PurposeThis study explored the feasibility and therapeutic potential of combining artificial intelligence (AI)-assisted visual elicitation with sensory-attuned guided reflection to support emotional expression and engagement in individuals with anorexia nervosa (AN).MethodsWe conducted a two-session, therapist-led intervention with two adults with restrictive AN. In session 1, we guided participants to reflect on emotionally challenging experiences using metaphor and sensory language cues. We translated these narratives into prompts for DALL·E (v3; OpenAI, San Francisco, CA, USA), an AI image-generation tool. In session 2, participants selected from curated images to reflect on and deepen their exploration of emotional experiences. We analysed the data using reflexive thematic analysis and performed a cross-case synthesis.ResultsVisual metaphors helped to externalise and communicate emotions, evoke embodied responses and refine affective descriptions. The co-creative process fostered therapeutic engagement and a greater sense of agency in both participants.ConclusionAI-assisted visual elicitation, integrated into a structured therapeutic process, may offer an additional benefit to talking therapy for individuals with AN. By enabling visual expression, this approach could support emotional insight and communication in populations with emotion labelling and regulation differences.

HintergrundPsychisch erkrankte Jugendliche benötigen im Übergang zum Erwachsenenalter stabile Versorgungsstrukturen. Der traditionell vorgeschriebene Behandlungswechsel mit 18 Jahren von der kinder- und jugendpsychiatrischen in die erwachsenenpsychiatrische Versorgung wurde diesem Bedarf nicht gerecht. Eine am 15. Mai 2024 in Österreich in Kraft getretene Novelle der Ärztinnen-/Ärzte-Ausbildungsordnung ermöglicht Kinder- und Jugendpsychiater:innen (KJPs) in Österreich offiziell, dass sie ihre Patient:innen über die Volljährigkeitsgrenze hinaus weiterbehandeln dürfen. Die vorliegende Studie untersucht erstmalig die Einschätzungen von KJPs zur Novelle und erhebt erste praktische Auswirkungen in der Versorgung.MethodologieEs wurden semi-strukturierte Interviews mit 16 KJPs aus verschiedenen Arbeitskontexten durchgeführt. Die Datenauswertung erfolgte mittels Reflexiver Thematischer Analyse.ErgebnisseDie Studie zeigt, dass die Novelle für viele KJPs überraschend eingeführt wurde, wobei vor allem die fehlende Vorlaufzeit bei einigen niedergelassenen KJPs für Unmut sorgte. Inhaltlich wurde sie jedoch überwiegend positiv bewertet, von einigen sogar als längst überfällig angesehen. Viele KJPs sehen sich aufgrund der hohen Auslastung weiterhin gezwungen, ihre begrenzten Ressourcen vorrangig für Minderjährige einzusetzen, woran auch die Novelle nichts ändere. Aufgrund des hohen Bettendrucks in Kliniken habe die Novelle auch im stationären Bereich noch nicht zu nennenswerten Veränderungen geführt.Fazit für die PraxisDie Novelle findet bei den befragten KJPs inhaltlich Zustimmung, jedoch verhindert der vorhandene Ressourcenmangel sowohl im stationären als auch im ambulanten Bereich die Realisierung des Potenzials. Ohne Kapazitätsausbau werden die durch die Novelle intendierten Verbesserungen der psychiatrischen Versorgung für Patient:innen im Transitionsalter voraussichtlich weitgehend ausbleiben.

Psychische Erkrankungen sind häufig mit einem deutlich reduzierten Aktivitätsniveau verbunden, was zu Inaktivitätsraten von 40–86 % führt. Dies ist problematisch, da Bewegung nicht nur positive Auswirkungen auf die körperliche Gesundheit hat, sondern auch eine evidenzbasierte, kostengünstige und risikoarme Behandlungsoption für psychische Störungen darstellt. Dennoch bleibt Bewegung in der psychiatrischen Versorgung unzureichend integriert, was unter anderem auf Barrieren bei Behandelnden und Patient:innen zurückzuführen ist. Zu den größten Hindernissen seitens der Patient:innen zählen Müdigkeit, Unsicherheit und finanzielle Einschränkungen, während Zeitmangel eine geringere Rolle spielt.Diese Übersicht untersucht die wissenschaftliche Evidenz für Bewegung als Therapiebaustein – „Exercise is Medicine®“ – bei psychiatrischen Erkrankungen und zeigt deren Wirksamkeit für ein breites Spektrum an Indikationen – von „A“ wie Angststörungen bis „Z“ wie Zwangsstörungen. Anschließend wird der „Knowledge-Action-Gap“ zwischen Wissen und Anwendung aufgezeigt und praxisnahe Handlungsempfehlungen aus der Motivierenden Gesprächsführung (Motivational Interviewing) vorgestellt. Neben einer Differenzierung der Begriffe körperliche Aktivität, Bewegung, Sport und Trainingstherapie werden Bewegungsempfehlungen, Techniken zur Verhaltensänderung sowie ein Gesprächsleitfaden und ein Flyer zur Patient:innen-Aufklärung präsentiert.Ziel des Artikels ist es, Bewegung als festen Bestandteil der psychiatrischen Behandlung zu etablieren und die Anwendbarkeit in der Praxis zu erleichtern. Durch die Integration von Bewegung können nicht nur die Lebensqualität und psychische Gesundheit der Betroffenen verbessert, sondern auch gesundheitliche Disparitäten reduziert werden. Der Artikel bietet evidenzbasierte Empfehlungen und praxisnahe Strategien zur Förderung körperlicher Aktivität in der psychiatrischen Versorgung.Zusatzmaterial onlineZusätzliche Informationen sind in der Online-Version dieses Artikels (10.1007/s40211-025-00535-5) enthalten.

This systematic review examines the connections between eating disorders, body image disturbance, self-esteem, and emotion regulation in adults. Following the PRISMA guidelines, a systematic search of PubMed, Scopus, and Web of Science databases was conducted for articles published between 2010 and June 2024. Studies were included if they involved participants aged 18 years and older, employed validated tools for measuring the variables, and presented original research that specifically addressed these psychological factors. Out of 1117 records, six studies met the inclusion criteria, with mostly female samples and a focus on body image, self-esteem, and emotion regulation in relation to eating disorders. The results indicate that body dissatisfaction is closely related to disordered eating behaviors, with a significant link to lower self-esteem and difficulties in emotion regulation. Obese individuals with binge eating disorder (BED) were found to have more negative attitudes toward obesity and greater levels of depression than their non-BED counterparts. Women with bulimia nervosa showed higher emotion-focused coping, which is associated with low self-worth. Differences in gender were evident, with women exhibiting greater vulnerability to body image dissatisfaction and emotion dysregulation. The results show that treatment for adults with eating disorders should focus on the enhancement of self-esteem, the improvement of body image perception, and the development of adaptive emotion regulation strategies. Lastly, practicing self-compassion techniques in psychotherapy could improve the treatment process for patients suffering from eating disorders, low self-esteem, emotion dysregulation, and body image disturbance. Future studies should investigate these variables in various non-Western cultural contexts for better understanding and clinical intervention for the adult population.

BackgroundThe aging global population has led to an increase in the number of dementia diagnoses, with projections indicating a continued upward trend. This demographic change presents profound challenges for patients, their families, and healthcare systems worldwide. Consequently, the demand for reliable and user-friendly screening tools that can detect dementia at early stages and monitor its progression is more critical than ever. The International Neurocognitive Test Profile (INCP), developed at the Medical University of Vienna, aims to address this need by offering a digital test battery for the early detection of dementia. This study forms a part of the INCP’s ongoing development and evaluation, specifically investigating the influence of gender on test outcomes.MethodsSeventy participants, recruited through flyers at the Vienna General Hospital, completed the INCP assessment using tablets as part of the study. The effect of gender on performance across various INCP subtests was analyzed using Mann–Whitney U tests. For further exploratory analysis, a correlation matrix was calculated encompassing demographic variables (age and education), screening data, and all INCP subtests.ResultsThe analysis revealed significant gender differences in two INCP subtests related to executive functions. Males outperformed females on the Figure Fluency Test (r = 0.30, indicating a moderate effect) and the Dice 2‑n Back Test (r = 0.29, indicating a small effect). However, when correcting for multiple comparisons, no significant gender disparities were observed in the scores of the subtests.ConclusionThe identification of possible gender differences in specific subtests underscores the importance of considering gender as a variable in the further development and evaluation of the INCP. These findings offer valuable insights for the design and planning of future studies involving the INCP.

The sharp rise in the number of predominantly natal female adolescents experiencing gender dysphoria and seeking treatment in specialized clinics has sparked a contentious and polarized debate among both the scientific community and the public sphere. Few explanations have been offered for these recent developments. One proposal that has generated considerable attention is the notion of “rapid-onset” gender dysphoria, which is assumed to apply to a subset of adolescents and young adults. First introduced by Lisa Littman in a 2018 study of parental reports, it describes a subset of youth, primarily natal females, with no childhood indicators of gender dysphoria but with a sudden emergence of gender dysphoria symptoms during puberty or after its completion. For them, identifying as transgender is assumed to serve as a maladaptive coping mechanism for underlying mental health issues and is linked to social influences from peer groups and through social media. The purpose of this article is to analyze this theory and its associated hypotheses against the existing evidence base and to discuss its potential implications for future research and the advancement of treatment paradigms.

The aim of this study is to describe coronavirus disease 2019 (COVID-19)-related dysfunctional anxiety and thinking in patients with stroke and caregivers who are family members and their effects on caregiver burden. This cross-sectional study included 79 stroke patients and their primary caregivers who were hospitalised in atertiary rehabilitation hospital. Coronavirus Anxiety Scale (CAS) and Obsession with COVID-19 Scale (OCS) were used to assess the levels of COVID-19-related dysfunctional anxiety and obsession of the patients and their caregivers. Caregiver burden was assessed via the Zarit Burden Interview (ZBI). In the patients with stroke, COVID-19-related anxiety and COVID-19-related obsession rates were 13.9% (n = 11) and 7.6% (n = 6), respectively, while 17.7% (n = 14) of caregiver family members had COVID-19-related anxiety and 11.4% (n = 9) had COVID-19-related obsession. The CAS score of caregivers showed asignificant positive correlation with the CAS and OCS scores of patients (p = 0.000, r = 0.423; p = 0.007, r = 0.300, respectively). The OCS score of caregivers showed asignificant positive correlation with the OCS scores of the patients (p = 0.000, r = 0.476). The mean ZBI score of caregiver family members was 31.9 ± 13.5. A significant positive correlation was observed between the caregiver's OCS and CAS scores and ZBI scores (p = 0.002, r = -0.349; p = 0.004, r = 0.323, respectively). In this study, a significant relationship between caregiver burden and COVID-19-related anxiety and obsession in the caregivers of stroke patients was identified. Therefore, caregivers of stroke patients should not be forgotten during pandemics and should receive physical and psychological support.

BackgroundChildren and adolescents living with mental health problems often experience stress and poor mood states, which may influence their quality of life and well-being. Arts interventions may improve mood and well-being and reduce physiological stress in this vulnerable population.MethodsA cohort of patients in child and adolescent psychiatry (N = 42; age range: 12–18 years) participated in one of four arts activities including choir singing (n = 11), textile design (n = 9), drama (n = 16), and clownery (n = 6). They were led by professional artists and delivered through five consecutive 90-min daily afternoon sessions over the course of 1 week. Questionnaires of mood and saliva samples before and after each session served to assess short-term psychobiological changes. In addition, patients reported their quality of life and well-being at the beginning and at the end of the 1‑week program.ResultsResults showed that alertness was significantly enhanced after textile design (∆post–pre = 4.08, 95% CI [0.77, 7.39]) and after singing (∆post–pre = 2.20, 95% CI [−0.55, 4.94]). Moreover, mood tended to be positively affected by textile design (∆post–pre = 2.89, 95% CI [−0.39, 6.18]). Quality of life increased significantly after singing (∆post–pre = 5.49, 95% CI [1.05, 9.92]). Arts participation except singing was associated with significant reductions in salivary cortisol (sCort) (textile design ∆post–pre = −0.81 ng/mL, 95% CI [−1.48, −0.14]; drama ∆post–pre = −0.76 ng/mL, 95% CI [−1.28, −0.24]; clownery ∆post–pre = −0.74 ng/mL, 95% CI [−1.47, −0.01]). No significant changes were observed for well-being over the whole program and salivary immunoglobulin A (sIgA) after any of the arts activities.DiscussionThese results suggest that arts participation can improve mood state and reduce stress in young people with mental disorders, but there is a need for further studies.

The main aim of the present study is to evaluate the influence of depressive symptoms on mortality in patients with SCD (subjective cognitive decline), naMCI (non-amnestic mild cognitive impairment), and aMCI (amnestic mild cognitive impairment). Additional factors (age, sex, years of school attendance, and neuropsychological performance) were considered to determine the impact on survival probability. A monocentric retrospective data analysis based on adjusted patient protocols (n = 1221) from the observation period 1998–2021, using the Cox Proportional Hazards model, assessed whether depressivity had an explanatory value for survival, considering SCD as the reference level in relation to naMCI and aMCI. Covariates were included blockwise. Cox regression revealed that depressiveness (Beck Depression Inventory, Geriatric Depression Scale) did not make a significant contribution as a risk factor for mortality in all five model blocks, BDI-II with HR 0.997 [0.978; 1.02] and GDS-15 with HR 1.03 [0.98; 1.08]. Increasing age with HR 1.09 [1.07; 1.11] and male sex with HR (inverted) 1.53 [1.17; 2.00] appeared as risk factors for increased mortality across all five model blocks. aMCI (vs. SCD) with HR 1.91 [1.33; 2.76] showed a significant explanatory value only up to the fourth model block. By adding the six dimensions of the Neuropsychological Test Battery Vienna in the fifth model block, the domains attention and perceptual speed with HR 1.34 [1.18; 1.53], and executive functions with HR 1.24 [1.11; 1.39], showed substantial explanatory values for survival. Accordingly, no tendency can be attributed to depressiveness as a risk factor on the probability of survival, whereas the influence of certain cognitive dimensions, especially attention and perceptual speed, and executive functions, can be seen as protective for survival.

PurposeThis study aimed to compare the mental health outcomes of children in North Tyrol, Austria, and South Tyrol, Italy, during the coronavirus disease 2019 (COVID-19) pandemic, considering the sociocultural and contextual differences between the two regions.MethodsThe Tyrolean COVID-19 Children’s Study (TCCS: n = 401; June 2021 to July 2021) and the Corona and Psyche in South Tyrol 2021 Study (COP‑S; n = 3402; May 2021 to June 2021) were used for data analyses. Both studies employed cross-sectional designs and collected data through online questionnaires completed by children aged 7–13 years and their parents. Various psychosocial assessment tools including the Child and Adolescent Trauma Screening, Children Anxiety Test, Child Behavior Check List, Screen for Child Anxiety Related Emotional Disorders, and Health Behaviour in School-Aged Children were used in the surveys.ResultsThe comparison between North Tyrol and South Tyrol revealed no significant differences in perceived threats, trauma, or anxiety among children. Similarly, there were no substantial disparities in psychosomatic complaints, indicating similar manifestations of emotional distress across the two regions.ConclusionThe comparative analysis of children’s mental health outcomes in North Tyrol and South Tyrol during the COVID-19 pandemic confirmed the analogous influence of sociocultural and contextual factors on their wellbeing. Despite presumable variations in pandemic events, management strategies, and healthcare systems, the study suggests comparable resilience among children and highlights the importance of sociocultural factors in shaping their wellbeing. The findings emphasize the need for comprehensive understanding and targeted interventions to support children’s mental health during challenging times.