Christian Plewnia Collaboration with family of young adults with first episode psychosis: psychoeducation or reflexive dialogue?

Manuel Tettamanti, Switzerland Fabrice Chantraine, Logos Curtis Additive effect of religious activity in the management of patients with schizophrenia: a study from Bangladesh M. Giampaolo Perna, Italy Daniela Caldirola Do specific symptoms moderate the association between disability and symptom count in generalized anxiety disorder? Janardhan Reddy, C. Morshed, Bangladesh Sultana Algin, S. Olofsdotter, S.

Vadlin, M. Ramklint, K. Martin Koehne, Germany Wie geht eine deutsche psychiatrische Klinik mit ihrer nationalsozialistischen Geschichte um? Niels Bergemann, Germany Wolfgang E. Kim Neural correlates of psychotherapeutic treatment of posttraumatic stress disorder: a systematic literature review Verena Rau, Germany Kathrin Malejko, Birgit Abler, Paul Plener, Joana Straub Spider phobia: fear of eight legged insects or more? Reuter, Peter Tonn. Two case reports Mohammadreza Shalbafan, Iran Farzaneh Malekpour Predictors of response to celecoxib augmentation of olanzapine therapy in schizophrenia in a randomized, double blind, controlled study Kabir Garg, India Anil Nischal, Anuradha Nischal, Adarsh Tripathi, Manu Agarwal Relationship between antipsychotic treatment and metabolic parameters in a group of patients with severe mental disorder and sedentary lifestyle Luisa San Emeterio, Spain M.

Filimonov, Sergey Nikulin, A. Rudik, Alexander Dmitriev, Lyudmila Savchenko, Eugeniy Bryun Memantine augmentation improves symptoms in patients with treatment-refractory obsessivecompulsive disorder: a randomized controlled trial Setareh Razoughi, Iran Mehdi Sayyah, Leila Kouti, Kaveh Eslami Efficacy of intravenous ketamine for treatment of acute post traumatic stress disorder Achyut Trivedi, India Ashok Singhal.

Groen, U. Peter, P. Hampel, A. Karow, J. Angermeyer, Georg Schomerus. Asokan, M. Strain, Albert Diefenbacher. Rao, Shivarama Varambally, B. Horwitz B. The educational programme will consider scientific and procedure-related knowledge that contributes to the preservation and further development of psychiatric-psychotherapeutic skills. The focus is on the teaching of subject-specific and interdisciplinary contents and practicing practical skills. Schulze, Germany Hussien Elkholy, Egypt. COM German language Session. Social Media Dein Kopf voller Fragen?

The application for permission must reach the Press Office at least 24 hours before the filming date. The permission does not include the courses offered as part of the educational programme. Image and sound recordings of the exhibition and Industry Symposia require additional prior permission from the sponsoring company.

The permission is only valid for the purpose requested. Every transfer of footage to third parties and every alternative use of footage requires prior permission from the DGPPN. German language Session. Drinks will be offered. A meeting point will be provided where young professionals can easily get in touch with each other and with renowned experts. The four band members front women Holly Rose lead vocals and guitar and Lily Black backing vocals and upright bass , lead guitarist Stevie, and drummer Carl came from all over Germany before deciding to form this unique Rockabilly band in Berlin.

It goes without saying that before even playing the first chord, you'll surely notice them. Fronted by two beautiful Chicabellas with Monroe hips and poisoned lips. The Pin Sharps will and there is no doubt about this catch your eye! Get ready for to hop, skip, and jump! Willem A. Neurostimulation als Optionstherapie bei schwerbehandelbaren Depressionen?

Chair: Thomas E. DeGPT e. KG 6 E Booth-No. KG 11 V Booth-No. Our comprehensive coverage includes: Articles: original research that advocates change in psychiatric practice Reviews: comprehensive overviews that are clinically focused and up-to-date on major mental health topics Commentary: informative opinion on important recent advances Personal Views: expert interpretation of recent evidence for decision makers Insight: profiles, reviews of books and other media, features on topical issues, and news Discover more about the journal at.

Make sure to secure your ticket at the counter. The scientific visits will be accompanied by an English-speaking guide. It looks back on a year history of healing, research and teaching at the top international level with 3, doctors and scientists. The museum's special exhibitions focus on current aspects of medicine and medical history of the last four centuries. In its stocks, the museum holds quite a few historical medical collections. They also provide objects for an ongoing material research in the fields of history of science and medicine.

The permanent exhibition includes pieces of pathological anatomic moist and dry compounds, models and images. Explore the museum on a private guided tour. Berlin in the 's in memoriam of the victims You will visit the Topography of Terror one of the most frequently visited places of remembrance in Berlin. There you will have some time to individually explore the exhibition. The second stop of the tour will be the T4 Memorial and Information point for the victims of the Euthanasia killings.

Rotzoll, an expert at the Institute for History and Ethics of Medicine of the University of Heidelberg, will provide insights and background information. Meeting point: bus parking. The aim is to get more insight into the daily clinical practice and workspace environment at German psychiatric hospitals.

Contact person: Sabine Prestele Hurry up and ask at the tour congress counter for last free places. All tours will be accompanied by an English-speaking guide. Please check at the congress tour counter which tours are currently available. Tour tickets will be sold on a first-come, first-served basis, so places are limited. Please purchase your ticket at least one day prior to the respective event. Please note that advance registration is required. The tour will take you through the city centre of Berlin.

The bus will then proceed along the green lung of Berlin, the Tiergarten, the former private hunting grounds for the king and the electors of Brandenburg, in which nowadays Berlin's inhabitants as well as tourists find time to relax. You will see the Victory Column, crowned with the golden Goddess of Victory and pass by Charlottenburg Palace, a late 17th century baroque masterpiece.

Here, you will also see the Memorial Church, the symbol of the city, preserved as a ruin. You will then continue towards Potsdamer Platz where you will get an impression of what used to be the biggest construction site of Europe. A historic place and the last stop on this tour will be Checkpoint Charlie, the famous former border crossing in the heart of Berlin.

Until the fall of the Berlin Wall on 9 November, , it signified the border between West and East, Capitalism and Communism, freedom and confinement. City of contrasts Mon, 9 Oct To many of the Berlin visitors and tourists, the most important attraction is in its recent decades. People want to discover the city's Cold War past and its island status. On this tour your guide will take you back in time and show you the most famous sites. During the 40 years of Berlin's separation, the East and the West side developed in completely different ways.

Although, the precise course of the wall is hardly traceable a lot of the aftermath of the separation is still noticeable and visible. Your guide will point this out along the way. A historic place and the first stop on this tour will be Checkpoint Charlie, the famous former border crossing in the heart of Berlin. Until the fall of the Berlin Wall on 9 November , it signified the border between West and East, Capitalism and Communism, freedom and confinement.

Afterwards you will pass the East Side Gallery, an 1,3 km long stretch of the former Berlin wall that was left as a memorial and painted by artists from all over the world after the fall of the Berlin Wall. It now stands as Europe's most famous open-air gallery with over one hundred paintings. The next and last stop is the Berlin Wall Memorial.

This part of the wall has been preserved in commemoration of the people who suffered communism. This is probably the best spot to see the wall as it really used to be. Here, you can visit the open-air exhibition, the Reconciliation Chapel and the documentation center with observation deck. The heart of Spandauer Vorstadt is the New Synagogue, which has always been and still is the symbol of Jewish culture in Berlin. The bus will drop you off at Hackescher Markt for a walking tour. You will be picked up again at the New Synagogue, home to the Centrum Judaicum.

The bus will then take you to the Jewish Museum in Berlin-Kreuzberg, which constitutes a spectacular highlight of modern architecture in Berlin. The Jewish Museum was opened in and gives an interesting insight into the history of the Jewish people. Its outstanding design by Daniel Libeskind is based on a process of connecting lines between locations of historic events and locations of Jewish culture in Berlin. A museumtour will be arranged. Price per person: EUR 55 Price includes: admission fee and guided tour at the Jewish Museum, transportation and English-speaking guide.

However, one can covet only something else. We wherever we form an insufficient estimate of the causes, even in the physical realms; the concept of accident is based on this. If a brick falls from the roof and strikes the ground near a person, he says, "I could have been struck by it. As a matter of fact it makes no difference in practice which point of view. It shows us how tendencies of pleasure and displeasure impel us to actions whose natural aim in this case the preservation of the species may be unwelcome to us, or not become.

They preserve the community, and hence they often conflict with the interests of the individuals; they also have a great many points of contact with sexuality. Nevertheless it is certain that the existing sexual ethics is not adapted to the. Indeed, our form one hand and the sexual impulse on the other often.

Other definitions of the word "impulse" of the section on Psychopathology. For it must be borne in mind that although superficially two phenomena may look alike, they may nevertheless have entirely different meanings, depending on their psychic environments and on their genesis. Moreover, and this is even more true here than in physical pathology, every symptom is. For a scientific study of the psychoses it is necessary to distinguish between primary and secondary symptoms.

Thus a paralysis of the abducens nerve is a primary symptom, whereas the subsequent contracture of the internal rectus and the diplopia are secondary symptoms. A certain disturbance of mental function in dementia praecox is a primary symptom while the resulting twilight state following it under the influence of an unpleasant experience is a secondary symptom.

If a paronoic conceives an indifferent experience in the sense of a delusion of reference, it is in a certain relation a primary symptom, but the reaction following it, in the form of an insult which is normal in itself, is a secondary symptom. The last example also shows that these concepts are only relative, inasmuch as a fundamental disturbance often produces a whole casual chain; for the delusion of reference is already a derivative symptom, in the particular case.

In some diseases it is of value to differentiate between principal and accessory symptom,s. The former appear in every one of these cases. One must therefore assume that in mice they are also present even where we do not yet see them, that because of insufficient intensity they have not yet crossed the diagnostic threshold. Among these we have the organic symptomcomplexes, in organic diseases, the association and affective disturbances in schizophrenics, and the manic and melancholic states in manic depressive psychoses.

The accessory symptoms, like hallucinations and Under the latter one includes the central sensory fields as well as the whole cortex as the carrier of the psyche. Disturbances of the Sensory Organs Disturbances of the sensory organs appear in part as accidental complications and in part as symptoms of individual psychoses, like paresis. The patient is often unable to recognize the origin of his paresthesias, and thinks that noises in his ear are bells, or.

Weakness of the sensory organs influences the psyche during its ears is. With the exception of the modern way of teaching the deaf and dumb, we perceive the whole cultural achievement of older generations directly or indirectly through hearing. Hence the deaf person, without special instruction, remains a psychic cripple in the most important relations, even if he is intelligent; and as he is unable to put the correct value on the behavior of his environment, he becomes irritable, hot-tempered, and suspicious.

Central Disturbances of the Sensations and Perceptions. SenIn are seldom disturbed through psychotic processes. Thus a dim light may seem glaring, knocking on the door may be conceived. Hysterical and hypnotized persons may, under certain conditions, react to the slightest sensory impressions in a manner unperceived by normals. Hyperalgesia too, is present in the same conditions and also as a as shooting, of the escaping result of organic processes in the nervous system.

Hypalgesia and Analgesia are quite common; they are centrally determined and present a great many different types. In coma of epilepsy and other diseases, it is assumed that there. In soporose and torpid states the threshold of feeling is generally raised and the perceived stimulus, too, is of lesser value than in normal states. In strong affects attention may be so one-sided that one may not even the most severe pain; thus the officer may first become cognizant of his shattered arm when he attempts to brandish his sword.

Maniacal patients often injure themselves when in an excited state without noticing it; but when their attention is directed to the pain as in a minor operation, they evince great suffering. The complete 2. Other hypesfhesias and anesthesias are not common psychoses. Depressed patients sometimes complain it feels like chewing straw or paper, that all colors look equally grey as if covered with ashes, but when one examines their sensations they are found to be normal.

The same phenomena may be produced in normal persons through a strong debased on auto- suggestion. Perception and comprehension show the following disturbances in They see idiots. Idiots cannot comprehend anything complicated. Or they recognize pictures with difficulty or not at all, while they can readily identify the. All this is due to the fact that they do not comprehend the color or the size in the whole picture-complex. The mistake that brings about the but they differ. Goethe Kanonenfieber bei Valmy clearness; but nevertheless it is as if the world assumed a distinct brown:.

In epilepsy the behavior is the same. There seems to be some difference but it cannot be definitely fixed. At ail events the symptoms correspond with the general retardation of the psychic processes in the patient. Thus mistaken named which, although they show no optic similarity to the real picture.

In profound melancholic states the apperception must be given more time if one wishes to avoid an abnormal number of mistakes. Manic states show nothing characteristic in the habitual perception of their environment, and in tests conducted without accurate. Analogous disturbances, though not so easy to demonstrate, are also found in the acoustic field. In organic patients particularly, one is often struck by the fact, that questions. The most important psychopathic manifestations in the centripetal sensory deceptions. They are divided into Illusions and Hallucinations.

Illusions are real perceptions pathologically changed. The striking becomes an insulting remark hand is hurled back because it or is. The real mistaking of personality where some one of the environment is looked upon as a relative or acquaintance of the patient, or as the president, it is. It is only a difference in quality, when during a markedly affective situation a tree stump is taken for a highway man, or a fog for an apparition of an angel, and yet the last examples can no longer be differentiated from the illusions of insane patients. Hallucinations are perceptions without corresponding stimuli from Everything perceived can also be hallucinated, and indeed,.

Besides, morbid functions apparently produce inner feelings, which never occur in any other way. One cannot decide whether one deals with hallucinations or illusions. In most cases the differentiation is simple. Visions which are not connected with definite objects are undoubtedly hallucinations, the same is true of words which are heard as coming from the wall, and this is especially confirmed in both cases when the optic and acoustic nerves in the case of voices rattle of the. The projection to the outer world is usually perfect. What the patients see and hear they accept as impugnable reality, and when hallucination and reality contradict each other they mostly conceive what is real to us, as unreal and falsified.

It is of no avail to try to convince the patient by his own observation, that there is no one in the next room talking to him; his ready reply is that the talkers just went out or that they are in the walls or that they speak through invisible apparatus. However, hallucinations evince all gradations.

There are hallucinations which are recognized as hallucinations but are none the less perceived with perceptible distinctness Kandinsky's Pseudo-hallucinaothers concerning which the patient cannot say whether they tions ;. The patients often localize in the body the voices, and sometimes also the visions mostly in the chest, sometimes in the head,. Projection is facilitated through a high perfection of the image. While the patient himself is never conscious of this deficiency, it may furnish the physician important suggestions that we deal here with an illusion.

One cannot, however, reason the other way, for there are also hallucinations endowed with the perfection of an actual perception. Remarkable are the "extracampine" hallucinations which are localized outside of the sensory field in question. Whether not, extracampine or designated as from thousands of miles should be voices which seem to is. Intensity fluctuates from the loudest reports of a cannon to the. During actual attacks, especially in schizophrenia, the intensity. Visions showing a tendency to become greater and greater and which at the same time in most cases seem to come nearer and nearer.

Hallucinations may be changeable or stable. The voices are often abrupt and fragmentary. Auditory hallucinations put together in a dramatic fashion point to alcoholism, particularly alcoholic insanity. Connected hallucinations which fit together, accompanied primarily by visual illusions are found in hysterical twilight states, and also in other cases. Voices can naturally be localized anywhere, in the next room, in the walls and in open spaces. Visions come in conflict with reality. Thus, behind the hallucinated man one cannot see anything of reality, or he appears transparent ghosts.

A hallucinated person can be placed in the. Thus a skull may be seen over the shoulder of a In most cases, however, the manifestations are inde-. The whole environment may be changed halhicinaThus a patient imagines himself in heaven instead of the.

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At the height of the disease the hallucinations in most. Thus if a healthy person would hear a command "Kill your child" , it would never occur to him to follow it, but the patient obeys it with or without That has nothing to do with the form of the command, resistance. Thus a paranoid patient suffering from pneumonia does not bother about the inflammation of the lungs, but oc-.

On the other hand, patients in an alcoholic delirium often view their conditions like an audience in the theatre, and demented schizophrenics may even constantly hallucinate and apparently pay no attention to it. Because the hallucinations really only express the thoughts of the patient, be they conscious or not, it is quite comprehensible how definite explanations are readily given to apparently incomprehensible hallucinations.

Thus a patient hallucinates the word "clean," nothing else, and becomes very excited over it because one means to tell her by this word that she has soiled the bed. A great many definitely recognize poisons in hallucinated odors and tastes, the real odor of which they do not at all know. This also shows the possibility of teleologic hallucinations which give the patient good advice or. The Maid of Orleans is told by the Holy Virgin what to do in order to conquer, but this only took place as long as the war situation was so simple that the girl's.

Sometimes warning and enticing, friendly and hostile voices, become separated into two persons which are endeavoring to persuade the. Others seek to explain them by machines, or by distant physical effects of all sorts. Nowadays one seldom hears of demoniacal influences. Some patients, who feel that their thoughts are read by others imagine themselves to be transparent.

Causation of hallucinations. Hallucinations accompany many mental diseases, toxemias, marked exhaustions, and normal sleep. In the psychoses their appearance is facilitated by an absence of sensory stimuli, thus the darkness of the night favors visions, and the quietude of the prison auditory hallucinations. On the other hand, real stimuli. Many patients close their ears in order to hear the voices well, and others in order to rid themselves of them. Occupation distraction of attention sometimes hinders them and more seldom promotes them. Exogenous experiences as well as thoughts may give rise to halluand determine their content when it is more a question of heightening of the momentary'- disposition.

Thus the patient seeing dishwater carried past him, hallucinates the insulting remark "foodcinations spoiler," or seeing the grass cut, he feels himself cut with every" stroke. At patients, but they easily dominate delirious and twilight states. Thus the patient imagines that he witnesses a theatrical performance which has nothing to do with him. It is quite different. The voices communicate with the patient from any distance, and through all possible hindrances by means of the most secret paths and through apparatus, especially invented for this purpose.

Hallucinations of smell and taste rarely appear alone. In ecstasies in the later stages of manic paresis, they enhance the in schizophrenic delusions of persecution. Other tastes and smells are only very rarely hallucinated. Cutaneous sense. They are also found in connection with bodily hallucinations, inasmuch as snakes which crawl to the genitals, blows, stabs, and similar hallucinations are also felt by the sense of touch.

The other qualities of the cutaneous hallucinations are still more difficult to differentiate from the following: Hallucinations of general sensations of the bodily organs are wont to appear in great. The physical hallucinations can be differentiated from paresthesias mostly through the fact that the patients feel the former as "done" from without. Hallucinations of kinesthetic sensations are most frequently seen in delirium tremens, where the patients imagine that they are at work.

Instead of expressing themselves in voices, the thoughts sometimes manifest themselves in kinesthetic hallucinations of the speech organs, so that the patients. Negative hallucinations, or not to perceive an object which is accesour senses, are rare occurrences in pathology but they can easily be produced in a state of hypnosis through suggestion. The peculiarity of the latter the fact that sensations of one organ are accompanied by sensafield.

However, the secondary sensations have nothing to do with hallucinations and in any case they have as yet no meaning in pathology. For they maintain that under normal conditions only those processes can be projected to the outer world which are accompanied by the corresponding sensory But since, as far as we know, we only perceive processes in stimuli. If we could speak at all about the "strength" of such processes we would say that it haa nothing to do with the difference between perception and ideas.

And principally it has just as little to do with localizations. Even the centres in the cortex; ,. The reality judgment, the substantiality of a true or hallucinated perception, depends almost altogether on the psychic environment. The difference between perceived and imagined space is an invention of speculative psychology. If I looked at the table and then turned my back on it, it still.

The more one abstracts from the sensory components and from the details of a physical idea, the lighter stantiality, although is. Delirious patients often regard their hallucinations as a moving-picture show. Another remarkable thing is the fact that the manifestations in alcoholic deliria are mostly colorless, while similar appearances in paresis and other organic insanities more. Hence the second type. Some assume that one cannot remember odors and tastes, still in many persons such memory pictures form a part of the concepts of foods, flowers, and similar articles smelt and Whether this or that sense predominates, undoubtedly depends tasted.

In some it is the optic memory'' pictures which constitute the most important components of their concepts and hence of their thinking, in others it is the acoustic, and in These differences are of still others it is the motor memory pictures. Persons respective sensory components in their concepts.

Due to a poverty of associations congenital defectives cannot make full use of their experiences in the formation of concepts, and conseconnect and combine the individual memory even of much more importance is the fact that they do not sufficiently comprehend the concepts which others convey to them through speech.

In this respect deaf persons are worse off, even. Both classes therefore form than normal people, and they are very apt to put an. They act like little children who may incorrect limitation on them. They also form insufficient, unclear, and inaccurate limitations; they cannot, for instance, distinguish between "state" and "country," or even between "sparrow" and "finch. However, there are types of congenital defectives, in whom the most essential deficiency is. John," but they are unable to comprise this reciprocal activity under the term "each other" or "one another. In the German part of Switzerland with its clumsy expression, the intelligence of foreigners is at first frequently overestimated in our Swiss clinic Germans, who are more fluent in speech, are not unfrequently diagnosed as manic cases, and real manic patients often seem much richer in concepts than they are.

A good fluent speech, congenital or acquired, often disguises real deep defects of intelligence, be it in society, in school, or even in the highest examinations, which only goes to show how imperfect these organizations are. In such cases one speaks of higher dementia. Also below the "Nature Healer" with his "Principle of Contrasts. Thus one may admit, that behind the properties of the psyche, there must be a carrier of the properties, a "being. Another excellent false deduction can also be seen Cancer may be caused by a cold; for all physiological reactions, hence also those leading to cancer are conditioned by an "irritant," and cold is surely an "irritant.

This gives rise to many coarse errors of thought, for instead of conceiving something as a mere figure, it frequently takes the place of the original concept, ships of the psyche. In psychoses, concepts may be profoundly distorted. New concepts are sometimes created or another patient speaks of the "Dossierpath,". In most of these cases we do not deal with a permanent injury. That an advanced paretic can no longer think of a complione anotlier. Disturbances of ideas naturally exist insofar as the psychic procDisturbances of perceptions, of memory.

Even normal persons who are "in good humor," or "stimulated" sometimes give the subjective and objective impression as if their thinking process ran with particular ease. Such people have more to say, and sometimes utter thoughts which are not habitual to them, especially jokes, even quite daring ones. To be sure, such performances cannot always stand the test of criticism. In pathological states, mostly in connection with euphoria and exalted self-reliance, we often find a morbid exaggeration of the afore-mentioned state, which is designated as flight of ideas.

Here the most striking phenomenon is the exaggerated distractability which at first comes from within but later also from without. The patients change their objective idea with abnormal frequency, and in the most serious cases it follows every thought uttered or indicated. Thus a patient wishes to tell about a trip to the Righi Mountains and he suddenly thinks of the donkeys which were used there before the construction of the railroad, then of salami sausage supposed to be made of donkey meat and then of Italy where these sausages come from.

In less severe cases the patient is ,. The secondary associations which also appear in normal persons but which not uttered, one can understand. This enhanced distractability may also be described as a disturbance of attention in the form of hypotenacity with hypervigility. Both subjectively and objectively one gains the impression that the flighty patients think. There is no doubt that the patient spends much less than the normal time on the individual ideas, which also accounts for the fact that they are insufficiently elaborated.

Thus flighty thinking is not aimless in content, although its aim is forever changing. When you are president you are the head of all, you are the head of every one of those, you have a big head, you are the smartest man in the world. I do testory and all scientist of the whole present, president of ' One of the main headings in the classification of associations is "Coordination" which includes associations of co-order, super-order, sub-order, or contrast.

Examples of super-order are "fly," "insect" "water," "ocean. Wherever the choice of impressions and ideas are inadequate there is also a lack in orderly arrangement. The average person cannot say some things, he cannot even think of them, because of consideration for others or himself or because an inner critique keeps him back, the flighty patient, however, ignores such reflections or they never occur to him, he knows no embarrassment. Sometimes, especially before merging into a depression or into a manic depressive mixed state, the patients firmly adhere to an apparent aim but leave out all logical connections.

Such persons limit their productions to a series of names of persons, places, offices, etc. Flight of ideas does not represent a simple acceleration of associations. Liepmann endeavored to explain it on the basis of a disturbance of attention, but one gains nothing. As we must also assume in other cases, the inhibiting resistance obtruding itself is relative in its. In view of all that, the resistance exerted. It is difficult, and often impossible for the patients to change the idea controlling them; this preferred idea deals with their imagThe patients are frequently aware of inary misfortune monideism their poverty of ideas and perceive it as dreary and monotonous.

Ideas which are incompatible with the depressive thoughts can be touched upon with difficulty or not at all; so that judgment becomes considerably warped and the development of delusions is made quite easy. On superficial observation the patients sometimes even give the impression. Whereas normally the patients were able, for instance, to do mentally an addition of four-digit numbers, they can now only add one one-digit number to a two-digit number without forgetting the problem.

The characteristic restrictions of organic disturb-. This restriction of thought for the time being to a specific cluster of ideas physically speaking, is. When only a few ideas can be grasped simultaneously, an orderly arrangement of them becomes difficult. Thus a patient states that he was born in , he knows that it is now , but nevertheless thinks that he was 62 years old ten years ago. He comes to this conclusion by subtracting 10 from 72 instead of from his present age. The coordinating associations as such. Korsakoff patients, become more and more egocentric and are particularly fond of concerning themselves with their own pleasures and woes, often in a very petty fashion.

Nevertheless, they are much. They are especially capable of showing a very affective and exaggerated for instance, organic epileptics, of occupying. It thus often happens that they still continue to give information about personal matters when that topic has long been finished and when the question may refer to their education. Besides those mentioned there are other mechanisms which often prevent the patients from leaving an idea. Thus in an association test. Here the associations are emoand contain many lepetiideas, and partly to poverty of or impossible to restrict the. The utterances often express a pronounced affect in its content, which is even more marked by its emit is.

Typical associations may be seen in the following: "My dearest Doctor, "I'm all wrong, O God in Heaven have pity on me. Father in Heaven be compassionate. Dear good Doctor, help me. The perseveration tendency often strongly preponderates. Complexes show Righto Oho! Egocentric reactions occur frequently, and are said to be quite banal, particularly in paralytic "I don't know of anything bad," and to consist of cases, thus, "bad,". The associations of states of organic confusion have not, as yet, been the subject of sufficient research. But one can often recognize even in the confusion the described type of the actual disease.

Neither a manic patient, nor a sound person thinks modern Italy at the mention of the name of Brutus. But a schizophrenic, by disregarding the component of time connected with the in schizophrenia. They differ from flight of ideas through the fact that a normal person can understand the individual steps of the latter, whereas many steps that are made in a schizophrenic train of thought are unintelligible to the normal person, or appear to associations.

He wandered with ships from Athens to Hain Mamre, took Caledonian grapes and pomegranates and overcame Bedouins. He besieged the Acropolis with gun-boats, and caused the Persian crew to be burnt as living torches. Spear-points of Christi Day. Kalifs, there is situated in the museum of Assyrian monuments from Macedonia. There plantain flourishes next to maize columns, oats, clover, and barley, also bananas, figs, lemons, oranges, and olives.

Olive-oil is an Arabian liqueur-sauce, with which Afghans, Moors, and Moslemites carry on the breeding of ostriches. The Indian plantain is the whiskey of the Parsee and of the Arab. The Parsee or the Caucasian possesses exactly as much influence over his elephant The camel is the sport of the as the Moor has over his dromedary. Jew and the Indian. In India, barley, rice, and sugar-cane, that is, artichoke, flourish luxuriantly. The Brahmins live in castes on Beluchistan.

The Circassian inhabit Manchuria of China. China is the Eldorado of Pawnees. The association is sometimes formed as a result of factors from without even when there is not the slightest real connection. Thus the patient explains his violent action on the ground that "the at-. The individual thoughts then have no connection with one another from the point of view of the observer, and in most cases also from that of the patient. Indeed, it not infrequently happens that the patient never produces any coherent thought, as the concepts are piled together without any logical connection.

Without the slightest regard for real and logical possibilities, the faintest wishes and fears are endowed with the subjective reality of the delusion. The most usual secondary associations, vague analogies and accidental of associations dereistic thinking in the highest degree,. When the obstruction is over, a new thought, which had no connection with the one preceding obstruction, the mental stream suddenly ceases remaining frequently crops up.

In profound disturbances the reactions to both anomalies are altogether or almost completely reduced to zero. If the difference does not tarded character of their movements. The obstruction may be compared to the closing of a valve in a piping system carrying a highly mobile fluid, while the inhibition is stance, be asked to count to.

In neuro-physiology, such stoppages of one function through another are designated as "inhibitions" while in psychopathology, the. There are, to be sure, still. Many are named in accordance with their causes, as schizophrenic swelling of the brain, brain pressure in. In another spoken of in a moral sense, thus a psychosis, or alcohol destroys the inhibitions connected with wrong Here again the meaning of the expression tends towards its actions.


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In superficial contradistinction to obstruction, schizophrenics often a "crowding of thoughts"; they are forced to think. In such cases the content subjectively seems rich and varied, and gives the impression of a continuous mental stream. But if the attempt is made to penetrate a little more deeply, one regularly gets the impression feel.

The most cases connected with a disagreeable The feeling of activity may, however, also be feeling of exertion. When the patient is asked to relate a fable which he has read, he is unable to proceed beyond the next step in the story, unless he is given an additional prod. When asked to tell about his divorce, he at first knows nothing except: "I am divorced. Pathological brevity of associations similar quality in persons who, for willing to give information. Accidental psychic processes, thoughts, and actions may become stereotyped; an idea is repeatedly thought and expressed in all variaStereotyped habits tions and connections, it is "worked to death.

Schizophrenic and dream-like disturbances of association hypothetically traced to the same origin: of attention deflect the associations. An imbecile described by Wernicke was driving a wagon which struck a rock and therefore could go no farther. He thereupon whipped the horses instead of driving around the rock; the act of resorting to the whip when the wagon will go no farther is really the habitual thing to do, while it happens only rarely that there is need for driving around an obstacle lying in the middle of the street.

Within particularly easy reach and at the same time easily stimulated are those ideas which concern the ego. That is to say, they belong to those ideas which are most easily thought of, a fact which gives rise, in imbeciles, to a sort of egocentricity, which is further strengthened by the lack of understanding for the matters which concern others.

For obvious reasons concomitant congenital weakness plus cerebral atrophy the associations of epileptics often show disturbances similar to those of imbeciles and organic cases but in addition, they present. Nevertheless, the line of demarkation from the organic cases is. The content is poor in ideas showing tautologies, meaningless definitions, and the " Bleuler, Storung der Assoziationsspannung, ein Elementarsymptom Schizophrenien Allgem.

Psychiatrie For more details see the chapter on oligophrenia. The entire circle of ideas gradually. Egocentric relations: wish health; naturally one would rather be well than sick; time would gladly for the sake of good fortune. Flower the flower belongs to the trimmings of the window-plants in the dwellings of people, that so?

Poverty of ideas manifests itself among other things grammatical constructions, tautoloand the like; thus, long is not short; loved what one likes is. They repeat themselves word for word or in tautologies, they use circumstantial modes of expression, they present a multitude of non-essential trifles and trivialities, but they do not lose their goal, nor can they be diverted from their snail-like paths is. Indeed the distractabnormally slight.

The circumstantiality of sometimes also reflected in their actions and their. Whereas a sound person will, so to speak, sit down in one conmany an epileptic finds it necessary to perform this act in the following manner: He first places the chair in a special tinuous movement, position, then he considers his spatial relation to the chair, then he.

In some cases the main element shows itself in an enormous exaggeration of the described peculiarities, in other cases there seems to be added something new, which has been incorrectly characterized. That which was today praised to heaven may be painted with coalblack colors tomorrow for just as many opposing reasons. For the rest their associations have not yet been sufficiently studied and can just as little be brought into a single purview as the morbid pictures. Other Disturbances of Association Besides these disturbances of associations, which are characteristic for definite illnesses or states, there are.

Outside of schizophrenia there are also pathological brevities of the associations: the patient always gets through with his thoughts quickly,. The patient does not think of related ideas even when they might have to follow of necessity, as in the case of wishing to give an account of something indeed, this occurs. In the acute stages happens that not only the thoughts become con-. In the same way paramimic and parathymic phenomena become connected with it. Confusions incident to delirious and twilight states are still quite insufficiently known.

As every one knows, marked emotional fluctuations normal and diseased persons lead to affective confusion at some flight of ideas. Repetitions and tautologies, essentials '"See below: "Hallucinatory Confusion. Circumstantiality sometimes originates from a feeling of uncertainty which impels the patient to add all sorts of corrective and sup-. Overvalued Ideas, Obsessions Obsessive Acts Overvalued Ideas are ideas that always obtrude themselves into the foreground, they are mostly remembrances of an affectful experience, but in contrast to autochthonous ideas the patients.

According to Wernicke they are not delusions in themselves, but through morbid relationships often give occasion for delusions. They are katathymic ideas, which.

Retention Management für Assistenzärzte in einer psychiatrischen Klinik (German Edition) Retention Management für Assistenzärzte in einer psychiatrischen Klinik (German Edition)
Retention Management für Assistenzärzte in einer psychiatrischen Klinik (German Edition) Retention Management für Assistenzärzte in einer psychiatrischen Klinik (German Edition)
Retention Management für Assistenzärzte in einer psychiatrischen Klinik (German Edition) Retention Management für Assistenzärzte in einer psychiatrischen Klinik (German Edition)
Retention Management für Assistenzärzte in einer psychiatrischen Klinik (German Edition) Retention Management für Assistenzärzte in einer psychiatrischen Klinik (German Edition)
Retention Management für Assistenzärzte in einer psychiatrischen Klinik (German Edition) Retention Management für Assistenzärzte in einer psychiatrischen Klinik (German Edition)
Retention Management für Assistenzärzte in einer psychiatrischen Klinik (German Edition) Retention Management für Assistenzärzte in einer psychiatrischen Klinik (German Edition)

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