LVR-Klinikum Düsseldorf Hospital of the Heinrich-Heine University ...

LVR Landschaftsverband Rheinland 

LVR-Klinikum Düsseldorf – Hospital of the Heinrich-Heine University Düsseldorf 

Bergische Landstraße 2, 40629 Düsseldorf 

Tel.: +49 211 922-0, Fax: +49 211 922-1010 

klinikum-duesseldorf@lvr.de – www.klinikum-duesseldorf.LVR.de 

LVR-Klinikum Düsseldorf Healthcare, Research, Teaching 2001–2009 

20% Schwarz 

LVR-Klinikum Düsseldorf 

Hospital of the Heinrich-Heine 

University Düsseldorf 


Hospital of the Heinrich-Heine University Düsseldorf 

Healthcare 

Research 

Teaching 

2001–2009 

LVR Clinic Association



Healthcare 

Research 

Teaching 

2001–2009

LVR-KLINIKUM DÜSSELDORF – HOSPITAL OF THE HEINRICH-HEINE UNIVERSITY DÜSSELDORF 

Published by 

The Board of Directors of the LVR-Klinikum Düsseldorf – 


W. Gaebel, MD, Professor of Psychiatry and Psychotherapy 

J. Heinlein 

K. Maas 

LVR Landschaftsverband Rheinland 

LVR-Klinikum Düsseldorf – Hospital of the 

Heinrich-Heine University Düsseldorf 

Bergische Landstraße 2 

40629 Düsseldorf 

Germany 

Phone: +49 211 922-0 

Fax: + 49 211 922-1010 

klinikum-duesseldorf@lvr.de 

www.klinikum-duesseldorf.lvr.de 

2 

Editorial Board 

B. Janssen, MD, Senior Lecturer in Psychiatry and 

Psychotherapy 

W. Wölwer, PhD, Professor of Experimental Psychopathology 

J. Zielasek, MD, Senior Lecturer in Neurology 

Design and Photography 

Wiedemeier Kommunikation GmbH 

Wilhelm-Tell-Straße 26 


www.wiedemeier-kommunikation.de 

Pictures of other photographers: 

Andreas Hub (p. 10, p. 30), Thomas Götz (pp. 6/7, p. 27), 

Hans-Theo Gerhards (p. 46) 

Translation 

Satellit Sprachen Service, J. Klesing, and the Editors 

To make the text easier to read, we have used the male 

form throughout. Wherever a single patient, medical doctor, 

student, etc. is referred to as “he”, this shall be deemed 

to include patients, medical doctors, students, etc. of both 

sexes. 

The reports in this book were conceived and written by 

people working in the respective divisions of the LVR- 

Klinikum Düsseldorf.

Table of contents 

Preface 6 

1. Responsibilities and Range of Services of the LVR-Klinikum Düsseldorf 10 

Responsibilities and Range of Services 12 

Mission Statement 15 

2. Healthcare 16 

2.1 Catchment Area and Perspectives for Future Development 18 

2.2 Clinical Facilities 24 

2.2.1 Department of Psychiatry and Psychotherapy 24 

2.2.1.1 Division of General Psychiatry and Psychotherapy I 24 

2.2.1.2 Division for General Psychiatry and Psychotherapy II 26 

2.2.1.3 Division of Gerontopsychiatry and Psychotherapy 32 

2.2.1.4 Division of Dependence Disorders 34 

2.2.1.5 Division of Neurology 36 

2.2.1.6 Division of Rehabilitation 38 

2.2.1.7 Scientific and Academic Staff of the Division of Psychiatry and Psychotherapy 41 

2.2.2 Department of Psychosomatic Medicine and Psychotherapy 42 

2.2.3 Division for Child and Adolescent Psychiatry, Psychosomatic Medicine 

and Psychotherapy 45 

2.2.4 Nursing 48 

2.2.5 Cross-divisional units 50 

2.2.6 Cross-divisional facilities 54 

3. Research 56 

3.1 Department of Psychiatry and Psychotherapy 58 

3.1.1 Research Networks 58 

3.1.1.1 Competence Network on Schizophrenia (FMER) 58 

3.1.1.2 Competence Network on Depression and Suicidality (FMER) 62 

3.1.1.3 Competence Network on Dementia (FMER) 63 

3.1.1.4 DFG Priority Programme “Nicotine: Molecular and Physiological 

Effects in the Central Nervous System” (DFG) 63 

3.1.1.5 Dependence Research Network North Rhine-Westphalia (FMER) 64 

3.1.1.6 “Psychotherapy of Psychotic Syndromes” Research Network (FMER) 64 

3.1.1.7 Associated Satellite Centre (ASC) within the Brain-Net Project Network (FMER) 65 

3.1.1.8 Benchmarking in Acute Psychiatric Treatment (BMG) 65 

3.1.2 Research Laboratories 66 

3.1.2.1 Neurobiochemistry Research Laboratory 66 

3.1.2.2 Experimental Psychopathology Research Laboratory 73 

3.1.2.3 Brain morphology research laboratory and animal 

experimental psychosis research 80 

3.1.2.4 Psychophysiology and Psychopathometry Research Laboratories 83 

3.1.2.5 Neuro-Psychiatric Research Laboratory 84 

CONTENTS 

3


4 

3.1.3 Research groups 88 

3.1.3.1 Classification of mental disorders 88 

3.1.3.2 Dependence disorders 89 

3.1.3.3 Long-term treatment of persons with schizophrenic psychoses 90 

3.1.3.4 Destigmatisation of people with mental disorders 95 

3.1.3.5 Gerontopsychiatry and dementia research 97 

3.1.3.6 Comorbidity in people with mental disorders 102 

3.1.3.7 Quality management and healthcare research 106 

3.1.3.8 Transcranial magnet stimulation 108 

3.1.4 Project groups 111 

3.1.4.1 Evaluation of work-rehabilitation measures 111 

3.1.4.2 Early diagnosis of psychotic disorders 111 

3.1.4.3 Borderline personality disorder 112 

3.1.5 Research Centres 113 

3.1.5.1 Clinical Psychology 113 

3.1.5.2 Psychiatric Sociology 113 

3.1.6 Outpatient Clinic 116 

3.1.7 Infrastructural facilities 116 

3.1.7.1 Study Service Centre 116 

3.1.7.2 Biometrics and documentation 118 

3.1.7.3 Audiovisual Centre 118 

3.1.8 Diploma and master theses, doctoral and habilitation dissertations 119 

3.1.8.1 Diploma and master theses 119 

3.1.8.2 Doctoral Dissertations 119 

3.1.8.3 Habilitation Dissertations 119 

3.1.9 Publications 120 

3.1.9.1 Publications in journals 120 

3.1.9.2 Book contributions 137 

3.1.9.3 Books and Publications 142 

3.1.10 Research funding 144 

3.1.11 Organised science symposia and congresses 145 

3.1.12 Personnel 146 

3.2 Department of Psychosomatic Medicine and Psychotherapy 148 

3.2.1 Research groups 148 

3.2.1.1 Microprocedural treatment course and long-term results in 

patients with different personality structures 148 

3.2.1.2 Psychodiabetology 149 

3.2.1.3 Somatoform disorders 150 

3.2.1.4 Psychotraumatology 150 

3.2.1.5 Psychooncology 151 

3.2.1.6 Psychosomatic epidemiology 151 

3.2.1.7 Psychosomatic basic care 151

3.2.1.8 Research group on clinical documentation and evaluation 

of inpatient psychotherapeutic treatment 151 

3.2.1.9 Psychometry basic research 152 

3.2.1.10 Qualitative methods 152 

3.2.2 Doctoral dissertations and habilitation dissertations 153 

3.2.2.1 Doctoral dissertations 153 

3.2.2.2 Habilitation dissertations 154 




3.2.3.3 Books and editorships 166 

3.2.4 Research funding 168 

3.2.5 Organised science symposia and congresses 170 

3.2.6 Personnel 171 

3.3 Department of Child and Adolescent Psychiatry, Psychosomatic Medicine 

and Psychotherapy 172 

3.3.1 Research projects 172 




3.3.2.3 Books and editorships 174 

3.4 Scientific library 175 

4. Teaching 176 

4.1 Academic Teaching for Students 178 

4.1.1 Psychiatry and Psychotherapy 178 

4.1.2 Psychosomatic Medicine and Psychotherapy 179 

4.2 Medical training, continuing medical education 

and post-graduate specialist training 180 

4.2.1 Department of Psychiatry and Psychotherapy 180 

4.2.2 Department of Psychosomatic Medicine and Psychotherapy 181 

4.2.3 Specialty Training in Neurology 188 

4.2.4 Specialty Training in Child & Adolescent Psychiatry 188 

4.2.4 Institute for Clinical Behaviour Therapy 188 

4.2.5 Internal Continuing Education Courses 189 

4.3 School of Nursing 189 

CONTENTS 

5


Preface 

The Research Report 2001–2009 of the LVR-Klinikum 

Düsseldorf – Hospital of the Heinrich-Heine University 

Düsseldorf – continues the tradition of our previous reports 

on research, academic training and hospital care and 

follows from the volume published in 2001 on the occasion 

of the Klinikum’s 125th anniversary1 . The Klinikum assumed 

its current name in 2009 having been previously – and 

throughout most of its long and distinguished history – 

called the Rheinische Kliniken Düsseldorf. This report, 

much in the same way as its predecessors, provides the 

readers with an overview of the Klinikum’s scope of duties, 

range of medical services and facilities before detailing its 

achievements in research and academic training. The size 

of the report reflects the need to record the large number of 

changes in the clinical, academic and educational structures 

that have occurred in the ten years since the last report of 

this kind was published. 

The research activities of the LVR-Klinikum have developed 

in such a way that they now cover most of the mental 

disorders commonly treated in psychiatry and psychotherapy 

and in psychosomatic medicine and psychotherapy, 

including the methods generally used for diagnosis and 

therapy. The research in the Department of Psychiatry and 

Psychotherapy also includes – in line with the institution’s 

translational approach – the neurobiological and systems 

biology foundations and therapy of mental illnesses, the 

conduct of controlled therapy studies including syndromeoriented 

psychotherapy research, the evaluation of 

innovative interventions, stigma research and healthcare 

6 

W. Gaebel, MD 

Professor of Psychiatry and Psychotherapy 

Medical Director 

research with a special focus on healthcare models and 

quality assurance techniques. Given this range of research 

targets, much of the institution’s attention is dedicated to 

schizophrenia, affective disorders, dependence disorders 

and dementia. Representatives of the LVR-Klinikum also 

contribute to the continuous international development of 

diagnostics and classification, playing an active role in the 

ongoing revision of the classification systems for mental 

disorders of the American Psychiatric Association (for 

DSM-V) and the World Health Organization (for ICD-11). 

All of these activities were and still are being performed 

in the middle of ongoing organisational and physical 

restructuring. It is particularly worth noting that, in 2005, 

we were able to complete the establishment of a new day 

clinic and an institutional outpatient unit for the Department 

of Psychiatry and Psychotherapy, on the grounds of the 

Düsseldorf University Hospital, an achievement celebrated 

by a scientific symposium. The completion of these new 

facilities represented a major – and long overdue – step 

towards an ever closer cooperation between the LVR- 

Klinikum and the Düsseldorf University Hospital, and we 

are already looking forward to the construction of three new 

day care units on the grounds of the University Hospital 

scheduled for 2010. 

In House 2 on the Bergische Landstraße site, a dedicated 

forensic-psychiatric ward was established in 2006 to care 

for patients – who had, until then, been scattered through 

the individual divisions of the hospital – in a single forensic 

1 Versorgung, Forschung und Lehre 1996–2000; Rheinische Kliniken Düsseldorf – Kliniken der Heinrich-Heine-Universität Düsseldorf; Hrsg.: W. Gaebel

J. Heinlein 

Director of 

Hospital Administration 

psychiatry unit, significantly improving the quality of the 

forensic-psychiatric treatment. The Divisions of Child and 

Adolescent Psychiatry and of Rehabilitation were able to move 

into newly constructed buildings. Houses 20 and 21, which 

had been erected during the period of promoterism, were 

comprehensively renovated to comply with the requirements 

of a day care clinic and an outpatient unit, respectively. In 

the course of this project, an additional entrance to the 

LVR-Klinikum was also built. This served to take the LVR- 

Klinikum one step closer to the objective of implementing 

the concept of an outwardly “open” hospital that provides 

day care and outpatient services close to the community it 

serves. In the middle of all these structural changes, the 

LVR-Klinikum Düsseldorf still dedicated the necessary 

amount of attention to process quality, as demonstrated by 

the successful certification and recertification, during the 

period under review, according to KTQ standards. It should 

also be mentioned that in 2007 the IKV, the “Institute for 

Clinical Behaviour Therapy”, was established at the LVR- 

Klinikum Düsseldorf, providing psychologists with the kind 

of theoretical as well as clinical and practical training they 

require to become psychological psychotherapists. 

In addition to the involvement of medical doctors from the 

LVR-Klinikum Düsseldorf in national and international 

projects, their activities in the internal organisation of 

the Klinikum, as cooperation partners in interdisciplinary 

research projects and as external consultants at the 

University Hospital Düsseldorf, are equally noteworthy. 

There are also various joint ventures in the field of student 

K. Maas 

Director of Nursing 

PREFACE 

teaching and training, an area that is assuming an ever more 

central position in the range of academic services. Teaching 

will be one of the special priorities in the new German policy 

of “performance-oriented allocation of funds”, in addition 

to the publication of impact-factor relevant papers and the 

acquisition of qualified third party funds. Fortunately, the 

LVR-Klinikum Düsseldorf has fared very well in the statewide 

comparison of these benchmarks between universities 

– as demonstrated by a survey conducted on behalf of the 

Ministry for Science and Research of the state of North 

Rhine-Westphalia in 2006. 

The achievements of the LVR-Klinikum Düsseldorf in the 

areas of research, academic teaching and healthcare 

presented in this report must be successfully continued 

but also further intensified in the coming years. As far as 

the provision of healthcare is concerned, the numbers of 

outpatients and inpatients are steadily rising, while the 

average duration of inpatient treatments is decreasing; this 

development has intensified the overall amount of clinical 

activity and necessitates a look into existing rationalisation 

potentials and the possibility of greater efficiencies. The 

introduction of a new joint flat-rate fee system for psychiatry, 

psychosomatic medicine and child and adolescent psychiatry 

will have unforeseeable consequences for the funding of 

healthcare institutions and, inevitably, also for the LVR- 

Klinikum Düsseldorf. 

In the field of research, a precisely targeted strategic 

positioning will be required for the continued success 

7


of our efforts to attract third-party funding. Successful 

structures must be protected and developed. This also 

applies to the structures of the Competence Network on 

Schizophrenia, funded by the German Federal Ministry 

for Education and Research, for which another period of 

financial assistance has been secured. By establishing a 

Chair of Experimental Psychopathology, the scientific and 

coordinative requirements for a sustainable development 

have been provided. The Competence Network, meanwhile, 

has started to host a regular European Schizophrenia 

Congress (every other year), and the establishment of a 

European Schizophrenia Society appears imminent. As soon 

as possible, a suitable candidate needs to be found to occupy 

the currently vacant W2 chair (specialisation: imaging 

techniques). The scientific cooperation with the WHO must 

be further expanded, with the agreed objective of obtaining 

accreditation as a WHO Collaborating Centre. 

In the field of academic teaching, there is active cooperation 

with the Medical Faculty of the Heinrich-Heine University in 

8 

implementing the “Curriculum 2011” initiative, a large-scale 

project to reform and optimise the teaching and training of 

medical students. 

Within the next few years, organisational and physical 

restructuring plans will continuously be implemented. 

Right now, the LVR-Klinikum is planning a new Centre for 

Neurology and Neuropsychiatry at the Bergische Landstraße 

site. The new centre will be operated in close cooperation 

with the Department of Neurology of the University Hospital 

Düsseldorf and will be dedicated to the scientific exploration 

and medical treatment of illnesses in the transition zone 

between neurology and psychiatry. 

One key challenge for the next few years will be the 

foreseeable lack of young medical doctors. In order to 

attract and promote talented young people, the Department 

of Psychiatry and Psychotherapy has improved the quality 

of its specialty training programme in psychiatry and 

psychotherapy and raised its profile as an institution of

higher academic learning by obtaining the certification 

of its post-graduate specialty training programme in 

psychiatry and psychotherapy by the German Association 

for Psychiatry and Psychotherapy (Deutsche Gesellschaft 

für Psychiatrie und Psychotherapie, DGPPN), in close 

coordination with the European Union of Medical Specialists 

(UEMS) in March 2010. Additional measures will serve to 

stimulate the scientific activities of young medical doctors in 

psychiatry and psychotherapy as well as in psychosomatic 

medicine and psychotherapy through specially designated 

training curricula, creating incentives for original research 

studies. In this area, too, the LVR-Klinikum will align its own 

programmes with the targets and development schedules 

of the Medical Faculty of the Heinrich-Heine University, 

particularly in the field of neuroscience. It is not for nothing 

that the expression “the decade of psychiatric disorders” is 

already making the rounds in international publications: the 

rapidly increasing knowledge about the aetiopathogenetic 

causes of mental illnesses in the context of interactions 

between genes and the environment will generate the type 

W. Gaebel, MD 

Medical Director 

J. Heinlein 

Director of Hospital 

Administration 

K. Maas 

Director of Nursing 

PREFACE 

of progress that will not only change the existing medical 

concepts but also – and particularly so – improve diagnostic, 

therapeutic-rehabilitative and preventive instruments, 

ultimately with a corresponding impact on the healthcare 

structures required to provide the services that have entered 

our reach. 

Healthcare, research and academic teaching in all the 

various fields of medicine will face a large number and 

variety of challenges. These challenges must be accepted 

and turned into opportunities in order to improve psychiatric 

diagnostics, treatment and healthcare for people with 

mental disorders – on a local, regional, national and 

international scale. This report for the period 2001–2009 

shows that the LVR-Klinikum – Hospital of the Heinrich- 

Heine University Düsseldorf is properly equipped and well 

poised to meet these challenges. 

9

lVR-KliniKum DÜSSelDoRF – HoSPitAl oF tHe HeinRiCH-Heine uniVeRSitY DÜSSelDoRF

1. Responsibilities and Range 

of Services of the 


StRuKtuR unD AuFgAbenSPeKtRum

lVR-KliniKum DÜSSelDoRF – HoSPitAl oF tHe HeinRiCH-Heine uniVeRSitY DÜSSelDoRF 

Responsibilities and Range of Services 

The LVR-Klinikum Düsseldorf – Hospital of the Heinrich- 

Heine University Düsseldorf), operated by the 

Landschaftsverband Rhineland (LVR, a public regional body), 

fulfils two roles simultaneously: it is a hospital for patients 

who require mental healthcare, psychosomatic healthcare or 

psycho therapy, and it is a university hospital with academic 

departments of psychiatry and psychotherapy (Chair: W. 

Gaebel, MD, Professor of Psychiatry and Psychotherapy, since 

1992) and psychosomatic medicine and psychotherapy (Chair: 

W. Tress, MD, PhD, Professor of Psychosomatic Medicine and 

Psychotherapy, since 1989). The LVR-Klinikum Düsseldorf is 

thus a provider of healthcare as well as a university hospital 

with responsibilities in research and academic teaching. 

Established in 1876 as the “Provinzial-Heil- und Pflegeanstalt 

12 

Grafenberg” under Carl Pelmann (1876–1989), the hospital 

– then headed by Josef Peretti – became associated in 1907 

with the “Akademie für Praktische Medizin”, in 1923 with the 

Medical Academy and in 1965 with the Medical Faculty of the 

University Düsseldorf (renamed Heinrich-Heine University 

Düsseldorf in 1988). In 1923, Franz Sioli (1923-1947) became 

the first Full Professor for Psychiatry. He was followed in this 

Chair by Gustav Störring (1949–1953), Friedrich Panse (1955– 

1967), Casper Kulenkampff (1967–1971) and Kurt Heinrich 

(1972–1992). In 1977, Annelise Heigl-Evers (1977–1989) 

received the first Full Professorship for Psychotherapeutic 

Medicine and Psychotherapy. In 2001 a comprehensive 

account of the first 125 years of the hospital was published by 

Gaebel, Heinlein and Maas on the occasion of its anniversary1 . 

Management chart for the LVR-Klinikum Düsseldorf – Hospital of the Heinrich-Heine University 

Medical Director: W. Gaebel, MD, Professor of Psychiatry 

Director of Nursing: K. Maas; Director of Hospital Administration: J. Heinlein 

Department of Psychiatry and Psychotherapy 

Director: W. Gaebel, MD, Professor of Psychiatry 

Divisions 

General 

Psychiatry I 

Division Heads 

S. Cohen, 

MD 

(comm.) 

General 

Psychiatry II 

W. Gaebel, 

MD 

Divisional Directors of Nursing 

Beds 

E. Haas 

P. Remmel 

J. Vermiert 

Gerontopsychiatry 

T. Supprian, 

MD 

Addiction 

Disorders 

P. Franke, MD 

Neurology Rehabilitation 

M. Griese, 

MD 

(comm.) 

R. Greis-Maibach 

Department of 

Psychosomatic 

Medicine and 


Director: 

W. Tress, MD, PhD 

Division of Child 

and Adolescent 

Psychiatry and 


Division Head: 

G. Ott, MD 

J. Vermiert E. Haas C. Foulon C. Foulon P. Remmel P. Remmel 

73 162 99 73 36 68 24 32 

Day Care Unit Places 

12 36 25 19 16 

Outpatients and Complementary Care 

Outpatient Clinics, Admission Units, Early Recognition Centre, Consultation Service, Home Treatment 

School of Nursing Treatment and Special Function Units 

Inpatient Ergotherapy, Music and Dance Therapy, 

Physiotherapy and Exercise Therapy, 

Clinical and EEG Laboratory, ECG, etc. 

Institute for Clinical Behavioural Therapy (ICB) 

Ombudsman 

H.-G. Ibold 

1 Psychiatrie im Wandel der Zeit: 125 Jahre „Grafenberg“ – Rheinische Kliniken Düsseldorf – Kliniken der Heinrich-Heine-Universität Düsseldorf; 1876–2001. 

– Köln [i.e.] Pulheim: Rheinland-Verl., 2001. 175 p.; many illustrations; ISBN: 3-7927-1847-2

A total of 940 people are employed by the LVR-Klinikum 

Düsseldorf (as per January 2010). This makes the Klinikum 

one of the largest hospitals run by the Landschaftsverband 

Rhineland (which operates and closely coordinates 

altogether ten hospitals under the joint umbrella of a 

hospital network and a common central administration 

office) and one of the key healthcare providers in the 

region. The Klinikum features all divisions of clinical 

psychiatry as well as central facilities for diagnosis 

and therapy, a research facility and a unit for academic 

teaching. It currently has 675 beds/treatment places, 108 

of which are for partial hospitalisation. The Department 

of Psychiatry and Psychotherapy of the Heinrich-Heine 

University Düsseldorf covers the field of psychiatry and 

psychotherapy and consists of four Divisions of General 

Psychiatry and Psychotherapy (General Psychiatry I, General 

Psychiatry II, Gerontopsychiatry, Dependence Disorders; 480 

beds/places, 73 of which are for partial hospitalisation), a 

Division of Rehabilitation (68 beds/places) and a Division of 

Neurology (36 beds). The Full Professor for Psychiatry and 

Psychotherapy is the medical director of the department. 

The LVR-Klinikum Düsseldorf – Hospital of the Heinrich- 

Heine University Düsseldorf also has a Division of Child and 

Adolescent Psychiatry and Psychotherapy (48 beds/places, 16 

of which are for partial hospitalisation) and a Department of 

Psychosomatic Medicine and Psychotherapy of the Heinrich- 

Heine University (43 beds/places, 19 of which are for partial 

hospitalisation). (All figures as per February 2010.) 

The LVR-Klinikum Düsseldorf also operates a range of out- 

patient facilities: a facility for pre-inpatient outpatient care, 

dedicated outpatient units, a polyclinic, several day care 

clinics, an early detection centre for mental disorders and 

several special outpatient centres, at both the main site 

(Bergische Landstrasse 2) and the Düsseldorf University 

Hospital (Moorenstrasse 5). The hospital grounds also 

accommodate a school for patients and a school of nursing as 

well as a train ing institute for psychological psychotherapists. 

Each of the eight divisions – with the exception of the 

rehabilitation division, which is run by a psychologist – 

is headed by a medical doctor, including the Division of 

General Psychiatry II (Head of the division: the Full Professor 

for Psychiatry and Psychotherapy) and the Department of 

Psychosomatic Medicine and Psychotherapy (Head of the 

department: the Full Professor for Psycho somatic Medicine 

and Psychotherapy). The top tier of the hospital management 

consists of an Executive Board (since 1 January 2010: the 

Board of Directors) featuring the Medical Director, the Director 

of Nursing and the Director of Hospital Administration (since 

ReSPonSibilitieS AnD RAnge oF SeRViCeS 

1 January 2010: the Chairman of the Board). (For more details, 

see the organisational chart on p. 12). 

The LVR-Klinikum Düsseldorf – Hospital of the 

Heinrich-Heine University Düsseldorf has the following 

responsibilities: 

s Provision of inpatient, partial hospitalisation, pre- and 

post-inpatient as well as outpatient care for (early) 

detection of mental and neurological disorders; 

treatment and alleviation of symptoms and prevention 

of deterioration 

s Research and academic teaching 

s Provision of post-graduate specialty training for 

medical doctors in the specialties of psychiatry 

and psychotherapy, psychosomatic medicine and 

psychotherapy, child and adolescent psychiatry and 

psychotherapy, and neurology 

s Implementation of hospital treatment orders as well as 

other hospitalisation and treatment orders under the 

laws of the federal state of North Rhine-Westphalia 

s Representation of the interests of people with mental 

and psychosomatic disorders, representation of the 

fields of psychiatry and psychotherapy, psychosomatic 

medicine and psychotherapy, neurology, and child and 

adolescent psychiatry and psychosomatic medicine and 

psychotherapy in academic societies as well as national 

and international organisations 

s Professional development of medical doctors through 

the provision of advanced training courses (continuing 

medical education) 

s Provision of expert opinions and official reports 

s Public relations 

Provided they have given their legally valid consent, persons 

with a wide range of mental illnesses can be integrated 

into the research and academic training efforts. This allows 

the acquisition of important research results on the basis 

of representative samples and ensures that the patients 

themselves benefit from scientific progress. It also enables 

the LVR-Klinikum to root the training of medical students, 

post-graduate specialist trainees and board-certified 

specialists in the broadest possible clinical foundation. 

The activities of staff members in medical organisations 

have ensured that the LVR-Klinikum Düsseldorf enjoys the 

reputation of a highly competent centre for all issues of 

diagnosis and treatment of mental disorders far beyond the 

narrow confines of the immediate region. This is reflected by 

the LVR-Klinikum’s presence at medical congresses and in 

scientific publications and the general media. 

13


Directorate Building of the LVR-Klinikum Düsseldorf 

14

Mission statement 

The LVR-Klinikum Düsseldorf (Hospital of the Heinrich-Heine University 

Düsseldorf) integrates a wide range of competencies involved in the 

provision of mental healthcare. Medical progress, the evolution of our 

society’s values and the structural changes of the healthcare system 

are challenges that we are actively facing by promoting the constant 

development of new approaches in medical care, research and academic 

teaching. Our management, doctors and staff are guided by the following 

principles: 

s The physical well-being of our patients is the be all and end all of our 

activities at the Klinikum. We respect their dignity and treat them with 

courtesy and consideration. 

s We work together to provide the best possible conditions for a successful 

course of treatments. By this we mean: the highest possible degree 

of recovery, lasting good health and the ability to lead a self-determined 

and full life. 

s One of our objectives is to make our patients understand their illnesses 

better and to come to terms with them. We also want to help our 

patients to assess and judge potential treatments and to assist us in our 

decisions. In close coordination with the patients themselves, we strive to 

make their families contribute to the success of their treatment. 

s Research and academic training are key tasks of the LVR-Klinikum. We 

are committed to a range of quality objectives and quality targets. We 

are engaged in a widening network of regional, national and international 

joint ventures and always strive for a quick implementation of the latest 

research results into our everyday medical practice. 

s The high quality of the services of the LVR-Klinikum is the result of 

the skills and commitment of all staff members as well as the staff’s 

readiness to adapt to and face new challenges. For this, they receive 

the full support of the hospital management. Staff and management 

deal with each other in a climate of openness and mutual respect. 

s Our managers always demonstrate exemplary commitment. They 

identify clear targets for their staff, design effective organisational 

processes and make sure that everyone is on board. 

s By conducting carefully planned campaigns and demonstrating 

personal commitment to the cause, we strive to improve the way people 

with mental illnesses are perceived by the wider public. We combat 

prejudice and discrimination and are working towards more acceptance 

of and understanding for people with for mental illnesses. 

s We are continuously improving the quality of our performance in 

all sections of the LVR-Klinikum – in ways that can be quantified by 

objective criteria. 

s We are actively engaged in joint ventures with the hospitals of the 

Landschaftsverband Rheinland and the hospitals of other public bodies, 

embracing best clinical practice as a guide and source of inspiration. 

s Economic success is a key condition for the safe future of our hospital. 

In order to achieve this objective, we act responsibly, cost-effectively 

and in full awareness of environmental concerns. 

Kolumnentitel leitbilD 

15

2. Healthcare

lVr-KlINIKUM DÜSSelDOrF – HOSPItal OF tHe HeINrIcH-HeINe UNIVerSItY DÜSSelDOrF 

2.1 Catchment Area and Perspectives for 

18 

Future Development 

Wittlaer 

Kaiserswerth 

Lohausen 

Angermund 

Kalkum 

Lichtenbroich 

Unterrath 

Rath 

Stockum 

Derendorf 

Mörsenbroich 

Lörick 

Golzheim 

Ludenberg 

Heerdt 

Grafenberg 

Niederkassel 

Düsseltal 

Pempelfort 

Oberkassel 

Gerresheim 

Altstadt 

Flingern Nord 

Stadtmitte Flingern Süd 

Hafen 

Karlstadt 

Friedrichstadt Lierenfeld 

Unterbilk 

Oberbilk 

Vennhausen 

Hamm Bilk 

Eller 

Mental health care area 


Sector I 

Sector II 

Sector III 

Flehe 

Volmerswerth 

Mental health care area 

Kaiserswerther Diakonie 

Florence Nightingale Hospital 

Location: LVR-Klinikum Düsseldorf 

Wersten 

Itter 

Himmelgeist 

Figure 1: Sector chart for mental health care of the City of Düsseldorf 

Reisholz 

Holthausen 

The LVR-Klinikum Düsseldorf provides psychiatric and 

psychotherapeutic care (under the German statutory 

health insurance regulations) for approximately 520,000 

of the 600,000 inhabitants of the city of Düsseldorf (i.e. 

all citizens except for those who live in the northern 

suburbs of Angermund, Kaiserswerth, Kalkum, Lörick, 

Lichtenbroich, Lohausen, Stockum and Unterrath). In 

1998, the hospital’s municipal target area was subdivided 

into three sectors (Figure 1), to which dedicated 

admission wards, sector wards and day clinic units of the 

LVR-Klinikum are allocated. 

Cooperation with the municipal 

government is close and includes 

regular sector conferences 

Hubbelrath with all institutions involved in 

the provision of healthcare to 

people with mental illnesses. 

Because of its major contribution to the 

provision of mental healthcare, the LVR-Klinikum 

Düsseldorf was closely involved in the 

compilation of the 2007 report by the 

Düsseldorf health authorities about 

the situation of people with mental 

Unterbach disorders. A project partly funded by 

the Landschaftsverband Rhineland to 

optimise regional mental healthcare 

Hassels 

and the cooperation with community 

mental health teams (“Sozialpsychiatrische 

Zentren”) was successfully implemented 

and was awarded the “Gesundes 

Land NRW 2009” prize of the State 

Garath of North Rhine-Westphalia. The 

LVR-Klinikum also plays a major 

Hellerhof role in the provision of supraregional 

healthcare, not least because of its function 

as a university department. The Division of Child 

and Adolescent Psychiatry provides mental healthcare for 

an area with 1.9 million inhabitants that comprises the city 

of Düsseldorf and the neighbouring county of Mettmann. 

Benrath 

Urdenbach 

The development of the number of cases, average lengths of 

stay and diagnosis patterns from 1999 until 2009 is shown in 

Table 1 and Figures 2 and 3. The statistical trends observed 

at the LVR-Klinikum reflected a nationwide development: an

Table 1: Number of inpatients of the LVR-Klinikum Düsseldorf (2001–2009; forensic cases excluded) 

HealtHcare 

2001 2002 2003 2004 2005 2006 2007 2008 2009 

General Psychiatry I (Sector III) 699 628 765 956 902 898 873 1,011 1,079 

General Psychiatry II (Sector II+III) 1,301 1,332 1,408 1,647 1,761 1,708 1,818 2,033 2,045 

Addiction Disorders 1,427 1,430 1,507 1,436 1,463 1,719 1,692 1,779 1,905 

Gerontopsychiatry 916 1,001 923 1,132 1,027 1,092 1,093 1,157 1,163 

Child & Adolescent Psychiatry and 


Percent 

326 309 274 375 359 417 399 394 450 

Neurology 418 453 516 608 605 544 593 572 583 

Psychosomatic Medicine 168 177 183 198 188 190 202 206 193 

Rehabilitation 16 9 19 15 11 18 9 14 9 

Total 5,271 5,339 5,595 6,367 6,316 6,586 6,679 7,166 7,427 

40 

35 

30 

25 

20 

15 

10 

5 

3.0 

23.9 

19.6 

0 

F0 F1 F2 F3 F4 F5 

ICD-10 Codes 

F6 F7 F8 F9 Others 

Figure 2: Relative proportion of diagnoses of inpatients in the LVR-Klinikum Düsseldorf 2009 

increase in the total number of annual inpatient admissions, 

primarily due to increasing numbers of people with affective 

disorders seeking inpatient treatment, accompanied by 

a decrease in the average length of inpatient stay. These 

trends led to a marked increase in the clinical workload 

density, which was aggravated by increasing documentation 

requirements. In order to relieve these pressures from the 

system and staff, a dedicated working group continuously 

improves the computer-based Hospital Information System. 

For some time now, the LVR-Klinikum Düsseldorf has been 

addressing quality assurance issues, resulting in 2006 in 

certification in accordance with KTQ standards and re- 

34.6 

1.5 

0.3 

2.6 

0.4 

0.0 

2.6 

11.6 

certification in 2009. In 2006, the Klinikum also received its 

initial EMAS certification in accordance with the European 

Eco Management and Audit Scheme (re-certification in 

2009). In order to further optimise the specialty training 

for young psychiatrists, the necessary steps were taken to 

obtain a special certification by the German Association for 

Psychiatry and Psychotherapy (which was awarded in March 

2010). 

In 2004, the German Medical Associations decided to extend 

the requirement that office-based medical doctors regularly 

attend Continuing Medical Education (CME) courses to 

medical doctors working in hospitals. As a consequence, 

19


Length of stay in days 

Figure 3: Mean values of the duration of inpatient treatments (green lines = 

standard deviation) in the LVR-Klinikum Düsseldorf (2001–2009; data does not 

include patients from the division of Rehabilitation and Forensic Psychiatry) 

20 

90 

80 

70 

60 

50 

40 

30 

20 

10 

36.5 

36.1 

32.1 

30.5 

2001 2002 2003 2004 2005 2006 2007 2008 2009 

30.3 

29.3 

30.0 

27.7 

25.3 

Year 

The new building 22 contains the 

outpatient and the day care unit 

of the Division of Child and 

Adolescent Psychiatry and 


Table 2: Conversions and new constructions in the LVR-Klinikum Düsseldorf 

Measure Year of 

Completion 

Moorenstraße Day Care Unit constructed 2004 

Ward 2C/E converted 2005 

Entrances to Houses 13 and 14 refurbished 2005 

Ward 2F converted for Forensic Psychiatry 2005 

Former dispensary converted for Business 

Administration 

2005 

House 29 converted into offices 2005 

House 20 converted into day care unit for 

General Psychiatry II 

2006 

House 21 converted into central outpatient unit 2006 

Newly built house 15 for 

Division of Rehabilitation 

2006 

Newly built House 22: day care unit and 

outpatient division for Child & Adolescent 

Psychiatry 

2006 

New building, Kiesheckerweg, for Division of 

Rehabilitation 

2006 

Refurbishment of kitchens and conversion to 

tray system 

2006 

House 8 converted to child day care centre 2007 

House 30 converted into offices 2008 

Conversion of former X-ray department 2008 

Creation of secure server areas in Houses 29 

and 30 

2008

The Day Care Unit House 20 of the Division of General Psychiatry and 

Psychotherapy II has been housed in a newly restored building 

CME courses provided by the LVR-Klinikum Düsseldorf 

since 2005 have been certified accordingly by the Medical 

Association North Rhine. 

Because of the growing importance of the internet 

as a medium of information, the website of the LVR- 

Klinikum Düsseldorf (www.klinikum-duesseldorf.lvr. 

de) was completely redesigned in 2004 and 2005 and has 

since been regularly updated. This website is intended 

as a readily accessible source of information – for staff 

members, students and the public – about the LVR-Klinikum 

Düsseldorf and its range of facilities in healthcare, research, 

student education and CME. This is also where the LVR- 

Klinikum Quality Report is available as a download. 

During the review period, a series of construction and 

maintenance projects (see Table 2) served to improve the 

outer appearance of the Klinikum. By removing walls and 

fences, the Klinikum has managed to find an architectural 

expression of its policy of openness, presenting an inviting 

and welcoming front to its neighbours and visitors. The 

target planning initiated already in 1993 by the LVR and the 

HealtHcare 

LVR-Klinikum is the framework in which a range of farreaching 

infrastructural measures are to be taken.This plan 

also foresaw a strengthening of the clinical and scientific 

ties with the Düsseldorf University Hospital, including the 

construction of three new day care clinics on the premises of 

the University Hospital (scheduled for 2010). 

Finally, the LVR-Klinikum Düsseldorf also supports activities 

that have developed as spin-off initiatives, largely through 

efforts by its staff members. These include the Kicherbohne 

crèche, operated by a parent initiative on the hospital site; 

the Elan organisation, which allows non-professional 

people to perform voluntary work at the Klinikum; the 

arbeit & integration association, which strives to facilitate 

professional rehabilitation (and which also features an 

integration company that operates the cafeteria on the 

premises); the Association of Psychiatrists and Neurologists 

Düsseldorf, which unites office-based psychiatrists and 

neurologists with hospital doctors; the Düsseldorf Alzheimer 

Society; the Alliance Against Depression Düsseldorf; and the 

Open The Doors Association. 

21


22 

13 

14 

P 

P 

33 

32 31 

P 

26 

23 

27 

P 

P 

29 

30 

P 

12 

22 

P 

Rennbahnstrasse 

Rennbahnstrasse 

15 

15 

28 

11 

17 

Pedestrian Entrance 

43 

43H 

10 

18 

P 

P 

P 

P 

P 

34 

Tramway Stop 

20 

È 

} È 

} 

8 

21 

19 

9 

Entrance 

P 

35 

P 

P 

P 

36 

4 

40 

41 

INFO 

P 

Bergische Landstraße 

Bergische Landstrasse 

6 

Pforte 

42 

7

P 

1 

P 

37 

5 

38 

2 

39 

P 

P 

P 

P 

P 

P 

House 2 

Emergency outpatients/ 

Admissions 

P 

3 

Figure 4: Diagrammatic plan of the LVR-Klinikum Düsseldorf 

HealtHcare 

Department of Psychiatry and Psychotherapy 

2 Emergency outpatients/admissions clinic and wards for the Division 

of General Psychiatry 2, as well as neurology/laboratories and research/ 

lecture hall 

3 Division of Gerontopsychiatry 

11 Division of General Psychiatry 2 

13 Wards of the Division of General Psychiatry 2 

and the Division of Addiction Disorders 

14 Wards of the Division of General Psychiatry 1 and the Division 

of Gerontopsychiatry 

15 (Internal) residential group of the Division of Rehabilitation 

20 “Auf der Hardt”: day care unit of the Division 

of General Psychiatry II 

21 Special outpatient facilities for depression and anxiety disorders 

of the Division of General Psychiatry II 

43H Residential group of the Division of Rehabilitation 

Department of Psychosomatic Medicine and Psychotherapy 

17 Day clinic of Psychosomatic Medicine and Psychotherapy 

18 Clinic for Psychosomatic Medicine and Psychotherapy 

19 Wards for the Department of Psychosomatic Medicine and Psychotherapy 

Division of Child and Adolescent Psychiatry and Psychotherapy 

1 Wards of the Division of Child and Adolescent Psychiatry and 


12 Wards of the Division of Child and Adolescent Psychiatry and 


22 Outpatients and day care unit of the Division of Child and Adolescent 

Psychiatry and Psychotherapy 

Other facilities of the LVR-Klinikum Düsseldorf 

7 Nursing expenses office/Behavioural Therapy Outpatient Clinic/Institute 

of Clinical Behavioural Therapy (ICB) 

8 Kicherbohne e.V. kindergarten 

23 Treatment bungalow, exercise therapy 

27 Social centre with cafeteria/kiosk 

33 School of Nursing 

39 Ergotherapy management 

41 Directorate building 

42 Administration building 

23


2.2 Clinical Facilities 

2.2.1 Department of Psychiatry and Psychotherapy 

2.2.1.1 Division of General Psychiatry and Psychotherapy I 

The Division of General Psychiatry and Psychotherapy I 

(GP I) comprises 73 inpatient beds and provides healthcare 

for the southern parts and suburbs of Düsseldorf, which 

have approximately 200,000 inhabitants (the districts of 

Unterbach, Vennhausen, Flingern, Lierenfeld, Eller, Wersten, 

Himmelgeist, Garath, Holthausen, Benrath, Urdenbach, 

Hellerhof, Hassels). People from these areas can be 

admitted and receive inpatient treatment in one of the two 

“sector wards” or attend the day care unit (14 treatment 

places) or the institute’s emergency admission unit. Division 

GP1 also offers two wards with special therapeutic facilities 

(such as a mother-and-child treatment area). 

Therapy facilities of the Division of General Psychiatry 1 

The division provides flexible treatment options integrating 

biopsychosocial treatment components. Treatment includes 

specific pharmacological treatment that addresses individual 

symptoms and the specific features of the illness and also a 

wide range of other treatment options in which the individual 

treatment plans are adapted by the medical doctors to suit 

their patients’ individual requirements. Therapy is provided 

in individual and group sessions and includes the full range 

of drug treatment, psychotherapy, social and milieu therapy, 

ergotherapy and physiotherapy approaches. 

24 

Sector Units 

Intensive Care Units 

Outpatient Clinic 

Division of General Psychiatry I – Sector 3 

73 Inpatient Beds 

12 Day Clinic Places 

Outpatient Clinic 

Secure Ward 14 E, Sektor 3 

Open Ward 14 H 

Day Care Unit 

Ward 14 F: Comorbidity 

Ward 14 G: Millieu therapy and 


Sector wards 

The secure ward 14 E is the primary emergency ward 

for patients from the southern areas and suburbs of 

Düsseldorf who appear to represent a risk to others or 

themselves. Thirty percent of the patients are free to leave 

the secure ward within a period of three days, 50% within 

a week. Further treatment is provided either by the open 

or specialised units or in the form of outpatient care (in 

the division’s own outpatient unit, if indicated). Ward 14 H 

is an emergency ward – open 24 hours a day, 7 days per 

week – for persons with psychotic or affective disorders 

or psychosocial crises. One special feature is the facility 

to admit “mother and child” in the event of postpartum 

psychoses or depressions. 

Specialised units 

Comorbidity unit 

This treatment unit has been designed for persons with 

psychotic, affective or personality disorders and an 

additional substance abuse who cannot be adequately 

reached by a symptom-oriented standard therapy or who 

would be likely to terminate such a therapy prematurely and 

who are likely to be overburdened by the requirements of 

dependence-specific treatment. Since – for most of these

persons – several target syndromes need to be addressed at the same time, 

individualised treatment plans are created on the basis of the entire range 

of treatments available in the division. The objective of the treatment – 

abstinence – is worked towards by using a psychoeducational approach in 

individual and group therapy sessions (for example in motivational groups 

in which addictive behaviour patterns are analysed). The Institutional 

Outpatient Unit provides continuity of treatment by allowing the patient 

to consult the medical doctor he has come to know from his inpatient 

treatment. 

Milieu therapy and psychotherapy unit 

The complex range of therapies offered by unit 14 G aims to treat acute 

mental disorders through drug treatment and psychotherapy, but also 

to prevent secondary disabilities and to promote the reintegration into 

an appropriate social environment. These therapies are designed to help 

persons who require – in addition to treatment for their acute symptoms – 

a range of additional person-centred or environment-related interventions 

(family and marital therapy) in an inpatient setting. On a social level, the 

preparations for a reintegration into active work and employment have a high 

priority. 

Day Care Unit 

The range of therapies offered by the Day Care Unit is mainly designed to 

help people suffering from depression, anxiety or the negative symptoms 

of a psychosis. Treatment is mainly based on psychoeducation and 

psychotherapy (in individual as well as group sessions) in combination with 

drug treatment. One advantage of this approach is that patients can receive 

treatment while remaining in their families and social environments. This 

allows us to narrow the focus of the therapy – for the entire length of its 

duration – to those areas of patients’ lives in which the disorder occurred 

or became apparent. Patients therefore have the opportunity to subject 

the experiences they have practised at the Day Care Unit to an immediate 

practical test – or, conversely, to analyse conflicts and problems experienced 

at home in the Day Care Unit. 

Institutional Outpatient Unit 

The Institutional Outpatient Unit provides therapies for persons with a 

difficult course or chronically recurrent symptoms, for example persons 

suffering from schizophrenic psychoses, affective disorders, severe 

personality disorders or comorbid symptoms. A multiprofessional team 

provides different types of diagnostics and treatments in highly individualised 

one-on-one and group sessions. The Institutional Outpatient Unit was 

established gradually between 2001 and 2008 and currently treats about 

1,500 patients per year. 

Division Head 

S. Cohen, MD 

(Interim Head since October 2008), 

H. Quadbeck, MD 

(until September 2008) 

Senior Consultant 

J. Closset (acting) 

HealtHcare 

Consultants 

T. Schillen, MD, Senior Lecturer (until 2004) 

R. Brosteanu, MD (until 2002) 

Divisional Director of Nursing 

E. Haas 

25


2.2.1.2 Division of General Psychiatry and Psychotherapy II 

26 

Sector Units 

Intensive Care Wards 

Polyclinic and Outpatient Clinic 

Early Recognition Centre 

Department of General Psychiatry and Psychotherapy 

Division of General Psychiatry II – Sectors 1 and 2 



Emergency Admission, Outpatient Clinic, Polyclinic 

Secure Ward 2 B, Sector 1 

Open Ward 13 E 

Day Care Unit House 20 

Secure Ward 2 D, Sector 2 

Open Ward 13 H 

Day Care Unit House 20 

Day Care Unit "Moorenstraße" at the 

University Hospital Düsseldorf 

Secure Ward 2 A 

Crisis Intervention 

Open Ward 13 F 

Personality Disorders and Post-Traumatic 

Stress Disorders 

House 11 (Open Ward) 

Milieu therapy and Psychotherapy 

Open Ward 13 G 

Depression, Mood Disorders 

Forensic Ward 2 F

The Division of General Psychiatry and Psychotherapy II (GP II) has 162 

beds and provides healthcare for the citizens in two sectors of the city of 

Düsseldorf. There is one secure ward and one milieu therapy unit for each 

of the sectors. The division also operates two Day Care Units, one (with 18 

places) on the site of the LVR-Klinikum Düsseldorf and one (7-day) Day Care 

Unit (with 18 places) on the grounds of the Düsseldorf University Hospital. 

Sector wards 

Treatment is provided to all people living in sectors 1 and 2 who are suffering 

from a mental disorder that requires them to be hospitalised in a secure 

ward. A multiprofessional team treats schizophrenia, affective disorders 

such as bipolar or manic-depressive disorders, dependence disorders 

and personality disorders. People are admitted to a secure ward if they 

appear – as a consequence of their disorder – to represent an acute risk to 

themselves or others. The wards have rooms for intensive care. Individuals 

are admitted either voluntarily or on the basis of the German Act for the 

Protection of the Mentally Ill. The range of therapeutic options includes 

psychiatric therapy (psychopharmacology and psychotherapy), nursing 

and sociotherapy, unit-based ergotherapy, occupational therapy, exercise 

therapy, support from social workers, psychoeducation and meetings with 

family members. If necessary, acute treatment can be given for somatic 

illnesses. All treatments primarily aim to ward off any acute and immediate 

risks for the patient and his environment. As soon as possible, treatment 

is continued in an open unit. There is a close cooperation with the milieu 

therapy unit of the sector, allowing the individual to enter an already familiar 

therapeutic setting if recurrent inpatient treatment is necessary. 

Specialized units 

The Division of General Psychiatry and Psychotherapy II comprises five 

specialised units. 

Crisis intervention unit 

This unit mainly admits people with acute psychiatric emergencies or acute 

mental crises who are deemed at admission to require only a short period 

of inpatient treatment or hospitalisation for one to two weeks in a secured 

environment. Treatment is provided for acute and post-traumatic stress 

disorders, adjustment disorders, neurotic and somatoform disorders, eating 

disorders and postpartum disorders, personality and behaviour disorders 

and a sub-category of first-episode acute psychoses. The ward is open to 

patients from all sectors of the catchment area apart from those – in general 

– for whom alternative forms of treatment are primarily indicated, such as 

people suffering from primary dependence disorders or chronic psychoses 

or who require intensive care or forensic hospitalisation. 

The therapies are mainly designed to address situations of acute crises, 

achieve a focused reduction of symptoms and quickly restore the individual’s 

ability to undergo treatment as an outpatient, in day care or on an open ward. 

Therapies are provided by a multiprofessional team, if possible following 

the “primary carer” principles where a human bond is created between 

patient and therapist. The therapies integrate elements and approaches 

HealtHcare 

Division Head 

W, Gaebel, MD, Professor of Psychiatry and 


Senior Consultants 

B. Janssen, MD, Senior Lecturer in 

Psychiatry and Psychotherapy (since 2005), 

A. Klimke, MD, Professor in Psychiatry and 

Psychotherapy (until 2004) 

F. Schneider, MD, PhD, Professor in 

Psychiatry and Psychotherapy (until 2004) 

G. Winterer, MD, Professor in Psychiatry 

and Psychotherapy (until 2009) 

Consultants 

J. Cordes, MD 

C. Luckhaus, MD 

J. Malevani, MD 

U. Sprick, MD, Professor in Psychiatry and 


M. Streit, MD (until 2003) 

M. von Wilmsdorff, MD 

J. Zielasek, MD, Senior Lecturer in 

Neurology 


(interim) J. Vermiert, P. Remmel 

27


from drug treatment, psychotherapy and sociotherapy. The 

specific problems of the children of mentally ill parents are 

addressed in close coordination with the Division of Child 

and Adolescent Psychiatry and Psychotherapy, for example 

by providing interactive group therapy sessions. 

Personality disorder and post-traumatic 

stress disorder unit 

Primary indications for admission are personality and 

behaviour disorders including, in particular, emotionally 

unstable borderline personality disorder, post-traumatic 

stress disorder and permanent personality changes as a 

consequence of exposure to extreme stress, adjustment 

disorders, neurotic and somatoform disorders, eating 

disorders and postpartum disorders as well as a subcategory 

of first-episode psychoses. 

There is a clear overlap with the patients of the crisis 

intervention unit, and the conceptual and therapeutic 

links between the two are close. The same concepts as 

those explained above are applied here. The range of 

therapeutic options comprises complete somatic care, 

psychiatric-psychotherapeutic group therapies (which 

may be complemented by individual sessions), nursing and 

sociotherapy treatment, ergotherapy, occupational therapy, 

music therapy, dance therapy, exercise therapy, relaxation 

techniques, marital and family therapy, the provision 

of advice to children and family members and support 

from social workers. Different group therapy sessions 

complement the range of options. 

Depression and anxiety unit 

Primary indications for admission are depression, 

schizoaffective disorders with depressive episodes, anxiety 

and panic attacks. By specifically taking the principles of 

cognitive behaviour therapy and learning psychology into 

account, the unit follows a combined approach of drug and 

psychotherapeutic treatment options that is adapted to suit 

the individual requirements of each patient. If indicated, it 

also provides somatic therapies. Individual psychotherapy 

sessions comply with the principles of cognitive and behaviour 

therapy. The depression and anxiety unit cooperates closely 

with the Institutional Outpatient Unit for depressive disorders. 

This interaction between outpatient and inpatient treatment 

options has allowed the unit to implement a range of 

contracts for the provision of integrated care (§ 140 SGB V, 

German Social Code). Under these contracts, people who 

receive treatment from office-based psychiatrists and 

28 

psychotherapists can also benefit from therapies offered by 

hospitals to either outpatients (in this case, by the special unit 

for depressive disorders) or inpatients. 

Building 11 

This unit treats patients suffering from any of the entire 

range of general psychiatric illnesses for whom a 

complex mix of (psycho-)therapeutic options is indicated. 

The therapeutic range of the unit matches the diversity 

of the indications for admission. The milieu-therapy– 

¬oriented setting of the unit has been designed around 

a complex mix of therapies aimed at a stable remission 

of symptoms, disease and conflict resolution and a 

differentiated occupational and social reintegration. In 

addition to syndrome-oriented acute drug treatment, the 

implementation of relapse-prevention steps and milieu 

therapy elements such as the establishment of ward 

conferences, joint outside activities and ergotherapy, an 

individualised therapy plan is assembled for each person, 

including non-verbal and body-focused therapies (exercise 

therapy, dance therapy, music therapy, breathing therapy, 

relaxation techniques), cognitive and integrated training 

methods (computer-assisted techniques, interpersonal 

therapy), psychoeducation, supportive discussions with 

patients, their partners and relatives and cognitive behaviour 

therapy in individual and group sessions. The ward can also 

perform sleep-EEG to assist the diagnosis and therapy of 

sleeping disorders. A surveillance unit also provides the 

facilities for the provision of intensive care to persons with 

difficult disease courses (such as severe depressions). 

Forensic unit 

The division also features a dedicated forensic unit. In 

addition to the treatment of 19 patients under § 63 of 

the German Penal Code (Hospitalisation in a Psychiatric 

Hospital), the multiprofessional team also provides forensic 

after-care services to approximately 15 outpatients whose 

sentences have been suspended or who have been released 

on parole. These forensic after-care services are provided in 

close cooperation with the Institutional Outpatient Unit and 

the Division of Rehabilitation of the LVR-Klinikum Düsseldorf. 

The members of the unit’s medical and forensic staff are 

often employed as forensic experts by civil, social and penal 

courts and asked for expert opinions on prognosis. The 

unit’s consultant has been certified as an expert in “Forensic 

Psychiatry” by the Medical Association North Rhine and 

registered as an independent expert for expert opinions on 

prognosis in compliance with §16.4 MRVG-NW.

Conversations with family members play a significant role 

in psychiatric/psychotherapeutic treatment 

Day Care Units 

The Day Care Units of GP II treat all mental illnesses, in 

particular psychoses, depression, adjustment disorders, 

personality disorders and anxiety. Patients are usually 

treated after referral from the office-based medical 

doctor who has been treating them as outpatients, so that 

admission as an inpatient can often be avoided. However, 

admission to the Day Care Unit can also follow inpatient 

treatment. The Day Care Unit, which is located on the 

grounds of the Düsseldorf University Hospital, can treat 

patients 7 days a week, allowing even acutely mentally ill 

people to receive close-meshed care without having to leave 

their home environment. 

The Day Care Units develop individual therapeutic plans in 

close cooperation with the patients. Therapy can include 

various approaches from ergotherapy, creativity therapy and 

cognitive behaviour therapy, different training programmes 

and discussion groups. 

Outpatient healthcare 

Outpatient healthcare at the LVR-Klinikum Düsseldorf is 

provided by psychiatric-psychotherapeutic Institutional 

Outpatient Units, allocated to the individual departments, 

and by the polyclinic of the university. 

VerSOrgUNgSeINrIcHtUNgeN 

Institutional Outpatient Units in the Division of General 

Psychiatry and Psychotherapy II 

Coordination: (interim) B. Janssen. MD, Senior Lecturer and 


The Institutional Outpatient Units and specialised outpatient 

units of the Division of General Psychiatry II treat more 

than 2,000 patients a year. Referrals to the Institutional 

Outpatient Unit of the GP II come partly – in compliance with 

§ 118 SGB V – from the network of in-house inpatient units 

and the after-care system. This means that people who 

need particularly intensive care and recurrent treatment 

because of the nature of their disorder can receive continued 

treatment as outpatients in the respective Institutional 

Outpatient Units. This ensures a high level of therapeutic 

continuity. Other referrals come from office-based medical 

specialists such as psychiatrists, neurologists and general 

practitioners, from other divisions of the Düsseldorf 

University Hospital (including the psychiatric counselling 

service) and from other hospitals in the region. Some 

people also come for treatment on the suggestion of 

outpatient support services (such as the Samaritans and 

the public health authority). The multidisciplinary teams at 

the Institutional Outpatient Units of the Division of General 

Psychiatry provide a range of general and specialised 

treatments, mainly for people with chronic mental disorders 

such as schizophrenic and affective disorders, personality 

29


disorders and behaviour disorders. A comprehensive system 

of psychiatric and psychological diagnostic facilities and 

therapies is provided to support each person individually 

(including special consultations). 

Here are some of the therapeutic interventions that are 

always on offer: 

s Group therapy sessions 

s Counselling and information for family members (also 

in the form of group sessions) 

s Psychoeducation 

s Relaxation therapy 

Therapies in the Institutional Outpatient Units are mainly 

designed for people who – due to the nature, the severity 

and the length of their disorders – require elaborate 

diagnostics and close-meshed treatment and care. The 

outpatient facility also has the tasks of avoiding unnecessary 

hospitalisation and preventing relapses. It has mainly been 

designed to address the following disorders: 

s First-episode schizophrenia 

s Chronic psychoses 

s Attention deficit and hyperactivity syndrome (ADHS) in 

adults 

s Personality disorders 

s Depressive syndromes, particularly in case of 

treatment resistance 

s Anxiety disorders 

s Obsessive compulsive disorders 

s Chronic pain syndromes that are treatment resistant 

30 

s Post-traumatic stress disorders 

s Somatoform disorders 

s Sleep disorders 

s It also provides the following services: 

s Integration of family members and staff of 

complementary services 

s Biopsychosocial concept of therapy with a 

multiprofessional approach combining 

s pharmacotherapy, somatic therapy (light therapy, TMS), 

psychotherapy (behaviour therapy, dialectic behaviour 

therapy, psychodynamic therapies, client-centred 

psychotherapy) and sociotherapy 

s Outpatient psychotherapy for groups of patients and 

family members 

Special services include an outpatient unit for people who do 

not speak German as a native language (with consultation 

services in Russian, Turkish, Romanian, Croatian, Spanish, 

French and Italian) and a special outpatient unit for people 

with borderline personality disorder, including an outpatient 

skills group that follows concepts of the dialectic behaviour 

therapy after Linehan (DBT) and cognitive behaviour therapy. 

In addition, the unit operates a special outpatient facility 

for people suffering from depression, a special outpatient 

unit for adults with attention deficit disorder/hyperkinetic 

syndrome and the Special Comorbidity Outpatient Unit on 

the site of the Düsseldorf University Hospital (Moorenstr. 

5). This special outpatient unit focuses on the treatment 

of people with mental disorders and comorbid somatic 

illnesses and works in close coordination with the medical 

Light therapy can be used 

to treat depression

doctors of the Düsseldorf University Hospital and the 

affiliated 7-day Day Care Unit on the grounds of the 

University Hospital. 

Emergency admission unit 

Medical Director: B. Janssen, MD, Senior Lecturer in 

Psychiatry and Psychotherapy, Senior Consultant (since 

2009), G. Winterer, MD, Professor of Psychiatry and 

Psychotherapy (from 2005 until 2009), 

F. Schneider, MD, PhD, Professor of Psychiatry and 


Divisional Director of Nursing: D. Kohl 

The emergency admission unit is the hospital’s first point of 

contact for patients suffering from mental problems and/ 

or known or suspected psychiatric, neurological or addictive 

disorders as well as for their family members in need of help. 

The services of the emergency admission unit feature – in 

addition to emergency assistance in the case of a sudden 

crisis – the provision of psychiatric-psychotherapeutic advice 

about the facilities for inpatient, day clinic and outpatient 

treatment at the LVR-Klinikum Düsseldorf, including external 

assistance and counselling (for example, in self-help groups). 

Such counselling services may also be provided by phone. 

Individuals come voluntarily for inpatient treatment mainly 

of their own accord, because their doctor has referred them 

or because they have been referred to the LVR-Klinikum 

by another hospital. Some individuals require psychiatric 

diagnostics and therapy because of legal regulations that 

regulate the hospitalisation and healthcare arrangements of 

vulnerable people. The emergency admission unit is open 24 

hours a day, seven days a week, and has at least one medical 

doctor and one nurse ready to see patients at all times. The 

unit cooperates closely with the outpatient units for borderline 

personality disorder, for people who either are migrants 

themselves or come from migrant families, and for people 

with ADHS in adulthood. 

Psychiatric-psychotherapeutic consultancy services 

Director: B. Janssen, MD, Senior Lecturer in Psychiatry and 

Psychotherapy, Senior Consultant (since 2009), G. Winterer, 

MD, Professor of Psychiatry and Psychotherapy (from 2005 

until 2009), F. Schneider, MD, PhD, Professor of Psychiatry 

and Psychotherapy (until 2004) 

The psychiatric consultancy service supports the Düsseldorf 

University Hospital and, until 2009, also supported the Sana 

Hospital at Gerresheim (the former Gerresheim Municipal 

Hospital). All psychiatric conditions are treated, in close 

coordination with the medical doctors from the respective 

hospitals. Any psychiatric advice that may be required will be 

given on the same day. The outpatient unit and the Day Care 

HealtHcare 

Unit on the site of the Düsseldorf University Hospital ensure 

that patients of the University Hospital can receive in situ any 

concurrent psychiatric treatment they may require. 

Centre for the early detection of mental 

disorders (FEZ) Düsseldorf 

Director: B. Janssen, MD, Senior Lecturer in Psychiatry and 

Psychotherapy (since 2009), G. Winterer, MD, Professor of 

Psychiatry and Psychotherapy (from 2005 until 2009). 

The FEZ Düsseldorf evolved from the “Early Detection 

Centre for the Provision of Advice and Assistance to Patients 

with an Increased Risk of Mental Disorders”, operated by 

the Competence Network on Schizophrenia (see p. 58). On 

the basis of the results from studies that have explored 

possible ways of detecting the early signs of at-risk states 

for psychosis, the FEZ aims at early detection and early 

intervention in the prodromal stage of psychotic disorders. A 

team of medical doctors and psychologists provides advice 

and assistance to those suffering from these symptoms 

and the members of their families. In addition to medical 

information, the team also provides counselling and support 

for social problems (at work, at school and with partners) and 

offers individual and group psychotherapy; drug treatment is 

offered if the individual is already in the late-prodromal stage 

of developing psychosis. The FEZ teams are also involved 

in PR campaigns to increase the general awareness about 

possibilities for early detection and intervention, for example 

by giving lectures and distributing information material to the 

public and organising seminars on the premises of the FEZ. 

The diagnostic methods they use and the psychotherapeutic 

and pharmacological interventions they offer are scientifically 

evaluated in the context of the Competence Network on 

Schizophrenia, in close cooperation with other University 

Hospitals. As part of the PREVENT study, researchers at the 

FEZ are evaluating cognitive behaviour therapy approaches in 

comparison to special drug treatment strategies. Their effects 

on the development of psychotic illnesses, i.e. their potential 

to prevent such disorders or to alleviate symptoms, have 

never been studied in this way before. 

31


2.2.1.3 Division of Gerontopsychiatry and Psychotherapy 

The Division of Gerontopsychiatry and Psychotherapy provides 

(inpatient and day clinic) healthcare to all sectors in the 

Düsseldorf region and roughly 560,000 citizens. In principle, 

patients aged 64 and older are admitted. The division has 

99 beds and 25 places in a Day Care Unit. After an initial 

assessment at the emergency admission unit, individuals are 

allocated to one of the specialised wards. 

Secure admission units 

Treatment by any of these units is provided to persons who are 

suffering from a mental disorder that requires hospitalisation 

in the secure conditions of a secure ward. A multiprofessional 

team addresses the various mental disorders that often 

accompany old age – among them, most commonly, depressive 

disorders and dementia. People are only admitted to a secure 

ward if they pose a risk to others or themselves. The secure 

wards are also equipped to provide persons suffering from 

acute and severe mental disorders and comorbid somatic 

illnesses with intensive medical and nursing care. The wards 

accommodate people who have come voluntarily as well as 

people who have been referred on the basis of the Act for 

the Protection of the Mentally Ill or on the initiative of a legal 

guardian. Treatment options include psychiatric therapies 

(through drug treatment and psychotherapy), nursing and 

sociotherapeutic interventions, ergotherapy, exercise therapy 

and physiotherapy as well as support from social workers. 

32 

Secure admittance wards 

3 A, 14 A, 14 B 

Intensive care ward 

14 C depression 

Intensive care ward 

14 D psychotic disorders 

Day clinic 3 B 

Outpatient clinic 

Division of Gerontopsychiatry und Psychotherapy 

Cross-sectoral 

99 Inpatient Beds and 25 Day Clinic Places 

Since older people often suffer from several illnesses at the 

same time, the secure ward follows an integrated approach, 

combining the treatment of mental disorders and the treatment 

of somatic illnesses in close coordination with medical doctors 

from the respective areas. 


Depression unit 

People with affective disorders are treated with drug 

treatment and behaviour therapy, assisted by ergotherapy 

and physiotherapy. The unit admits people who have been 

directly referred by medical doctors in general practice or who 

are being transferred from the secure wards of the Klinikum. 

All patients receive individualised therapy and may, after 

attenuation of their acute symptoms, be sent home or gradually 

reintegrated through attendance of the Day Care Unit. 

Psychotic disorders unit 

This unit mainly provides drug treatment and behaviour therapy 

to people suffering from chronic paranoid-hallucinatory 

psychoses. Ergotherapy and physiotherapy are also offered. The 

unit admits people who have been directly referred by medical 

doctors in general practice or who are being transferred from 

the secure wards of the Klinikum. Since it is often difficult to 

achieve psychosocial reintegration of people suffering from 

chronic paranoid-hallucinatory psychoses, the unit also offers 

sociotherapy. Most people need to be reintegrated gradually 

through attendance of the Day Care Unit. 

Day Care Unit 

All psychiatric disorders that are commonly associated with old 

age – specifically dementia, depression and psychoses – are 

treated in the Day Care Unit. Treatment is given subsequent 

to full inpatient treatment, in the form of a temporary crisis 

intervention or as a part of a diagnostic clarification that 

requires something more permanent than an outpatient 

arrangement while not demanding full inpatient admission. 

Essentially, Day Care Unit treatments are designed to prepare 

individuals for returning to their home environments. As a rule,

people are admitted following inpatient treatment or are directly referred by their 

office-based specialists or general practitioners. A personalised treatment plan 

addresses all aspects of the individual’s disorder. Key therapy modules include 

drug treatment, psychotherapy with individual and group behaviour therapy 

sessions, conflict-focused client-centred therapy, age-adapted self-efficacy and 

desensitisation training, cognitive behaviour therapy, empowering memory and 

concentration training, reality orientation training and training in routine skills. 

Ten of the 25 places in the Day Care Unit are reserved for people with dementia. 

Outpatient units 

The gerontopsychiatric outpatient unit treats approximately 1,300 people 

annually, focusing on the early detection and treatment of Alzheimer’s dementia 

and other forms of dementia. The Institutional Outpatient Unit also treats people 

with other mental illnesses (specifically affective disorders and schizophrenic 

psychoses as well as all other mental disorders commonly associated with old 

age) in cases in which the severity of the disorder rules out treatment by officebased 

specialists. Division Head 

T. Supprian, MD, Senior Lecturer 

in Psychiatry and Psychotherapy 

(since April 2005), 

C. Kretschmar, MD 

(until April 2005) 

Neuropsychological tests are an important diagnostic measures in gerontopsychiatry 

HealtHcare 


C. Lange-Asschenfeldt, MD, Senior Lecturer 

in Psychiatry and Psychotherapy 

Consultants 

T. Salamon, MD 

R. Ihl, MD, Professor in Psychiatry and 



J. Vermiert 

33


2.2.1.4 Division of Dependence Disorders 

The Division of Dependence Disorders has 73 beds and 

treats people from all sectors in the catchment area. 

It comprises four specialised units and an Institutional 

Outpatient Unit that focuses on the psychiatric treatment 

of dependence disorders. The division is represented in a 

number of working groups, official bodies and quality circles 

(such as the Working Group on Drugs and Dependence of 

the municipal health authority, the Psychosocial Working 

Group, the Düsseldorf Working Group Against the Dangers 

of Dependence, the Association for Professional Inpatient 

Acute Treatment of Drug Addicts North Rhine-Westfalia 

and the Working Group on Dependence North Rhine). It 

seeks close cooperation with sociopsychiatric institutions, 

psychosocial counsellors for people with dependence, the 

sociopsychiatric public services, institutions that operate 

units of assisted living and the municipal public services that 

render support, as well as the rehabilitation clinics and selfhelp 

groups in the catchment area. 

Following the principles of holistic treatment of mental 

disorders, concomitant or secondary somatic diseases and 

social problems, treatment is offered by interdisciplinary 

34 

Division of Dependence Disorders 

Cross-sectoral 


Secure ward 13 A 

Illegal drug detoxification 

Secure acute admission ward 13 B 

Crisis intervention 

Open ward 13 C 

Alcohol and prescription drug detoxification 

Open ward 13 D 

Treatment of comorbidity 


teams – under the supervision of medical doctors – and 

makes use of approaches that have been derived from 

medical science, nursing, psychotherapy and social therapy. 


Detoxification from illegal drugs 

The unit admits people diagnosed with opiate dependence 

and simultaneous dependence on more than one drug, 

including opioid types and people who require treatment 

for concomitant use of illicit drugs even though they are 

receiving substitution treatment. Admissions follow an 

interview with the individual and are not conditional on any 

specific requirements. Therapies are focused on providing 

qualified detoxification and diagnosing and treating 

concurrent mental disorders. In close cooperation with 

local drugs counsellors, information about dependence 

disorders is provided in order to motivate the individual to 

undergo further therapies, to change their behaviour and 

to prevent relapses. To this end, individuals are invited to 

participate in one-on-one interviews with their doctors 

and in psychoeducational group therapy sessions. It is also 

possible to provide support from social workers to solve 

personal problems, in cooperation with complementary 

institutions of dependence support organisations and the 

public social services. 

Crisis intervention 

The unit admits people with mental crises and dependence 

emergencies (acute danger of suicide and/or danger to 

third parties, severe comorbidity requiring hospitalisation 

in a secure environment) relating to substance abuse and 

dependency (all substances). The therapeutic focus is placed 

on crisis interventions and acute treatments as well as on 

the therapy of severe and complex withdrawal syndromes in 

a secured setting. It is also possible to provide support from 

social workers to solve personal problems, in cooperation 

with complementary institutions of dependence support 

organisations and the public social services (including 

psychoeducational information groups). Depending on the 

individual indication, ergotherapy and physiotherapy may 

also be used. 

Detoxification from alcohol and prescription drugs 

This unit primarily admits people who are dependent 

on alcohol or prescription drugs. Admissions follow an 

interview with the individual in the Institutional Outpatient 

Unit. Therapy is aimed at treating withdrawal symptoms 

of average severity. The therapy programme is based on

multiprofessional, qualified treatment of withdrawal symptoms under 

medical supervision and is complemented, if required, by one-on-one 

interviews with the doctor and psychological diagnostics. Depending on the 

individual indication, ergotherapy and physiotherapy may also be used. 

Alcohol dependence and drug dependence – 

treatment of people with comorbidity 

The primary indication for admission is comorbidity of a dependence 

disorder with depression or anxiety. One objective of therapy is to encourage 

the individual to undergo further measures such as psychoeducational group 

therapy sessions, under medical supervision, on depression and anxiety. 


The Institutional Outpatient Unit has designed its range of services in 

dependence psychiatry and psychotherapy mainly for people who have just 

completed inpatient treatment, aiming to secure the longer-term success of 

their treatment. The specific services offered include the following: 

Diagnosis and therapy for people suffering from dependence disorders and 

concomitant mental disorders (such as anxiety and depression), possibly 

including drug treatment 

s Group-therapy–based behaviour therapy and psychoeducation 

s In individual cases: outpatient detoxification treatment (only for mild 

withdrawal symptoms that do not require inpatient treatment) 

s In individual cases and to support psychiatric-psychotherapeutic 

treatment: subsequent to inpatient treatment, follow-up treatment with 

recognised drugs for relapse prevention 

• for people with alcohol dependence (e.g., acamprosate) 

• for people with opiate dependence (naltrexone) 

s Consultations and group sessions for consumers of cannabis and other 

so-called “party drugs” 

s Group sessions for non-substance dependence (such as Internet 

surfing, gambling, shopping) 

s Outpatient nicotine withdrawal 

s Information groups for family members, offered by the social services 

s Consultations offered by the social services for people from the 


s Cooperation with the outpatient ergotherapy department of the LVR- 

Klinikum Düsseldorf (primarily for patients with a chronic dependence 

and cognitive disorders) 

Division Head 

P. Franke, MD, Senior Lecturer in 


(since July 2005), 

W. Burtscheidt, MD (until 2004) 


M. Warnecke, MD 

Consultants 

C. Schmiegelt, MD (until March 2010) 

V. Reissner, MD (until 2007) 

H. Schönell, MD (until 2004) 

H. Streb, MD (until 2005) 


E. Haas 

HealtHcare 

35


The assessment of the brain‘s electrical activity (EEG) is an important diagnostic method in many mental and neurological disorders 

2.2.1.5 Division of Neurology 

36 

Division of Neurology 


Optional secure ward 2 C 

Neurological disorders in (neuro-) 

psychiatric disorders 

Open ward 2 E 

Neurological disorders 

The Division of Neurology comprises a secure ward and 

an open ward, with together 36 beds. It provides inpatient 

healthcare to approximately 600 patients and medical 

advice to another 1,800 patients each year. The division was 

primarily established to provide neurological healthcare to 

the psychiatric patients of the LVR-Klinikum Düsseldorf. This 

target group includes mentally ill patients with concomitant 

neurological illnesses and those whose disorders have been 

caused by organic brain diseases. 

Neurological disorders concomitant with 

(neuro-)psychiatric disorders 

On the one hand, patients include those of the LVR-Klinikum 

Düsseldorf who have a primary psychiatric disorder and 

are suffering from neurological complications, so that they 

require intercurrent neurological care. These patients suffer 

from the following, in decreasing order of frequency of 

occurrence:

s Cerebral epileptic seizures, for example people with existing organic 

brain damage, oligophrenia, etc. 

s Disturbed cerebral blood flow: stroke, cerebral bleeding 

s Neurological complications of psychiatric medication 

s Parkinson’s Syndrome 

s Illnesses of the peripheral nervous system: polyneuropathies, multiple 

mononeuropathies, pressure palsies of the peripheral nervous system, 

Guillain-Barré syndrome 

s Inflammatory diseases: e.g., multiple sclerosis 

s Myoclonus, dystonia, epileptic seizures, delirium 

s Other rare illnesses: brain tumours, muscle illnesses 

On the other hand, people with primary neurological illnesses and secondary 

mental disorders are treated; they have been diagnosed with the following 

medical conditions: 

s Degenerative brain disorders (Morbus Alzheimer, Parkinson “Plus”, 

frontal-temporal atrophies such as Pick’s disease, Huntington’s 

disease, Lewy body dementia, etc.) 

s Acute/chronic organic brain syndromes (such as HIV encephalopathy, 

syphilis, neuroborreliosis, traumatic brain injuries, disturbed cerebral 

blood flow, anoxia, Korsakoff’s syndrome) 

This group of people has been one of the key target groups of the division 

ever since it was established, and the division has received relatively large 

numbers of referrals from other hospitals including other neurology 

departments as well as directly from doctors in general practice both from 

within and outside the region. 

Neurological illness without mental disorders 

Frequently treated patient groups who require neurological care or combined 

care at the neighbouring General Hospital suffer from: 

s Disturbed cerebral blood flow 

s Epilepsy or cerebral seizures 

s Peripheral-neurological disorders as a consequence of head 

injuries or surgery 

Disturbed cerebral blood flow is numerically the largest group of all 

neurological illnesses. The division provides neurological care and advice 

at the Sana Hospital in Gerresheim. After diagnostics and acute therapy, 

these patients require differentiated treatment, which is provided by the 

Division of Neurology at the LVR-Klinikum Düsseldorf. This also applies to 

people suffering from cerebral epileptic seizures. The situation is similar for 

peripheral neurological care required in the wake of emergency surgery and 

senology performed at the Sana Hospital in Gerresheim and required by the 

LVR-Klinikum Düsseldorf, mainly by the Division of Dependence Disorders 

(alcoholic neuropathies, pressure palsies). 

Division Head 

M. Griese, MD 

(interim since January 2008) 

F.-J. Schuier, MD, Senior Lecturer 

(until January 2008) 


J. Nickel, MD (acting, since 2010) 

M. Dihné, MD (until December 2009) 

M. Griese, MD (until 2008) 


Ms C. Foulon 

HealtHcare 

37


2.2.1.6 Division of Rehabillitation 

The Division of Social Rehabilitation at the LVR-Klinikum 

Düsseldorf currently has 68 places, divided between one onsite 

communities (20 places) and three external communities 

(10, 11 and 17 places), which strive to achieve the active social 

rehabilitation of their members, and one transitional unit (10 

places) that combines social rehabilitation with medical and 

professional rehabilitation. In the period between 2001 and 

2008, 111 members of these residential communities were 

discharged while 89 new people from the region who were in 

search of rehabilitation were admitted. In August 2006 and 

38 

Division of Rehabilitation 

68 Places 

On-site community building 15 

Building 43 

External residential community Limburgstraße 

External residential community Kieshecker Weg 17 

External residential community Im Schlank 13/13A 

Secure housing for outpatients 

February 2007, the two buildings that had been used as 

residential accommodation by the on-site communities were 

abandoned after a new building with 20 places had been 

completed on the site of the LVR-Klinikum and a further 

external residential community had been established. 

On-site community House 15 

The on-site community House 15 was constructed in 

2006 as a replacement for two older buildings. The House 

provides 16 group places (four residential groups with four 

members each) and four individual places (single-occupancy 

apartments). The House provides its inhabitants with a 

maximum of individuality and protection of their private 

spheres, but also a certain degree of social encounters and 

community experience. It accommodates groups (providing 

20 places for four residential communities with four 

members each) and individuals (in four single-occupancy 

apartments). House 15 is equipped with a large enclosed 

garden and located at the periphery of the hospital site near 

the staff dormitory and the social centre. 

External residential community Limburgstraße 25 

This building, constructed in the 1960s, comprises four 

spacious flats and has a large garden. It is located in central 

Düsseldorf near the city’s Ostpark. The infrastructure 

is highly suitable for the provision of community-based 

psychiatric care. The building housed the first external 

residential community of the Klinikum’s Division of Social 

Rehabilitation. It has two-and-a-half floors and a basement 

View into a room in a residential community 

of the Division of Rehabilitation

flat, providing space for a total of ten residents. The terrace, which can be 

accessed from the basement flat, and a balcony above the annex add to the 

charm of the property, making it a very pleasant place to live. 

External residential community Im Schlank 13/13A 

This external residential community is housed in the Düsseldorf suburb of 

Lichtenbroich. The property consists of two semi-detached homes with twoand-a-half 

floors each, accommodating 17 residents. 

External residential community Kieshecker Weg 17 

This community is also housed in the Düsseldorf suburb of Lichtenbroich. 

The back garden of this house shares a border with the garden of the Im 

Schlank residential community, which means that the two residential 

groups are connected by a large (virtually common) garden and a paved 

path. The two-storey building was erected in 2006, according to LVR 

specifications, as a residential home for mentally ill persons. The first 

tenants moved in in February 2007. The house provides twelve places in two 

residential communities with four bedrooms each and four single-occupancy 

apartments. The objective of the project is to provide apartments with a 

maximum of independence. The individual groups or “apartment units” are 

meant to become responsible for themselves. Support is provided by the 

team that manages the Im Schlank residential community. 

House 43 

House 43 currently provides ten places for patients who are undergoing 

medical rehabilitation for two to a maximum of three years. The residents 

are mainly recruited from the patients of the LVR-Klinikum Divisions of 

General Psychiatry. 

Assisted living 

Since other providers in the catchment area may find it impossible – for a 

number of reasons – to provide care for people who have been discharged 

from the Division of Social Rehabilitation having spent many years in 

institutions and/or are suffering from severe mental disabilities, we have 

been offering an assisted living scheme for these people since 1 January 

2008. This scheme is designed to benefit residents of the Division of Social 

Rehabilitation who would probably require no more than outpatient care but 

who lack the courage to make this step because 

s they need the safety afforded to them by the continuous relationship 

with the staff members from the Division of Social Rehabilitation. 

s they are stressed by the prospect of simultaneously losing their 

familiar living structures and the relationships they have established 

with the staff members of the Division of Social Rehabilitation. 

s they need the familiar context of the institution to develop a minimum of 

mental stability. 

The provision of an assisted living scheme (including the planned extension/ 

conversion of inpatient places) for the aforementioned group of residents is 

de signed to widen the circle of people who can move from inpatient accom- 

modation into a more independent domestic arrangement with outpatient 

care. 

Division Head 

R. Greiss-Maibach, Dipl.-Psych. 

(certified psychologist) 


C. Foulon 

HealtHcare 

39


Rehabilitation includes various activities to prepare for transferring to the jobs market, including assistance with computer training and improving cognition. 

Products from the candle workshop are sold in the LVR-Klinikum. 

Outpatient and day clinic schemes 

In July 1996, staff members of the LVR-Klinikum Düsseldorf, 

the LVR and committed citizens established the non-profit 

association “arbeit & integration” (a&i), which has the 

primary objective of allowing people with mental disorders 

to find a way back into employment and their former 

professional lives. The association arranges vocational 

integration courses and professional orientation courses to 

establish each patient’s individual capacity to deal with the 

pressures at work and his existing skills, i.e. to what extent 

he can be retrained. It also actively seeks employment 

opportunities in so-called “integration companies” 

(commercial enterprises that make it a point to hire people 

with disabilities). For this purpose, individuals may, for 

a maximum period of 12 months, undergo a vocational 

integration course with the support of the Federal Job 

Agency and the social insurance authority. This course is 

based on the “place and train” approach, which also provides 

the foundation for the American Supported Employment 

programmes (SE). The placement of people into such work 

experiences/internships on the primary employment market 

does not require long periods of preparation in a secure 

environment, provided the patients are sufficiently motivated 

and clinically stable. 

At the same time, medical doctors, psychologists and 

educationists work closely together with the individual 

patients to develop strategies, on the basis of a behaviour 

therapy concept, for solving problems that may emerge in 

connection with their mental disorders and disabilities. 

The target group consists of mentally ill individuals who 

require outpatient care for the foreseeable future (medium 

40 

or long term), specifically those who have been diagnosed 

with one of the following disorders: 

s Schizophrenia 

s Affective disorders 

s Neurotic and stress disorders 

s Eating disorders 


Currently, 25 places are available in two teaching groups. 

Professional orientation course 

Since February 2004, a&i has been conducting threemonth 

orientation courses (on behalf of the associations 

that provide the funding) to assess the extent to which 

patients are actually capable of coping with the pressures 

and stress factors in an employment situation. The threemonth 

diagnostic course is intended to benefit people whose 

professional qualifications need to be checked, extended 

or changed in order to match the requirements of the 

primary employment market. Following this course, both the 

funding association and the individual can be provided with 

a reasonably reliable assessment of the professional and 

integrative prospects. 

Integration company “a&i” 

The cafeteria in the social centre of the LVR-Klinikum 

Düsseldorf is operated by the a&i association. It has seven 

staff members, four of whom are suffering from a mental 

disorder; these include people with a difficult and complex 

case history who have not been actively engaged in the 

employment market for years. The cafeteria has no sponsor. 

It relies on the revenue generated by its sales and occasional 

or temporary subsidies.

2.2.1.7 Current Scientific and Academic Staff 

of the Division of Psychiatry and Psychotherapy 

Medical doctors 

M. Arends, F. Bäßler, T. Bayraktar, F. Braisch, S. Bramer- 

Ugur, K. M. Burchert, J. Closset, S. Cohen, J. Cordes, 

M. Dihné, J. Dolgner, K. Fauerbach, St. Ferrea, O. Fischer, 

P. E. Franke, W. Friedrich, W. Gaebel, D. M. Gescher, 

B. Gonschior, P. Görtz, M. Griese, P. Hassel, F. Hellen, 

C. Hirsch, B. Höft, K. Hückelheim, N. Huseynova, T. Jäger, 

B. Janssen, S. Jantzen, M. Kiefer, S.-J. Kim, D. Klecha, 

T. Kobuß, L. Kostorz, G. Kotrotsios, L. Kuypers, C. Lange- 

Asschenfeldt, S. Lehmann, C. Luckhaus, B. Mahabadi, S. 

Mai, J. Malevani, P. Messinger, A. Mobascher, F. Musso, 

B. Nicksch, T. Nolting, M. Ramacher, A. Ruttmann, 

T. Salamon, V. Schlemper, C. Schmidt-Kraepelin, 

F. Schottmüller, R. Schwark, A. Sinha-Röder, D. Spiegelberg, 

E. Streit, B. Stueeken, T. Supprian, M. Tollkötter, 

J. Urban-Ukic, S. Wahl, M. Warnecke, M. Weickert, 

F. Wiechmann, M. von Wilmsdorff, I. Wittib, 

M. Wolff, W. Wölwer, M. Zemlicka, J. Zielasek 

HealtHcare 

Psychologists and other non-medical members 

of the academic staff 

A. Baden, S. Beulen, J. Bludau, S. Botterweck, 

J. Brinkmeyer, A. Chille, H.-R. Cleveland, B. Conradt, 

K. Drusch, J. Ebert, M. Freimüller, N. Frommann, 

R. Greis-Maibach, R. Keuntje, S. Kiszkenow, M. Küpper, 

H. Luethcke, F. Lüneborg, E. Manns, M. Marekwica, 

E. Moenikes, S. Müller, J. Pott, M. Riesbeck, R. Schneider, 

E. B. Sliman, K. Sommerlad, W. Strauß, S. Stroth, 

J. A. Szpak, K. Teufel, T. Warbrick, W. Wölwer 

41


2.2.2 Department of Psychosomatic Medicine and Psychotherapy 

Department of Psychosomatic Medicine 

and Psychotherapy 



Psychosomatic ward 

“Viktor von Weizsäcker” 

Psychosomatic ward 

“Werner Schwidder“ 

Day clinic 


Division of inpatient treatment 

The Department of Psychosomatic Medicine and 

Psychotherapy of the LVR-Klinikum Düsseldorf – Hospital 

of the Heinrich-Heine University Düsseldorf – treats people 

who have been admitted with one or several of the following 

indications: 

Team meeting in the Department of 

42Psychosomatic 

Medicine and Psychotherapy 

s Psychosomatic disorders in the narrower sense 

of the term 

s Psychovegetative and functional disorders labelled 

as “somatoform disorders”: somatisation disorders, 

somatoform function disorders and somatoform pain 

disorders 

s Anxieties and phobias 

s Obsessive-compulsive disorders 

s Stress reactions and adjustment disorders, including 

post-traumatic stress disorders 

s Dissociative disorders (conversion disorders) 

s Eating disorders, specifically anorexia nervosa and 

bulimia nervosa 

s Sexual dysfunctions 

s Affective disorders, particularly episodes of depression 

and persistent affective disorders on the basis of 

neurotic and personality disorders 

s As the most common comorbidity: personality 

disorders following severe traumatic experiences in 

childhood and adolescence, particularly borderline 

personality disorders, narcissistic personality 

disorders, dependent personality disorders, histrionic 

personality disorders 

s Somatopsychic disorders (mental disorders following 

somatic illnesses) 

The inpatient unit comprises two wards with 12 beds each: 

the “Viktor von Weizsäcker” and “Werner Schwidder” wards.

The psychotherapeutic treatment concept is psychodynamically oriented. 

Its conceptual framework is provided by the psychodynamic theory of 

pathogenesis and its various treatment strategies. Individual and group 

psychotherapy (psychoanalysis sessions) are supported and intensified 

by approaches from behaviour therapy, trauma therapy, creative therapy 

(so-called “non-verbal” methods) and a social therapy that empowers the 

patients. 

In the field of Psychosomatic Medicine and Psychotherapy, the focus is 

clearly on strategies of psychotherapy. If drug treatment is indicated – 

something which, in psychosomatic medicine, is understood as a 

consequence of the limitations of the effectiveness and availability of 

psychotherapeutic measures – this psychotherapy may be complemented 

or supported by courses of drug treatment. 

The intensive psychodynamic individual and group psychotherapy sessions 

serve to uncover the pathogenic conflicts in which the neurotic disorders 

are rooted. The technique of psychoanalytic-interactive psychotherapy 

is particularly suitable for addressing the deficits in interpersonal 

communication skills that can be so frequently observed in people suffering 

from personality disorders. Family members are regularly asked to 

participate in diagnostic-therapeutic interviews, and therapy interventions 

are offered for couples and families. Each patient on the ward is assigned 

a “primary carer” who is available throughout the treatment period for 

discussions about everyday issues in connection with hospital routines and 

related conflicts. Creative therapy sessions – art therapy, body therapy, 

music therapy, ergotherapy – are organised once or twice per week for 

individuals or small groups. 

Art therapy uses creative media on a psychodynamic basis (colours, sound, 

etc.). The personal experience of the artistic act and the subsequent verbal 

and emotional reactions allow the patient to develop deep insights into his 

own inner self. Body therapy and kinesitherapy can teach an individual to 

experience his own and other people’s selves on a higher level of awareness, 

to abandon fixed motion patterns and to extend the range of expression and 

behaviour. Music therapy uses – mainly – the method of free improvisation to 

uncover current emotional states, moods and experiences. Ergotherapy uses 

handicraft techniques and materials for therapeutic purposes. 

The social therapy group discusses practical and social issues, developing 

and testing solutions, ultimately in role-playing models. One-on-one social 

therapy sessions mainly serve to help individual patients to overcome 

concrete social problems. All patients attend the physical education lessons 

conducted by a gymnastics teacher. Patients are also provided an opportunity 

to participate in autogenic training group sessions under the instruction of 

a medical doctor. All these methods are coordinated in a target-oriented 

individual therapy schedule. An integrated team of professionals with 

different specialisations designs and coordinates the individual treatment 

activities. 

HealtHcare 

Director 

W. Tress, MD, PhD, Professor in 

Psychosmatic Medicine and Psychotherapy 


L. Joksimovic, MD, MPH 

(since May 2009), 

J. Kruse, MD, Professor in 

Psychosomatic Medicine and Psychotherapy 

(until April 2009) 

Consultants 

St. Dechering, MD 

N. Hartkamp, MD (until 2005) 

A. Jüttemann-Lembke, MD (until 2008) 


P. Remmel 

43


Healthcare for Outpatients and Day Care Patients 

Day Care Unit 

The Day Care Unit of the Department of Psychosomatic 

Medicine and Psychotherapy of the LVR-Klinikum Düsseldorf 

provides 19 places for treatment of people suffering from 

psychosomatic disorders, affective disorders, anxiety 

disorders, obsessive-compulsive disorders, adjustment 

disorders, dissociative disorders or eating disorders, 

many of whom are also afflicted by comorbid personality 

disorders. Day care treatment strategies have proved 

specifically effective in the treatment of people from these 

groups whose requirements would not have been met by a 

conventional outpatient psychotherapy and for whom full 

hospitalisation would have been either unnecessary or, 

bearing in mind their emotional needs for interpersonal 

distance and autonomy, counterproductive. The methods 

and objectives of the Day Care Unit do not differ substantially 

from those of the inpatient ward. The patients still spend the 

majority of their time in their customary and familiar social 

contexts, spending eight hours a day for five days a week in 

the Day Care Unit. This means that patients have to engage 

with both the situation at the Day Care Unit – the wide range 

of therapeutic options, the interpersonal relationships and 

the standards – and the relationships and conditions of their 

external everyday lives that have been altered through their 

therapies. 


The Institutional Outpatient Unit of the Department of 

Psychosomatic Medicine and Psychotherapy examines 

persons suffering from psychosomatic disorders, affective 

disorders, anxiety disorders, obsessive-compulsive 

disorders, adjustment disorders, dissociative disorders, 

eating disorders and decompensated personality disorders 

44 

and, if necessary, recommends outpatient treatment, day 

care or full hospitalisation. Subsequent to descriptivepsychopathological 

and psychodynamic diagnostics, 

and after acquiring some background information about 

the individual’s social conditions, the patient is referred 

for appropriate treatment according to the indication. 

If necessary, individuals are invited to participate in 

additional interviews to strengthen their motivation to 

undergo psychotherapy and to assist in their search for a 

therapy place. Offers for special treatment include a shortterm 

group psychotherapy for patients with somatoform 

disorders, a short-term psychotherapy for patients with 

personality disorders and psychosomatic disorders and 

group therapy sessions for gerontopsychosomatic patients. 

Culture-sensitive individual and group therapy programmes 

are also provided for victims of torture, migrants and 

refugees. 

Special consultation hours are held for people suffering 

from attention-deficit/hyperactivity syndrome. 

Current Scientific staff 

Medical doctors 

C. Brinschwitz, S. Dechering, K. Eder, A. Gdawietz, M. Jente, 

L. Joksimovic, U. Nawarotzky, J. Rademacher, W. Tress, 

M. A. Wulf 

Psychologists and other (non-medical) staff 

V. Bergstein, H.-J. Bernard, J. Bierwirth, M. Cavka, J. Hardt, 

D. Hecke, M. Hoshino, D. Kunzke, S. Michalek, E. Neumann, 

N. Schmitz, M. Schröder, A. Stratkötter

2.2.3 Division of Child and Adolescent 

Psychiatry, Psychosomatic Medicine and 


Division of Child & Adolescent 



16 Day Care Places 

Children‘s ward 

Adolescent ward 12 a 

Adolescent ward 12 b 

Day clinic 


The Division of Child and Adolescent Psychiatry and Psychotherapy of 

the LVR-Klinikum Düsseldorf provides its services to the 572,000 citizens 

of Düsseldorf and the 506,000 citizens of Mettmann County. The division 

features 32 inpatient beds and a Day Care Unit with 16 places for the 

treatment of infants, children and adolescents up to the age of 18. 

Inpatient unit 

The unit features 32 inpatient beds including a children’s ward (8 beds) for 

children between the ages of 5 and 14. 

The division aims to keep the inpatient part of its young patients’ treatment 

to the bare minimum and to transfer them to outpatient treatment 

structures at the earliest stage possible in order to preserve their network of 

family relationships. Patients between the ages of 14 and 18 are preferably 

admitted to one of the two adolescents’ wards (12 beds each), which have 

similar organisational structures and target groups. The adolescents’ wards 

12 A and 12 B follow the same concept: children, adolescents and young 

adults are provided with psychiatric or psychotherapeutic crisis intervention. 

The treatment is combined with measures intended to help the young 

patients acquire independence and self-sufficiency skills. 

The division applies selective-adaptive treatment concepts on the basis of 

a salutogenetic approach. Assistance in exploiting existing resources is of 

paramount importance. The objective is to promote the healthy parts of the 

young individuals’ own selves, improve their social skills and prepare them 

for reintegration into their home environments. Following the tenets of a 

Division Head 

G. Ott, MD 


O. Sokolowa, MD 


P. Remmel 

HealtHcare 

45


multimodal system, treatment strategies are individually 

designed and take account each patient’s family and social 

situation. Such strategies include: 

s Comprehensive diagnostics of child and adolescent 

psychiatric disorders 

s Comprehensive psychological diagnostics (learning 

and performance abilities, emotional behaviour) 

s Individualised therapy, either psychodynamic or 

cognitive-behaviour therapy depending on the nature of 

the disorder 

s Involvement of the domestic environment (e.g., family, 

home, school) with systemic/interactive therapy options 

or intensive counselling 

s Different group therapy options (such as social skills 

training, skills training according to the concept of 

dialectical behaviour therapy, anti-aggression training, 

group sessions for parents and children with ADHS 

issues, additional parent groups, etc.) 

s Music/creative therapy, individual or group sessions 

s Mental and physical exercise techniques (autogenic 

training, progressive muscle relaxation, yoga) 

46 

The Division of Child & Adolescent 

Psychiatry treats patients 

aged between 5 and 18 

s Social and educational care (following the concept of 

the “primary carer”), various social care options for 

individuals and groups 

Day Care and Outpatient Unit 

The Day Care Unit, established in 1986 and extended to its 

present size in 2007, comprises two wards with eight places 

each for children and adolescents. All known disorders 

in child and adolescent psychiatry can be treated here. 

Treatment strategies are tailored to the young patients’ 

and their families’ individual needs, with psychosocial 

reintegration being a high priority. 

It is planned to establish another Day Care Unit with twelve 

beds in Hilden (Mettmann County). 

The outpatient ward can give appointments at short notice 

to parents and their children or adolescents who are 

suffering from mental disorders. It specialises in outpatient 

diagnostics, the outpatient treatment of emotionally unstable 

young people (following the tenets of dialectical behaviour

therapy), trauma therapy (for example eye-movement 

desensitisation and reprocessing therapy) and outpatient 

individual and group sessions for children and adolescents 

with attention disorder/hyperactivity disorder. Special 

consultation hours are held for migrant families, children 

of mentally ill parents, parents with children suffering from 

sleep and developmental disorders or who fail to thrive, and 

for children with attention disorder/hyperactivity issues. 

In compliance with the principles of community-based 

healthcare, the Division of Child and Adolescent Psychiatry 

strives to cooperate with office-based medical doctors, 

counselling centres, youth welfare offices and private 

associations with similar agendas, schools and other 

hospitals. It also provides the University Hospital Düsseldorf 

with consultation services (for young individuals of all 

ages, including infants), generally in cases where suicide 

risks need to be assessed, where indications need to be 

verified in the event of transfers and, less frequently, where 

concomitant mental disorders need to be treated alongside 

somatic illnesses. 

Treatment includes creative therapy 

Current Scientific staff 

Medical Doctors 

M. Beetz, D. Hamzei, G. Ott, O. Sokolova, N. Vens, 

C. Wagner, N. Zaki 

Psychologists and other (non-medical) scientists 

U. Bowi, T. Ferrari, S. Klassen, P. Motz, G. Pingel, 

G. Rulcovius, M. Walg 

HealtHcare 

47


2.2.4 Nursing 

Director: K. Maas 

The nursing staff of the LVR-Klinikum Düsseldorf support 

the patients in their efforts to cope with everyday stress 

situations, to achieve physical and mental well-being, to 

maintain, restore or adjust physical, mental and social 

functions and to cope with existential experiences, i.e. to 

solve problems and to manage human relationships. 

Those members of the multiprofessional team whose 

primary responsibility is the provision of nursing services do 

not focus exclusively on the illness: nursing is understood 

as a task that involves individual problem-solving strategies, 

health preservation resources and important social and 

domestic factors. The relationships between nursing staff 

and patients can assume a key role in the therapeutic 

process. 

Nursing means to plan and to design, in agreement with 

the patient and on the basis of a requirement-oriented 

information-gathering process, activities aimed at improving 

the patient’s individual well-being, interpersonal and 

relationship skills, coping strategies, compliance, selfsufficiency 

skills and self-confidence, at preserving existing 

skills and at reducing or, better, eliminating risks and their 

consequences. 

Psychiatric nursing is closely involved in the therapeutic task 

management and assumes – in close cooperation with the 

other professional groups – responsibility for the individuals’ 

safe passage through the course of treatment. 

Nurses who deal with inpatients and day care patients have 

the following main responsibilities. 

Continuous accompaniment of patients and observation of 

the following: 

s Illness-related limitations and resources, 

s Changes in behaviour, 

s Appearance and overall demeanour, 

s Patients’ behaviour in standard situations (during 

meals, leisure activities, etc.), 

48 

s Patients’ behaviour in situations of social contact (with 

other patients, nurses, etc.) 

s Drug adherence and the effectiveness of these drugs. 

Also: 

s Designing and implementing patient-specific 

psychiatric and psychotherapeutic nursing strategies 

s Application of existing guidelines and nursing standards 

pertaining to coercive and prophylactic measures 

s Provision of stress relief for the patient through careful 

cultivation of interpersonal relationships (one-on-one 

conversations, relaxation techniques, skills, etc.) 

s Provision of instructions and support (perhaps 

compensation and active involvement) concerning 

personal hygiene, maintenance of schedules and 

routines to support time-structuring efforts, orientation 

through explanations of rules, leisure activities 

s Organisation of group activities (well-being 

programmes to train the patients’ ability to enjoy 

themselves, training of social skills, psychoeducation) 

The rapidly changing legal and economic framework and 

further innovations of the past ten years have had a major 

impact on the face of nursing. Nursing has become less 

conservation and preservation and more an instrument of 

support for the development of self-sufficiency skills and 

rehabilitation. This change also means that the results of 

scientific research have been integrated into the field of 

nursing. Effective and patient-oriented nursing requires 

a permanent transfer of theory into practice, something 

that is ensured by the LVR-Klinikum Düsseldorf through a 

comprehensive range of internal and external professional 

courses of continuing education, among other things. 

The following processes were restructured 

within the past few years 

Since the LVR is in the process of converting the 

entire records of its hospital network to an electronic 

data management system (project title: “KIS” 

[“Krankenhausinformationssystem”]; Hospital Information 

System), a system was required that was capable of

documenting all types of nursing information. The Directors 

of Nursing at the LVR decided in favour of the NANDA-I 

system of classifying nursing diagnoses. NANDA-I appeared 

to be particularly well suited to their purpose, having been 

globally tested longer than any rival system. Also, other 

institutions in the German-speaking countries had already 

gathered experiences with its implementation. 

As a consequence, since 2004 all members of the LVR- 

Klinikum’s nursing staff have been (and still are) undergoing 

training courses – division by division – to diagnose nursing 

requirements, to integrate the required measures into the 

therapeutic process and to record the procedure in the KIS. 

NANDA-I nursing diagnoses enable the users of the system 

to represent individually relevant situations of patients and 

their family members as well as the responsibilities of the 

nursing staff in a differentiated and flexible manner. 

Implementation of a comprehensive decubitus, 

fall and wound management 

This includes the following elements: 

s Design and implementation of internal nursing 

standards, based on the national standards of the 

German Network of Quality Development in Nursing, in 

close coordination with the Nursing Academy 

s Provision of training courses 

s Risk assessment, using rating scales and checklists 

s Design of a protocol to record the number and severity 

of falls and of a decubitus reporting form 

s Annual evaluation of the incidences for falls and 

decubitus 

s Introduction of suitable materials for hospital beds, hip 

protectors, low bedsteads 

s Structural alterations: lighting concepts, floor 

coverings 

s Design and implementation of a wound anamnesis and 

a report form to record the development of wounds 

s Provision of training for two staff members, one each 

from the Divisions of Neurology and Gerontopsychiatry, 

to help them acquire certification as wound healing 

experts from the Initiative for Chronic Wounds (ICW) 

s Provision of advice to wound experts who are assessing 

chronic wounds at the hospital 

HealtHcare 

Implementation of a de-escalation management 

This includes the following elements: 

s Design and implementation of nursing standards in the 

treatment of fixated and isolated patients 

s Introduction of a “risk of violent behaviour” checklist 

and a standardised instrument for recording aggressive 

incidents 

s Annual evaluation of the aggressive incident recording 

tool (SO-AS-R) 

s Provision of training for two staff members to help 

them qualify as tutors in de-escalation and protection 

techniques 

s Introduction of comprehensive compulsory training 

programmes in de-escalation and protection 

techniques 

Launch of new group activities and 

nursing strategies, for example: 

s NADA ear acupuncture in the Division of Dependence 

Disorders 

s Well-being programme to train the patients’ ability to 

enjoy themselves (various divisions) 

s Yoga group in the Division of Child and Adolescent 


s Psychoeducation 

s Validation in the Division of Gerontopsychiatry 

In addition, first aid training programmes were conducted 

by a specifically qualified staff member who has been 

assigned to assume special responsibilities in the event 

of an emergency (emergency equipment management, 

in situ advice, etc.), and a position was established for a 

“Professional Development and Quality Assurance Manager 

for Nursing” who will report directly to the Director 

of Nursing and be in charge of in-house professional 

development and the implementation of measures and 

systems designed to develop the range of services and to 

ensure their permanently high quality. 

49


2.2.5 Cross-divisional units 

Centre for Diagnostics 

Many diagnostic examinations are performed at the 

hospital and subsequently processed and evaluated inhouse, 

including clinical-chemical laboratory tests, 

electroencephalography (EEG), evoked potentials, 

neurography, electromyography, electrocardiography, sleep 

laboratory and sonography of the blood vessels supplying 

the brain. Imaging procedures (computer tomography, 

magnetic resonance tomography and positron emission 

tomography) are performed in close cooperation with 

the Sana Hospital at Gerresheim, the University Hospital 

Düsseldorf and the Research Centre at Jülich. 

Clinical Chemistry Unit 

Director: W, Gaebel, MD, Professor of Psychiatry and 

Psychotherapy, H. Quadbeck, MD (until September 2008) 

This unit carries out all clinical-chemical laboratory tests 

that may be required, including blood level analyses of 

prescription drugs, which may be of crucial importance for 

therapeutic decisions. Occasionally, this unit is supported by 

a specialised laboratory in Cologne. 

Psychophysiology Unit 

Directors: J. Zielasek, MD, Senior Lecturer in Neurology 

R. Ihl, MD, Professor (until 2005) 

The hospital is equipped with three digital 

electroencephalography (EEG) recording devices 

50 

and one analogue device and a sleep laboratory. 

Electrocardiography (ECG) equipment is available 

throughout the hospital. The unit performs and evaluates 

about 2,000 electroencephalograms and more than 6,000 

electrocardiograms per year. The EEG recordings comply 

with the guidelines of the German Society for Clinical 

Neurophysiology (duration: 20 minutes with hyperventilation 

and photostimulation). Results are generally provided on the 

day of the examination. 

Psychological tests/neuropsychological diagnoses 

Directors: W. Strauß, psychologist (interim), 

I. Lehmann, D.Sc., Professor (until 2004) 

A wide range of psychological test methods is applied by 

both the inpatient and the outpatient units, which record 

(premorbid and current) cognitive functions, personality 

structures, different aspects and levels of severity of mental 

disorders and their impact on performance and overall 

personality. In the course of the treatment, it therefore 

becomes possible to promptly detect, measure and describe 

improvements as well as deteriorations. 

Psychological tests are conducted to establish levels of 

performance and to diagnose patients, but also in the 

course of clinical studies, post-marketing phase IV studies, 

comparisons between therapies and other research projects 

that have not been quantitatively recorded. 

Assessment of the electrical activity of the brain (EEG)

Other diagnostic techniques 

s Computer tomography and magnetic resonance 

tomography: Christ, MD, Professor, Division of 

Radiology, Sana Hospital Gerresheim 

s Magnetic resonance tomography: U. Mödder, MD, 

Professor, Institute of Radiology, 

s University Hospital Düsseldorf 

s Positron Emission Tomography: K. Zilles, MD, 

Professor, and A. Bauer, MD, Professor, Jülich 

Research Centre 

s Sonography of the blood vessels supplying the brain 

as well as electromyography and electroneurography 

examinations are conducted at the Neurology Division 

of the LVR-Klinikum Düsseldorf. 

Therapy Units 

Medical Director: W, Gaebel, MD, Professor of Psychiatry 


Electroconvulsive therapy and repetitive 

transcranial magnet stimulation therapy 

Electroconvulsive therapy is provided at the LVR- 

Klinikum Düsseldorf in cooperation with the Institute for 

Anaesthesiology (B. Pannen, MD, Professor) of the University 

Hospital Düsseldorf. It is also possible to apply the innovative 

method of repetitive transcranial magnetic stimulation 

therapy. 

Consultation services of other specialists 

The LVR-Klinikum Düsseldorf is responsible for providing 

psychiatric advice to the Sana Hospital Gerresheim and 

the University Hospital Düsseldorf. Conversely, patients 

who receive treatment in psychiatry and psychosomatic 

medicine at the LVR-Klinikum Düsseldorf can also 

attend regular consultation hours held by board-certified 

specialists in internal medicine, dentistry, ophthalmology 

und gynaecology. Board-certified specialists of the University 

Hospital Düsseldorf from any other field can be readily 

consulted at any time. 

Physiotherapy, exercise therapy and kinesitherapy 

Physiotherapy 

Therapists: H. Gerrits, J. Zukowski 

The hospital uses a range of physiotherapy techniques. 

Physical education is used as an additional form of treatment 

for patients who require physiotherapeutic activity and a 

gradual improvement of their physical condition. Heat therapy 

is performed by applying infrared radiation, mainly before 

HealtHcare 

massages, to help the individual relax and to improve blood 

circulation. Fango packs also assist relaxation and may, for 

example, be applied before subjecting persons suffering from 

a hardening of the muscles – often one of the concomitant 

problems of depression – to an otherwise inevitably painful 

massage. Classic massage techniques are designed to reduce 

increased muscle tone and release tensions. Partial and full 

body massages can, for example, be applied to loosen and 

relax hardened muscles. Manual lymphatic drainage (MLD; 

also a decongestive therapy) is applied if excessive amounts 

of liquid have accumulated in the tissue in order to ensure or 

accelerate the flow of the lymphatic fluid through the lymph 

vessels. Lymphatic drainage serves to avoid complications 

that may arise as a consequence of oedema in the tissue. 

MLD is also used as pain relief to reduce the pressure on 

tissue and nerves. 

Exercise therapy 

Director: C. Luckhaus 

The starting point is the patient’s current movement pattern. 

Objectives of exercise therapy may include: 

s Improve communication and interactive skills 

s Enable the patients to better express themselves 

s Increase, improve and maintain their levels of overall 

competence 

s Improve self-awareness 

s Increase confidence and self-esteem 

s Teach strategies of coping with everyday challenges 

s Improve general well-being 

s Improve physical condition 

Exercise therapy uses elements from the Feldenkrais 

method, eutony, yoga, tai chi, Jacobson’s progressive 

muscle relaxation, concentrative exercise therapy, breathing 

therapy, dance therapy, chi gong, therapy of movement, 

stamina training and the so-called small and big games. 

Ergotherapy 

Director: Dipl.-Psych. W. Höhl 

Ergotherapy is a collective term for a wide range of 

therapeutic methods and techniques, many of which 

are used at the LVR-Klinikum. One particular feature of 

ergotherapy is the use of therapeutic tools such as design 

techniques – which, in turn, use different materials (clay, 

textiles, peddig tubes, etc.) – as well as routine everyday 

activities. It is crucial, however, that these tools are used 

with a clear purpose, which is derived from the indication 

51


– this is what distinguishes ergotherapy from simply doing 

handicrafts. The treatment aims to restore, improve or 

compensate for skills and functions the individual has 

completely or partially lost as a consequence of his illness. 

Nearly all units of the hospital provide such ergotherapy 

treatment. On top of that, occupational therapy sessions 

are also on offer. In contrast to the ergotherapy courses, 

however, occupational therapy is organised on a centralised 

basis for the entire hospital. Roughly one third of the 

approximately 25 ergotherapists work in this area. 

Occupational therapists instruct patients in how to complete 

specific tasks to achieve certain therapeutic objectives. The 

hospital operates five occupational therapy areas: wood, 

office, gardening, housekeeping and industry. Patients from 

different departments and units of the hospital jointly use 

these therapy courses, which are provided in designated 

central therapy facilities. Between 100 and 150 people per 

month are treated in this way. 

The occupational therapy unit also features a small number 

of places with day care. This programme allows patients to 

receive uninterrupted treatment before they return to their 

jobs or start a rehabilitation programme. During the past 

four years, about 70 day care patients per year attended 

these courses for an average duration of approximately five 

months. 

On top of that, a new option of “outpatient ergotherapy” 

was added in 2005. This new offer allows people to continue 

their ergotherapy treatment as outpatients after they have 

been discharged from the hospital. People who have had 

no previous contact with our hospital can also join the 

outpatient ergotherapy courses. One key difference to the 

day care occupational therapy is the wide use of all therapy 

tools of psychiatric ergotherapy – such as creative design 

and cognitive training – in addition to activities of work in the 

narrower sense of the word. Whereas day care occupational 

therapy courses are generally scheduled every day (and are 

also designed to occupy much of the day and structure it), 

outpatient ergotherapy is provided in a remedial function 

(much in the way of speech therapy and physiotherapy) for 

no more than two consecutive hours once or twice a week. 

Outpatient ergotherapy courses are attended by about fifteen 

people a month. We still have very little reliable information 

about the effects of occupational therapy and ergotherapy. 

Bachelor and other degree theses – to be written by young 

scientists from the unit – are about to address this deficit. 

52 

Creative therapy 

Director: F. Mecklenbeck 

The term “creative therapy” describes different forms of 

therapy, all of which encourage the patients to express 

themselves artistically. The LVR-Klinikum Düsseldorf offers 

courses in art therapy, creative social therapy, music therapy 

and dance therapy. In all of these courses, communication is 

always conducted in the language of the medium. Creative 

therapy is activity and experience centred. People express 

themselves through an activity, which is associated with 

an intense experience. Both therapist and patient are 

emotionally involved. The change takes place without taking 

a detour via the spoken word. Verbal reflections, however, 

are part of the therapy, creating another dimension for the 

patients in which they can question their behaviour through 

cognitive insights and develop new forms of conduct. Each 

creative therapy is characterised by different methods, 

techniques and objectives that may be applied depending on 

the individual patient’s illness and the therapist’s strategies. 

Creative therapy is a target-oriented form of treatment which 

may be used as a diagnostic tool and to achieve indicationbased, 

precisely defined treatment objectives. Both individual 

and group sessions are possible. This type of therapy is 

generally suitable for all patients with emotional, social, 

cognitive and psychomotor problems. Creative therapies 

are offered by all departments and divisions of the LVR- 

Klinikum Düsseldorf. The hospital has been certified as a 

teaching institution for music therapy in Germany, Austria 

and Switzerland, as a teaching institution for creative therapy 

in the Netherlands, and – as the only one among all similar 

institutions in Germany – as a “Clinical Training Facility” by 

the American Music Therapy Association. All creative therapy 

facilities at the Klinikum have dedicated and well-equipped 

therapy rooms. 

Publications 

Mecklenbeck F (2001): Musiktherapie in den Rheinischen Kliniken 

Düsseldorf. In: Mit allen Sinnen, video/DVD 54 Min., LVR Cologne/ 

Medienzentrum Düsseldorf 

Pirkl U (2001): Tanztherapie in den Rheinischen Kliniken Düsseldorf. 

In: Mit allen Sinnen, video/DVD 54 Min., LVR Cologne/Medienzentrum 

Düsseldorf

Social services 

Coordinator: Christiane Sieger, Dipl.-Soz. 

(certified social worker) 

The social services unit of the LVR-Klinikum Düsseldorf 

provides help to people whose illnesses, disabilities and 

psychosocial stress situations have created problems in 

their own lives and in the lives of their families and friends. 

This assistance is intended to enable these individuals 

to acquire or reacquire and to preserve important social 

skills, making it easier for them to achieve (re-)integration 

into their social environments. Clinical social work is 

therefore an element of psychiatric, psychotherapeutic and 

psychosomatic therapy and, at the same time, an important 

link between the hospital and the social environment 

of the individual. Social services are provided centrally 

for all departments and divisions of the hospital, its unit 

reporting to the Medical Director. At the end of 2008, the 

social services unit employed 25 staff members, all of 

them graduates in social work or social education. The unit 

provides its services to inpatients, but also increasingly 

to outpatients as a consequence of the establishment 

and expansion of several specialised outpatient units 

over the past few years. Staff members also contributed 

to the development of the concept for the establishment 

of a network of intercultural outpatient units. Since its 

HealtHcare 

Creative therapy can support other treatment processes 

in various types of mental disorders 

establishment in 2008, the social services unit has tried to 

extend the range of intercultural treatment services provided 

by the LVR-Klinikum Düsseldorf and to make its existence 

better known to the general public. Employees of the social 

services unit contribute to the efforts of several local and 

regional working groups that aim to improve the healthcare 

provisions for people with mental disorders. 

The unit also provides internships on a regular basis for 

students of social work and social education. The unit 

contributed to several regional healthcare research projects 

(on behalf of the LVR-Klinikum Düsseldorf) and to a oneyear 

study about possible improvements of the healthcare 

provisions for people with schizophrenia (following their 

discharge from inpatient care) through guideline-assisted 

medical, psychoeducational and sociotherapeutic measures 

(in cooperation with the health insurance company Techniker 

Krankenkasse). All employees are assigned to specific 

divisions and wards and are part of the respective ward 

team. Their range of responsibilities includes the provision 

of individual social therapy as well as group social therapy 

to inpatients, outpatients and day care patients, but also 

the development and implementation of individual support 

measures. 

53


2.2.6 Cross-divisional facilities 

Company healthcare 

The LVR-Klinikum Düsseldorf operates a dedicated company 

healthcare service which is in charge of providing medical 

assistance to its own staff. It is headed by Th. Kniest, MD. 

Ombudsperson for the patients 

The ombudsperson (complaint officer) is elected by the 

Hospital Committee of the Landschaftsversammlung 

Rhineland (regional parliament) for a period of two years 

at a time. Hans-Georg Ibold has been representing the 

interests of the patients in this capacity since October 2001. 

The primary idea is to have someone who knows the system 

and who can react quickly to any concern a patient may 

voice. The ombudsperson is also expected to inform and, if 

necessary, involve the hospital management. 

Alfred Adler School – Municipal School for Patients 

Director: J. Hinne-Fischer, special schools teacher 

The “School for Patients” in Düsseldorf carries the name 

of Alfred Adler, the founder of the science of individual 

psychology. The school provides education for children who 

are being treated as inpatients at the hospital or at a similar 

healthcare institution and who are therefore prevented from 

attending lessons at their usual school for at least four 

weeks (Education Act of the Federal State of NRW, most 

recently amended on 27 June 2006). The school accepts 

pupils from all types of schools, from primary schools to 

vocational colleges. Lessons comply with the guidelines 

and curricula of the schools the pupils used to attend at 

home. The pupils are supported individually or in groups, 

according to their psychological and physical condition. 

For patients of school age, school lessons are routine and 

therefore represent a slice of normality in their special life 

situation. With its range of lessons, the school contributes 

to the development of the children’s healthy resources. The 

Alfred Adler School features three departments, one of 

which (Municipal School for Patients – Department of Child 

and Adolescent Psychiatry) has been attached to the LVR- 

Klinikum Düsseldorf. The school teaches up to 40 pupils, 

aged between 6 and 20, roughly equally divided into boys 

and girls. Most pupils attend lessons in Secondary Stage I 

(years 6 through to 11), about 30% have been transferred 

from primary schools and different types of special 

schools. Education is generally provided over a period of 

several weeks or months, in a few cases for even longer. 

The range of disorders includes psychoses, obsessive 

54 

compulsive disorders, (school) phobias, depressions, 

suicidal tendencies, borderline syndromes, hyperactivity, 

eating disorders, epileptic seizures, etc. Close cooperation 

with the clinical units is a key condition for the successful 

work with mentally ill children and young people. Weekly 

team meetings and daily phone calls before lessons plus, 

if required, personal meetings and crisis meetings all 

play an essential part in the efforts of the Division of Child 

and Adolescent Psychiatry of the Alfred Adler School. The 

individual treatment units make sure that the morning hours 

are kept as free as possible for the school lessons, generally 

scheduling therapeutic sessions and other activities for 

the afternoons. The school, in close coordination with the 

hospital, maintains contact with the pupils’ parents as well 

as with their pupils’ former and future schools. 

School newspaper, KraSs 

For fifteen years, the school published the bi-annual school 

newspaper KLAPSE, which was very successful and won 

several prizes. KLAPSE ceased publication in 2007, but the 

newly established school newspaper KraSs – for “Kranke 

Schüler schreiben” (“Ill pupils write”) – pursues a similar 

agenda, striving to make psychiatry more transparent, to 

provide the – often poorly informed – general public with an 

insider perspective and to combat prejudices. 

Work experiences for pupils 

Pupils of age 14 and up can be placed in an internship for 

a certain period. These internships are very important for 

many pupils, helping them to experience real life situations 

and stabilise themselves. Experiential education courses 

include horse riding and therapeutic work in the school 

garden. 

Central Archive for Medical Records and Basic 

Documentation (BADO) 

Director: Dr. med. J . Malevani 

Staff: B. Will, I. Fiering, S.-O. Cho 

The Central Archive for Medical Records provides medical 

records for the healthcare departments and various 

research groups as well as prompt replies to clinically 

relevant requests from external institutions. Quality 

assurance and economic viability were two priorities of 

recent years. Since 2006, the return times of borrowed and 

newly created files has been statistically evaluated. The 

archive also started to create protocols of incoming requests

for medical reports and the requesting authorities. The new 

statistical reports will identify trends and developments. 

Since the rules of access to historic files have been 

restructured and simplified, staff members have been able 

to support several doctoral candidates simultaneously in 

their comprehensive archive research efforts. 

For example: 6,000 patient files are currently being 

evaluated for a scientific project about the victims of violence 

(in cooperation with the Institute of Forensic Medicine of 

the Heinrich-Heine University Düsseldorf). Other research 

for doctoral theses is concentrating on the “Effectiveness 

of Different Types of Anti-Parkinson Medication” (in 

cooperation with the Division of Neurology of the LVR- 

Klinikum Düsseldorf) and the “Causes of Hyponatremia 

in Gerontopsychiatry” (in cooperation with the Division of 

Gerontopsychiatry of the LVR-Klinikum Düsseldorf). The 

unit for basic documentation concentrates on plausibility 

checks and completeness checks of BADO and AMDP 

data, IT records and the provision of these records as 

well as statistical evaluations and reports (BADO: basic 

documentation; AMDP: Association for Methods and 

Documentation in Psychiatry). 

Some of these statistical evaluations are performed when 

needed to support certain projects or the work of the 

departments and divisions who have requested them. 

Regular evaluations, performed in cooperation with project 

and research groups, include the following: 

s The number of people in secure wards and the average 

duration of their inpatient treatment is calculated 

annually for the project “Drug Safety in Psychiatry”, 

in cooperation with the Psychiatric Hospital of the 

Ludwig-Maximilian University, Munich 

s A compilation of sociodemographic and illness-related 

data and data on the average length of hospitalisation 

of persons suffering from depression for the project 

(module) Quality Assurance of the Competence 

Network on Depression 

s Processing and evaluation of clinically relevant data 

as part of the joint venture with the research group on 

“Borderline Personality Disorders” 

The unit also creates an annual report for the LVR-Klinikum 

Düsseldorf which is based on the BADO data and an annual 

AMDP standard report which is based on the AMDP data. 

HealtHcare 

IT 

Staff: M. Busch, W. Horstmann 

The LVR-Klinikum Düsseldorf, Hospital of the Heinrich- 

Heine University Düsseldorf, provides its scientific research 

units with a service-oriented IT infrastructure. For the 

scientists, this means: 

s The highest possible stability of servers and services 

s Globally unrestricted communication through Internet 

channels 

s The option of introducing productivity-enhancing tools 

ad hoc 

s The highest possible levels of data protection and data 

security 

s Continuous adjustment of storage capacities and 

terminals in line with requirements 

The following steps were taken to help the unit to reach 

these objectives: 

s Construction of two new secure server rooms with 

uninterruptible power supply, fire protection, protection 

from burglary, backup systems and backup site 

s Regular maintenance and security servicing for all 

central components 

s On-site service and support through external providers 

s Permanent monitoring of capacities and infrastructural 

adjustments with economically viable modern products 

55

LVR-KLINIKUM DÜsseLDORF – hOsPITaL OF The heINRIch-heINe UNIVeRsITY DÜsseLDORF

3. Research 

ReseaRch

LVR-KLINIKUM DÜsseLDORF – hOsPITaL OF The heINRIch-heINe UNIVeRsITY DÜsseLDORF 

3.1 Department of Psychiatry and Psychotherapy 

3.1.1 Research Networks 

During the reporting period, the LVR-Klinikum Düsseldorf 

was a member or at the head of several countrywide or 

regional research networks. Worthy of specific mention here 

are the “Competence Networks in Medicine” which, since 

1999, have been funded by the German Federal Ministry for 

Education and Research (FMER) to improve cooperation 

between the leading research institutions in specific research 

areas (horizontal networking) and those providing routine 

care (vertical networking) for individual clinical pictures 

across all fields of medicine. The programme is designed 

to make a contribution to improving the treatment of people 

with clinical pictures characterised by high morbidity and/or 

mortality rates. The Competence Network on Schizophrenia 

was one of the (initially nine, now eighteen) federally-funded, 

countrywide competence networks. The network was 

essentially the brainchild of the Department of Psychiatry 

and Psychotherapy of the Heinrich-Heine University, LVR- 

Klinikum Düsseldorf, together with the Department of 

Psychiatry and Psychotherapy of the Ludwig-Maximilian 

University, Munich (H.-J. Möller) and, since its start in 1999, 

has been coordinated by the Network Headquarters at the 

Department of Psychiatry and Psychotherapy, LVR-Klinikum. 

The spokesperson for the competence network is W. Gaebel. 

In addition, the LVR-Klinikum Düsseldorf has also been linked 

with research projects within the Competence Networks on 

Depression and Suicidality and has participated in projects of 

the Competence Network on Dementia. In close collaboration 

with the Competence Network programme, the FMER has 

set up other associated research funding programmes, in 

which the Department of Psychiatry and Psychotherapy 

takes part. This allowed, for instance, corresponding brain 

banks from different Competence Networks to be pooled 

into a cross-illness brain bank that can be used as a 

reference centre for CNS disorders (BrainNet), with which 

the Department of Psychiatry and Psychotherapy is linked 

as an Associate Satellite Centre. In order to work on joint 

legal, organisational and technical solutions to problems 

simultaneously facing a number of research associations, the 

FMER set up the Telematics Platform for Medical Research 

Networks (TMF e. V.), which has since taken the legal form 

of a registered non-profit association. The Competence 

Network on Schizophrenia is, amongst others, a member of 

this “umbrella association” of medical research networks and 

together with other neuropsychiatric competence networks 

has attracted project funding for the creation of interfaces 

for exchanging data between clinical documentation systems 

58 

from the TMF. Finally, when the second funding period for 

the Competence Network on Schizophrenia ended in 2005, a 

countrywide research network for “Psychotherapy in Positive 

Symptoms” (POSITIVE) was set up, which was conceived and 

initiated by the Tübingen University Hospital (S. Klingberg 

and G. Buchkremer) in close collaboration with cooperation 

partners from the Competence Network on Schizophrenia, 

including the network headquarters, and which has been 

coordinated by colleagues from Tübingen since its approval in 

2006. The Department of Psychiatry and Psychotherapy is an 

active participant in almost all of these research association 

projects. In the area of dependence and basic research, the 

DFG Priority Programme 1226 “Nicotine: Molecular and 

Physiological Effects on the Central Nervous System” has 

been coordinated since 2006 at the LVR-Klinikum Düsseldorf 

with G. Winterer as the spokesperson. He initiated the 

programme, has contributed various projects and has 

participated in other projects. The objective of these partially 

multi-site projects was the elucidation of the moleculargenetic 

principles of the effects of nicotine and nicotine 

dependence, as well as the neurobiological and clinical 

effects of nicotine. Moreover, the LVR-Klinikum Düsseldorf 

was part of the Dependence Research Network North Rhine- 

Westphalia, initially conceived and managed by the LVR- 

Klinikum Essen. The LVR-Klinikum Düsseldorf contributed 

an own multi-centre project to this network and assumed its 

leadership in 2006. 

3.1.1.1 Competence Network on Schizophrenia (FMER) 

Spokesperson: W. Gaebel 

Network Headquarters: W. Wölwer, V. Toeller (from 2005), 

L. Freimüller (from 2008), S.-K. Schultheis (2005–2007), 

T. Ferrari (2003–2006), A. Weßling (until 2005) 

The Competence Network’s objectives 

The main concern of the Competence Network on 

Schizophrenia is the creation of scientific prerequisites for 

the optimisation of the prevention, acute and long-term 

treatment, and the rehabilitation of schizophrenic disorders. 

Contributions will be made to the following concrete 

objectives by means of practice-related and networked 

research projects and measures for health education:

s Early diagnosis of persons with an increased risk for 

schizophrenia through the use of an early diagnosis 

inventory. 

s The prevention of disease onset by early psychological 

and pharmacological treatment of at-risk persons. 

s The optimisation of acute and long-term treatment of 

first-episode schizophrenia. 

Special project networks 

Projects on General Topics 

PAN I 

Early recognition and 

early intervention 

Optimisation 

of early recognition 

Development and evaluation of 

an early recognition inventory 

Biological basis of the risk of 

disorder 

Psychological early inter- 

vention in early prodromal 

stages 

Pharmacological and 

psychological early inter- 

vention in late prodromal 

stages 

Biological basis of early 

intervention 

PN II SN 1 

Acute treatment and care 

Optimisation 

of acute treatment 

Drug treatment in first- 

episode schizophrenia 

Guideline-supported quality 

management 

PN II SN 2 

Long-term treatment 

and care 

Optimisation 

of the long-term treatment 

of first episodes 

Long-term drug-treatment 

strategies 

Psychological intervention 

strategies 

Prodrome-based relapse 

prevention and early 

intervention 

Biological basis of relapses 

Functional brain indicators 

of risk of relapse 

Molecular and pharmacogenetics 

Health economics/Public Education/Education, including Continuing Medical Education/ 

Quality assurance/Documentation and methodology 

Figure 5: Research projects of the Competence Network on Schizophrenia; PN = Project Network, SN= Sub-netwok 

PN II SN 3 

ReseaRch 

s Relapse prevention by improved relapse prediction and 

early intervention. 

s Improve quality of care through the use of treatment 

guidelines for outpatients and inpatients. 

s The prevention of chronification through targeted 

rehabilitation. 

s Investigation of the brain-biological and genetic 

principles of the disorder. 

Collection and optimisation 

of outpatient treatment and care 

Acute course and 2-year course 

under current treatment conditions 

Optimisation of treatment in 

general medical practice 

Quality management in 

psychiatrists’ practices 

Therapeutic drug monitoring 

Rehabilitation of residual 

processes 

Optimisation of the 

rehabilitation of patients 

with residual courses 

Biological basis of drug 

treatment 

Functional brain-indicators 

of negative symptoms 

Psychological interventions 

in cognitive and emotional 

disorders 

Evaluation of occupational 

rehabilitation measures 

59


Symptom 

60 

Project Network I 

Early Recognition 

and Early Intervention 

SN 1: Diagnostics and treatment of acute schizophrenia 

SN 2: Relapse prevention and long-term treatment 

SN 3: Prevention and rehabilitation of residual disease courses 

Project Network II 

Treatment and 

Rehabilitation 

1 

Subnetworks (SN) 

2 3 

Acute Long-term Rehabili - 

treatment treatment tation 

Manifestation threshold 

Figure 6: Research projects of the Competence Network on Schizophrenia (CNS) related to the course of schizophrenia 

s Transfer of the results of basic research into 

healthcare. 

s The cost/effectiveness analysis of innovative treatment 

procedures. 

s Improvement in educating and informing patients, 

relatives and (healthy) lay persons and experts through 

the targeted transfer of knowledge. 

The precondition for achieving these goals is the creation, 

expansion and intensive and routine use of networked 

structures between research and care. 

The Structure and Themes of the Competence Network 

The Competence Network is organised, in accordance with 

the course of the disorder, into two essential project networks 

(PN), with several sub-networks (SN), focusing on treatment 

and care needs in the prodromal phase or initial episode (PN 

I) and after initial admission as an inpatient (PN II) (Figure 

5). Whereas PN I mainly deals with projects designed to 

improve and establish early diagnosis and early intervention, 

PN II is involved with projects for optimising acute and longterm 

treatment (SNs I+II), as well as for rehabilitation (SN 

III), in particular in residual schizophrenia. In addition, there 

is a project network devoted to molecular genetics and 

several cross-discipline projects (such as health economics, 

educating the public, continuous medical education and 

post-graduate specialty training, etc.). In the third funding 

Disorder 

Course 

Time 

period, which has been running since 2005, in addition to four 

projects following up studies from the initial funding period 

specific so-called transfer projects were adopted relating 

to the core interests of the Competence Network, in which 

network results are prepared for transfer to the care sector. 

Partners involved in the 

Competence Network across Germany 

Across Germany, the Competence Network on 

Schizophrenia involves a total of 19 university psychiatric 

departments, 14 state, district and specialist hospitals, and 

6 psychiatric and general medicine practice networks. The 

work of the Competence Network is supported by the World 

Psychiatric Association (WPA), German national specialist 

associations (such as the DGPPN representing psychiatrists 

and the DEGAM representing general practitioners) and 

professional associations (such as the BVDN representing 

German office-based neurologists and psychiatrists), as well 

as the Central Association of Health Insurance Funds (GKV- 

Spitzenverband in German). In addition to the approximately 

16 million Euros of funding given by the FMER for the entire 

network and its over thirty projects since 1999, additional 

resources (around 5% of the budget) were made available by 

the pharmaceutical industry for research projects (Bristol- 

Meyers Squibb, Eli Lilly, Janssen-Cilag, Lundbeck, Sanofi- 

Synthelabo and Wyeth) or for educating the public (including

Table 3: Research projects of the Competence Network on Schizophrenia (CNS) with the participation of the research units 

of the Department of Psychiatry and Psychotherapy of the Heinrich-Heine University 

Project 

Network of 

the CNS 

Project Participating Research Unit 

or Staff Member 

PN 1 Biological basis of the risk of developing a disorder RL Experimental Psychopathology; RG 

Cognitive neurophysiology (until 2003) 

PN 1 Development and evaluation of psychological early intervention 

strategies in at-risk persons in the early prodromal stage 

PN 1 Pharmacological and psychological early intervention in at-risk 

persons in the late prodromal stage 

PN 2, SN 1 Guideline-supported quality management in the inpatient 

treatment of schizophrenia 

PN 2, SN 2 Optimisation of the treatment of schizophrenia in general medical 

practice 

PG Prodrome of schizophrenic firsttime 

disorders 

ReseaRch 

Participation 

status 

CP 

CP 

CP 

RG Quality assurance in psychiatry PM 

PN 2, SN 2 Guideline-supported quality management in psychiatrists’ practices PM 

PN 2, SN 2 Transfer project “Quality assurance” PM 

PN 2, SN 1 Acute course and 2-year course of schizophrenia under current RG Long-term treatment of 

CP 

treatment and care conditions 

schizophrenic psychoses; RG 

PN 2, SN 1 Improvement in the acute treatment of first-episode schizophrenia Psychopharmacology and 

CP 

by using new drug treatment strategies 

neuroimaging (until 2004) 

PN 2, SN 2 Drug-treatment strategies for the prevention of relapse in firstepisode 

schizophrenia 

PM 

PN 2, SN 2 Prodrome-based relapse prevention and early intervention in 

schizophrenia 

PM 

PN 2, SN 2 5-year follow-up of first-episode schizophrenia PM 

PN 2, SN 2 Transfer project “Treatment of first-episode patients” PM 

PN 2, SN 2 Biological basis of relapses RL Experimental psychopathology; RG 

Cognitive neurophysiology 

PM 

PN 2, SN 2 Functional brain indicators of the risk of relapse RG Neuroimaging of emotional 

processes (until 2003) 

PM 

PN 2, SN 2 Psychological intervention strategies for relapse prevention in RG Long-term treatment of 

CP 

first-episode schizophrenia 

schizophrenic psychoses 

PN 2, SN 2 Optimisation of relapse prevention in the outpatient treatment of RG Psychopharmacology and PM 

schizophrenia: therapeutic drug-monitoring 

neuroimaging (until 2004) 

PN 2, SN 3 Biological bases of pharmacological interventions to treat negative 

symptoms 

PM 

PN 2, SN 3 Brain-function indicators of emotional disorders with negative RG Cognitive neurophysiology PM 

symptoms 

(until 2003) 

PN 2, SN 3 Psychological intervention strategies with cognitive and 

emotional disorders 

RL Experimental psychopathology PM 

PN 2, SN 3 Psychological intervention strategies with cognitive and emotional 

disorders: Generalisation and sustainability of the effects of 

mimicking affect decoding training (ADT) 

RL Experimental psychopathology PM 

PN 2, SN 3 Comparative evaluation of occupational rehabilitation measures PG Occupational rehabilitation CP 

PGT Public education: reduction of stigma and the discrimination of RG Destigmatisation of mentally ill PM 

schizophrenic patients 

patients 

PGT Transfer project “Destigmatising schizophrenic disorders” RG Destigmatisation of mentally ill 

patients 

PM 

PGT Illness-related quality assurance: knowledge transfer and quality 

management in the out- and inpatient treatment and care of 

schizophrenic patients 

RG Quality assurance in psychiatry PM 

PGT Telematics Prof. Dr. A. Klimke (until 2004) 

Network headquarters (from 2005) 

PM 

PGT Network central unit Prof. Dr. W. Wölwer PM 

RL = Research laboratory, RG = Research group, PG = Project group, PM = Project management, CP = Cooperation partner, PN = Project Network, 

SN = Subnetwork, PGT = Projects on General Topics 

CP 

61


Astra Zeneca, Bayer Vital, Hexal, Novartis, Neuraxpharm 

and Pfizer). 

Local research facilities participating in 

the Competence Network 

The Department of Psychiatry and Psychotherapy of the 

Heinrich-Heine University Düsseldorf, as the primary 

applicant of the Competence Network, is actively involved 

in a total of 27 projects, 19 of which have mainly been 

conceived by one of the Department´s various research 

laboratories and research groups, which also appointed the 

respective project director of these studies. In addition, the 

Department´s research units are associated with eight other 

projects as the cooperation partner of other institutions 

(Table 3). A differentiated description of these projects as 

well as the current type of participation can be found in the 

respective report chapters by the research laboratories and 

groups in this volume. 

3.1.1.2 Competence Network on Depression 

62 

and Suicidality (FMER) 

Centre directors: W. Gaebel, F. Schneider (until 2004) 

The main objective of the Competence Network on 

Depression and Suicidality is to contribute to improving 

the prevention, diagnosis and treatment of depression 

and suicidality. This is achieved through the networking of 

research, care, self-management, cost-carriers and patient 

representatives within the context of an extensive range of 

application-oriented research patterns, as well as informing 

the public and persons with depression or suicidality. In 

more detail, this guiding idea is put into practice by means of 

the following sub-goals: 

s Suicide prevention through the continuous training 

of general practitioners and educating persons with 

depression or suicidality and the public. 

s Expanding existing knowledge regarding the biological 

causes of the disorder and the social framework 

conditions 

s Improving the treatment of mild and sub-diagnostic 

depressive disorders. 

s Improving the treatment of relapsing brief depressive 

disorders and preventing chronification. 

s Improving the quality of diagnosis and treatment 

through the use of guidelines. 

s Evaluating quality-related measures through 

comparative health economic analyses. 

s Developing and testing guideline-oriented 

compensation systems. 

s Investigating the biological mechanisms of 

antidepressants. 

s Improving pharmacotherapy by redetermining 

intervention points. 

s Basic research for the development of new 

medications. 

s Investigating genetic predispositions for affective 

disorders. 

s Investigating the relationship between genetic factors 

and medication-related treatment processes. 

s Investigating the conditions of chronification and 

treatment resistance; developing new intervention 

strategies. 

s Informing the public, persons with depression or 

suicidality, and their relatives through targeted 

knowledge transfer. 

The structures and topics of the Competence Network 

The Competence Network on Depression and Suicidality is 

subdivided into six projects (PP), each of which is divided 

into various sub-projects (SP). In accordance with the 

Competence Network’s comprehensive target setting, 

the research associated with PP 1–3 was thematically 

concentrated on optimising and assuring adequate 

healthcare procedures in office- and hospital-based 

treatment settings, as well as educating the public and 

persons with depression or suicidality, whereas the SP 

4–6 projects were concerned with investigating the genetic 

and brain-biological causes of depressive illnesses 

and, accordingly, should lead to ideas for treatment and 

prediction (cf. Table 4). 

Partners involved in the Competence 

Network across Germany 

Across Germany, the Competence Network on Depression 

and Suicidality includes 18 scientific institutions, several 

psychiatric departments (university, state, regional and 

specialist hospitals) as well as psychiatric and general 

medicine practice networks, self-help groups (Horizonte, 

DASH and MASH), the Drug Commission of the German 

Medical Association and numerous State Associations of 

Statutory Health Insurance Physicians. The Competence 

Network’s work is supported by specialist associations 

(such as the German Association of Psychiatry and 

Psychotherapy, DGPPN), professional associations and the 

health funds’ umbrella associations (Central Association of 

Health Insurance Funds [“GKV-Spitzenverband”in German]; 

Federation of Alternative Health Insurance Funds [“Verband

No. Project Participating research units 

or co-workers 

SP 3.1 Comprehensive out-patient quality management RG Quality Assurance in Psychiatry CP 

SP 3.5 External quality assurance CP 

SP 3.6 Inpatient quality management PM 

SP 3.7 Financial analyses and qualityoriented 

remuneration system 

PM 

SP 6.1 Treatment resistance/chronicity/suicidality in acute treatment and 

in the 4-year follow-up of depressive disorders (basic study) 

J. Cordes CP 

SP 6.1 Comparison of systematic treatment algorithms with the standard 

treatment of inpatients with unipolar depression 

J. Cordes CP 

PM = Project management, CP = Cooperation partner, RG = Research group 

ReseaRch 

Table 4: Research projects of the Competence Network on Depression and Suicidality with the participation of research units of the Department of Psychiatry 

and Psychotherapy of the Heinrich-Heine University 

der Ersatzkassen” in German]). In addition, the network is 

funded by representatives of the pharmaceutical industry 

(Pfizer, Promonta Lundbeck and Synthelabo). 

Local research facilities participating in the 

Competence Network 

Within the context of its participation in the Competence 

Network on Depression and Suicidality, the Department 

of Psychiatry and Psychotherapy has taken over the role 

of coordinating sub-project 3 “Quality Management in the 

Treatment of Depression” (W. Gaebel), as well as taking 

part in a total of six sub-projects. In most of these research 

projects, the Department took part as the main applicant, 

taking over leadership of the project in two of them (c. Table 

4). The projects were successfully concluded in the reporting 

period and were published in international medical journals 

(v. reference list). 

3.1.1.3 Competence Network on Dementia (FMER) 

Centre directors: C. Luckhaus and T. Supprian (from 2005), 

R. Ihl (until 2005) 

Scientific assistants: B. Grass-Kapanke (until 2007), 

I. Blaeser (until April 2008) 

The work of the Department of Psychiatry and 

Psychotherapy within the context of the Competence 

Network on Dementia funded by the FMER started in 2003 

and ended when the funding period expired at the end of 

2008. The Division of Gerontopsychiatry was one of the 13 

centres of the Competence Network. The network dealt 

with the four main focuses of dementia research: early and 

differential diagnosis, pharmacological and psychosocial 

treatment, epidemiology and genetics, as well as aetiology 

and pathogenesis. Within the clinical research topics, the 

Department of Psychiatry and Psychotherapy took part 

in research on the pre- and early stages of dementia, as 

well as gaining closer insights into the effectiveness of 

pharmacological interventions in mild cognitive impairments 

(MCI) und Alzheimer’s Disease (AD). Included in the core 

scientific focuses were the creation of cross-regional biodatabases, 

which represent an important basis for research 

into illness markers and genetic associations in the various 

forms of dementia. The network cooperated with the 

Institute for Radiology of the Heinrich-Heine University, 

Düsseldorf (Director: U. Mödder) 

3.1.1.4 DFG Priority Programme “Nicotine: Molecular 

and Physiological Effects in the Central Nervous 

System” (DFG) 

Spokesperson: G. Winterer 

This priority programme was set up by the DFG in 2006 

to make a contribution to a better comprehension of the 

central nervous system effects of nicotine. Funding was 

made available by means of international assessment 

procedures for 16 out of 50 submitted projects from basic 

and clinical research (Table 5), essentially relating to the 

following areas: 

s The clinical characterisation (phenotyping) of large 

multi-centre random samples of the general population 

and neuropsychiatric patients in consideration of 

the changes during nicotine withdrawal and the 

determination of risk factors for relapse. 

s Functional analysis of the physiological effects of 

nicotine and nicotine withdrawal in the brain through 

imaging and endocrinological investigations. 

s The molecular-genetic principles of nicotine 

dependence with a genome-wide multi-centre 

association study. 

Designated project directors from eleven institutions countrywide 

were responsible for the 16 research projects, which were 

63


Table 5: Research projects for the “Nicotine” Deutsche Forschungsgemeinschaft (DFG) Priority Programme with participation of the research units of the 

Department of Psychiatry and Psychotherapy of the Heinrich-Heine University Düsseldorf 


or co-workers 

P3 Attention network, nicotine dependence and alpha4beta2 

according to receptor genotype in healthy subjects and 

schizophrenic patients. 

P7 Effects of nicotine on social cognition and social stress in 

schizophrenia. 

P10 Genetics of nicotine dependence – clinical and neurobiological 

phenotypes in a multi-centre case-controlstudy. 

P12 Molecular and physiological effects of nicotine in the central 

nervous system (SPP coordination) 

PM=Project management 

carried out in the initial funding period from 2006 to 2008. Other 

institutions were associated with the priority programme as 

cooperation partners. During this period, the LVR-Klinikum 

Düsseldorf hosted a coordination project directed by the coordinator 

of the priority programme, G. Winterer. Elsewhere, the 

Neuropsychiatric Research Laboratory ran two projects as 

well another project related to the programme, in cooperation 

with the Experimental Psychopathology Research Laboratory. 

Descriptions of these projects can be found in the report 

sections of both research laboratories. 

SUCHTFORSCHUNGSVERBUND NRW 

3.1.1.5 Dependence Research Network 

64 

North Rhine-Westphalia (FMER) 

Spokesperson: W. Gaebel (from 2006), M. Gastpar 

(LRA Clinic, Essen, until 2006) 

The Dependence Research Network North Rhine-Westphalia 

is one of four national dependence research networks that 

were funded by the FMER from 2001 to 2007. One of the 

projects designed and directed by the Dependence Disorders 

Research group of the LVR-Klinikum Düsseldorf was 

related to the interaction of anti-craving substances with 

behavioural therapy in the outpatient treatment of persons 

with alcohol dependence and was realised from 2002 to 

2007 as one of a total of seven research projects within 

the context of this network. The LVR-Klinikum Düsseldorf 

has subsequently been a member of this network of the 

dependence research groups of the Universities of Essen, 

Bonn and Münster, set up in 1996. After the retirement of 

the previous spokesperson, M. Gastpar (Essen), in 2006, W. 

Gaebel took over this position. 

Participation 

status 

Neuropsychiatric Research Laboratory PM 

RL Experimental Psychopathology; 

Neuropsychiatric Research Laboratory 

PM 



3.1.1.6 “Psychotherapy of Psychotic Syndromes” 

Research Network (FMER) 

Centre director: W. Wölwer 

The “Psychotherapy of Psychotic Syndromes” Research 

Network investigates whether disorder-specific cognitive 

behavioural therapy (CBT) can lead to an improvement 

in psychotic positive symptoms (delusionary ideas and 

hallucinations) and investigates its mode of action. The 

central project was a multi-centre, randomised clinical 

trial investigating the efficacy and mode of action of 

psychotherapy – in addition to pharmacological treatment 

– on positive symptoms in psychotic disorders. In 

addition, studies were carried out to evaluate economic 

aspects, to study the interaction of neurobiological and 

psychosocial factors and to determine the applicability of the 

aforementioned forms of treatment in adolescent patients, 

and detailed analyses were performed of mediators and 

moderators in the psychotherapeutic process. The research 

network is coordinated by S. Klingberg and G. Buchkremer 

of the University of Tübingen and includes the eight 

university departments for psychiatry and psychotherapy in 

Bonn, Düsseldorf, Essen, Frankfurt, Köln, Leipzig, Marburg 

and Tübingen. Since 2006, the network has been funded by 

the German Federal Ministry for Education and Research 

(FMER). The Experimental Psychopathology Research 

Laboratory is involved in five projects (Table 6) and the 

Neuropsychiatric Research Laboratory in a further one.


or co-workers 

1 Cognitive behavioural therapy (CBT) for the treatment of positive 

symptoms in psychotic disorders 

2 Effect factors of CBT and their influence on positive symptoms in 

psychotic disorders 

3 Economic evaluation of cognitive behavioural therapy (CBT) in the 

treatment of positive symptoms in psychotic disorders 

4 Neuronal correlates of the effects of cognitive behavioural therapy in 

the treatment of positive symptoms in psychotic disorders 

3.1.1.7 Associated Satellite Centre (ASC) within the 

Brain-Net Project Network (FMER) 

Centre director: M. von Wilmsdorff 

As an Associated Satellite Centre, the Brain Morphology 

laboratory was part of the Brain-Net Project Network. 

Brain-Net was set up in the neuropsychiatric sector on 

the Competence Network’s initiative as a cross-section 

project and service institution with the main goal of creating 

a countrywide German brain and tissue bank. The Brain- 

Net is the German centre of reference for disorders of the 

central nervous system, which is coordinated by a central 

network secretariat located at the Institute of Neuropathology 

in Munich. In addition to creating the tissue bank, there is 

the additional task of informing and educating people about 

the reason and need for a brain-tissue bank. The network 

operates in close collaboration with the Competence Network 

on Schizophrenia, as well as the Institute for Neuropathology, 

Heinrich-Heine University Düsseldorf. 

3.1.1.8 Benchmarking in Acute Psychiatric 

Treatment (BMG) 

Centre director: B.Janssen 

In association with nine specialist psychiatric hospitals 

of the Rhineland Regional Council (Landschaftsverband 

Rheinland, LVR), an internal benchmarking process (prepost 

design; three years) was started, which was closely 

linked to the existing quality management structures 

(EFQM, KTQ©) of the hospitals. The goal was to improve 

acute inpatient treatment in three selected patient groups 

(alcohol dependence, older persons with depression as well 

as persons with schizophrenia and a high rehospitalisation 

rate). At the start, in order to ensure a valid data base, 

IT-supported, quality-oriented treatment documentation 

was implemented in the participating hospitals (1,856 

ReseaRch 

Table 6: Research network on the “Psychotherapy of the psychotic syndrome” with participation of the research units of the Department of Psychiatry and 

Psychotherapy of the Heinrich-Heine University Düsseldorf 

Participation 

status 

RL Experimental Psychopathology CP 



Neuropsychiatric Research Laboratory 

Research Laboratory; RL Experimental 

Psychopathology 

5 Cognitive disorders, delusional symptoms and treatment success RL Experimental Psychopathology CP 

CP=Cooperation partner 

treatment documents [pre-census] for the identification and 

reporting of hospital-specific and network-wide optimisation 

potential). 

During the course of the project, the essential elements of 

a benchmarking process could be implemented (creation of 

project structures with accompanying advisory board and 

census instruments; definition of the individual improvement 

themes, milestones and defined implementation paths). 

In addition to the individual processing of the topics, 

three inter-hospital, diagnosis-specific “benchmark 

working circles” produced consented, guideline-oriented 

recommendations for treatment optimisation. The 

progress of the implementation was checked in a follow-up 

assessment (n=1,696). 

For the main target parameters (a 10% reduction in 

the drop-out rate of persons with alcohol dependence; 

improvement of the BDI score at discharge of elderly 

persons with depression; a 10% reduction in the 

rehospitalisation rate of persons with schizophrenia) an 

improvement was achieved by most hospitals, although the 

10% margin was not always achieved by all. An additional 

significant improvement could also be achieved in the 

completeness of patient self-report documents, which had 

been selected later on as a further inter-hospital topic. The 

majority of the participating hospitals could also improve 

their individually selected, hospital-specific optimisation 

areas. In order to ensure these achievements, measures to 

implement these quality management procedures in routine 

operation have been coordinated. 

CP 

65


3.1.2 Research Laboratories 

Neurobiochemical Research Laboratory: evaluation of a western blot 

3.1.2.1 Neurobiochemical Research Laboratory 

Scientific Directors: C. Luckhaus (from 2005), 

A. Klimke (until December 2004) 

Deputy and Technical Director: U. Henning 

Scientific Assistants: K. Fehsel, U. Henning, 

K. Krieger (until 2006) 

Other assistants: M. Geisler (MTA), I. Wijaya (until 2005) 

Cooperation partner from the Department of Psychiatry and 

Psychotherapy: S. Ferrea, C. Lange Asschenfeldt, P. Goertz, 

S. Löffler (until 2005) 

Doctoral candidates: A. Boers, B. Mahabadi, W. Perl, 

C. Werner 

The basic science-oriented investigation topics of the 

last reporting period continued to be addressed in the 

Neurobiochemistry Research Laboratory, where the 

investigations were closely meshed with departmentally 

oriented questions, in order to contribute to the 

explanation of the pathogenesis of mental disorders and 

the therapeutic effect mechanisms of drug components. 

In addition to running its own research projects, the 

research laboratory, because of its number of staff and 

66 

good technical ability, is linked to the German Competence 

Network on Schizophrenia, the German Competence 

Network on Dementia, and – via the local research group 

on dependence disorders – to the Dependence Research 

Network of North Rhine-Westphalia. Since the change 

of leadership on 1 January 2005, the research laboratory 

has been led by Consultant Psychiatrist C. Luckhaus. 

This change in leadership has gone hand in hand with 

a constant reorientation in setting research targets. In 

addition to a further characterisation of biochemical and 

cellular parameters as disorder-specific state or trait 

characteristics of mental disorders, the early identification 

and diagnosis of which will contribute to an improvement 

in patient care, mechanisms were sought which lead to 

the dysregulation and, therefore, the dysfunction of the 

body´s biochemical circuits. In particular, these included 

investigations of the effect of psychotropic drugs on RNA 

and protein expression. The basic laboratory equipment was 

significantly improved by the procurement of a thermocycler 

to carry out polymerase chain reactions (PCR), a 2D 

electrophoresis unit to assess protein expression and a 

documentation device. By using well-characterised tumour

cells, the cultivation of which was an important component 

of the experimental investigations, the disorder-dependent 

dysregulation of the cytosolic glucocorticoid receptor in 

affective disorders, the intracellular transport of clozapine 

via the vesicular monoamine transporters and additionally 

apoptotic mechanisms of neutrophil granulocytes involved in 

clozapine-induced agranulocytosis could be characterised in 

more detail. In addition to the investigations in neuronal and 

glial tumour cells, the laboratory has started to isolate and 

cultivate native neurones, astrocytes and stem cells from 

the CNS of mice. The aim of these experiments is, amongst 

other things, to test in how far the in vitro survival rates of 

such cells depend on the neuronal/glial composition and in 

how far drug components influence cell activity by promoting 

or restricting cell vitality. In addition, in order to be able to 

represent the electrophysiological activity of neurones in 

vitro, the so-called Multi-Electrode-Array (MEA) technique 

was established. This provides the experimental opportunity 

to model the spontaneous excitation in native neuronal 

cells as a correlate of neuronal-glial networks in vitro. By 

using this investigation technique, a lesion model will be 

created which can be used to investigate mechanisms of cell 

damage (whether physically through oxygen withdrawal or 

chemically through incubation with neurotoxic substances). 

It appears especially interesting to investigate in how far 

a reversal of cell damage can be achieved through certain 

psychotropic drugs. 

Cooperation 

s M. Dihné, Department of Neurology, 

Heinrich-Heine University, Düsseldorf 

s K. Hemmrich, Department of Plastic Surgery, 

RWTH Aachen 

s M. Jäger, Department of Orthopaedia, 

Heinrich-Heine University Düsseldorf 

s G. Kobbe, Department of Haematology, Oncology and 

Departmental Immunology, Heinrich-Heine University, 

Düsseldorf 

s V. Kolb-Bachofen, Immunobiological Research Group 

for Molecular Medicine, Biological-Medical Research 

Center, Heinrich-Heine University, Düsseldorf 

s T. Königshausen, Sana Hospital, Düsseldorf 

s M. Nöthen, Institute of Human Genetics at the 

University of Bonn 

s P. Sand, Molecular Genetics Laboratory, Department 

of Psychiatry and Psychotherapy, University of 

Regensburg 

s O. Sergeeva, Institute for Neuro- and Sensory 

Physiology, Heinrich-Heine University, Düsseldorf 

ReseaRch 

s H. Willenberg, Department of Endocrinology, 

Diabetology and Rheumatology, Heinrich-Heine 

University, Düsseldorf 

s J. Wiltfang, LVR-Klinikum, Essen, Department of 

Psychiatry and Psychotherapy, University of Duisburg- 

Essen 

Projects 

Enhanced glucocorticoid receptor down-regulation in 

immortalised B-lymphocytes of persons with mental 

disorders versus healthy controls as parameters for 

stress-related disorders 

U. Henning, K. Krieger, C. Luckhaus, A. Klimke 

in cooperation with M. Nöthen (Bonn) 

Project period: 2000–2005 

Financing: Departmental research budget 

A dysregulation of glucocorticoid-dependent functions 

has been described for patients with affective psychoses. 

The disorder is characterised by an over-activity of the 

hypothalamic-pituitary-adrenocortical axis, which results in 

the increased secretion of cortisol into the blood. Cortisol 

receptors are not only expressed in the central nervous 

system, they are also present in many other organs. The 

receptors are also found on peripheral blood cells and 

transformed B-lymphoblasts. As a peripherally accessible 

in vitro cell model, the number of glucocorticoid receptors 

on B-lymphoblasts of the family members of large Spanish 

families with hereditary depression was quantified. In cell 

culture, there is a significant difference in the quantity 

(Bmax) of the glucocorticoid receptors between the 

B-lymphoblasts of patients with Major Depression (MD) 

and those of healthy controls: a significantly higher number 

of receptors was measured in persons with MD (Bmax = 

985.2 ± 342.3 fmol/mg protein) than in controls (Bmax = 

576.9 ± 190.3 fmol/mg protein). After a short incubation of 

the B-lymphoblasts over 48 hours with hydrocortisone (0.1 

µM), a stronger down regulation of the cytosolic receptors 

(32.9 ± 7.5 %, n = 14) was measured in family members 

with affective psychoses than in healthy controls (45.8 ± 8.2 

%, n = 13). The regulation of the glucocorticoid system of 

the lymphoblasts, measurable as an indicator and termed 

“regulative tolerance”, represents an individually constant 

trait characteristic that is influenced neither by the evolution 

of the disorder nor by the medical treatment of the person. 

67


Investigations into the change of functional protein 

patterns (proteomes) of B-lymphoblasts in test persons 

with different stress reactibility resulting from the effects 

of antidepressant drug components 

K. Krieger, U. Henning, A. Klimke 



The proteome, which is defined as the total of all proteins in 

one cell, is of great significance in disorders, especially in 

mental disorders, because, for example, synapse receptor 

proteins trigger spike generation and other phenomena of 

cellular excitation. 

After in vitro hydrocortisone exposure, B-lymphoblasts from 

persons with hereditary affective psychoses demonstrated 

a greater decrease of the glucocorticoid receptors than 

B-lymphoblasts from healthy controls, which indicates 

differences in glucocorticoid receptor auto-regulation. We 

investigated these tumour cell lines (B-lymphoblasts) for 

differences in the proteome. In this regard it is interesting 

how, on the one hand, there were inter-individual differences 

in the proteome and, on the other, changes of the functional 

protein pattern caused by the action of drug components. 

Genetic variants and function of the oestrogen 

receptors in Alzheimer’s Dementia 

C. Luckhaus, A. Boers, A. Klimke, U. Henning 

in cooperation with P. Sand (Regensburg) 

Project period: from 2002 


Basic scientific investigations document neurotrophic, 

neuroprotective and connectivity-promoting effects of 

oestrogen in the CNS. In middle-aged women experimental 

oestrogen administration resulted in improved performance 

in memory tasks, which differs between the sexes. 

Epidemiological investigations also indicate the positive 

effect of oestrogen substitution on the risk of developing 

Alzheimer’s Dementia (AD). However, current study results do 

not support a general effectiveness of oestrogen substitution 

as a prophylaxis for or treatment of AD in postmenopausal 

women. The oestrogen hypothesis of AD is still particularly 

relevant for early disorder mechanisms: oestrogen availability 

or its effects in the CNS would undergo long-term changes 

due to a genetically determined or acquired biological trait, 

promoting neurodegenerative processes. 

In a candidate-gene–related approach, we investigated 

frequently occurring genetic variants of the oestrogen 

receptors and the oestrogen sulphotransferase in association 

with AD and found positive associations of individual 

68 

haplotypes. We could not demonstrate an oestrogen receptor 

dysregulation using the IL-6 regulation in monocytes. 

Cellular uptake and transportation of psychotropic drugs 

U. Henning, K. Krieger, C. Luckhaus, A. Klimke 



In addition to the communication of cells using 

neurotransmitter receptors, which are associated with 

the regulation of downstream intracellular signalling 

pathways, the intracellular accumulation of agents, which 

are taken up both passively (e. g. through diffusion) and 

actively via transporter proteins in cells and can influence 

the cellular metabolism as far as apoptosis, is also of 

interest from a research point of view. In order to investigate 

the active transportation of clozapine – the agent of the 

atypical antipsychotic drug Leponex® – promyeloid human 

HL-60 tumour cells were used, which are established 

as models for neutrophil granulocytes. These cells 

appeared suitable for investigating the cytotoxic effects 

of clozapine after its possible intracellular accumulation 

with regard to the aetiopathogenesis of clozapine-induced 

agranulocytosis. Our results show a temperature- and 

pH-dependent accumulation of clozapine which is clearly 

inhibitable through sodium azide, an agent decoupling the 

mitochondrial respiratory chain, and by means of transport 

inhibitors (e.g. indatraline). In addition, the main metabolites 

of clozapine (desmethyl clozapine and clozapine N oxide) are 

actively accumulated intracellularly. An intracellular uptake 

of clozapine could be measured in glial and neuroblastoma 

cells. Experiments currently being carried out into the 

pharmacological characterisation of the transporter indicate 

that this involves the intracellular transportation of clozapine 

in storage vesicles, particularly in synaptic vesicles, which 

occurs through the vesicular mono-amine transporter 

system. 

Influence of clozapine on haematopoiesis 

K. Fehsel, S. Ferrea, C. Luckhaus in cooperation S. Loeffler, 

G. Kobbe, V. Kolb-Bachofen and T. Königshausen 


Financing: Research commission of the Faculty of Medicine 

at the Heinrich-Heine University, Düsseldorf (until 2001) 

The most dangerous side effect of clozapine, agranulocytosis, 

draws attention to the drug’s effects on the haematopoietic 

system. At the acute stage of agranulocytosis, we find an 

extremely significant production of superoxide anions in 

neutrophil granulocytes, as well as a strong p53 and Bax a 

expression. Most of the remaining neutrophil granulocytes are 

apoptotic.

Since agranulocytosis usually occurs 6-8 weeks after the 

start of clozapine treatment, we investigated the question 

of what influence clozapine usually has on haematopoiesis 

before and during this period. In studies of the spontaneous 

course, it was clearly shown that clozapine at first causes 

oxidative stress in neutrophil granulocytes. The NF kappa B 

transcription factor becomes activated and the anti-oxidative 

proteins A1, HO1 and NQO1 become expressed. In addition, 

there is an increased transgression of CD34-positive stem 

cells into the blood and the number of neutrophils increases, 

whereas the number of erythrocytes falls. In addition, under 

treatment with clozapine the neutrophils live longer and there 

is a constitutive expression of the HIF1 alpha transcription 

factor. The high proportion of oxygen in the venous blood (86% 

versus 44%) of persons treated with clozapine indicates that 

mitochondrial respiration is inhibited. Since cellular glucose 

uptake is inhibited during clozapine treatment, clozapine 

treatment corresponds to a preconditioning of the cells 

through the deprivation of oxygen and glucose (OGD). Initial 

results show that clozapine causes NO-mediated effects. 

Under ischemic conditions, NO inhibits both the electron 

transport chain and glucose import into mitochondria. This 

ischemia-like condition could also be triggered by clozapine. 

S-nitrosylation of the amino acid cysteine in position 93 of the 

haemoglobin molecule causes a stronger binding of oxygen 

to the haem group of haemoglobin, so that less oxygen is 

delivered to the cells. If this preconditioning is disturbed, 

cells do not develop protective measures against clozapineinduced 

oxidative stress – the neutrophil granulocytes become 

apoptotic and agranulocytosis ensues. Armed with this 

knowledge, it should be possible to determine markers which 

point to imminent agranulocytosis and which differentiate 

early on between benign neutropenia and agranulocytosis. 

Molecular effects of psychotropic drugs on adipogenesis 

K. Fehsel, C. Luckhaus in cooperation with K. Hemmrich 

Project period: from middle 2007 

Financing: BIOMAT Interdisciplinary Centre for 

Departmental Research of the Medical Faculty of RWTH 

Aachen (IZKF VVB110-c) 

Weight gain is a frequent side effect of treatment with 

atypical antipsychotic drugs. Whereas in most drug 

therapies a weight plateau is achieved after 1-2 years, 

patients treated with clozapine continue to gain weight 

and weight increases of 20-30 kg are not rare. We could 

show in vitro that clozapine significantly increases the 

differentiation of fat precursor cells (pre-adipocytes) and 

that oxidative stress plays a decisive role in this process. 

In the current project, in cooperation with the Department 

of Plastic Surgery of the Heinrich-Heine University 

Preparing tests in the Neurobiochemical Research Laboratory 

ReseaRch 

69


Düsseldorf, the hypothesis was investigated that several 

atypical antipsychotic drugs influence adipogenesis at a 

cell-biological level. Initial results show that olanzapine and 

risperidone enhance the differentiation and lipid storage 

of the pre-adipocytes. However, aripiprazole inhibits 

differentiation. This effect was also found in patients 

receiving co-medication with clozapine and aripiprazole. 

Lithium chloride had no effect on adipogenesis. 

Investigations into the molecular pathophysiology of 

neurogenesis during therapy with psychotropic drugs 

U. Henning and C. Luckhaus 


Financing: Department’s research budget 

Neurobiological concepts of the pathogenesis of depression 

state that neurogenesis in the hippocampus may play 

a central role in improving the disease course. Animal 

experiments could show that an increased serotonin level 

activates neurogenesis in the dentate gyrus. Contrarily, 

stress leads to inhibition. In addition, neurogenesis can be 

stimulated through drug components (such as lithium). It 

is supposed that these agents enhance the production of 

growth factors by regulating the expression of transcription 

factors. In order to test drug effects on neurogenesis in 

the CNS, we would like to establish a murine in vitro cell 

model composed of hippocampal neurones and glial cells. 

Of specific interest is the question of how far astrocytes 

contribute to the metabolisation of psychotropic drugs 

and thereby influence the activity of drug components. For 

initial pilot investigations, we produced primary cell cultures 

70 

from hippocampus neurones from adult mice in the animal 

experiments section of the Heinrich-Heine University, 

Düsseldorf, and cultivated these cells in the department’s 

own research laboratory. In order to increase the purity and 

yield of these native cells and, in particular, to conserve the 

vitality of the neurones and astrocytes in long-term culture, 

neurone and glial cells from neonatal mice were used in 

cell culture with the support of the Institute for Neuroand 

Sensory Physiology of the Heinrich-Heine University, 

Düsseldorf. 

The nicotine acetylcholine receptor (nAChR) in 

B-lymphoblasts: investigation of receptor regulation 

during nicotine exposure as a correlation of nicotine 

addiction in healthy persons vs. persons with 

schizophrenia 

U. Henning, S. Ferrea, C. Luckhaus 


Financing: Research Commission of the Faculty of Medicine 

of the Heinrich-Heine University, Düsseldorf 

Secondary illnesses of nicotine dependence are the most 

frequent causes of premature death in high-income 

countries, so that early diagnosis and targeted therapies of 

nicotine dependence represent a significant future target. 

The biological mechanisms of nicotine dependence are, 

however, still little understood, although genetic disposition 

factors apparently play a considerable predisposing 

role. The nicotine dependence rates of around 80% in 

individuals with schizophrenia are clearly higher than 

in the population in general (20-30%). Joint biological 

Microscopy of cell cultures in a 

micro-electrode array

predisposition factors, which affect the biochemical 

characteristics of nicotinic acetylcholine receptors (nAchR), 

could underlie this comorbidity of schizophrenia and nicotine 

dependence. The aim of our investigation is, therefore, 

to characterise the expression and regulation of nAChR 

subtypes, which have already been associated with the 

pathogenesis of nicotine dependence (alpha4/beta2) and 

schizophrenia (alpha7, alpha4/beta2). As an experimental 

investigation model, B-lymphoblast lines of mentally healthy 

individuals as well as of smokers and non-smokers with 

schizophrenia were established. The B-lymphoblast model 

we established earlier for other research questions allows 

the quantification and characterisation of cell receptors 

(here, nicotinic acetylcholine receptors) under standardised, 

experimental conditions ex vivo (Figures 7 and 8). Directly 

effective regulatory influences, such as high nicotine 

consumption and endocrine or immunological infections, 

can be excluded as irrelevant, although outlasting cellular 

biological characteristics of the individual organism of origin 

of the cultivated cells could, as an “imprint”, affect the 

cellular regulation of receptors and be preserved as a trait 

characteristic in vitro. 

The development and validation of cerebrospinal fluid 

(CSF)-based biomarkers for Alzheimer’s Dementia 

C. Luckhaus, K. Fehsel in cooperation with AG Wiltfang 

within the FMER –funded Competence Network on Dementia 


Financing: Sub-project within the FMER-funded 

Competence Network on Dementia (Funding No: 01GI0420) 

Molecular correlates of central pathogenetic processes 

of Alzheimer’s Dementia, such as hyperphosphorylated 

tau protein and beta amyloid, are suitable early diagnosis 

markers in the CSF and, possibly, also in the blood. In 

cooperation with J. Wiltfang’s group within the Competence 

Network on Dementia, various aspects of the development 

of biomarkers were analysed, such as the optimisation of 

measurement procedures (multi-analyte profiling [Luminex] 

technique), establishing combinations of biomarkers (e.g. 

betaA1-42/betaA1-40 ratio) and comparative investigations 

in the blood and CSF compartments. The aim of this project 

was to establish the best possible diagnostic markers for 

Alzheimer’s Dementia for clinical use. 

120 

80 

40 

Figure 7: Specific binding of radioactive nicotine to 

B-lymphoblasts; figure modified after Ferrea S, Henning 

U, Luckhaus C (2008). B-lymphoblasts as an in vitro model 

for the study of nicotinic acetylcholine receptor regulation 

in schizophrenics in relation to nicotine abuse. Int J 

Neuropsychopharmacol 11 (Suppl.1): 260. Abstract 

Nicotine acetylcholine receptors (fmol/10 cells) 

4,0 

3,5 

3,0 

2,5 

2,0 

1,5 

1,0 

0,5 

a) b) c) d) 

ReseaRch 

Spec. binding in 1.2 million cells (radioactive count rate, dots per minute) 

Spec. binding in 2.4 million cells (radioactive count rate, dots per minute) 

0 

0.0 0.4 0.8 1.2 

H-nicotine concentration (nM/L) 

(*p =0.006) (p = 0.071) (p = 0.182) *p = 0.046) 

0,0 (-) (+) (-) (+) (-) (+) (-) (+) 

Control persons Schizophrenia Control Schizophrenia 

Smoker Non-smoker 

Figure 8: Scattergramm of the binding of H nicotine to B-Lymphoblasts, 

after long-term incubation with nicotine, in healthy and control persons 

with schizophrenia. Modified after Ferrea S, Henning U, Luckhaus C (2008). 

B lymphoblasts as an in vitro model for the study of nicotinic acetylcholine 

receptor regulation in schizophrenics in relation to nicotine abuse. Int J 

Neuropsychopharmacol 11 (Suppl.1): 260. Abstract 

71


Genetic principles of brain perfusion 

in Alzheimer’s Dementia 

C. Luckhaus, K. Fehsel in cooperation with H. J. Wittsack 

(Institute for Radiology of the Heinrich-Heine University, 

Düsseldorf) and the FMER-funded Competence Network on 

Dementia 


Financing: Sub-project within the FMER-funded Competence 

Network on Dementia (Funding No: 01GI0420) 

In an ongoing functional neuroimaging study, we were able 

to provide evidence for substantial changes of regional brain 

perfusion already at the stage of mild cognitive impairment 

(MCI), which appeared independently of regional atrophy 

and of the APOE epsilon genotype. We are now looking 

at the question of how far regional and global blood flow 

values are associated with functional variants of relevant 

candidate genes (endothelin 1, IL1beta, PP2A activator, NF 

kappa B subunit B, KCNN3, NOS 3). Initial findings point to 

a specific association of two variants of the NOS3 gene with 

global brain perfusion in MCI and Alzheimer’s Dementia. 

It is planned to confirm this association and to test other 

associations with other candidate genes in a larger sample. 

Establishing a murine neuronal lesion model in vitro: 

investigations into the change of electrical spontaneous 

activity of neuronal/glial networks through physical and 

neurotoxic lesions 

U. Henning, P. Görtz, Ch. Lange-Asschenfeldt and C. Luckhaus 



In relation to a possible regeneration of the central cellular 

organisation, investigations were carried out, published in 

the 1960s, into a paradigm shift proposing that neurons 

were able to regenerate constantly in the brain. New animal 

experiments show that neurogenesis can be stimulated by 

activating the brain, as well as by drug components. It is 

possible to measure the functional integrity of a neuronalglial 

cell association in vitro using multi-electrode array 

chip technology (MEA). The functional characteristic of 

this cell model is the formation of electrical impulses, the 

so-called “bursts”, which can be recorded using a special 

recording system. These bursts are quantifiable in relation 

to the number of bursts and their amplitude. This method 

appears to be very suitable for investigating the integration 

of embryonic stem cells (ES) into an electrophysiologically 

active cell association. The integration and, thereby, the 

differentiation of ES, which are experimentally added into 

72 

the network, should influence the functional integrity of the 

cell association and, thereby, the MEA-based recording of 

network-evoked potentials (bursts). 

Our approach to the investigation of functional neurogenesis 

uses MEA technology to measure the activity of neuronal 

networks before and after the induction of lesions. The 

initial basic experiments will aim to define the threshold 

concentrations at which cellular damage occurs. A second 

phase will test whether drug components may prevent 

damage or result in the restoration of neuronal activity. 

Comorbidity of Alzheimer’s Dementia and Osteoporosis 

C. Luckhaus, B. Mahabadi, T. Supprian, K. Fehsel in 

cooperation with M. Jäger and H. Willenberg 



Epidemiological and clinical disease course studies not 

only prove a comorbidity link between osteoporosis (Op) and 

Alzheimer’s Dementia (AD), but also a link with prodromal 

illness stages, such as cognitive decline und decline of 

bone mineral density (BMD). In addition, several molecular 

factors, such as oestrogen, NO, ROS and intracellular 

signalling pathways, such as GSK-3, are documented as 

pathogenetically relevant factors in both illnesses. In this 

context, we are investigating biochemical factors of bone 

metabolism – which are quantifiable in blood plasma – 

in patients with Alzheimer’s Dementia, mild cognitive 

impairment, osteoporosis and healthy controls. This 

should lead to an answer to the question whether common 

pathogenetic factors underlie these comorbidities. Initial 

findings already indicate significant differences between the 

diagnostic groups, which point to asymptomatic, vitamin 

D-independent bone resorption and bone remodelling 

processes at the MCI stage. Specific markers of bone 

resorption will now be investigated. A cell-biological 

approach will address the question of whether these and 

additional plasma factors altered in AD have an influence 

on the proliferation and differentiation of CD34-negative 

mesenchymal stem cells.

3.1.2.2 Experimental Psychopathology 

Research Laboratory 

Directors: W. Wölwer, W. Gaebel 

Scientific personnel: N. Frommann, S. Stroth (from 2008), 

K. Drusch (from 2009), S. Beulen (from 2009), K. Fisahn 

(2008-2009), F. Lüneborg (from 2008), A. Witt (2007-2009), 

S. Kiszkenow (from 2007), M. Memmou (2007–2009), 

M. Weickert (2006–2009), B. Lindel (2006–2007), 

S. Halfmann (2004–2006), M. Streit (until 2003) 

Non-scientific personnel: P. Pitters 

The focus of the research laboratory’s work is essentially 

related to cognitive and emotional-affective impairments 

in schizophrenic psychoses as well as – based upon this 

– related to the development of a functional diagnostic 

approach to psychopathology. Within this context, 

neuropsychological predictors of relapse in schizophrenia 

and alcohol dependency are investigated in more detail, 

and rehabilitative interventions for cognitive impairments 

in schizophrenia are developed and evaluated. In addition, 

the research laboratory is active in national multi-centre 

evaluation studies on cognitive behavioural therapy in 

people with schizophrenia. The Department cooperated 

closely with the “Long-term Treatment of Schizophrenic 

Psychoses”, “Dependence Disorders” and “Transcranial 

magnetic stimulation” research groups, as well as the 

Neuropsychiatry Research Laboratory. 

Cooperation 

s H. Ellgring, Institute of Psychology, University 

of Würzburg: Objective evaluation of expression 

characteristics in schizophrenia 

ReseaRch 

s P. Falkai, Department of Psychiatry and Psychotherapy, 

University of Göttingen: Neuropsychological and 

brain-morphology investigations in people with 

alcohol dependence and in relatives of patients with 

schizophrenia 

s G. Fink, J. Shah, Jülich Research Centre: Brain-imaging 

correlates of social-cognitive processes and the effects 

of nicotine on these processes 

s U. Habel, F. Schneider, Department of Psychiatry 

and Psychotherapy, RWTH Aachen: Brain-imaging 

correlates of social-cognitive rehabilitation in people 

with schizophrenia 

s S. Klingberg, Department of Psychiatry and 

Psychotherapy, University of Tübingen: Evaluation 

of Cognitive Behavioural Therapy in people with 

schizophrenia 

s V. Larach Walters, Andres Bello University, Faculty of 

Medicine, Department of Psychiatry, Santiago, Chile: 

Expression characteristics in people with schizophrenia 

undergoing antipsychotic treatment 

s W. Schmidbauer, Forensic Psychiatry Department, 

Haina: Evaluation of social-cognitive rehabilitation in 

forensic psychiatry patients with schizophrenia 

s R. Vauth, Department of Psychiatry and Psychotherapy, 

University of Basel: Rehabilitation strategies in socialcognitive 

impairments in people with schizophrenia 

s M. Wagner, Department of Psychiatry and 

Psychotherapy, University of Bonn: Neuropsychological 

investigation in people with schizophrenia and persons 

at risk for schizophrenia. 

In addition, within the Competence Network on 

schizophrenia and the POSITIVE Psychotherapy Research 

The Team of the Experimental 

Psychopathology Research Laboratory 

73


Network, there are close links with a lot of other working 

groups, based on joint participation in multi-centre projects. 

Projects 

Neuropsychological relapse predictors in 

persons with alcohol dependence 

Sub-project of the study “Acamprosat and integrative 

behavioural therapy in the outpatient treatment of alcohol 

dependency” (Principal investigator: W. Gaebel) 

W. Wölwer, W. Gaebel in cooperation with the Dependence 

Disorders research group 


Financing: FMER funding 01 EB 0133 

Although cognitive disorders in people with alcohol 

dependence have been known for a long time, the question 

of the interaction of such disorders with the treatment 

process is still relatively unclear because of conflicting 

results. Some findings from a previous study in 120 patients 

with alcohol dependence, who, after inpatient detoxication, 

were randomly assigned to one of three six-month outpatient 

psychotherapy conditions, indicate that those patients 

74 

Assessment of the electrophysiological correlates of facial affect 

decoding in the Experimental Psychopathology Research Laboratory 

relapsing already within this treatment period – independent 

of the treatment – demonstrated more pronounced cognitive 

impairments (particularly in verbal memory and visualmotor 

functions) already before they entered the treatment 

than patients remaining abstinent. This finding could only 

partially be confirmed within the context of the present 

project involving 371 persons with alcohol dependence, 

who, after detoxification, were randomly assigned to one of 

three six-month combination treatments with medication 

and psychotherapy components (anti-craving medication 

plus cognitive behavioural therapy or plus consultations 

during ward rounds, or placebo plus cognitive behavioural 

therapy). Cognitive impairments had an impact, particularly 

in the sense of a reduced rate of successful treatment 

completions, if the anti-craving substance (acamprosat) was 

used without accompanying cognitive behavioural treatment. 

However, no predictive effect of cognitive impairments was 

identifiable under the two strategies based on behavioural 

therapy, possibly because the therapists had intuitively 

matched the psychotherapy in individual settings to the 

patients’ individual deficits and resources.

Clinical symptom index More symptoms 

1.0 

0.9 

0.8 

0.7 

0.6 

0.5 

0.4 

+ 

- 

Neuropsychological vulnerability index 

+ + 

+ 

Biological principles of the risk of illness 

for psychotic disorders 

Participation in the homonymous, multi-centre project 

of the Competence Network on Schizophrenia (Principal 

investigator: M. Wagner, University of Bonn) 

W. Wölwer, M. Streit, J. Brinkmeyer, S. Stroth 


Financing: FMER funding 01 GI 9934, 01 GI 0234 to 

Wagner, Bonn 

This sub-project aims, amongst other things, to test 

whether neuropsychological indicators of increased 

vulnerability to psychosis can contribute to predicting the 

actual development of a psychotic disorder in persons 

who have been identified using clinical criteria as at-risk 

groups (Figure 9). Known neuropsychological vulnerability 

indicators were assessed in at-risk persons in the assumed 

early and late prodromal stages of a psychotic development 

both at inclusion into one of the early diagnosis and early 

intervention projects of the Competence Network and after 

twelve months. Compared with healthy controls the risk 

group in the late prodromal stage demonstrated statistically 

- 

+ + + + 

+ 

+ 

++ 

+ 

- 

- 

- - 

- 

- 

- - -- 

-- 

- 

- 

- 

- 

- 

- -- 

- 

++ + 

+ + 

++ 

+ 

+ 

+ ++ + + 

+ 

++ + 

++ ++ +++ +++ 

+ 

+ 

+++++ 

+ 

+ 

+ 

+ 

0.4 0.5 0.6 0.7 0.8 0.9 1.0 

+ 

+ 

Increased vulnerability 

High-risk group 

- + 

ReseaRch 

No clinical deterioration 

Clinical deterioration within one year 

Figure 9: Prediction of the clinical 

deterioration of patients with 

schizophrenia within one year of 

illness onset: the risk of a clinically 

poor disease course is particularly 

high in patients with incompletely 

remitted acute symptoms at the 

start of long-term treatment and 

a high degree of vulnerability to 

illness (after Wölwer et al. 2008, 

Neuropsychological impairments 

predict the clinical course in 

schizophrenia. Eur Arch Psychiat 

Clin Neurosc 258: 28–34) 

significant cognitive impairments in all cognitive functions 

under investigation, including facial affect decoding. These 

impairments were qualitatively similar but quantitatively 

less marked than those found in patients with manifest 

schizophrenia. The risk group in the early prodromal stage 

demonstrated on average only mild cognitive impairments, 

which differed significantly from the cognitive functions of 

healthy controls only in terms of executive functions and 

facial affect decoding. However, in the early prodromal 

group as opposed to the late prodromal group, cognitive 

impairments in verbal memory and executive functions were 

found to be predictive of a later transition into a psychotic 

episode. This is confirmed by findings in the recent literature 

describing a predictive validity of cognitive impairment 

for the development of a psychosis. The fact that this was 

detectable in our own study only in at-risk persons in the 

early prodromal stage could suggest that, in later stages, 

the effect of vulnerability factors is superimposed by 

further (supposedly psychosocial stress) factors and only 

contributes together with these factors to the accumulation 

of a higher risk at this later stage of psychosis development. 

75


Biological principles of relapse in schizophrenia 

Participation in the homonymous multi-centre project 

within the Competence Network on Schizophrenia (Principal 

investigators: W. Gaebel and W. Wölwer) 

W. Wölwer, M. Streit, J. Brinkmeyer, W. Gaebel 


Financing: FMER funding 01 GI 9932, 01 GI 0232 

Using the vulnerability-stress-coping model of schizophrenia 

as a starting point, the three components of this model were 

assessed in 125 first-episode patients with schizophrenia 

at the start and after the first and second year of longterm 

treatment in order to investigate their contribution 

to the risk of relapse as well as their relationship with the 

occurrence of prodromal symptoms and severe clinical 

deterioration. 

The study showed that patients with later clinical 

deterioration demonstrate stronger cognitive impairments in 

executive functions before the start of long-term treatment 

than patients with relatively stable clinical remission. Such 

cognitive impairments prove to be significant predictors 

of clinical development in regression analyses, even 

exceeding in predictive validity clinical variables such as 

the remaining positive symptoms at the start of long-term 

treatment. However, they demonstrate only low sensitivity 

(72%) and specificity (51%), which clearly restricts their use 

for individual risk predictions. In this regard, combinations 

of the neuropsychological (executive functions) and clinical 

parameters (residual symptoms) taken from the start of 

long-term treatment were superior, insofar as only the risk, 

not the time of clinical deterioration was to be predicted. 

To predict the time when such a deterioration could occur, 

unspecific prodromal symptoms – assessed fortnightly 

during the course of the long-term treatment – proved to be 

the superior predictors. 

24 

22 

20 

18 

16 

14 

76 

Number of correct responses in a 

standardised test of facial affect recognition 

Training of affect decoding 

Cognitive remediation training 

No training 

T 0 T1 

Before training After training 

Psychological intervention strategies in 

cognitive and emotional disorders 

W. Wölwer, N. Frommann, S. Halfmann, M. Streit in 

cooperation with R. Vauth (University of Freiburg/Basel) 


Financing: FMER funding 01 GI 9932 

Impairments in social-cognitive processes, such as facial 

affect decoding, are well documented in people with 

schizophrenia, are stable across the course of the disorder 

and make a significant contribution to the often poor 

social functioning of people with schizophrenia. Since the 

impairments remain largely uninfluenced by the usual 

treatment strategies, the search remains for alternative 

treatment approaches. For this reason, the Training of 

Affect Recognition (TAR) was newly developed in the 

Experimental Psychopathology Research Laboratory. The 

TAR was first evaluated with regard to potential increases 

in performance in facial affect recognition in a randomised 

pre-post control group design in comparison with an active 

control condition (basic-cognitive remediation training [CRT] 

for the improvement of neurocognitive basic functions) and 

compared with usual treatment (Treatment as Usual [TAU]) 

without any additional cognitive training (Figure 10). At the 

same time, such “molecular” training approaches focusing 

on circumscribed cognitive functions were compared with 

broader “molar” training strategies addressing a number of 

cognitive and behaviour-related functions. Altogether, the 

results produced a picture of a double dissociation, in which 

social-cognitive training strategies improve facial affect 

decoding, but do not improve memory performance, whereas 

basic-cognitive training improves memory, but not affect 

decoding. Both effects were achieved almost independently 

of the type of training strategy (molar vs. molecular) that was 

used for the respective area. Correspondingly, impairments 

of facial affect decoding in people with schizophrenia can 

in general be treated if training strategies that specifically 

address social-cognitive functions are used. 

Figure 10: Improved performance in facial affect recognition after training 

in patients with schizophrenia. A specifically devised training programme to 

improve facial affect recognition resulted in a clear improvement, whereas 

a training programme oriented more to the general improvement of 

cognitive performance (“cognitive remediation training”) had no effects on 

facial affect decoding (modified after Wölwer W., Frommann N., Halfmann 

S., Piaszek A., Streit M., Gaebel W. Remediation of impairments in facial 

affect recognition in schizophrenia: Efficacy and specificity of a new training 

program Schizophr Res. (2005) 80; 295-303.)

Brain-imaging correlates of therapeutic 

changes in affect recognition in schizophrenia 

W. Wölwer, M. Streit, N. Frommann, J. Brinkmeyer in 

cooperation with U. Habel and F. Schneider (both RWTH 

Aachen) 


Financing: FMER funding 01 GI 9932 and Departmental 

research budget 

Whereas several cross-sectional studies of brainfunctional 

correlates of impaired facial affect recognition 

in schizophrenia have been reported in the literature, 

longitudinal studies are still missing. This project, in addition 

to the aforementioned treatment evaluation, investigated 

possible improvements in facial affect decoding and its 

neurofunctional correlates in schizophrenia during the 

course of the above mentioned TAR training. Ten patients 

each under TAR (Training of Affect Recognition) and under 

TAU (Treatment As Usual control group) were investigated 

twice in a pre-post design, at the start and after the end 

of the six-week treatment phase, and compared with 10 

healthy controls. An fMRI assessment during a facial affect 

recognition test was used to investigate changes in the 

brain activation pattern and its relationship to changes in 

performance after the training period. Increased activations, 

associated with the training-specific improvements in facial 

affect recognition following the training phase, were found in 

the left middle and upper occipital lobes, in the right lower 

and upper parietal cortex and bilaterally in the lower frontal 

cortex under TAR as compared with TAU patients. This was 

one of the first investigations in this area describing the 

neurobiological correlates of a successful social-cognitive 

rehabilitation training for people with schizophrenia. 

ReseaRch 

Effects of repetitive transcranial magnetic stimulation 

(rTMS) on facial affect decoding in schizophrenia 

Sub-project of the study “Repetitive transcranial magnetic 

stimulation for the treatment of negative symptoms in 

chronic schizophrenia” (Principal investigator: J. Cordes), 

M. Streit, W. Wölwer, J. Brinkmeyer in cooperation with the 

“Transcranial magnetic stimulation” research group 

(J. Cordes) 



Since impairments in affect decoding have been found 

to be unaffected by traditional treatment, alternative 

treatment approaches need to be investigated. Within a 

larger treatment study with a randomised pre-post control 

group design, which primarily compared clinical effects of 

dorsolateral/prefrontal 10 Hz rTMS applied in 10 sessions 

over two weeks with those of a sham stimulation, effects 

on facial affect decoding were also investigated in 36 

patients with chronic schizophrenia. Alongside significant 

clinical improvements under verum stimulation, specific 

improvements could also be found in facial affect decoding. 

If these findings should prove to be replicable within the 

context of the current multi-centre RESIS clinical study (see 

“Transcranial magnetic stimulation” research group), in 

addition to function-specific cognitive rehabilitation, rTMS 

could also be a way to improve social-cognitive function 

impairments in the future. 

Generalisation and duration of the effects 

of facial affect recognition training 

W. Wölwer, N. Frommann 



On the one hand this project serves to replicate the positive 

effects on facial affect recognition of the Training of Affect 

Recognition (TAR) developed in the above described project. 

On the other hand it will investigate the sustainability of 

the effects beyond the end of the training and possible 

generalisations to prosodic affective recognition, theory 

of mind abilities and social competence. Until now, 2 x 

19 patients with schizophrenia have been included in the 

ongoing randomised, controlled pre-post study and treated 

over six weeks with one of two cognitive rehabilitation 

programmes, i.e. TAR or basic-cognitive remediation 

training (CRT). 

77


Effects of facial affect recognition training in 

patients with schizophrenia and violence 

N. Frommann, W. Wölwer in cooperation with 

W. Schmidbauer (Department or Forensic Psychiatry, Haina) 


Financing: Research budgets of participating departments 

With regard to the association reported in the literature 

between impaired affect decoding for negative emotions 

and violence, this project is designed to investigate 

whether a positive effect on facial affect recognition by 

means of Training of Affect Recognition (TAR) can also 

be demonstrated in patients with schizophrenia and 

violent behaviour. Moreover, the relationship between 

affect decoding and other, known predictors of aggressive 

behaviour will be investigated. So far, 22 male patients have 

been included in the ongoing study at the Department for 

Forensic Psychiatry Haina and treated over six weeks with 

TAR within a randomised waiting-group design. 

Decoding of facial affect and violence in 

schizophrenia: principles and treatment 

N. Frommann, S. Stroth, J. Brinkmeyer, W. Wölwer 

in cooperation with C. Luckhaus 


Financing: Research commission of the Faculty of Medicine, 

Heinrich-Heine University, Düsseldorf 

As an extension of the aforementioned project, possible 

performance differences between patients with 

schizophrenia with and without violent behaviour are being 

investigated in this project. In addition, the relationship 

between the performance deficits of violent persons and 

the type of emotion, as hypothesised in the literature, is 

being tested. In order to get hints about the neurobiological 

principles of these impairments, electrophysiological 

correlates of facial affect decoding are being assessed over 

the course of a six-week treatment and compared with those 

of healthy controls, who are also investigated twice within 

six weeks. So far, 16 patients with schizophrenia, with and 

without violent behaviour, have been included in the ongoing 

study, along with 10 healthy control persons. 

The effects of nicotine on social cognitions 

and social stress on schizophrenia 

W. Wölwer, J. Brinkmeyer, K. Drusch, K. Fisahn in cooperation 

with the Neuropsychiatric Research Laboratory (G. Winterer) 

and the Jülich Research Centre (G. Fink and J. Shah) 


Financing: DFG funding WO 640/3-1 

Against the background of the hypothesis that the high 

prevalence of nicotine dependence in schizophrenia is to be 

understood in the sense of a self-medication of cognitive 

78 

impairments and increased sensitivity to stress, this project 

investigates how nicotine affects facial affect decoding 

(as a basic building block for social cognition) and stress 

reactions in association with social interaction in patients 

with schizophrenia. Using a 2 x 2 factorial, randomised and 

controlled design, the effects of nicotine vs. placebo on 

facial affect decoding are being experimentally investigated 

in nicotine-addicted patients with schizophrenia vs. healthy 

controls. In addition, electrophysiological and brainfunctional 

correlates of facial affect decoding as well as nonverbal 

behaviour in a communication role-play are being 

analysed. The study is being carried out as an associated 

project of the study “Attention, nicotine dependence & nACh 

receptor α4β2 genotype” (Project director: G. Winterer) using 

simultaneous EEG and fMRT measurements in the Jülich 

Research Centre. Following an extensive preparation period, 

within the reporting period 22 subjects were included in the 

study. 

Effects of aripiprazole vs. haloperidol on the expression 

and perception of facial affect in patients with 

schizophrenia by using objective measurements 

W. Gaebel, W. Wölwer, B. Lindel in cooperation with 

V. Larach-Walters (Andres Bello University, 

Santiago de Chile) 


Financing: Bristol-Myers-Squibb 

In this project, the hypothetical benefits of atypical 

antipsychotics in the treatment of negative symptoms 

were evaluated by using objective assessment methods to 

compare the effects of aripiprazole with those of haloperidol 

as standard typical antipsychotic treatment. In addition 

to clinical-psychopathological assessment of affective 

flattening in the context of negative symptoms, the objective 

methods should address in particular characteristics 

of decoding and of non-verbal expressions of affects in 

social interaction. The project, carried out at both the LVR- 

Klinikum and the Andes Bello University in Santiago de 

Chile, included a total of 56 patients; n=25 of those treated 

with aripiprazole and n=20 of those treated with haloperidol 

could be fully investigated before and after the 6-week 

treatment phase. An additional 12 healthy control persons 

were recruited at both centres. The project is currently in the 

phase of statistical analysis.

Cognitive behaviour therapy for the treatment of 

negative symptoms in schizophrenia (TONES) 

Participation in the homonymous, multi-centric project 

(Principal investigator: S. Klingberg, University of Tübingen) 

W. Wölwer, N. Frommann, S. Halfmann, M. Memmou, 

M. Weickert 


Financing: DFG funding KL 1179/3-1 to Klingberg, Tübingen 

Since to date negative symptoms in schizophrenia often 

cannot be satisfactorily treated with the available drug 

and psychotherapeutic strategies, this project investigates 

whether these symptoms can be reduced by means of a 

cognitive behaviour therapy (CBT) specifically adjusted to 

meet the needs of such patients. A newly designed variant of 

CBT was compared with a cognitive remediation treatment 

over 20 sessions, distributed over 9 months of treatment, 

within the context of a controlled randomised clinical trial in 

198 patients. In 2008, full recruitment of 66 patients at each 

of the three participating centres (the University Psychiatry 

Departments of Tübingen, Düsseldorf and Frankfurt) 

could be achieved and the nine-month treatment could be 

concluded in almost all patients. The project is currently in 

the phase of statistical analysis. 

Cognitive behaviour therapy in the treatment of positive 

symptoms in psychotic disorders (POSITIVE) 

Participation in the homonymous, multi-centre project 

within the POSITIVE Psychotherapy Research Network 

(Principal investigator: S. Klingberg, University of Tübingen) 

W. Wölwer, S. Kiszkenow, A. Witt, S. Beulen 


Financing: FMER funding 01 GV 0618 

to S. Klingberg, Tübingen 

New psychotherapy research – particularly from the UK – 

provides evidence that cognitive behavioural therapy can be 

used successfully to reduce previously persistent symptoms. 

This project, in addition to replicating such findings in the 

German language area, aims to provide an explanation of the 

mechanisms of effect. According to current psychological 

models relating to the development and persistence of 

psychotic symptoms, these mechanisms include, amongst 

other things, a change of defined cognitive biases and are 

not only be based on unspecific factors that do not depend 

on treatment forms. To shed light on this question, the effect 

of cognitive behavioural therapy (CBT) versus supportive 

therapy (ST) on psychopathological symptoms and 

neuropsychological indicators of cognitive biases is being 

investigated in a multi-centre, randomised, controlled study. 

A total of 163 patients will be included in each treatment 

condition, which comprises 20 sessions of 50 minutes in an 

outpatient setting over a period of nine months. Follow-up 

ReseaRch 

assessments will be carried out four times over two years to 

check the stability of the achieved effects. By the end of 2009, 

326 of the total planned recruitment number of 330 patients 

had been included into the study. 

Threat-sensitivity in patients with psychotic disorders: 

behaviour indicators and neuronal correlates 

Sub-project of the studies “Cognitive biases as a basis for 

delusion symptoms and their alteration with a cognitive 

behavioural therapy in patients with psychotic disorders” 

(Principal investigator: W. Wagner, University of Bonn) and 

“Multi-centre fMRT-study of the neuronal correlates of a 

cognitive behavioural therapy in patients with psychotic 

disorders” (Principal investigator: T. Kircher, RWTH Aachen/ 

University of Marburg) within the POSITIVE Psychotherapy 

Research Network 

W. Wölwer, J. Brinkmeyer, S. Kiszkenow in cooperation with 

the Neuropsychiatry Research Laboratory (G. Winterer) and 

the Department for Neuroradiology 


Financing: FMER funding to M. Wagner, Bonn 

and T. Kircher, Aachen/Marburg 

This project addresses the higher sensitivity for threatening 

stimuli in psychotic disorders with symptoms of delusion, 

as supposed in the literature, and the neurobiological basis 

of this cognitive bias. An increased sensitivity to being 

threatened is part of the cognitive biases that contribute to 

the current psychological models for the development and 

persistence of psychotic symptoms. A paradigm, developed 

in our research laboratory, for assessing the sensitivity to 

being threatened is being used in the neuropsychological 

sub-project being carried out at all centres and with all 

patients in the previously described clinical psychotherapy 

trial. In addition, the paradigm is also being used during 

an fMRI assessment of selected study patients of the LVR- 

Klinikum. 

79


3.1.2.3 Brain morphology research laboratory and 

animal experimental psychosis research 

Director: M. von Wilmsdorff (from 2002), 

U. Sprick (until 2002) 

Scientific personnel: M.-L. Bouvier 

The brain morphology and animal experimental 

schizophrenia research laboratory focused on the 

development of a new animal model which ascribes the 

aetiology of schizophrenia to disturbances during prenatal 

brain development. Since 2003, the laboratory’s research 

work has been extended to the effects of antipsychotic 

drugs on somatic control systems in the animal model. 

Here, on the one hand, the influence of typical and atypical 

antipsychotic drugs on the secretion of leptin into the 

blood and the regulation of hypothalamic leptin receptors 

was investigated. A second project aimed to explain how 

typical and atypical antipsychotic drugs influence metabolic 

parameters of the metabolic syndrome. 

80 

Evaluating tests results in the histological laboratory 

Projects 

Prenatal excitotoxic damage of the hippocampus 

in rats as a model of schizophrenia 



On the basis of the results of epidemiological studies and 

the hypothesis that disorders in prenatal neurodevelopment 

in humans may lead to schizophrenia after puberty, 

the study investigates for the first time the influence of 

damage to the hippocampus during the foetal period in 

rats. The damaging agents are applied in the time interval 

that corresponds to the second trimester of pregnancy 

in humans, a time period that is particularly sensitive to 

neuronal defects. The behaviour of the rats administered 

kainic acid prenatally into the intracerebral ventricles was 

compared with that of untreated animals in several sets of 

tests over a period of six months. The assessments included 

changes in weight, motor coordination and spontaneous 

locomotion, working memory deficits, the development of

specific anxiety behaviour and associated alterations in 

exploration behaviour, as well as aspects of social behaviour. 

Morphological changes of hippocampal pyramidal cells 

and histochemical parameters such as the activity of 

acetylcholine esterase and cytochrome-c-oxidase were also 

investigated. After sexual maturation, the animal model 

of prenatal damage established by our group led to sexspecific 

alterations in weight, behaviour (anxiety and social 

behaviour, learning and memory functions) and the length 

of hippocampal pyramidal cells, findings comparable with 

symptoms of individuals with schizophrenia. 

Influence of selected antipsychotic drugs on serum 

leptin levels and the distribution of leptin receptors in 

the hypothalamus of rats 



Food intake, energy consumption and the closely associated 

long-term regulation of body weight are physiological 

control mechanisms which are partly located in the brain 

and partly in peripheral tissues. Here, leptin plays a key role, 

since it signals body fat mass to the brain and regulates 

the secretion of neuropeptides mediated by hippocampal 

leptin receptors. The treatment of patients with mental 

disorders with antipsychotic drugs may lead to a range 

of unwanted side effects. Particularly in treatment with 

atypical antipsychotic drugs, some individuals gain so 

much weight that, in the worst cases, medication may 

have to be discontinued. Overweight may lead to serious 

cardiovascular, respiratory and gastrointestinal disorders. 

Typical and atypical antipsychotic drugs were administered 

in a feeding experiment to three-month-old rats, to avoid the 

hormonal effects of puberty. Body weight, daily food intake 

and drinking behaviour were investigated over a period 

of six weeks. Serum and cardial blood leptin levels were 

determined. The distribution of the leptin receptor in the 

hypothalamus was determined immunochemically by using 

electrophoresis and Western Blot. It could be demonstrated 

that typical (haloperidol) and atypical (clozapine and 

ziprasidone) antipsychotic drugs have no effect on the leptin 

level in the serum or the expression of the leptin receptor in 

the hypothalamus. 

Mean value ± SEM (length in mm) 

90 

89 

88 

87 

86 

* 

*** 

*** 

* 

Control right 

Control left 

Treated rats right 

Treated rats left 

*** 

*** 

Male Female 

ReseaRch 

Figure 11: After prenatal damage by neurotoxic kainic acid, which was 

injected into the third ventricle of the brain, rats show sex-specific changes 

in the length of the pyramidal cells. This tallies with post-mortem findings 

in patients suffering from schizophrenia (figure modified after: v Wilmsdorff 

M, Sprick U,Bouvier ML, Schulz D, Schmitt A, Gaebel W: Sex-dependent 

behavioral effects and morphological changes in the hippocampus after 

prenatal invasive interventions in rats: implications for animal models of 

schizophrenia. Clinics. 2010; 65(2): 209–219) 

* 

** 

*** 

Preparation of brain sections (rats) for microscopic investigation 

81


Mean value ± SEM (weight in g) 

Influence of selected antipsychotic drugs on 

parameters of the metabolic syndrome in rats 



The metabolic syndrome is a complex system comprising 

increased visceral fat tissue, dyslipidemia, arterial 

hypertonia und impaired glucose metabolism, including 

insulin resistance. Persons with the metabolic syndrome are 

at a threefold increased risk of type II diabetes mellitus and 

cardiovascular complications. Persons with schizophrenia 

have a high prevalence of the individual risk factors of the 

metabolic syndrome; the prevalence rate of the metabolic 

syndrome in this group is 36%. The mortality of individuals 

with schizophrenia is 2.5 times higher than in the nonaffected 

population. To date it is unclear if the metabolic 

dysfunctions are caused by schizophrenia or by the 

treatment with antipsychotic drugs. 

82 

450 

400 

350 

300 

250 

200 

150 

100 

50 

0 

** 

** 

** 

** 

6 7 8 12 16 20 24 Age in weeks 

Control male animals 

Treated animals; male 

Control female animals 

Treated animals; female 

Figure 12: In an animal model, male rats with prenatal damage to the hippocampus show a statistically significant lack of weight gain, unlike female 

animals. A weight reduction during puberty in male patients can therefore be taken as a possible indicator of a schizophrenic disorder (Figure modified 

after: v Wilmsdorff M, Sprick U,Bouvier ML, Schulz D, Schmitt A, Gaebel W: Sex-dependent behavioral effects and morphological changes in the 

hippocampus after prenatal invasive interventions in rats: implications for animal models of schizophrenia. Clinics. 2010; 65(2): 209–219) 

** 

** 

In order to clarify the influence of typical and atypical 

antipsychotic drugs, male and female Sprague Dawley rats 

(aged 12 weeks) were given an exactly-defined amount of 

medicine in their food every day over 12 weeks. Weight, food 

and water intake were calculated per week. At the end of 

the investigation, the weight of the fat and liver tissues was 

determined. The leptin, adiponectin, insulin and ghrelin 

levels in the serum were assessed (using ELISA tests), in 

addition to a range of other blood parameters (leukocyte, 

erythrocyte and thrombocyte counts), HBA1c, glucose, 

cholesterol including HDL and LDL, and triglycerides. In 

contrast to haloperidol, clozapine resulted in weight gain 

in male animals and in a range of associated metabolic 

changes, such as increased glucose and triglyceride levels; 

these results are comparable with those of investigations in 

patients on clozapine medication.

3.1.2.4 Psychophysiology and Psychopathometry 

Research Laboratories 

Director: J. Zielasek 

Personnel: T. Jäger, J. Brinkmeyer 

This group is currently analysing the results of routine 

EEG investigations within the context of work towards a 

medical doctorate. First results show that around 40% of 

those investigated had slight EEG alterations and around 

5% severe EEG alterations (Figure 13), which led to further 

follow-up investigations. These investigations will build the 

basis for the development of evidence-based, diagnosisrelated 

recommendations regarding the rational use of 

routine EEG in psychiatry and psychotherapy. In addition, 

the group participates in the EEG investigations within the 

context of research into Alzheimer’s disease. 

Test-psychological investigations/ 

neuropsychological diagnosis 

The Test-Psychological Investigations (TPI) function unit 

is assigned to different departments. TPI serves as an 

instrument to support the diagnostic process and the 

investigations are carried out at the request of the treating 

doctor in relation to the (suspected) diagnosis and the 

questions to be answered. 

ReseaRch 

Test-psychological investigations within the context of 

clinical studies and research projects 

In clinical studies and research projects, TPI is used 

according to the study protocol to monitor the disease 

course or as a measurement of the changes at various times 

and/or compared between groups. The procedures are used 

to measure the current cognitive performance, observe 

disorder-related traits and investigate self-assessed mood. 

The defined target parameters represent a measurement of 

the methods used. The following areas are investigated: 

s Intelligence and performance tests 

s Personality assessment procedures 

s Screening tests to identify specific disorders Figure 13: Spike-wave complexes in the awake electroencephalogram of a 

patient with epileptic seizures 

83


3.1.2.5 Neuro-Psychiatric Research Laboratory 

Director: G. Winterer (May 2006 to August 2009) 

Scientific personnel: F. Musso, A. Mobascher, T. Warbrick, 

M. Arends, J. Brinkmeyer, S. Botterweck, W. Friedrich, 

V. Schlemper, R. Schwark, C. Wessels (2008) 

Non-scientific personnel: K. Mann, 

M. T. Düsterhus 

The main aim of the Neuropsychiatric Research Laboratory 

(NPRL) is to measure and understand brain functions 

in patients suffering from mental disorders, as well as 

genetic influences on these functions. As methods, the 

NPRL uses, in particular, functional magnetic resonance 

tomography (fMRT) and electroencephalography (EEG). 

Internationally, this research strategy is often designated 

as “Genetic Imaging”. The method of simultaneous EEGfMRT 

measurements, established in the laboratory, also 

allows complex data analyses (multimodal imaging and 

multimodal data analysis). Another of the laboratory’s goals 

is to use the above methods to measure pharmacological 

effects on brain function (pharmaco-imaging). One example 

of this is the influence of nicotine on brain function. Brain 

activity is usually measured not only at rest, but also whilst 

carrying out certain tasks or during the presentation of 

certain stimuli. A central focus of NPRL is the investigation 

of the attention network, the activation of which is often 

disturbed in patients suffering from mental disorders such 

Modern computer systems help to analyse and assess 

numerous neuropsychiatric research data 

84 

as schizophrenia. Another focus during the last 2 years was 

the investigation of the cerebral representation of pain. The 

NPRL investigates on the one hand healthy subjects, mostly 

from a population-based sample, and on the other hand 

patients from the LVR-Klinikum who are suffering from 

mental disorders, particularly patients with schizophrenia. 

Cooperation 

s G. Fink, J. Shah, Institute of Medicine, Helmholtz 

Research Center Jülich 

s J. Gallinat, Neuroimaging Group, Dept. of Psychiatry, 

Charity – University Medicine Berlin 

s T. Sander, Cologne Center for Genomics, University of 

Cologne, 

s T. Kircher, Dept. of Psychiatry and Psychotherapy, 

University of Aachen 

s G. Gruender, Dept. of Psychiatry and Psychotherapy, 

University of Aachen, 

s P. Falkai, Dept. of Psychiatry and Psychotherapy, 

Georg-August-University Goettingen, 

s N. Dahmen, Andreas Konrad, Dept. of Psychiatry and 

Psychotherapy, Johannes Gutenberg-University Mainz, 

s D. Rujescu, Dept. of Psychiatry and Psychotherapy, 

Molecular Neurobiology Group, Ludwig-Maximillians- 

University, 

s C. Beckmann, FMRIB Analysis Group, University of 

Oxford, UK

s D. Durstewitz, Centre for Theoretical and 

Computational Neuroscience, University of Plymouth, 

UK 

s D. R. Weinberger, Genes, Cognition & Psychosis 

Program, National Institute of Mental Health, National 

Institutes of Health, USA 

s R. W. Cox, Analysis of Functional NeuroImages (AFNI), 

National Institute of Mental Health, National Institutes 

of Health, USA 

s R. Coppola, MEG Priority Facility, National Institute of 

Mental Health, National Institutes of Health, USA 

In addition, there are close contacts with several other 

groups within the context of the DFG priority programme 

1226 “Nicotine”. 

Projects 

Double-blind dose-titration study for investigating the 

security, tolerance and pharmacokinetics of multi-doses 

of the test substance JNJ-x administered once and twice a 

day to male and female patients with stable schizophrenia 

Participation in the homonymous multi-centre study at the 

request of FOCUS Clinical Drug Development und Janssen- 

Cilag International 

F. Musso, W. Friedrich, G. Winterer in cooperation with the 

study service centre of the LVR-Klinikum 

Project period: 2008 

Financing: FOCUS Clinical Drug Development and 

Janssen-Cilag International 

In this multicentre phase II trial (with a total of 5 study 

centres) the study drug JNJ-x…, which has not yet been 

approved, was tested for the first time in male and female 

patients with schizophrenia. The main objective of this study 

was to investigate the safety and tolerability of JNJ-x… with 

increasing dosages (dose titration), the pharmacokinetic 

profile in patients’ plasma of JNJ-x… administered once or 

twice a day and the effect of JNJ-x… on the plasma prolactin 

level. In addition to the 6 planned patients, the NPRL also 

included 5 additional patients in the study. 

ReseaRch 

Multi-centre randomised, double-blind, 

placebo-controlled, parallel group, dose effect 

study to assess the effectiveness and security of 

OROS methylphenidate retard in adults with attention 

deficit syndrome (“Lambda2”) 

Participation in the homonymous multi-centre study of 

Janssen-Cilag International 

G. Winterer, S. Botterweck, R. Schwark 


Financing: Janssen-Cilag International 

The aim of the study was to investigate the efficacy 

and safety of two different doses (54 and 72 mg/day) of 

OROS Methylphenidate Retard in adults with ADHS in 

comparison with a placebo treatment. The study assessed 

the degree of severity before, during and after a treatment 

period of 13 weeks by using observer and self-rating 

procedures for ADHS in adults (CAARS) and various other 

psychopathological measures of comorbidity (particularly 

depression, anxiety and dependence behaviour), and also 

assessed the effects of treatment on social and vocational 

measures and physiological parameters (to evaluate basic 

safety criteria). Between October and November 2008 

(start of data collection to the end of the stated recruitment 

period), the Düsseldorf test centre included a total of eight 

patients in the study. 

Attention network, nicotine addiction and 

alpha4beta2-nAch receptor genotype in healthy 

subjects and patients with schizophrenia 

G. Winterer, A. Mobascher, T. Warbrick, J. Brinkmeyer, 

F. Musso in cooperation with the Institute for Neuroscience 

and Medicine, Jülich Research Centre (G. Fink, J. Shah) 


Financing: DFG funding Wi 1316/7-1 

In this pharmaco-imaging study, healthy smokers and nonsmokers 

from the above mentioned multi-centre study are 

being investigated, as well as smokers and non-smokers 

suffering from schizophrenia. The aim is to evaluate the 

influence of nicotine on attention processes in subjects 

without mental disorders and in patients with schizophrenia 

in relation to smoking status. In addition, genetic influences 

are being investigated. The study is a double-blind, placebocontrolled 

study with a cross-over design, i.e. subjects take 

nicotine and placebo in randomised order, before performing 

tasks that require attention. Brain activity is studied using 

EEG and fMRT simultaneously. On the following day, 

the conditions (nicotine and placebo) are repeated when 

85


smokers are in a state of nicotine withdrawal. For nonsmokers, 

the measurements on day 2 are essentially to 

check the reliability of the methods. To date, 90 of the 200 

planned number of subjects have been recruited into the 

study. Data relating to the main questions have not yet been 

assessed, although aspects of the methods have already 

been published. 

Genetics of nicotine dependence: Clinical and 

neurobiological phenotypes – A multi-centre study 

G. Winterer, A. Mobascher, J. Brinkmeyer in cooperation 

with a further 7 institutions from the DFG priority 

programme 1226 “Nicotine” 


Financing: DFG funding Wi 1316/9-1 

In this multi-centre study (with a total of 6 study centres), 

a randomly selected population-based sample of mentally 

healthy smokers and non-smokers is being investigated. The 

main aim of the study is to describe the “smoker” phenotype 

at the behavioural level, biological level (biomarkers, stress 

hormones, etc.) and endophenotype level (neuropsychology 

and electrophysiology) and, in a second phase, to describe 

(endo)phenotype/genotype relations in order to gain 

a better understanding of the genetics of smoking or 

nicotine dependence, respectively. To this end, subjects 

Tracing electrical brain activity (electroencephalography) whilst 

simultaneously monitoring brain perfusion with magnetic resonance 

tomography 

86 

are extensively genotyped. The original recruitment target 

of 2,500 subjects has almost been achieved, with 2,380 

having signed up. In addition to its coordination tasks, the 

Düsseldorf study centre deals above all with analysing 

the electrophysiological data (P300 and P50 paradigms). 

Corresponding manuscripts are currently being prepared or 

are already published. 

Multi-centre fMRT study of neuronal correlates 

of cognitive behavioural therapy in patients 

with psychotic disorders 

Participation in the homonymous multi-centre study 

(Principal Investigator: T. Kircher, RWTH Aachen/University 

Marburg) within the POSITIVE Psychotherapy Research 

Network 

F. Musso, J. Brinkmeyer, G. Winterer in cooperation with 

the Experimental Psychopathology Research Laboratory 

(W. Wölwer) and the Institute for Radiology at the Heinrich- 

Heine University, Düsseldorf (A. Saleh) 


Financing: FMER funding for T. Kircher, Aachen/Marburg 

This countrywide, multi-centre study, with six study centres, 

includes fMRT assessments in patients with schizophrenia 

before and after treatment within the clinical trial “Cognitive 

behavioural study of the treatment of positive symptoms 

of psychotic disorders” (cf. Experimental Psychopathology 

Research Laboratory). This accompanying brain imaging 

is designed to provide neuronal correlates of illusions 

and hallucinations and their modifications in the course 

of the treatment. A total of 80 patients with schizophrenia 

will be included across all centres; after the initial fMRI 

assessment half of the patients will be treated over nine 

months with cognitive behaviour therapy and half with 

supportive therapy, followed by a second fMRI assessment. 

In order to standardise the assessment and estimate 

possible treatment-dependent reorganisation processes 

in the brain, 80 healthy subjects will also be investigated 

twice, at a 9-month interval. During the fMRI assessment, 

cognitive test paradigms are used which (A) on the one hand 

assess the potentially relevant processes in the creation and 

persistence of illusions and (B) on the other hand are in the 

focus of the therapeutic intervention: selective attention for 

threatening stimuli, jumping to conclusions and neuronal 

correlates of hallucinations. Recruitment went according to 

plan in the reporting period; analyses have so far only been 

performed and published for secondary objectives of the 

study.

Influence of the m-opioid receptor genotype on 

the cortical representation of pain 

A. Mobascher, J. Brinkmeyer, T. Warbrick, T., G. Winterer 

in cooperation with A. Schnitzler (Institute for Medical 

Psychology and Clinical Neurosciences) and A. Saleh and 

H.-J. Wittsack (Institute for Radiology, Heinrich-Heine 

University, Düsseldorf) 



of the Heinrich-Heine University, Düsseldorf 

In this genetic-imaging study, genetic influences on cortical 

pain processing are investigated by means of simultaneous 

EEG-fMRT. Genetic variations in the opioid system are of 

special interest within this project. To date, 75 of the 100 

planned healthy subjects have been investigated. The 

genetic analyses of the subjects investigated so far were not 

completed at the time of reporting, thus results related to 

the main genetic objectives of the project have not yet been 

answered. However, several methodical aspects, relating to 

multimodal imaging (EEG-fMRT or EDA-EEG-fMRT; EDA = 

electrodermal activity), could already be published. 

Effects of repetitive transcranial magnetic 

stimulation (rTMS) on attention processes and 

their brain-imaging correlates 

Sub-project of the multi-centre study RESIS – “Efficacy 

of repetitive transcranial magnetic stimulation for the 

treatment of negative symptoms in schizophrenia” (Principal 

Investigator: P. Falkai, Göttingen) 

M. Arends, J. Brinkmeyer, G. Winterer, in cooperation with 

the “Transcranial magnetic stimulation” research group 

(J. Cordes) 


Financing: DFG funding to P. Falkai, Göttingen 

This project uses simultaneous EEG/fMRT measurement 

during an attention-related task (visual oddball task). 

Measurement takes place before and after a three-week 

rTMS treatment, which is applied above the left dorsolateral 

prefrontal cortex in schizophrenia patients with negative 

symptoms in accordance with the study protocol for the 

clinical RESIS trial. The present sub-project looks for pre/ 

post changes of the activation pattern in the dorsolateral 

prefrontal cortex. To date, 30 of the planned 45 patients have 

been included in the study. 

ReseaRch 

Effects of a drug treatment with methylphenidate 

depending on the COMT genotype in adult patients 

with ADHS 

C. Wessels, S. Botterweck, F. Musso, R. Schwark, G. 

Winterer in cooperation with C. Ohmann (Coordination 

Centre for Clinical Studies) and the Institute for Radiology, 

Heinrich-Heine University, Düsseldorf and the Institute of 

Genetics of the University of Cologne 



of Heinrich-Heine University, Düsseldorf 

This study (still in the preparation phase) is designed to 

investigate the effects of short-term intervention with 

methylphenidate in adults with ADHS in relation to the 

catechol-O-methyl transferase (COMT) genotype. The 

background is the observation that effects of drug treatment 

with methylphenidate are highly variable in people with 

ADHS. One of the factors that could influence this variability 

is a polymorphism in the COMT gene (val158met), which 

co-promotes the availability of dopamine in the prefrontal 

cortex. Therefore, in the present double-blind, randomised, 

placebo-controlled cross-over study, N = 48 patients will 

be investigated in three groups corresponding to the three 

possible COMT genotypes. The influence of methylphenidate 

administration on the relevant cerebral function systems 

and attention will be assessed by using imaging and 

electrophysiological techniques (EEG/fMRT simultaneously) 

and neuropsychological tests. 

87


3.1.3 Research groups 

3.1.3.1 Classification of mental disorders 

Director: W. Gaebel 

Scientific coworker: J. Zielasek 

The international classification systems of mental 

disorders are currently being revised. The aim of this 

project is to identify new scientific knowledge which could 

possibly be of interest to the revisions and to assess its 

significance for the classification of mental disorders. The 

research group on the classification of mental disorders 

has undertaken this work for the German Association for 

Psychiatry and Psychotherapy (Deutsche Gesellschaft 

für Psychiatrie, Psychotherapie und Nervenheilkunde, 

DGPPN). The research group has been in existence since 

autumn 2007. W. Gaebel is a member of the Mental Health 

Topic Advisory Group of the World Health Organization 

(WHO), which advises the WHO on the revision of the 

international classification system ICD-10, the ICD-11, which 

is currently being developed. In this context, the research 

group constructed – for the Global Scientific Partnership 

Network of the WHO (Chair: Prof. Dr. N. Sartorius, 

Geneva) – a questionnaire for an international survey. In 

collaboration with the DGPPN, the research group used this 

questionnaire in 2008 to survey psychiatrists in Germanspeaking 

countries (Germany, Austria and Switzerland) 

on their opinions on the need for a revision of the ICD-10 

chapter on mental illnesses. In addition, a group of Germanspeaking 

experts was formed for questions on the revision 

of psychiatric classification systems, and in collaboration 

with the WHO a systematic review of the German-language 

literature was started to collect German-language 

publications that may be relevant for the revision process. 

For the GSPN group, an international working session was 

organised and coordinated in Berlin within the framework of 

the DGPPN annual congress in 2008. In addition, W. Gaebel 

has been a member since 2008 of the Psychosis Workgroup 

of the American Psychiatric Association (APA), which advises 

the APA on the revision of the classification of psychotic 

disorders. 

National cooperation partners 

DGPPN, German Institute for Medical Documentation and 

Information (DIMDI, Cologne) 

International cooperation partners 

Department of Mental Health and Substance Abuse, WHO 

(Geneva); American Psychiatric Association (Arlington, USA); 

Section on Schizophrenia, World Psychiatric Association. 

88 

Modular psychiatry 


Scientific coworkers: J. Brinkmeyer, W. Wölwer, J. Zielasek 

Within the context of the classification of mental disorders, 

this research group further developed the concept of 

orientating classification systems of mental disorders to the 

neurobiological foundations of the disorders. To this end, 

this project aims to identify physiological brain modules, 

which are first to be identified and then studied with 

regard to their characteristics in mental disorders. Having 

determined the conceptual foundations of this approach, 

which were published in international journals, the research 

group is currently preparing empirical investigations of the 

concept of modular psychiatry using magnetic resonance 

imaging and EEG. 

Frame analysis of psychiatric classification texts 

Director: J. Zielasek 

Scientific assistants: I. Girgin, J. Weiland, S. Jungbluth 

Cooperation partner: Institute of Linguistics, Heinrich-Heine 

University, Düsseldorf (W. Löbner) 

Resource funding: Humanities and Medical Scientific 

Research Centre, Heinrich-Heine University, Düsseldorf 

This project originated from the shared interest of 

the working group, the Institute of Linguistics and the 

Philosophical Institute of the Heinrich-Heine University 

Düsseldorf in the further development of the concepts of 

the classification of mental disorders. On the basis of L. 

Barsalou´s Frame Theory, the research group investigates 

in an interdisciplinary research approach whether Frame 

Theory can be used to identify and analyse concepts of 

the representation of mental disorders in psychiatric 

classification texts. To this end, both texts of the current 

classification systems for mental disorders (ICD-10, DSM- 

IV) and historical texts (Kraepelin, Bleuler, Schneider) 

were analysed in close cooperation with the Institute of 

the History of Medicine (H. Fangerau, now Ulm, Germany). 

Currently, the group is working on questions of the notation 

of frame structures, as well as on the use of process 

analytical procedures and the inclusion of neurobiological 

fundamentals of psychopathological phenomena in Frame 

analysis.

3.1.3.2 Dependence disorders 

Director: W. Gaebel, W. Wölwer, P. Franke (from 2005), 

W. Burtscheidt (until 2004) 

Scientific assistants: N. Frommann (2005–2009), 

M. Warnecke (from 2008), Th. Nolting (from 2008), 

S. Halfmann (2004–2006), B. Eikerling (2004–2006), 

E. Kilgus (2003–2007), B. Weinbrenner (2005–2006) 

The research group principally deals with the area of 

treatment and care research. The primary interest lies in 

the investigation of the effect of outpatient behavioural 

therapy on relapse prophylaxis in persons with alcohol 

dependence as well as medical intervention strategies in the 

detoxification and relapse prophylaxis in people dependent 

on alcohol or opiates. 

Cooperation 

s N. Scherbaum, Department of Psychiatry and 

Psychotherapy, LVR Clinic Essen, University of 

Duisburg-Essen 

s W. Maier, Department of Psychiatry and Psychotherapy, 

University of Bonn 

s P. Falkai, T. Wobrock, Department of Psychiatry and 

Psychotherapy, University of the Saarland, Homburg/ 

Saar 

s T. Kuhlmann, Psychosomatic Clinic, Bergisch Gladbach 

s C. Ohmann, Coordination Centre for Clinical Studies 

(KKS), Heinrich-Heine University, Düsseldorf 

s M. F. Leweke, Psychiatric Department, University of 

Cologne. 

Projects 

Acamprosate and integrative behavioural therapy in 

the outpatient detoxification of individuals with alcohol 

dependence (“PITA”) 

W. Gaebel, W. Burtscheidt, W. Wölwer, N. Frommann, P. 

Franke, E. Kilgus, B. Eikerling, S. Halfmann, B. Weinbrenner 

in cooperation with the University Psychiatric Hospitals 

of Essen (N. Scherbaum), Bonn (W. Maier, Schütz) and 

Homburg (P. Falkai, T. Wobrock), the Psychosomatic Hospital 

of Bergisch Gladbach (Thomas Kuhlmann) and the Centre 

for the Coordination of Clinical Studies of the Heinrich-Heine 

University, Düsseldorf (C. Ohmann) 


Financing: FMER funding 01 EB 0133 

ReseaRch 

The overriding aim of the project carried out by the North 

Rhine-Westphalia Dependence Research Network was 

the experimental investigation of the interaction between 

behavioural therapy interventions and the anticraving 

substance acamprosate in the outpatient treatment of 

persons with alcohol dependence. This was a multi-centre, 

prospective, randomised and – regarding medication – 

double-blind clinical trial. The hypothesis tested was that (a) 

behavioural therapy in combination with acamprosate was 

superior regarding rates of abstinence to (b) a combination 

of behavioural therapy with placebo and (c) a combination 

of acamprosate with supportive talks. Immediately after 

detoxification, 371 patients were randomly assigned to 

one of the three aforementioned treatment arms at four 

participating centres. The inpatient treatment lasted 6 

months, followed by a six-month follow-up phase with 

investigations every 3 months. 

The beneficial effects of the two behavioural therapy 

approaches over treatment arm (c) found at the end of the 

initial treatment period were not sustained until the end of 

the follow-up period; all three treatment arms had a success 

rate of approximately 30%. Additional analyses of secondary 

endpoints showed that the following factors influence the 

success rates: social integration with regard to gainful 

employment, comorbid personality disorders, symptoms of 

depression and cognitive impairments. 

Effectiveness and safety of Vivitrol® in adults receiving 

inpatient treatment for alcohol dependence 

Participation in the homonymous multi-centre study 

commissioned by the company Alkermes 

W. Gaebel, P. Franke, M. Warnecke, Th. Nolting in 

cooperation with the departmental study service centre 


Financing: Alkermes 

In this multi-centre, prospective, randomised, placebocontrolled, 

double-blind Phase IIIb study, the efficacy and 

safety of naltrexone i.m. in the post-inpatient treatment 

of alcohol dependence will be evaluated over 12 weeks. 

Recruiting only started at the end of the period covered by 

this report. 

89


3.1.3.3 Long-term treatment of persons with 

schizophrenic psychoses 


Scientific assistants: B. Conradt, N. Frommann, 

Dipl.-Stat. M. Jänner, M. Riesbeck, M. von Wilmsdorf, 

W. Wölwer, R. Zemlicka 

In most cases, schizophrenic illnesses take an episodicrecurrent 

course, which is why long-term treatment 

is indicated for all patients. In order to offer long-term 

treatment strategies that take into consideration the disease 

course and patient needs, existing procedures have to be 

developed further and assessed on the basis of scientific 

evidence. The research group therefore deals with questions 

relating to the comparative evaluation of the different 

1 VSC model: 

Vulnerability stress 

coping model, 2BZD: Benzodiazepine, 

3NL: Neuroleptic, 

antipsychotic 

90 

Atypical NL3 (risperidone) 

Acute study 

Typical NL3 (haloperidol) 

pharmacological and psychological long-term treatment 

strategies, the development and prognosis of schizophrenic 

disorders, as well as the relapse-predictive significance 

of prodromal symptoms and other clinical and biological 

characteristics. 

Projects 

Network project for the optimisation of the long-term 

treatment of first-episode patients with schizophrenia 

Coordination: W. Gaebel 


Financing: FMER funding 01 GI 9932/01 GI 0232 

s This multi-centre network project represented a 

central component of the Competence Network 

on Schizophrenia (q.v.). It performed empirical 

T0 (Entry) 

Determination of risk 

status according to 

VSC model1 T1 (1 year) 



VSC model1 T2 (2 years) 



VSC model1 Biological basis of relapses 

I I I 

Prodromes & early intervention 

Prodrome collection 

VSC-oriented 


+ Psychoeducation 

Psychoeducation 

VSC-oriented 


+ Psychoeducation 


long-term medication 



Typical NL3 (haloperidol) 


Prodrome collection and early intervention, 

where applicable 

Long-term medication + early intervention 

with BZD2 Long-term medication + early intervention 

with NL3 Long-term medication + early intervention 

with BZD2 Psychoeducation Typical NL3 (haloperidol) 

Long-term medication + early intervention 


with NL3 Psychological 

intervention Pharmacotherapeutic strategies 

Figure 14: Study plan for Network projects designed to optimise the long-term treatment of patients with schizophrenia, divided into subprojects.

investigations of different questions on the optimisation 

of the long-term treatment of patients with 

schizophrenia (Figure 14): 

s Benefits of (“atypical”‘) second generation antipsychotic 

drugs compared with those of the first generation 

(“typicals”); 

s Necessary period of continuous maintenance 

medication for further stabilisation and relapse 

prophylaxis; 

s Opportunities afforded by an improved use of 

prodromal symptoms for early diagnosis and 

intervention; 

s Improvement of the risk estimation for relapses and 

residual course developments, as well as 

s The effectiveness of psychological intervention 

strategies with regard to relapse prophylaxis and other 

outcome criteria through the modification of individual 

vulnerability, stress response and coping skills. 

Pharmacotherapeutic strategies for relapse prevention in 

first-episode patients with schizophrenia 

Director: W. Gaebel, H.J. Möller (Psychiatric Department of 

Ludwig-Maximilian University, Munich) 



A core element of the above network projects was the 

2-phase pharmacotherapeutic long-term study (cf. Figure 

15). After an eight-week period of acute treatment (Möller 

et al. 2008), drug treatment was continued with either 

the typical antipsychotic drug haloperidol or the atypical 

drug risperidone at a low maintenance dose for one year 

Cumulative frequency 

1.0 

0.8 

0.6 

0.4 

0.2 

0.0 

Risperidone (n = 77) 

Kaplan-Meier estimated mean time to appearance 

of clinical deterioration: 38.8 weeks 

Haloperidol (n = 74) 

Kaplan-Meier estimated mean time to appearance 

of clinical deterioration: 40.5 weeks 

Log Rank = 0.1; df = 1; p > 0.05 

0 10 20 30 40 50 60 

Time (weeks) in a long-term study (first year) 

ReseaRch 

(randomised, double-blind design). Afterwards, at the start 

of the second year, patients (after sufficient stabilisation) 

were again randomised before continuing with either 

maintenance treatment or phased withdrawal of the 

antipsychotic drug. In both types of treatment, an early 

intervention took place if early signs of relapse occurred 

(i.e. prodromal symptoms) (see below). The main results 

of the first year (maintenance treatment continued with a 

typical vs. atypical antipsychotic drug) were as follows: Both 

medications are equally (i.e. very) effective with regard to 

relapse prophylaxis and further symptom improvement. 

However, there was a considerable drop-out rate in both 

arms of the study. The results of the second year are 

as follows: In first-episode patients with schizophrenia 

(sufficiently stabilised after one year of maintenance 

therapy) the risk for relapse or clinical deterioration is 5-10 

times higher after intermittent treatment (after phased 

withdrawal of the antipsychotic drugs) than with continued 

maintenance therapy. However, in the intermittent treatment 

arm, around half of the patients remain stable. Around 20% 

of all patients demand the discontinuation of maintenance 

therapy after one year. 

Prodrome-supported relapse prediction and early 

intervention in patients with first-episode schizophrenia 

Director: W. Gaebel, W. Wölwer, M. Riesbeck 



According to the VSC model, persons with schizophrenia 

display increased vulnerability which leads, in the presence 

of (persistent) stress and maladaptive coping strategies, 

Figure 15: Proportion of patients 

with no clinical deterioration 

in the course of treatment with 

risperidone and haloperidol (based 

on Gaebel et al., J Clin Res, 2007) 

91


to unspecific (prodromal) symptoms that (can) progress to 

the full-blown clinical picture of schizophrenia. Accordingly, 

prodromes have a predictive and (potentially) interventionguiding 

function. This was also empirically investigated 

within the context of the 2-year study. In addition, the 

effectiveness of benzodiazepines as early intervention 

medication for relapse prophylaxis was compared with 

that of antipsychotic drugs. It was shown that prodromal 

symptoms are superior regarding their relapse-predictive 

validity, but that further research is necessary to use them 

effectively for relapse prediction and early intervention. 

The (intermittent) use of benzodiazepines in addition to 

antipsychotic drugs appears to be an additional treatment 

option. 

Biological principles of illness relapses 

Director: W. Gaebel, W. Wölwer, J. Brinkmeyer 



Besides the prodromal symptoms detected during 

the disease course, also biological components of the 

VSC models were assessed for risk characterisation 

using questionnaire-based neuropsychological and 

neurophysiological (see section on the Research Group 

Experimental Psychopathology), neurobiochemical and brain 

morphometric indicators. These factors were assessed 

also in the long-term disease course with respect to their 

relation to the appearance of prodromal symptoms and 

relapses. The main interests were: a) the predictive value 

of these components regarding relapse risk and outcome, 

especially after discontinuation of treatment, and b) their 

modifiability by the pharmacological and psychological 

treatment regimens used in the study. In cooperation with 

a research group on prodromal symptoms before firstepisode 

schizophrenia in the framework of the Competence 

Network of Schizophrenia, the risk pattern for relapses 

(relapsing disorder) was compared with the risk pattern 

for first-episode schizophrenia (employing the same 

methods of investigation). When characterised by means 

of neuropsychological indicators of vulnerability, patients 

with first-episode schizophrenia (after initial treatment) 

showed clear deficits in all test methods employed. The 

profile was qualitatively very similar to that of persons with 

92 

a (markedly) increased risk for first-episode schizophrenia. 

However, persons after first-episode schizophrenia had 

quantitatively more pronounced impairments. During the 

course of the first year of long-term treatment, persons with 

first-episode schizophrenia were characterised by slight 

improvements in cognitive functions, but a severe reduction 

compared to healthy controls was noted in nearly all areas 

tested. Using neuropsychological parameters, relapses or 

worsening of symptoms could be equally well predicted 

as by tests employing prodromal signs and symptoms 

(with prodromal signs and symptoms also permitting a 

time-related prediction). Similar results were obtained 

with neurophysiological tests (especially P300 latency and 

amplitude) as indicators of vulnerability. But not only the 

persons with increased vulnerability had an increased risk 

of relapse or clinical worsening (compared to the remaining 

persons), so did those with a higher degree of stress 

exposure or decreased coping skills (as would have been 

expected according to the VSC model), especially when these 

factors co-occurred in an individual. 

Psychological intervention strategies in the relapse 

prophylaxis of first-episode schizophrenia 

Director: G. Buchkremer, S. Klingberg (University 

Department of Psychiatry and Psychotherapy of Tübingen); 

W. Gaebel, W. Wölwer, B. Conradt (Department of 

Psychiatry and Psychotherapy of the LVR Clinic, Düsseldorf 

– Hospital of the Heinrich-Heine University, Düsseldorf); 

Schaub (Psychiatric Department of the Ludwig-Maximilian 

University, Ludwig-Maximilian University Munich); 

M. Wagner (Department of Psychiatry and Psychotherapy, 

University of Bonn); A. Bechdolf (Department of Psychiatry 

and Psychotherapy, University of Cologne) 



In accordance with the VSC concept, in addition 

to pharmacotherapeutic long-term treatment 

psychotherapeutic interventions are urgently indicated 

for relapse prophylaxis in persons with first-episode 

schizophrenia. This project dealt with the question whether 

there were differences between short- and long-term 

interventions in the two-year relapse rate. Short-term 

intervention consisted of psychoeducation over eight weeks,

long-term intervention of psychoeducation, cognitive training 

and cognitive behavioural therapy plus information for 

relatives over 12 months. These methods were applied as 

described in a manual in a randomised study design within 

the framework of the pharmacotherapeutic basic study. No 

major differences were found between the two treatment 

arms in the following outcome parameters: clinically 

relevant worsening, several psychopathological and testpsychological 

scales. Only the drop-out rate was significantly 

increased in the cognitive-behavioural therapy arm of the 

study. When interpreting the results, one has to consider the 

self-levelling (positive) effects of pharmacotherapy, “ceiling 

effects” in regard to the positive selection of persons with a 

high degree treatment compliance and the longer duration 

of the cognitive-behavioural therapy arm with the associated 

higher likelihood of drop-out. 

S3 – Schizophrenia treatment guideline 

W. Gaebel, S. Weinmann 


Financing: DGPPN and departmental research budget 

Under the aegis of the German Association for Psychiatry 

and Psychotherapy (DGPPN) and within the context of the 

guidelines/quality assurance section of the DGPPN (project 

manager: W. Gaebel), a new treatment guideline on the 

diagnosis and treatment of persons with schizophrenia 

was developed and published (see also Research 

Group on Quality Assurance in Psychiatry). With the 

participation of the Association of the Scientific Medical 

Societies in Germany (AWMF), the highest quality level of 

guideline development (S3) was followed which took into 

consideration all the elements of a systematic development 

(evidence-based medicine, achieving formal consent, 

algorithms, decision analysis and outcome analysis). Thus, 

knowledge about the (long-term) treatment of persons with 

schizophrenia is summarised on a high-quality foundation 

and made available as guideline recommendations to those 

working in clinical practice to support their decision-making 

and thus improve the quality of healthcare. 

ReseaRch 

Transfer of scientific knowledge from the Competence 

Network on Schizophrenia to healthcare practice: 

optimisation of healthcare for persons with first-episode 

schizophrenia (transfer module/TM II) 


Assistant: B. Conradt, M. Riesbeck, R. Zemlicka in 

cooperation with H.-J. Möller (Psychiatric Department of 

the Ludwig-Maximilian University Munich); J. Klosterkötter 

(Department of Psychiatry and Psychotherapy, University of 

Cologne); 

S. Klingberg (University Department of Psychiatry and 

Psychotherapy,f Tübingen) 



On the basis of the results of the above mentioned firstepisode 

study (pharmacological acute and long-term 

treatment, psychological interventions) and in cooperation 

with the research projects for early recognition of firstepisode 

schizophrenia, various structural and procedural 

measures were developed and implemented in healthcare 

practice to improve the treatment of persons with firstepisode 

schizophrenia, especially in the early phases 

of incipient schizophrenia. A central goal of optimised 

healthcare is – besides improving early recognition and 

affording the earliest possible treatment of incipient 

schizophrenia – to retain persons with first-episode 

schizophrenia for the longest possible period of time on 

a by and large effective therapy with a low degree of side 

effects. To this end, a variety of information material was 

made available – mainly to mental healthcare professionals 

– through various types of media (papers, workshops, 

seminars), providing information about the evidencebased 

knowledge on increasing adherence to therapy in 

particular. At the centre of the project is a practice manual, 

in which the characteristics of the treatment of persons 

with first-episode schizophrenia are explained, and the 

establishment of specially qualified treatment centres, 

which offer optimised therapy to persons with first-episode 

schizophrenia. These centres should be able to provide 

expert knowledge in pharmacotherapy and psychological 

methods and should guarantee the continuity of treatment 

across diverse healthcare sectors (inpatient, day care, 

outpatient). 

93


5-year follow-up of the study “Pharmacotherapeutic 

strategies for the prevention of relapse in persons 

with first-episode schizophrenia” to identify prognostic 

indicators for the course of the illness 


Assistant: R. Zemlicka in cooperation with University 

Psychiatry Departments at Berlin, Bonn, Essen, Göttingen, 

Halle, Jena, Köln, Mannheim, Munich and Tübingen 



As was described in the section on the first-episode longterm 

study (see above), more than 70% of the patients 

discontinued treatment prematurely. Of the more than 300 

individuals included in the acute study, only approximately 

70 could be followed over at least one year. A presumed 

(strong) selection bias considerably impaired disease 

course prognosis and the identification of course indicators, 

94 

especially regarding the generalisability of the results of this 

research project. Therefore, this project aimed at a 5-year 

follow up of the ca. 650 persons with schizophrenia from 

among the ca. 1370 who had been screened, to determine 

the therapeutic success and disease course of the persons 

who had been treated in the first-episode study. Further 

aims of the study were quality management and to identify 

valid risk indicators for non-response to therapy or an 

unfavourable disease course in persons with first-episode 

schizophrenia. The research project was mainly supported 

by our local working group with additional support by those 

study centres that had participated in the first-episode study, 

in particular with regard to contacting the persons who had 

participated in the first-episode study and admitting them for 

follow-up. However, the study was prematurely terminated 

because the vast majority of study participants could not be 

motivated to attend a follow-up investigation. 

Facial affect decoding training significantly improves 

the identification of emotions in a face

3.1.3.4 Destigmatisation of people with mental disorders 


Scientific assistants: A. Baumann (until 2008), H.-R. 

Cleveland (since 2009), M. Marekwica (2009-2010), H. Zäske 

Scientific assistant in cooperation with the German 

Association for Psychiatry and Psychotherapy, DGPPN): 

P. Schlamann 

Cooperation with the network headquarters of the 

Competence Network on Schizophrenia: L. Freimüller 

International and national cooperations 

s World Psychiatry Association (WPA) 

• Member of the WPA Section “Stigma and Mental 

Health” 

• Member of the Task Force on the Destigmatisation of 

Psychiatry and Psychiatrists 

• National partner of the worldwide programme 

against stigma and discrimination of schizophrenia – 

Open the doors 

• Development of the World Psychiatric Association 

Global Program Training Guide 

s AG Economou (Athens, Greece): Cooperation in 

the framework of a study on the legal situation and 

practice of hospitalisation and compulsory treatment in 

European countries 

s AG Niklewski/Richter (Skopje, Macedonia): Comparative 

analysis of population surveys 

Social Distance (Average) 

12.0 

11.5 

11.0 

10.5 

11.85 

11.42 

11.54 

11.51 

ReseaRch 

s AG Stuart/Arboleda-Florez (Kingston, Canada): 

Comparative analysis of population surveys 

s Coordinating centre for Open the Doors Germany 

s Cooperation with the Düsseldorf Anti-depression 

Alliance 

s Chair of the Mental Health Alliance (together with the 

DGPPN under the aegis of the Federal Ministry for 

Health U. Schmidt, from 2009 P. Rösler) 

Projects 

Public education: Reduction of stigma and discrimination 

of persons with schizophrenia 

Project director: W. Gaebel 

Project coordination: A. Baumann 

Scientific assistants: H. Zäske in cooperation with 

H.-J. Möller (Ludwig-Maximilian University, Munich), N. 

Sartorius (Geneva), W. Rössler (Zürich), G. Thornicroft 

(London) 


Persons with schizophrenia are heavily burdened by 

stigmatisation and discrimination in addition to their 

symptoms and the immediate consequences of the 

disorder. The lack of knowledge about the causes, types 

and treatments of schizophrenia, and the lack of contact 

with persons with schizophrenia lead to prejudices and 

negative attitudes against those afflicted by the disorder – 

and in consequence lead to stigmatisation, social exclusion 

Antistigma Awareness Control Total 

Figure 16: Evaluation of a structured programme against stigmatization compared to a programme aiming at enhancing „awareness“ of schizophrenia by 

using a representative telephone survey (N=4,568): Change in social distance (as assessed with a standardised six-item scale; the figure shows group means; 

higher group means represent a more pronounced social distance of the interviewee from people with schizophrenia) between 2001 and 2004 in six German 

cities. There is a significant reduction in social distance in cities using the antistigma programme (Düsseldorf and Munich) as compared to cities using the 

awareness programme (Bonn and Cologne) or cities without any specific intervention (Berlin and Essen). For more details see Gaebel et al., Schizophr Res. 

2008 Jan; 98 (1-3): 184-93. 

11.57 

11.44 

11.65 

11.46 

2001 

2004 

95


and discrimination. Stigma and discrimination occur not 

only as individual negative experiences of individuals with 

schizophrenia in personal contact with others, but also for 

example in legislation and in the media. In the framework 

of an adequate treatment of persons with schizophrenia 

it is necessary to fight against the stigmatisation of 

schizophrenia in the general population and in selected 

target groups. To this end, the global anti-stigma 

programme “Fighting Stigma and Discrimination because 

of Schizophrenia – Open the Doors”, initiated in 1996, is 

being implemented and evaluated in the framework of the 

Competence Network on Schizophrenia (Project 4.2.2.). 

First, a survey of needs was performed (surveys of patients 

and in the general population) to identify potential target 

groups and topics for antistigma interventions. Following 

this, anti-stigma interventions were carried out from 2001 

on in Düsseldorf and Munich (Ludwig-Maximilian University) 

and were evaluated in a pre-post design. The effects of this 

programme on the general population were evaluated using 

a representative longitudinal population survey in 2001 and 

2004. The target groups of the intervention encompass: 

s General population: public readings, art exhibitions, 

movie and theatre nights, all in association with podium 

discussions 

s Journalists: press workshops 

s Students, teachers, parents: readings in municipal 

institutions for adult education and schools 

s Expert audiences: lectures, workshops, poster 

presentations, information stands, scientific 

publications 

Basic research: Within the context of the projects 

“Communication-related causal factors of social distance” 

and “Population survey by mail in the context of the opening 

of a psychiatric day clinic and outpatient department”, 

the principles of the stigma of mental illnesses were 

investigated. 

Anti-stigma intervention: Communication of anti-stigma 

competence: in cooperation with the network headquarters 

of the Competence Network on Schizophrenia, an 

educational activity on the topic of anti-stigma competence 

was developed, piloted and evaluated. The target group are 

employees in the psychosocial and psychiatric fields. 

96 

Cooperation in the anti-stigma programme of the Alliance 

for Mental Health: Within the context of a project funded 

from 2008 to 2011 by the Federal Health Ministry, the pilot 

project of a national anti-stigma project has been created by 

means of a systematic survey of the current situation and a 

needs analysis. 

Participation as cooperation centre in international projects 

(EU-funded projects, coordination by King’s College 

London): 

INDIGO (International Study on the Discrimination and 

Consequences of Stigmatisation) 

ITHACA (International Study to Investigate the Human 

Rights Situation and General Healthcare in Care and Welfare 

Institutions) 

ASPEN (Anti-stigma Programme: European Network) 

Coordinating centre of an international survey project 

(funded by the World Psychiatry Association and the 

DGPPN): The research group is the coordinating centre of 

the “Stigma of psychiatry and psychiatrists: an international 

control group study” research project funded by the WPA and 

the DGPPN since the end of 2009.

3.1.3.5 Gerontopsychiatry and dementia research 

Director: T. Supprian (from April 2005), 

C. Kretschmar (until April 2005) 

Coworkers: C. Lange-Asschenfeldt (from August 2005), 

R. Ihl (until April 2005) 

Early diagnosis and treatment of Alzheimer’s Dementia 

Director: T. Supprian, C. Lange-Asschenfeldt, as well as, 

for the Competence Network on Dementia: R. Ihl (until 

2005), C. Luckhaus (from 2005) 

Scientific assistants: T. Salamon, B. Höft, J. Szpak, 

B. Grass-Kapanke (until 2007), I. Blaeser (until 2008) 

Cooperation (external): H. Kessler, Department of 

Psychiatry and Psychotherapy, University Hospital Saarland, 

Homburg (Saar), K. Fast, Department of Psychiatry and 

Psychotherapy, Ludwig-Maximilian University, Munich, 

as well as the Competence Network on Dementia 

(Spokesperson: W. Maier, Department of Psychiatry and 

Psychotherapy of the University of Bonn). 

Financing: Funding from the Competence Network on 

Dementia, as well as departmental research budget 

In this research area, the projects started earlier in the 

department were continued, and the memory outpatient unit 

(Director: C. Lange-Asschenfeldt) of the gerontopsychiatry 

institute outpatient clinic was used for research purposes. 

Worthy of note is the active participation in projects of the 

Competence Network on Dementia. In addition to the larger 

projects, described in more detail below, in the context of 

dissertations the working group also created an instrument 

for assessing dementia patients’ insight into their illness 

as well as the suitability of the Bielefeld Famous Faces 

Tests (BFFT) for the early diagnosis of depression and 

Alpha 

Beta 

0.8 

0.6 

0.4 

0.2 

0 

0.2 

0.15 

0.1 

0.05 

0 

* p < 0.05 

MCI AD 

MCI AD 

ReseaRch 

dementia. Other areas of interest include cardiovascular and 

metabolic comorbidity in Mild Cognitive Impairment (MCI) 

and the analysis of persons visiting an outpatient psychiatric 

memory unit. 

Projects 

Study E 1: Early and differential diagnosis 

The aim of this study, performed within the context of the 

Competence Network on Dementia, was to use the subprojects 

on neuropsychology, neurochemical dementia 

diagnostics and magnetic resonance imaging (MRI) to 

improve the diagnosis of the early stages of dementias. In 

Düsseldorf, over 160 patients with Mild Cognitive Disorders 

(MCI) and beginning dementia were included. The annual 

follow-up investigations were concluded in the summer of 

2008. As an associated satellite project in Düsseldorf, an 

MRI study was carried out with the aim of assessing regional 

cerebral perfusion by means of perfusion-weighted MRI in 

MCI and beginning Alzheimer’s Dementia (AD). This new 

imaging technique, which allows structural and functional 

MR imaging within a single investigation, showed early ADspecific 

alterations at the MCI stage. In addition, it also 

provided information about increases in regional cerebral 

perfusion, which correspond to functional compensation 

mechanisms for activation, in the subgroups amnestic MCI 

and beginning AD. An add-on EEG investigation was also 

carried out in cooperation with the psychophysiology unit. 

Routine surface EEG was recorded in the majority of the 

individuals included in E1. In the individuals included in E2.2, 

32-channel surface EEG was recorded before and during 

pharmacological treatment, including recording eventcorrelated 

potentials (P300). Computer-assisted quantitative 

Delta 

Theta 

2 

1.5 

1.0 

0.5 

0 

0.6 

0.4 

0.2 

0 

FZ (Front zone) CZ (Centrocentral area) PZ (Parietocentral area) 

MCI AD 

MCI AD 

Figure 17: Investigations into the change of brain-electrical activity using electroencephalography (EEG) in the progression from MCI (Mild Cognitive Impairment) 

to early Alzheimer’s Dementia. Four frequency bands of normal rest activity are represented in the EEG (Alpha, Beta, Theta, Delta) in three brain areas, FZ 

(central frontal area), CZ (Centrocentral area) and PZ (Parietocentral area). This showed a statistically significant divergence of Alpha activity in the parietal zone 

which was specific to both frequency band and brain area (no significant EEG change in other regions or other frequency bands). Figure modified after: Luckhaus 

et al.: Quantitative EEG in progressing vs stable mild cognitive impairment (MCI): results of a 1-year follow-up study; Int J Geriatr Psychiatry 2008 (11): 1148-55. 

97


Alpha 

evaluation is being used to address the question of whether 

EEG alterations in MCI or beginning AD are associated with 

the course of the illness and drug effects (v. Figures 17 and 

18). 

Study E 2.2: Pharmacological treatment of 

patients with mild cognitive impairment 

The subject of this 24-month treatment study within 

the context of the Competence Network on Dementia 

was the preventive effectiveness of early anti-dementia 

treatment in patients with mild cognitive impairment (MCI). 

In Düsseldorf, 30 patients were included in the study. 

They were treated in a double-blind study design with 

placebo, the acetylcholinesterase inhibitor galantamine or 

with a combination of galantamine and memantine. The 

administration of study drugs in this study was terminated 

prematurely because two major, international, multicentre 

98 

FZ (Front zone) CZ (Centrocentral area) PZ (Parietocentral area) 

1.0 

0.8 

0.6 

0.4 

0.2 

0.0 

S-MCI P-MCI AD 

Figure 18: Investigations into the change of brain-electrical activity using 

electroencephalography (EEG) in the progression from MCI (Mild Cognitive 

Impairment) to early Alzheimer’s Dementia. Represented is the so-called 

alpha frequency band (8-12 Hz) of normal resting activity in the EEG in 

three brain areas, FZ (Front central area), CZ (Centrocentral area) and PZ 

(Parietocentral area). This showed a statistically significant decrease of the 

normal Alpha activity in the parting zone in Alzheimer patients (AD) compared 

with a clinically stable MCI (S-MCI), although there was also an Alpha 

reduction in clinically progressing MCI syndromes (P-MCI) in comparison with 

clinically stable MCI patients. This represents an EEG-based differentiation of 

various early forms of cognitive disorders, which will be investigated in later 

studies in terms of their predictive value for the development of Alzheimer’s 

in cases of MCI. Figure modified after Luckhaus et al.: Quantitative EEG in 

progressing vs stable mild cognitive impairment (MCI): results of a 1-year 

follow-up study. Int J Geriatr Psychiatry 2008 (11): 1148-55 

studies that tested the effectiveness of galantamine in the 

aforementioned indication found no improvement in the 

primary outcome variable “conversion rate”. The last followup 

investigations of the Düsseldorf study participants were 

concluded in the spring of 2006. 

Study E 3.2: Identification of 

genetic markers for dementia disorders 

The aim of this study, also performed within the context of the 

Competence Network on Dementia, was to elucidate the role 

of genetic factors as the cause of dementia disorders. Several 

genes may influence the disease risk in sporadic forms. The 

aim of this study is the search for dementia risk genes and 

the identification of genes which modify the disease course 

and the therapeutic response. To this end, a central DNA 

bank was established. The LVR-Klinikum participates in the 

collection of specimens. 

Project Experimental Gerontopsychiatry 

Director: C. Lange-Asschenfeldt 

Scientific assistants: P. Görtz, U. Henning 

Cooperation (internal): C. Luckhaus, General Psychiatry II 

Department 

Cooperation (external): G. Kojda, Pharmacology Heinrich- 

Heine University, M. Siebler, MediClin Essen-Kettwig, 

M. Riepe, Gerontopsychiatry, University of Ulm, M. Dihné, 

Department of Neurology Heinrich-Heine University, 

Düsseldorf, A. Schnitzler, Department of Medical Psychology 

and Neurosciences, Heinrich-Heine University, Düsseldorf, 

D. Willbold (Jülich Research Centre). 


This project deals with experimental methods to study 

synaptic plasticity and neuronal network activity. 

It also deals with pharmacological effects on such 

systems and develops both in vivo and in vitro models of 

neurodegenerative disorders. The methods used include 

– among others – microelectrode arrays, primary cortical 

and hippocampal neuronal cell cultures (mouse and rat), 

fluorescence microscopy, extracellular field potential 

recordings in acute and organotypic hippocampal slices 

(mouse and rat) and immunoblotting. In several research 

projects, performed in collaboration of the above mentioned 

partner laboratories, the effects of amyloid-ß (1-42) 

administration on spontaneous neuronal network activity 

and its putative pharmacological manipulation is being 

studied in microelectrode arrays (Figure 19).

Burst rate 

140 

120 

100 

80 

60 

40 

20 

0 

* 

DMSO 10 nM 100 nM 1.000 nM DMSO 10 nM 100 nM 1.000 nM 

Acute effects 

Project Drug Safety in Gerontopsychiatry 

Director: C. Lange-Asschenfeldt 

Scientific assistants: P. Görtz, A. Gillmann 

Cooperation (internal): J. Cordes 

Cooperation (external): R. Grohmann, Ludwig-Maximilian 

University, Munich 

Drug safety in psychiatry project (“Arzneimittelsicherheit in 

der Psychiatrie”, AMSP), 

B. Lange-Asschenfeldt, Dermatology, Charité Berlin, 

F. Lederbogen, ZI Mannheim 

Financing: Foundation for Geriatric Research at the 

Heinrich-Heine University, Düsseldorf, plus departmental 

research budget 

Within this thematic area, the working group investigates 

the undesired effects of drugs and their preconditions, as 

well as general drug safety in older age. Current special 

focuses are psychotropic-drug–induced hyponatraemia, 

the syndrome of inadequate antidiuretic hormone secretion 

and cardiac tolerability of psychotropic drugs. The group 

used the database of the clinical laboratory of the LVR- 

Klinikum from the years 2003-2006 to identify cases of 

hyponatraemia in gerontopsychiatry and general psychiatry 

inpatients separately. These data were related to the sample 

of all persons treated at the LVR-Klinikum. Based on a 

retrospective analysis of case records, risk factors and risk 

conditions were determined, including a “risk ranking” of 

psychotropic drugs. Besides this project, notifications of 

unwanted dermatological drug effects in 1993-2005 from 

70 participating psychiatric hospitals and departments in 

Germany, Austria and Switzerland (as of December 2008) 

were evaluated in the framework of the drug monitoring 

project AMSP. 

* 

* 

Effects after 24 hours 

ReseaRch 

Figure 19: Effects of an amyloidal protein on spontaneous neuronal network 

activity in cell cultures (microelectrode array). Left: Significant (*) dosedependent 

suppression of spontaneous burst rates after administration of 

the amyloidal protein Ab(1-42) to the cell culture medium in concentrations 

of 10-1000 nM/L (carrier substance DMSO = control). Right: Reversibility 

of the amyloidal-induced suppression of the burst rate after 24 hours. 

The system represents a cell culture model for synaptic or network 

dysfunctions, including how they could appear in the early stages of 

Alzheimer’s; Figure modified after Görtz P et al.: Transient reduction of 

spontaneous neuronal network activity by sublethal amyloidal ß (1-42) 

concentrations. J Neural Transm (2009) 116: 351-355. 

Use of microelectrode arrays with neuronal cell cultures 

(mice and rats) in experimental psychiatry 

99


A discussion between members of the gerontopsychiatry research team 

Project Outpatient Care in Gerontopsychiatry 

Director: B. Höft 

Scientific assistants: J. Dolgner, T. Kobuß, M. List 

Cooperation (external): ): Dementia Service Centre for the 

Düsseldorf Region (Office of Social Security and Integration, 

City of Düsseldorf in cooperation with Alzheimer’s Society, 

Düsseldorf & Kreis Mettmann e. V.); Caring services 

to relieve care-giving relatives (“Betreuungsangebote 

zur Entlastung pflegender Angehöriger”, BEAtE) as a 

cooperative organisation (Caritasverband Stadt Düsseldorf 

e. V., Kaiserswerther Diakonie, Diakonie in Düsseldorf, 

German Red Cross, Düsseldorf); State-initiative 

Dementia Service for North Rhine-Westphalia (Ministry 

for Employment, Health and Social Issues for the state 

of North Rhine-Westphalia and the state welfare funds); 

Gerontopsychiatry and Care in Gerontopsychiatry Working 

Group at the Düsseldorf Health and Care Conference 

Financing: Ministry for Employment, Health and Social 

Issues for the state of North Rhine-Westphalia and State 

associations of welfare funds within the “NRW Dementia 

Service” state initiative. 

100 

s The research in this area includes setting up and 

continuing investigations relating to the optimisation of 

outpatient assistance for individuals with dementia in a 

metropolitan environment (healthcare, cooperation and 

supportive conditions). Experience shows that persons 

with dementia who have informed and committed 

relatives are characterised by low thresholds for entry 

into the healthcare system in Düsseldorf. The research 

group is closely associated with the Düsseldorf 

dementia network, which was founded by the local 

cooperation partners – the Dementia Service Centre, 

Caritas, the German Red Cross, Diakonie in Düsseldorf, 

Kaiserswerther Diakonie and the Gerontopsychiatry 

Institute outpatient department of the LVR-Klinikum – 

to cover the following three main topics: 

s Consultation services that actively approach people 

with dementia 

s Home care and care agency for hour-wise relief of 

relatives at home 

s Care groups for relieving nursing relatives

Within the “Active approach consultation” model project 

of the Düsseldorf dementia network, in addition to lowthreshold 

care groups (BEAtE) and home care for dementia 

patients, volunteers from this working group set up an 

active approach consultation service as the third part of this 

project. This is aimed at those individuals with dementia who 

– because of their dementia – cannot perceive their need 

for help and therefore do not use assistance or even refuse 

it. The aim is to inform these individuals and their relatives 

about the opportunities for help and motivate them to use 

these opportunities. Gerontopsychiatric-consultative home 

visits (performed by a specialist from the gerontopsychiatric 

institutional outpatient clinic with gerontopsychiatric 

experience and the administrator of the BEAtE group 

nearest to the place where the person with dementia lives) 

allow the person with dementia to enter the support system 

before a crisis occurs because of a lack of diagnostic efforts 

or treatment and because of long-lasting inadequate care of 

the individual, all of which may even lead to hospitalisation 

or admission to a nursing home. In the model phase 

of the project, approximately 70 persons with cognitive 

impairments who refused assistance and lacked insight into 

the nature of their mental illness received consultations, as 

did their families. In 54 cases, home visits were made. 

Alzheimer’s Dementia and cognitive disorders in 

systemic lupus erythematosus 

Director: M. Haupt (until September 2002 Gerontopsychiatry 

Department of the LVR Clinic, Düsseldorf, from October 

2002 Neuro-Centre Düsseldorf, Neurological Research 

Institute, primary practice – brain performance disorders) 

Scientific assistants: A. Karger, B. Höft, M. Jänner, S. Müller 

Cooperation (external): M. Schneider, Department of 

Rheumatology, Heinrich-Heine University, Düsseldorf; 

Kuratorium Deutsche Altershilfe (KDA) and the University of 

Witten/Herdecke; Alzheimer-Gesellschaft Düsseldorf und 

Mettmann e. V. 

The main task was to plan, coordinate and execute a 

scientific programme on the detection and treatment of 

Alzheimer´s disease as the most frequent type of dementia 

of older age. Another focus was research into cognitive 

impairments in systemic lupus erythematosus (SLE). In 

one of the projects, neuropsychological tests were used to 

assess cognitive impairments in a sample of 100 people 

with SLE. These were correlated with somatic disease 

parameters like accelerated vascular aging. Based on this 

project, another project dealt with a highly structurised and 

manualised psychoeducation therapy in individuals with 

SLE and mental problems. This lead to an improvement of 

depression, anxiety and general disease load. Annual public 

sessions and joint sessions with the Alzheimer Society 

ReseaRch 

Düsseldorf and Mettmann informed the regional and supraregional 

public about the state of knowledge about dementia 

disorders. In addition, the workgroup participated in the 

writing of a scientifically based national guideline about 

dementia disorders coordinated by the University Witten/ 

Herdecke (2002-2003; cooperation in the topics behaviour 

disorders, drug therapy, psychotherapy, psychoeducation), 

the curriculum for advanced education and specialisation in 

gerontopsychiatry and gerontopsychotherapy of the German 

Academy of Gerontopsychiatry and Gerontopsychotherapy 

(DAGPP) (2003-2004; collaboration on the topic “dementia 

disorders”), and the framework recommendations for 

nursing care of individuals with dementia commissioned 

by the Federal Health Ministry in cooperation with the 

Kuratorium Deutsche Altershilfe and the University Witten/ 

Herdecke (2003-2004: member of the expert committee). 

Test situation for determining cognitive impairment 

101


3.1.3.6 Comorbidity in people with mental disorders 

Director: J. Cordes 

Scientific assistants: G. Regenbrecht, 

C. Schmidt-Kraepelin, F. Hellen, K. Beseoglu, L. Kostorz 

Doctoral candidates: P. Messinger, O. Messinger, 

M. Woite, F. Keskin 

Internal cooperation: W. Wölwer, J. Zielasek, 

C. Lange-Asschenfeldt, U. Henning, W. Gaebel, A. Klimke, 

HW. Müller, C. Antke, R. Larisch, J. Thünker 

External cooperation: University of Bochum: MW. Agelink, 

J. Kornischka, G. Juckel, U. Sprick; University and Technical 

University Munich: R. Grohmann, H. Hauner; University of 

Dresden: C. Kirschbaum, University of Bremen: B. Kudielka, 

University of Hanover: K. Kahl, Alexianer; Krefeld Hospital: 

A. Horn, J. Hummes, H. Eich; Psychiatric Hospital Aalborg, 

Denmark: P. Munk-Joergensen; Hospital General Carlos 

Haya in Málaga, Spain: G. Orozco 

Allergic exanthemas after treatment 

with psychotropic drugs 

J. Cordes, C. Lange-Asschenfeldt, D. Geßner, R. Grohmann 


Financing: departmental research budget 

Allergic skin reactions are potentially severe complications 

and in individual cases may have considerable consequences 

for the duration of treatment and treatment compliance. 

There is a lack of data about the risk of allergic reactions after 

therapy with psychotropic drugs and the potential risk factors. 

In the framework of the above mentioned project “Drug safety 

in psychiatry”, 221 severe drug-induced allergic exanthemas 

were reported from 1993 until 2003, making exanthemas the 

third most frequent side effect. An analysis was performed 

regarding the frequency of use of psychotropic drugs in this 

sample dataset (Figure 20). 

Antipsychotics (19 %) 

Antidepressants (29 %) 

102 

Others (12 %) 

Lithium carbonate (1 %) 

Anti-epileptics, 

mood stabilisers 

(39 %) 

View into the neurobiochemical research laboratory 

Physical illness in mental disorders 

J. Cordes, W. Gaebel, J. Zielasek, P. Munk-Joergensen 


Financing: departmental research budget, Pifzer Pharma 

GmbH, Tanita Europe 

This local sub-project of an international multi-centre quality 

assurance programme to detect comorbidity in mental 

disorders included a weekly assessment of the presence 

of the metabolic syndrome in psychiatric inpatients. In 

addition, an impedance assessment of the visceral fat index 

(VFI) was performed. The dataset contains 225 males and 

252 females with an average age of 43.1±14.5 years and 

an average observation period of 12 weeks. An increase 

in body weight and VFI and decrease in HDL was found at 

4 weeks in a significantly higher proportion of males than 

females. Higher age was associated with an increased 

prevalence of cardiovascular risk factors, increased body 

weight, elevated mean fasting blood glucose levels, increased 

mean triglycerides levels and decreased levels of HDL. All 

study participants showed a significant increase in mean 

body weight, BMI, overweight, waist circumference, VFI 

and triglycerides over 12 weeks. Correlations (Spearman´s 

coefficient) were found between VFI and BMI, waist 

circumference, triglycerides, fasting blood glucose and total 

Figure 20: Relative frequency of individual psychopharmaceutical groups 

as triggers of allergic skin reactions; Figure (modified) after Lange- 

Asschenfeldt et al. Cutaneous adverse reactions to psychotropic drugs: data 

from AMSP Multicenter Surveillance Program. J Clin Psychiatr 2009, 70: 

1258-1265

cholesterol. These results demonstrate the negative effects 

of inpatient treatment on cardiovascular risk factors and 

metabolic parameters. 

Influence of psychosocial burden, alcohol detoxification 

and hypothyreosis on saliva cortisol levels 

J. Thünker, J. Cordes, A. Klimke, P. Messinger, 

C. Kirschbaum, B. Kudielka, U. Henning, M. Warnecke, 

L. Kostorz, R. Larisch, HW. Müller, C. Antke, M. Woite 


Financing: departmental research budget, Servier Pharma 

Nineteen healthy controls and 32 persons with partially 

remitted depression were studied. The Trier Social Stress 

Test was used as a social stressor, in which after a short 

preparation time a free speech of a few minutes duration 

has to be delivered. Cortisol, noradrenaline and dopamine 

were measured before and 10, 20, 30, 45 and 60 minutes 

after the test. In addition, study participants completed five 

self-rating scales including the Measure to Assess Stress 

Proneness (MESA) and the Trier Inventory to Measure 

Chronic Stress (TICS). The BDI was used to assess levels of 

depression. When both groups were compared, differences 

were found in depression scores (t(35)=3.177, p=0.003); 

stress proneness (MESA, t(37)=2.153, p=ß.038); the two 

subscales of the TICS, “sorrows” (t(35)=2.135, p=0.040) 

and “burdening memories” (t(35)=2.297, p=0.028); and the 

neuroendocrinological parameter noradrenaline (F(1)=5.283, 

p=0.030). Correlations between neurophysiological and 

psychological measures were found for dopamine and the 

sleepiness scale of the multidimensional mental state scale 

(MDBF; r


Serum prolactin (µIU/ml) 

as well as Professor Hippius and Dr. Grohmann (Munich). 

The system is used to record clinically significant severe 

side effects. All recorded cases are discussed in central 

conferences, and the correlation between undesirable 

effects and the medication administered is evaluated. Biannual 

investigations of census samples allow a comparative 

estimation of the relative frequency of undesirable drug 

side effects for various psychotropic drugs. In addition, case 

documentation is used for the casuistic analysis of unusual, 

new side effects. 

104 

400 

360 

320 

280 

240 

200 

160 

800 

400 

250 

200 

150 

100 

50 

0 

-50 

Change in prolactin level (µIU/ml) 1.200 

Comparison group 

Patients 

120 -40 -20 0 20 40 60 80 100 120 140 

Time (min) 

Control group Unmedicated Medicated 

(n=12) (n=6) (n=14) 

Serum cortisol (ng/ml) 

200 

180 

160 

140 

120 

100 

80 

Comparison group 

Patients 

60 -40 -20 0 20 40 60 80 100 120 140 

Time (min) 

Figure 21: Serum hormone concentration (A, B) and maximum individual change in hormone levels after clomipramine infusion (C, D) prolactin (A, C) and cortisol 

(B, D) in control groups as well as patients in remission after an acute manic-depressive illness or depression, before and after the end of psychopharmaceutical 

treatment (unmedicated vs. medicated). Figure modified after Cordes et al., Depression and Anxiety 2009; 26:E111-E119. 

Change in cortisol level (µIU/ml) 

200 

150 

100 

50 

0 

-50 

Control group Unmedicated Medicated 

(n=12) (n=6) (n=14) 

Prevention of weight gain and metabolic changes during 

treatment with olanzapine: a randomised clinical trial 

J. Cordes, J. Thünker, A. Klimke, H. Hauner, B. Schuler, 

H. Franken-Rugies, C. Humpf 


Financing: Lilly GmbH Deutschland 

A total of 100 persons with schizophrenia newly treated with 

olanzapine were included. After four weeks of screening, 

participants were randomised into two groups: a prevention 

group (n=36), which participated in a psychoeducative weight 

management programme, and a control group (n=38), which

eceived only brief information about the prevention of weight 

gain. The remaining individuals (n=26) prematurely terminated 

their participation during the screening phase or did not 

fulfil inclusion criteria. In the diet group, a group therapy 

was offered every fortnight over for weeks in which patients 

worked interactively on eating and exercise behaviour with a 

dietary assistant. The following parameters were assessed: 

body mass index (BMI), physiological and laboratory 

parameters (including glucose tolerance), eating behaviour 

(FEV), physical activity (Freiburger Aktivitätsbogen), quality of 

life (LQLP), health state (SF-36, CGI, PANSS) and psychosocial 

adaptation (GAF). Follow-up was performed after 48 weeks. 

Thirty-four percent of the participants completed the study. 

At 48 weeks weight increase (PG: 5.2+7.9 kg, CG: 10.4+7.4 

kg) and increase of waist circumference (PG: 4.6+8.3 cm, 

CG: 10.7+7.3 cm) were lower in the prevention group (PG) 

than in the control group (CG). However, the differences were 

not significant. While the participants in the CG showed a 

worsening of glucose metabolism in the glucose tolerance 

test, this effect was prevented in the PG. These first results 

indicate the preventive efficacy of weight management in 

antipsychotic drug treatment of persons with schizophrenia 

with respect to the development of impaired glucose 

tolerance. 

Double-blind comparison of the cardiovascular side 

effects of olanzapine and clozapine in a randomised, 

multi-centre study 

R. Dittmann, A. Klimke, J. Cordes, C. Schmidt-Kraepelin, 

F. Hellen, A. Ruttmann 



In this randomised, double-blind study, two groups of 

patients were investigated. Of these, one received olanzapine 

at daily doses of between 5 and 25 mg (women n=23, men 

n=35), and the other clozapine at daily doses between 25 and 

450 mg (women n= 22, men n=35). The study participants, 

who were initially treated as inpatients, were weighed 

before the start of treatment, during various visits and at 

the end of the investigation after 26 weeks. An analysis of 

variance was carried out with repeated measurements for 

the factors medications and sex. In addition, Spearman’s 

Rank Correlation Coefficient was calculated between 

weight gain and age, initial weight and the ratios of 

psychopathological scales (CGI-S, PANSS positive, negative 

and general psychopathology scale). Results: both treatment 

groups gained weight. There was no significant difference 

between the mean weight gain (mean value ± SD) in study 

ReseaRch 

participants receiving olanzapine (+3.2± 5.7 kg) and those 

receiving clozapine (+5.4±6.6 kg). In those treated with 

olanzapine, there was no significant difference between 

male and female study participants (p=0.986). Interestingly, 

in those treated with clozapine, there was a significantly 

larger weight gain in men than in women (p=.001). Overall, 

younger individuals (r=-.237, p=.008) and individuals with 

better treatment successes demonstrated greater weight 

gains (CGI-S: r=-.385, p=.043; PANSS positive: r=-.281, 

p=.003, PANSS negative: r=-.195, p=0.043; PANSS complete: 

r=-.313, p=.001; SWN: r=.270, p=.005). 

Effectiveness of weight management programmes for the 

prevention of weight gain in patients with schizophrenia 

treated with olanzapine: a randomised, multi-centre, 

controlled open study 

J. Cordes, G. Juckel, M. Bruene, C. Schuhmacher, J. Hahn, 

U. Sprick, A. Horn, H. Eich, J. Hummes 



This study evaluates the BELA psychoeducative manual, 

which is already used extensively in clinical practice, with 

regard to the effect of preventing weight gain and metabolic 

parameters in patients treated with olanzapine and 

quetiapine. 

105

Team of the Research Group on quality 

management and health care research 

3.1.3.7 Quality management and healthcare research 


Assistants: B. Janssen, J. Zielasek, C. Schmidt-Kraepelin, 

K. Sommerlad, M. Jänner, R. Zemlicka 

Doctoral candidates: S. Mai, A. Pelzer, J. Fiege 

Benchmarking in acute psychiatric treatment 

(W. Gaebel, B. Janssen, M. van Brederode, R. Kukla) 

Project period: 2004–2006, 

Financing: Federal Ministry of Health and Social Issues 

BMGS 

The project, realised in a model network of the nine 

psychiatric departments of the Rhineland Regional 

Association (LVR), is designed to achieve the following major 

targets: 

1. Quality improvement in treatment strategies and 

treatment results in three selected diagnosis groups 

(depression, schizophrenia and alcohol dependence) 

on the basis of a benchmarking-supported systematic 

development process, according to a best practice 

model. 

2. The use of optimised treatment guidelines and treatment 

paths for individuals from the diagnostic focus groups 

with special consideration of persons with severely 

chronified disease courses or the imminent threat of 

chronification. 

A detailed description of the project activities, including the 

final report, can be found at www.lernen-vom-besten.de 

106 

Optimisation of post-inpatient care of persons with 

schizophrenia through guideline-supported medical, 

psychoeducative and socio-therapeutic measures 

B. Janssen, W. Gaebel 


Financing: Techniker Krankenkasse, Barmer Krankenkasse 

and Deutsche Angestelltenkrankenkasse within the context 

of a model project in accordance with § 63/65 Social Code 

Book V 

The aim of this project is to improve satisfaction and quality 

of life in a “high-risk group” of persons with schizophrenia, 

who have previously been hospitalised, by avoiding further 

early, stressful and costly readmissions. This aim should 

be achieved by means of an improved cross-sectoral 

outpatient/inpatient coordination and networking in aftercare; 

in addition, evaluated psychoeducative and sociotherapeutic 

procedures that, hitherto, have only been 

individually assessed for efficacy, will be assessed as 

integrated elements of a complex therapeutic aftercare 

programme. This after-care programme is made 

available by a multi-disciplinary specialist team of doctors, 

psychologists, nurses and social workers and can be used 

in a guideline-based fashion by the office-based psychiatrist 

or neurologist/psychiatrist, if the person with schizophrenia 

agrees. The project is then seen, as a whole, as a model for 

an integrated, guideline-assisted preventive treatment in 

a politically important field of psychiatric care. In the NRW 

2004 Health Prize competition, the project was awarded 

the first prize and accepted into the “Healthy State of North 

Rhine-Westphalia” association: 

www.gesundheitspreis.nrw.de 

Transfer project “Quality management schizophrenia” 

Director: W. Gaebel in cooperation with M. Berger (Freiburg) 

Assistants: B. Janssen, C. Schmidt-Kraepelin 


Financing: Federal Ministry for Education and Research 

FMER (within the Competence Network on Schizophrenia) 

In the quality management projects under the umbrella 

of the Competence Network on Schizophrenia, a range of 

instruments and methods for guideline implementation in 

outpatient/inpatient treatment settings was developed and 

evaluated for people with schizophrenia (e.g. electronic 

quality-oriented documentation system, interactive decision 

support system [Figure 22], benchmarking of treatment 

outcome and guideline adherence). The objective of the third 

funding period is to collate the broad experiences gathered 

to date and to ensure that they are transferred fully into 

routine care through the publication of a range of so-called 

quality management modules. In addition to instructions

egarding compiling quality-related documentation and 

their meaningful statistical evaluation, it is also planned 

to offer assistance for creating internal and external 

quality management systems in outpatient practice and in 

hospitals. The implementation practice will be supported by 

establishing a competence centre for quality management in 

mental healthcare. 

Improving network cooperation 

W. Gaebel, B. Janssen, H. Schneitler, R. Zemlicka 


Financing: Rhineland Regional Association 

This project is designed to improve the cooperation between 

the LVR-Klinikum Düsseldorf and the complementary 

institutions of the City of Düsseldorf within the Mental 

Healthcare Sector 1. The main topic is the definition 

of healthcare pathways for people with severe mental 

illnesses. (Awarded the “Healthy State of NRW” prize 2009). 

Benchmarking Project 

W. Gaebel, F. Kitzig 


Financing: Rhineland Regional Association 

The project is designed to introduce routine benchmarking 

between all clinics of the Rhineland Regional Association 

(LVR) for, at present, two diagnostic groups (schizophrenia 

and depression). To develop regular benchmarking, there 

has been close collaboration with the LVR KIS working group 

and to develop quality indicators, with the existing DGPPN 

working groups. 

Transfer Project Quality Management in Depression 

M. Haerter, I. Bermejo, W. Gaebel, R. Menke 



FMER (within the Depression and Suicidality Competence 

Network) 

Notwithstanding the significant progress made in the 

treatment of people with depression, existing guidelines 

and multi-dimensional care models are not yet being 

taken into sufficient consideration by general practitioners, 

specialists and psychotherapists. An evaluation of the 

former quality management projects under the umbrella 

of the Competence Network on Depression indicates, 

however, that the implementation of treatment guidelines 

and associated quality management measures helps to 

improve the treatment of depression. The main objective 

of this project is the transfer of the established guidelines 

and quality management tools into routine mental 

healthcare, with discussions being held with general 

PANSS positive score 

15 

14 

13 

12 

10 

9 

8 

ReseaRch 

PC+EDS PD+QZ PC PD 

Start of study 3 months 6 months 9 months 12 months 

EDS = Documentation software supporting decisions 

PD = Paper documentation 

PC = PC documentation 

QZ = Quality circle 

Figure 22: Guideline implementation using documentation software to 

support decisions has a positive influence on the guideline adherence in the 

treatment of schizophrenia patients as well as on the quality of the treatment 

result; here: positive symptoms in the course of treatment (Positive symptom 

score of the Positive and Negative Symptom Scale (PANSS)); Figure (modified) 

after: Janssen et al. Improving outpatient treatment in schizophrenia: Effects 

of computerized guideline implementation – results of a multicenter-study 

within the German Research Network on Schizophrenia. Eur Arch Psychiatry 

Clin Neurosci 2009; 260: 51-57 

practitioners, specialists and psychotherapists as well 

as psychiatric-psychotherapeutic hospitals within the 

context of a naturalistic study design. By implementing ITbased 

documentation and further education materials, the 

treatment routine – particularly with regard to cooperation 

and transfer procedures – will be coordinated and improved. 

Interfaces between documentation systems 

in care and research 

W. Gaebel, R. Menke, W. Oertel, G. Antony 


Financing: Telematics Platform for Medical Research 

Associations TMF, Berlin 

Within this project, three objectives, closely linked in terms 

of content, are being pursued: 

s The creation of a principal technical/theoretical 

consensus guideline for the implementation of 

interfaces between documentation systems in 

healthcare and research. 

s The preparation of corresponding standardised data 

models in cooperation with SCIPHOX and CDISC. 

s Agreement and exemplary implementation of a 

modular documentation and guideline platform for the 

neuropsychiatric competence networks in medicine. 

107

As a result of the planned project work, a complete 

package of generic specification profiles can be made 

available for networkable documentation platforms. In 

addition, the necessary conceptual, legal and technical 

preconditions are created to place the recruitment of 

extensive samples for clinical studies and epidemiological 

and economic studies on a broader basis. In addition, 

within the framework of a business model, economic 

framework conditions can be defined, in order to place any 

future adaption and implementation by other competence 

networks on a basis that would ensure success. Finally, 

practical experience values will be assured through the 

exemplary implementation of a case implementation of the 

neuropsychiatric research networks. 

Research project for the cross-sectoral analysis of 

healthcare of people with mental disorders: “Crossdisciplinary 

and –sectoral healthcare analysis with the 

aim of optimising the healthcare situation of people with 

mental and psychosomatic illnesses” 


Scientific assistants: J. Zielasek, S. Kowitz 

Financing: Federal Medical Chamber 

Cooperation partner: Federal Medical Chamber; DGPPN, 

IGES Institute of Health System Research, Berlin; VdEK, 

Berlin; HKK, DAK, KKH. 

In this third-party–funded project, obtained from the 

DGPPN in 2008 and funded within the healthcare research 

programme of the Federal Medical Chamber, for the first 

time data from three health insurance companies will be 

combined anonymously with the datasets from the German 

Pension Insurance Association in order to carry out a 

cross-sectoral analysis of the utilisation of health services 

because of mental disorders. Indicators for over-, underand 

inadequate healthcare will be identified and analysed. 

In addition to descriptive statistical procedures, methods 

will also be used to model healthcare systems. The aim is to 

obtain information regarding the necessary improvements 

in mental healthcare by analysing treatment pathways and 

identifying predictors of unfavourable disease courses such 

as somatic comorbidity. 

Additional Mental Health Survey within the 

German Health Survey 2009-2011 


Scientific assistant: J. Zielasek 

Financing: DGPPN, Federal Health Ministry 

Cooperation partner: DGPPN; Institute for Psychology, TU 

Dresden (U. Wittchen), Robert Koch Institute Berlin (B. Kurth) 

In this project, funded by the DGPPN, the project group has 

carried out – within the context of the new additional Mental 

108 

of the German Health Survey (Project director: Robert Koch 

Institute, Berlin) – investigations since 2008 into the early 

diagnosis of psychotic disorders in the general population by 

means of questionnaire interviews with around 7,000 German 

citizens. The investigations are designed to determine the 

frequency of subclinical psychotic symptoms in the general 

population in a cross-sectional study and then follow up these 

individuals in future surveys, thereby providing new knowledge 

about the prospective significance of subclinical psychotic 

phenomena in healthy adults, which could be significant for 

the early diagnosis and prevention of psychoses. 

3.1.3.8 Transcranial magnet stimulation 

Director: J. Cordes 

Scientific assistants: E. Ben Sliman, K. Hoppe, 

S. Arnau, T. Nolting, J. Brinkmeyer, S. J. Kim, J. Kotrotsios, 

L. Kostorz, M. Arends, F. Hellen 

Clinical assistants: J. Closset, C. Lange-Asschenfeldt, 

B. Stueken, T. Salamon, J. Malevani, C. von Hirsch, 

J. Kotrotsios, C. Huck 

Doctoral candidates: S. J. Kim, J. Kotrotsios 

Internal cooperation: W. Wölwer, W. Gaebel, 

A. Mobascher, P. Kienbaum, T. Klenzner, C. Plettenberg 

External cooperation: Ruhr University, Bochum: 

M. W. Agelink, J. Kornischka; Georg-August University, 

Göttingen: P. Falkai, T. Wobrock; University of Regensburg: 

B. Langguth, G. Hajak, P. Eichhammer, M. Landgrebe; 

Offenbach City Hospital: A. Klimke 

Financing: German Research Association (GRA) 

16 

14 

12 

10 

8 

6 

4 

2 

0 

GAF Score Health Survey (Coordinator: U. Wittchen, Dresden) as part 

Control group rTMS 

Figure 23: Statistically significant (p=0.048) improvement of global 

functioning (measured as improvement in the Global Assessment of 

Functioning (GAF) scale) in patients with schizophrenia with pronounced 

negative symptoms (score on the negative symptom scale of the Positive 

and Negative Symptom Scale (PANSS) > 17) after treatment with repetitive 

transcranial magnetic stimulation (rTMS) compared to a control group 

(figure modified after: Cordes et al., Psychiatr. Res. 2009; DOI:10.1016/j. 

psychres.2009.01.014)

Effectiveness of rTMS in persons with schizophrenic 

psychoses in partial remission: A randomised doubleblind, 

two-arm, placebo-controlled study 

J. Cordes, M. Arends, J. Thünker, M.W. Agelink, 

A. Mobascher, G. Kotrotsios, S. J. Kim, W. Wölwer, 

J. Brinkmeyer, U. Henning, A. Klimke, G. Winterer, 

T. Wobrock, T. Schneider-Axmann, W. Gaebel 


Financing: Departmental research budget, Alpine Biomed 

This extensive study primarily aims to investigate in a 

placebo-controlled design the clinical effectiveness of 

high-frequency 10 Hz rTMS on psychopathology (Clinical 

Global Impression, PANSS Positive and Negative Scale) 

and cognition as an add-on treatment in people with 

schizophrenia in partial remission. In addition, against the 

background of new reports relating to reduced cardio-vagal 

modulation in patients with schizophrenia on the one hand 

and a non-specific activation of the sympathetic modulations 

following rTMS treatment in controls on the other, for the 

first time the effects on the HPA axis, monoamine system 

and the autonomous nervous system will be investigated. 

This goes together with the investigation of the effects on 

the diurnal cortisol profile before and after the series of 

treatments, as well as the acute effects of rTMS treatment 

on peripheral monoamine metabolites. In total, 10 serial 

10 Hz rTMS treatments were applied via the dorsolateral 

prefrontal cortex; parallel to this, before and during the 

course of the treatment, serial measurements were taken, 

in accordance with standardised guidelines, of the heartrate 

variability (HRV), including spectrum analysis. As the 

primary measurement of cognitive performance, facial affect 

Improvement in CGI-S 

1,2 

1,0 

0,8 

0,6 

0,4 

0,2 

0 


Figure 24: Statistically significant (p=0.049) clinical improvement (measured 

as improvement in the Clinical Global Impression Score, illness severity 

subtest (CGI-S)) in patients with schizophrenia with pronounced negative 

symptoms (score on the negative symptom scale of the Positive and 

Negative Symptom Scale (PANSS) > 17) after treatment with repetitive 

transcranial magnetic stimulation (rTMS) compared to a control group 

(figure modified after: Cordes et al., Psychiatr. Res. 2009; DOI:10.1016/j. 

psychres.2009.01.014) 

ReseaRch 

decoding was investigated, including its electrophysiological 

correlates (P100, N170 and N240), by using a 

32-channel EEG at the start and end of rTMS treatment. 

Psychopathology was assessed by means of the PANSS 

score both before the start and at the end of the tenth 

session. The study involved 36 individuals with schizophrenia 

and 16 healthy controls. Initial results show significant 

improvements in the affect decoding capability under 

verum conditions and corresponding electrophysiological 

correlates. 

Evaluation differences in medical interventions 

(rTMS, depot antipsychotic application) in different 

population groups 

M. Arends, J. Cordes, U. Müller, J. Thünker 


Financing: Departmental research budget, 

Janssen Cilag GmbH 

With any new treatment method such as TMS, it is important 

to take attributes and opinions into consideration, as these 

are relevant to the outcome of the illness under this new 

type of treatment. Whereas this was extensively investigated 

for psychotropic drugs and ECT, it was found that, to 

date, only one investigation has been published relating 

to magnetic stimulation. Here, individuals who had been 

treated with rTMS were asked about their opinions and 

experience, with the majority assigning positive attributes to 

rTMS. However, the study participants negatively assessed 

the waiting time for rTMS and, in rare cases, headaches. 

This project set itself the target of finding out about 

attitudes, opinions and positions regarding rTMS. Initial 

Improvement in 

PANSS negative score 

8 

6 

4 

2 

0 


Figure 25: Statistically significant (p=0.022) improvement in the so-called 

negative symptoms (such as lack of drive), measured as an improvement in 

the subtest for negative symptoms on the Positive and Negative Symptom 

Scale (PANSS) in patients with schizophrenia with pronounced negative 

symptoms at the start of the study (score on the negative symptom scale 

of the PANSS > 17) after treatment with repetitive transcranial magnetic 

stimulation (rTMS) compared to a control group (figure modified after: 

Cordes et al., Psychiatr. Res. 2009; DOI:10.1016/j.psychres.2009.01.014). 

109


Team meeting of the Research Group „Transcranial Magnetic Stimulation“ 

experiences from clinical practice lead to the assumption 

that there is a rather positive view of rTMS, although this has 

not yet been systematically investigated. 

A representative telephone survey was carried out in 

Germany in which 754 people were asked about their 

attitude towards antipsychotic depot medication. The mean 

age of the participants was 49.4 years, and 46.9% were 

male. 54.1% had experience with taking drugs over a period 

of more than 3 months, 27.7% knew people with mental 

disorders and 6.4% had a mental disorder themselves. This 

questionnaire survey was constructed to elucidate the rather 

critical attitudes towards psychotropic depot medication. 

The study investigates the causes of and factors influencing 

the lack of acceptance of antipsychotic depot medication in 

the general population and in those groups of persons who 

come into direct or indirect contact with psychotropic drugs. 

110 

Repetitive transcranial magnetic stimulation (rTMS) 

for the treatment of the negative symptoms of 

schizophrenia (RESIS) 

P. Falkai, T. Wobrock, J. Cordes, B. Langguth, 

P. Eichhammer, G. Hajak, G. Winterer, W. Wölwer, 

M. Arends, C. Ohmann, E. Ben Sliman 


Financing: German Research Association GRA 

(FA 241/10-1), Alpine Biomed 

This is a multicentre GRA project to evaluate the therapeutic 

effect of high-frequency rTMS treatment on negative 

symptoms in people with schizophrenia (Figures 23 to 25).

Repetitive transcranial magnetic stimulation 

(rTMS) for the treatment of tinnitus 

B. Langguth, G. Hajak, D. P. Eichhammer, M. Landgrebe, 

J. Cordes, M. Ramacher, L. Kostorz 

Financing: German Research Association (GRA)(HA 3547/4- 

1), Alpine Biomed 

This is a multi-centred GRA project to evaluate the 

therapeutic effect of low-frequency rTMS treatment on 

tinnitus in mentally healthy test subjects. 

3.1.4 Project groups 

3.1.4.1 Evaluation of work-rehabilitation measures 

Director: W. Höhl 

Scientific assistants: C. Kirchoff, A. Pfeiffer 



(FMER No: 01 GI 9932) 

In the project group “Evaluation of work rehabilitation 

measures”, a sub-project with the same name was 

performed within the Competence Network on 

Schizophrenia. The following external collaborating centres 

were included with their own local research groups: 

s University Department of Psychiatry and 

Psychotherapy, Tübingen, G. Längle (coordinating 

centre until 2002) 

s University Medical School of Hanover, Social Psychiatry 

and Psychotherapy Department, W. Wielant Machleidt 

s Central Institute for Mental Health, Bailer, H. J. Salize 

s Lower Saxony State Hospital Osnabrück, K. H. Wiedl 

The evaluation was directed by the local project group at 

the University Department of Psychiatry and Psychotherapy 

in Tübingen until the end of 2002 and then transferred 

to our project group until its completion. Before this 

project, there had been hardly any empirical testing of the 

effectiveness of work-related measures. The aim of the 

project was, therefore, to evaluate the effectiveness of such 

measures, starting from the question of whether, when 

performed during the post-acute inpatient treatment phase, 

different occupational therapy models have better effects 

in terms of occupational capabilities than non-specific 

ergotherapeutic measures not oriented towards work life. A 

further objective of this project was the investigation of the 

two-year rehabilitation process of the study participants. 

In addition, groups of participants that take certain 

rehabilitation courses were to be identified. To evaluate 

inpatient work rehabilitation measures, a total of 227 

ReseaRch 

patients were enrolled in a 4-week prospective, controlled 

study and randomly assigned to one of two interventions: 

the study investigated the specific question of whether work 

rehabilitation measures show better efficacy in improving 

work-relevant capabilities of schizophrenia patients in 

the post-acute phase than an ergotherapeutic treatment 

that is not oriented towards the world of work. There were 

only small changes in occupational capabilities over time 

and small differences between the two groups, which 

were in favour of the ergotherapeutic intervention. A more 

differentiated evaluation employing hierarchical cluster 

analysis yielded three subgroups of participants that differed 

in their level and course of occupational capabilities. It was 

also investigated whether there was a positive correlation 

between social and occupational integration of people with 

schizophrenia. The results of this project do not support 

a transfer of capabilities between these two domains in 

people with schizophrenia. The Osnabrück and Düsseldorf 

study centres also studied optimised work rehabilitation 

measures. The results indicate better efficacy of the 

optimised treatment compared with the regular four week 

treatment. 

3.1.4.2 Early diagnosis of psychotic disorders 

Early intervention in early psychotic prodromes 

M. Streit, A. Henning, M. Hambrecht, A. Bechdolf, W. Gaebel 



(Funding 01 GI 9935 to A. Bechdolf, Cologne) 

The objective of this multi-centre project within 

the Competence Network on Schizophrenia was to 

systematically use a multimodal psychological intervention 

programme for people with early psychotic prodromes for 

whom medical treatment with anti-psychotic drugs had 

not (yet) been initiated and to evaluate this target group for 

the first time worldwide within the context of a controlled 

treatment study. The study participants were randomly 

assigned to a treatment group with the intervention 

programme and clinical management or a control group 

with clinical management only (conventional, low-frequency 

advice). The intervention programme included helping 

at-risk persons to self-record increased risk, as well as 

problem- and symptom-related psychological interventions 

for depression and anhedonism, learning problems and 

cognitive impairments, social deficiencies, social anxiety and 

continuing family conflicts. In order to adequately address 

the expected differentiated problem situations of these 

groups, different behaviour therapy intervention techniques 

111


were used that had been tested in other contexts (stress 

relief procedures, competency training, problem-solving 

training). The results show that behaviour therapy of atrisk 

persons in the early prodromal stage can successfully 

prevent the transition to late-prodromal or psychotic stages 

in many cases. 

Early intervention in late-prodromal psychosis 

M. Streit, M. List, S. Ruhrmann, J. Klosterkötter, W. Gaebel 


Financing: Federal Ministry or Education and Training 

(Funding 01 GI 9935 to S. Ruhrmann, Cologne) 

This multi-centre clinical trial within the Competence 

Network on Schizophrenia assessed the efficacy of 

amisulpride in persons in late pre-psychotic prodromal 

stages of schizophrenia. The study was performed in 

a randomised, open, parallel-group design in in- and 

outpatients in early adulthood. Study participants were 

treated either with amisulpride plus clinical management 

or only with clinical management. Amisulpride was used 

in the dose range 50-800 mg. Primary outcomes were the 

improvement of prodromal symptoms and the prophylactic 

efficacy measured as the ratio of the probability in the two 

groups of developing manifest psychosis during the study. 

This atypical antipsychotic drug was effective in reducing 

both pre-existing symptoms and the transition rate to 

psychosis. Longer follow-up is necessary to determine 

whether these transitions are truly reduced or just delayed. 

Secondary prevention of schizophrenia: a randomised 

controlled study (PREVENT) 

B. Janssen (from 2009), G. Winterer (until 2009), E. Streit, 

K. Teufel, A. Bechdolf, J. Klosterkötter, W. Gaebel 

Project period: since 2008 

Financing: German Research Association (Funding to J. 

Klosterkötter, Cologne) 

The “PREVENT” multi-centre study, initiated by the 

Cologne Early Diagnosis and Treatment Centre, builds 

immediately on the results of both of the above studies by 

the Competence Network on Schizophrenia. In the threearmed 

study design, a cognitive behaviour therapy treatment 

is being tested directly against low-dose antipsychotic 

treatment or placebo for the first time in people at increased 

risk of psychosis. The study period is a total of three and a 

half years. 

112 

3.1.4.3 Borderline personality disorder 

Director: J. Malevani 

Scientific assistants: D. Gescher, A. Ruttman, 

H. Lüthcke 

The research group’s work focuses on both epidemiological 

healthcare aspects and clinical pharmaceutical aspects 

of borderline personality disorder. In the first phase, 

healthcare patterns for these patients were investigated 

and evaluated using a retrospective naturalistic study 

design employing DGPPN-BADO data from 2004-2008. 

Assessments included the following parameters: admission 

modality (referral, legal background, prior treatment), 

demographic aspects (age, sex distribution, education, 

training, professional situation) and aftercare. As a first 

interim result it was found that the treatment of people with 

borderline disorder on a specialised ward – be it secure 

or open – has a beneficial effect on outpatient treatment 

continuation. In a naturalistic retrospective approach, 

sociodemographic features of inpatients with borderline 

disorder are assessed using DGPPN-BADO datasets. 

Because of the early onset of borderline symptoms in youth 

or early adulthood, basic deficits in shaping one’s life can 

occur, which lead to the early termination of education and 

training, problems in work life and social disintegration. The 

analysis of sociodemographic features could therefore yield 

essential epidemiological information that is relevant for the 

estimation of psychosocial risk factors and that may have 

prognostic value and be relevant for therapy.

3.1.5 Research Centres 

3.1.5.1 Clinical Psychology 

Director: E. Lehmann (until 2004) 

Scientific assistant: W. Strauss 

Non-scientific assistants: H. Hruschka (until 2009), 

C. Schulze-Oben 

The Clinical Psychology Research Centre was founded in 

1980 and was in existence until the retirement of its director, 

E. Lehmann. Its task was to carry out treatment-related 

experimental clinical research to aid patients with mental 

disorders. 

In cooperation with the Institutes of Psychology of the 

Universities of Bonn, Bremen, Cologne, Mainz and Münster, 

the Departments of Psychiatry and Psychotherapy of the 

Universities of Berlin, Bochum/Gelsenkirchen, Erlangen- 

Nuremberg, Innsbruck, Magdeburg, Munich and Würzburg 

and care institutions, this Research Centre investigated 

modifying factors for drug and psychotherapeutic effects, 

developed experimental strategies for efficacy studies, and 

investigated the personality structures of criminals who had 

committed homicide with the aim to uncover the personal 

and situational conditions of homicide. 

Projects 

The studies already published can be found in the list of 

publications. Other completed projects: 

Surveillance study on the influence of Kava-Kava on 

preoperative anxiety 

W. Gollnik, E. Klieser, E. Lehmann 


Financing: Research budget of the Frauenklinik des 

Evangelischen Krankenhauses Gelsenkirchen 

One day before a gynaecological surgery, 20 women received 

3 x 150 mg standardised dry extract of Kava root stock. A 

randomly formed comparison group did not receive this 

medication. The effect on self-reported and observer-based 

anxiety ratings and the degree of physiological anxiety were 

investigated. 

3.1.5.2 Psychiatric Sociology 

Director: U. Müller (until 2009) 

ReseaRch 

Investigation of personal and situational 

conditions of homicide 

E. Lehmann 


So far, 104 of the planned 120 criminals who have committed 

homicides have been investigated using standardised 

psychological tests (HAWIE, MWT-B, Ci-Test, MMPI, 16PF, 

questionnaires on life history). In addition, the situation of 

the criminal act (motivation, development of the criminal act, 

how it was done and subsequent behaviour) was explored 

in detail. The planned data analysis should highlight the 

characteristics of the criminals and situations with regard to 

the risk of relapse and prevention. 

Because of the special characteristics of this Research 

Centre, two introductory sentences are necessary: “Medical 

Sociology” is a scientific discipline that uses the theories and 

methods of empirical sociology to analyse the phenomenon 

of “health” and “illness” as well as health institutions and 

professionals in their interaction with patients. “The aim 

of these analyses is a better understanding of the social 

influences on the maintenance of health and occurrence and 

pathogenesis of illnesses, and a better comprehension of 

the opportunities and thresholds of medical measures and 

their effects on the individual and society”. This definition 

is also applicable to Psychiatric Sociology, which, as a subdiscipline 

of Medical Sociology, marks the boundaries of 

its subject area by focussing on “mental health and mental 

disorders”. 

Research focuses: 

s Questions concerning the organised system of 

psychiatry 

s Social-epidemiological questions, particularly with 

regard to psychiatric community care 

s Sociological “service” for research projects of other 

research units of the LVR-Klinikum Düsseldorf 

113


In addition, within the reporting period the Psychiatric Sociology 

Research Centre was active in compiling the health report 

on the care of people with mental disorders for the City of 

Düsseldorf and wrote an overview of the situation of the 

specialist area of psychiatry and psychotherapy in Germany for 

the Royal College of Psychiatry in Great Britain (in cooperation 

with W. Gaebel and J. Zielasek). The director of the Research 

Centre was also actively engaged in shedding light on the 

unknown fate of victims of the “T4 action”. The Federal Health 

Ministry, the Federal Association of Sickness Funds as well 

as the Federal Medical Chamber awarded the editors of the 

book entitled “Forgetting the Holocaust is being part of the 

Holocaust”, P. Fuchs, M. Rotzoll, U. Müller, P. Richter and 

G. Hohendorf, pro rata the prize in 2008 for scientific work 

on medical policies during the NS period. The book resulted 

from the DFG-funded study entitled “Scientific coverage and 

assessment of the documentary evidence of the National 

Socialists’ T4 Euthanasia Action” under the leadership of G. 

Hohendorf (Heidelberg) and dealt with the individual fates 

of mentally ill people who were victims of the T4 action and 

whose fate could only now be discovered as new documents 

were revealed. The prize money was 3,000 EUR. The DGPPN 

supported the surplus costs of printing the book, in 2007, which 

is now in its second edition. 

Projects 

Evaluation of the implementation of sectorisation in the 


M. Schwarz, U. Müller, H. Schönell, 



Various questionnaires were used to evaluate whether 

the planned effects on patients, care and medical staff 

of implementing sector-based allocation of patients 

to Divisions of General Psychiatry actually occurred. 

(Cooperation project with Divisions of General Psychiatry I 

and II). 

The living conditions of the mentally ill 

U. Müller, H. Schönell, A. Gernand 



Investigations of the changes of the pre-inpatient, inpatient 

and post-inpatient living conditions of people with mental 

disorders with regard to their working life, their domestic 

environment and their leisure behaviour (Cooperation with 

the Division of General Psychiatry I and the Social Science 

Institute, Faculty of Philosophy of the Heinrich-Heine 

University, Düsseldorf). 

114 

Analysis of social event chains before 

compulsory hospitalisation 

U. Müller, M. Schwarz, H. Schönell 



The subjective perceptions of these events by adolescent 

and adult patients and their relatives were assessed by 

using standardised questionnaires in order to identify 

typical patterns of the events and coping mechanisms 

for compulsory inpatient admission to the Klinikum 

(cooperation with the Division of General Psychiatry II, the 

Division of Child and Adolescent Psychiatry and the Social 

Sciences Institute at the Faculty of Philosophy, Heinrich- 

Heine University, Düsseldorf). 

Clientele of a social-psychiatric centre 

U. Müller in cooperation with K. Behrends, Düsseldorf 

Health Service, J. F. Squire, N. Preston, Fremantle Hospital 

and Health Services, Australia 


Financing: Departmental research budget, Health Service 

of the City of Düsseldorf and Fremantle Hospital and Health 

Services 

The demands of the clientele of an inner-city socialpsychiatric 

centre were investigated with respect to various 

parameters of social competence and assistance-seeking 

and communication behaviour as well as psychopathological 

parameters. 

National Socialism and psychiatry 

U. Müller in cooperation with A. Genger, Mahn- und 

Gedenkstätte Düsseldorf 


Financing: Departmental research budget and funds from 

Mahn- und Gedenkstätte Düsseldorf 

This project is divided into two sub-projects: 

1. Analysis of the visitor books of the Mahn- und 

Gedenkstätte Düsseldorf: content-analysis study. 

2. Provinzial-Heil und Pflegeanstalt Düsseldorf- 

Grafenberg and official opinion in the Düsseldorf quarter 

of Gerresheim at the time of National Socialism: 

Interviews with contemporary witnesses

Investigation of the clientele of §§39/72 FSAL institutions 

in Düsseldorf 

U. Müller, H. Schönell, H. H. Lorenz, M. Schwermer, 

F. Wenzel, W. Wiese 


Financing: Departmental research budget, as well as 

resources from the participating Düsseldorf §§ 39/72 FSAL 

institutions 

By using a standardised analysis instrument, the abilities, 

skills and impairments as well as the individual need 

for help of visitors to and residents of institutions for the 

homeless were surveyed by random sampling from January 

to April 2001 (n=296). All 30 institutions of this type took 

part in the study. The project was initiated by the institutions 

and was used as part of the health report as well as for the 

further planning of such institutions and the help required by 

their clientele. This project was run in cooperation with the 

“Psychosocial Work Association in Düsseldorf”. 

Alternative health structure 

U. Müller, A. M. Möller-Leimkühler, A. Fein, J. Horn. 


Financing: Departmental research budget and funds from 

the Department of Psychiatry and Psychotherapy of the 

Ludwig-Maximilian University, Munich 

Increasing use is being made of institutions and staff from 

the alternative health sector, also by persons with mental 

disorders. A multi-centre survey of inpatients with mental 

disorders is therefore being prepared, asking them to what 

extent and from whom they sought help in the alternative 

health structure. Places of pilgrimage and folk religion were 

also counted as alternative health cultures. 

ReseaRch 

115


3.1.6 Outpatient Clinic 

Director: B. Janssen (2004–2005 and from September 2009), 

G. Winterer (from 2006 until August 2009), F. Schneider (until 

2004) 

The university’s Outpatient Clinic treats patients with all 

types of psychiatric diagnoses. The Outpatient Clinic has 

no legal coverage mandate, but is the university institution 

for research and teaching. Within this context, in addition to 

offering general psychiatric-psychotherapeutic consultations 

it provides specialised care for the following mental 

disorders in the form of specialised outpatient clinics: 

s Chronic schizophrenic disorders 

s Treatment-resistant depressive syndromes 

s Anxiety and compulsive disorders 


s Chronic treatment-resistant pain disorders 

s Post-traumatic stress disorders 

s Forensic outpatient clinic 

s Behaviour therapy outpatient clinic 

There is close cooperation with the wards of the LVR- 

Klinikum. Thus, in particular those patients who – because 

of the severity of their disorder – need to have therapist 

continuity and be treated in the long term at one hospital can 

receive treatment at the Outpatient Clinic. A total of 1,200- 

1,600 patients are treated per year. In addition, the Outpatient 

Clinic provides psychiatric and psychotherapeutic care for 

the Düsseldorf University Hospital and the Sana-Hospital 

Gerresheim. Patients of the Outpatient Clinic are included 

in research projects by the various research laboratories 

and groups described earlier in this report. In addition, 

the Outpatient Clinic plays a role in the training of medical 

and psychology students in the form of seminars, practice 

sessions and internships. 

3.1.7 Infrastructural facilities 

3.1.7.1 Study Service Centre 

Directors: J. Cordes; W. Wölwer 

Scientific assistant: L. Kostorz, M. Jänner 

Non-scientific assistant: K. Beseoglu, P. Pitters 

The objective of the Study Service Centre, which is under the 

direct control of the Medical Director, is to professionalise 

clinical studies in the Department of Psychiatry and 

Psychotherapy by pooling competences, making appropriate 

resources available and optimising processes on a 

116 

Study Service Centre team 

qualitatively high level. This approach should ensure that 

innovative and investigator-initiated clinical studies are 

carried out to the highest standards of quality and according 

to GCP, the AMG (German drug law) and GCP-V as well as 

other applicable laws and regulations. 

The Study Service Centre, which was founded in 2008 and is 

still in the process of becoming fully established, is seen as 

a provider of services to all scientists within the department. 

It supports studies by the pharmaceutical industry and 

scientific studies with third party funding in the reporting 

process to the LVR as well as in their realisation. In addition, 

it provides advice for third party-funded scientific studies 

in the planning phase and, after completion, also offers 

support for data analyses. Collating all studies into the 

Study Service Centre of the LVR-Klinikum Düsseldorf should 

allow effective collaboration across studies and support the 

implementation of all applicable laws and guidelines for the 

realisation of clinical studies. 

The spectrum of services includes the following: 

s Support of reporting procedures within the LVR 

s Study coordination in situ (pre-screening, screening, 

recruitment, scheduling, recall, etc.) 

s Supervision of study patients 

s Support of investigators to realise studies according to 

the study protocol (assessments, interventions, etc.) 

s Creating and monitoring the compliance of internal 

SOPs 

s Advice on questions relating to AMG, GCP-V and 

ICH-GCP 

s Drug accountability 

s Documentation and data entry 

s Sampling and sample logistics 

s SAE reporting 

s Preparing and supporting monitor visits 

s Statistical advice and support for analyses

s Archiving study documents 

s Supporting collaboration with CCS (see below, noncommercial 

studies) 

In non-commercial studies, the cost-effective close 

collaboration with the Coordination Centre for Clinical 

Studies (CCS; Director: C. Ohmann) of the Heinrich-Heine 

University is obligatory in most cases. Collaboration is based 

on a standard quality assurance with joint SOPs. The SOPs, 

available in the CCS, are made available by the Study Service 

Centre for this purpose. 

Support of pharmacological studies 

Since the foundation of the Study Service Centre in 2008, the 

following pharmacological studies have been supported: 

s The effectiveness of the ENLA weight management 

programme in the prevention of weight gain in 

patients with schizophrenia treated with olanzapine: 

a randomised multi-centre controlled open study 

(ENLA = Exercise Nutrition Learning Accepting) (ENLA 

study) 

s Efficacy and Safety of Vivitrol® in Adults Completing 

Inpatient Treatment for Alcohol Dependence (VIVITROL 

study) 

Study report, insurance certificate 

and conditions. Ethics elements, 

approval by BfARM, cost calculation, 

explanation and declaration of 

consent 

SSZ Study administration 

Sign all documents with letter 

from SSZ director and A3 

information form for LVR 

After positive 

decision 

Medical director 

Signature on test plan, 

A3 information form LVR 

Board 

Rheinland State Association (LVR) 

LVR assessment 

Board 

Figure 26: Planning phase (III) of a study: Approval and reporting (internal) 

Local study director 

Finance department 

Contract checking 

Board 

Signature 

SSZ study administration 

ReseaRch 

s A 48-Week, Multicenter, Randomized, Double-Blind, 

Parallel-Group Evaluation of the Comparative Efficacy, 

Safety and Tolerability of Exelon ® 10 and 15 cm Patch 

in Patients with Alzheimer’s Disease Showing Cognitive 

Decline during an Open-Label Treatment Phase 

(OPTIMA study) 

s Evaluation of the efficacy and safety of methylphenidate 

in adult patients with attention deficit syndrome and 

hyperactivity 

s Open, prospective clinical testing of the investigation 

of the tolerability, safety and efficacy of flexible doses 

of paliperidone ER in patients with schizophrenia 

(PERFlex) 

s A double-blind dose-titration study investigating the 

safety, tolerability and pharmacokinetics of multiple 

doses of JNJ-x administered once or twice a day to 

male and female patients with stable schizophrenia 

s RISSCH-4091 Risperdal® consta®: Post-acute 

treatment of patients with schizophrenia with 

Risperdal® consta® in outpatient units 

Report to local authorities, 

if not done from sponsors 

With assistance from 

SSZ, if necessary 

Non-commercial studies report to 

www.clinicaltrials.gov 

Release of study programme and dispatch of 

partially completed F3 (report form) 

117


3.1.7.2 Biometrics and documentation 

Director: W. Wölwer 

Scientific assistants: M. Jänner, M. Riesbeck 

The Biometrics Unit was set up in 1994 for the methodical 

support of scientific work in the Department of Psychiatry 

and Psychotherapy; it has two part-time positions. The 

tasks of the Biometrics Unit include giving advice on and 

overseeing research projects in the hospital with regard to 

questions on making applications, planning and analysing 

studies and managing data. Since 2008, the Biometrics 

Unit has also been associated with the newly refurbished 

Study Service Centre. In addition, the Biometrics Unit also 

helps in the assessment of the basic documentation data 

(BADO) of the department’s patients. This is for the purpose 

of periodical reports on hospital data, to support quality 

assurance measures, as a database for structural projects 

and for numerous individual questions. 

Cooperation 

s Comparative evaluation of basic documentation for the 

purpose of external quality comparisons (B. Janssen) 

s Relapse-predictive validity of prodromal symptoms in 

patients with schizophrenia (W. Gaebel) 

s Training of cognitive functions in patients with 

schizophrenia (W. Wölwer) 

s Benchmarking in acute psychiatric treatment (Project 

of the network of Rhineland State Clinics) (W. Gaebel/B. 

Janssen) 

s Network project “Optimisation of the long-term 

treatment of first-episode schizophrenia” (W. Gaebel/ 

H.-J. Möller) 

s Pharmacotherapeutic strategies for relapse prevention 

in first-episode schizophrenia (W. Gaebel) 

s Prodrome-based relapse prevention and early 

intervention in first-episode schizophrenia (W. Gaebel) 

s Biological principles of relapse (W. Gaebel/W. Wölwer) 

s Schizophrenia treatment guidelines (W. Gaebel) 

s Transfer of scientific knowledge from the Competence 

Network on Schizophrenia to treatment practice: 

Optimisation of the care of first-episode schizophrenia 

(W. Gaebel) 

s 5-year follow-up study: “Pharmacotherapeutic 

strategies for preventing relapse in first-episode 

schizophrenia” to identify prognostic indicators of the 

course of schizophrenia (W. Gaebel) 

s NODPAM (Needs-oriented planning and monitoring of 

hospital discharging of patients with high demands on 

psychiatric care) (B. Janssen, C. Schmidt-Kraepelin) 

118 

s Optimising the post-inpatient care of patients with 

schizophrenia through guideline-supported, medical, 

psychoeducative and sociotherapeutic measures (W. 

Gaebel/B. Janssen) 

s DGPPN survey on the classification of mental disorders 

according to ICD-10 (W. Gaebel/J. Zielasek) 

s Analysis of data from the transcranial magnetic 

stimulation projects (J. Cordes) 

s ENLA study (J. Cordes) 

s Survey “Use of rTMS” (J. Cordes) 

s Survey “Use of deep brain stimulation” (M. Arends) 

s Perfusion and brain volumes in Alzheimer patients (C. 

Luckhaus) 

s Osteoporosis in Alzheimer patients (C. Luckhaus) 

3.1.7.3 Audiovisual Centre 

Director: W. Wölwer (Research), 

M. Streit (until 2003, Clinical documentation), N.N. 

The Audiovisual Centre was founded at the Department 

of Psychiatry and Psychotherapy in 1994 and is used for 

both clinical documentation and quality assurance, e.g. for 

therapeutic process evaluation and treatment supervision, 

as well as for teaching and research purposes. Next to the 

technician’s room there is a recording studio for clinical 

documentation in small groups or for dyadic interactions. 

A further room serves as a research measurement area for 

detailed videotaping of nonverbal behaviour. In the central 

technician’s room, since extensive technical modernisation 

in 2008, there is a computer-assisted videotaping and 

cutting area (Software: Adobe Premiere). The four digital 

colour cameras on rotating heads in the two studios can be 

fully controlled remotely from the technician’s room (two 

cameras each for the recording studio and for the research 

laboratory). Several monitors, a video mixing desk and a 

12-channel sound mixer are also available. For research 

purposes, it was made possible to feed PC-generated 

video signals and EEG measurements into the system. All 

components can be interconnected, separately for the video 

and audio area, using matrix systems. An evaluation area 

for detailed analyses of videos is also available, with a largeformat 

monitor and a PC for picture-by-picture control and 

storage of behavioural coding. A suitably equipped DVD 

recorder is available for digitalising old videos using S-VHS, 

VHS- or UMATIC standard.

3.1.8 Diploma and master theses, 

doctoral and habilitation dissertations 

3.1.8.1 Diploma and master theses 

Virnich J (2002): Quasiexperimentelle Untersuchung zur Zeitstabilität 

des Defizits der mimischen Affektdekodierung bei Schizophrenen. 

Diplomarbeit im Fach Psychologie an der Heinrich-Heine-Universität 


Bittner E (2004): Defizite in sozialen Kognitionen und ihre Bedeutung 

für das soziale Funktionsniveau in der prodromalen Phase der 

Schizophrenie. Diplomarbeit im Fach Psychologie an der Heinrich- 

Heine-Universität Düsseldorf 

Halfmann S (2004): Kognitive Rehabilitation von schizophren Kranken: 

Wirksamkeit von spezifischen Trainingsmaßnahmen und 

Möglichkeiten zur Abschätzung des individuellen Rehabilitationspotentials. 

Diplomarbeit im Fach Psychologie an der Universität 

Bremen 

Ferrari T (2005): Versorgungszentren für ersterkrankte schizophrene 

Patienten-Modelle und Evaluationsergebnisse, Master-Arbeit im 

Fach Public Health an der Heinrich-Heine-Universität Düsseldorf 

Peltzer M (2007): Der Einfluss eines Trainingsprogramms zur Dekodierung 

des mimischen Ausdrucks (TAD) für an Schizophrenie Erkrankte 

auf die soziale Kompetenz. Diplomarbeit im Fach Psychologie 

an der Heinrich-Heine-Universität Düsseldorf 

Fleiter J (2008): Der Einfluss eines Trainingsprogramms der Affektdekodierung 

(TAD) auf die Perzeption der affektiven Prosodie bei 

schizophren Erkrankten. Diplomarbeit im Fach Psychologie an der 

Heinrich-Heine-Universität Düsseldorf 

Miss H (2008): Teststatistische Entwicklung einer Arbeitsprobe zur 

Erhebung von Arbeitsstörungen bei psychisch kranken Menschen. 

Unveröffentlichte Diplomarbeit, Heinrich-Heine-Universität Düsseldorf, 

Institut für experimentelle Psychologie 

Müller S (2008): Monetäre Bewertung der immunsuppressiven Langzeitmedikation 

des systemischen Lupus erythematodes (SLE): 

Qualitative und Quantitative Analyse einer deutschlandweiten Patientenbefragung. 

Magisterarbeit zur Erlangung des akademischen 

Grades „Magister für Public Health, postgrad.“ (MPH) aus dem 

Zusatzstudiengang „Public Health“ an der Medizinischen Fakultät 

der Heinrich-Heine-Universität Düsseldorf 

Steinbring A (2008): Evaluation des Trainings zur Affektdekodierung 

(TAD) bei schizophren Erkrankten: Effekte auf sozial kognitive 

Leistungen und deren Zeitstabilität. Diplomarbeit im Fach Psychologie 

an der Heinrich-Heine-Universität Düsseldorf 

Trischmann C (2008): Untersuchung der Testgüte eines neu entwickelten 

Instrumentes zur Erhebung von Arbeitsstörungen bei 

psychisch kranken Menschen. Unveröffentlichte Diplomarbeit, 

Heinrich-Heine-Universität Düsseldorf, Institut für experimentelle 

Psychologie 

ReseaRch 

Wördehoff FC (2008): Bias in the perception and interpretation of fa- 

cial affects in patients suffering from schizophrenia; Master-Arbeit 

im Fach Psychologie an der Universiteit Maastricht 

Theile R (2009): Untersuchung zur Sensitivität für bedrohliche Reize 

bei schizophren Erkrankten; Diplomarbeit im Fach Psychologie an 


3.1.8.2 Doctoral Dissertations 

Baumann A (2007): Reduktion von Stigma und Diskriminierung schizophren 

Erkrankter durch „Antistigma“-Programme: Theoretische 

Aspekte der Entstehung und Überwindung sozialer Distanz und 

die Wirksamkeit des „Open the doors“-Programms des Kompetenznetzes 

Schizophrenie. Dissertation. Klinik für Psychiatrie und 

Psychotherapie der Universität zu Köln 

Bohnhardt-Schneider A (2003): Entwicklung eines Screeningverfahrens 

zur Erfassung depressiver Symptomatik im Alter: KTD 

– Kurztest Depression. Dissertation. Heinrich-Heine-Universität 


Pukies G (2002): Erhebung von Patientenurteilen zur Erfassung relevanter 

Variablen und Indikatoren für eine qualitativ hochwertige 

Behandlung im Rahmen der Evaluation stationärer psychiatrischer 

Behandlung 

Werner C (2001): Veränderungen von Monoaminmetaboliten unter 

Clomipramin-Challenge: Eine Untersuchung an Probanden und 

Patienten aus Familien mit hereditären affektiven Psychosen. Medizinische 

Fakultät der Heinrich-Heine-Universität Düsseldorf 

Seeber H (2002): Die Häufigkeit von Patientenverfügungen und Bevollmächtigungen 

in gesundheitlichen Angelegenheiten bei psychisch 

kranken älteren Personen. Disseration. Heinrich-Heine- 

Universität Düsseldorf 

Quack R (2008): Krankheitswahrnehmung bei Alzheimer Demenz, 

Dissertation an der medizinischen Fakultät der Heinrich-Heine- 


3.1.8.3 Habilitation Dissertations 

2005 

Wölwer W (2005): Differenzierung kognitiver Störungen schizophren 

Erkrankter mittels Augenbewegungsanalysen, Medizinische Fakultät 


2009 

Janssen B (2009): Qualitätsmanagement in der Psychiatrie am Beispiel 

der Behandlung schizophrener Patienten – Ergebnisse psychiatrischer 

Versorgungsforschung. Medizinische Fakultät der 


119


3.1.9 Publications 

During the reporting period, staff at the Department of 

Psychiatry and Psychotherapy were responsible for, on 

average, around 43 publications in specialist journals (range: 

20–85 publications), as the first or last author, or involved 

in such publications as co-authors. Over the years, not only 

has the number of publications increased significantly, but 

the articles are also being increasingly published in highranking 

journals, thereby increasing the average “impact 

factor” (a measurement of the frequency of quotations from 

a journal and, therefore, a measurement of the journal’s 

significance in the specialist area) from around 2.0 in 2001 to 

around 3.8 in 2009. 

3.1.9.1 Publications in journals 

2001 

Böhner H, Hummel T, Sandmann W, Schneider F (2001): Current diagnosis 

and therapy of postoperative delirium. Dt Med Wochenschr 

126: 504–506 

Burtscheidt W, Schwarz R, Wölwer W, Gaebel W (2001): Verhaltenstherapeutische 

Verfahren in der ambulanten Behandlung von Alkoholabhängigen. 

Abstinenzverhalten und soziodemographische 

Faktoren. Fortschr Neurol Psychiat 69: 526–531 

Burtscheidt W, Wölwer W, Schwarz R, Strauss W, Löll A, Lüthcke H, 

Redner C, Gaebel W (2001): Out-patient behaviour therapy in alcoholism: 

relapse rates after 6 months. Acta Psychiatr Scand 103: 

24–29 

Gaebel W (2001): Editorial: Krankheitstheorie und die Identität der 

Psychiatrie. Nervenarzt 72: 320–330 

Gaebel W (2001): Strategien der pharmakologischen Langzeitbehandlung 

schizophrener Störungen. Fortschr Neurol Psychiat 69: 

113–119 

Gaebel W (2001): Wo stehen wir heute? Behandlung der Schizophrenie. 

Neuro-Psychiatrische Nachrichten 07: 9 

Gomille T, Meyer RA, Falkai P, Gaebel W, Königshausen T, Christ F 

(2001): Prävalenz und klinische Bedeutung computertomographisch 

gesicherter idiopathischer Stammganglienverkalkungen. 

Radiologe 41: 205–210 

Habel U, Schneider F (2001): Psychosocial intervention to help child 

and adolescent witnesses in court. Psychother Psychosom Med 

Psychol 51: 160–165 

Habel U, Wild B, Topka H, Kircher T, Salloum JB, Schneider F (2001): 

Transcranial magnetic stimulation: no effect on mood with single 

pulse during learned helplessness. Prog Neuropsychopharmacol 

Biol Psychiatry 25: 497–506 

Haupt M (2001): Akute Verwirrtheit – akutes „Altersdelir“. Geriatrie 

Journal, 10: 156–157 

Haupt M (2001): Lebenserhaltende Maßnahmen – was ist noch maßvoll? 

Z Gerontopsychol Psychiat 14: 22–28 

120 

Haupt M (2001): Pharmacology in Cerebral ischemia – Buchbespre- 

chung. Fortschr Neurol Psychiatr 69: 388 

Haupt M (2001): Therapie von Demenzkranken. Forschung und Pra- 

xis 325: 131–133 

Haupt M. (2001): Therapie von Demenzkranken – was ist zur Zeit 

machbar? ÄZ Forschung & Praxis 20: 11–13 

Haupt M. (2001): VII. Gerontopsychiatrisches Fachgespräch. Fortschr 

Neurol Psychiatr 69: 242–243 

Janssen B, Sielk M (2001): Umgang beim psychiatrischen Notfall in 

der Allgemeinarztpraxis. Z. Allg: 77: 354–357 

Karger A, Haupt M (2001): Die Behandlung nichtkognitiver Störungen 

bei Demenzkranken. Nervenheilkunde 20: 42–48 

Larisch R, Klimke A, Mayoral F, Hamacher K, Herzog HR, Vosberg 

H, Tosch M, Gaebel W, Rivas F, Coenen HH, Müller-Gärtner HW 

(2001): Disturbance of serotonin 5HT2 receptors in remitted patients 

suffering from hereditary depressive disorder. Nuklearmedizin 

40: 129–134 

Linden M, Godemann F, Gaebel W, Köpcke W, Müller P, Müller- 

Spahn F, Pietzcker A, Tegeler J (2001): A prospective study of factors 

influencing adherence to a continuous neuroleptic treatment 

program in schizophrenic patients during two years. Schizophrenia 

Bull 27: 585–596 

Menke R, Janssen B, Gaebel W (2001): „Diseasemanagement“ in der 

Versorgung schizophrener Patienten. NeuroTransmitter 11: 36–44 

Posse S, Binkofski F, Schneider F, Gembris D, Wiese S, Kiselev V, 

Graf T, Elghawaghi B, Eickermann T (2001): A new approach to 

measure single event related brain activity using real-time fMRI: 

feasibility of sensory, motor, and higher cognitive tasks. Human 

Brain Mapping, 12: 25–41 

Rodriguez de la Torre B, Dreher J, Malevany I, Bagli M, Kolbinger M, 

Omran H, Luderitz B, Rao ML (2001): Serum levels and cardiovascular 

effects of tricyclic antidepressants and selective serotonin 

reuptake inhibitors in depressed patients. The Drug Monit 23: 

435–440 

Schneider F, Habel U, Holthusen H, Kessler C, Posse S, Müller-Gärtner 

HW, Arndt JO (2001): Subjective ratings of pain correlate with 

subcortical-limbic blood flow: an fMRI study. Neuropsychobiology 

43: 175–185 

Schneider F, Habel U, Wagner M, Franke P, Salloum JB, Shah NJ, 

Toni I, Sulzbach Ch, Hönig K, Maier W, Gaebel W, Zilles K (2001): 

Subcortical Correlates of Craving in Recently Abstinent Alcoholic 

Patients. Am J Psychiatry 158: 1075–1083 

Schneider F, Stieglitz RD, Gaebel W (2001): Qualitätssicherung in der 

stationären psychiatrischen Behandlung. psycho 27: 207–210 

Schneider U, Altmann A, Baumann M, Bernzen J, Bertz B, Bimber 

U, Broese T, Broocks A, Burtscheidt W, Cimander KF, Degkwitz 

P, Driessen M, Ehrenreich H, Fischbach E, Folkerts H, Frank H, 

Gurth D, Havemann-Reinecke U, Heber W, Heuer J, Hingsammer 

A, Jacobs S, Krampe H, Lange W, Lay T, Leimbach M, Lemke MR,

Leweke M, Mangholz A, Massing W, Meyenberg R, Porzig J, Quattert 

T, Redner C, Ritzel G, Rollnik JD, Sauvageoll R, Schläfke D, 

Schmid G, Schröder H, Schwichtenberg U, Schwoon D, Seifert J, 

Sickelmann I, Sieveking CF, Spiess C, Stiegemann HH, Stracke R, 

Straetgen HD, Subkowski P, Thomasius R, Tretzel H, Verner LJ, 

Vitens J, Wagner T, Weirich S, Weiss I, Wendorff T, Wetterling T, 

Wiese B, Wittfoot J (2001): Comorbid anxiety and affective disorder 

in alcohol-dependent patients seeking treatment: the first Multicentre 

Study in Germany. Alcohol Alcohol 36: 219–223 

Streit M, Ioannides AA, Sinnemann T, Wölwer W, Dammers J, Zilles 

K, Gaebel W (2001): Disturbed facial affect recognition in patients 

with schizophrenia associated with hypoactivity in distributed brain 

aegions: A magnetoencephalographic study. Am J Psychiatry 158: 

1429–1436 

Streit M, Wölwer W, Brinkmeyer J, Ihl R, Gaebel W (2001): EEG-correlates 

of facial affect recognition and categorisation of blurred 

faces in schizophrenic patients and healthy volunteers. Schizophr 

Res 49: 145–155 

Wölwer W, Burtscheidt W, Redner C, Schwarz R, Gaebel W (2001): 

Out-patient behaviour therapy in alcoholism: impact of personality 

disorders and cognitive impairments. Acta Psychiatr Scand 103: 

30–37 

Wölwer W, Gaebel W (2001): Eye Movement Strategies in Schizophrenia: 

A Window to Frontal Lobe Dysfunctions? Z Neuropsychol 12: 

21–25 

2002 

Böhner H, Sandmann W, Schneider F (2002): Regarding: Transient 

advanced mental impairment: an underappreciated morbidity after 

aortic surgery. J Vas Surg 36: 425 

Burtscheidt W, Wölwer W, Schwarz R, Strauss W, Gaebel W (2002): 

Out-patient behaviour therapy in alcoholism: treatment outcome 

after 2 years. Acta Psychiatr Scand 106: 227–232 

Cordes J, von Wilmsdorff M, Ghiassi V, Kudielka BM, Henning, C 

Kirschbaum, A Klimke (2002): Hormonelle Responsivität auf sozialen 

Stress bei Depressionen. Psychiatrie und Dialog 3: 13–14 

Falkai P, Honer WG, Alfter D, Schneider-Axmann T, Bussfeld P, Cordes 

J, Blank B, Schonell H, Steinmetz H, Maier W, Tepest R (2002): 

The temporal lobe in schizophrenia from uni- and multiply affected 

families. Neurosci Lett 31: 25–28 

Gaebel W (2002): Editorial: Schwerpunkt Psychosen im Kindes- und 

Jugendalter. ZaeFQ 566: 1 

Gaebel W, Baumann A, Witte AM, Zaeske H (2002): Public attitudes 

towards people with mental illness in six German cities. Results of 

a public survey under special consideration of schizophrenia. 

Europ Arch Psychiatr Clin Neurosc 252: 278–287 

Gaebel W, Baumann A, Witte M (2002): Einstellungen der Bevölkerung 

gegenüber schizophren Erkrankten in sechs bundesdeutschen 

Großstädten. Nervenarzt 73: 665–670 

ReseaRch 

Gaebel W, Jänner M, Frommann N, Pietzcker A, Köpcke W, Linden 

M, Müller P, Müller-Spahn F, Tegeler J (2002): First vs multiple 

episode schizophrenia: two-year outcome of intermittent and 

maintenance medication strategies. Schizophr Res 53: 145–159 

Habel U, Posse S, Schneider F (2002): Fundamentals of functional 

magnetic resonance imaging in clinical psychology and psychiatry. 

Fortschr Neurol Psychiatr 70: 61–70 

Härter M, Bermejo I, Niebling W, Schneider F, Gaebel W, Berger M 

(2002): Vernetzte Versorgung depressiver Patienten – Entwicklung 

eines Behandlungskorridors und Implementierung evidenzbasierter 

Behandlungsempfehlungen. Z Allg Med 78: 231–238 

Haupt M (2002): Frühdiagnostik dementieller Syndrome. Ist es Alzheimer? 

MMW 144: 30–36 

Henning U, Loeffler S, Krieger K, Klimke A (2002): Uptake of 

clozapine into HL-60 promyelocytic leukaemia cells. Pharmaco- 

psychiatry 35: 90–95 

Höhl W, Großer J (2002): Psychiatrische Ergotherapie – Bisherige 

Entwicklung und aktuelle Umbruchphase. Krankenhauspsychia- 

trie 13: 8–13 

Ihl R (2002): Dementing disorders. What benefits do the new anti- 

dementia drugs have? MMW 6; Suppl 2: 24–26, 28–29 

Janssen B, Gaebel W (2002): Therapie der Schizophrenie 2002, MMW 

144: 72–76 

Janssen B, Gaebel W (2002): Bessere Prognose durch neue Behand- 

lungsansätze: Therapie der Schizophrenie 2002. MMW Sonderheft 

2: 72–78 

Karger A, Haupt M (2002): Seltener beachtete Demenzen. Med Welt 

53: 116–119 

Kornischka J, Burtscheidt W, Gaebel W (2002): Interferon-induzierte 

paranoide Psychose – Literaturübersicht und Kasuistik. Nervenarzt 

73: 463–467 

Möller-Lehmkühler AM, Schwarz R, Burtscheidt W, Gaebel W 

(2002): Alcohol dependence and gender-role orientiation. Eur 

Psychiatry 17: 1-8 

Oades RD, Klimke A, Henning U, Rao ML (2002): Relations of clinical 

features, subgroups and medication to serum monoamines in 

schizophrenia. Hum Psychopharmacol 17: 15–27 

Sand P, Luckhaus C, Schlurmann K, Götz M, Deckert J (2002): 

Untangling the human estrogen receptor gene structure. J Neural 

Transm 109: 567–583 

Schneider F, Böhner H, Habel U, Salloum JB, Stierstorfer A, Hummel 

TC, Miller C, Friedrichs R, Müller EE, Sandmann W (2002): 

Risk factors for postoperative delirium in vascular surgery (2002): 

Gen Hosp Psychiatry 24: 28–34 

Wernicke C, Smolka M, Gallinat J, Winterer G, Schmidt LG, Rommelspacher 

H (2002): Evidence for the importance of the human dopamine 

transporter gene for withdrawal symptomatology of alcoholics 

in a German population. Neurosci Lett 15 : 45–48 

Wölwer W, Gaebel W (2002): Impaired Trail Making Test-B performance 

in patients with acute schizophrenia is related to inefficient 

sequencing of planning and acting. J Psychiatric Res 36: 407–416 

121


2003 

Baumann A, Zaeske H, Gaebel W (2003): Das Bild psychisch Kranker 

im Spielfilm: Auswirkungen auf Wissen, Einstellungen und soziale 

Distanz am Beispiel des Films „Das weiße Rauschen“. Psychiatr 

Prax 30: 372–378 

Bermejo I, Kratz S, Schneider F, Gaebel W, Mulert Ch, Hegerl U, Berger 

M, Härter M (2003): Konkordanz von Arzt- und Patienten-Einschätzung 

bei depressiven Störungen. ZaeFQ 9 (Suppl IV): 44–49 

Böhner H, Friedrichs R, Habel U, Müller EE, Sandmann W, Schneider 

F (2003): Delirium increases morbidity and length of stay after 

vascular surgery operations. Results of a prospective study. 

Chirurg 74: 931–936 

Böhner H, Hummel TC, Habel U, Miller C, Reinbott S, Yang Q, Gabriel 

A, Friedrichs R, Müller EE, Ohmann C, Sandmann W, Schneider 

F (2003): Predicting delirium after vascular surgery: a model 

based on pre- and intraoperative data. Ann Surg 238: 149–1556 

Bonnet U, Banger M, Leweke FM, Specka M, Müller BW, Hashemi T, 

Nyhuis PW, Kutscher S, Burtscheidt W, Gatpar M (2003): Treatment 

of acute alcohol withdrawal with gabapentin: results from a 

controlled two-center trial. J Clin Psychopharmacol 23: 514–519 

Erdmann G, Wölwer W, Wissel R (2003): Habituelle Situationskontrolltendenz, 

aktuelles Kontrollverhalten und Belastungsreaktionen 

auf kontrollierbare vs. nicht-kontrollierbare aversive Reize: 

Untersuchung zur experimentellen Validierung des Subtests „Situationskontrollversuche“ 

des SVF. Z f Differentielle Diagnostische 

Psychologie 24: 85–95 

Falkai P, Schneider-Axmann T, Honer WG, Vogeley K, Schönell H, 

Pfeiffer U, Scherk H, Block W, Träber F, Schild HH, Maier W, Tepest 

R. (2003): Influence of genetic loading, obstetric complications 

and premorbid adjustment on brain morphology in schizophrenia: 

a MRI study: Eur Arch Psychiatry Clin Neurosci 253: 

92–99 

Fallgatter AJ, Bartsch AJ, Zielasek J, Herrmann MJ (2003): Brain 

electrical dysfunction of the anterior cingulate in schizophrenic 

patients. Psychiatry Res. Neuroimaging 124: 37–48 

Frommann N, Streit M, Wölwer W (2003): Remediation of schizophrenics‘ 

impairments in facial affect recognition: A new training 

program. Psychiatry Res 117: 281–284 

Gaebel W, Baumann A (2003): „Open the doors“. Weltweite Initiative 

gegen die Stigmatisierung psychisch Kranker. MMW 12: 34–37 

Gaebel W, Baumann A (2003): Interventions to reduce the stigma 

associated with severe mental illness: experiences from the Open 

the doors Program in Germany. Can J Psychiatry 48: 657–662 

Gaebel W, Falkai P (2003): DGPPN-Referat Qualitätssicherung und 

Leitlinien. Aktueller Stand und Perspektiven der Leitlinienentwicklung. 

Nervenarzt 74: 94–99 

Gaebel W, Janssen B, Riesbeck M (2003): Modern Treatment Concepts 

in Schizophrenia. Pharmacopsychiatry 36 (Suppl 3): 168–175 

Gaebel W, Lepper H (2003): Qualitätsberichte in der Psychiatrie. Nervenarzt 

9: 14–19 

122 

Gaebel W, Menke R (2003): Leitlinienorientierte Patienteninformati- 

onen zur Depression – ein Beitrag zur Bereitstellung fachlich fun- 

dierter Gesundheitsinformationen für Betroffene und Angehörige. 

ZaeFQ 9 (Suppl IV): 80–89 

Gaebel W, Riesbeck M, Janssen B, Schneider F, Held T, Mecklenburg 

H, Sass H (2003): Atypical and typical neuroleptics in acute schizophrenia 

and related delusional disorders. Eur Arch Psychiatry Clin 

Neurosci 253: 175–184 

Gaebel W, Wölwer W (2003): Facial expressivity in the course of schizophrenia 

and depression. Eur Arch Psychiatr Clin Neusosc 254: 

335–342 

Gaebel W, Wölwer W (2003): Impaired Visuomotor Integration in Acute 

Schizophrenia. World J Biol Psychiatry 4: 124–128 

Godemann F, Linden M, Gaebel W, Köpcke W, Müller P, Müller- 

Spahn F, Tegeler J, Pietzcker A (2003): Is interval medication as 

successful treatment regimen for schizophrenic patients with 

critical attitudes towards treatment? Eur Psychiatry 18: 82–84 

Gustafson L, Burns A, Katona C, Bertolote JM, Camus V, Copeland 

JR, Dufey AF, Graham N, Ihl R, Kanowski S, Kühne N, de Mendonça 

Lima CA, Mateos Alvarez R, Rutz W, Tataru NL, Tudose C 

(2003): European Association of Geriatric Psychiatry. Skill-based 

objectives for specialist training in old age psychiatry. Int J Geriatr 

Psychiatry 18: 686–693 

Härter M, Bermejo I, Kratz S, Schneider F (2003): Continuing education 

and quality management measures for the implementation of 

clinical practice guidelines]. Z Arztl Fortbild Qualitatssich Suppl 4: 

67–73 

Härter M, Bermejo I, Berger M, Dausend S, Gaebel W, Schneider F 

(2003): Vernetzte Versorgung depressiver Patienten in der hausärztlichen 

Praxis. Hausarzt-Kolleg 1: 66–69 

Härter M, Bermejo I, Dausend S, Schneider F, Gaebel W, Berger M 

(2003): Entwicklung und Evaluation von Diagnose- und Therapieempfehlungen. 

PsychoNeuro 29: 217–226 

Härter M, Bermejo I, Schneider F, Gaebel W, Niebling W, Berger M 

(2003): Umfassendes ambulantes Qualitätsmanagement in der 

Versorgung depressiver Patienten. ZaeFQ 9 (Suppl IV): 9–15 

Härter M, Bermejo I, Schneider F, Kratz S, Gaebel W, Hegerl U, 

Niebling W, Berger M (2003): Versorgungsleitlinien zur Diagnostik 

und Therapie depressiver Störungen in der hausärztlichen Praxis. 


Ihl R (2003): The impact of drugs against dementia on cognition in 

aging and mild cognitive impairment. Pharmacopsychiatry 36, 

Suppl 1: 38–43 

Janssen B, Gaebel W (2003): Krisen-Management bei der Schizophrenie 

– moderne Therapiemöglichkeiten ausschöpfen. Kolloquium 

Neurologie. Medical Tribune 14: 3–4 

Janssen B, Gaebel W (2003): Schizophrenie: Neue Aspekte der Diagnostik 

und Therapie. extracta psychiatrica/neurologica 9: 16–22 

Kornischka J, Schneider F (2003): Delusion of pregnancy. A case 

report and review of the literature. Psychopathology. 36: 276–278

Kratz S, Härter M, Bermejo I, Berger M, Schneider F, Gaebel W 

(2003): Beratungsanlass und Diagnosestellung bei depressiven 

Patienten in der haus- und nervenärztlichen Praxis. ZaeFQ 9 

(Suppl IV): 50–56 

Larisch R, Klimke A, Hamacher K, Henning U, Estalji S, Hohlfeld T, 

Vosberg H, Tosch M, Gaebel W, Coenen HH, Muller-Gartner HW 

(2003): Influence of synaptic serotonin level on [18F]altanserin binding 

to 5HT2 receptors in man. Behav Brain Res. 17: 21–29 

Loeffler S, Fehsel K, Henning U, Fischer J, Agelink M, Kolb-Bachofen 

V, Klimke A (2003): Increased apoptosis of neutrophils in a case of 

clozapine-induced agranulocytosis – a case report. Pharmacopsychiatry 

36: 37–41 

Luckhaus C, Jacob C, Zielasek J, Sand P (2003): Olfactory reference 

syndrome manifests in a variety of psychiatric disorders. Int. J 

Psychiatry Clin Pract 7: 41–44 

Menke R, Schneider F, Härter M, Salize HJ, Berger M, Gaebel W 

(2003): Kostenoptimierung ambulanter Depressionsbehandlung. 


Posse S, Fitzgerald D, Gao K, Habel U, Rosenberg D, Moore GJ, 

Schneider F (2003): Real-time fMRI of temporolimbic regions 

detects amygdala activation during single-trial self-induced sadness. 

Neuroimage 18: 760–768 

Schneider F, Dausend S, Gaebel W, Bermejo I, Berger M, Härter M 

(2003): Ambulantes Qualitätsmanagement in der hausärztlichen 

Depressionsbehandlung. Hausarzt-Kolleg 1: 70–73 

Schneider F, Habel U, Volkmann J, Regel S, Kornischka J, Sturm V, 

Freund HJ (2003): Deep brain stimulation of the subthalamic nucleus 

enhances emotional processing in Parkinson disease. Arch 

Gen Psychiatry 60: 296–302 

Schneider F, Härter M, Kratz S, Bermejo I, Mulert Ch, Hegerl U, Gaebel 

W, Berger M (2003): Unzureichender subjektiver Behandlungsverlauf 

bei depressiven Patienten in der haus- und nervenärztlichen 

Praxis. ZaeFQ 9 (Suppl IV): 57–66 

Streit M, Brinkmeyer J, Wölwer W, Gaebel W (2003): EEG brain 

mapping in schizophrenic patients and healthy subjects during facial 

emotion recognition. Schizophr Res 61: 121–122 

Streit M, Dammers J, Simsek-Kraues S, Brinkmeyer J, Wölwer W, 

Ioannides AA (2003): Time course of regional brain activations 

during facial emotion recognition in humans. Neurosci Lett 342: 

101–104 

Tass PA, Klosterkötter J, Schneider F, Lenartz D, Koulousakis A, 

Sturm V (2003): Obsessive-compulsive disorder: development of 

demand-controlled deep brain stimulation with methods from 

stochastic phase resetting. Neuropsychopharmacology 28, 

Suppl 1: 27–34 

Wölwer W, Buchkremer G, Häfner H, Klosterkötter J, Maier W, Möl- 

ler HJ, Gaebel W (2003): German research network on schizophre- 

nia. Bridging the gap between research and care. Eur Arch Psychi- 

atry Clin Neurosci 253: 321–329 

ReseaRch 

Wölwer W, Falkai P, Streit M, Gaebel W (2003): Trait Characteristic of 

Impaired Visumotor Integration during Trail-Making Test B Perfor- 

mance in Schizophrenia. Neuropsychobiology 48: 59–67 

Wölwer W., Gaebel W. (2003): Impaired visuomotor integration in 

acute schizophrenia. World J Biol Psychiatry 4: 124–128 

2004 

Agelink MW, Klimke A, Cordes J, Sanner D, Kavuk I, Malessa R, Klie- 

ser E, Baumann B (2004): A functional-structural model to under- 

stand cardiac autonomic nervous system (ANS) dysregulation in 

affective illness and to elucidate the ANS effects of antidepressive 

treatment. Eur J Med Res 2004: 37–50 

Barkow K, Heun R, Üstün BT, Berger M, Bermejo I, Gaebel W, Härter 

M, Schneider F, Stieglitz RD, Maier W (2004): Identification of 

somatic and anxiety symptoms which contribute to the detection 

of depression in primary health care. Europ Psych 19: 250–257 

Baumann A, Zäske H, Decker P, Möller H-J, Gaebel W (2004): Entstigmatisierung 

schizophrener Erkrankungen. PsychoNeuro 30: 

624–627 

Brinkmeyer J, Grass-Kapanke B, Ihl R (2004): EEG and the Test for 

the Early Detection of Dementia with Discrimination from Depression 

(TE4D): a validation study. Int J Geriatr Psychiatry 19: 749–753 

Cohen S, Scholz P (2004): Sexualstörungen in der Behandlung depressiver 

Erkrankungen. Eine Herausforderung für die behandelnden 

Ärzte. PsychoNeuro 30: 164–168 

Cohen S (2004): Bei Depression Sexualstörungen mitbehandeln. Medical 

Tribune 39: 21 

Cordes J, Streit M, Loeffler S, von Wilmsdorff M, Agelink M, Klimke A 

(2004): Reversible neutropenia during treatment with olanzapine: 

three case reports. World J Biol Psychiatry 5: 230–234 

Falkai P, Tepest R, Honer WG, Dani I, Ahle G, Pfeiffer U, Vogeley K, 

Schulze TG, Rietschel M, Cordes J, Schonell H, Gaebel W, Kuhn 

KU, Maier W, Traber F, Block W, Schild HH, Schneider-Axmann 

T (2004): Shape changes in prefrontal, but not parieto-occipital 

regions: brains of schizophrenic patients come closer to a circle in 

coronal and sagittal view. Psychiatry Res 30: 261–271 

Falkai P, Tepest R, Schulze TG, Müller DJ, Rietschel M, Maier W, 

Träber F, Block W, Schild HH, Steinmetz H, Gaebel W, Honer WG, 

Schneider-Axmann T, Wagner W (2004): Etiopathogenetic mechanisms 

in long-term course of schizophrenia. Pharmacopsychiatry 

37 (Suppl 2): 136–140 

Gaebel W (2004): Die Stellung der Psychiatrie in der Medizin. Die 

Psychiatrie 1: 9–24 

Gaebel, W (2004): Course typologies, treatment principles, and research 

concepts. In: Relapse mechanisms and prophylactic principles 

in schizophrenia and affective disorders. Pharmacopsychiatry 

37 (Suppl 2): 90–97 

Gaebel W (2004): Strategien und Leitlinien der antipsychotischen 

Langzeitbehandlung. Steht ein Paradigmenwechsel bevor? Psychopharmakotherapie 

11: 2–3 

123


Gaebel W (2004): Course Typologies, Treatment Principles, and Research 

Concepts. In: Relapse Mechanisms and Prophylactic Principles 

in Schizophrenia and Affective Disorders. Bensberg, Germany, 

September 18–19, 2003. Pharmacopsychiatry 37 (Suppl 2): 

90–97 

Gaebel W (2004): Editorial: In: Relapse Mechanisms and Prophylactic 

Principles in Schizophrenia and Affective Disorders. Bensberg, 

Germany, September 18–19, 2003. Pharmacopsychiatry 37 

(Suppl 2): 89 

Gaebel W, Möller HJ, Buchkremer G, Ohmann Chr, Riesbeck M, 

Wölwer W, von Wilmsdorff M, Bottlender R, Klingberg S (2004): 

Pharmacological long-term treatment strategies in first episode 

schizo phrenia. Study design and preliminary results of an ongoing 

RCT within the German Research Network on Schizophrenia. Eur 

Arch Psychiatry Clin Neurosci: 254: 129–140 

Gaebel W, Weinmann St (2004): Kommentar zum Thema „Antipsychotische 

Therapie“. extracta psychiatrica/neurologica 1–2: 8 

Gaebel W, Wölwer W (2004): Facial expressivity in the course of 

schizophrenia and depression. Eur Arch Psychiat Clin Neurosc 

254: 335–342 

Gaebel W, Zäske H, Baumann A (2004): Stigma erschwert Behandlung 

und Integration. Deutsches Ärzteblatt 12: 553–555 

Gaebel W, Zäske H, Baumann A (2004): Stigmatisierung und Diskriminierung 

psychisch Erkrankter als Herausforderung für die Gesundheitsversorgung 

in Deutschland. Deutsches Ärzteblatt 101: 

3253–3255 

Häfner H, Maurer K, Ruhrmann S, Bechdolf A, Klosterkötter J, Wagner 

M, Maier W, Bottlemder R, Möller HJ, Gaebel W, Wölwer W 

(2004): Early detection and secondary prevention of psychosis: 

facts and visions. Eur Arch Psychiatry Clin Neurosci 254: 117–128 

Hermann-Lingen C, von Troschke J, Gaebel W (2004): Psycho-Social- 

Medicine – More than just another journal. Psychosoc Med Jul 1 

(epub ahead of print) 

Höhl W (2004): Assessments der neuen Theoriemodelle: Anmerkungen 

zu methodischen Grundlagen und praktischer Anwendung. 

Ergotherapie und Rehabilitation 12: 6–13 

Höhl W, Kirchhoff C, Längle G, Bailer W, Machleidt W, Salize W, Wiedl 

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Weßling A, Wölwer W, Heres S, Mayenberger M, Rummel C, Sievers 

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Zielasek J (2006): Herz und Psyche – Psyche und Herz. Med Klinik 

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Allardyce J, Gaebel W, Zielasek J, van Os J (2007): Deconstructing 

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Bermejo I, Frey C, Kriston L, Schneider F, Gaebel W, Hegerl U, Berger 

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Gaebel W (2007): Editorial: Europ Arch Psychiatr Clin Neurosc 257 

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Gaebel W (2007): Gewissenhafte Therapie. Medical Tribune 7: 34–35 

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Gaebel W, Riesbeck M (2007): Akutbehandlung schizophrener Psychosen. 

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Gaebel W, Wölwer W (2007) (Hrsg.): 1st European Conference on Schizophrenia 

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September 2007, Düsseldorf, Germany. Europ Arch Psych Clin 

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Gaebel W, Zielasek J, Müller U (2007): Psychiatry in Germany. International 


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John ER, Prichep LS, Winterer G, Herrmann WM, di Michele F, Halper 

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Koethe D, Jülicher A, Nolden BM, Klosterkötter J, Niklewski G, 

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Kornischka J, Cordes J, Agelink MW (2007): 40 Years Beta-Adrenoceptor 

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Lange-Asschenfeldt C, Lohmann P, Riepe MW (2007): Spatial performance 

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Reske M, Kellermann T, Habel U, Shah J, Backes V, von Wilmsdorf 

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Ruhrmann S, Bechdolf A, Kühn KU, Wagner M, Schultze-Lutter F, 

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Schneider F, Habel U, Klein M, Kellermann T, Stöcker T, Shah J, Zilles 

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Wölwer W, Frommann N (2007): Therapie von sozial-kognitiven Störungen 

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Bär KJ, Boettger MK, Andrich J, Epplen JT, Fischer F, Cordes J, 

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Bär KJ, Wernich K, Boettger S, Cordes J, Boettger MK, Löffler S, 

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Baumann AE, Ahrens W, Gaebel W (2008): Aktionsbündnis für seelische 

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Cordes J, Sinha-Röder A, Kahl KG, Malevani J, Thuenker J, Lange- 

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Diefenbacher A, Gaebel W (2008): Leitlinien in der Konsiliar-Liaisonpsychiatrie. 

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Dihné M, Schuier FJ, Schuier M, Cordes J, Hartung HP, Knehans A, 

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Falkai P, Owen M, Myin-Germeys I, Harrison P, Bilkei-Gorzo A, 

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Fritze J, Aldenhoff J, Bergmann F, Eckermann G, Maier W, Möller 

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Fritze J, Gaebel W (2008): Brennpunkt: Voraussetzungen einer zielorientierten 

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Funke SA, Birkmann E, Henke F, Görtz P, Lange-Asschenfeldt C, 

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Gaebel W (2008): Grußwort zum DGPPN Kongress 2008. Neurotransmitter 

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Gaebel W (2008): Kommentar zur Kirsch-Metaanalyse. INFO Neurologie 

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Gaebel W (2008): Editorial: Psychiatrie als therapeutische Disziplin 

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Gaebel W (2008): Editorial: Versorgung psychisch Kranker. Mehr 

Möglichkeiten für den Hausarzt. Der Allgemeinarzt 15: 3 

Gaebel W (2008): Wie gut ist in Deutschland die Versorgung von 

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Ziel ist die Verbesserung der Versorgungssituation. 

Treffpunkte – Frankfurter Zeitschrift für Gemeindepsychiatrie 

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Gaebel W (2008): Zum Thema: Perspektiven der Psychiatrie als therapeutische 

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Gaebel W (2008): Pro und Contra: Verwendung von Leitlinien. Psychiatrie 

und Psychotherapie uptodate 3: 138–141 

Gaebel W, Haessler F; Deutsche Gesellschaft für Psychiatrie, Psychotherapie 

und Nervenheilkunde (DGPPN); Deutsche Gesellschaft 

für Kinder- und Jugendpsychiatrie, Psychosomatik und 

Psychotherapie (DGKJP) (2008): The problem of infanticide. Nervenarzt 

79: 856–857 

Gaebel W, Marneros A, Müller-Spahn F, Sartorius N (2008): Editorial: 

Zum 200. Geburtstag der Psychiatrie. Die Psychiatrie 5: 231 

Gaebel W, Riesbeck M (2008): Commentary on DeMasi et al. The Italian 

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Gaebel W, Zäske H, Baumann AE, Klosterkötter J, Maier W, Decker 

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against stigma and discrimination because of schizophrenia – 

Open the doors“: Results from representative telefone surveys before 

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Gaebel W, Zielasek J (2008): Der Doktor spricht nicht mit dem Gehirn. 

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Gaebel W, Zielasek J (2008): DGPPN Kongress 2007. Herausforderungen 

auf dem Weg zu einer europäischen Psychiatrie: Das Forum 

European Leaders in Psychiatry. Nervenarzt 79: 375–378 

Gaebel W, Zielasek J (2008): Mission Statement der Deutschen Gesellschaft 

für Psychiatrie, Psychotherapie und Nervenheilkunde. 

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Gaebel W, Zielasek J (2008): Editorial: Psychiatry as a diagnostic. Eur 

Arch Psychiatry Clin Neurosci 258 (Suppl 5): 1 

Gaebel W, Zielasek J (2008): Stand der Entwicklung von ICD-11 und 

DSM-V. Nervenarzt 79: 376–378 

Gaebel W, Zielasek J (2008): Tendenzen in der Revision von ICD-10 

und DSM-IV. Brennpunkt Psychiatrie 1: 6–9 

Gaebel W, Zielasek J (2008): The DSM-V initiative „Deconstructing 

Psychosis“ in the context of Kraepelin’s concept on nosology. European 

Archives of Psychiatry and Clinical Neuroscience 258 (Suppl 

2): 41–47 

Green MF, Penn D, Bentall R, Carpenter W, Gaebel W, Gur R, Kring 

A, Park S, Silverstein S, Heinssen R (2008): Social Cognition in 

Schizophrenia: NIMH Consensus Meeting on Definitions, Assessment, 

and Research Opportunities. Schizophrenia Bull: 34: 1211– 

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Kessler H, Baye TA, Bach D, Schneider-Axmann T, Supprian T, Hermann 

W, Haber M, Multhaup G, Falkai P, Pajonk FG (2008): Intake 

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Alzheimer’s disease: a pilot phase 2 clinical trial. J Neural Transm 

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Jäger M, Messer T, Laux G, Pfeiffer H, Naber D, Schmidt LG, Gaebel 

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Jäger M, Riedel M, Schmauß M, Pfeiffer H, Laux G, Naber D, Gaebel 

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Kahn R, Fleischhacker W, Boter H, Davidson M, Vergouwe Y, Keet IP, 

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Klingberg S, Hesse K, Herrlich J, Kossow S, Wiedemann G, Wittorf A, 

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Lewczuk P, Kamrowski-Kruck H, Peters O, Heuser I, Jessen F, Popp 

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Haerter P, Wienker TF, Sullivan PF, Nöthen MM, Kiefer F, Spanagel 

R, Mann K, Rietschel M (2009): Genome-wide association study 

of alcohol dependence. Arch Gen Psychiatry 66: 773–784 

Wernicke C, Reese J, Kraschewski A, Winterer G, Rommelspacher H, 

Gallinat J (2009): Distinct haplogenotypes of the dopamine D2 receptor 

gene are associated with non-smoking behaviour and daily 

cigarette consumption. Pharmacopsychiatry 42: 41–50 

Wittorf A, Jacobi U, Bechdolf A, Müller B, Sartory G, Wagner M, Wiedemann 

G, Wölwer W, Herrlich J, Buchkremer G, Klingberg S 

(2009): The influence of baseline symptoms and insight on the therapeutic 

alliance early in the treatment of schizophrenia. European 


Wobrock T, Falkai P, Schneider-Axmann T, Pfeiffer U, Wölwer W, 

Gae bel W (2009): Effects of abstinence on brain morphology in al- 

coholism: A MRI study. Eur Arch Psychiat Clin Neurosc 259: 143–150 

Wobrock T, Gruber O, Schneider-Axmann T, Wölwer W, Gaebel W, 

Riesbeck M, Maier W, Klosterkötter J, Schneider F, Buchkremer 

G, Möller HJ, Schmitt A, Bender S, Schlösser R, Falkai P (2009): 

Internal capsule size associated with outcome in first-episode 

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Wobrock T, Weinmann S, Falkai P, Gaebel W (2009): Quality assurance 

in psychiatry: quality indicators and guideline implementation. 

Arch Psychiatry Clin Neurosci (Suppl) 259: 219–226 

Wölwer W, Frommann N (2009): Entrenamiento en el reconocimiento 

de afectos – Programa especifico para el tratamiento de los trastornos 

cognitivo-sociales de los pacientes esquizofrénicos. Rehabilitacion 

Psicosocial (in press) 

Wölwer W, Drusch K (2009): Neuropsychologische Aspekte psychischer 

Störungen über die Lebensspanne. Die Psychiatrie 6: 184–190 

Zielasek J, Freyberger HJ, Jänner M, Kapfhammer HP, Sartorius N, 

Stieglitz RD, Gaebel W (2009): Assessing the opinions and experiences 

of German-speaking psychiatrists regarding necessary 

changes for the eleventh revision of the mental disorders chapter 

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(in press) 

Zielasek J, Gaebel W (2009) Modularity in philosophy, the neuroscience, 

and psychiatry. Poiesis & Praxis 6: 93–108

3.1.9.2 Book contributions 

2001 

Gaebel W (2001): General Principles of the Treatment of Schizophrenic 

Disorders. In: Henn FA, Sartorius N, Helmchen H, Lauter H 

(eds): Contemporary Psychiatry, Vol 3: Specific Psychiatric Disorders, 

Part 1 Schizophrenic. Affective and Related Disorders. 

Springer, Berlin: 129–138 

Gaebel W (2001): Quality Assurance in Psychiatry. In: Henn FA, Sartorius 

N, Helmchen H, Lauter H (Hrsg.): Contemporary Psychiatry, 

Vol 1: Foundations of Psychiatry, Part 2 General Psychiatry. Springer, 

Berlin: 211–228 

Gaebel W (2001): Standortbestimmung und Thesen zur weiteren Entwicklung 

in Psychiatrie und Psychotherapie. In: Gaebel W, Heinlein 

J, Maas K (Hrsg.): Psychiatrie im Wandel der Zeit. 125 Jahre „Grafenberg“ 

– Rheinische Kliniken Düsseldorf – Kliniken der Heinrich-Heine-Universität 

Düsseldorf. Festschrift. Rheinland Verlag, 

Köln: 13–35 

Gaebel W, Lehmann E (2001): Stellungnahme zur Konzeption und 

empirischen Basis von Soteria. In: Ciompi L, Hoffmann H, Broccard 

M (Hrsg.): Wie wirkt Soteria? Eine atypische Psychosenbehandlung 

kritisch durchleuchtet. Huber, Bern: 219–222 

Haupt M, Palm B, Siebel U, Kretschmar JH (2001): Paartherapeutische 

Gruppenbehandlung von Demenzkranken und ihren pflegenden 

Partnern. In: Deutsche Alzheimer Gesellschaft (Hrsg.): Brücken 

in die Zukunft. Kongressbeiträge auf dem Alzheimer Europe 

10th Anniversary Meeting, Berlin: 483–493 

Haupt M, (2001): Affektive Störungen. In: Klingelhöfer J, Spranger M 

(Hrsg.): Leitfaden für die Klinik, Neurologie, Psychiatrie. 2. Aufl. Fischer, 

Ulm: 548–563 

Haupt M, Kurz A (2001): Neurotische Störungen. In: Klingelhöfer J, 

Spranger M (Hrsg.): Leitfaden für die Klinik, Neurologie, Psychiatrie, 

2. Aufl. Fischer, Ulm: 577–596 

Höft B (2001): Umgang mit schwerwiegenden Verhaltensstörungen 

demenzkranker Heimbewohner. In: iso-Institut: Zehn Jahre BMG- 

Modellprogramm „Förderung der Versorgung demenzkranker 

Menschen in stationären Pflegeeinrichtungen“. Dokumentation 

der Fachtagung vom 7. bis 9. Mai 2001 in Bonn. Saarbrücken 

Ihl R (2001): Der Test zur Früherkennung von Demenzen mit Depressionsabgrenzung 

(TFDD). In: Deutsche Alzheimer Gesellschaft, 

Brücken in die Zukunft. Deutsche Alzheimer Gesellschaft e. V., 

Berlin 

Klimke A, Löffler S, Fehsel K, Henning U (2001): Neue Forschungsergebnisse 

zur Clozapin-induzierten Agranulozytose. In: Naber D, 

Müller-Spahn F (Hrsg.): Clozapin – Pharmakologie und Klinik eines 

atypischen Neuroleptikums. Springer, Berlin: 21–29 

Löll A, Lüthcke H, Strauss WH, Gaebel W (2001): Praxisrelevante verhaltenstherapeutische 

Ansätze in der ambulanten Suchtbehandlung. 

In: Hielscher H, Klieser E (Hrsg.): Somatische Probleme des 

Alkoholismus aus neurologischer und psychiatrischer Sicht. Pabst 

Science Publishers, Lengerich: 189–196 

ReseaRch 

Mentrup H, Haupt M (2001): Organisch bedingte psychische Störun- 

gen. In: Klingelhöfer J, Spranger M (Hrsg.): Leitfaden für die Kli- 

nik, Neurologie, Psychiatrie. 2. Aufl. Fischer, Ulm: 628–647 

Schneider F (2001): Herz im Kopf oder Mandelkerne mit Gefühl: Zur 

funktionellen Neurobiologie der Emotionen. In: Rektor der Hein- 

rich-Heine-Universität Düsseldorf (Hrsg.). Jahrbuch 1994–1997. 

Heinrich-Heine-Universität, Düsseldorf: 311–316 

Wölwer W, Burtscheidt W, Gaebel W (2001): Neuropsychologische 

Prädiktoren der Rückfälligkeit bei Alkoholkranken. In: Hielscher 

H, Klieser E (Hrsg.): Somatische Probleme des Alkoholismus aus 

neurologischer und psychiatrischer Sicht. Pabst Science Publishers, 

Lengerich: 90–101 

2002 

Burtscheidt W, Schneider F (2002): Grundlagen der Alkoholkrankheit. 

In: Schneider F, Frister H (Hrsg.): Alkohol und Schuldfähigkeit. 


Cordes J, Malevani J (2002): Labordiagnostik in der Psychiatrie In: 

Gaebel W, Müller-Spahn F (Hrsg.): Diagnostik und Therapie psychischer 

Störungen. Kohlhammer, Stuttgart: 766–787 

Gaebel W (2002): Leitlinien störungsspezifischer Diagnostik und Therapie: 

Schizophrenie. In: Gaebel W, Müller-Spahn F (Hrsg.): Diagnostik 

und Therapie psychischer Störungen. Kohlhammer, Stuttgart: 

1168–1196 

Gaebel W (2002): Psychisch Kranke in der Gesellschaft – zwischen 

Akzeptanz und Stigmatisierung. In: Zapotoczky K, Grausgruber A, 

Mechtler R (Hrsg.): Gesundheit im Brennpunkt. Der Patient zwischen 

Vernetzung und Isolation. Bde 8/1 und 8/2. Universitätsverlag 

Rudolf Trauner, Linz: 176–202 

Gaebel W (2002): Schizophrenie, schizotype und wahnhafte Störungen. 

In: Gaebel W, Müller-Spahn F (Hrsg.): Diagnostik und Therapie 

psychischer Störungen. Kohlhammer, Stuttgart: 244–372 

Gaebel W (2002): Schizophrenien und wahnhafte Störungen. In: Freyberger 

HJ, Schneider W, Stieglitz RD (Hrsg.): Kompendium Psychiatrie, 

Psychotherapie, Psychosomatische Medizin. 11., vollst. ern. 

u. erw. Aufl. Karger, Basel: 82–99 

Gaebel W (2002): Standortbestimmung und Thesen zur künftigen 

Entwicklung in Psychiatrie und Psychotherapie. In: Gaebel W 

(Hrsg.): Zukunftsperspektiven in Psychiatrie und Psychotherapie. 

Steinkopff, Darmstadt: 11–17 

Gaebel W, Müller-Spahn F (2002): Diagnostisch-therapeutischer Prozess 

in der Psychiatrie – Grundprinzipien. In: Gaebel W, Müller- 

Spahn F (Hrsg.): Diagnostik und Therapie psychischer Störungen. 

Kohlhammer, Stuttgart: 1–72 

Gaebel W, Schwarz M, Janssen B (2002): Qualitätsmanagement. In: 

Gaebel W, Müller-Spahn F (Hrsg.): Contemporary Psychiatry, Vol. 

1: Foundations of Psychiatry, Part 2 General Psychiatry. Springer, 

Berlin: 211–228 

137


Gaebel W, Schwarz M, Janssen B (2002): Qualitätsmanagement in 

der Psychiatrie. In: Gaebel W, Müller-Spahn F (Hrsg.): Diagnostik 


1257–1273 

Habel U, Schmitt-Frister P, Koppenhöfer B, Schneider F (2002): Prävention 

sekundärer Traumatisierungen bei Opferzeugen. In: Barton 

S (Hrsg.): Verfahrensgerechtigkeit und Zeugenbeweis: Fairness 

für Opfer und Beschuldigte. Nomos, Baden-Baden: 117–128 

Habel U, Schneider F (2002): Diagnostik und Symptomatik von Alkoholintoxikation, 

schädlichem Gebrauch und Alkoholabhängigkeit. 

In: Schneider F, Frister H (Hrsg.): Alkohol und Schuldfähigkeit. 


Haupt M (2002): Delir. In: Gaebel W, Müller-Spahn F (Hrsg.): Diagnostik 


110–120 

Haupt M (2002): Medizinische Aus-, Weiter- und Fortbildung. In: Hallauer 

F, Kurz A (Hrsg.): Weißbuch Demenz. Thieme, Stuttgart: 

110–113 

Haupt M (2002): Stand der nicht-medikamentösen Therapie. In: Hallauer 

F, Kurz A (Hrsg.): Weißbuch Demenz. Thieme, Stuttgart: 

48–51 

Haupt M (2002): Verhaltensstörungen bei der Alzheimer Krankheit. 

In: Klingelhöfer J, Conrad B (Hrsg.): Neurologie für die Praxis: 

Fortschritte in Diagnostik und Therapie. MMV, München: 214–222 

Haupt M, Burtscheidt M (2002): Leitlinien zum Delir. In: Gaebel W, 

Müller-Spahn F (Hrsg.): Diagnostik und Therapie psychischer Störungen. 


Haupt M, Kretschmar Ch. (2002): Gerontopsychiatrie. In: Gaebel W, 



Höft B, Paulus HJ (2002): Empfehlungen für Leistungsstandards in 

der gerontopsychiatrischen Pflege – Eine Option für die Qualitätssicherung 

in der Rehabilitation Demenzkranker? In: Oldiges FJ, 

Schian HM, Schönle PW (Hrsg.): Pflegebedürftigkeit – Herausforderung 

für die Rehabilitation. Deutsche Vereinigung für die Rehabilitation 

Behinderter e. V., Interdisziplinäre Schriften zur Rehabilitation 

Bd 11. Universitäts-Verlag, Ulm 

Höhl W (2002): Ergotherapie. In: Gaebel W, Müller-Spahn F (Hrsg.): 

Diagnostik und Therapie psychischer Störungen. Kohlhammer, 

Stuttgart: 1015–1026 

Ihl R (2002): Demenzen. In: Gaebel W, Mueller-Spahn F (Hrsg.): Diagnostik 

und Therapie psychischer Erkrankungen. Kohlhammer, 


Ihl R (2002): Leitlinien. In: Gaebel W, Mueller-Spahn F (Hrsg.): Diagnostik 

und Therapie psychischer Erkrankungen. Kohlhammer, 


Ihl R, Gronau-Adams A (2002): Elektroenzephalographie. In: Gaebel 

W, Mueller-Spahn F (Hrsg.): Diagnostik und Therapie psychischer 

Erkrankungen. Kohlhammer, Stuttgart: 788–800 

138 

Ihl R, Weyerer S (2002): Forschungsarbeiten zur Hochaltrigkeit un- 

ter besonderer Berücksichtigung der Demenz. In: Bundesminis- 

terium für Familie, Senioren, Frauen und Jugend (Hrsg.): Vierter 

Bericht zur Lage der älteren Generation in der Bundesrepublik 

Deutschland: Risiken, Lebensqualität und Versorgung Hochaltriger 

– unter besonderer Berücksichtigung demenzieller Erkrankungen. 

Berlin: 60–70 

Ihl R, Weyerer S, Wojnar J (2002): Gesundes Altern, Demenzrisiko 

des hohen Alters. Folgen der Demenz und Leben mit Demenz. 

In: Bundesministerium für Familie, Senioren, Frauen und Jugend 

(Hrsg.): Vierter Bericht zur Lage der älteren Generation in der 

Bundesrepublik Deutschland: Risiken, Lebensqualität und Versorgung 

Hochaltriger – unter besonderer Berücksichtigung demenzieller 

Erkrankungen. Berlin: 164–183 

Ihl R, Weyerer S, Wojnar J (2002): Therapie der Demenz. In: Bundesministerium 

für Familie, Senioren, Frauen und Jugend (Hrsg.): 

Vierter Bericht zur Lage der älteren Generation in der Bundesrepublik 

Deutschland: Risiken, Lebensqualität und Versorgung 

Hochaltriger – unter besonderer Berücksichtigung demenzieller 

Erkrankungen. Berlin: 288–303 

Klimke A, Malevani J (2002): Psychopharmakotherapie. In: Gaebel W, 



Kretschmar C, Haupt M (2002): Gerontopsychiatrische Aspekte endogener 

Psychosen und neurotischer Störungen. In: Möller HJ, Laux 

G, Kapfhammer HP (Hrsg.): Psychiatrie & Psychotherapie. Springer, 

Berlin: 1783–1798 

Krücken A, Habel U, Schneider F (2002): Persönlichkeitsstörungen 

(F60, F61, F62, F68). In: Gaebel W, Müller-Spahn F (Hrsg.): Diagnostik 


612–639 

Krücken A, Schneider F (2002): Leitlinien störungsspezifischer Diagnostik 

und Therapie: Persönlichkeitsstörungen. In: Gaebel W, 



Lehmann E, Schneider F (2002): Abnorme Gewohnheiten und Störungen 

der Impulskontrolle (F63). In: Gaebel W, Müller-Spahn F 

(Hrsg.): Diagnostik und Therapie psychischer Störungen. Kohlhammer, 


Mecklenbeck F, Clausnitzer S (2002): Musiktherapie. In: Gaebel W, 

Müller–Spahn F (Hrsg.): Diagnostik und Therapie psychischer Störungen. 


Pirkl U, Schwarz M (2002): Tanztherapie. In: Gaebel W, Müller–Spahn 

F (Hrsg.): Diagnostik und Therapie psychischer Störungen. Kohlhammer, 


Schneider F, Habel U, Bestmann S (2002): Affektive Störungen. In: 

Förstl H (Hrsg.): Frontalhirn – Funktionen und Erkrankungen. 

Springer, Heidelberg: 207–240

Schneider F, Habel U (2002): Emotionen: Neuropsychologische und 

funktionell bildgebende Korrelate. In: Gaebel W (Hrsg.): Zukunftsperspektiven 

in der Psychiatrie und Psychotherapie. Steinkopff, 

Darmstadt: 107–123 

Schneider F, Hummel T, Gaebel W (2002): Psychiatrisch-Psychotherapeutische 

Konsiliar- und Liaisontätigkeit. In: Gaebel W, Müller- 

Spahn F (Hrsg.): Diagnostik und Therapie psychischer Störungen. 


Schneider F, Krücken A (2002): Persönlichkeits- und Verhaltensstörungen 

(F6). Einführung. In: Gaebel W, Müller-Spahn F (Hrsg.): 



Strauss WH (2002): Angststörungen. In: Gaebel W, Müller-Spahn F 

(Hrsg.): Diagnostik und Therapie psychischer Störungen. Kohlhammer, 


Strauss WH (2002): Leitlinien störungsspezifischer Diagnostik und 

Therapie: Angststörungen. In: Gaebel W, Müller-Spahn F (Hrsg.): 



Wölwer W (2002): Test- und neuropsychologische Untersuchung. In: 

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2003 

Adler G, Ihl R (2003): Elektrophysiologische Untersuchungsverfahren. 

In: Förstl H (Hrsg.): Lehrbuch der Gerontopsychiatrie, 2. Aufl. 

Enke, Stuttgart: 143–151 

Cordes J, Kornischka J (2003): Verlaufsbeobachtungen von klinischen 

Behandlungen mit Amisulprid. Universitätskolloquium zur 

Schizophrenie. Hans Hippius (Hrsg.). Band 1. Steinkopff, Darmstadt: 

327–331 

Gaebel W (2003): Ätiopathogenetische Konzepte und Krankheitsmodelle 

in der Psychiatrie. In: Möller HJ, Laux G, Kapfhammer HP 

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Gaebel W (2003): Ergebnispräsentation der Arbeitsgruppe: Psychiatrie. 

In: Anforderungen an Qualitätsberichte – Nutzen und Spezifikationen. 

Workshop-Bericht. Schriftenreihe der Arbeitsgemeinschaft 

zur Förderung der Qualitätssicherung in der Medizin (AQS), 

Bd 2: 40–42 

Gaebel W (2003): La Medicina Gestionada en Alemania. In: Guimón J, 

De La Sota E, Sartorius N (eds): La Gestión de las Intervenciones 

Psiquiatricas. Universidad de Deusto/Core Academic, Bilbao 

Gaebel W (2003): Langzeittherapie der Schizophrenie. In: Falkai P, 

Pajonk FG (Hrsg.): Psychotische Störungen – Systematische Therapie 

mit modernen Neuroleptika. Thieme, Stuttgart: 47–63 

Gaebel W (2003): Psychiatrie im Wandel – Zur Neujustierung des Verhältnisses 

zwischen klinischer Psychiatrie und Gemeindepsychiatrie. 

Tagungsdokumentation „Auslauf- oder Zukunftsmodell – das 

Sozialpsychiatrischen Zentrum im Wandel der Systeme“. Hausdruckerei 

Landschaftsverband Rheinland: 41–57 

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Gaebel W (2003): Struktur der Klinik und Forschungsbeispiele. In: 

Hippius H (Hrsg.): Universitätskolloquien zur Schizophrenie. Bd. 1. 


Gaebel W, Falkai P (2003): Schizophrenie, schizotype und wahnhafte 

Störungen. In: Gastpar MT, Kasper S, Linden M (Hrsg.): Psychiatrie 

und Psychotherapie. 2., vollst. neu bearb. Aufl. Springer, Wien: 

97–115 

Haupt M (2003): Nicht-pharmakologische Interventionen. In: Möller 

HJ, Hampel H, Padberg F (Hrsg.): Alzheimer Krankheit. Wiss. Verlagsgesellschaft, 


Haupt M (2003): Psychoedukation mit pflegenden Angehörigen von 

Demenzkranken. In: Wancata J, Meise U, Marksteiner J (Hrsg.): 

Die Versorgung älterer psychisch Kranker. Kongressband VIP 

Innsbruck, Innsbruck: 147–159 

Haupt M (2003): Strategien bei kognitiven Störungen. In: Förstl H 

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Thieme, Stuttgart: 188–197 

Haupt M, Bürger K, Karger A, Hampel H (2003): Angehörigenarbeit. 

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Wiss. Verlagsgesellschaft Stuttgart: 414–425 

Ihl R (2003): Altern und Demenz. In: Schneider F, Fink GR (Hrsg.): 

Psychiatrie und Neurologie, Springer, Heidelberg 

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OA, Steurer J (Hrsg.): Kompendium evidenzbasierte Medizin: 

Huber Bern: 460 

Ihl R (2003): Tests und Skalen. In: Förstl H (Hrsg.): Lehrbuch der Gerontopsychiatrie. 

2. Aufl. Enke, Stuttgart: 542–583 

Janssen B (2003): Qualitätssicherung. In: Hippius H (Hrsg.): Universitätskolloquien 

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Padberg F, Karger A, Hampel H, Haupt M (2003): Pharmakotherapie 

II: Behandlung nicht-kognitiver Störungen. In: Möller HJ, Hampel 

H, Padberg F (Hrsg.): Alzheimer Krankheit. Wiss. Verlagsgesellschaft 


Schneider F, Habel U (2003): Emotionale Dysfunktionen schizophrener 

Patienten: Ergebnisse der funktionellen Kernspintomographie. 

In: Hippius H (Hrsg.): Universitätskolloquien zur Schizophrenie, 

Band 1. Steinkopff, Darmstadt: 155–157 

Wölwer W, Gaebel W (2003): Experimentelle Psychopathologie. In: 

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2004 

Biesenbach A, Brieber S, Grass-Kapanke B, Ihl R (2004): ADAS – Alzheimer 

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Brieber S, Biesenbach A, Grass-Kapanke B, Ihl R (2004): TFDD – Test 

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Strauß B, Schumacher J (Hrsg.): Klinische Interviews und Ratingskalen. 

Hogrefe, Göttingen: 464–467 

Frommann N, Wölwer W (2004): Ein Trainingsprogramm zur Dekodierung 

des mimischen Affektausdrucks für schizophrene Kranke. 

In: Hermer M, Klinzing HG (Hrsg.): Nonverbale Prozesse in der 

Psychotherapie. DGVT-Verlag, Tübingen: 307–319 

Gaebel W, Baumann A, Zäske H (2004): Gesellschaftsrelevante Ansätze 

zur Überwindung von Stigmatisierung und Diskriminierung. 

In: Rössler W (Hrsg.): Psychiatrische Rehabilitation. Springer, Berlin: 

875–886 

Gaebel W, Klosterkötter J, Weßling A, Baumann A, Köhn D, Zäske H 

(2004): German Research Network on Schizophrenia. Public education 

programmes in Düsseldorf and Cologne, Germany. In: Saxena 

S, Garrison PJ (Hrsg.): Mental Health Promotion. Case studies 

from countries. A joint publication of the World Federation for 

Mental Health and the World Health Organization. WHO, Geneva: 

38–40 

Gaebel W (2004): Schizophrenia: Treatment issues in the 21st Century. 

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Vol 5. Steinkopff, Darmstadt: 459–469 

Gaebel W, Riesbeck M (2004): Differentielle Ansätze zur pharmakologischen 

Rezidivprophylaxe schizophrener Störungen. In: Möller 

HJ, Müller N (Hrsg.): Schizophrenie. Langzeitverlauf und Langzeittherapie. 

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Gaebel W, Riesbeck M (2004): Differentielle Indikation zur pharmakologischen 

Langzeittherapie bei Patienten mit schizophrenen Störungen. 

In: Fleischhacker WW, Hummer M (Hrsg.): Schizophrene 

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neuer pharmakologischer Therapien. Proceedings des 18. 

Alpenländischen Psychiatrie-Symposiums, Seefeld 2002. Verlag 

Integrative Psychiatrie, Innsbruck: 49–69 

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psychisch Erkrankter als Herausforderung für die Gesundheitsversorgung 

in Deutschland. In: Berger M, Fritze J, Roth- 

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Grass-Kapanke B, Brieber S, Biesenbach A, Ihl R (2004): Reisbergskalen. 

In: Strauß B, Schumacher J (2004): Klinische Interviews 

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Höhl W (2004): Motivation und Rehaziele psychiatrischer Ergotherapie 

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Wobrock T, Falkai P, Gaebel W (2004): Implementing early detection 

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Gaebel W (2005): New developments and treatment issues in schizophrenia. 

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Gaebel W (2005): Psychogene körperliche Störungen. In: Knuth P, 

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Gaebel W, Bittner E, Wölwer W (2005): Depressive syndromes in 

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Gaebel W, Zäske H, Baumann A (2005): Stigma in the developed 

world. In: Okasha A, Stefanis CN (Hrsg.): Perspectives on the Stigma 

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Haupt M (2005): Nicht-medikamentöse Behandlung der Demenz: 

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(Hrsg.): Gerontopsychiatrie – Grundlagen, Klinik und Praxis. Wiss. 

Verlagsgesellschaft, Stuttgart: 491–503 

Haupt M, Padberg F, Hampel H (2005): Pharmakotherapie dementieller 

Syndrome. In: Bergener M, Hampel H, Bürger K, Möller HJ, 

Zaudig M (Hrsg.): Gerontopsychiatrie – Grundlagen, Klinik und 

Praxis. Wiss. Verlagsgesellschaft, Stuttgart: 441–491 

Höft B (2005): Integrierte Versorgung Demenzkranker in Kooperation 

einer Chirurgischen Klinik am Allgemeinkrankenhaus mit der 

Institutsambulanz Gerontopsychiatrie. 7. Jahrestagung der Deutschen 

Gesellschaft für Gerontopsychiatrie und -psychotherapie 

e. V., Frankfurt. In: Teising M, Gutzmann H (Hrsg.): Alt und psychisch 

krank – im Spannungsfeld von Ethik und Ressourcen, Kohlhammer, 

Stuttgart 

Ihl R (2005): Verhaltensstörungen. In: Förstl H (Hrsg.): Demenzen: 

Perspektiven in Forschung und Praxis. Elsevier, München: 155–168 

Lange-Asschenfeldt C (2005): Intoxikationen mit Psychopharmaka. 

In: Benkert O, Hippius H (Hrsg.): Kompendium der Psychiatrischen 

Pharmakotherapie. 5. Aufl. Springer, Berlin: 559–573 

Lange-Asschenfeldt C (2005): Pharmakotherapie psychiatrischer 

Akutsituationen. In: Benkert O, Hippius H (Hrsg.): Kompendium 

der Psychiatrischen Pharmakotherapie. 5. Aufl. Springer, Berlin: 

483–507 

Lange-Asschenfeldt C (2005): Psychopharmaka im Alter und bei internistischen 

Erkrankungen. In: Benkert O, Hippius H (Hrsg.): 

Kompendium der Psychiatrischen Pharmakotherapie. 5. Aufl. 


Supprian T, Rösler M (2005): Psychische Störungen und ihre Behandlung 

im Alter. In: Nissen G, Warnke A, Badura F: Therapie 

altersabhängiger psychischer Störungen. Schattauer Verlag, 

Stuttgart: 143–151

2006 

Baumann A (2006): Stigmatisierung, soziale Distanz und Ausgrenzung 

auf Grund psychischer Erkrankung: der psychisch erkrankte 

Mensch als Fremder. In: Richter-Sokolovska K, Ortakov V, Belevska 

D (Hrsg.): Psihjatrija vo zaednicata (Psychiatrie in der Gemeinde). 

Kodeks sistemi za kvalitet: 191–203 (Artikel in Mazedonisch) 

Baumann A, Zäske H, Gaebel W (2006): Stigma und Diskriminierung 

schizophren erkrankter Menschen. In: Schmauss M (Hrsg.): Schizophrenie 

– Pathogenese, Diagnostik und Therapie. Unimed Verlag, 

Bremen: 364–382 

Gaebel W (2006): Die Identität der Psychiatrie aus internationaler 

Perspektive. In: Schneider F (Hrsg.): Entwicklungen der Psychiatrie. 

Symposium anlässlich des 60. Geburtstages von Henning 

Saß. Springer Medizin Verlag, Heidelberg: 39–49 

Gaebel W, Bergmann F, Toeller V, Zielasek J (2006): Schizophrenien 

und schizoaffektive Störungen. In: Hohagen F, Nesseler T (Hrsg.): 

Wenn Geist und Seele streiken. Handbuch psychische Gesundheit. 

Südwest Verlag, München: 221–236 

Gaebel W, Riesbeck M (2006): Aktuelle Aspekte der Langzeittherapie 

bei Schizophrenie. In: Möller HJ, Müller N (Hrsg.): Aktuelle Aspekte 

der Pathogenese und Therapie der Schizophrenie. Springer, 

Wien: 133–145 

Gaebel W, Schwarz M (2006): Qualitätsmanagement in der psychiatrischen 

Therapie. In: Möller HJ (Hrsg.): Therapie psychischer Erkrankungen. 

3., vollst. überarb. Aufl. Thieme, Stuttgart: 156–167 

Höhl, W (2006): Forschungsprojekt der Rheinischen Kliniken Düsseldorf 

– Darstellung eines arbeitsrehabilitativen Teilprojekts im 

Rahmen des Kompetenznetzes Schizophrenie. In: Walkenhorst 

U, Klemme B (Hrsg.): Interdisziplinäres Arbeiten in der Ergo- und 

Physiotherapie. Borgmann, Dortmund 

Janssen B, Gaebel W (2006): Qualitätsmanagement in der ambulanten 

und stationären Versorgung schizophren erkrankter Patienten. 

In: Pawils S, Koch U (Hrsg.): Psychosoziale Versorgung in der Medizin. 

Entwicklungstendenzen und Ergebnisse der Versorgungsforschung. 

Schattauer, Stuttgart: 363–377 

Klosterkötter J, Zemlicka R, Gaebel W (2006): Therapieresistente 

Schizophrenie. In: Voderholzer U, Hohagen F (Hrsg.): Therapie 

psychischer Erkrankungen, 2. Aufl. Elsevier Urban & Fischer, 

München: 99–112 

Menke R, Gaebel W (2006): Effektivität leitlinienorientierter Therapie. 

In: Möller HJ, Müller WE, Schmauß M (Hrsg.): Innovation und 

Wandel der antidepressiven Therapie in Deutschland. Thieme, 


Menke R, Janssen B (2006): Qualitätssicherung in der fachärztlichen 

Versorgung – KN Schizophrenie. In: Bundesministerium für 

Bildung und Forschung (Hrsg.): Von der Forschung in die Versorgung: 

Kompetenznetze in der Medizin. Bonn/Berlin: 67–69 

2007 

Gaebel W, Bittner E, Wölwer W (2007): Depressive syndromes in 

ReseaRch 

schizophrenia. In: Marneros A, Akiskal HS (Hrsg.): The overlap of 

affective and schizophrenic spectra. Cambridge University Press: 

156–181 

Gaebel W, Riesbeck M (2007): Kommentar zum Artikel „Schizophrenie“ 

der Psychiatrischen Erkrankungen. In: Ollenschläger 

G, Bucher HC, Donner-Banzhoff N, Forster J, Gaebel W, Kunz R, 

Müller OA, Neugebauer E, Steurer J (Hrsg.): Kompendium evidenzbasierte 

Medizin. 6. Aufl. Huber, Bern: 1264–1265 

Gaebel W, Zielasek J (2007): Ätiopathogenetische Konzepte und 

Krankheitsmodelle in der Psychiatrie. In: Möller HJ, Laux G, Kapfhammer 

HP (Hrsg.): Psychiatrie & Psychotherapie. 3. Aufl. Springer, 


Gaebel W, Zielasek J (2007): Diagnostik und Behandlung psychischer 

Störungen. In: Knauer E, Schlegel J, Schulz F: Die großen Gedanken 

kommen aus dem Herzen. Festschrift zur Verabschiedung von 

Landesrat Kukla. Eigenverlag des Landschaftsverbandes Rheinland, 

Köln: 33–64 

Gaebel W, Zielasek J (2007): Krankheitskonzepte in der Psychiatrie – 

Aktueller Stand und Bedeutung für die Identitätsentwicklung des 

Faches. In: Marneros A, Röttig, D (Hrsg.): Biogenese und Psychogenese. 

Roderer, Halle/Saale 2007: 69–82 

Gaebel W, Zielasek J (2007): Die Subjektivität in der modularen Psychiatrie. 

In: Fuchs T, Vogeley K, Heinze M (Hrsg.): Subjektivität und 

Gehirn. Pabst Science Publishers, Lengerich: 211–232 

Gaebel W, Zielasek J (2007): Geleitwort. In: Fuchs T, Vogeley K, Heinze 

M (Hrsg.): Subjektivität und Gehirn. Pabst Science Publishers, 

Lengerich. 

Gaebel W, Zielasek J (2007): Psychopathologie und Neurowissenschaften. 

In: Kircher T, Gauggel S (Hrsg.): Neuropsychologie der 

Schizophrenie. Springer, Heidelberg: 118–131 

Höft B (2007): Die Versorgung von demenzkranken Heimbewohnern 

durch eine Gerontopsychiatrische Institutsambulanz. In: Seelische 

Gesundheit und Lebensqualität im Alter – Ressourcen, Kompetenzen, 

Behandlungsstrategien. 8. Jahrestagung der Deutschen Gesellschaft 

für Gerontopsychiatrie und -psychotherapie e. V., Mannheim: 

223–226. 

Höhl W (2007): Zur Bedeutung von Beurteilungen und Assessments. 

In: Köhler K, Steier-Mecklenburg F (Hrsg.): Arbeitstherapie und 

Arbeitsrehabilitation – Arbeitsfelder der Ergotherapie. Thieme, 


Höhl W (2007): Zur Bedeutung von Forschung und evidenzbasierter 

Praxis In: Köhler K, Steier-Mecklenburg F (Hrsg.): Arbeitstherapie 

und Arbeitsrehabilitation – Arbeitsfelder der Ergotherapie. Thieme, 


Klosterkötter J, Zemlicka R, Gaebel W, Leucht S (2007): Therapieresistente 

Schizophrenie. In: Voderholzer U, Hohagen F (Hrsg.): Therapie 

psychischer Erkrankungen, 3. Aufl. Urban & Fischer, Düsseldorf: 

117–130 

141


Lange-Asschenfeldt C (2007): Intoxikationen mit Psychopharmaka. 

In: Benkert O, Hippius H (Hrsg.): Kompendium der Psychiatrischen 

Pharmakotherapie, 6. Aufl. Springer, Berlin: 665–679 

Zielasek J, Gaebel W (2007): Klinik und Poliklinik für Psychiatrie und 

Psychotherapie. In: Halling T, Vögele J (Hrsg.): 100 Jahre Hochschulmedizin 

in Düsseldorf 1907–2007. düsseldorf university 

press, Düsseldorf: 457–460 

2008 

Anghelescu I, Lange-Asschenfeldt C, Heuser I (2008): Pharmakotherapie 

psychiatrischer Notfallsituationen. In: Benkert O, Gründer G, 

Holsboer F (Hrsg.): Handbuch der Psychiatrischen Pharmakotherapie. 

1. Aufl., Springer, Berlin: 1049–1058 

Baumann AE, Gaebel W et al. (2008): Fighting stigma and discrimination 

because of schizophrenia – Open the Doors: a collaborative 

review of the experience from the German project centres. In: 

Arboleda-Flórez, Sartorius N (Hrsg.): Understanding the Stigma of 

Mental Illness. John Wiley & Sons., Chichester, England: 49–67 

Franke P, Maier W (2008): Genetische Epidemiologie. In: Holsboer F, 

Gründer G, Benkert O (Hrsg.): Handbuch der Psychopharmakotherapie. 

Springer, Heidelberg: 439–449 

Gaebel W, Zielasek J (2008): Die Rolle von Biomarkern aus der Sicht 

der Wissenschaftlichen Fachgesellschaften. In: Schmitz G, Endres 

S, Götte D (Hrsg.): Schattauer, Stuttgart: 64–74 

Janssen B, Menke R, Gaebel W (2008): Qualitätsmanagement, Leitlinien: 

Entwicklung und Implementierung von Leitlinien. In: Riederer 

P, Laux G (Hrsg.): Lehrbuch Neuro-Psychopharmaka. Springer, 

Wien (im Druck) 

Klosterkötter J, Zemlicka R, Leucht S, Gaebel W (2008): Therapieresistente 

Schizophrenie. In: Voderholzer U, Hohagen F (Hrsg.): 

Therapie psychischer Erkrankungen, 4. Aufl. Elsevier Urban & Fischer, 


Lange-Asschenfeldt C (2008): Durch Medikamente ausgelöste psychische 

Erkrankungen. In: Schneider F (Hrsg.): Klinikmanual Psychiatrie, 

Psychosomatik und Psychotherapie. 1. Aufl. Springer, 

Berlin: 140–145 

Lange-Asschenfeldt C (2008): Psychopharmaka bei internistischen 

Erkrankungen. In: Benkert O, Gründer G, Holsboer F (Hrsg.): 

Handbuch der Psychiatrischen Pharmakotherapie. 1. Aufl. Springer, 

Berlin: 1071–1079 

Wölwer W (2008): Experimentelle Ansätze zur Erfassung von Verhaltensindikatoren 

der Angst im Humanbereich. In: Janke W, 

Schmidt-Daffy M, Debus G (Hrsg.): Experimentelle Emotionspsychologie: 

Methodische Ansätze, Probleme, Ergebnisse. Papst, 

Lengerich: 424–441 

Wölwer W, Gaebel W (2008): Kompetenznetz Schizophrenie: Konzept, 

Ergebnisse, Perspektiven. In: Labisch A (Hrsg.): Jahrbuch der 

Heinrich-Heine-Universität Düsseldorf 2007/2008. düsseldorf university 

press, Düsseldorf: 153–170 

142 

2009 

Becker T, Spiessl H, Zielasek J, Gaebel W (2009): Die Verwendung 

von Routinedaten in der Qualitätssicherung in Psychiatrie und 

Psychotherapie. Zusammenfassung und Ausblick. In: Gaebel W, 

Spiessl H, Becker T (Hrsg.): Routinedaten in der Psychiatrie. Sektorenübergreifende 

Versorgungsforschung und Qualitätssicherung. 

Steinkopf, Heidelberg: 105–114 

Gaebel W, Wölwer W, Riesbeck M, Zielasek J: The Cross-sectional 

and Longitudinal Architecture of Schizophrenia: Significance for 

Diagnosis and Intervention? In: Gattaz W (Hrsg.): Search for the 

causes of schizophrenia. Springer, Berlin (im Druck) 

Gaebel W, Zielasek J (2009): Arbeitplatzsituation, Arztpersönlichkeit 

und Befinden in der Weiterbildung als Determinanten weiterer 

Karriereentscheidungen – zur Nachwuchsproblematik am Beispiel 

der Psychiatrie und Psychotherapie. In: Fuchs C, Kurth BM, Scriba 

PC (Hrsg.): Report Versorgungsforschung, Bd. 2: Schwarz FW, Angerer 

P (Hrsg.): Arbeitsbedingungen und -befinden von Ärztinnen 

und Ärzten. Deutscher Ärzteverlag, Köln: 199–208 

Gaebel W, Zielasek J (2009): New developments and treatment issues 

in schizophrenia. In: Christodoulou GN (Hrsg.): Advances in 

Psychiatry, Vol III. World Psychiatric Association (WPA): 17–24 

Gaebel W, Zielasek J (2009): Schizophrenia and related disorders. In: 

Salloum IM, Mezzich JE (Hrsg.): Psychiatric Diagnosis. Challenges 

and Prospects. Wiley-Bleckwell, Chichester: 85–94 

Gaebel W, Zielasek J, Wölwer W: Schizophrenie. In: Schiepek G 

(Hrsg.): Neurobiologie der Psychotherapie (im Druck) 

Janssen B (2009): Routinedaten und Qualitätssicherung. In: Gaebel 

W, Spiessl H, Becker T (Hrsg.): Routinedaten in der Psychiatrie. 

Darmstadt, Steinkopff: 49–52 

Janssen B, Menke R, Gaebel W (2009): Qualitätsmanagement, Leitlinien: 

Entwicklung und Implementierung von Leitlinien. In: Riederer 

PF, Lanx G (Hrsg.): Grundlagen der Neuro-Psychopharmakologie 

– Ein Therapiehandbuch, Wien, Springer: 601–610 (im Druck) 

Wölwer W, Combs DR, Frommann N, Penn DL: Treatment approaches 

with a special focus on social cognition: overview and empirical 

results. In: Roder V, Medalia A (Hrsg.): Understanding and treating 

neuro- and social cognition in schizophrenia patients. Karger, 

Basel (im Druck) 

3.1.9.3 Books and editorships 

2001 

Gaebel W (Hrsg.) (2001): Versorgung, Forschung und Lehre 1996– 

2000. Rheinische Kliniken Düsseldorf – Kliniken der Heinrich-Heine-Universität 

Düsseldorf. kölnermedienfabrik, Köln 

Gaebel W, Heinlein J, Maas K (Hrsg.) (2001): Psychiatrie im Wandel 

der Zeit. 125 Jahre „Grafenberg“ – Rheinische Kliniken Düsseldorf 

– Kliniken der Heinrich-Heine-Universität Düsseldorf. Festschrift. 

Rheinland Verlag, Köln 

Haupt M (2001): Der Verlauf der Alzheimer Krankheit. Schöningh, 

Paderborn

2002 

Gaebel W, Müller U (2002): Stand und Perspektiven der psychiat- 

risch-psychotherapeutischen Versorgung in Düsseldorf. Fachta- 

gung am 26. Oktober 2001 in Düsseldorf. kölnermedienfabrik AG, 

Köln 

Gaebel W, Müller-Spahn F (Hrsg.) (2002): Diagnostik und Therapie 

psychischer Störungen. Kohlhammer, Stuttgart 

Lopez-Ibor JJ, Gaebel W, Maj M, Sartorius N (Hrsg.) (2002): Psychiatry 

as a Neuroscience. Wiley & Sons, West Sussex 

Maj M, Gaebel W, Lopez-Ibor JJ, Sartorius N (Hrsg.) (2002): Psychiatric 

Diagnosis and Classification. Wiley & Sons, West Sussex 

Sartorius N, Gaebel W, Lopez-Ibor JJ, Maj M (Hrsg.) (2002): Psychiatry 

in Society. Wiley & Sons, West Sussex 

Schneider F, Frister H (Hrsg.) (2002). Alkohol und Schuldfähigkeit: 

Entscheidungshilfen für Ärzte und Juristen. Springer, Berlin 

2003 

Gaebel W, Falkai P (2003): Praxisleitlinien in Psychiatrie und Psychotherapie. 

Bd. 6: Behandlungsleitlinie Psychopharmakotherapie. 

Deutsche Gesellschaft für Psychiatrie, Psychotherapie und Nervenheilkunde 

(Hrsg.). Steinkopff, Darmstadt 

Gaebel W, Hartung HP (Hrsg.) (2003): Psyche, Schmerz, sexuelle 

Dysfunktion. Springer, Berlin 

Härter M, Bermejo I, Schneider F, Gaebel W, Berger M (Hrsg.) (2003): 

Versorgungsleitlinien für depressive Störungen in der ambulanten 

Praxis. ZaeFQ 9 (Suppl IV) 

Hohm H, Mecklenbeck F, LVR Köln (Hrsg.) (2003): Kreativtherapien 

– Wissenschaftliche Akzente und Tendenzen, Rhein-Eifel-Mosel- 

Verlag, Pulheim 

Ollenschläger G, Bucher HC, Donner-Banzhoff N, Forster J, Gaebel 

W, Kunz R, Müller OA, Steurer (Hrsg.) (2003): Kompendium evidenzbasierte 

Medizin. 2. Aufl. Huber, Bern 

2004 


W, Kunz R, Müller OA, Steurer J (Hrsg.) (2004): Kompendium evidenzbasierte 

Medizin. 3. Aufl. Huber, Bern 

2005 

DGPPN (2005): Praxisleitlinien in Psychiatrie und Psychotherapie. 

Band 7: Behandlungsleitlinie Psychosoziale Therapien. Redaktion: 

Gaebel W, Falkai P. Steinkopff, Darmstadt 

Gaebel W, Möller HJ, Rössler W (Hrsg.) (2005): Stigma – Diskriminierung 

– Bewältigung. Der Umgang mit sozialer Ausgrenzung psychisch 

Kranker. Kohlhammer, Stuttgart 


W, Kunz R, Müller OA, Steurer J (Hrsg.) (2005): Kompendium evidenzbasierte 

Medizin. 4. Aufl. Clinical Evidence Concise. Huber, 

Bern 

ReseaRch 

2006 

Gaebel W, Falkai P, Weinmann S, Wobrock T (Leitlinienprojektgruppe) 

(2006): Behandlungsleitlinie Schizophrenie. Bd. 1. In: DGPPN 

(Hrsg.): S3 Praxisleitlinien in Psychiatrie und Psychotherapie. 

Steinkopff, Darmstadt 

Höft B (2006): BEAtE – Einbindung niedrigschwelliger Angebote in 

die kommunale Versorgungsstruktur. Demenz-Servicezentrum für 

die Region Düsseldorf. Düsseldorf 


W, Kunz R, Müller OA, Neugebauer E, Steurer J (Hrsg.) (2006): 

Kompendium evidenzbasierte Medizin. 5. Aufl. Huber, Bern 

Schmidt LG, Gastpar M, Falkai P, Gaebel W (Hrsg.) (2006): Evidenzbasierte 

Suchtmedizin. Behandlungsleitlinie Substanzbezogene 

Störungen. Deutscher Ärzteverlag 

Wölwer W (2006): Kognitive Störungen schizophren Kranker: Eine 

Differenzierung über Blickbewegungsanalysen. Lengerich, Pabst 

Science Publishers 

2007 

Gaebel W, Falkai P (2007): Praxisleitlinien in Psychiatrie und Psychotherapie 

der DGPPN und DGfS. Behandlungsleitlinie: Störungen 

der sexuellen Präferenz. Band 8. Steinkopff, Darmstadt 

Gaebel W, Wölwer W (2007) (Hrsg.): 1st European Conference on Schizophrenia 

Research. Perspectives from European Networks. 26– 

28 September 2007, Düsseldorf, Germany. Europ Arch Psychiatry 

Clin Neurosci 257 (Suppl 19): 1–40 


W, Kunz R, Müller OA, Neugebauer E, Steurer J (Hrsg.) (2007): 

Kompendium evidenzbasierte Medizin. 6. Aufl. Huber, Bern 

2008 

Gaebel W, Müller-Spahn F (Hrsg.) (2008): Stieglitz RD: Diagnostik 

und Klassifikation in der Psychiatrie. Kohlhammer, Stuttgart 

Gaebel W, Zielasek J (Hrsg.) (2008): Psychiatry as a diagnostic discipline. 

An international perspective. Eur Arch Psychiatr Clin Neurosci 

258 (Suppl 5): 1–119 

2009 

Gaebel W, Falkai P (2009): Behandlungsleitlinie Therapeutische 

Maßnahmen bei aggressivem Verhalten. Bd. 2. In: DGPPN (Hrsg.): 

S2 Praxisleitlinien in Psychiatrie und Psychotherapie. Steinkopff, 

Darmstadt 

Gaebel W, Wölwer W, Toeller V (2009): Guest Editors of Eur Arch Psychiat 

Clin Neurosc 259 (Suppl. 1): 1–105 

Gaebel W, Zielasek J (2009): Psychiatry as a therapeutic discipline. 

An international perspective. Europ Arch Psych Clin Neurosci 259 

(Suppl 2): 1–232 

Sielk M, Janssen B, Abholz HH (2009): Praktische Psychiatrie für den 

Hausarzt, Deutscher Ärzteverlag 

143


3.1.10 Research funding 

A considerable number of qualified research grants (e.g. 

DFG, FMER) were obtained within the current reporting 

period. In the years 2001 to 2009, the total amount of 17.43 

million Euro was divided among several projects; the 

projects have already been reported in more detail in the 

chapter dealing with the individual research laboratories and 

research groups. The average funding received amounted 

to 1.94 million Euro per annum (range: 1.21 to 2.94 million 

Euro/p.a.). The large amount of funding can be attributed 

in particular to the department’s strong participation in 

medical research associations, which were funded to such 

a high degree by the German Federal Ministry for Education 

and Research (FMER) for the first time during this reporting 

period. 

The majority of the funding received by the department 

came from various federal ministries, especially the 

FMER, with funds also being increasingly obtained from 

the German Research Association (GRA) – thanks to the 

initiation and coordination of a new GRA priority programme 

– as well as by participation in a range of multi-centre 

clinical studies. In comparison with other psychiatric 

university departments in North Rhine-Westphalia (NRW), 

according to the report of the NRW University Medicine 

Expert Commission (2006) during the evaluation period 

2002-2004 this department achieved the second-best 

ratio of resources earned (and weighted according to the 

type of sources) to available budgets in NRW (see Figure 

27). In terms of content, the primary focus was on clinical 

144 

Funds obtained (Euro) 

2,500,000 

2,000,000 

1,500,000 

1,000,000 

500,000 

0 

schizophrenia research, which, for many years, has been a 

focus in the department and which was mainly funded by 

the FMER within the reporting period. Within the context 

of the co-initiated Competence Network on Schizophrenia, 

which is coordinated by the department, the department 

has led studies on the disease course and treatment of 

persons with first-episode schizophrenia, including clinicalpsychopathological 

investigations and neuropsychological 

and neurophysiological investigations by means of 

fMRT and evoked potentials. Furthermore, employees 

of the department led several investigations relating to 

quality assurance in the treatment, destigmatisation and 

rehabilitation of socio-cognitive disorders. Beyond the 

Competence Network on Schizophrenia, the department 

participated in a number of multi-centre clinical trials 

in schizophrenia, increasingly in the field of evaluating 

cognitive-behavioural approaches to treatment. Other 

more extensive research activities with qualified third party 

funding, headed by departmental employees, related to 

quality assurance projects in the treatment of depressive 

disorders within the context of the Competence Network 

on Depression, a multi-centre clinical trial on detoxification 

treatment in alcohol dependence as well as the analysis 

of the clinical, brain-functional and molecular effects of 

nicotine and nicotine withdrawal within the context of the 

GRA Priority Programme 1226, 1226 “Nicotine: Molecular 

and physiological effects in the central nervous system”, 

which was initiated and coordinated in the department. 

0 500,000 1,000,000 1,500,000 2,000,000 2,500,000 3,000,000 

Budget (Euro) 

m = 0.306 Aachen 

Bochum 

Figure 27: Comparison of third-party funds raised and available to budgetary resources of the psychiatric university hospitals in North Rhine-Westphalia (NRW) 

according to the report of the university medicine expert commission, 2006. The size of the circle depicted represents the quality level of the publication (i.e. 

the size corresponds to the mean impact factors in 2001-2005). Since the commission of experts was unaware of the budgetary levels of the Department of 

Psychiatry and Psychotherapy in Düsseldorf, the position of the circular area was corrected in the figure by the authors of this report (see arrow). 

Bonn 


Essen 

Cologne 

Münster

3.1.11 Organised science symposia and congresses 

s Symposium of the Nervenärztliche Gesellschaft 

Düsseldorf e. V. in cooperation with the professional 

association of general practitioners and the German 

Society for General and Family Medicine, 18.– 

19.05.2001: New insights into Alzheimer’s Disorder 


Düsseldorf e. V., 16.06.2001 Düsseldorf: Transcultural 

psychiatry 


Düsseldorf e. V., 25.05.2002 Düsseldorf: Multiple 

sclerosis – New aspects of research and practice 

s 1st Düsseldorf Psychiatric-Psychotherapeutic 

Colloquium, 13.07.2002 Düsseldorf: Treatment and care 

of schizophrenic disorders – State of the art 

s 9th Congress of the German Society of Biological 

Psychiatry in Düsseldorf, 10.–12.10.2002: Future 

perspectives of Biological Psychiatry in Diagnostics and 

Therapy 

s 30th Symposium of the European Network for 

Gerontopsychiatry, Padua, Italy, 14.–16.11.2002 


Düsseldorf e. V. and the Network of Child and 

Adolescent Psychiatrists Düsseldorf, 07.12.2002: 

Attention Deficit/ Hyperactivity Syndrome (ADHS) in 

Children and Adults 

s 2nd Düsseldorf Psychiatric-Psychotherapeutic 

Colloquium 12.07.2003: Diagnosis and treatment 

of affective disorders – State of the art workshop, 

15.11.2003 

s Neuroleptic long-term treatment – Atypical depot 

treatment as a building-block of the modern treatment 

concept; Düsseldorf 

s 31st Symposium of the European Network for 

Gerontopsychiatry Wroclaw, Poland, 25.–27.11.2003 

s 3rd Düsseldorf Psychiatric-Psychotherapeutic 

Colloquium, 10.07.2004: Diagnosis and treatment of 

personality disorders – State of the art 

s 32nd Symposium of the European Network for 

Gerontopsychiatry Oslo, Norway, 23.–25.09.2004 


Düsseldorf e. V., 11.12.2004: Dependence Disorders. 4th Düsseldorf Psychiatric-Psychotherapeutic Colloquium, 

25.06.2005: Disorders in the transition zone between 

psyche und soma – An interdisciplinary dialogue 

s 1st Düsseldorf Schizophrenia Symposium, 29.10.2005: 

Innovative treatment and care concepts 

s 5th Düsseldorf Psychiatric-Psychotherapeutic 

Colloquium, 10.06.2006: Diagnosis and classification of 

ReseaRch 

psychotic disorders in the 21st century – On the future 

development of the classification systems 

s 33rd Symposium of the European Network for Gerontopsychiatry 

Basel, Switzerland, 27.–29. October 2005 

s 2nd Düsseldorf Schizophrenia Symposium, 23.09.2006 

Düsseldorf: Treat basal illness processes early on and 

rigorously 

s 34th Symposium of the European Network for Gerontopsychiatry, 

Cologne, Germany, 21.–23.09.2006 

s Düsseldorf Interdisciplinary Symposium, 30.09.2006 

Düsseldorf: Pain and depression from an interdisciplinary 

point of view. From primary research to the 

multimodal treatment concept 

s Farewell event for State Councillor Rainer Kukla; 

Invitation from the directors of the LVR Clinics, 

25.01.2007 Düsseldorf 


Colloquium, 16.06.2007 Düsseldorf: The future of 

psychiatric-psychotherapeutic care between economic 

constraints and quality requirements 

s 5th Information Fair on Schizophrenia, 29th September 


s 3rd Düsseldorf Schizophrenia Symposium, 13.10.2007 

Düsseldorf: Patient relevance and person orientation in 

the treatment of schizophrenic illnesses 


Düsseldorf e. V., 04.12.2007 Düsseldorf: Dissociative 

and somatoform neurological disorders 

s Annual congress of the German Association of 

Psychiatry and Psychotherapy and Neurology, Berlin, 

2007: Psychiatry as a diagnostic discipline 

s 1st European Conference on Schizophrenia Research: 

Perspectives from European Networks. Congress of 

Competence Network on Schizophrenia in collaboration 

with the Association of European Psychiatrists and 

the German Society for Psychiatry, Psychotherapy and 

Neurology. Düsseldorf, 2007 

s International Scientific Symposium on Dependence 

Research. Scientific symposium for the Dependence 

Research Network NRW, Düsseldorf, 2007 

s The treatment of dependence illnesses – an 

interdisciplinary challenge. Certified continuous 

training for the Dependence Research Network NRW, 

Düsseldorf, 2007 


Colloquium 05.07.2008: Combination treatment – 

between evidence base and polypragmasia 

s 4th Düsseldorf Schizophrenia Symposium, 27.09.2008: 

Schizophrenia – between research and practice 

145


s Session of the Global Scientific Partnership Network of 

the WHO; Berlin 2008 

s Annual Congress of the German Association for 

Psychiatry and Psychotherapy, Berlin, 2008: Psychiatry 

as a therapeutic discipline 

s 5th Düsseldorf Schizophrenia Symposium, 31.10.2009: 

Schizophrenia – “Update 2009” 


Colloquium, 14.11.2009: Psychiatry between financial 

and human resources 

s Fifth Düsseldorf Workshop “Philosophy and Cognition 

Sciences”: Awareness without Relation to the World. 

Philosophical, neuroscientific and psychiatric aspects 

of hallucinations, imagination and dreams. 2007 

Humanities and Medical Research Centre of the 

Heinrich-Heine University, Düsseldorf 2007 

s 2nd European Conference on Schizophrenia Research: 

From Research to Practice. Congress of the 

Competence Network on Schizophrenia in collaboration 

with the Association of European Psychiatrists and 

the German Society for Psychiatry, Psychotherapy and 

Neurology. Berlin, 2009. 

3.1.12 Personnel 

W. Gaebel 

s Since 1992, Professor and Chair of the Department 

of Psychiatry and Psychotherapy, Heinrich-Heine 

University, Düsseldorf; Medical director of the LVR- 

Klinikum Düsseldorf – Hospital of the Heinrich-Heine 


s Honorary member of the World Psychiatric Association 

and the Czech Society of Psychiatry 

s Leading positions in medical, national and international 

s scientific organisations: 

s President of the German Association of Psychiatry and 

Psychotherapy (Deutsche Gesellschaft für Psychiatrie, 

Psychotherapie und Nervenheilkunde, DGPPN) 1995– 

1996, 2005–2006 President elect and 2007–2008 

President, since 2009 Past President; President of the 

Annual Congress of the DGPPN in 1996, 2007 and 2008 

s President of the German Society for Biological 

Psychiatry (DGBP) 1999–2002, Vice president 2003– 

2006 

s Since 1999 Initiator, spokesperson and project 

director of the FMER-funded Competence Network on 

Schizophrenia 

s Since 2000 Vice-Chairman Association of the Scientific 

Medical Societies (Arbeitsgemeinschaft wissenschaftlicher 

medizinischer Fachgesellschaften, AWMF) 

146 

s 2000–2007 Chairman of the Teaching Commission III 

of the Faculty at Medicine, Heinrich-Heine University 


s Since 2000 Chairman Psychosenetz e. V. 

s Since 2000 Chairman of the national “Open the doors” 

association, part of the programme implemented 

worldwide by the World Psychiatric Association 

(WPA) in 1996 to reduce the stigmatisation of and 

discrimination against persons with schizophrenia. 

s Since 2000 Cooperation of DGPPN with the “Open the 

doors” association with the assistance of the Federal 

Ministry for Health (FMH): Initiation of the “National 

Programme for the Destigmatisation of Mental 

Illnesses” 

s 2001 Congress organisation, World Congress of the 

World Federation of Societies of Biological Psychiatry 

(WFSBP) 

s 2002 Congress president, German Society for Biological 

Psychiatry (DGBP) 

s Since 2001 Member of the German Academy of Natural 

Science Scientists LEOPOLDINA, Halle 

s Since 2001 Chairman of the Task Force on Nosology 

and Psychopathology of the World Federation of 

Societies of Biological Psychiatry (WFSBP) 

s Since 2002 Chair of the Section on Schizophrenia of the 

World Psychiatric Association (WPA) 

s Since 2002 Co-chair of the Section on Quality 

Assurance of the World Psychiatric Association (WPA) 

s From 2002–2007 Spokesperson and project director 

in the Dependence Research Network NRW (FMERfunded) 

s From 2003–2005 Member of the Ethics Commission of 

the North Rhine Medical Chamber 

s Since 2003 Spokesperson and project director of the 

“Benchmarking in patient care” project network funded 

by the German Health Ministry 

s Since 2004 Chairman of the German Association for 

Mental Health (funded by the Federal Ministry of Health) 

s Since 2004 Scientific advisor to the Federal Medical 

Chamber, working group on tr eatment research 

s 2005 Visiting Professor Universidad Andres Bello, 

Health Science Faculty and Medical School, Santiago de 

Chile 

s From 2007–2009 Member of the Global Scientific 

Partnership Network of the World Health Organization 

(WHO) 

s Since 2009 Board Member of the European Psychiatric 

Association 

s Since 2009 Co-Chair Section on Schizophrenia, 

European Psychiatric Association 

s Since 2009 1st chairman of the Aktionskreis Psychiatrie e. V.

s From 2009–2010 Member of the WHO International 

Advisory Group for the Revision of ICD-10 Mental and 

Behavioural Disorders 

s Member of the Psychosis Workgroup of the American 

Psychiatric Association 

s Member of the Topic Advisory Group Mental Health of 

the WHO 

s Since 2007 Chairman of the Classification System 

Working Group of the DGPPN 

s Since 2009 Chairman of the Quality Indicators Project 

Group of the DGPPN 

s Founding Editor and Editor-in-Chief of “Die Psychiatrie” 

journal, Schattauer Verlag 

s Editor of the series of monographs: Concepts and 

Methods of Clinical Psychiatry, Kohlhammer Verlag 

s Scientific advisor to several scientific journals 

J. Cordes 

s Regional Director (NRW) of the Association “Drug Safety in 

Psychiatry” (AMSP) 

B. Janssen 

s Member of the Psychosocial Network of the City of 


s Member of the “Violence and health” working group of 

the City of Düsseldorf health conference, as well as the 

associated “Hospitals” working group 

s Member of the “Future for children” working group of 

the City of Düsseldorf health conference, 

s Member of the “Psychiatry and psychotherapy steering 

group” of the City of Düsseldorf health conference 

F. Mecklenbeck 

s Member of the board of the German Society of Music 

Therapy, Berlin (professional and specialist music 

therapy association) from 1990–2000 

s Since 2000 on advisory board and representative of the 

board of the German Music Therapy Society. 

G. Ott 

s Member of the Ethics Commission and the Academy for 

Continuing Medical Education of the Association for Child 

and Adolescent Psychiatry, Psychosomatic Medicine and 


s Director of the Academy for Psychoanalysis, Düsseldorf 

T. Supprian 

s Member of the board of the Düsseldorf Bündnis gegen 

Depression e. V. 

s Advisor to the board of the Landesverband der 

Alzheimergesellschaften NRW e. V. 

s Member of the board of the Landesverband 

Gerontopsychiatrie NRW e. V. 

ReseaRch 

W. Wölwer 

s Since 2008, Professor of Experimental 

Psychopathology, Heinrich-Heinrich University, 


s Since 1999, Member of the board of the German 

Competence Network on Schizophrenia 

s Since 2003, Member of the advisory board to the 

“Benchmarking in acute psychiatric treatment” project 

association 

s Since 2009, Member of the advisory board to the 

“Zürcher pulse programme for the sustainable 

development of psychiatry (ZinEP)” project association 

J. Zielasek 

s Secretary to the Board and board member of the 

German Association of Psychiatry and Psychotherapy 

(DGPPN) 2007–2008 

s Since 2007, Member of the Classification Systems 

working group of the DGPPN 

s Since 2007, Member of the Scientific Committee of the 

DGPPN congress 

s Since 2009, Member of the Quality Indicators project 

group of the DGPPN 

s Since 2010, Managing editor of “Die Psychiatrie”, 

Schattauer Verlag 

s Founding Member of the review committee for 

multiple-choice questions of the Teaching Commission 

III of the Faculty of Medicine of the Heinrich-Heine 


Some other people are worthy of special mention here. 2004 saw the much 

too premature death of the head of the Division of Dependence Disorders, 

W. Burtscheidt. The successor as head of the division, P. Franke, came to 

Düsseldorf from Bonn. In 2005, the long-term head of the Department of 

Gerontopsychiatry Dr. Ch. Kretschmar, retired and was succeeded by T. 

Supprian from Homburg/Saar. In 2008, the long-serving head of the Division of 

General Psychiatry I, H. Quadbeck, retired, and was succeeded by S. Cohen. The 

retirement of Prof. Dr. rer. nat E. Lehmann in 2004 and Dr. rer. soc. U. Müller in 

2009 saw the departure of the long-term directors of the Clinical Psychology 

and Psychiatric Sociology Research Units of the department, respectively. 

Two consultants at the LVR-Klinikum Düsseldorf took up chairs elsewhere in 

their relevant specialist areas (Prof. Dr. rer.soc. F. Schneider, Psychiatry and 

Psychotherapy, RWTH Aachen in 2004; Prof. Dr. med. J. Kruse, Psychosomatic 

Medicine and Psychotherapy, University of Gießen in 2009). Another 

appointment was that of the long-term head of the network headquarters for 

the Competence Network on Schizophrenia, Prof. Dr. phil. W. Wölwer, who was 

appointed Professor of Experimental Psychopathology at the Heinrich-Heine 

University Düsseldorf in 2008. 

147


3.2 Department of Psychosomatic Medicine 


3.2.1 Research groups 

3.2.1.1 Microprocedural treatment course and long-term 

148 

results in patients with different personality 

structures 

Director: W. Tress 

Personnel: B. Junkert-Tress, N. Schmitz, L. König, 

D. Hecke 

Time-limited psychodynamic treatments are provided in 

outpatient settings for a broad spectrum of psychogenic 

disorders. The Düsseldorf Short-term Psychotherapy Study 

is investigating short-term psychotherapies (25 sessions). 

The various instruments of the SASB-CMP methods are 

used to identify indicators of short-, mid- and long-term 

effects, as well as predictors for favourable or unfavourable 

psychotherapeutic procedures, and for the success or failure 

of psychodynamic short-term treatments. Various disorder 

groups are compared with one another, under consideration 

of patient variables such as differences in personality 

structures. The Problem Treatment Outcome Congruency 

principle is used to relate mental disorders, treatment 

courses and outcomes with each other. The stability of the 

success of the treatment is evaluated at several follow-up 

evaluations. 

As a result of this research project, relevant results are 

expected to help optimise therapeutic activity in treatment 

with psychoanalytical short-time psychotherapy, and for 

further training. 

Figures 28 a-e: Reduction of symptoms after 25 hrs of native-language, 

specific, stabilising psychotherapy in traumatised refugees (unpublished 

results) 

BSS total score 

6 

4 

2 

0 

Admission Discharge 6 months 1 year 2 years 

Time of assessment 

Figure 28 a: General mental impairment measured as the GSI value of 

the SCL-90-R in traumatised refugees before and after psychotherapy 

compared with the waiting group 

GAF current mean value 

100 

75 

50 

25 

0 



Figure 28 b: Development of trauma symptoms (PTSD) in refugees before 

and after psychotherapy compared with the waiting group 

T values 

80 

60 

40 

20 



Figure 28 c: Physical symptoms (SOMS) in refugees before and after 

psychotherapy compared with the waiting group 

T values 

80 

60 

40 

20 



Figure 28 d: Current anxiety (SCL 90) 

T values 

80 

60 

40 

20 



Figure 28 e: Current depression (SCL 90)

3.2.1.2 Psychodiabetology 

Director: J. Kruse; W. Tress, 

Personnel: M. Cavka, L. Joksimovic, U. Naworotzky, 

M. Nigro, H. Sager, K. Schnitzler, U. Simson 

The research group studies somatopsychic and 

psychosomatic factors of diabetes mellitus. Within the 

context of a population-related sample, the research 

group has shown that over a course of 30 years depressive 

symptoms lead to significantly increased mortality in 

people with diabetes. At an epidemiological level, the 

group – funded by the Heigl Foundation – together with 

the GSF in Munich is investigating within the framework 

of the KORA Study the significance of depression and 

traumatic life experiences for quality of life, functionality 

and gylcaemic control in patients with type 2 diabetes. In a 

further population-based cross-sectional study, predictors 

of depression were defined. At a clinical level, the research 

group has used randomised controlled intervention studies 

to test the effectiveness of psychotherapeutic interventions 

within the context of a psychosomatic consultation service. 

At the same time, the research group is taking part very 

Staff in conversation in front of the Department of 


ReseaRch 

successfully, as a study centre, in the depression and 

diabetes study (DAD study). This multi-centre study is 

investigating the effects of a cognitive behavioural therapy 

on depression in people with insulin-dependent diabetes 

who are being treated in specialised diabetes practices. 

This study receives funding from the FMER until 2011 in the 

“Clinical Studies” funding programme. 

In terms of basic research, in cooperation with the German 

Diabetes Centre the research group is investigating 

psychosomatic links at a neuroendocrinological level. In 

experimental studies, the modification by psychosocial 

influence factors of the immune response to glucose 

stimulation is being studied. The immune response to 

glucose is considered to be a significant factor in the 

pathogenesis of type 2 diabetes and the development of 

complications. The research group is therefore looking at 

the question of how far glucose-induced immune responses 

are exacerbated by psychosocial stress. The research group 

is cooperating intensively with the German Diabetes Society 

and the DGPM/DKPM to develop guidelines for psychosocial 

healthcare for people with diabetes. 

149


2.5 

2.0 

1.5 

1.0 

0.5 

0.0 

Before 1 year after 

treatment treatment 

Figure 29 a: General mental impairment measured as 

GSI value of SCL-90-R in traumatised refugees before 

and after psychotherapy compared with the waiting 

group 

4.0 

3.5 

3.0 

2.5 

2.0 

1.5 

1.0 

0.5 

0.0 

Figure 29 b: Development of trauma symptoms (PTSD) 

in refugees before and after psychotherapy compared 

with the waiting group 

40 

35 

30 

25 

20 

15 

10 

5 

0 

Figures 29 a–c: Snapshot of illness symptoms after 25 

hours of mother-tongue, trauma-specific, stabilising 

psychotherapy in traumatised refugees; the complete 

study results can be found in Kruse et al. Effects of 

trauma-focused psychotherapy upon war refugees. 

Journal of Traumatic Stress, 2009: 22 (6) 585-592 

150 

GSI pre/post comparison 

PTSD pre/post comparison 



SOMS pre/post comparison 



Psychotherapy group 

Waiting group 

Figure 29 c: Physical symptoms (SOMS) in refugees 

before and after psychotherapy compared with the 

waiting group 

3.2.1.3 Somatoform disorders 

Director: J. Kruse, W. Tress 

Within the context of a multi-centre, randomised controlled study, the 

research group is investigating the effects of psychodynamic shortterm 

psychotherapy on patients with multi-somatoform disorders. The 

intervention targets an increase in the health-related quality of life, a change 

in self-perception and understanding of symptoms, and a reduction of an 

individual’s psychophysiological stress reactivity. The study is funded by 

the DFG as part of the “Clinical studies” programme. The study group is 

simultaneously looking at the attachment styles of these patients using 

cross-sectional studies. Various methods are used (HAI interview, Bochumer 

Bindungsbogen), which have been co-developed and evaluated by coworkers 

of the study. The research group also investigated the effects 

of childhood traumatisation in patients with somatoform pain disorders, 

providing evidence for a high rate of post-traumatic stress disorders in 

this patient group and documenting the fact that, in particular, traumaassociated 

symptoms determine illness behaviour in these patients. 

3.2.1.4 Psychotraumatology 


Personnel: H.-J. Bernard, J. Bierwirth, M. Cavka, L. Joksimovic, M. Schröder 

The research group is focussing on the trauma-associated disorders and 

treatment opportunities in refugees and migrants from former Yugoslavia. 

Within the context of a project funded by the faculty of medicine, the 

research group has identified the effects of the stabilisation phase of a 

trauma-specific psychotherapy. Despite insecure residency status and 

extreme traumatisation, the research group succeeded in reducing the 

mental burden of these patients. This work led to a collaboration with the 

psychosocial centre for refugees, within which, in the context of the EUfunded 

programme “Life after torture”, the research group has received a 

research grant from the European Union for the care of and the evaluation 

of the care of torture victims. Another focus of the research group is 

investigating the close connection of post-traumatic stress disorder with 

somatoform disorders in this patient group. The high comorbidity is another 

indication of the need for the conceptualisation of a complex post-traumatic 

disorder.

3.2.1.5 Psychooncology 

Director: J. Kruse, J. Hardt, W. Tress 

Personnel: B. Clar, A. Grinschgl, C. Heckrath 

The research group is investigating the possibility of 

using communication training to optimise the doctor/ 

patient relationship between office-based medical doctors 

and patients in oncology. In a project jointly funded by 

the North Rhine Statutory Health Insurance Physicians’ 

Association and the Rhineland Health Insurance Funds 

(AOK Rhineland), 30% of the office-based medical doctors 

in Mönchengladbach were trained in communication 

skills. The effects of the training were assessed using 

standardised actor patients. The results impressively 

documented the effects of this training. The doctors 

responded more appropriately to their patients’ problems 

and displayed a more patient-centred conversation style. 

At the moment, the research group is taking part in multicentre 

studies into doctor-patient communication funded by 

the German Cancer Aid Association (Deutsche Krebshilfe). 

It is investigating the effects of communication training on 

oncologists. Another focus is the evaluation of the integrated 

care programme for patients in oncology, “JaVita”, in 

Mönchengladbach. The effects of a consultation centre for 

oncology patients in Mönchengladbach are being evaluated, 

with the central target criterion being the improvement in 

the patients’ quality of life. 

3.2.1.6 Psychosomatic epidemiology 

Director: N. Schmitz, J. Kruse, W. Tress 

The research group is looking at the evaluation of 

population-based datasets. Using the data from the German 

Federal Health Survey and in cooperation with the Robert- 

Koch Institute, the project group elucidated the relationship 

between mental disorders and the illness behaviour 

and illness experiences of people with chronic somatic 

disorders. The research group identified an increased 

prevalence of depressive disorders in people with diabetes 

as well as a relationship between depressive symptoms and 

limited quality, lack of physical activity, increased nicotine 

dependence rates and reduced quality of life. The research 

group found that people with mental disorders are clearly 

less able to manage their known hypertonia correctly with 

medications, and that they display a risky illness behaviour. 

3.2.1.7 Psychosomatic basic care 


Personnel: C. Heckrath, N. Schmitz 

ReseaRch 

The research group deals with the question of diagnosing 

medical disorders in general practice. Within the context 

of a field study, the diagnostics of these disorders and the 

determinants of the diagnostic process were studied in 

more detail. The research group identified the significance 

of doctor/patient communication for the diagnostic process. 

The research group was able to prove empirically that 

a conversation dominated by the doctor considerably 

influences the patient’s description of health problems 

and makes it harder to diagnose mental disorders. 

Simultaneously, individual discussion strategies could be 

identified which enable the patient to open up. The research 

group also investigated sex-specific aspects, although no 

difference could be identified between the communication 

behaviour of male and female medical doctors. 

3.2.1.8 Research group on clinical documentation and 

evaluation of inpatient psychotherapeutic 

treatment 

Director: N. Hartkamp, W. Tress 

Colleagues: S. Michalek, N. Schmitz 

One basis of quality assurance in the area of psychosomatic 

and psychotherapeutic medicine is documentation, including 

psychometric investigation data. Previous experience 

shows that psychometric investigation data provide a not 

inconsiderable amount of information, which is helpful 

when estimating prognosis. A frequently occurring problem 

is the fact that the evaluation of psychometric data 

occurs with such a time delay that it is no longer of use to 

current treatment. For this reason, a network-supported 

computerised application was set up. This allows basic 

documentation data and data from psychometric findings to 

be collected together as so-called “report cards” and made 

rapidly available to doctors. The system is in use in around 

10 other departments, including two university departments 

of psychosomatic medicine and psychotherapy 

151


3.2.1.9 Psychometry basic research 

Director: N. Schmitz, N. Hartkamp 

Personnel: S. Michalek 

Psychometric tests are used in diagnostic studies, 

outcome studies and the status description of patients 

and test persons. Within the context of basic research the 

quality of existing instruments was tested using modern 

psychometric procedures, and alternatives were developed 

to assess quality (Mokken analyses, item bias analyses and 

confirmatory factor analyses). Concepts were developed for 

assessing changes in outcome studies (concept of statistical 

and clinical significance) and tested in empirical studies. 

The effects of a computer-assisted test application were 

investigated in a randomised, controlled study for two widely 

used instruments, the symptom checklist SCL-90-R and the 

inventory of interpersonal problems. . 

3.2.1.10 Qualitative methods 

Director: A. Jüttemann-Lembke, A. Stratkötter 

Personnel: V. Bergstein, R. Bertram, A. Brand, M. Hilberink, 

M. Köbel, R. Liebig, D. Welschof 

The work of the research unit is mainly centred on a) 

questions to psychotherapists regarding their person and 

relating to the subjective treatment concepts of therapists 

and their practical relevance, as well as b) questions on the 

152 

psychotherapeutic process and the subjective treatment 

and disorder concepts of patients. The methodical principle 

behind this is the grounded theory approach of Glaser 

and Strauss. The research group investigated transcripts 

of “natural” discussion situations (initial interviews, 

treatment discussions) as well as partly structured or 

narrative interviews with patients and therapists, with the 

aim of developing, from larger and complex bodies of text, 

condensing and interpretive models relating to the various 

investigation models. The following ongoing and concluded 

sub-projects can be listed: 

s Disorder-specific narratives in psychotherapeutic 

initial encounters 

s Qualitative investigation of music-therapy 

improvisations 

s Psychosocial aspects of illness experiences of patients 

with endometriosis 

s Perspectives of the course of partial inpatient 

psychosomatic treatment 

s Self and others concepts of departmental heads 

s Indication and activity concepts of practice 

psychoanalysts 

The current focus of the work is the qualitative analysis of 

group psychotherapy sessions with patients in the second 

halves of their lives. 

Team discussion in the Department of 

Psychosomatic Medicine and Psychotherapy

3.2.2 Doctoral dissertations and habilitation dissertations 

3.2.2.1 Doctoral dissertations 

2001 

Jackstadt R (2001): Untersuchung zu Ergebnissen und Effekten von 

tagesklinischer Psychotherapie. Medizinische Fakultät der Heinrich-Heine-Universität 


Longhi V (2001): Qualitá di vita in pazienti affetti da melanoma cutaneo. 

Facoltá di Psicologia Universitá degli Studi di Roma La Sapienza 

Meckel-Haupt AV (2001): Ein Beitrag zur Validierung des deutschsprachigen 

soc-Fragebogen von Aaron Antonowsky. Medizinische 


Oette MA (2001): Medizinische Berichterstattung in den Printmedien: 

Eine Analyse medizinischer Veröffentlichungen in der Tages- und 

Wochenpresse des Jahrgangs 1990 unter besonderer Berücksichtigung 

der Prävention. Medizinische Fakultät der Heinrich-Heine- 


Richter K (2001): Fünf Lehr- und Lernvideos zum Arzt-Patienten-Gespräch 

– Entwicklung und Darstellung eines am Problemorientierten 

Lernen (POL) orientierten didaktischen Konzept. Medizinische 


Schadlu D (2001): Zur Interaktion zwischen Arzt und Patient. Eine 

temporelle Untersuchung von Arzt-Patienten-Gesprächen. Medizinische 


Schmidtova K (2001): Zusammenhänge zwischen den subjektiv wahrgenommenen 

Beziehungen zu wichtigen Bezugspersonen und 

einige Variablen der Krankheitsbewältigung bei Patienten mit 

Asthma bronchiale. Medizinische Fakultät der Heinrich-Heine- 


2002 

Bretschneider P (2002): Psychosoziale Belastungen bei Patienten mit 

Basaliom und bei Patienten mit malignem Melanom in verschiedenen 

Tumorstadien. Medizinische Fakultät der Heinrich-Heine- 


Klein J (2002): Kooperation und Behandlungsrisiken im Krankenhaus 

aus Sicht von Ärzten und Pflegekräften. Medizinische Fakultät der 


Larisch M (2002): Über den Zusammenhang zwischen Arbeitsbelastungen 

und depressiven Störungen: Eine Querschnittstudie an 317 

Beschäftigten eines großstädtischen Verkehrsbetriebes. Medizinische 


Schüller N (2002): Zusammenhang zwischen Examenstress und Gestaltung 

der Lernzeiten und körperlichen Beschwerden bei Medizinstudenten 

während der Examenvorbereitung. Medizinische Fakultät 


ReseaRch 

Weiser C (2002): Vergleichende inhaltsanalytische Untersuchung ei- 

ner psychoanalytisch-interaktionellen und tiefenpsychologischfundierten 

Gruppentherapie. Medizinische Fakultät der Heinrich- 


2004 

Brand A (2004): Subjektive Krankheits- und Behandlungstheorien 

von Patienten und Einzeltherapeut im Rahmen einer teilstationären 

Psychotherapie – eine qualitativ inhaltsanalytische Verlaufsuntersuchung. 

Medizinische Fakultät der Heinrich-Heine-Universität 


Brinschwitz C (2004): Vergleich zwischen Computer- und Bleistift- 

Version psychodiagnostischer Test am Beispiel des Inventars zur 

Erfassung Interpersoneller Probleme (IIP) und der Symptom- 

Checkliste SCL-90-R bei einer Untersuchung von Patienten einer 

psychosomatischen Poliklinik. Medizinische Fakultät der Heinrich- 


Bünger H (2004): Prognosefaktoren in der stationären Psychotherapie. 

Medizinische Fakultät der Heinrich-Heine-Universität Düsseldorf 

Görtz A (2004): Psychophysiologische Reaktionsmuster von Bruxisten 

im Vergleich zu Nicht-Bruxisten unter affektneutral-kognitiver Belastung 

und affektinduktivem Stress mit besonderer Berücksichtigung 

des Masseter-Elektromyogramms. Medizinische Fakultät 


Hey A (2004): Wirkfaktoren in der stationären Psychotherapie. Medizinische 


Hirt F (2004): Krankheitsverarbeitung bei Typ-I-Diabetes-Patienten. 


Michalik M (2004): Patienten einer psychosomatisch/psychotherapeutischen 

Poliklinik: Studien zur Geschlechtsspezifität von Störungsformen 

und Inanspruchnahme. Medizinische Fakultät der 


Mohmmed M (2004): Interpretation and comparison of two shortterm 

psychotherapies of patients with narcissistic personality 

disorder using the Structural Anlaysis of Social Behavior and the 

Cyclic Maladaptive Pattern as a part of the Düsseldorf Short-Term 

Psychotherapy-Projekt. Medizinische Fakultät der Heinrich-Heine- 


Windgassen F (2004): Diagnostische Prädiktoren und Prozessanalyse 

des Abbruchs bei psychodynamischen Kurzzeittherapien. Medizinische 


2006 

Beckmann J (2006): Entwicklung von Algorithmen zur Diagnostik 

psychischer Erkrankungen im Sinne der ICD-10 unter Zuhilfenahme 

der SCL-90-R. Medizinische Fakultät der Heinrich-Heine-Universität 

153


Brunotte D (2006): Interaktion in hausärztlichen Praxen als Parameter 

für die Identifikation psychischer/psychosomatischer Störungen. 


Hartmann K (2006): Prozessstudie zweier psychodynamischer Kurzzeittherapien 

mittels des Zyklisch Maladaptiven Musters (CMP), 

der Strukturalen Analyse Sozialen Verhaltens (SASB) und den 

Maßen der Ulmer Textbank. Medizinische Fakultät der Heinrich- 


Heger F (2006): Teamsupervision in einem multidisziplinären medizinischen 

Forschungsprojekt: Evaluation einer Teamsupervision. 


Kuhnigh M (2006): Traditionelle Medizin, Körper- und Krankheitsverständnis 

im peruanischen Andendorf Lahuaytambo. Medizinische 


Turowski F (2006): Anwendung der Digitalis bei psychischer Erkrankung 

in der deutschen Medizin des 19. Jahrhunderts. Medizinische 


3.2.2.2 Habilitation Dissertations 

2001 

Kruse J (2001): Diagnostische Falleinschätzung und ihre Determinanten 

bei Patienten mit psychischen und psychosomatischen Beschwerden 

und Störungen in hausärztlichen Praxen. Medizinische 


2002 

Schmitz N (2002): Grundprobleme der epidemiologischen Psychometrie 

– diskutiert am Beispiel der Symptom-Check-Liste SCL-90-R 

und das General Health Questionnaire GHQ-12. Medizinische Fakultät 

der Heinrih-Heine-Universität Düsseldorf 



2001 

AÄGP, DGPM, DGPPN (2001): Medizinische Behandlungsnotwendigkeit 

in der kassenärztlichen psychotherapeutischen Versorgung. 

Z Psychosom med Psychother 47: 416–418 

Franz M, Schneider C, Schäfer R (2001): Testgütekriterien der deutschen 

Version des TAS-20. Validitätshinweise und Faktorenstruktur. 

Psychother Psychosom Med Psychol 51: 90–91 

Franz M, Schneider C, Schäfer R, Schmitz N, Zweyer K (2001): Faktorenstruktur 

und Testgütekriterien der deutschen Version der 

Toronto-Alexithymie-Skala bei psychosomatischen Patienten. 

Psychother Psychosom Med Psychol 51: 48–55 

154 

Häfner S, Franz M, Lieberz K, Schepank H (2001): Psychosoziale Risi- 

ko- und Schutzfaktoren für psychische Störungen: Stand der For- 

schung. Psychosoziale Schutzfaktoren, Teil 1. Psychotherapeut 46: 

403–408 

Häfner S, Franz M, Lieberz K, Schepank H (2001): Psychosoziale Risiko- 

und Schutzfaktoren für psychische Störungen: Stand der Forschung. 

Psychosoziale Risikofaktoren, Teil 2. Psychotherapeut 46: 

343–347 

Häfner S, Lieberz K, Hölzer M, Wöller W (2001): Indikationen für die 

stationäre Psychotherapie – Wann gehört Ihr Patient in die Klinik? 

MMW-Forschr Med 143: 892–895 

Heigl-Evers A, Ott J (2001): Franz Seraphin Heigl – Leben und Werk. 

Jahrbuch für Gruppenanalyse 7: 165–186 

Heigl-Evers A, Ott J (2001): Hass und Liebe – Zum therapeutischen 

Umgang mit diesen Affekten in der Gruppe. Jahrbuch für Gruppenanalyse 

7: 29–42 

Höwer S, Möslein G, Goecke T, Alberti L (2001): Psychologische Aspekte 

im Rahmen der genetischen Beratung von Hochrisikofamilien. 

Der Onkologe 7: 185–190 

Höwer S, Möslein G, Goecke T, Alberti L (2001): Psychosocial aspects 

encountered durin genetic counselling of high risk families Psycho-Oncology 

Abstracts of the 11th Conference of the European 

Society for Psychosocial Oncology. Psycho-Oncology 10: 1–90 

Junkert-Tress B, Schnierda U, Hartkamp N et al. (2001): Effects of 

short-term dynamic psychotherapy (STDP) for neurotic, somatoform, 

and personality disorders: A prospective one-year follow-up 

study. Psychother Res 11: 187–200 

Karger A (2001): Anmerkungen zu Kraepelins Forschungsprogramm 

und der Konstitution von Krankheit. Spektrum der Psychiatrie und 


Karger A (2001): Die Borderline-Störung: Ein geeignetes diagnostisches 

Konzept für die Gerontopsychiatrie und -psychotherapie? 

Persönlichkeitsstörungen, Theorie und Therapie 5: 56–65 

Karger A, Haupt M (2001): Die Behandlung nicht-kognitiver Störungen 

bei Demenzerkrankungen. Nervenheilkunde 20 (1): 42–47 

Ommerborn MA, Schneider C, Schäfer R, Franz M, Raab WHM 

(2001): Zusammenhang von psychischer Belastung und Bruxismus. 

Rheinisches Zahnärzteblatt 6: 357–358 

Rollnik JD, Schmitz N, Kugler J (2001): Cardiovascular reactions induced 

by unpredictable, predictable, and controllable painful stimuli 

during sphygmomanometry. Int J Psychophysiol 40: 161–165 

Rollnik JD, Schneider U, Siggelkow S, Schmitz N, Kugler J (2001): 

Gender differences in cardiovascular responses to sphygmomanometric 

measurements. J Psychophysiol 15: 43–46 

Schmitz N, Hartkamp N, Baldini Ch, Rollnik J, Tress W (2001): Psychometric 

properties of the German version of the NEO-FFI in 

psychosomatic outpatients. Personality and Individual Differences. 

31: 713–722

Schmitz N, Kruse J, Tress W (2001): Improving Screening for Mental 

Disorders in Primary Care Setting by Combining GHQ-12 and SCL- 

90-R Subscales. Comprehensive Psychiatry 42: 166–173 

Tress W (2001): Der Traum in der Tiefenpsychologie heute. Zeitschrift 

für Klinische Psychologie, Psychiatrie und Psychotherapie 

49: 361–372 

Tress W (2001): Von konfliktneurotischen Störungen bis zu persönlichkeitsgestörten 

Patienten. Tiefenpsychologisch fundierte Psychotherapie 

heute. psycho 27: 25–29 

Wöller W, Kruse J (2001): Deutende Interventionstechniken bei 

schweren Persönlichkeitsstörungen. Psychotherapeut 46: 326–331 

2002 

Didjurgeit U, Kruse J, Schmitz N, Stückenschneider P, Sawicki PT 

(2002): A time-limited problem orientated psychotherapeutic intervention 

in Type 1 diabetic patients with complications: a randomised 

controlled trial. Diabetic Medicine 19: 814–821 

Egle TU, Hardt J, Franz M, Hoffmann SO (2002): Psychosoziale Belastungen 

in der Kindheit und Gesundheit im Erwachsenenalter. 

Psychotherapeut 47: 124–127 

Franz M (2002): Wenn der Vater fehlt. Frühe Kindheit. Zeitschrift der 

Deutschen Liga für das Kind. 3:14–17 

Hartkamp N, Schmitz N, Schulze-Edinghausen A, Ott J, Tress W 

(2002): Spezifisches Gegenübertragungserleben und interpersonelle 

Problembeschreibung in psychodynamischer Psychotherapie. 

Der Nervenarzt 73: 272–277 

Höwer S, Möslein G, Unger A, Vogel T, Goecke T, Alberti L (2002): 

Psychoonkologische Aspekte bei der Betreuung von Patientinnen 

im Rahmen des HNPCC-Syndroms. Zentralbl Gynäkol 124: 1–5 

Joksimovic L, Starke D, Knesebeck O.v.d., Siegrist J (2002): Percived 

work-stress and self reported musculoskeletal pain: a cross sectional 

investigation. International Journal of Behavioral Medicine 

9: 122–138 

Karger A (2002): Seltener beachtete Demenzen. Medizinische Welt 

53: 116–119 

Knesebeck O.v.d., Joksimovic L, Badura B, Siegrist J (2002): Evaluation 

of a community level health policy intervention. Health Policy 

61 (1): 111–122 

Linnemeier A, Schäfer R, Koeckmann R, Siegmann S, Siegmund K 

(2002): Psychophysiologische Reaktionen auf Lärm in Abhängigkeit 

von Pegel, Frequenz und Persönlichkeitsfaktoren. In Nowak D, 

Praml G (Hrsg.): Dokumentationsband über die 42. Jahrestagung 

der Deutschen Gesellschaft für Arbeitsmedizin und Umweltmedizin. 

Rindt-Druck, Fulda: 310–311 

Schäfer R, Schneider C, Sitte W, Franz M (2002): Faktorenstruktur 

und Validitätshinweise der Deutschen Version der TAS-20. Psychother 

Psychosom med Psychol 52: 449–453 

ReseaRch 

Schmitz N, Franz M (2002): A bootstrap method to test if study drop- 

outs are missing randomly. Quality and Quantity 36: 1–16 

Schmitz N, Hartkamp N, Franz M, Buse S, Karig R, Tress W (2002): 

Properties of the Symptom Check List (SCL-90-R) in an Psycho- 

somatic Consultation-Liaison Setting. Psychological Reports 90: 

1201–1207 

Schmitz N, Kruse J (2002): The relationship between mental disorders 

and Medical service utilization in a representative community 

sample. Soc Psychiatry and Psychiatr Epidemiol 37: 1–7 

Sitte W, Schäfer R, Franz M (2002): Different event related potentials 

(ERPs) to hemifield presentation of emotional and neutral faces 

and objects. Neurophysiological correlates of face and object processing 

in humans. Eur Arch Psychiatry Clin Neurosci 252: I/66 

Söllner W, Silx P, Stein B, Franz M, Lampe A, Herzog T (2002): Qualitätskriterien 

für den psychosomatischen Konsiliar-Liaison-Dienst. 

Wiener Medizinische Wochenschrift 152: 528–534 

Tress W (2002): Medizinische Behandlungsnotwendigkeit in der 

kassenärztlichen psychotherapeutischen Versorgung. 


2003 

Albert SJ, Junkert-Tress B, Tress W (2003): Dynamische Kurzzeitpsychotherapie 

zwischen Stützen und Deuten. Therapeutische 

Interventionen auf der Basis des zyklisch-maladaptiven Beziehungsmusters 

(CMP) bei Patienten mit unterschiedlichem Niveau 

der Ich-Funktionen. Fortschritte der Neurologie-Psychiatrie 71: 

89–102 

Franz M, Lensche H (2003): Alleinerziehend – alleingelassen? Die 

psychosoziale Beeinträchtigung alleinerziehender Mütter und ihrer 

Kinder in einer Bevölkerungsstichprobe. Zschr. Psychosom. 

Med. 49: 115–138 

Franz M, Lensche H, Schmitz N (2003): Psychological distress and 

socioeconomic status in single mothers and their children in a 

German city. Soc. Psychiatry Psychiatr Epidemiol 38: 59–68 

Franz M, Schaefer R, Schneider C (2003): Psychophysiological response 

patterns of high and low alexithymics under mental and 

emotional load conditions. Journal of Psychophysiology 

17: 203–213 

Herpertz S, Petrak F, Albus C, Hirsch A, Kruse J, Kulzer B (2003): 

Psychosoziales und Diabetes mellitus. Diabetes und Stoffwechsel 

12: 69–94 

Karger A (2003): Pluralität der Wissenschaften. Forum der Psychoanalyse 

19: 246–254 

Kruse J, Grinschgl A, Wöller W, Söllner W, Keller M (2003): Psychosoziale 

Interventionen bei Patientinnen mit Brustkrebs. Psychotherapeut 

48: 93–99 

155


Kruse J, Schmitz N, Thefeld W (2003): On the association between 

diabetes and mental disorders in a community sample. Diabetes 

Care 26: 1841–1846 

Kruse J, Schmitz N, Wöller W, Clar B, Meier E, Grinschgl A, Tress W 

(2003): Effekte eines psychosozialen Fortbildungsprogramms zur 

Verbesserung der Arzt-Patient-Interaktion mit Krebspatienten. 

Zschr. Psychosom. Med. 49: 232–245 

Larisch M, Joksimovic L, Knesebeck O.v.d., Starke D, Siegrist J 

(2003): Berufliche Gratifikationskrisen und depressive Symptome: 

eine Querschnittstudie bei Erwerbstätigen im mittleren Erwachsenenalter. 

Psychotherapie, Psychosomatik, Medizinische Psychologie 

53: 223–228 

Lensche H, Junkert-Tress B, Franz M (2003): Konzept und Evaluation 

einer supportiven Gruppen-Kurzintervention für alleinerziehende 

Mütter. Gruppenpsychother. Gruppendynamik 39: 340–361 

Schmitz N, Kruse J, Kugler J (2003): Tobacco Smoking and Nicotine 

Dependence: Disabilities, Quality of Life, and Associated Mental 

Disorders. American Journal of Psychiatry 160: 1670–1676 

Tress W (2003): Kritik der psychoanalytisch begründeten Psychotherapien 

aus der Sicht des Psychoanalytikers. Psychotherapie 

8: 272–278 

Tress W (2003): Tief innen brodelnder Feuerofen. Bemerkungen zur 

Anthropologie aus der Sicht eines Psychoanalytikers. Zeitzeichen 

6: 43–45 

Tress W, Junkert-Tress B, Hartkamp N, Wöller W, Langenbach M 

(2003): Spezifische psychodynamische Kurzzeittherapie von Persönlichkeitsstörungen. 


Wöller W, Kruse J (2003): Persönlichkeitsstörungen und die Psychopathologie 

in Folge von Traumen. Nervenarzt 74: 972–976 

2004 

Franz M, Schaefer R, Schneider C, Sitte W (2004): Visual event related 

potentials in alexithymic subjects. Hints to a modified processing 

of emotional aversive informations? American Journal of 


Frommer J, Hoffmann T, Hartkamp N, Tress W, Franke GH (2004): 

Psychometrische Merkmalsprofile von Angstpatienten und depressiven 

Patienten im Ost-West-Vergleich. Psychotherapie 

Psychosomatik Medizinische Psychologie 54: 206–213 

Hartkamp N (2004): Psychiatrie und Migration: Forschungsperspektiven. 

Psychoneuro 30 (2): 109–111 

Kruse J, Schmitz N, Wöller W, Heckrath C, Tress W (2004): Warum 

übersieht der Hausarzt die psychischen Störungen seiner Patienten? 

Determinanten der hausärztlichen Identifikation psychischer 

Störung. Psychother Psych Med 54: 45–51 

156 

Larisch R, Kley K, Nikolaus S, Sitte W, Franz M, Hautzel H, 

Tress W, Müller HW (2004): Depression and Anxiety in Different 

Thyroid Functions States. Horm Metab Res 36: 650–653 

Rohleder N, Joksimovic L, Wolf J, Riegler S, Kirschbaum C (2004): 

Hypocortisolism and increased glucocorticoid sensitivity of proinflammatory 

cytokine production in Bosnian war refugees with 

posttraumatic stress disorder. Biological Psychiatry 55: 745–751 

Schmitz N, Kruse J, Kugler J (2004): The association between physical 

exercises and health related quality of life in subjects with 

mental disorders: results from a cross sectional survey. Preventive 

Medicine 39: 1200–1207 

Stirn A, Hartkamp N (2004): Krankheitstypische Gegenübertragungsreaktionen. 


Tress W (2004): Der lange Weg zum Purzelbaum. Zeitzeichen 

5. Jhrg., 12: 40–43 

Tress W (2004): Stalking: Psychopathologie eines modernen Phänomens. 

Schatten, die nicht weichen. MMW Fortschritte der Medizin 

147. Jhrg., 6: 31/91–35/95 

Franz M (2004): Wenn der Vater fehlt. Psychologie heute. 4: 20–25 

2005 

Franz M (2005): Wenn Mütter allein erziehen. Prax Kinderpsychol 

Kinderpsychiat 54: 817–832 

Franz M, Balló H, Heckrath C, Frenzel A, Schilkowsky G, Schneider 

C, Schmitz N, Löwer-Hirsch M, West-Leuer B, Hirsch M, Ott J 

(2005): Tinnitus als soziale Infektion? Tinnitus als ein Indikator eines 

dekompensierten Gruppenprozesses innerhalb einer Organisation. 


Karger A (2005): Otto Gross. Selbstbegründung und Sohnesopfer in 

den Anfängen der Psychoanalyse. Texte. Psychoanalyse – Ästhetik 

– Kulturkritik 17: 7–32 

Neumann E, Tress W (2005): Bindung und Liebe in den Partnerschaften 

von Psychotherapiepatienten. Verminderte Beziehungsqualität 

als Hinweis auf psychische Erkrankungen. Psychotherapeut 

50: 267–270 

Ommerborn M, Giraki M, Schneider C, Schäfer R, Gotter A, Franz M, 

Raab WHM (2005): Considerations for the quantification of sleep 

bruxism: A new computer-based analyzing method for the Bruxcore 

bruxism-monitoring device. Journal of Orofacial Pain 

19: 232–238 

Petrak F, Herpertz S, Albus C, Hirsch A, Kulzer B, Kruse J (2005): 

Psychosocial factors and diabetes mellitus: evidence-based treatment 

guidelines. Current Diabetes Review 1 (3): 255–270 

Schneider C, Tress W (2005). Stalking. Psychopathologie eines modernen 

Phänomens. MMW Fortschritte der Medizin, 147, 30–35

Simson U, Martin K, Schäfer R, Janssen P, Franz M (2005): Alexithymie 

in einer klinischen Stichprobe. Psychother Psych Med 

55: 347–353 

Sitte W, Schafer R, Roper M, Franz M (2005): Asymmetric visual 

event-correlated potential processes in lateralised presentation of 

emotional and neutral facial expression and neutral everyday objects 

in high- and low alexithymia patients. Psychother Psychosom 

Med Psychol 55: 151–152 

Tress W (2005): Der Kranke als lebensgeschichtliches Subjekt. 

Notfall & Hausarztmedizin 12: 571 

Tress W (2005): Zur Geschichte der Psychosomatischen Medizin. 

Zeitschrift für Psychosomatische Medizin und Psychotherapie 

Jubliäums-CD 51: 20–27 

Wöller W, Tress W (2005): Die psychotherapeutische Behandlung von 

Persönlichkeitsstörungen. Zeitschrift für Psychosomatische Medizin 

und Psychotherapie 51: 110–127 

2006 

Franz M (2006): Neurobiologische Grundlagen und Funktion des Willens. 

Agora. Düsseldorfer Beiträge für Psychoanalyse und Gesellschaft. 

6: 18–23 

Franz M (2006): Traumatische Kindheit – ihre Folgen für das Erwachsenenleben. 

Kindheit: 83–88 

Franz M (2006): Wenn der Vater fehlt – Spätfolgen einer vaterlosen 

Gesellschaft. Bulletin. Nachrichten aus dem Deutschen Institut 

für Jugend und Gesellschaft. 1(6): 22–31 

Herpertz S, Petrak F, Kruse J, Kulzer B, Lange K, Albus C (2006): 

Essstörungen und Diabetes mellitus. Therapeutische Umschau 

63: 31–35 

Kruse J, Icks A (2006): Depression und Diabetes. Rheinisches Ärzteblatt 

6: 23–24 

Kruse J, Petrak F, Herpertz S, Albus C, Lange K, Kulzer B (2006): 

Diabetes mellitus und Depression – eine lebensbedrohliche Interaktion. 

Z Psychosom Med Psychother 52: 289–309 

Larisch R, Sitte W, Antke C, Nikolaus S, Franz M, Tress W, Müller HW 

(2006): Striatal dopamine transporter density in drug naive 

patients with attention-deficit/hyperactivity disorder. Nuclear Medicine 

communications 27: 267–270 

Ommerborn MA, Schneider C, Giraki M, Schäfer R, Singh P, Franz M, 

Raab WHM (2007): In vivo evaluation of noncarious cervical lesions 

in sleep bruxism subjects. J Prosthet Dent 98: 150–158 

Schmitz N, Thefeld W, Kruse J (2006): Mental Disorders and Hypertension: 

Factors Associated With Awareness and Treatment of Hypertension 

in the General Population of Germany. Psychosomatic 

Medicine 68: 246–252 

Simson U, Martin K, Schäfer R, Franz M, Janssen P (2006): Veränderung 

der Wahrnehmung von Emotionen im Verlauf stationärer 

psychotherapeutischer Behandlung. Psychother Psych Med 

56: 376–382 

ReseaRch 

Simson U, Perings C, Plaskuda A, Schäfer R, Brehm M, Bader D, 

Tress W, Franz M (2006): Einfluss des Bindungsmusters, sozialer 

Unterstützung und der Häufigkeit von ICD-Entladungen auf die 

psychische Belastung bei Patienten mit einem implantierten Kardioverter 

Defibrillator (ICD). Psychother. Psychosom. med. Psychol. 

56: 493–499 

Tress W (2006): Entscheidungsfreiheit und Psychoanalyse. Wege zum 

Menschen 2, 58. Jhrg. 149–158 

Tress W (2006): Psychodynamische Beziehungsanalyse als Beitrag zu 

einer mehrdimensionalen Psychopathologie. Die Psychiatrie 

4: 207–214 

Tress W, Janssen P, Hildenbrand G, Merkle W, Loew TH (2006): Psychiatrische 

Versorgungsprobleme: Klagen und Klärung aus Sicht 

der Psychosomatischen Medizin und ärztlichen Psychotherapie. 

Zeitschrift für Psychosomatische Medizin und Psychotherapie 

1: 86–102 

Wöller W, Kruse J (2006): Beziehungs- und Identitätsstiftung in der 

ärztlichen Psychotherapie. Gedanken eines Psychodynamikers. 

Ärztliche Psychotherapie 1: 18–23 

2007 

Bergstein V, Jüttemann-Lembke A (2007): Autonomie-Abhängigkeitskonflikte 

im Lebenslauf psychosomatisch erkrankter Frauen 

im 3. Lebensalter – Eine kasuistisch vergleichende klinische Fallstudie. 

Psychotherapie im Alter 3/4: 23–33 

Bergstein V, Jüttemann-Lembke A (2007): Persönlichkeitsstörungen 

und Paarkonflikte im Alter – eine Fallstudie. Psychotherapie im 

Alter 1/4: 91–101 

Franz M, Hardt J, Brähler E (2007): Vaterlos: Langzeitfolgen des Aufwachsens 

ohne Vater im Zweiten Weltkrieg. Z Psychosom Med 

Psychother 53: 216–227 

Franz M, Popp K, Schäfer R, Sitte W, Schneider C, Hardt J, Decker O, 

Braehler E (2007): Alexthymia in the German general population. 

Soc Psychiatry Psychiatr Epidemiol 43: 54–62 

Grässner M, Deimel H (2007): Kampfkunst in Psychosomatik und 

Psychotherapie. Bewegungs- und Gesundheitssport 23: 66–71 

Gripp S, Moeller S, Bölke E, Schmitt G, Matuscheck C, Asgari S, 

Asgharzadeh F, Roth S, Budach W, Franz M, Willers R (2007): 

Survi vial prediction in terminally ill cancer patients by clinical esti- 

mates, laboratory tests, and self-rated anxiety and depression. 

Journal of clinical oncology 25: 3313–3320 

Hardt J, Egle UT, Johnson JG (2007): Suicide attempts and retrospective 

reports about parent-child relationsships: evidence for 

the affectionless control hyptohesis. Psycho-Social-Medicine 4: 

1–10 

Hardt J, Franke P (2007): Validity, reliability and objectivity of the family 

history method in psychiatry: A meta analysis. Eur Psychiatry 

22: 49–58 

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Hardt J, Goergen G (2007): Relative Risk, odds Ratio, relative and absolute 

risk reduction – some comments about their relations and 

interpretation. Journal of Biostatistics 2: 123–128 

Hartkamp N, Franz M (2007): STOP-D stationäre tiefenpsychologisch 

orientierte Psychotherapie depressiver Patientinnen. Psychodynamische 

Psychotherapie (6): 119–132 

Hunziger J, Egle UT, Vossel G, Hardt J (2007): Stabilität und Stimmungsabhängigkeit 

retrospektiver Berichte elterlichen Erziehungsverhalten. 

Z Klein Psychol Psychothera 36: 235–242 

Matheis A, Martens U, Kruse J, Enck P (2007): Irritabe bowel syndrome 

and chronic pelvic pain: A singular or two different clinical syndrome? 

World J Gastroenterol 13 (25): 3446–3455 

Neumman E, Tress W (2007): Enge Beziehungen in Kindheit und Erwachsenenalter 

aus der Sicht der Strukturalen Analyse Sozialen 

Verhaltens (SASB) und der Bindungstheorie. Psychother Psych 

Med 57: 1–9 

Popp K, Schäfer R, Schneider C, Brähler E, Decker O, Hardt J, Franz 

M (2007): Faktorstruktur und Reliablität der Toronto-Alexithymie- 

Skala (TAS-20) in der deutschen Bevölkerung. PPmP 5: 208–214 

Ronel J, Kruse J, Gündel H (2007): Somatoforme Störungen. Erfahrungen 

und neue Behandlungsmöglichkeiten. Psychosom Konsiliarpschiatr 

1: 132–140 

Schäfer R, Popp K, Jörgens S, Lindenberg R, Franz M, Seitz RJ 

(2007): Alexithymia-like disorder in right anterior cingulate infarction. 

Neurocase: 1–8 

Schäfer R, Schneider C, Tress W, Franz M (2007): Cortical augmenting 

in alexithymic subjects after unpleasant acoustic stimulation. 

J Psychosom Res 63: 357–364 

Schmitz N, Kruse J (2007): The SF-36 summary scores and their relation 

to mental disorders: Physical functioning may affect performance 

of the summary scores. Journal of Clinical Epidemiology 

60: 163–170 

Schmitz N, Kruse J, Kugler J (2007): Smoking and its association 

with disability in chronic conditions: Results from the Canadian 

Community and Health Survey 2.1. Nicotine & Tobacco Research 

9: 959–964 

Schneider C (2007): Psychoonkologische Aspekte bei gynäkologischen 

Malignomen. Der Gynäkologe 11: 865–871 

Schneider C, Schäfer R, Ommerborn M, Giraki M, Goertz A, Raab 

WHM, Franz M (2007): Maladaptive Coping Strategies in Patients 

with Bruxism Compared to Non-Bruxing Controls. Int J Behav Med 

4: 257–261 

Tress W (2007): Psychosomatik der schweren Persönlichkeitsstörungen. 

Ärztliche Psychotherapie 3: 133–141 

Tschuschke V, Weber R, Horn E, Kiencke P, Tress W (2007): Ambulante 

psychodynamische Kurzgruppentherapie bei Patienten mit 

somatoformen Störungen. Z Psychiatr Psychol Psychother 55: 

87–95 

158 

Wöller W, Hartkamp N, Tress W (2007): Einfluss von Persönlichkeits- 

merkmalen auf die erlebte Hilfe und Belastung durch Gruppen- 

therapie und Mitpatienten in der stationären psychodynamischen 

Psychotherapie. Z Psychosom Med Psychother 53: 163–176 

2008 

Bork K, Bygum A, Hardt J (2008): Benefits and risks of danazol in 

hereditary angioedema: a long-term survey of 118 patients. Ann 

Allergy Asthma Immunol 100: 153–161 

Bork K, Staubach P, Hardt J (2008): Treatment of skin swellings with 

C1-inhibitor concentrate in patients with hereditary angiooedema. 

Allergy 63(6): 751–757 

Bowi U, Ott G, Tress W (2008): Faustlos – Gewaltprävention in der 

Grundschule. Prax Kindperschol Kinderpsychiatr 57:509-520 

Eigelshoven S, Löcher-Ernst D, Schneider C, Krüssel JS, Müller- 

Mattheis V, Kruse R, Neumann NJ (2008): Sperm retrieval by 

transrectal elector-ejaculation in primary anorgasmy. Hautarzt 

59: 285–286 

Franz M (2008): Vom Kindesopfer zur Beschneidung. Zur interkulturellen 

Psychohistorie eines archaischen Genitaltraumas. psychosozial 

112: 41–55 

Franz M, Gertheinrichs T, Guttgemanns J, Haubold S, Schafer R 

(2008): News from PALVE – effect of an structured attachment oriented 

parental training for single mothers. Psychother Psychosom 

Med Psychol 58: 86–86 

Franz M, Popp K, Schaefer R, Sitte W, Schneider C, Hardt J, Decker 

O, Braehler E (2008): Alexithymia in the German general population. 

Soc Psychiatry Psych Epidem 43(1): 54–56 

Hardt J, Goldberg J, Jacobsen C, Nickel R, Buchwald D (2008): 

Prevalences of chronic pain in the US. Pain Med 9: 803–812 

Hardt J, Sidor A, Nickel R, Kappis B, Petrak P, Egle UT (2008): Childhood 

adversities and suicide attempts: A retrospective study. J 

Fam Violence 23: 713–718 

Hecke D, Hardt J, Tress W (2008): Zur Effektivität und klinischen Relevanz 

psychodynamischer Kurztherapie: Das Düsseldorfer Kurzzeittherapieprojekt 

(seit 1991). Zeitschrift für Psychosomatische 

Medizin und Psychotherapie 54: 107–131 

Hiltl M, Bielmer P, Krumm B, Franz M, Schepank H, Lieberz K 

(2008): Spurensuche: Psychische Entwicklung der Großstadtkinder 

aus dem 2. Weltkrieg. Psyhother Psych Med 58: 1–7 

Kruse J (2008): Der Körper als Botschafter – Konzepte der psychodynamischen 

Psychotherapie. PiD 3: 217–222 

Kruse J, Ladwig KH, Schmitz N, Heinrich J (2008): Depressive symptoms 

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tolerance – Result of 30 years follow-up of a prospective cohort 

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Hayne M, Kunzke D (2004): Moderne Gruppenanalyse – Was zeichnet 

sie aus? In: Hayne M, Kunzke D (Hrsg.): Moderne Gruppenanalyse 

– Theorie, Praxis und spezielle Anwendungsgebiete. Psychosozial- 

Verlag, Gießen: 9–28 

Karger A (2004): Gibt es kollektive Traumata? Anmerkungen zu einem 

modischen Begriff. In: Karger A, Heinz R (Hrsg.): Trauma 

und Gruppe. Psychoanalytische, philosophische und sozialwissenschaftliche 

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Kunzke D (2004): Joseph D. Lichtenbergs Theorie der Motivationssysteme 

und ihre mögliche Anwendung auf die gruppenanalytische 

Praxis. In: Hayne M, Kunzke D (Hrsg.): Moderne Gruppenanalyse 

– Theorie, Praxis und spezielle Anwendungsgebiete. Psychosozial-Verlag, 

Gießen: 132–152 

Tress W (2004): Macht und Ohnmacht in Psychoanalysen. In: 

Dreyer KA (Hrsg.): Entwicklungen und Veränderungen. Aufgeben 

oder Aufgabe? Arbeitstagung der Deutschen Psychoanalystischen 

Vereinigung Ulm 2004: 145–154 

2005 

Albus C, Kruse J, Wöller W (2005): „Hätte ich die Beschwerden nicht, 

wäre alles gut“. Patienten mit funktionellen psychosomatischen 

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Basisbuch und Praxisanleitung. 2. Aufl., Schattauer, Stuttgart: 

330–338 

Egle UT, Hardt J (2005): Pathogene und protektive Entwicklungsfaktoren 

für die spätere Gesundheit. In Egle UT, Hoffmann SO, 

Joraschky P (Hrsg.): Sexueller Missbrauch, Misshandlung, Vernachlässigung: 

Erkennung, Therapie und Prävention der Folgen 

früher Stresserfahrungen Schattauer, Stuttgart S. 20–43 

Franz M (2005): Bedarfslagen von Alleinerziehenden und ihren Kindern. 

In: Collatz J, Barre F, Arnhold-Kerri S: Prävention für Mutter 

und Kind. Wissenschaftlicher Verlag, Berlin: 130–141 

163


Franz M (2005): Epidemiologie psychosomatischer Erkrankungen. In: 

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Franz M (2005): Langzeitfolgen von Trennung und Scheidung. In: Egle 

et al. (Hrsg.): Sexueller Missbrauch, Misshandlung, Vernachlässigung. 

3. Aufl., Schattauer, Stuttgart: 116–128 

Franz M (2005): Psychosomatische Erkrankungen: Neurologie. In: 

Janssen P et al. (Hrsg.): Leitfaden Psychosomatische Medizin und 

Psychotherapie. Deutscher Ärzteverlag, Köln: 208–224 

Höwer S (2005): Gesundheitsverhalten bei vererbbarem Darmkrebs 

HNPCC (Hereditary Non-Polyposis Colorectal Cancer) unter besonderer 

Berücksichtigung von Kontroll- und Kompetenzüberzeugungen. 

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Deutschen Krebshilfe geförderten Forschungsprojekts „Familärer 

Darmkrebs“. Peter Lang Verlag, Frankfurt, Berlin, Bern 

Karger A (2005): Überlegungen zum Problem von Folter und 

Schmerz. In: Karger A, Heinz R (Hrsg.): Trauma und Schmerz. 

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Knesebeck O.v.d., Joksimovic L, Dragano N, Siegrist J (2005): Belastungen 

am Arbeitsplatz und in der Familie: Die Auswirkungen 

von Spillover-Effekten auf depressive Symptome. In: Kastner M 

(Hrsg.): Die Zukunft der Work Life Balance, Asanger Verlag, 

Kröning 

Kruse J (2005): Psychotherapie in der Palliativmedizin. In: Janssen 

PL, Tress W, Joraschky PJ (Hrsg.): Leitfaden Psychosomatische 

Medizin und Psychotherapie. Deutscher Ärzteverlag, Köln: 

364–367 

Kruse J (2005): Psychotraumatologie in der Inneren Medizin. In: 

Reddemann L (Hrsg.): Der seelisch verletzte Patient in der primärärztlichen 

Praxis. Deutscher Ärzteverlag, Köln 

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Basisbuch und Praxisleitfaden. Schattauer, Stuttgart, New York: 

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imbalance at work on health. In: Antoniou AS, Cooper CL (Hrsg.): 

Reseach Companion to Organizational Health Psychology. Edward 

Elgar Publishing Ltd., Cheltenham 

Tress W (2005): SASB Structural Analysis of Social Behavior (Strukturale 

Analyse Sozialen Verhaltens). In: Strauß B, Schumacher J 

(Hrsg.): Klinische Interviews und Ratingskalen. Hogrefe, Göttingen 

Wöller W, Bernard HJ, Kruse J, Albus C (2005): Spezielle psychotherapeutische 

Techniken bei Patienten mit defiziären Ich-Funktionen. 

In: Wöller W, Kruse J (Hrsg.): Tiefenpsychologisch fundierte 

Psychotherapie. Basisbuch und Praxisanleitung. 2. Aufl. 

Schattauer, Stuttgart New York: 249–279 

Wöller W, Bernard J, Kruse J (2005): Angst und Panik. Patienten mit 

Angsterkrankungen. In: Wöller W, Kruse J (Hrsg.): Tiefenpsychologisch 


2. Aufl. Schattauer, Stuttgart New York: 315–321 

Wöller W, Kruse J (2005): Beziehungsaufbau und Problemexposition. 

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Wöller W, Kruse J (2005): Übertragungsphänomene erkennen. In: 


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Wöller W, Kruse J (2005): Widerstände sind beziehungsregulierend – 

Zur Technik der Widerstandsanalyse. In: Wöller W, Kruse J (Hrsg.): 


Praxisleitfaden. 2. Aufl. Schattauer, Stuttgart, New York: 171–184 

Wöller W, Kruse J (2005): Wie vermittle ich eine positive Beziehungserfahrung. 

In: Wöller W, Kruse J (Hrsg.): Tiefenpsychologisch 

fundierte Psychotherapie. Basisbuch und Praxisleitfaden. 2. Aufl. 


Wöller W, Kruse J, Albus C (2005): Besondere Patientengruppen. In: 


Basisbuch und Praxisleitfaden. 2. Aufl. Schattauer, Stuttgart, 

New York: 281–301 

Wöller W, Kruse J, Albus C (2005): Übertragungsanalyse im Hier und 

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2006 

Kruse J, Wöller W (2006): Psychotraumatologie in der inneren Medizin. 

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Köln: 86–101 

Franz M (2006): Die biografische Langzeitwirkung kriegsbedingter 

Vaterlosigkeit. Befunde aus der Mannheimer Kohortenstudie. In: 

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69–84 

Franz M (2006): Götterspeise – Vom Kindesopfer zur Beschneidung 

und zurück. In: Hirsch M (Hrsg.): Das Kindesopfer. Eine Grundlage 

unserer Kultur. Psychosozial-Verlag, Gießen: 113–134 

2007 

Franz M (2007): Neurobiologische Grundlagen und Funktion des 

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und Neurobiologie. Vandenhoeck und Ruprecht, Göttingen 

S. 47–64 

Franz M (2007): Vaterlosigkeit – Krise der Familie. In: Jedem Abschied 

folgt ein Anfang – Krise als Herausforderung, Impulse für 

die Psychotherapie, Band 12. Akademie für ärztliche Fortbildung 

der Ärztekammer Hannover: 51–88 

Reddemann L, Wöller W, Bering R, Fischer G, Gast U, Kruse J (2007): 

Psychodynamische Traumatherapien der Borderline-Persönlichkeitsstörung. 

In: Damman G, Janssen PL: Psychotherapie der 

Borderline-Störungen. 2. Aufl. Thieme, Stuttgart, New York 

Tress W (2007): Entscheidungsfreiheit und Psychoanalyse. In: Tress 

W, Heinz R (Hrsg.): Willensfreiheit zwischen Philosophie, Psychoanalyse 

und Neurobiologie.Vandenhoeck & Ruprecht, Göttingen: 

94–105 

Tress W (2007): The Ghost Train of Neurobiology – eigentlich (k)eine 

Satire. In: Tress W, Heinz R (Hrsg.): Willensfreiheit zwischen Philosophie, 

Psychoanalyse und Neurobiologie. Vandenhoeck & 

Ruprecht, Göttingen: 122–134 

Tress W (2007): Trotzdem: Willensfreiheit. In: Tress W, Heinz R 

(Hrsg.): Willensfreiheit zwischen Philosophie, Psychoanalyse und 

Neurobiologie. Vandenhoeck & Ruprecht, Göttingen: 65–68 

Tress W, Heinz R (2007): Einleitung. In: Tress W, Heinz R (Hrsg.): 

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Wöller W, Kruse J (2007). Perspektivenvielfalt und Methodenintegration. 

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in der Psychotraumatologie. Methodenintegrative Therapie. 


2008 

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péce. Para: Portal: 187–196 

Franz M, Kruse J (2008): Casté ortopedické klinické obrazy nemoci. 


péce. Para: Portal: S. 147–164 

Hardt J, Engfer A (2008): Misshandlung, Vernachlässigung und Missbrauch 

von Kindern. In: Oerter R, Montada L (Hrsg.): Entwicklungspsychologie: 

Ein Lehrbuch. Beltz, Weinheim: 803–821 

Joksmivoic L, Bierwirth J (2008): Psychotherapeutische Ansätze für 

traumatisierte Flüchtlinge in der Ambulanz für transkulturelle 

Psychosomatik und Psychotherapie Düsseldorf. In: Golsabahi S, 

Heise T: Von Gemeinsamkeiten und Unterschieden. Das transkulturelle 

Psychoforum. VWB Verlag, Berlin: 187–198 

Joksimovic L, Bierwirth J, Kruse J (2008): Traumatisierte Flüchtlinge 

in der Psychotherapie. In: Muthny FA, Bermejo I (Hrsg.): Interkulturelle 

Medizin. Deutscher Ärzteverlag: 105–119 

Kruse J (2008): Geleitwort. In: Franz M, Frommer J (Hrsg.): Medizin 

und Beziehung. Vandenhoeck & Ruprecht, Göttingen: 11–15 

Kruse J (2008): Die Arzt-Patient-Beziehung in der Diabetologie – 

Von der Compliance zum Empowerment. In: Franz M, Frommer J 

(Hrsg.): Medizin und Beziehung. Vandenhoeck & Ruprecht, 

Göttingen: 210–225 

Kruse J (2008): Umírovjicí pacient. In: Tress W, Kruse J, Ott J (Hrsg.): 

Základní psychosomatická péce. Para: Portal: 339–348 

Kruse J, Rosin U, Wöller W (2008): Psychosomatika lékare. In: Tress 

W, Kruse J, Ott J (Hrsg.): Základní psychosomatická péce. Para: 

Portal: 371–378 

Kruse J, Wöller W (2008): Chronicky nemocni pacient. In: Tress W, 

Kruse J, Ott J (Hrsg.): Základní psychosomatická péce. Para: 

Portal: 311–330 

Kruse J, Wöller W (2008): Onemocnêní lákové v mêny – diabetes mellitus. 

In: Tress W, Kruse J, Ott J (Hrsg.): Základní 

psychosomatická péce. Para: Portal, S. 129–132 

Kruse J, Wöller W (2008): Poruchy príjmu potravy. In: Tress W, 

Kruse J, Ott J (Hrsg.): Základní psychosomatická péce. Para: 

Portal: 133–146 

Kruse J, Wöller W (2008): Psychosomatické aspekty speciálních 

obrazu nemoci. In: Tress W, Kruse J, Ott J (Hrsg.): Základní 

psychosomatická péce. Para: Portal: 83–86 

Kruse J, Wöller W (2008): Somatoformní holestivá porucha (F45.4). 


péce. Para: Portal: 181–186 

Kruse J, Wöller W (2008): Somatoformní poruchy (F 45). In: Tress 


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Kruse J, Wöller W (2008): Trávicí trakt. In: Tress W, Kruse J, Ott J 

(Hrsg.): Základní psychosomatická péce. Para: Portal: 115–128 

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Ott J, Kruse J, Tress W (2008): Rozhovar lékare a pacienta. . In: Tress 



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vztahu mezi lékarem a pacientem. In: Tress W, Kruse J, Ott J 


Tress W, Rosin U, Kruse J (2008): Odborné zvysování kvalifikace a 

zajistování kvality v oblasti základní psychosomatické péce. In: 

Tress W, Kruse J, Ott J (Hrsg.): Základní psychosomatická péce. 

Para: Portal: 365–370 

Wöller W, Kruse J (2008): Duchací orgány. In: Tress W, Kruse J, Ott J 


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Wöller W, Kruse J (2008): Závislostní onemocnení (návyková 

onemocnení) (F10). In: Tress W, Kruse J, Ott J (Hrsg.): Základní 

psychosomatická péce. Para: Portal: 251–260 

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2009 

Franz M (2009): Mannheimer Kohortenstudie: Langzeitfolgen kriegsbedingter 

Vaterlosigkeit. In Fooken I, Zinnecker J (Hrsg.): Trauma 

und Resilienz. Juventa, Weinheim: 95–108 

Franz M, Schäfer R (2009): Affekt ohne Gefühl: Entwicklungspsychologische 

und neurowissenschaftliche Aspekte der Alexithymie. In: 

Grabe HJ, Rufer M (Hrsg.): Alexithymie: Eine Störung der Affektregulation. 

Huber, Bern: 47–68 

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und Informationsverarbeitung. In: Grabe HJ, Rufer M (Hrsg.): Alexithymie: 

Eine Störung der Affektregulation. Huber, Bern: 83–103 

Joksimovic L (2009): Ethnosoziokultureller Leitfaden für die interkulturelle 

Psychotherapie mit Migranten aus dem ehemaligen Jugoslawien. 

In: Erim Y: Klinische Interkulturelle Psychotherapie. Ein 

Lehr- und Praxisbuch. Kohlhammer, Stuttgart: 288–296 

Tress W (2009): Traditionen und Innovationen der Psychosomati- 

schen Medizin und Psychotherapie – eine Zusammenschau. In: 

Janssen PL, Joraschky P, Tress W (Hrsg.): Leitfaden Psychosomatische 


14–23 

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In: Janssen PL, Joraschky P, Tress W (Hrsg.): Leitfaden Psychosomatische 

Medizin und Psychotherapie. Deutscher Ärzteverlag, 

Köln: 480–484 

Tress W, Erny N (2009): Ethische Grundprobleme der Psychotherapie. 



Köln:118–124 

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422–425 

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Köln: 416–421 


2001 

Flatten G, Hofmann A, Liebermann P, Siol T, Wöller W, Petzold E 

(2001): Posttraumatische Belastungsstörung. Leitlinie der AWMF 

und Quellentext. Schattauer, Stuttgart New York 

Heinz R, Tress W (2001): Traumdeutung. Zur Aktualität der Freudschen 

Traumtheorie. Passagen Verlag, Wien 

Karger A, Knellesen O, Lettau G, Weismüller C (2001): Sexuelle Übergriffe 

in Psychoanalyse und Psychotherapie. Vandenhoeck & Ruprecht, 

Göttingen 

Wöller W, Kruse J (2001): Tiefenpsychologisch fundierte Psychotherapie. 

Basisbuch und Praxisleitfaden. Schattauer, Stuttgart, New 

York 

2002 

Tress W, Wöller W, Hartkamp N, Langenbach M, Ott J (2002): Persönlichkeitsstörungen. 

Leitlinie Psychosomatische Medizin und 

Psychotherapie. Schattauer, Stuttgart

2003 

Kruse J (2003): Arzt-Patient-Kommunikation und diagnostische 

Schlussbildung – Determinanten der Diagnose psychischer Störungen 

in hausärztlichen Praxen. VAS, Frankfurt 

Tress W, Kruse J, Ott J (2003): Psychosomatische Grundversorgung. 

Kompendium der interpersonellen Medizin. Schattauer, Stuttgart, 

New York 

2004 

Hayne M, Kunzke D (2004): Moderne Gruppenanalyse – Theorie, 

Praxis und spezielle Anwendungsgebiete. Psychosozial-Verlag, 

Gießen 

Karger A, Heinz R (2004): Trauma und Gruppe. Psychoanalytische, 

philosophische und sozialwissenschaftliche Perspektiven. Psychosozial, 

Gießen 

Karger A, Weismüller C (2004): Gewalt und Globalisierung. Peras, 


Stratkötter A (2004): Konformität und Eigenständigkeit. Qualitative 

Analyse psychoanalytischer Praxiskonzepte und Berufsbio gra- 

phien. LIT-Verlag, Münster 

2005 

Karger A, Heinz R (2005): Trauma und Schmerz. Psychoanalytische, 

philosophische und sozialwissenschaftliche Perspektiven. Psycho- 

sozial-Verlag, Gießen 

Wöller W, Kruse J (2005): Tiefenpsychologisch fundierte Psycho- 

therapie. Basisbuch und Praxisleitfaden. 2., überarbeitete Aufl. 


2006 

Janssen PL, Joraschky P, Tress W (2006): Leitfaden Psychosomatische 

Medizin und Psychotherapie. Deutscher Ärzteverlag, Köln 

Karger A, Weismüller C (2006): „Ich hieß Sabina Spielrein“. Von einer, 

die auszog, Heilung zu suchen. Vandenhoeck & Ruprecht, 

Göttingen 

Weismüller C, Karger A (2006): Gewalt und Globalisierung. Peras, 


2007 

ReseaRch 

Tress W, Heinz R (2007): Willensfreiheit zwischen Philosophie, Psy- 

choanalyse und Neurobiologie. Vandenhoeck & Ruprecht, Göttin- 

gen 

2008 

Franz M, Frommer J (2008): Medizin und Beziehung. Vandenhoeck & 

Ruprecht, Göttingen 

Kunzke D (2008): Sucht und Trauma. Grundlagen und Ansätze einer 

psychodynamisch-integrativen Behandlung. Psychosozial-Verlag, 

Gießen 

Tress W, Kruse J, Ott J (2008): Základní psychosomatická péce. Para: 

Portal 

2009 

Janssen PL, Joraschky P, Tress W (2009): Leitfaden Psychosomatische 

Medizin und Psychotherapie. Deutscher Ärzteverlag, Köln 

167


3.2.4 Research funding 

The department intensified the procurement of thirdparty 

funding in the reporting period. Since research 

in psychotherapy/psychosomatic medicine is very staff 

intensive, the procurement of staff positions lies at the heart 

of procuring third party funding. For the period 2001–2008 

there were three funded research focuses: 

Within the context of psychotherapy research, the DFG 

supported the Düsseldorf short-time psychotherapy 

study, which aims to investigate the processes and 

outcomes of short-term psychotherapies in a range of 

disorders. In addition, the resources of the Heigl-Evers 

Foundation allowed the analysis of the differential effects 

of this intervention in patients with early traumatisation. 

At the same time, the DFG funded a study of inpatients 

with personality disorders. In collaboration with the 

Association of Dependence Help (Gesamtverband der 

Suchtkrankenhilfe), a concept was evaluated for quality 

assurance in inpatient dependence treatment. 

The second focus of the funding is in the area of 

basic psychosomatic care, which is used to integrate 

psychosomatic aspects into general medical care. In 

this way, the FMER, within the context of a public health 

research focus, supports a healthcare-epidemiology study, 

which estimates the prevalence of mental disorders in 

general practice and assesses the determinants of general 

practitioners’ diagnostic evaluation of mental disorders. 

Thanks to the financial support of the North Rhine Statutory 

Health Insurance Physicians’ Association (KV Nordrhein) and 

the Rhineland Health Insurance Funds (AOK Rhineland), we 

assess within the context of a model project the possibility of 

modifying the communicative behaviour of doctors dealing 

with oncology patients. 

The third publicly funded research area deals with 

somatoform disorders. In a DFG-funded project, the 

influence of severe traumatisation on healthcare utilisation 

by patients with functional disorders is being studied. The 

Faculty of Medicine is supporting a study that analyses the 

influence of post-traumatic disorders on the development 

of functional syndromes in migrants from the former 

Yugoslavia. 

All in all, within the reporting period, third-party funding 

amounting to ca. 821,000 Euro was obtained, making the 

mean annual third-party funding income ca. 91,000 Euro 

(Range: 17,000 to 177,000 Euro/p.a.). 

168 

Third-party funded projects: 

The return of torture? 

Applicants: C. Altenhain, R. Görling, J. Kruse. Own area 

of research Mental and neurobiological consequences 

of extreme violence; funding period: 2008–2011, funding 

organisation: Volkswagen Foundation 

The influence of inpatient/partial-inpatient 

psychotherapeutic treatment on subclinical inflammation 

in patients with depression 

Applicants: B. Rose, J. Kruse; funding period: 2008–2009; 

funding organisation: Heigl Foundation 

Evaluation of the “JaVita” patient chaperonage for patients 

with oncological illnesses 

Applicants: J. Kruse, J. Hardt; funding period: 2008–2009; 

funding organisation: AOK Rhineland Hamburg 

Traumatic life events and psychosomatic interactions in 

people with diabetes mellitus 

Applicants: J. Kruse, K. H. Ladwig, A. Icks, C. Herder, 

W. Rathmann, S. Martin, N. Schmitz; funding period: 

2007–2008; funding organisation: Heigl Foundation 

Life after Torture - beyond PTSD 

Applicants: Psychosocial centre for refugees, Düsseldorf; 

Cooperation partner: J. Kruse, L. Joksimovic; funding 

period: 2006–2008; funding organisation: European 

Commission, European Initiative for Democracy and Human 

Rights within the Rehabilitation of Victims of Torture funding 

focus 

Evaluation of the prevention measure “My body belongs to 

me” for the prevention of sexual abuse 

Applicants: J. Kruse, U. Bowi, G. Ott, W. Tress; funding 

period: 2006–2007; funding organisation: NRW state 

Cognitive Behavioural Therapy vs. sertraline in patients 

with depression and poorly controlled diabetes mellitus: A 

randomised controlled trial (DAD study) 

Applicants: F. Petrak, J. Kruse, B. Kulzer, R. Meinert, 

M. Müller, N. Hermanns, S. Herpertz, Schmidt; funding 

period: 2005–2008; funding organisation: DFG/FMER within 

a clinical studies funding programme

Psychosomatic intervention for patients with 

multisomatoform disorder in different somatic specialities 

(PISO) 

Applicants: P. Henningsen P, J. Kruse, M. Sack, H. Gündel, 

G. Schneider, C. Lahmann , E. Guthrie, C. Ohmann; funding 

period: 2005–2008; funding organisation: DFG/FMER within a 

clinical studies funding programme 

Qualitative evaluation and process research in group 

psychotherapy of patients of a higher age (Belle Epoque) 

Applicants: A. Jüttemann-Lembke; funding period: 

2004–2006, funding organisation: Heigl foundation 

Evaluation of a psychosomatic intervention for the 

reduction of depression inin diabetic inpatients with 

diabetic foot syndrome 

Applicants: J. Kruse, W. Scherbaum; funding period: 

2004–2006; funding organisation: Heigl-Evers foundation 

Mental patterns of attachment and interpersonal 

behaviour patterns 

Applicants: W. Tress, L. König; funding period: 2003–2004; 

funded by: Research commission of the Faculty of Medicine 

of the Heinrich-Heine University, Düsseldorf (9772-180) 

Depression and risky illness behaviour in patients with 

type 2 diabetes within the diabetes structural contract 

agreement 

Applicants: J. Kruse, L. Altenhofen, B. Hagen, A. Grinschgl; 

funding period: 2003; funding organisation: Westphalia Lippe 

Statutory Health Insurance Physicians´ Association 

Mental representations and interpersonal behaviour 

patterns in psychotherapy 

Applicants: W. Tress; funding period: 2002; funding 

organisation: Heigl Foundation 

Somatoform disorders and post-traumatic disorders in 

migrants in general practices – prevalence, influence of 

traumatisation and evaluation of an integrated treatment 

concept 

Applicants: J. Kruse, L. Joksimovic; funding period: 

2001–2003; funding organisation: Research commission of 

the Faculty of Medicine of the Heinrich-Heine University, 


ReseaRch 

Functional lower abdominal problems in medical 

practices – predictors of medical diagnosis, treatment and 

healthcare utilisation 

Applicants: J. Kruse, W. Tress, P. Enck; funding period: 

1999–2002; funding organisation: German Research 

Association (KR 1933/1-1) 

169


3.2.5 Organised science symposia and congresses 

s 8 th Psychotherapy Day NRW: Theme: Personality 

disorders – models, diagnosis, treatment and advice, 

31.10.–06.11.2001 

s Workshop on the treatment of severe personality 

disorders with Professor L. Smith-Benjamin, 

27.04.–01.05.2002 

s 9th psychotherapy day, NRW: Part 1: Tranquillity – 

the future of an illusion? Part 2: Body and society – 

psychosomatic medicine today, 28.10.–03.11.2002 

s 10th psychotherapy day, NRW: Part 1: Lifestyles in 

the post modern era, Part 2: New forms of treatment 

for new illnesses? Psychosomatic medicine and 

psychotherapy in the post modern era, 

31.10.–06.11.2003 

s 11th psychotherapy day, NRW: Part 1: Psychotherapy 

in somatic illnesses, Part 2: Somatoform disorders, 

29.10.–04.11.2004 

s SASB workshop: The cyclical maladaptive focus in 

psychodynamic short-term therapy, 01.–02.09.2005 

s 12th psychotherapy day, NRW: Lines of attachment in 

life, 29.10.–02.11.2005 

s Workshop: Treatment of severe personality disorders 

with Professor L. Smith-Benjamin from Utah, 

03.–05.03.2006 

s 1st Congress of transcultural psychiatry, psychotherapy 

and psychosomatic medicine in the German-speaking 

area, 06.–09.09.2007 

s 10 years Academy for Psychoanalysis and 

Psychosomatic Medicine Düsseldorf e. V.: Global 

violence – Intimate violence 23.09.2006 

s 13th psychotherapy day, NRW: Love heals? – 

Love hurts?, 01.–05.11.2006 

s Topic: “Of happiness and meaning in old age”, Andreas 

Kruse, 09.11.2006 

s Workshop: Treatment of severe personality disorders 

with Professor L. Smith-Benjamin 09.–11.03.2007 

s Workshop on the structure-related psychoanalytical 

treatment of personality disorders with G. Rudolf, 

16.–18.03.2007 

s Workshop: The structural analysis of social behaviour 

(SASB), 01.09.2007 

170 

s Workshop: New ways of parent-baby/small 

child psychotherapy. From mirror neurons to 

intergenerational transfers of relationship experiences 

with M. Papousek, 13.–14.10.2007 

s 14th psychotherapy day, NRW: “Anger – a challenge?”, 

31.10.–04.11.2007 

s Trauma symposium: “Psychotraumatology – Current 

paths and developments, 22.–23.02.2008 

s Symposium: “15 years of training of doctors in 

psychosomatic medicine and psychotherapy”, 

04.04.2008 

s 2nd congress of transcultural psychiatry, psychotherapy 

and psychosomatic medicine in the German–speaking 

area, 26.–28.09.2008 

s 15th psychotherapy day, NRW: Biographical locations 

and internal landscapes, 29.10.–02.11.2008 

s Workshop Treatment of severe personality disorders 

with Professor L. Smith-Benjamin, 13.–15.03.2009 

s “What remains of men – The problem of male identity” 

with Professor Hollstein, 18.06.2009 

s Workshop: Complex trauma, dissociative disorders and 

work on the “inner stage” with Dr. Michaela Huber, 

28.–29. 08.2009 

s 3rd Congress of transcultural psychiatry in the Germanspeaking 

area, 11.–13.09.2009 

s 16th Psychotherapy day, NRW: How much change can 

people bear? 28.10.–02.11.2009

3.2.6 Personnel 

Tress, Wolfgang 

Membership of scientific advisory boards: 

s Psychology/Psychiatry Advisory Board, Freie Universität 

Berlin 

s Clinical Psycholinguistic Advisory Board in the Psychiatry 

Centre, Department of Psychosomatic Medicine and 

Psychotherapy, Johann-Wolfgang-Goethe-University 

Frankfurt/M. 

s Member of the advisory board of the Centre for 

Qualitative Educational, Advisory and Social Research 

(JQEAS), and of the advisory board of its homonymous 

Journal, Otto-von-Guericke-University Magdeburg, 

Faculty of Humanities, Social and Pedagogic Sciences 

s Advisory board, Deutsche Gesellschaft für 

Zwangserkrankungen e. V., Osnabrück 

s Advisory board: Journal of the Society for Psychotherapy 

Research. Guilford Publications, New York, USA 

s Advisory board: Journal für Psychologie. Asanger, 

Heidelberg 

s Advisory board for the Journal of Psychotherapy in 

Psychiatry, Psychotherapeutical Medicine and Clinical 

Psychology. CIP-Medien, Munich 

s Co-Editor: Journal for Psychosomatic Medicine and 

Psychoanalysis, Verlag Vandenhoeck & Ruprecht 

Consultation and committee activites: 

s Chairman: Allgemeine Ärztliche Gesellschaft für 

Psychotherapie (AÄGP) 

s Honorary chairman: Deutsche Gesellschaft für 

Psychosomatische Medizin und ärztliche Psychotherapie 

(DGPM) 

s Chairman: Akademie für Psychoanalyse und 

Psychosomatik Düsseldorf 

s Chairman: Institut für Psychotherapeutische Medizin, 

Psychotherapie und Psychosomatik Düsseldorf an 

der Akademie für Psychoanalyse und Psychosomatik 


s Chairman of the Förderverein für Psychosomatische 

Medizin an der Akademie für Psychoanalyse und 

Psychosomatik Düsseldorf 

s Chairman: Psychotherapy Days, NRW 

Kruse, Johannes 

Membership of scientific advisory boards: 

s Advisory board for psychotherapy days, NRW 

s Scientific advisory board for the Journal for 


ReseaRch 

Advisory and committee activity: 

s Board member: Allgemeine Ärztliche Gesellschaft für 

Psychotherapie (AÄGP) 

s Board member: Institut für Psychotherapeutische 

Medizin, Psychotherapie und Psychosomatik Düsseldorf 

an der Akademie für Psychoanalyse und Psychosomatik 


s Board member: Deutsche Gesellschaft für 

Psychosomatische Medizin und ärztliche Psychotherapie 

(DGPM) 

s Board member: Deutsche Kollegium für 

Psychosomatische Medizin (DKPM) 

s Scientific advisory board for the Journal for 


s Scientific advisory board for the Psychotherapy Days 

NRW 

s Deputy chairman of the Institut für Psychotherapeutische 

Medizin, Psychotherapie und Psychosomatik e. V. (IPPP) 

s Cross-association working group: Continuing education 

of psychosomatic medical associations 

s Working group of the German Diabetes Societies and 

DGPM on “Psychosocial and Diabetes” guidelines 

Joksimovic, Ljiljana 

Advisory and committee activity: 

s Board member and managing director of the Funding 

Association for Psychosomatic Medicine and the 

Academy of Psychoanalysis and Psychosomatic 

Medicine, Düsseldorf 

s Board member of the Umbrella Association for 

Transcultural Psychiatry, Psychotherapy and 

Psychosomatics in the German-speaking area 

171


3.3 Department of Child and Adolescent Psychiatry, 


% 

50 

45 

40 

35 

30 

25 

20 

15 

10 

172 

Control group 

Evaluation group 

1 2 3 4 

Years 

Figure 30: Decrease in aggressive characteristics (boys); control and 

evaluation groups over an observation period of 4 years; Figure modified 

after Bowi et al. 2007: Faustlos – Crime prevention in Düsseldorf primary 

schools and day care groups for children. Evaluation for Düsseldorf state 

capital, crime prevention council, State Capital of Düsseldorf. 

3.3.1 Research projects 

The various research projects are coordinated and managed 

by U. Bowi. The department is taking part in a multicentre 

study carried out by the Department of Therapeutic 

Pedagogy and Rehabilitation of the University of Cologne. 

In the context of the PRECONDIS study, a scientific 

assistant, M. Walg, has been employed in the department 

since 01.09.2007 (for 19.5 hours/week) as well as a student 

assistant. 

Projects 

Faustlos – Prevention of violence in primary 

schools and kindergarten 

Applicants: W. Tress, Gudrun Ott , Ulrike Bowi 

Funding period: 2006–2007 

Funding organisation: State capital, Düsseldorf 

In cooperation with the Funding Association for 

Psychosomatic Medicine of the clinical institute and the 

Department of Psychosomatic Medicine and Psychotherapy 

at the Heinrich-Heine University Düsseldorf 

In recent years, the terms violence and aggression among 

school children have moved more and more into the public 

spotlight. Various studies show that around 10–15% of school 

% 

70 

60 

50 

40 

30 

20 

10 

1 2 3 4 

Years 

High 

Low 

Figure 31: Decrease in aggressive characteristics (boys); control and 

evaluation groups over an observation period of 4 years; separated 

according to high and low levels of aggression in school children; Figure 

modified after Bowi et al. 2007: Faustlos – Crime prevention in Düsseldorf 

primary schools and day care groups for children. Evaluation for State 

Capital of Düsseldorf, crime prevention council, State Capital of Düsseldorf.

PRECONDIS-study: Parent training for families with children suffering 

from attention-deficit hyperactivity disorder (ADHD) 

Problems in families with children with ADHD 

s Doing homework 

s Conflicts and power struggles 

s Joint meals 

s Television 

s Visits 

s Going to bed 

Educational objective of the parent training 

s To more effectively guide the child towards showing 

desirable behaviour 

s To strengthen positive relationships with the child 

s To structure everyday processes more effectively (based 

concrete everyday situations) 

Individual 

training 

Diagnostics 

Additional assignment 

Group 

training 

Figure 32: Structure of PRECONDIS project 

Waiting/control 

group 

children have been involved in aggressor/victim conflicts. In 

cooperation with the specialist institute for violence prevention 

of the state capital Düsseldorf, and with the support of 

the capital’s crime prevention board, the “Faustlos” crime 

prevention curriculum has been used in Düsseldorf primary 

schools to prevent aggressive behaviour among school 

children and at the same time promote social skills. The 

effects of the project were evaluated, and it was found that 

school children are clearly benefiting from the curriculum. 

There has been a clear reduction in the instances of 

aggressive behaviour as well as a clear increase in the ability 

to empathise (Figures 30 and 31). The curriculum is now 

taught in 40 primary schools in Düsseldorf and in over 100 day 

care centres. 

Evaluation of the prevention measure “My body belongs to 

me” for the prevention of sexual abuse in primary schools 

in the state capital Düsseldorf 

Applicants: J. Kruse, U. Bowi , G. Ott, W. Tress 


Funding organisation: NRW state 

In cooperation with the Department of Psychosomatic 

Medicine and Psychotherapy of the Heinrich-Heine 

University Düsseldorf. 

Support through parent training 

s Improve educational behaviour 

s Support by means of a proven 

competence training 

s Everyday life with the children in the family 

should be conflict free and less stressful 

Trainer 

A certified psychologist qualified in psychotherapy is 

responsible for the execution of the training. 

ReseaRch 

Target group 

s Parents, whose children are aged between 6 and 12 years 

and suffer from attention-deficit hyperactivity disorder 

s A total of 258 families will participate 

What can the families expect? 

s Seven weekly sessions of 2-3 hours 

s Sessions will be held in the premises of the 

cooperating hospitals 

s Questionnaires must be completed at three points in time 

s All personal data will be handled confidentially 

The effects of the “My body belongs to me” theatre project 

were tested in over 800 Düsseldorf primary schools in 

children in years three and four. In addition, teachers and 

parents were surveyed. School children who took part in the 

project demonstrated more differentiated knowledge of the 

topic of “sexual abuse” in comparison with a control group 

and could name several options for actions. 

PRECONDIS study: Evaluation of a Parent Training for 

Families with Children Suffering from ADHD 

Applicants: G. Lauth, Department of Therapeutic Pedagogy 

and Rehabilitation, University of Cologne 


Funding organisation: Deutsche Forschungsgemeinschaft 

(DFG, German Research Association) 

The department is one of the cooperating departments in 

this multi-centre trial (Figure 32). The study aims to confirm 

the effectiveness of a specific training programme for 

parents of children with ADHS. The parents receive support 

by means of a competence training that has been tested for 

many years. A scientific assistant and a student assistant 

work in the department within the framework of this 

study. 

173




2006 

Habel U, Krasenbrink I, Bowi U, Ott G, Schneider F (2006): A special 

role of negative emotion in children and adolescents with schizophrenia 

and other psychoses. Psychiatry Res 145: 9–19 

Schanwell CM, Ott G, Brehm M, Strauer BE (2006): Fünf Jahre autologe 

intracoronare Stammzelltransplantation. Aktueller Stand und 

Perspektiven. Internist 47: 1087–1092 

2008 

Bowi U, Ott G, Tress W (2008): Faustlos – Gewaltprävention in der 

Grundschule. Praxis der Kinderpsychologie und Kinderpsychiatrie 

57: 509–520 


2002 

Bowi U (2002): Entspannungstherapie. In: Knopp ML, Ott G (Hrsg.): 

Total Durchgeknallt. Psychiatrie Verlag, Bonn: 180–184 

2003 

Ott G (2003): Hat der Wertewandel Einfluss auf seelische Störungen 

und Behandlungskonzept im Kindes- und Jugendalter? In: Kruse 

G, Gunkel S (Hrsg.): Impulse für die Psychotherapie 8. Hannoversche 

Ärzte-Verlags-Union, Hannover: 145–168. 

2004 

Ott G (2004): Kindes- und Jugendalter. In Tress W, Kruse J, Ott J 


interpersonellen Medizin. 3, überarb. Aufl. Schattauer Verlag, 


174 

2008 

Bowi U,Ott G, Tress W (2008): Faustlos – Gewaltprävention in der 

Grundschule zur Förderung sozialer und emotionaler Kompetenzen 

im Schulalltag. In: Franz M, West-Leuer B(Hrsg.): Bindung 

Trauma Prävention. Entwicklungschancen von Kindern und Jugendlichen 

als Folge ihrer Beziehungerfahrungen. Gießen, Psychosozial-Verlag: 

163–178 


2002 

Ott G, Bowi U (2002): Kooperation von Klinik und Praxis. Zeitschrift 

für ärztliche Fortbildung und Qualitätssicherung 9: 587–596 

2007 

Bowi U, Kruse J (2007): Abschlussbericht Evaluation der Präventionsmaßnahme 

„Mein Körper gehört mir“ zur Vorbeugung des sexuellen 

Missbrauchs an Grundschulen der Landeshauptstadt Düsseldorf. 

Januar 2006 bis Oktober 2007. Rheinische Kliniken Düsseldorf, 

Kliniken der Heinrich-Heine-Universität. 

www.regierung-mv.de/cms2/Regierungsportal_prod/Regierungsportal/de/bm/_Aktuelles_Blickpunkte/Mein_Koerper_gehoert_ 

mir_ein_Praeventionsprogramm_fuer_Grundschulen/index.jsp 

Bowi U, Ott G, Tress W (2007): Faustlos – Gewaltprävention an Düsseldorfer 

Grundschulen und Tageseinrichtungen für Kinder. Evaluation 

für die Landeshauptstadt Düsseldorf. Kriminalpräventiver 

Rat, Landeshauptstadt Düsseldorf

The scientific library of the LVR-Klinikum Düsseldorf contains a large number of 

historic volumes on medicine and psychiatry 

3.4 Scientific library 

Director: A. Hinsche-Böckenholt (since 2009), 

D. Knippel (until 2008) 

The library of the LVR-Klinikum Düsseldorf is a specialised 

scientific library. In connection with the Departments of 

Psychiatry and Psychotherapy and Psychosomatic Medicine 

and Psychotherapy of the Heinrich-Heine University 

Düsseldorf the library procures the necessary literature 

and information for research, education, continuous 

medical education and specialist training. With over 30,000 

publications and 70 subscribed specialist journals, it offers 

an extensive reference library, which is complemented by 

online access through the University Library of Düsseldorf 

to full-text articles from around 10,000 electronic specialist 

journals. In addition, the library has a comprehensive 

collection of historic books and journals which document 

the development of psychiatry from its beginnings in the 

sixteenth century to the present day. 

The scientific core areas of the collection are as follows: 

s Psychiatry 

s Psychotherapy 

s Psychosomatic medicine 

s Psychoanalysis 

s Psychology 

s Child and adolescent psychiatry and therapy 

s Neurology 

s Rehabilitation 

s Nursing science 

s Nursing care 

ReseaRch 

The library’s collection is freely accessible in 9 connecting 

and representative rooms and in a large reading room with 

the latest editions of journals. The internet/intranet allows 

systematic searches by author, title and keyword in the 

form of an online catalogue (OPAC). Ten quiet workstations, 

a large reading corner, a PC with internet access and a 

printer, a scanner and a copier ensure that the user has 

optimum working conditions. When A. Hinsche-Böckenholt 

took over as director of the library in August 2009, the 

innovative conceptual further development of the library’s 

services to a central, service-oriented information provider 

was initiated. In addition to procuring and forwarding 

literature, expanding and cataloguing the collection and 

providing information, the library offers specialist research, 

selection and retrieval of publications, information and 

data to support the scientific, clinical and administrative 

specialist staff: 

s Research-relevant database search 

s Permanent topic-specific literature search 

s Short-term needs-oriented document profiles 

s Specific article procurement 

s Bibliographic evidence 

s Publication lists 

s Alerts 

s Preparatory support for lectures and presentations. 

The scientific library of the LVR-Klinikum Düsseldorf is open 

Monday to Thursday from 10 a.m. to 3 p.m. and Fridays from 

10 a.m. to 2 p.m. 

175

4. Teaching


4.1 Academic Teaching for Students 

4.1.1 Psychiatry and Psychotherapy 

W. Gaebel, Professor of Psychiatry and Psychotherapy, 

is the chairman of the Department of Psychiatry and 

Psychotherapy of the Medical Faculty of the Heinrich-Heine 

University Düsseldorf. Until 2007, Professor Gaebel was the 

chair of the Academic Teaching Commission III (UK III) of the 

Medical Faculty of the Heinrich-Heine University Düsseldorf, 

making him responsible for year 5 of the curriculum (Blocks 

E and F). J. Zielasek is the UK III timetable coordinator for 

Block E. The Hospital for Psychiatry and Psychotherapy 

hosts lectures for students of medicine and psychology 

(who are studying psychiatry as an additional subject). F. 

Schneider coordinated the academic teaching programme 

until 2004, when he was succeeded by A. Klimke who, in 

turn, was succeeded by J. Zielasek in 2005. In the wake of 

changes to the German licensing regulations for medical 

doctors, the University of Düsseldorf – no different from 

all other universities in the country – had to change its 

academic curriculum in 2004 and 2005. The number of 

medical students has since risen to 150–180 per semester, 

the number of psychology students to 10–15. At the same 

time, the sizes of the groups in practical bedside teaching 

was reduced, thus increasing small-group bedside teaching. 

Psychiatry and psychotherapy are interesting additional 

subjects for students of psychology, since many of these 

students ultimately want to become clinical psychologists 

or psychological psychotherapists. The Department of 

Psychiatry and Psychotherapy conducts two compulsory 

courses for students of medicine: it provides a contribution 

to the seminar “Introduction to Clinical Medicine” for 

students of preclinical medicine and, for students of 

clinical medicine, a lecture course on “Psychiatry and 

Psychotherapy”, which is accompanied by a new (also 

compulsory) seminar in which students work in groups 

of 20, and hospital bedside teaching in groups of 6 per 

teacher (down from 10 per teacher before 2005). Students of 

psychology may also attend these courses or take any other 

course from the wide range of optional seminars that are on 

offer at the Department of Psychiatry and Psychotherapy. 

Another compulsory course for all students of clinical 

medicine (Block E) is the lecture series on “Rehabilitation-I”, 

coordinated by J. Zielasek on behalf of the Department of 

Psychiatry and Psychotherapy. In addition, the Department 

of Psychiatry and Psychotherapy also provides medical 

students with tuition in their practical year, preparing them 

in colloquia for their final exams. 

178 

Table 7: Courses of the Department of for Psychiatry and 

Psychotherapy in the summer term 2010 

Course title Lecturer 

Lectures, Seminar and Bedside 

Teaching in Psychiatry and 


Gaebel et al. 

Rehabilitation I Zielasek et al. 

Colloquium for Doctoral Students Gaebel/Janssen 

Case Seminar Depression Gaebel/Janssen 

Early Diagnosis and Treatment of 

Mental Disorders 

Gaebel 

Seminar for Medical Doctors in 

Specialty Training for Psychiatry and 


Gaebel et al. 

Gerontopsychiatric Seminar Supprian et al. 

Psychiatry for Students of Psychology Wölwer et al. 

Practical Training in the Analysis 

of the EEG 

Zielasek 

Forensic-psychiatric Seminar Cordes et al. 

Seminar Addiction Medicine Franke/Warnecke 

Psychopathology in Arts and Literature Lange-Asschenfeldt 

Colloquium for Doctoral Students Ihl 

Psychometry in Psychiatry Ihl 

Psychophysiological Seminar Ihl 

Forgetfulness and Dementias: 

Neuropathological, Clinical and Ethical 

Aspects 

Haupt/Korth 

Tutorial in Scientific Working Sprick et al. 

Diagnostic Methods in 

Gerontopsychiatry 

Haupt 

Biological Psychiatry Sprick 

Neuropsychology of Mental Disorders Wölwer 

Seminar Psychopathology Zielasek et al. 

The changes to the German licensing regulations for 

medical doctors required a complete structural overhaul of 

the medical examination system. The fields “Psychiatry and 

Psychotherapy” introduced cross-departmental multiplechoice 

tests (for the “Cross-Departmental Certificate of 

Achievement in Neuropsychiatry”), jointly conducted by 

the Department of Psychiatry and Psychotherapy, the 

University Department of Neurology and the Department 

of Psychosomatic Medicine. Similarly, in “Rehabilitation-I” 

there is now a joint examination with the Department of 

General Medicine (Rehabilitation Medicine, Complementary 

Medicine and Naturopathy). The multiple-choice questions 

are subjected to a formal and technical review by a dedicated 

Review Committee of Curricular Commission III. J. Zielasek 

was the initial spokesman for this Committee. Lecturers

from the Department of Psychiatry and Psychotherapy work 

as examiners in the oral state examinations of students of 

medicine and students of psychology. 

The re-launch of the LVR-Klinikum’s web pages also 

involved the section on academic teaching. The presentation 

of lecture schedules, learning objectives and lecture slides 

was overhauled and updated. The results can be seen in the 

Internet under 

http://www.rk-duesseldorf.lvr.de/05_forschung/02informatio 

nen/01lehrveranstaltungen/index.htm 

The University Calendar is also available online under 

https://lsf.verwaltung.uni-duesseldorf.de/qisserver/servlet/ 

de.his.servlet.RequestDispatcherServlet?state= 

user&type=0 

Table 7 provides an overview of the courses offered at the 

Department of Psychiatry and Psychotherapy during the 

summer term 2010. It is planned to increase the proportion 

of practice-centred tuition in small groups, despite the 

large number of students, for example through new forms 

of “problem-oriented learning” in the framework of the 

medical faculty’s next curricular reform “Curriculum 

2011”. Special seminars have already been developed to 

teach students the fundamentals of psychopathological 

diagnostics, an elementary skill that every medical doctor 

and particularly every psychiatrist should have. The 

technological potential of the video lab will be increasingly 

exploited. Students will also receive guidance as to how to 

conduct scientific research. Changes to the curricula of 

psychology students appear to be impending in the wake of 

a move at the Heinrich-Heine University from the traditional 

“university diploma” to a system of bachelor’s and master’s 

degrees. It is also planned to develop and extend existing 

efforts in education research. In 2006, for example, the 

Department conducted a survey about the stigmatisation of 

the mentally ill among medical students, which is currently 

being evaluated. At the moment, teaching research focuses 

on the “Lack of Medical Doctors in Psychiatry” as part 

of a research project supported by the World Psychiatric 

Association (see also Chapter 3.1.3.4 – Destigmatising 

Persons with Mental Illnesses). 

teACHinG 

4.1.2 Psychosomatic Medicine and Psychotherapy 

The following excerpts from the University Calendar for 

the summer term 2010 provide an overview of the courses 

offered at the Department for Psychosomatic Medicine and 

Psychotherapy. 

Table 8: Teaching seminars in the Department of Psychosomatic 

Medicine and Psychotherapy 

Seminar Title 

Neurobiology of affect recognition and 

processing 

Participating 

lectures 

Schäfer/Franz 

Doctoral Students Seminar Tress/ 

Stratkötter 

Clinical Seminar Tress 

Scientific Workshop Tress 

Diagnostics and indications in psychosomatic 

medicine and psychotherapy 

Tress/ 

Dechering/ 

Joksimovic 

Mind and Body Hand in Hand Schäfer 

Modular Teaching in the Second Year Tress et al. 

Main Seminar for Doctoral Students Franz/Schäfer 

Patient-centered self experience Karger 

Practical Exercises in Psychosomatic Medicine Tress et al. 

Psychoanalysis and Society West-Leuer/ 

Tress 

Qualitative research methods in psychotherapy Tress/Stratkötter 

Studying without handicaps - Working 

Through and Finding Solutions for typical 

conflict situations in everyday studying of ill or 

handicapped students 

Franz 

From relationship to diagnosis Franz 

Lectures in Psychosomatic Medicine and 


Tress et al. 

179


180 

4.2 Medical training, continuing medical education 

and post-graduate specialist training 

4.2.1 Department of Psychiatry and Psychotherapy 

Thirty-eight medical doctors currently receive post-graduate training in psychiatry and psychotherapy 

(Training Supervisor: W. Gaebel; Training Manager: M. von Wilmsdorff). The hospital is fully authorised as 

a provider of post-graduate specialist training and offers all training elements required for a post-graduate 

Table 9: Programme of medical psychiatry specialty training seminars 2009/2010 

Date Lecturer Couse Title 

06.03.09 Moderation: v. Wilmsdorff Case presentation: General Psychiatry II 

13.03.09 Moderation: v. Wilmsdorff Case presentation: Child & Adolescent Psychiatry 

20.03.09 Lange-Asschenfeldt Psychopharmacotherapy: Antidepressivants 

27.03.09 Warnecke Treatment of dependence disorders I 

03.04.09 Warnecke Treatment of dependence disorders II 

17.04.09 Moderation: v. Wilmsdorff Case presentation: Gerontopsychiatry 

24.04.09 Lange-Asschenfeldt Psychopharmacotherapy: Antipsychotics 

08.05.09 Moderation: v. Wilmsdorff Case presentation: Addiction 

15.05.09 Moderation: v. Wilmsdorff Case presentation: General Psychiatry I 

29.05.09 Pfarrerin Atkins Social psychiatry I: presentation on telephone counselling 

05.06.09 Zäske Social psychiatry II: Stigmatisation research 

19.06.09 Winterer Consultation psychiatry 

26.06.09 Zäske Social psychiatry III: self-help and empowerment, part 1 


14.08.09 Moderation: v. Wilmsdorff Case presentation: Dependence 


28.08.09 Zielasek Psychopharmacotherapy of delirium 



18.09.09 Salamon Psychopharmacotherapy in gerontopsychiatry 

25.09.09 Cohen Crisis intervention (role playing and crisis conversation) 

02.10.09 Luckhaus Forensic psychiatry I 

09.10.09 Luckhaus Forensic psychiatry II 

16.10.09 Wölwer Psychodiagnosis IV 




13.11.09 Moderation: v. Wilmsdorff Case presentation: Dependence 


04.12.09 Zielasek EEG I 

11.12.09 Zielasek EEG II 

18.12.09 Zielasek EEG III 

08.01.10 Zielasek EEG IV 

15.01.10 Zielasek EEG V 

22.01.10 Zielasek EEG VI 

29.01.10 Höhl Ergotherapy 

05.02.10 Mecklenbeck Creative therapy I 

12.02.10 Mecklenbeck Creative therapy II 

19.02.10 Zäske Social psychiatry III: self-help and empowerment, part 2 

26.02.10 Greis-Maibach Group psychiatry

specialisation in psychiatry and psychotherapy (including 

psychotherapy oriented towards cognitive-behaviour therapy) 

at no cost to the doctors undergoing specialty training. The 

practical neurology year, which is compulsory for every 

trainee in psychiatry, is provided through an exchange with 

the Department of Neurology of the University Hospital 

Düsseldorf and the Division of Neurology at the LVR- 

Klinikum. In the autumn of 2007, a working group was 

established to procure certification by the DGPPN (the 

German Association for Psychiatry and Psychotherapy) 

for the post-graduate specialty training (Coordinator: J. 

Zielasek). This group features the Training Manager, the 

hospital’s Quality Management Representative (T. Fabis) 

and the representatives of the junior doctors in specialty 

training (M. Dolgner, M. Blaeser [until 2008], C. Schmidt- 

Kraepelin [since 2008]). This group had suggested several 

organisational and structural improvements, which were 

gradually implemented, including the systematic organisation 

of theoretical seminars, changes in the way post-graduate 

training courses are conducted, the introduction of a 

mentor system and the conduct of a survey among doctors 

undergoing specialty training about possible improvements 

of their curriculum at the LVR-Klinikum (being performed in 

addition to the survey initiated by the Medical Associations 

in spring 2009). Certification was obtained in March 2010. 

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The LVR-Klinikum Düsseldorf hospital is fully authorised as 

a provider of post-graduate specialist training in psychiatry 

and psychotherapy (Training Supervisor: W. Gaebel) and 

in psychosomatic medicine and psychotherapy (Training 

Supervisor: W. Tress). It is also certified, for one year, as a 

provider of post-graduate specialist training in neurology 

(Training Supervisor: M. Griese). The post-graduate specialty 

training conference meets once a week. The curriculum is 

designed to enable post-graduate medical doctors to acquire 

the specialisation in psychiatry and psychotherapy after a 

period of 5 years (Table 9). 

The Department of Psychiatry and Psychotherapy hosts 

regular psychiatric-psychotherapeutic colloquia for medical 

doctors and psychologists, generally held on Wednesdays 

between 5 p.m. and 6.30 p.m. Since 2008, these colloquia 

have been dealing with scientific topics of particular 

relevance and are regularly certified by the Medical 

Association North Rhine with 2 CME points. Coordination: 

W. Gaebel with A. Klimke (until 2004) and J. Zielasek (since 

2005). (List of speakers and topics during the review period: 

Table 10–18) 

Table 10: Psychiatric-psychotherapeutic colloquia 2001 

Lecturer Course Title 

C. Ohmann, Düsseldorf Clinical use of guidelines 

P. Hoff, Aachen From Kraepelin to ICD 10 – the significance of illness models for 

diagnosis 

C. Kirschbaum, Düsseldorf Cortisol: A link between psyche and soma? 

U. Passant, Lund/Schweden The Lund Longitudinal Dementia Study – A perspective on differential 

diagnosis, neuropathology and treatment 

G. Reifenberger, Düsseldorf Molecular pathogenesis of tumours of the nervous system – basic 

information and clinical relevance 

J. Siegrist, Düsseldorf Working life and mental health: New research results and their 

significance for psychiatry in hospitals and practices 

A. Heinz, Mannheim Disposition and maintenance of alcohol dependence – neurobiological 

findings. 

H. Katschnig, Vienna 100 years of modern psychiatry: Where has it come from? What is it 

like? Where is it going? 

H.-P. Hartung, Düsseldorf Progress in the understanding and treatment of multiple sclerosis 

U. Hegerl, Munich Neurophysiological methods for brain function diagnosis in psychiatry 

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182 



S. Herpertz, Aachen Affect regulation and impulse control in personality disorders 

V. Sturm, Cologne Neurobiological concepts of psychiatric-surgical interventions 

M. Jüptner, Essen PET and fMRI studies on the pathophysiology of cognitive impairments 

in patients with schizophrenia 

K. Amunts, Jülich From neuroanatomy to an understanding of mental functions 

A. Rohde, Bonn The differentiation of post-partal mental disorders 

A. Batra, Tübingen The neurobiology of tobacco dependence and its implications for 

withdrawal treatments 

K. Vogeley, Jülich Self-construct and schizophrenia 

L. Baving, Magdeburg Neurobiological foundation of hyperkinetic disorder in children and 

adolescents 

U. Hegerl, Munich Pathways to the better care patients with depression 



C. Hiemke, Mainz Clinical benefits of therapeutic drug motoring in psychiatry 

I. Kryspin-Exner, Vienna Computer-controlled neuropsychology and its implications for 

diagnosis and treatment 

T. Becker, Leipzig Approaches to the evaluation of mental health care 

H. Coenen, Jülich PET radiotracers for the in vivo assessment of cerebral 

neurotransmission 

I. Gaertner, Tübingen Therapeutic drug monitoring in acute therapy and relapse prophylaxis 

with atypical antipsychotics 

P. Sand, Regensburg Genetic variability exemplified by dopamine metabolism 

U. Dirnagl, Berlin Endogenic protection mechanisms of the brain 

G. Winterer, Mainz The genetics of pre-frontal functions in schizophrenia 

M. Siebler, Düsseldorf Neuronal networks on microchips: biosensors or brain function 

models? 

I. Gaertner, Tübingen Therapeutic drug monitoring of atypical neuroleptic drugs 



M. Hautzinger, Tübingen Opportunities and limits of the psychological treatment of alcohol 

dependence 

M. Schmidt-Degenhardt, Düsseldorf Delusion and imagination 

U. Stockhorst, Düsseldorf Insulin in the brain: Effects on cognitive functions and eating 

behaviour 

J. Deckert, Münster Genetic fundamentals of anxiety disorders 

T. Bilzer, Düsseldorf Improvements of neurogenesis disorders in rats after infection with 

the Borna Disease Virus 

A. Schmitt, Mannheim Neuronal developmental disorder: basis for schizophrenia and animal 

models 

M. Schmidt-Degenhardt, Düsseldorf Anthropological aspects of the problem of delusion 

C. Schmahl, Mannheim Borderline disorder – neurobiological and therapeutic aspects 

A. Fallgatter, Würzburg Near-infrared spectroscopy and vagus-evoked potential as new 

diagnostic methods in psychiatry


Referent Course Title 

A. Schmitt, Mannheim Neuronal developmental disorder: basis for schizophrenia and animal 

models 

K. G. Kahl, Lübeck The metabolic syndrome in psychiatry 

W. Huckenbeck, Düsseldorf The medical autopsy 

B. Hemmer, Düsseldorf New findings on the causes, development and treatment of multiple 

sclerosis 

M. Riesbeck, W. Gaebel, Düsseldorf Pharmacotherapeutic long-term treatment strategies in first-episode 

patients with schizophrenia 

S. Klingberg, Tübingen Pharmacotherapeutic long-term treatment strategies in first-episode 

patients with schizophrenia 

G. Winterer, Düsseldorf Frontal-brain disorders in schizophrenia 

U. Henning, K. Krieger, C. Luckhaus, Düsseldorf The stress-dependent regulation of glucocorticoid receptors in 

B-lymphoblasts in patients with hereditary affective disorders: 

relevant for mental disorders? 

A. Schmidtke, Würzburg Suicide prevention and dealing with suicidality in inpatients 

T. Supprian, Düsseldorf Structural mRT investigations of brainstem in affective psychoses 

P. Eikelenboom, Amsterdam Neuro-inflammation in Alzheimer’s disease: clinical and therapeutic 

implications 

B. Janssen, S. Ludwig, W. Gaebel, 

Guidelines and decision-support-systems in the outpatient treatment 


of schizophrenia 

D. Riemann, Freiburg Pharmacological and psychotherapeutic approaches to treating sleep 

disorders in mental disorders 

G. Wiesbeck, Basel Current status of medical relapse prophylaxis in addiction medicine 

M. Rothermundt, Münster Immunology of schizophrenia 



C. Behl, Mainz Age, hormones and neuro-protection 

N. Frommann, Düsseldorf Acamprosat and integrative behaviour therapy 

Ch. Gwosdz, Düsseldorf Transcranial magnetic stimulation and tinnitus 

E. van Keuk, Düsseldorf Compliance and comprehension of illness in transcultural settings 

A. Schmidtke, Würzburg Suicide prevention in psychiatric outpatients 

N. Dahmen, Mainz New procedures in psychiatric genetics 

V. Larach-Walters, Santiago de Chile Psychiatry in Chile 

W. Paulus, Ravensburg Pregnancy and neuroleptic drugs 

H. Wiendl, Würzburg The role of inflammation in axonal degeneration, using multiple 

sclerosis as an example 

M. Werning, Düsseldorf Neuroscientific and humanities perspectives of cognitive processes – 

the search for a bridge between them 

M. Banger, Bonn The Bonn Project for patients with chronic multiple addictions 

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184 



H. W. Folkerts, Wilhelmshaven The practice of electroconvulsive treatment 

W. Retz, Homburg/Saar ADHS in adults: diagnosis and treatment 

M. Bohus, Mannheim The neurobiology of borderline disorder 

H. Fangerau, Düsseldorf “Informed Consent” and free will in psychiatry – a historical 

perspective 



T. Bayer, Saarbrücken The amyloid hypothesis of Alzheimer’s dementia: pro and cons 

Y. Wübben, Berlin “Emil Kraepelin and literary anthropology. Considerations on the 

relationship of science, literature and psychiatry around 1900“, 

C. Mulert, Munich Cognition and motivation in patients with schizophrenia – results of 

neuropsychology and neuroimaging 

N. Dragano, Siegrist , N. Frommann, P. Franke, Integrative long-term treatment of patients with alcohol dependence – 

W. Wölwer, W. Gaebel, Düsseldorf 

clinical results and sociological moderator variables 

A. Meyer-Lindenberg, Mannheim Imaging genetics: A new research path for schizophrenia? 

T. Jahn, Munich Neurological soft-signs in schizophrenia patients 

J. van Os, Maastricht Dimensional classifications for schizophrenia diagnostics 

H. Op de Beeck, Leuven Modern concepts of the modularity of brain functions 

N. Jimeno Bulner, Valladolid Side effects of risperidone: experience in Elsevier Annual Reviews 

C. Lange-Asschenfeldt, Düsseldorf Synaptic plasticity in the hippocampus 



M. Linden, Berlin Does psychiatric psychotherapy exist? Empirical fundamentals and 

consequences for further education 

J. Fritze, Pulheim The new, all-inclusive remuneration system for psychiatry and 

psychosomatic medicine 

H. Melchinger, Hanover Structural issues relating to outpatient mental health care 

J. Klosterkötter, Cologne The prevention of mental disorders: the gold standard for the future? 

J. Siegrist, Düsseldorf Social aspects of mental disorders: The example of Workplace Mental 

Health 

H. U. Wittchen, Dresden The new federal health survey and the additional “Mental Health” 

module 

F. Schneider, Aachen Shortage of young psychiatrists and problems in promoting the 

recruitment of young psychiatrists 

D. Bhugra, London Mental Health Care in the United Kingdom: Future Trends

4.2.2 Department of Psychosomatic Medicine 


The department provides specialty training in 

psychotherapeutic medicine, in compliance with the relevant 

guidelines of the Medical Association North Rhine. Doctors 

in their medical internship as well as doctors undergoing 

specialty training are encouraged to acquire skills, 

experiences and knowledge in the theoretic fundamentals, 

diagnostics, differential diagnostics and therapy of mental 

illnesses and disorders. 

Post-graduate medical doctors need at least five years for 

their specialist training in psychotherapeutic medicine. 

Three of these years must be spent in psychotherapeutic 

medicine, one year in internal medicine and one year 

in psychiatry. During this time, the doctors undergoing 

specialty training acquire comprehensive theoretical 

knowledge as well as experiences in a wide range of 

psychotherapy techniques. They also have the opportunity 

of familiarising themselves with these techniques in 

different types of psychotherapy environments (inpatient, 

partial hospitalisation and outpatient). These intensive 

psychotherapies are supervised internally as well as – in 

the course of casuistic-technical seminars – by external 

supervisors. Lectures and seminars serve to convey 

the fundamentals of psychobiology, psychophysiology, 

development psychology, personality models and 

the science of neuroses. We also familiarise young 

graduates with psychodiagnostic test methods, behaviour 

diagnostics, the dynamics of relationships between 

couples and members of the same group as well as the 

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psychoanalytical and cognitive-behavioural methods of 

psychotherapy. The specialty training in psychotherapeutic 

medicine extends beyond the acquisition of theoretical 

knowledge and experiences in the supervised application of 

psychotherapeutic techniques to self-awareness exercises, 

conducted in Balint groups and in individual as well as group 

sessions. Psychologists who participated in this programme 

during the period under review ultimately obtained the 

license to practice as psychological psychotherapists. 

The specialty training curricula were delivered in close 

cooperation with the Institute for Psychotherapeutic 

Medicine, Psychosomatic Medicine and Psychotherapy 

Düsseldorf and the Institute for Psychoanalysis and 

Psychotherapy Düsseldorf. Joint ventures such as these are 

necessary because some of the courses the post-graduates 

are supposed to take – for example, the self-awareness 

training – cannot legally take place in the context of an 

(office) relationship of dependence. In cooperation with 

these institutions of higher learning, the hospital can provide 

medical doctors and psychologists in general practice with 

a wide range of continuing medical education and specialty 

training courses. Both the courses in the fundamentals 

of psychosomatic medicine and the specialty training in 

psychotherapy and psychoanalysis serve to integrate the 

psychotherapeutic/psychosomatic healthcare approaches 

into the primarily somatic work of medical doctors. In 

addition, external experts are regularly invited as guest 

speakers and as contributors to seminars. (See overview of 

programmes 2001-2009: Table 19) 

Table 19: Continuing medical education and specialty teaching seminars in 2001 


E. Brähler, Leipzig Sex- and age-dependency of physical complaints over the 

course of time 

E.-M. Biermann-Rathjen, Hamburg Association theory and the theory of client-centred psychotherapy 

Heide, Düsseldorf Child and adolescent psychosomatic medicine 

M. Löwer-Hirsch, Düsseldorf Social dreaming 

A. Kolping-Derichsweiler, Mönchengladbach Integrative physical therapy: an introduction to the Hakomi method 

A. Schweickhardt What are we actually doing when we are empathetic? 

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186 

Table 20: Continuing training seminars in 2002 


R. Larisch, Düsseldorf Imaging procedures in brain research. An overview of the procedures 

used 

A. Klimke, Düsseldorf Investigating patients with depression using imaging methods 

S. Klein Improving illness management in SLE patients 

C. Kirschbaum, Düsseldorf Psychoendocrinological stress research 

Y. Erim, Essen Psychosomatic aspects of the care of transplant patients 

R. Huber-Schaffrath, Mönchengladbach Spiritual phenomena in psychotherapy 

R. Lutz, Düsseldorf Principles of euthymia treatment 



B. Klose, Düsseldorf Concepts and countertransference phenomena of suicide dynamics 

H. Gündel, Munich Grief, pain, alexithymia: New findings regarding the role of the anterior 

cingular cortex in affect processing 

M. Schwarz, Düsseldorf Hereditary metabolism disorders in adults 

E. Koch, Essen What do referring doctors except from hospital-based 

psychotherapists of migrants? 

Chr. Weismüller, Düsseldorf Theoretical aspects of the group 

Th. Rotthoff, Düsseldorf Adipositas from the view of internal medicine 

M. Schmidt-Degenhardt, Düsseldorf Oneiroid as a coping therapy in extreme situations 

J. Eversmann, Osnabrück Affect regulatory functions in binge-eating 

H. J. Maaz/U. Gedeon, Düsseldorf The integrative approach to structural disorders (clinical experiences 

with the Lilith complex) 



A. Thakkar-Scholz, Düsseldorf Environmental medicine and mental disorders 

J. Eversmann, Osnabrück Affect regulatory functions in binge-eating 

S. Winter, Langenfeld The effectiveness of antidepressants 

G. E. Jacoby, Bad Oeynhausen A special hospital for eating disorders 

W. Reuter, Düsseldorf Spiritual care: a psychoanalytically oriented use of spiritual care for 

mental illnesses 

B. Tutschek, Düsseldorf Ethics in perinatal medicine 

R. Görling, Düsseldorf Violence in the media and its effects 

F. Schäfer, Wuppertal The central processing of emotional facial expressions 

M. Langenbach, Cologne Essentially an ego-displacement – A subjective experience of organ 

transplant 



K. Förster, Tübingen Medical opinion in psychosomatics medicine 

U. Nitz, Düsseldorf Interdisciplinary breast centre in the University Hospital of Düsseldorf 

– conceptualisation and structure 

K. Grossmann/K. E. Grossmann, Regensburg Relationship with parents and expectations from life partners



A. Kruse, Heidelberg Of happiness and meaning in old age 

L. Schulz Brain-physiological correlations of expectations and confidence in 

alexithymia 

H. Graß, Düsseldorf Care of victims of violence in UKD, retrospectives and project sketches 

U. Pasch, Düsseldorf Content and practical work of the outpatient clinic for victims of 

violence situated at the Public Health Office Düsseldorf 

R. Tritt, Düsseldorf Trialog-bewo: Providers of sheltered residential care introduce 

themselves 

E. van Keuk, Düsseldorf Psychotherapy in an intercultural setting 

H. Graß, Düsseldorf Violence and sex from a forensic medicine point of view 

R. Obliers, Cologne New forms of teaching and their use in Cologne 

P. Liebermann, Leverkusen Trauma therapy with EMDR 

v. d. Knesebeck, Hamburg Social influences on mental health in old age 



N. Dragano, Düsseldorf Results of the RECALL Study (Risk Factors, Evaluation of Coronary 

Calcification, and Lifestyle) I 

O. Luminet, Brüssel Current research results for alexithymia 



D. Lansch, Cologne Gentle EMDR according to the four-fields plan 

P. Potthoff, Ratingen Postmodern group analysis – from fragmentation to reintegration. 

New models – new techniques? 

U. Volz, Kamp Lintfort Body-related countertransference reactions and their use in treatment 

practice 

T. Nuhn, Gruiten The placebo effect in treatment studies of classical homeopathy and 

conventional medicine (results of an overview) 



K. Teufel, Düsseldorf Early detection of persons at increased risk of psychoses 

H. Rieder, Düsseldorf Genetics in psychotherapy 

C. Rosanowski, Düsseldorf Psychocardiology 

G. Lauth, Cologne Parent training 

Also, casuistic-technical seminars were conducted regularly (fortnightly) until 2005. These seminars were 

supervised by: G. Standke, Hilden; M. Hirsch, Düsseldorf; B. Neuzner, Düsseldorf; K. Bilitza, Duisburg; B. 

Nitzschke, Düsseldorf; R. Heinz, Düsseldorf; W. Pohlmann, Cologne; C. Sies, Neuss; E. Ferchland-Malzahn, 

Aachen; J. Baur-Morlok, Düsseldorf 

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4.2.3 Specialty Training in Neurology 

Head: M. Griese 

Medical doctors pass specialty training in neurology in the 

Division of Neurology according to the standards of the 

Medical Chamber of Northrhine Westphalia. Neurology 

specialty training takes five years, four of these in neurology 

(two years can be completed in the Division of Neurology) 

and one year in psychiatry. Trainees in psychiatry can 

complete their obligatory neurology year in the Division of 

Neurology. 

Trainees in neurology attain in-depth proficiency and 

practical capabilities in the diagnosis, differential diagnosis 

and therapy of neurological disorders. Trainees in neurology 

are introduced into the method of doppler sonography and 

the usual electrophysiological tests. 

188 

4.2.4 Specialty Training in Child & Adolescent Psychiatry 

Head: G. Ott 

Specialists for Child & Adolescent Psychiatry are being 

trained in the Division of Child & Adolescent Psychiatry 

according to the specialty training standards of the Medical 

Chamber of Northrhine Westphalia. Trainees in Child & 

Adolescent Psychiatry can attain in-depth knowledge, 

experiences and capabilities in the theoretical foundations 

of the diagnosis, differential diagnosis and therapy of mental 

disorders and disorders of child and adolescent age. 

Specialty training in Child & Adolescent Psychiatry lasts five 

years, including four years in Child & Adolescent Psychiatry 

and one year either in pediatric medicine or Adult Psychiatry. 

During this time, trainees acquire extensive theoretical 

knowledge and experiences in a range of psychotherapeutic 

methods.

4.2.5 Institute for Clinical Behaviour Therapy 

Department of Behaviour Therapy and Institute 

of Clinical Behaviour Therapy (IKV) at the LVR- 

Klinikum Düsseldorf – Hospital of the Heinrich- 

Heine University Düsseldorf 


Executive Director: W. H. Strauß 

The establishment of a behaviour therapy outpatient unit 

and the Institute of Clinical Behaviour Therapy was intended 

to assist the integration of behaviour therapy research 

projects into the training and continuing education of 

psychologists and medical doctors and into patient therapy. 

Training and continuing education schemes for employees of 

the hospital and other hospitals (including case supervision 

and self-awareness training in behaviour therapy) have since 

been regularly conducted. 

Following years of negotiation with the Landschaftsverband 

Rhineland and subsequently the relevant public authority 

(the Landesprüfungsamt), the Institute succeeded in 

February 2006 in obtaining the official certificate which 

allows it to train graduate psychologists who want to go into 

general practice. In April 2007, the first course to prepare 

psychologists for the state examination in psychological 

psychotherapy started with 12 candidates who subsequently, 

as part of their training-related activities in the hospital, 

significantly extended the Klinikum’s behaviour therapy 

range for outpatients and inpatients. Lecturers of the 

Institute conducted the training and supervision of the 

candidate therapists, also involving them in several studies 

which investigated the effectiveness of psychotherapy 

approaches for people with alcohol dependence (PASTA and 

PITA studies) and persons suffering from schizophrenia 

(first-episode study, PREVENT study). 

Lecturers of the Institute also organised several national 

and international workshops and symposiums. Examples: 

s Behaviour therapy in the treatment of persons suffering 

from schizophrenia (DGPPN seminars Berlin, 2001, 

2002, 2003, Strauss & Conradt, Therapy of Persons with 

First-Episode Schizophrenia 2004, 2005, 2006, Conradt) 

s Efficacy of Behaviour Therapy in People with Alcohol Dependence 

(EABCT-Congress Manchester 2004, Thessaloniki 

2005, Oxford 2006, Strauß) 

s Efficacy of Behaviour Therapy in People with Schizophrenia 

(EABCT-Congress Thessaloniki 2005, Strauß & Conradt) 

4.2.6 Internal Continuing Education Courses 

Director: Claudia Reichmann 

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The Internal Continuing Education scheme (IBF) of the LVR- 

Klinikum Düsseldorf has continuously increased its range of 

activities over the past ten years. Many of today’s continuing 

education courses are structured as cross-occupational 

events, strengthening multiprofessional cooperation. 

The courses are furthermore designed not only to assist 

members of staff in their professional development, but 

also to improve the general health of the workforce, thus 

becoming an integral element of the human resources 

management and structural development policy. 

The IBF is conceptually based on existing legal requirements 

and economic considerations, new insights from nursing 

theory and related academic fields, the continuing 

education needs of the Klinikum’s staff and the objectives 

of the Executive Board. The curriculum makes clear 

which of the courses are compulsory for whom and which 

courses have been specifically organised for certain subgroups 

and sub-divisions. The paramount objective of 

internal continuing education is to give the employees the 

opportunity of strengthening and expanding their technical, 

methodological, social and personal skills. The IBF at the 

LVR-Klinikum Düsseldorf concentrates on: 

s Teaching the students how and when (appropriate to 

the situation) to apply the methods and techniques that 

comply with the principles of modern nursing theory 

and related academic fields 

s Implementation, reinforcement and evaluation of nursing 

concepts, nursing standards and new working methods. 

Key concepts: assessment process, nursing records, 

national professional standards, therapeutic 

group sessions 

s Provision of advice to other members of staff concerning 

the resolution of complex patient problems and the 

implementation of new concepts and methods 

s Development of leadership skills, for example through 

update training sessions for experienced ward managers 

s Provision of advice and support to “influencers” 

The continuing education courses are listed in an annual 

programme, evaluated and – if necessary, on short 

notice – adjusted in line with current requirements. They 

aim to provide members of the nursing staff with the 

knowledge, skills and behaviour patterns that are required 

for certain, particularly complex nursing tasks. The LVR- 

189

Klinikum Düsseldorf works closely together with a range of 

government-approved institutions of continuing education, 

especially the LVR Academy for Mental Health. These are 

some of the training schemes on offer: 

s Special skills: Psychiatric nursing 

s Specialty training required in the treatment of dependence 

illnesses, in psychiatric rehabilitation, child and 

adolescent psychiatry, gerontopsychiatry and forensic 

psychiatry 

s Special skills for nursing staff in psychotherapy and 

psychosomatic medicine 

s Special skills required by ward managers/senior nursing 

staff 

s Training to become a teaching nurse 

4.3 School of Nursing 

Headmistress: B. Kirchhoff – Teacher for nursing 

Deputy Headmaster: W. Schmitz – Teacher for nursing 

The government-approved School of Nursing of the LVR-Klinikum 

Düsseldorf – Hospital of the Heinrich-Heine University 

Düsseldorf – can teach up to 75 students. The Academy 

is operated by the Landschaftsverband Rhineland (Cologne) 

and was officially recognised by the responsible public 

authority (the District Government in Düsseldorf) in a letter 

dated 8 October 2004. The curriculum, which had also been 

submitted, was also approved. The Academy has developed 

an integrated training scheme which matches the current 

and future requirements of a modern healthcare system, 

enabling the students to provide competent nursing care 

and to cooperate responsibly in the detection, treatment and 

prevention of illnesses in compliance with the generally recognised 

principles of nursing, medicine and related areas 

of knowledge. Theoretical and practical lessons are provided 

by full-time teachers for nursing and by lecturers. The Academy 

can also invite guest lecturers including medical doctors 

from the LVR-Klinikum Düsseldorf.

LVR-Klinikum Düsseldorf Hospital of the Heinrich-Heine University ...

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