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Tics are defined as involuntary, quick, sudden, and stereotypical movements or phonic productions. Despite the fact that tic suppression plays an important role for the patient's ability to cope with tic disorders, investigations of the underlying neural correlates using functional imaging focused on tic generation rather than tic suppression. We examined a patient with Gilles de la Tourette syndrome with regard to neural mechanisms of tic generation and tic suppression using fMRI. Three different conditions were compared: "tics", "tics suppressed", and "tics imitated". The comparisons of "tics" to tics suppressed" and of "tics" to "tics imitated" showed similar activation in the anterior cingulate cortex. This leads to distinct suggestions concerning the neural network involved in tic suppression. Similar mechanisms may be involved in tic suppression via mental efforts or active movements.

The present study evaluated a new integrated treatment concept offering inpatient care, acute psychiatric day hospital and outpatient treatment by the same therapeutic team. 178 patients participated in this randomized controlled trial. Data on psychopathology, global and social functioning, patient satisfaction, continuity of care and administrative data was gathered on admission, throughout the course of treatment, upon discharge and at 1-year follow-up. In addition, the physicians in charge rated the therapeutic relationship. The data analysis consists of group-wise comparisons and regression analyses (cross-tabulations and χ(2) test statistics for categorical data and Mann-Whitney U tests for continuous data). Differences between groups over time were analyzed with a series of generalized linear mixed model. The integrated care group showed a significant reduction in psychopathological impairment (20.7%) and an improvement of psychosocial functioning (36.8%). The mean number of days before re-admission was higher in the control group when compared to the integrated care group (156.8 vs. 91.5). There was no difference in the number of re-admissions and days spent in psychiatric institutions. This new approach offers a treatment model, which facilitates continuity of care. Beside it improves psychopathological outcome measures and psychosocial functioning in patients with mental illness.

STAR can serve as an important tool in research concerning the therapeutic relationship. We suggest conducting further analyses concerning the validity of the subscales in the German version.

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Due to the deficits of schizophrenic patients regarding the understanding of vague meanings (D. Ketteler and S. Ketteler (2010)) we develop a special test battery called HOLF (high order linguistic function test), which should be able to detect subtle linguistic performance deficits in schizophrenic patients. HOLF was presented to 40 schizophrenic patients and controls, focussing on linguistic features such as ambiguity, synonymy, hypero-/hyponymy, antinomy, and adages. Using the HOLF test battery we found that schizophrenic patients showed significant difficulties in discriminating ambiguities, hypero- and hyponymy, or synonymy compared to healthy controls. Antonyms and adages showed less significant results in comparing both groups. The more difficult a linguistic task was, the more confusion was measured in the schizophrenic group while healthy controls did not show significant problems in processing high order language tasks.

Background: The Health of the Nation Outcome Scales (HoNOS) were developed to assess the severity of a mental illness. They are used as outcome measures in different countries, and are meanwhile translated from the original English version into many languages, among others into German (HoNOS-D). We conducted a study in order to estimate the concurrent validity and sensitivity to change using clinical parameters as ICD-10 diagnoses, as well as the Clinical Global Impression Scale (CGI), and the Association for Methodology and Documentation in Psychiatry (AMDP) psychopathology scale, a frequently used psychopathological rating system, in a representative clinical sample. Sampling and Methods: Data on the three instruments (CGI, AMDP, HoNOS-D) were collected at admission and discharge of 100 psychiatric inpatients using a representative clinical sample. Experienced clinicians completed the CGI, AMDP and HoNOS-D. Descriptive and comparative data analyses were performed. We estimated the concurrent validity by calculating correlations between the HoNOS and other scales. Secondly, we examined the differences between HoNOS scores related to diagnoses and demographic parameters. Thirdly we calculated change criteria and outcome effect size for the HoNOS. Results: Even in a small clinical sample (n = 100), the HoNOS-D items are highly correlated with the corresponding AMDP syndromes (p < 0.003). The HoNOS-D score is associated with the CGI score (p < 0.01). Correlations of HoNOS symptoms, behavior and impairment items with AMDP syndromes as well as differences in diagnoses were appropriate and comprehensible as regards clinical content, and change on the HoNOS total score is statistically significant (t = 6.57, d.f. = 89, p < 0.0001). Conclusion: This study is the first to investigate the concurrent validity of HoNOS-D concerning psychopathology using the AMDP rating system in a clinical sample of patients with mental disorders in an inpatient setting. HoNOS-D can be recommended for routinely screening outcomes in inpatient psychiatric settings. Our analysis showed that HoNOS-D covers psychopathology corresponding to the AMDP rating system. A limitation of the study is that the study sample comprised only an inpatient population; there may well be differences compared to an outpatient sample.