Oberberg Stiftung

The Obsessive-Compulsive Inventory-Revised (OCI-R) is widely used to assess symptoms of Obsessive-Compulsive Disorder (OCD). Despite its consistent factor structure, criticism on its syndromal validity has been raised. With the recent update of the commonly used diagnostic manuals, hoarding symptoms are now better captured by the diagnosis "pathological hoarding". Furthermore, the neutralising scale suffers from relatively low psychometric properties. Consequently, a 12-item version of the scale (OCI-12), excluding hoarding and neutralising items was recently developed in English. The current study examined the psychometric properties of the German version of the OCI-12. The psychometric properties of the translated German version of the OCI-12 were investigated in a German-speaking sample, consisting of 102 participants with OCD, 69 participants with an anxiety-related disorder, and 248 non-clinical controls. The German version of the OCI-12 replicated the four-factor structure of the original English version, with a higher order factor of general OCD symptoms. In addition, similar to the original version, the German OCI-12 showed good internal consistency and test-retest reliability, moderate-to-good construct validity, and good-to-excellent diagnostic accuracy. The German version of the OCI-12 represents a syndromally valid and reliable inventory for assessing OCD symptoms. Psychometric properties are good-to-excellent and comparable to the original English version. The diagnostic sensitivity is good-to-excellent and further supports using the OCI-12 in clinical and research settings.

This narrative review provides an overview of the structure, financing models, and challenges facing the German mental healthcare system for adults. The German mental healthcare system is divided into distinct sectors, including inpatient, outpatient, rehabilitation, and regional complementary services, each with its own financing mechanisms. Statutory health insurance, covering about 88% of the population, funds the majority of the system. Germany allocates 13% of its GDP to healthcare—one of the highest proportions globally—with over 10% of this directed toward mental health. Key challenges include an overemphasis on inpatient services, poor coordination between inpatient and outpatient sectors, insufficient severity-based treatment allocation, limited adherence to clinical guidelines, and a lack of digitalization and routine outcome evaluations. The COVID-19 pandemic led to a temporary reduction in service use and intensified issues with inter-sector collaboration. In the long-term, a healthcare workforce shortage further complicates care delivery. Proposed solutions include regional budgets for integrated care, outcome-based quality assurance, stepped-care models to optimize treatment allocation, and digital infrastructure improvements for better data sharing and transparency. These reforms aim to enhance patient-centered care, improve outcomes, and make more efficient use of resources.

Autobiographical-episodic memory is considered to be the most complex of the five long-term memory systems. It is autonoetic, which means, self-reflective, relies on emotional colorization, and needs the features of place and time; it allows mental time traveling. Compared to the other four long-term memory systems-procedural memory, priming, perceptual, and semantic memory-it develops the latest in phylogeny and ontogeny, and is the most vulnerable of the five systems, being easily impaired by brain damage and psychiatric disorders. Furthermore, it is characterized by its fragility and proneness to distortion due to environmental influences and subsequent information. On the brain level, a distinction has to be made between memory encoding and consolidating, memory storage, and memory retrieval. For encoding, structures of the limbic system, with the hippocampus in its center, are crucial, for storage of widespread cortical networks, and for retrieval again a distributed recollection network, in which the prefrontal cortex plays a crucial role, is engaged. Brain damage and psychiatric diseases can lead to what is called "focal retrograde amnesia." In this context, the clinical picture of dissociative or functional or psychogenic amnesia is central, as it may result in autobiographical-emotional amnesia of the total past with the consequence of an impairment of the self as well. The social environment therefore can have a major impact on the brain and on autobiographical-episodic memory processing. This article is categorized under: Psychology > Memory.

Zusammenfassung. Dissoziative Amnesie verläuft unter Umständen chronisch und kann zu lebenslanger Arbeitsunfähigkeit führen. Die Krankheit tritt gehäuft im Zusammenhang mit Migration auf und verläuft dann schwerer als in anderen Fällen. Sie ist im Grunde reversibel, d. h., der Abruf der Gedächtnisinhalte ist nur blockiert. Betroffen sind Patienten, die nicht verarbeitete Stress- und Traumaerlebnisse als Hintergrund haben und dann ein erneutes Stresserlebnis erfahren, welches zum dissoziativen Amnesiezustand führt. Es wird postuliert, dass in erster Linie Patienten betroffen sind, die im neuen Heimatland nicht ausreichend und ihrem Anspruch entsprechend Fuß fassen konnten. Mangelnde Sprachkenntnisse und eine nicht den Erwartungen entsprechende neue Arbeitssituation sind am ehesten als Gründe anzuführen.