By pure endpoint diagnosis of the disease, the risk of developing schizophrenia has been repeatedly associated with specific variants of the neuregulin1 (NRG1) gene. However, the role of NRG1 in the etiology of schizophrenia has remained unclear. Since Nrg1 serves vital functions in early brain development of mice, we hypothesized that human NRG1 alleles codetermine developmentally influenced readouts of the disease: age of onset and positive symptom severity. We analyzed 1,071 comprehensively phenotyped schizophrenic/schizoaffective patients, diagnosed according to DSM-IV-TR, from the GRAS (Göttingen Research Association for Schizophrenia) Data Collection for genetic variability in the Icelandic region of risk in the NRG1 gene. For the case-control analysis part of the study, we included 1,056 healthy individuals with comparable ethnicity. The phenotype-based genetic association study (PGAS) was performed on the GRAS sample. Instead of a risk constellation, we detected that several haplotypic variants of NRG1 were, unexpectedly, less frequent in the schizophrenic than in the control sample (mean OR=0.78, range between 0.68 and 0.85). In the PGAS we found that these "protective" NRG1 variants are specifically underrepresented in subgroups of schizophrenic subjects with early age of onset and high positive symptom load. The GRAS Data Collection as a prerequisite for PGAS has enabled us to associate protective NRG1 genotypes with later onset and milder course of schizophrenia.
For patients, being diagnosed with cancer means being confronted with a life-threatening illness and can thus be considered a traumatic experience. This situation is compounded by the fact that having cancer is usually not an isolated event but is generally a long-term stressor. The aim of the present study was a) the assessment of psychotraumatic and comorbid distress in tumor patients both in the acute stage (T1) and over time (T2), b) the identification of possible protective factors, and c) the identification of risk factors for the development of a posttraumatic stress reaction (PTSR) following the diagnosis of a tumor. The sample consisted of 46 patients who had to undergo surgical treatment for a newly developed tumor for either diagnostic or therapeutic purposes. The following psychosocial factors were examined: posttraumatic stress, dissociative reactions, anxiety, depression, cognitive-emotional distress, social support and processing the illness. More than 25 % of the patients demonstrated signs of a clinically relevant PTSR at the acute stage (T1) and almost 40 % did so four months later (T2). Significantly more women showed a PTSR at both points of measurement, but particularly at follow-up. No significant relationship could be found between the type of the tumor at T1 and the emergence of a PTSR at T2. Patients with PTSR at T2 showed higher scores for anxiety and depression. The most important predictors for the development of clinically relevant posttraumatic symptoms at the four-month follow-up examination were female sex, PTSR at T1 as well as elevated levels of depression. The results indicate the clinical relevance of psychotraumatic screening examinations in patients with acute cancer illnesses both for diagnostic as well as therapeutic investigations.
Wenngleich davon auszugehen ist, dass viele PsychodramatikerInnen kein "schulenreines" Psychodrama einsetzen, sondern auch Elemente aus anderen Verfahren in ihre Arbeit integrieren, sind mögliche Perspektiven einer integrativen Arbeit mit dem Psychodrama in der Literatur nur punktuell beschrieben. Dies mag auf Konkurrenzerleben und Abgrenzungsbestrebungen gegenüber einer als übermächtig erlebten Verhaltenstherapie, auf den Wunsch nach einer klaren Identität oder der hohen Identifikation mit Morenos Methoden-und Theoriekosmos zurückgehen. Wenngleich das psychodramatische Verfahren mit seinen Theoriebeständen zweifellos ein hohes und bislang außerhalb der Community weithin unerkanntes Potenzial für eine komplexe Sicht auf den Menschen bietet (vgl. das Interview mit Hilarion Petzold zu Beginn dieses Bandes sowie den kürzlich erschienenen ZPS-Sonderband "Jacob Levy Moreno revisited", Ameln und Wieser 2014), droht eine selbstreferenzielle Beschränkung auf ein tradiertes und als "rein" verstandenes Psychodrama in eine Wagenburg-Mentalität und letztlich in traditionalistische Erstarrung zu münden:"The presumption among psychodramatists has been that all the ideas for innovations lie within Moreno's theoretical ideas […]. Traditional psychodramatists spend their time trying to fit psychodramatic concepts to other theories rather than transporting external concepts that can enrich the practice of psychodrama and improve on its classical methodology […]. For all its insightful ideas,
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