Autoimmun-Enzephalitiden – eine Erkrankungsgruppe mit vielen Gesichtern

During the last 10 years a number of syndromes with antibodies against neuronal surface antigens have been characterized. Adults as well as children can be affected. Patients may suffer from amnestic syndrome, other cognitive deficits, seizures, or psychiatric symptoms. Some patients develop generalized encephalopathy with altered levels of consciousness, hyperkinesias, and hypothalamic disorders. In some patients, ovarial teratoma, thymoma, or small cell lung cancer can be diagnosed. However, in most patients no tumor is found. These syndromes were previously called autoimmune channelopathies. In fact, most antigens are not part of an ion channel but proteins or part of protein complexes on the cell surface of neurons, axons, dendrites, or synaptic terminals. These proteins are expressed throughout the nervous system. Interestingly, in limbic encephalitis very circumscribed brain regions are affected. This may be due to an increased vulnerability or accessibility of the affected brain regions. Limbic encephalitis is a well-characterized form of autoimmune encephalitis, which can be associated with different antibodies. Anti-NMDA-receptor encephalitis is not restricted to the limbic system. Characterization of other syndromes and auto-antibodies are expected in the future. In this review, aspects of limbic encephalitis and anti-NMDA-receptor encephalitis will be discussed.     

Die Hysterie im neuen Gewand und im Wandel der Zeit

Classical symptoms of hysteria – especially symptoms of hysterical neurosis (conversion type) – are not commonly seen any more. On the one hand, general knowledge about the function of hysterical has led to suppression of the underlying hidden conflicts, possibly up to resomatization. On the other hand, those affected may have rather subtle symptoms, e.g., vague pain, circulatory disorders, or fatigue. Overall, the hysterical phenomena have not become less common but have become “contemporary” and, therefore, more difficult to identify. Reliable epidemiological data, however, are difficult to obtain. Rough estimates indicate that 2–6?% of all people have dissociative disorders (ICD-10 definition). Histrionic personality disorder is estimated to occur with a frequency of 2–3?%. In 75?% of cases, the disease manifests relatively early, between the ages of 17 and 32 years and with a 3:1 female to male ratio. An average of 7 years elapses between first manifestation and the start of psychiatric–psychotherapeutic treatment.     

Lumbale Radikulopathie

Back pain is a common pain syndrome in the general population. The most common cause is lumbar disc disease and only rarely bony degenerative changes of the spine. Other causes of lumbar radiculopathy include local lesions. Inflammatory changes or meningeal carcinomatosis may also lead to lumbar nerve root damage. With pronounced clinical symptoms, motor deficits of the associated muscles can occur, including weakening of muscle reflexes. In addition to thorough education of the patient about the origin, likely duration, and treatment of the disease, a combination of physical therapy and pharmacotherapy is the basis for successful treatment of lumbar radiculopathy. In cases of severe paralysis, bladder and rectal paralysis, and corresponding compression of nerves, urgent spinal surgery is inevitable.     

Eine erfolgreiche Behandlunsgkette bei Zwangsstörung

Obsessive-compulsive disorder (OCD) belongs to a group of disorders with an estimated lifetime prevalence of 2?%, associated with a high socio-economic burden and the risk of chronification. In the latest version of the DSM-5, OCDs were detached from the chapter of anxiety disorders, similar to the ICD-10. Consequently, the fifth revision of the DSM highlights the fact that scientific results so far, like the overactivation of basal-ganglia thalamocortical circuits, basically support a common model for OCDs. Although in the past, OCDs have been ignored as a diagnostic entity, in the DSM-5, the concept of obsessive–compulsive spectrum disorders according to Hollander was partly realized. The present case report outlines an example of a successful therapeutic chain in the treatment of a severe case of OCD with a 90?% reduction of symptoms throughout a calendar-year, emphazising the importance of efficient treatment chains within psychiatric disorders.     

Personal choice: A blessing or a burden,or both? A cross‐cultural investigation on need for closure effects in two Western and two East‐Asian societies

The present study investigates the role of dispositional need for closure (NFC) in how individuals within a particular culture perceive and appreciate choice. Data sets from the US (283 adults), Europe (263 adults and 427 students), China (218 adults and 309 students) and Singapore (258 students) were collected. The results showed that in Western cultures, people perceived choice in a linear way as either a burden or a blessing, whereas in Chinese culture, such opposition between perspectives did not appear, and individuals generally saw choice as both burden and blessing simultaneously. In Western cultures, high dispositional NFC was strongly associated with viewing choice‐as‐a‐burden, whereas Chinese respondents with a high NFC perceived choice as a blessing and a burden simultaneously. The Singaporean results were similar to the Western pattern. These findings are discussed in terms of the NFC literature and cultural differences in dialectic versus differentiation thinking styles.     

Lay beliefs about the causes of and solutions to dehumanization and prejudice: do nonexperts recognize the role of human–animal relations?

We investigate laypeople's beliefs about the causes of and solutions to out‐group dehumanization and prejudice. Specifically, we examine whether nonexperts recognize the role that beliefs in the human–animal divide play in the formation and reduction of intergroup biases, as observed empirically in the interspecies model of prejudice. Interestingly, despite evidence in the present study that human–animal divide beliefs predict greater dehumanization and prejudice, participants strongly rejected the human–animal divide as a probable cause of (or solution to) dehumanization or prejudice. We conclude with a meta‐analytic test of the relation between human–animal divide and prejudice (mean r = .34) in the literature, establishing the human–animal divide as an important but largely unrecognized prejudice precursor. Applied implications for the development and implementation of prejudice interventions are considered.