Psychoeducation improves adherence and motivates patients to accept a maintenance therapy as recommended by the guidelines. This would mean a daily consumption of at least 300 chlorpromazine (CPZ) units in the long run and should lead to an increase of the antipsychotic dosage in comparison to patients with treatment as usual (TAU). This raises 2 important questions: whether more side effects are provoked and do the patients have a corresponding benefit with a better outcome. A total of 41 patients with a diagnosis of schizophrenic or schizoaffective disorder were randomized at study entry, either to bifocal psychoeducation (21), or to standard treatment (20). They were compared concerning compliance, type of medication, dosage (CPZ equivalents), motor side effects and number of days in hospital. The average daily antipsychotic medication 2 and 7 years after index discharge was 365 and 354 CPZ-units respectively in the intervention group (IG), but 247 and 279, respectively in the control group (CG). The extent of motor side effects was slightly smaller in the IG, but they showed a small and statistically not significant increase in the rate of tardive dyskinesia (TD) after 7 years. At the 7-year follow-up the patients in the IG had spent 74.7 days in hospital compared to 243.4 days for the patients in the CG (P < .05). The course of illness was significantly better in the IG without increasing motor side-effects. Therefore, psychoeducation should be integrated more systematically into the routine treatment. These data are part of a previous study, published 2007, with a sample size of 48 patients. Seven patients-3 of the IG and 4 of the CG-could not be included, because they were not able to complete the very complex "Computer-based kinematic analysis of motor performance." In this article all conclusions are referred to the new sample size, therefore some results are slightly different in comparison to the previous data.

Introduction: In mice there might be an association between sleep deprivation and amyloid plasma levels. Hence, we examined whether amyloid plasma levels are associated with sleep duration or fragmentation in 17 psychiatrists on-call. Methods: Amyloid (A)42, A 40, and soluble amyloid precursor protein (sAPP-) plasma concentrations were measured at the beginning and end of 90 on-call nights, and analyzed using generalized linear models. Results: In on-call nights, a 10.7% reduction of A 42 was revealed overnight. Every single short sleep interruption diminished this reduction by 5.4%, as well as every pg/mL of sAPP-by 1.2%, each copy of APOE 4 by 10.6%, and each year of professional experience by 3.0%. Discussion: The extent of sleep fragmentation diminishes the physiological overnight reduction of A 42 but not A 40 plasma levels in the same direction as the enzyme for A 42 production, the genetic risk factor for Alzheimer's disease (AD), and on-call experience. Might on-call duty and sleep fragmentation in general alter the risk for AD?

Angesichts des komplexen Krankheitsprozesses bei Schizophrenie muss bei einem Großteil der Patienten zunächst von einer als physiologisch zu bezeichnenden Wissensasymmetrie bezüglich der Erkrankung und der erforderlichen Behandlungsmaßnahmen ausgegangen werden. Hier eignen sich psychoedukative Gruppenprogramme, um das Wissen der Patienten zu verbessern und einen konstruktiven Dialog zwischen Patient und Behandler zu ermögli-chen. Über die Wirkmechanismen psychoedukativer Interventionen liegen bisher noch wenige Erkenntnisse vor. Analog zu Ergebnissen der Psychotherapieprozessforschung in anderen Bereichen wäre zu erwarten, dass die Art und Weise, wie betroffene Patienten am Gruppengeschehen teilnehmen, Auswirkungen auf das Erreichen der Behandlungsziele hat. Dies kann mithilfe eines neuen Untersuchungsinstruments, dem "Teilnahmequalitätsbogen" (TQB), evaluiert werden.

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