The analysis of individual cognitive profiles and the assessment of executive function components contributes to abetter understanding of the problems that children, adolescents, and adults with intellectual disabilities experience in coping with social demands. Characteristic profiles and abnormalities in executive functions in Down syndrome, fragileX syndrome, and Prader-Willi syndrome are described. These examples illustrate associations with psychological problems-so-called behavioral phenotypes-in children, adolescents, and adults with these genetic syndromes.

Intentional foreign body ingestion (iFBI) represents an increasingly relevant clinical challenge that remains insufficiently evidence based in terms of treatment. Existing somatic (gastroenterologic) and psychiatric care structures may contribute to the maintenance of this behavior. The aim of the present study is to highlight an aspect of the treatment of iFBI that has received little attention to date: the potential risk of misuse and dependence associated with propofol in the context of repeated endoscopic interventions. Our goal is to raise awareness that for vulnerable patient groups with iFBI such as individuals with borderline personality disorder (BPD), propofol should be considered not only as an anesthetic agent but also as asubstance with dependency potential and as apositive dysfunctional reinforcer within complex behavioral patterns. Narrative review of the pharmacological characteristics as well as the potential for misuse and addictive potential of propofol in the context of endoscopic interventions, based on published literature (case reports and retrospective studies). The literature reports euphoric and anxiolytic effects of propofol related to endoscopic procedures, which may persist beyond the immediate post-procedural period. In addition, apotential risk of propofol misuse and dependence is discussed in the context of endoscopic interventions. When indirect propofol misuse is suspected in the setting of intentional foreign body ingestion (iFBI), alternative sedation strategies should be considered.

The mental health status of medical students regarding depressive symptoms suicidal ideation and mental stress has become the subject of increasing scientific research; however, in Germany, no nationwide surveys have so far been performed. The present study presents the results from the first nationwide survey on the mental health of medical students in Germany. The aim of this article is to present the general aspects on psychological and physical health as well as specific data regarding depressive symptoms of German medical students. The data were analyzed in asemester-based and gender-based comparison and possible risk or protective factors were evaluated. Applying an online survey during the COVID-19 pandemic of 8137 medical students from all German medical faculties and study semesters, we collected diverse sociodemographic variables as well as data on psychological and physical health status based on single item measures and questionnaires. Besides sociodemographic information this paper presents data on the physical and mental health status (using single item measures and the Beck Depression Inventory II, BDI-II) as well as correlating influencing factors. Group differences were measured by comparison of mean values and the multivariate dependencies between BDI-II scores and further covariates were analyzed. The survey was completed by 48.3% of the respondents. Of the respondents 13.8% stated that they were not physically healthy and 36.1% stated that they felt mentally unwell. Using the BDI-II questionnaire, at least mild depressive symptoms were identified in 51.1% of respondents in the first semester. Of the respondents 22% reported current suicidal thoughts. Potential risk and protective factors could be identified, which significantly correlated with the BDI-II scores. Among those risk factors were female gender, lower age, physical complaints, need of university support and the presence of amigration background. In contrast, social support, sports and social engagement seem to be potential protective factors. Our analyses showed that medical students have ahigher prevalence of depressive symptoms compared to the general population, whereby the survey during the pandemic hindered the direct comparison with pre-pandemic data. The possible risk and protective factors identified can serve as abasis for the development of preventive programs to improve the mental health of medical students.

It can be concluded that digital services can certainly add value to mental healthcare; however, the sustainable integration into care is linked to improvements in structural conditions (such as the cost-benefit ratio and better information for those providing treatment) as well as consideration and compensation for socially unequal access conditions.

In 2023 atotal of 57,776 people were imprisoned in German correctional facilities (JVA). According to international studies 50-75% of prison inmates suffer from mental disorders; however, so far there are no well-founded data on the psychiatric psychotherapeutic care situation in German prisons. The survey of the German Society of Psychiatry and Psychotherapy, Psychosomatics and Neurology (DGPPN) is intended to provide an initial insight into the specific service provision. The online survey was designed as aunique cross-sectional survey. Atask force (TF) of the DGPPN developed aquestionnaire with 12topics and 85items. To reflect the situation in the institutions, the questionnaire was sent to the Criminological Service in advance. Targeted suggestions for improvement were implemented. The survey was conducted with the support of the Prison Committee, acommittee of the federal states that, among other things, monitors conditions in prisons, in the period from 1March-30April 2024. The questionnaire was sent online and as aprintout to the prisons in the federal states via the Prison Committee. The feedback was sent to the DGPPN. Participation in the survey was voluntary and anonymous. The data were evaluated descriptively. According to the information provided by the 137 (77.8%) institutions participating in the study, 41,173 persons were imprisoned as of 1 March 2024, including prisoners in pretrial detention, sentenced prisoners and preventive detention. Of the participating institutions 86.7% reported problems caring for prisoners with mental disorders. The capacities of full and partial inpatient psychiatric treatment were assessed by most of the institutions as not covering the actual needs. Athird of the specialist positions were not filled. In the last 12months 128 institutions recorded 5812 placements in specially secured detention rooms (15.9% of prisoners). The study confirmed the assumption of experts working in the field of psychiatric-psychotherapeutic care: the resources for the care of prisoners with mental disorders in German prisons are perceived as insufficient. Above all, there is alack of specialist staff and psychiatric treatment capacities. Sufficient funding to improve the service provision is indispensable. Treatment standards that conform to guidelines should be developed and introduced.

On 15 October 2025, the revised S3 guideline on schizophrenia (living) was published and transferred to the MAGICapp evidence ecosystem and will be updated annually in the future. This narrative review summarizes essential innovations and explains their development. New and revised recommendations and MAGICapp background information were extracted and summarized. The guideline is now fully integrated into MAGICapp and annually updated. Key changes include adowngrading of the recommendation for antipsychotic monotherapy, asubstantial expansion of guidance on adverse effect monitoring and management and astrengthened emphasis on evidence-based psychotherapeutic interventions, such as metacognitive training and systemic therapy. Additionally, 4 new recommendations (digital/technology-assisted interventions, mindfulness-based procedures, acceptance and commitment therapy [ACT], trauma-focussed therapy for post-traumatic stress disorder [PTSD]) were implemented and 12 were removed. All chapters were comprehensively revised.

The International Statistical Classification of Diseases and Related Health Problems version 11 (ICD-11) represents aconceptual advance over ICD-10 in the classification of dementias. Although the syndromic classification in the chapter "Neurocognitive disorders" remains in principle unchanged, the introduction of severity levels and the central positioning of mental and behavioral symptoms enables a more precise coding of the clinical diagnoses. Furthermore, the introduction of mild neurocognitive disorder as aprodromal state of dementia is new. The clinical criteria developed by international experts, e.g., for frontotemporal dementia or Lewy body disease, are not yet sufficiently included in ICD-11. Biomarkers for the etiological diagnostics of dementia are also not mentioned, so that it is unclear which role they play in the disease classification in ICD-11. Due to the rapid development in the field of neurodegenerative diseases, regular updates would be desirable.

Value-based healthcare (VBHC) is aconcept in health economics that aims to improve patient care through needs-oriented treatment approaches while considering the costs incurred. "Value" describes the ratio of patient-centered outcome and experience data to the costs incurred. To analyze and optimize the workflows of the Outpatient Memory Clinic of the ZI Mannheim according to VBHC criteria. The aim of the study was to improve the quality of care from the patient's perspective, to measure the changes in benefits for all involved parties and simultaneously to evaluate the costs and revenues of the diagnostic process. The initial diagnostic process was analyzed in 25dyads (patient + caregiver) using standardized (State-Trait Anxiety Inventory (STAI), Patient Assessment of Chronic Illness Care (PACIC), Euroquol visual analogue scale (EQ-VAS)) and process-oriented questionnaires. After staff training, amodified diagnostic process (VBHC-M) was implemented in apilot study. This process was then evaluated in asecond survey of 17dyads and 8additional patients using the same questionnaires. The results from both surveys were compared using t‑tests or Mann-Whitney Utests. Acost and revenue analysis (CRA) was conducted using annual data. The quality of care (PACIC) for patients (p < 0.001) and caregivers (p = 0.004) improved following VBHC‑M, as did patient satisfaction and expectations (process-oriented questionnaires). The CRA showed that VBHC‑M resulted in afinancial disadvantage for the care provider. The workflows of the outpatient memory clinic could be successfully optimized in the sense of patient-centered care, leading to an increased number of patients treated, higher patient and caregiver satisfaction and cost savings. This shows that VBHC can be implemented in outpatient memory clinics; however, the accelerated diagnostic process is reimbursed at alower rate under the current flat-rate quarterly payment system, highlighting the need for adjustments to reimbursement models.