Hintergrund: Knochensarkome sind eine Gruppe sehr seltener maligner Tumoren. Es existieren nur wenige Studien zur psychischen Belastung der betroffenen Patienten. Ziel war es, die Prävalenz erhöhter psychischer Belastung in dieser Gruppe zu ermitteln, damit assoziierte Faktoren zu untersuchen und die Inanspruchnahme psychoonkologischer Angebote zu erfassen. Methode: Die Kohortenstudie PROSa (Krankheitslast und Versorgungssituation bei Sarkomen) wurde zwischen 2017 und 2020 in 39 deutschen Studienzentren durchgeführt. Für die vorliegende Analyse wurden Baseline-Querschnittsdaten von erwachsenen Knochensarkompatienten ausgewertet. Die psychische Belastung wurde mit dem Patient Health Questionnaire (PHQ-4) evaluiert. Sozioökonomische und klinische Faktoren wurden als mögliche Prädiktoren erhöhter psychischer Belastung mit multivariablen logistischen Regressionsmodellen exploriert. Resultate: Bei den 194 eingeschlossenen Patienten betrug die Prävalenz von Ängsten 18%, die von Depressivität 22%. Insgesamt waren 29% der Patienten überschwellig psychisch belastet. 23% hatten eine psychoonkologische Betreuung in Anspruch genommen. Im vollen Modell waren arbeitslose Patienten (Odds Ratio [OR] 5,7; 95%- Konfidenzintervall [CI] 1,6–20,0) und Patienten mit Erwerbsminderungsrente (OR 3,6; 95%-CI 1,03–12,9) im Vergleich zu solchen in Beschäftigung häufiger belastet, Patienten mit Altersrente, in Vorruhestand oder in Altersteilzeit dagegen weniger häufig (OR 0,2; 95%-CI 0,05–0,9). Die Häufigkeit psychischer Belastung war bei Patienten 5 Jahre nach Diagnose (Vergleich Diagnose <6 Monate) geringer (OR 0,1; 95%-CI 0,04–0,4). Konklusion: Die Prävalenz erhöhter psychischer Belastung bei Knochensarkompatienten ist hoch. Arbeitslose Patienten, solche mit Erwerbsminderungsrente sowie neu diagnostizierte Patienten sind besonders vulnerabel. Das Behandlungsteam sollte sich dieser Faktoren bewusst sein und auch diese sozialen Aspekte der Erkrankung berücksichtigen.

Background Perinatal markers of prenatal development are associated with offspring psychiatric symptoms. However, there is little research investigating the specificity of perinatal markers for the development of specific disorders. This study aimed to explore if perinatal markers are specifically associated with adolescent substance use disorder (SUDs). Methods Adolescent participants from two study centers, one for SUD patients (n = 196) and one for general psychopathology (n = 307), were recruited for participation. Since the SUD participants presented with a number of comorbid disorders, we performed a 1-on-1 matching procedure, based on age, gender, and specific pattern of comorbid disorders. This procedure resulted in n = 51 participants from each group. From all participants and their mothers we recorded perinatal markers (mode of birth, weeks of completed pregnancy, birth weight, Apgar score after 5 min) as well as intelligence quotient (IQ). The SUD sample additionally filled out the Youth Safe Report (YSR) as well as the PQ-16 and the DUDIT. We aimed to distinguish the two groups (SUD sample vs. general psychiatric sample) based on the perinatal variables via a logistic regression analysis. Additionally, linear regressions were performed for the total group and the subgroups to assess the relationship between perinatal variables and IQ, YSR, DUDIT and PQ-16. Results The perinatal variables were not able to predict group membership (X2 [4] = 4.77, p = .312, Cox & Snell R² = 0.053). Odds ratios indicated a small increase in probability to belonging to the general psychiatric sample instead of the SUD sample if birth was completed via C-section. After Bonferroni-correction, the linear regression models showed no relation between perinatal markers and IQ (p = .60, R² = 0.068), YSR (p = .09, R² = 0.121), DUDIT (p = .65, R² = 0.020), and PQ-16 (p = .73, R² =0.021).

Background: Although the majority of German patients in a palliative state prefer to die at home, the actual place of death is most often a hospital. Unplanned hospital readmissions (UHA) not only contradict most patients’ preferences but also increase the probability of an aggressive end-of-life treatment. As limited knowledge is available which factors contribute to an UHA, the PRePP-project aims to explore predictors related to informal caregivers (IC) as well as medical and structural factors. - Methods: This prospective, observational, mono-centric study will assess structural and medical factors as well as ICs’ psychological burden throughout seven study visits. Starting in April 2021 it will consecutively include 240 patients and their respective IC if available. Standardized measures concerning ICs’ Quality of Life (WHOQOL-BREF), psychological distress (NCCN-Distress Thermometer), anxiety (GAD-7) and depressiveness (PHQ-9) will be assessed. If participants prefer, assessment via phone, browser-based or paper-based will be conducted. Medical records will provide routinely assessed information concerning patient-related characteristics such as gender, age, duration of hospital stay and medical condition. Nurse-reported data will give information on whether hospitalization and death occurred unexpectedly. Data will be progressed pseudonymized. Multivariable regression models will help to identify predictors of the primary endpoint “unplanned hospital admissions”. - Discussion: The PRePP-project is an important prerequisite for a clinical risk assessment of UHAs. Nevertheless, it faces several methodological challenges: as it is a single center study, representativity of results is limited while social desirability might be increased as the study is partly conducted by the treatment team. Furthermore, we anticipated an underrepresentation of highly burdened participants as they might refrain from participation.

We present an overview of the evidence of how nature benefits mental health, popular theories used to explain the effects, and the development potential of these theories. A large body of evidence highlights the beneficial effects of nature on mental health, with observed outcomes ranging from alleviating the symptoms of psychiatric disorders to improvements in cognitive abilities. The theoretical backbone for these salutary effects of nature consists of a set of models, mainly the attention restoration theory (ART), the stress reduction theory (SRT), and the Biophilia hypothesis. However, these high-level models are only loosely related and lack a pronounced biopsychological basis. While biopsychological measurements have been used widely in recent years, these efforts have not sufficiently been reflected in theories aiming to explain the benefits of nature contact for mental health. This paper seeks to encourage interdisciplinary work and further theory development to guide both research and practice toward strategically green and healthy living conditions. / Der Beitrag bietet einen Überblick über Forschungsbefunde zu positiven Effekten von Naturkontakt auf die psychische Gesundheit, über gängige Theorien zur Erklärung dieser Effekte und das Entwicklungspotenzial dieser Theorien. Es gibt zahlreiche Belege für die positiven Auswirkungen der Natur auf die psychische Gesundheit, wobei die beobachteten Ergebnisse von der Symptomlinderung psychischer Störungen bis zur Verbesserung kognitiver Fähigkeiten reichen. Die theoretische Grundlage für diese gesundheitsförderlichen Effekte der Natur besteht vor allem aus der Attention Restoration Theory (ART), der Stress Reduction Theory (SRT) und der Biophilie-Hypothese. Diese relativ abstrakten Modelle stehen miteinander nur in losem Zusammenhang und haben keine ausgeprägte biopsychologische Grundlage. Während biopsychologische Messungen in den letzten Jahren zunehmend in der Forschung eingesetzt wurden, steht eine Integration dieser Erkenntnisse in den genannten Theorien noch aus. Dieser Beitrag soll die interdisziplinäre Arbeit und die weitere Theorieentwicklung fördern, um Forschung und Praxis in Richtung grüner und gesunder Lebensbedingungen zu lenken.

Over the past 150 years of neuroscientific research, the field has undergone a tremendous evolution. Starting out with lesion-based inference of brain function, functional neuroimaging, introduced in the late 1980s, and increasingly fine-grained and sophisticated methods and analyses now allow us to study the live neural correlates of complex behaviors in individuals and multiple agents simultaneously. Classically, brain-behavior coupling has been studied as an association of a specific area in the brain and a certain behavioral outcome. This has been a crucial first step in understanding brain organization. Social cognitive processes, as well as their neural correlates, have typically been regarded and studied as isolated functions and blobs of neural activation. However, as our understanding of the social brain as an inherently dynamic organ grows, research in the field of social neuroscience is slowly undergoing the necessary evolution from studying individual elements to how these elements interact and their embedding within the overall brain architecture. In this article, we review recent studies that investigate the neural representation of social cognition as interacting, complex, and flexible networks. We discuss studies that identify individual brain networks associated with social affect and cognition, interaction of these networks, and their relevance for disorders of social affect and cognition. This perspective on social cognitive neuroscience can highlight how a more fine-grained understanding of complex network (re-)configurations could improve our understanding of social cognitive deficits in mental disorders such as autism spectrum disorder and schizophrenia, thereby providing new impulses for methods of interventions.

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