Background: The relationship of panic attacks (PA), panic disorder (PD) and agoraphobia (AG) is controversial. The aim of the current study is to prospectively examine the 10-year natural course of PA, PD and AG in the first three decades of life, their stability and their reciprocal transitions. Methods: DSM-IV syndromes were assessed via Composite International Diagnostic Interview – Munich version in a 10-year prospective-longitudinal community study of 3,021 subjects aged 14–24 years at baseline. Results: (1) Incidence patterns for PA (9.4%), PD (with and without AG: 3.4%) and AG (5.3%) revealed differences in age of onset, incidence risk and gender differentiation. (2) Temporally primary PA and PD revealed only a moderately increased risk for subsequent onset of AG, and primary AG had an even lower risk for subsequent PA and PD. (3) In strictly prospective analyses, all baseline groups (PA, PD, AG) had low remission rates (0–23%). Baseline PD with AG or AG with PA were more likely to have follow-up AG, PA and other anxiety disorders and more frequent complications (impairment, disability, help-seeking, comorbidity) as compared to PD without AG and AG without PA. Conclusions: Differences in incidence patterns, syndrome progression and outcome, and syndrome stability over time indicate that AG exists as a clinically significant phobic condition independent of PD. The majority of agoraphobic subjects in this community sample never experienced PA, calling into question the current pathogenic assumptions underlying the classification of AG as merely a consequence of panic. The findings point to the necessity of rethinking diagnostic concepts and DSM diagnostic hierarchies.

Despite a wealth of studies on differences regarding the biobehavioral and social–psychological bases of mental disorders in men and women and repeated calls for increased attention, women-specific issues have so far not been comprehensively addressed in past diagnostic classification systems of mental disorders. There is also increasing evidence that this situation will not change significantly in the upcoming revisions of ICD-11 and DSM-V. This paper explores reasons for this continued failure, highlighting three major barriers: the fragmentation of the field of women's mental health research, lack of emphasis on diagnostic classificatory issues beyond a few selected clinical conditions, and finally, the “current rules of game” used by the current DSM-V Task Forces in the revision process of DSM-V. The paper calls for concerted efforts of researchers, clinicians, and other stakeholders within a more coherent and comprehensive framework aiming at broader coverage of women-specific diagnostic classificatory issues in future diagnostic systems.

Discussion surrounds the question as to whether criteria for generalized anxiety disorder (GAD) should change, particularly in youth. This study examines the effects of possible criteria changes on GAD prevalence and clinical correlates. DSM-IV GAD was assessed using the M-CIDI in a community sample of adolescents and young adults. Diagnostic thresholds were modified in two age spans (9–20 and 21–34 years) using a person-by-year data file (N = 38,534 cases). Relaxing the duration or excessiveness criteria led to the most pronounced changes in GAD prevalence, while relaxing frequency, uncontrollability, or associated-symptom criteria had smaller effects. A lower duration requirement increased rates more in older than younger age spans. Opposite effects occurred for changes in associated-symptoms or clinical-significance criteria. Broader GAD definitions identified cases in both age spans that appeared mostly milder than DSM-IV cases but that still differed from non-GAD cases in various clinical factors and validators. Developmental aspects require stronger consideration in future diagnostic systems.

Background Among adolescents and young adults with DSM-IV alcohol use disorders (AUDs), there are inter-individual differences in the speed of transition from initial alcohol use (AU) to AUD. AUDs are highly co-morbid with other mental disorders. The factors associated with rapid transition from first AU to AUD remain unknown and the role of mental disorders in rapid transitions is unclear. Given this background we examined (1) whether prior anxiety, mood, externalizing and non-alcohol substance use disorders are related to the risk and speed of transition from first AU to DSM-IV alcohol abuse (AA) and alcohol dependence (AD) and (2) whether early age of onset of prior mental disorders (PMDs) is a promoter of rapid transition. Method A total of 3021 community subjects (97.7% lifetime AU) aged 14–24 years at baseline were followed up prospectively for up to 10 years. AU and mental disorders were assessed with the DSM-IV/M-CIDI. Results Among subjects with lifetime AU, several PMDs, such as specific phobia, bipolar disorder and nicotine dependence, were associated with an increased risk of AUD independent of externalizing disorders. Associations of PMDs with the speed of transition to AUDs were mostly weak and inconsistent. Only social phobia and externalizing disorders were associated with faster transitions to AD even after adjustment for other PMDs. Earlier age of onset of PMD was not associated with rapid transition. Conclusions Mental disorders are associated with the risk of AUD. With the possible exception of social phobia and externalizing disorders, they do not promote rapid transition, even if they occur particularly early. Future research needs to identify factors relevant to rapid transition to AUD.

Viena iš naujausių sistemų kūrimo metodikų – sričiai orientuotas modeliavimas (angl. domain specific modeling). Ji paremta sričiai orientuotos kalbos kūrimu ir jos panaudojimu sistemos kūrimui. Ši metodika leidžia sistemos kūrimui naudoti sąvokas, artimas probleminei sričiai, kas padidina abstrakcijos lygi projektavimo metu. Srities sąvokos aptariamos ir įvardinamos kartu su ekspertais ar paprastais darbuotojais, dirbančiais analizuojamoje srityje, ir nebūtinai išmanančiais sistemų kūrimo metodus. Ši metodika leidžia sistemos projektuotojui lengviau susikalbėti su užsakovais, nes modeliuose figūruojančios sąvokos yra užsakovui suprantamos ir aiškios. / Domain Specific Modeling is a software engineering methodology for designing and developing information systems. It involves systematic use of a graphical domain specific language (DSL) to represent the various facets of a system. DSM languages tend to support higher-level abstractions than general purpose modeling languages, so they require less effort and fewer low-level details to specify a given system which is very important nowadays, when the functionality of information system must be maximized with minimum development time and cost. This paper compares usage of DSL for information system development with other two, most often used methodologies for this purpose: MDA and usage of UML. It gives basic advantages and disadvantages of DSL and DSM usage, describes differences of DSL (DSM), UML and MDA. This paper also describes usage of DSM methodology (creating DSL and using it for software development) for creating information system. It covers main steps of creation process’s: describing the domain concepts, describing the artifacts that are planning for the DSL, building domain model, building the designer for DSL, building the artifact generator, implementing validations and constraints, testing and deploying the DSL.

Aims: To investigate the gender differences in the patterns of cannabis use (CU), namely frequency, times of day, social context and methods and in their association with DSM-IV cannabis dependence. Methods: A sample of 3,904 students from German universities was recruited via an internet survey. Logistic regressions and associated areas under the ROC curve (AUC) were calculated among current cannabis users (at least once a month, n = 843). Results: CU using a water pipe was more often reported by males (50 vs. 34.6%). Usual CU ‘before going to sleep at night’ was more often reported by females (47.3 vs. 35.7%). Most CU patterns showed a similar association with DSM-IV cannabis dependence in both genders. The association of CU ‘with strangers’ was stronger in females (AUC 0.68 vs. AUC 0.56). Slightly different multiple models were found (females AUC 0.86, males AUC 0.77). Conclusions: There are considerable gender differences in the CU patterns and, thus, in the way CU functions. In the association of CU patterns with cannabis dependence, the similarities are rather great. Examining the CU patterns might make a considerable contribution to the better detection of high-risk population segments for prevention and early intervention in both genders. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

Notre étude porte sur deux échantillons de patients Tunisiens : un groupe clinique composé de sujets (N = 41) diagnostiqués trouble de personnalité limite par leur psychiatre en référence aux critères du DSM-IV (APA, 2003) et un groupe témoin composé de patients schizophrènes (N = 27). Nous avons utilisé le test de Rorschach en Système intégré (Exner, 1993) et avons fixé comme premier objectif de dégager les caractéristiques du fonctionnement des patients limites au Rorschach selon les paramètres de l’organisation limite de la personnalité décrits par Kernberg (1997). Notre deuxième objectif est de vérifier si le fonctionnement de ces sujets, tel que traduit dans le Rorschach, permet de les différencier des sujets schizophrènes. Le troisième objectif est d’étudier, par une approche test re-test avec un intervalle de 6 à 9 mois, la stabilité des variables du Rorschach à travers le temps. Les résultats de notre étude montrent que les protocoles des patients limites diffèrent par rapport à certaines variables-clés (7 variables) de ceux des schizophrènes. Ces variables constituent des indicateurs pertinents du fonctionnement limite. Néanmoins, nous avons relevé une hétérogénéité à l’intérieur de notre échantillon de sujets limites. En effet, plusieurs niveaux de fonctionnements ont émergé à l’intérieur de ce groupe. Par ailleurs, il n’y a pas eu de différence significative entre la plupart des variables en T1 et T2 aussi bien chez les sujets limites que les schizophrènes. Toutefois, la stabilité semble dépendre du fonctionnement sous-jacent. / This study concerns two samples of Tunisian patients: a clinical group (N = 41) with subjects who received a diagnosis of Borderline personality disorder in reference to DSM-IV (APA, 2003) by their psychiatrist and a control group of schizophrenic patients (N = 27). We used the Rorschach comprehensive system (Exner, 1993) in order to identify, as a first purpose, the characteristics of the Rorschach’s borderline functioning based on the Kernberg’s description of the borderline organisation (1997). In parallel, we aimed, to verify whether the Rorschach’s functioning characteristics are able to distinguish our clinical group from the Schizophrenic group. Furthermore, both of groups were tested once in the beginning of our study and again, with an interval of 6 at 9 months in order to study the stability of the Rorschach’s variables. The results indicated that seven (7) variables distinguish our group of Borderline subjects from the schizophrenics. These variables represent highly relevant indicators of borderline functioning. Nevertheless, our clinical group is heterogeneous. In fact, different ranges of functioning have emerged. Elsewhere, there is no significant difference between the most variables in T1 and T2 but the stability may differ depending on the underlying functioning.

Objective. This article reports on the test–retest reliability and sensitivity to change of a set of brief dimensional self-rating questionnaires for social anxiety disorder (SAD-D), specific phobia (SP-D), agoraphobia (AG-D), panic disorder (PD-D), and generalized anxiety disorder (GAD-D), as well as a general cross-cutting anxiety scale (Cross-D), which were developed to supplement categorical diagnoses in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). Methods. The German versions of the dimensional anxiety scales were administered to 218 students followed up approximately 2 weeks later (Study 1) and 55 outpatients (23 with anxiety diagnoses) followed-up 1 year later (Study 2). Probable diagnostic status in students was determined by the DIA-X/M-CIDI stem screening-questionnaire (SSQ). In the clinical sample, Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) diagnoses were assessed at Time 1 using the DIA-X/M-CIDI. At Time 2, the patient-version of the Clinical Global Impression— Improvement scale (CGI-I) was applied to assess change. Results: Good psychometric properties, including high test–retest reliability, were found for the dimensional scales except for SP-D. In outpatients, improvement at Time 2 was associated with significant decrease in PD-D, GAD-D, and Cross-D scores. Discussion. Major advantages of the scales include that they are brief, concise, and based on a consistent template to measure the cognitive, physiological, and ehavioral symptoms of fear and anxiety. Further replication in larger samples is needed. Given its modest psychometric properties, SP-D needs refinement. Conclusion. Increasing evidence from diverse samples suggests clinical utility of the dimensional anxiety scales.

The proposed diploma thesis aims to study the biotechnological production of poly(3-hydroxybutyrate-co-4-hydroxybutyrate) copolymer. The subject of the experimental part was first to select a suitable bacterial strain from five selected microorganisms with different carbon precursors applied at various concentrations. The five selected microorganisms used in the experimental part include bacterial strains Cupriavidus malaysiensis DSM 19416, DSM 19379, and DSM 25816. Furthermore, the strain Thermomonas hydrothermalis DSM 14834 and Aneurinibacillus thermoaerophilus H1 CCM 8960. The experiment shows that the most suitable candidate for biotechnological production is the bacterial microorganism Cupriavidus malaysiensis DSM 19379. Finally, the biotechnological production of the copolymer was investigated utilizing a batch cultivation technique in a laboratory bioreactor.

The purpose of this thesis is to look into the accuracy of various depictions of mental illness in YA literature, and to discuss the benefits of such literature in understanding adolescent mental illness, given a background of bibliotherapy and illness narratives. This paper analyzes five fictional novels that were selected with consideration to their popularity, relevance, and relatability. These are analyzed using the method of content analysis. The results bring up the depictions of symptoms of depression, mania, trauma, obsessions and compulsions, and suicidal ideations. To evaluate the clinical accuracy of the symptoms described in the selected books, they are compared to the DSM5. The disorders considered in this paper are Major Depressive Disorder, Bipolar I Disorder, Posttraumatic Stress Disorder, and Obsessive- Compulsive Disorder, and the suicidal risk of these. The results suggest that the literature has accurate representations of adolescent mental illness. Furthermore, the use of metaphors deepens the reader’s understanding of the characters’ subjective experiences of mental illness. Thanks to its accuracy and ability to convey subjectivity, reading this kind of literature may be beneficial to anyone who seeks to further understand adolescent mental illness. / Syftet med denna rapport är att undersöka hur verklighetstrogna skildringar av psykisk ohälsa är i ungdomslitteratur och att diskutera fördelarna med sådan litteratur när det gäller att förstå psykisk ohälsa hos ungdomar, med bakgrund av biblioterapi och sjukdomsberättelser. Denna artikel analyserar fem ungdomsromaner som valts ut med hänsyn till deras popularitet, relevans och reliabilitet. Dessa analyseras med hjälp av metoden content analysis. Resultaten tar upp skildringar av symtom på depression, mani, trauma, tvångstankar och självmordstankar. För att utvärdera skildringarna av symptom som beskrivs i de utvalda böckerna jämförs de med den diagnostiska manualen DSM-5. De störningar som behandlas i denna rapport är Major Depressive Disorder, Bipolar I Disorder, Posttraumatic Stress Disorder och Obsessive-Compulsive Disorder, och självmordsrisken för dessa. Resultaten tyder på att litteraturen har verklighetstrogna framställningar av psykisk ohälsa hos ungdomar. Dessutom fördjupar användningen av metaforer läsarens förståelse för karaktärernas subjektiva upplevelser av mental sjukdom. Tack vare litteraturens realistiska skildringar och förmåga att förmedla subjektivitet kan läsning av denna typ vara till nytta för alla som försöker att bättre förstå ungdomars psykiska ohälsa.