Weight gain among psychiatric inpatients is a widespread phenomenon. This change in body mass index (BMI) can be caused by several factors. Based on recent research, we assume the following factors are related to weight gain during psychiatric inpatient treatment: psychiatric medication, psychiatric diagnosis, sex, age, weight on admission and geographic region of treatment. 876 of originally recruited 2328 patients met the criteria for our analysis. Patients were recruited and examined in mental health care centres in Nigeria (N = 265), Japan (N = 145) and Western-Europe (Denmark, Germany and Switzerland; N = 466). There was a significant effect of psychiatric medication, psychiatric diagnoses and geographic region, but not age and sex, on BMI changes. Geographic region had a significant effect on BMI change, with Nigerian patients gaining significantly more weight than Japanese and Western European patients. Moreover, geographic region influenced the type of psychiatric medication prescribed and the psychiatric diagnoses. The diagnoses and psychiatric medication prescribed had a significant effect on BMI change. In conclusion, we consider weight gain as a multifactorial phenomenon that is influenced by several factors. One can discuss a number of explanations for our findings, such as different clinical practices in the geographical regions (prescribing or admission strategies and access-to-care aspects), as well as socio-economic and cultural differences.
Introduction/Objective. Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive and safe brain stimulation method for the treatment of therapy resistant depression in adulthood. The German S3 guideline for unipolar depression recommends the use of high frequency rTMS of the left dorsolateral prefrontal cortex for depressive patients who did not respond primarily to antidepressant pharmacotherapy. Although a number of meta-analyses demonstrated its antidepressant efficacy on a high evidence level, rTMS is rarely offered to patients with mental disorders in German psychiatric hospitals. Methods. We introduced a questionnaire-based survey examining patients? (n = 122) and medical students? (n = 53) attitude towards rTMS. The questionnaire consisted of 10 questions with a 5-point Likert-scale. When testing for group differences, we conducted ?2 tests. Results. The majority of students and patients are not aware of rTMS as a psychiatric treatment of depression, with more patients than students not being aware (?2(1) = 9.462, p = 0.002; 39.3% vs. 17%). However, participants wish to be informed in more detail about rTMS. In general, positive attitudes cover the assumption of safety, while negative attitudes show concerns regarding the efficacy and a lack of trust in the method, mainly due to the fear of irreversible brain damage. Most participants would rather take psychiatric medication than rTMS. rTMS was assumed to be a helpful [?2(2) = 16.710, p < 0.001 (patients: 32.8% vs. students: 5.7%)] and well-tolerated treatment [?2(1) = 9.110, p = 0.003 (36.1% vs. 15.1%)] significantly more often by patients than by students. Conclusion. Our results show a clear need for more information on rTMS as a psychiatric treatment for patients and medical students to fight present prejudices and negative assumptions so that this treatment method with fewer side effects than medication may be used more often.
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