Process-Results Research Section

Head: Prof. Dr phil. Bernd Puschner

The section aims to provide answers to the question "Which treatment measure by whom, at what time, leads to which result in what time for this individual with this specific problem under what conditions?".
Therapy process includes formal, technical, intra- and interpersonal as well as temporal aspects of treatment with a special focus on the therapeutic working relationship ("helping alliance"). Treatment outcome refers to short-, medium- and long-term effects of therapeutic interventions on the client in terms of symptom severity, quality of life and needs, among others, and is measured using validated instruments. Research designs include randomised controlled trials, process evaluations and prospective observational studies. Qualitative and quantitative methods are used as research methods, with a focus on hierarchical linear models.
Another important focus of the section is meta-analyses for the systematic review of the effectiveness of pharmacological and psychotherapeutic interventions (Dr Markus Kösters).

Profilbild von Prof. Dr. phil. Bernd Puschner

Prof. Dr. phil. Bernd Puschner

Leiter der Sektion Prozess-Ergebnis-Forschung

Research Secretariat

Profilbild von  Beate Dillinger

Beate Dillinger

Staatl. geprüfte Fremdsprachliche Wirtschaftskorrespondentin (Europakorrespondentin) | Forschungs- und Projektadministration

Profilbild von  Eva Paul

Eva Paul

Diplomübersetzerin (Angewandte Sprach- und Kulturwissenschaft) | Forschungs- und Projektadministration

Postal address:

Process-Outcome Research Section
Clinic for Psychiatry and Psychotherapy II
of the University of Ulm at Günzburg District Hospital
Lindenallee 2
89312 Günzburg

Ongoing projects

Examination of the suitability of the "platform model" as an instrument for staff assessment in psychiatric and psychosomatic clinics
Duration: 04/2021 - 03/2024

Project website:www.eppik-projekt.info

Project management:
Priv. Doz. Dr Markus Kösters, Department of Psychiatry and Psychotherapy II, University of Ulm

Consortium partners:
Forum für Gesundheitswirtschaft gGmbH (Dr Peter Brückner-Bozetti)
Heidelberg University Hospital, Heidelberg (Prof. Dr Hans-Christoph Friederich, PD Dr Ulrike Dinger-Ehrenthal, Prof. Beate Wild)
Deutsches Krankenhausinstitut e. V. (Dr Karl Blum)

Co-operation partners:
DGPPN
DGPM
DGKJP

Collaborators University of Ulm:
Priv. Doz. Dr Markus Kösters
Dr Johanna Breilmann
Kathrin Mayer
Thomas Klein

Funding: Innovation Committee of the Federal Joint Committee (G-BA)

Funding amount: € 2,026,730

Duration: 04/2021 - 03/2024

Summary:
With the aim of improving the determination of personnel requirements, a working group of scientific societies and professional associations (Platform for Personnel Assessment) has developed a structural model (so-called "platform model") that is intended to enable the estimation of treatment costs, taking into account demand and treatment clusters as well as guideline-compliant treatment.

The EPPIK project aims to contribute to the evaluation and validation of the platform model. To this end, two sub-projects will create a basis for a final target estimate of staffing levels for all professional groups based on the platform model, both for psychiatry and for psychosomatic medicine and psychotherapy (PSM-PT). In the psychiatry sub-project, the reliability of the allocation of patients to treatment clusters will first be examined for adult and paediatric psychiatry. In addition, prototypical guideline-compliant components of treatments are defined for case vignettes of the needs clusters in order to enable an assessment of the treatment needs derived from the treatment guidelines across the professional groups. In the PSM-PT sub-project, it is necessary to modify the staffing levels due to a different work and care structure and a different focus of the disorders. For PSM-PT, the validity of the treatment clusters developed by experts as part of the platform model will therefore be examined. Secondly, the actual staffing levels and the prototype treatment plans for the treatment clusters developed in the project will be used to estimate the target staffing requirements.

If successful, the project will develop guideline-orientated prototypes for the demand and treatment clusters, which will allow a structured, evidence- and expert-based assessment of the profession-specific staffing requirements.

TuTo3 - PEER- and TEAM-SUPPORT for mental health: Recovery through experiential expertise
Duration: 02/2022 - 01/2025

Project website: https://tuto3.pat.support

Project management: CNP - Saint Martin Neuro-Psychiatric Centre, Namur, Belgium

Project partner:
EPSM Lille Metropole, France
Centre intégré de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Canada
En route ASBL, Brussels, Belgium
University of Ulm
Universitatea Aurel Vlaicu din Arad, Romania
ESPAIRS, Lyon, France
Inland Norway University of Applied Sciences, Lillehammer, Norway
Haute Ecole de la Province de Namur, Belgium
University of Barcelona, First Person Mental Health Research Group, Spain

Collaborators University of Ulm:
Prof. Dr Bernd Puschner (project leader)
Ramona Hiltensperger (research assistant)
Selina Girit (research assistant)

Funding: EU and Erasmus+ programme

Funding amount: € 40,150

Duration: 02/2022 - 01/2025

Summary:
More and more peer counsellors are working in multidisciplinary teams, especially in the field of mental health. This development brings with it several challenges related to the recognition of peer supporters' competences, their training, the preparation of teams that want to hire them and finally the structuring of peer support organisations. To address these challenges, TuTo3-PAT brings together six mental health peer support organisations and partners from the professional and academic world. Based on the expertise of peer supporters, the partners will develop common goals and practical tools to support the development and professionalisation of peer support. These tools will be made freely available to peer facilitators worldwide through a MOOC* at the end of the project.

*Massive Open Online Course = online courses with large numbers of participants without access and admission restrictions

Peer support for the development of empowering care for people with mental illness
Duration: 01/2018 - 09/2023

Project website:https://www.upsides.org/

Project management: Prof. Dr phil. Bernd Puschner

Project partners:
University of Nottingham, United Kingdom
University Medical Center Hamburg-Eppendorf, Germany
Butabika National Referral Hospital, Uganda
London School of Hygiene and Tropical Medicine, United Kingdom
Ifakara Health Institute, Tanzania
Ben-Gurion University of the Negev, Israel
Centre for Mental Health Law and Policy, India

Ulm University staff:
Prof. Dr phil. Bernd Puschner
Dr biol. hum. Annabel Sandra Müller-Stierlin
Prof. Dr rer. soc. Reinhold Kilian
Priv. Doz. Dr phil. Silvia Krumm
Eva Paul
Ramona Hiltensperger, M. Sc.

Funding: EU (HORIZON2020), Global Alliance Chronic Diseases (GACD)

Funding amount: € 3,100,000

Duration: 01/2018 - 09/2023

Summary:

A large number of people with severe mental illnesses do not receive treatment. This treatment gap is very pronounced in low- and middle-income countries (LMIC) and has detrimental effects on individuals (social role, quality of life, stigmatisation) and societies (equity, costs). Peer support is an established treatment method in which a person who has experienced mental illness supports other people with mental illness. Recovery counsellors are an untapped resource in the global care of people with mental illness.

UPSIDES aims to establish the recovery counsellor model of care for people with severe mental illness in high, middle and low income countries. An international practice-based community of recovery support workers, researchers and other key stakeholders will be established in Europe, Africa and Asia (8 study centres in 6 countries). There, peer support will be implemented and adapted to local conditions. Peer support is evaluated comprehensively at various levels using a mixed-method approach: Affected people and recovery companions (psychosocial and clinical endpoints), care performance (cost-effectiveness, return on investment) and implementation (uptake, sustainability and organisational change). Science-based guidelines will be provided to local, national and international stakeholders to ensure the sustainability and dissemination of the care model.

UPSIDES will improve the lives of many people in Europe and LMIC by transforming mental health care systems through the inclusion of people with psychiatric experience. The involvement of recovery counsellors is particularly important for developing countries in view of the shortage of professionals in these countries. The efficiency of psychiatric care systems is maximised by actively involving and empowering those affected. This leads to system changes in the direction of patient-centredness, recovery orientation and community participation. UPSIDES aims to change the care system so that mental health is realised as a human right.

Completed projects

Application study for the practical testing and validation of quality indicators for the integrated care of people with schizophrenia
Duration: 2010 - 2011

Stocktaking of care for mentally ill people in Germany: care practice and cooperation between service providers
Duration: 2009 - 2010

Publications:

  1. Bramesfeld, A.; Ungewitter, C.; Böttger, D.; El Jurdi, J.; Losert, C.; Kilian, R. (2012): What promotes and inhibits cooperation in mental health care across disciplines, services and service sectors? A qualitative study. In: Epidemiol Psychiatr Sci 21 (01), pp. 63-72. DOI: 10.1017/S2045796011000539
  2. Ungewitter C, Böttger D, El-Jurdi J, Kilian R, Losert C, Ludwig K, Steinkohl V, Bramesfeld A. (2012). Struktur und Kooperation in der Versorgung psychisch Kranker Service structure and cooperation in mental health care. Nervenarzt (DOI 10.1007/s00115-011-3433-1)

Child and adolescent mental health in enlarged Europe: development of effective policies and practices
Duration: 2006 - 2008

Publications:

  1. Kilian, Reinhold; Losert, Carolin; Park, A-La; McDaid, David; Knapp, Martin (2010): Cost-Effectiveness Analysis in Child and Adolescent Mental Health Problems: An Updated Review of Literature. In: International Journal of Mental Health Promotion 12 (4), pp. 45-57. DOI: 10.1080/14623730.2010.9721825
  2. McDaid, David; Park, A-La; Knapp, Martin; Losert, Carolin; Kilian, Reinhold (2010): Making the Case for Investing in Child and Adolescent Mental Health: How can Economics Help? In: International Journal of Mental Health Promotion 12 (4), pp. 37-44. DOI: 10.1080/14623730.2010.9721824
Implementation and evaluation of a family-based intervention programme (CHIMPs) for mentally ill children and adolescents of psychiatrically ill parents - a randomised controlled multicentre study
Duration: 04/2014 - 03/2017

Project management (coordination):
Prof. Dr habil. Silke Wiegand-Grefe (Medical School Hamburg)

Cooperation partners and co-applicants:
Prof Dr Martin Lambert (UKE)
Prof Dr Karl Wegscheider (UKE)
Prof Dr Franz Petermann (University of Bremen)
Prof Dr Reinhold Kilian (University of Ulm)
Prof Dr Ullrich Bauer (University of Essen/Duisburg)
Dr Doris Mallmann (Klinik Rheinhöhe, Vitos Rheingau)
Prof Dr von Klitzing (Leipzig University Hospital)

Collaborators University of Ulm:
Prof. Dr Reinhold Kilian (Project Manager University of Ulm)
Maja Stiawa M.A. soz. (Project Coordination)
Maike Gäns (Student Assistant)

External collaborators:
Artur Geis, qualified psychologist, psychological psychotherapist, employee of the Educational and Youth Welfare Association (EJV), Günzburg Counselling Centre
Jörn Eugen, qualified social pedagogue, systemic counsellor, employee of the Educational and Youth Welfare Association (EJV), Illertissen Counselling Centre

Funding:
The project is funded by the Federal Ministry of Education and Research (BMBF) under grant number O1GY1337.

Total funding amount: € 902,772.00

Funding amount University of Ulm: € 163,919.00

Duration: 01.04.2014 - 31.03.2017

 

Background:
In Germany, there are around 3 million children and adolescents with mentally ill parents, who are known to be a high-risk group for developing their own mental illnesses. The risk of these children becoming ill is several times higher than that of children with healthy parents. As a rule, these children do not receive professional treatment because their parents keep them away from healthcare institutions due to fears, feelings of shame and guilt.

According to needs assessments in the international literature, family-orientated interventions appear to be particularly useful because they effectively counter parents' fears and, on the basis of a trusting relationship with the parents, can prevent later abnormalities in the children and bring children with mental health problems to early intervention and early treatment.

Around half of the children of mentally ill parents already exhibit mental health problems themselves, making them a target group of high health economic relevance. From a health economic perspective, it is known that mental illnesses are associated with high individual and social costs and often have their precursors in childhood and adolescence. Recognising the need for treatment of these affected children at an early stage and initiating adequate early detection and early treatment is necessary not only for ethical but also for economic reasons. Early treatment can prevent protracted phases of illness in children and chronicity, which often leads to later illness in adulthood.

Despite the awareness of this problem, there is still no evidence-based intervention implemented in routine care for this high-risk and patient group in German-speaking countries.

Research question / objective:
The central objective of the study is to implement the manualised family intervention CHIMPs for children and adolescents with mentally ill parents aged 4-18 years in routine care at the five participating centres. This is in line with the federal policy objectives of supporting children of mentally ill parents as a known high-risk population. The intervention aims to sustainably improve the mental health and quality of life of affected children and adolescents and, in the sense of early treatment and early intervention, to provide intervention for children and adolescents who are already at risk. The long-term effectiveness of this intervention under real-life conditions will be tested in comparison to a control group receiving the usual follow-up treatment (TAU = treatment as usual), taking health economic aspects into account. The project thus implements a structurally anchored, evaluated family intervention and thus a psychosocial and clinical care structure for this target group.

Method:
This study is a prospective randomised, controlled (RCT) multicentre study comparing the intervention and control groups (TAU = treatment as usual) in a pre-post design with a 1-year case history. The perspective of the ill parent, the partner and each child (4-9 years only external assessment, from 10 years additionally self-assessment) as well as the therapists are recorded. Both indirect (pre-post measurements) and direct measurements (at the end of the intervention) take place.

The aim of this systematic review is to summarise the available evidence on the effects of treatment guidelines in psychiatry on treatment and treatment outcome.
Duration: 2012 - 2014

Publications:

  1. Barbui C, Garlanda F, Ay E, Cipriani A, Becker T, Koesters M (2014) Implementation of treatment guidelines for specialist mental health care. Cochrane Database Syst Rev 1:CD009780. doi: 10.1002/14651858.CD009780.pub2
  2. Garlanda F, Fiedler I, Ay E, Barbui C, Koesters M (2013) Guideline implementation strategies for specialist mental healthcare. Current Opinion in Psychiatry 26:369-375. doi: 10.1097/YCO.0b013e328361e7ae
  3. Koesters M, Garlanda F, Ay E, Cipriani A, Barbui C (2012) Implementation of treatment guidelines for specialist mental health care of severely mentally ill patients (protocol). vts.uni-ulm.de/doc.asp

Clinical decision making and treatment outcome in routine care for people with severe mental illness
Duration: 2009 - 2012
Funding: European Commission, 7th Research Framework Programme (Contract No. 223290)
Identifier: FP7-HEALTH-2007-B
Project website: www.cedar-net.eu

Publications:

  1. Puschner B, Steffen S, Slade M, Kaliniecka H, Maj M, Fiorillo A, Munk-Jørgensen P, Larsen J, Égerházi A, Nemes Z, Rössler W, Kawohl W, Becker T (2010): Clinical Decision Making and Outcome in Routine Care for People with Severe Mental Illness (CEDAR): Study protocol. BMC Psychiatry, 10 (90) (http://www.biomedcentral.com/1471-244X/10/90)

Duration: 2009 - 2010

Publication:

  1. Kösters M, Zhang Y, Ma Y C, Weinmann S, Becker T, Jin WD (2011): What can we learn from Chinese randomised controlled trials? A systematic review and meta-analysis of Chinese venlafaxine studies. Journal of Clinical Psychopharmacology 31(2), 194-200 (IF 4.857)

The influence of long-term antipsychotic treatment with atypical neuroleptics on the functional impairment and subjective quality of life of patients with schizophrenic disorders
Duration: 03/2005 - 12/2009

Systematic investigation of the "efficacy-effectiveness gap" in the treatment of depression with venlafaxine and duloxetine
Duration: 2011 - 2013

Publication:

  1. Kösters M, Holtrup AC, Fiedler I, Becker T (2013) Systematic evaluation of the "efficacy-effectiveness gap "in the treatment of depression with Venlafaxine and Duloxetine (protocol). vts.uni-ulm.de/doc.asp

Outcome monitoring and outcome management in inpatient psychiatric care
Duration: 06/2005 - 11/2007

The development of a method for measuring empowerment in the psychiatric treatment of patients with severe mental illness
Duration: 2008 - 2011

Strengthening the quality of life and independence of people with severe psychiatric illnesses through supported employment
Duration: 2003 - 2005

European profile of disease prevention and health promotion in mental health care
Duration: 02/2011 - 09/2011

Study management: Prof. Dr Reinhold Kilian, Dr phil. Silvia Krumm

Duration: 2007-2009

Summary:
With the increasing recognition of psychiatric patients' right to self-determination, the opportunities for mentally ill women to make individual decisions about family planning and motherhood have also expanded. However, reproductive decisions must be made against the background of the social stigmatisation of mentally ill mothers on the one hand and their own fears regarding the health risks for mother and child on the other. The increasing dissemination of information on genetic research can raise both hopes and fears, which can complicate the decision-making situation for the women concerned. At the same time, the issue is rarely discussed in public or in professional or scientific discourse. The planned study aims to investigate how affected women today experience decision-making situations in connection with the desire to have children and family planning and to what extent conflicts between their own preferences and social expectations are perceived and dealt with. Biographical interviews will be used to reconstruct the subjective ideas of young women with severe mental illnesses about family planning, reproduction and motherhood.

Publications:

  1. Krumm S (2010): Biography and the desire to have children in women with severe mental illness. A sociological and socio-psychiatric study. Bonn: Psychiatrie-Verlag
  2. Krumm S, Kilian R, Becker T (2011): "I certainly won't bring her into the world just like that...". The social context of the desire to have children from the perspective of women with mental illness. A qualitative study. Psychiatric Practice 38, 23-30
  3. Krumm S, Kilian, R, Becker, T (2010): "A child would already be a wish..." The desire to have children and mental illness from the subjective perspective of affected women. Psychiatric Practice 37, 134-41

Counselling for families with a mentally ill parent
Duration: 03/2006 - 02/2008

Generic emergency plan and adaptive process model to protect local government in the event of a pandemic
Duration: 2009 - 2012

Publications:

  1. von Gottberg, Carolin; Krumm, Silvia; Porzsolt, Franz; Kilian, Reinhold (2016): The analysis of factors affecting municipal employees' willingness to report to work during an influenza pandemic by means of the extended parallel process model (EPPM). In: BMC public health 16 (1), p. 26. DOI: 10.1186/s12889-015-2663-8
  2. Meilicke, Gerald; von Gottberg, Carolin; Krumm, Silvia; Kilian, Reinhold (2014): Avoiding presenteeism - promoting work readiness. A conflict of objectives in pandemic planning? In: Prev Gesundheitsf 9 (2), pp. 123-129. DOI: 10.1007/s11553-013-0421-2

European network to promote the health of residents of psychiatric treatment and care facilities
Duration: 2008 - 2011
Project website: www.uni-ulm.de/helps-net/index.htm

Publications:

  1. Weiser, Prisca; Kilian, Reinhold; McDaid, David; Berti, Loretta; Burti, Lorenzo; Hjorth, Peter et al. (2014): Rationale, Component Description and Pilot Evaluation of a Physical Health Promotion Measure for People with Mental Disorders across Europe. In: J Community Med Health Educ 4 (4), pp. 1-10
  2. Park, A-La; McDaid, David; Weiser, Prisca; von Gottberg, Carolin; Becker, Thomas; Kilian, Reinhold (2013): Examining the cost effectiveness of interventions to promote the physical health of people with mental health problems: a systematic review. In: BMC Publ Health 13 (1), p. 787. DOI: 10.1186/1471-2458-13-787
  3. Weiser P, Becker T, Losert C, Alptekin K, Berti L, Burti L, Burton A, Dernovsek M, Dragomirecka E, Freidl M, Friedrich F, Genova A, Germanavicius A, Halis U, Henderson J, Hjorth P, Lai T, Larsen JI, Lech K, Lucas R, Marginean R, McDaid D, Mladenova M, Munk-Jørgensen P, Paziuc A, Paziuc P, Priebe S, Prot-Klinger K, Wancata J, Kilian R. (2009) European network for promoting the physical health of residents in psychiatric and social care facilities (HELPS): background, aims and methods. BMC Public Health. Aug 28;9:315-327
Effectiveness and cost-effectiveness of a programme to promote a healthy lifestyle for people with mental illness in community psychiatric residential and day care facilities
Duration: 05/2016 - 11/2018

Project management:
Prof. Dr rer. soc. Reinhold Kilian

Project partners:
Kliniken des Bezirks Oberbayern
AOK Bayern - Die Gesundheitskasse
AWO Bezirksverband Obb. e.V.
AWO Sozialtherapeutische Einrichtungen
Frauentherapiezentrum FTZ gGmbH
kbo Sozialpsychiatrisches Zentrum gGmbH
SpDi Schwabing des Caritasverband München-Freising e.V.
Sozialpsychiatrisches Zentrum München gGmbH
Wohnprojekt Berg am Laim
Soziale Dienste Psychiatrie gGmbH

Collaborators University of Ulm:
Prof. Dr rer. soc. Reinhold Kilian
Dipl. Annabel Sandra Müller-Stierlin, M. Sc.
Ümmügülsüm Dinc, B. Sc.
Natalie Lamp, B. Sc.
Dr hum. biol. Prisca Weiser

Funding:
AOK Bayern, clinics of the district of Upper Bavaria and the participating organisations

Funding amount: €58,235

Duration: May 2016 - November 2018

 

Summary:

Patients with mental illness are more likely to suffer from physical illnesses (e.g. obesity, diabetes, cardiovascular disease) compared to the rest of the population. Unhealthy lifestyle habits, side effects of medication, unfavourable living conditions and neglect of physical health are considered to be the main causes of poor physical health among those affected. The Department of Psychiatry and Psychotherapy II at the University of Ulm, Günzburg has therefore developed a health promotion programme for people with severe psychiatric illnesses. The HELPS research project is investigating whether participation in this programme to promote a healthy lifestyle leads to an improvement in the health behaviour and physical well-being of people with mental illness. The knowledge gained from this study should contribute to the further development of existing care models in the future. By establishing effective health promotion programmes in the care of people with mental illness, the aim is to prevent physical illness in this at-risk population. To this end, over a period of 18 months, a group of people with mental illness who take part in the programme (we call them the intervention group) will be compared with a group of patients who will not take part in the programme (we call them the control group). A total of 70 participants will be recruited from the Munich area. The participants in both groups will be interviewed at four survey points six months apart.

Implementation of the patient guideline on psychosocial therapies for patients with severe mental illness
Duration: 09/2018 - 08/2021

Project management: Dr Markus Kösters

Project partners:
University Hospital Munich (Department of Psychiatry and Psychotherapy) (PD Dr Alkomiet Hasan, Prof. Dr Peter Falkai)
Leipzig University (Institute for Social Medicine, Occupational Medicine and Public Health, ISAP) (Dr Uta Gühne, Prof. Dr Steffi G. Riedel-Heller)
Ulm University (Institute for Epidemiology and Medical Biometry) (Prof. Dr Rainer Muche)
Bezirkskrankenhaus Günzburg (Prof. Dr Thomas Becker)
Bezirkskrankenhaus Kempten (Prof. Dr Markus Jäger)
Bezirkskrankenhaus Memmingen (Dr Andreas Küthmann)
Bezirkskrankenhaus Donauwörth (PD Dr Karel Frasch)
Bezirkskrankenhaus Augsburg (Prof. Dr Max Schmauß)
Bezirkskrankenhaus Kaufbeuren (PD Dr Albert Putzhammer)
kbo-Isar-Amper-Klinikum (Prof. Dr Peter Brieger)

Collaborators University of Ulm:
Dr Markus Kösters
Dr Johanna Breilmann
Prof. Dr Reinhold Kilian
Natalie Lamp, M.Sc.
Katrin Mayer, M.Sc.
Tamara Waldmann, M.Sc.
Michael Bachmaier
Jasmin Buchberger
Theodor Deggendorfer
Lea Eichele
Sarah Fritz
Dr Dagmar Gröber-Grätz
Paulo Kling Lourenco
Juliane Lott
Susanna Müller-Tischmacher
Ursula Nägele
Iris Schicker
Michael Willi

Other employees:
Janine Quittschalle (University of Leipzig)
Gabriele Gaigl (University Hospital Munich)
Katharina Merz (University Hospital Munich)
Jana Nolden (University Hospital Munich)
Esther Täumer (University Hospital Munich)

Funding: Innovation Committee of the Federal Joint Committee (G-BA)

Funding amount: €2,660,000

Duration: 09/2018 - 08/2021

Summary:

Psychosocial therapies are a central component of the treatment of people with severe mental illnesses. To date, however, there has been no structured recording of the available services and the utilisation of these services by clients. The "IMPPETUS" project aims to identify gaps in the provision of psychosocial care for people with psychiatric illnesses and to help close these gaps.

In the first phase of the project, the psychosocial care situation and the current implementation of the S3 guideline "Psychosocial therapies for severe mental illness" will be analysed in ten care regions in Bavaria. In the second phase, a randomised, controlled study will examine whether the multimodal, structured implementation of the patient version of the S3 guideline "Psychosocial therapies for severe mental illness" and associated information services increases the participation of those affected in treatment, increases the use of psychosocial therapies and contributes to a better treatment outcome.

The project partners include ten Bavarian clinics in which a total of around 500 patients and their relatives are surveyed in each project phase. Patients with schizophrenia, schizotypal and delusional disorders as well as affective disorders are included.

Sub-project - SUSIBER: Analysing the subjective sense of security in the population of conurbations in selected threat scenarios
Duration: 2014 - 2016

Project management: Prof. Dr rer. soc. Reinhold Kilian

Project partners:
University of Paderborn
City of Dortmund, fire service
City of Gelsenkirchen, fire service
Robert Koch Institute
PRO DV AG
Hamm-Lippstadt University of Applied Sciences
University Hospital Ulm
City of Bochum, fire service (associated)
City of Essen, fire service (associated)
Ministry of the Interior and Local Authorities NRW (associated)
State Health Centre NRW (associated)

Funding: Federal Ministry of Education and Research (BMBF)

Funding amount: € 450,456

Duration: January 2014 - December 2016

Staff Ulm University:
Carmen Checchia
Ann-Christien Holtrup
Annabel Stierlin
Dr biol. hum. Carolin v. Gottberg

 

Interkom project objective:
The aim of the Interkom joint project is to strengthen the population's sense of security in order to increase the resilience of urban centres and keep them stable in crisis situations. To this end, a holistic concept with four solution components is being researched which, through their interaction in crisis management, create a high sense of security among the population.

SUSIBER project objective:
Targeted influence on the subjective sense of security of the population requires comprehensive knowledge of the dimensional components as well as the personal and environmental factors influencing the subjective sense of security. As a central prerequisite for the objectives of the joint project, this sub-project will therefore analyse the dimensional structure and influencing factors of the subjective sense of security of the population in conurbations with regard to the threat situations of power outages, pandemics and biological hazards. Furthermore, it will be investigated how differences in the perception of danger and the subjective sense of security affect potential behaviour when a dangerous situation occurs, particularly with regard to cooperation with administrative bodies and security forces.

Effectiveness and efficiency of contracts for integrated care for people with severe mental illness under real-world conditions with special consideration of improving empowerment and quality of life
Duration: 2013 - 2016

Project partners:
PD Dr Matthias Schützwohl, Dresden University of Technology (sub-project management for the Berlin and Dresden region)
Birgit Görres, Dachverband Gemeindepsychiatrie e.V.
Kay Herklotz, Medizinisch-therapeutisches Versorgungszentrum Dresden gGmbH
Stephanie Lerf, Gesellschaft für innovatives Gesundheitsmanagement mbH AWOLYSIS
Holger Steckermaier, Gemeinnützige GmbH des Projektvereins
Gisela Riederle, KIELER FENSTER
Wolfgang Faulbaum-Decke, Brücke Schleswig-Holstein
Marius Greuèl, MVZ-Pinel gGmbH
Dr. Thomas Floeth, NiG Pinel gGmbH
Dr Nils Greve, GpG NRW PTV Solingen

Collaborators University of Ulm:
Prof. Dr rer. soc. Reinhold Kilian (overall project management)
Prof. Dr med. Thomas Becker (medical project management)
Annabel Stierlin

Funding:
Federal Ministry of Health / DLR project management organisation
Research to improve the care of people with mental disorders

Funding amount: €409,685

Duration: 2013 - 2016

Identifier: II A 5 - 2513 FSB 012

 

Background:
Various models for improving psychiatric care are currently being trialled in Germany. The focus is on improving the quality of life and the possibility of independent living (empowerment) of people with mental illness. This study serves to evaluate various psychiatric care concepts. The knowledge gained from this study is intended to provide a better understanding of the need for outpatient and inpatient psychiatric care and could contribute to the further development of existing care models in the future.


Method:
The aim of the project is to analyse the effectiveness and cost-effectiveness of IV contracts based on the Network for Mental Health (NWpG) model in comparison with standard psychiatric care under real-world conditions. The study takes place in five different regions in Germany (Berlin, Dresden, Schleswig-Holstein, Munich, Rhineland). As part of the study, patients and their relatives will be interviewed at four six-monthly intervals over a period of two years. The survey includes information on the patients' state of health, quality of life and assessment of their independence. In addition, information on the medical and psychotherapeutic treatment services utilised is recorded.

Expected results:
The programmes for integrated psychiatric care examined in the study are currently being tested in various parts of Germany. However, systematic data on effectiveness and efficiency are not yet available. The results of the studies should provide service providers and cost bearers with data on the extent to which these programmes in their current form lead to improvements in psychiatric treatment, particularly with regard to overcoming existing deficits at the interfaces between outpatient and inpatient psychiatric care, thereby improving the quality of treatment outcomes from the perspective of patients, cost bearers and the national economy. In addition, the study is intended to provide information on deficits in the current NWpG model and ways of overcoming them.

Publication:

  1. Stierlin A (2013) NWpG contracts for integrated care are evaluated. Psychosoziale Umschau 3, 9.

Algorithm-supported implementation of evidence-based guidelines in acute inpatient schizophrenia treatment
Duration: 02/2005 - 08/2006

Mental Health Economics European Network
Duration: 04/2003 - 2008

Mental health and support needs of people with intellectual disabilities
Duration: 2012 - 2014

An SMS-supported mindfulness-based intervention for relapse prevention in depression
Duration: 2013 - 2014

Publication:

  1. Kraft, S., Wolf, M., Klein, T., Becker, T., Bauer, S., & Puschner, B. (2017). Text Message Feedback to Support Mindfulness Practice in People With Depressive Symptoms: A Pilot Randomised Controlled Trial. JMIR mHealth and uHealth, 5(5)
Vocational integration measures in RPK and BTZ facilities with and without Supported Employment components for people with severe mental illness (RPK_BTZ_MOSES)
Duration: 18 months

Applicant/project management:
Prof. Dr Thomas Becker, Medical Director; Department of Psychiatry and Psychotherapy II, University of Ulm
Prof. Dr Katarina Stengler, Head of Psychosocial Research Group, University of Leipzig

Coordination: Prof. Dr rer. soc. Reinhold Kilian

Cooperation partners:
All RPK facilities in Germany, coordination: Board of the BAG RPK, Dipl.-Psych. Anette Theißing, Hanover
All BTZ facilities in Germany, coordination: Member of the Board of the BAG BTZ, Dr Reinald Faß, Berlin

Employees University of Ulm:
Dipl.-Jur. Paulo Kling Lourenco
M. A. Soz. Maja Stiawa
Dr biol. hum. Carolin von Gottberg

External collaborators (Leipzig):
Lisa Leyendecker

Funding: German Pension Insurance

Funding amount: €95,900

Duration: 18 months

 

Background:
To date, there has been a lack of convincing data on the effectiveness of vocational rehabilitation programmes in Germany. Of particular interest is which of the many different structures, settings and methodological approaches to vocational integration show the best results in terms of regaining employment and to what extent the internationally successful SE model can be implemented under the given conditions in Germany. For people with severe mental illness, rehabilitation in RPK facilities is one of the most frequently utilised integrative services in Germany. In addition, vocational training centres (BTZ), as regional, outpatient vocational rehabilitation facilities in accordance with Section 35 SGB IX, are very well suited to supporting people returning to the general labour market after a mental illness. Data from both BTZs and RPKs indicate good integration results following vocational rehabilitation. Against this background, a preliminary study will investigate the extent to which and how SE content is implemented in RPKs and BTZs in Germany. This should help to analyse the influence of these measures on rehabilitation outcomes and to identify individual and other context-related determinants that influence the success of vocational rehabilitation.

Research question/project objectives:
Characterisation of the type and scope of vocational integration measures based on the Supported Employment (SE) concept to examine and improve the allocation of resources in vocational rehabilitation measures in RPKs and BTZs. Character of the study: Preliminary study in preparation for a prospective quantitative longitudinal survey on the effectiveness and efficiency of vocational integration measures in RPKs and BTZs in Germany To what extent and in what form are SE elements implemented in BTZ and RPK facilities in Germany? Under which setting- and facility-specific conditions are SE-like vocational integration programmes implemented in BTZs and RPKs?

Methods:
Multicentre cross-sectional survey with quantitative and qualitative methodsQuestionnaire survey (SE orientation) - use of the modified IPS Fidelity Scale in the Delphi processin all RTC facilities (n=57) and in all BAGBTZ member facilities (n=22) in Germany. Qualitative sub-project: guideline-centred interviews in defined subgroups(facilities with high versus low SE proximity) Evaluation: Grounded Theory57 RPK and 22 BTZ facilities: Assessment of the "SE proximity" of the vocationalintegration programmes using a modified IPS Fidelity Scale questionnaire by facility employees (n= 79).

In addition, a survey instrument is to be developed to collect data specific to the facility and setting, which is based on the basic documentation established in the facilitiesand includes parameters such as urban vs. ruralsetting, regional unemployment, size of the facility, number of rehabilitants,outpatient and/or inpatient unit, etc.

Analysis:
The quantitative part of the study was analysed using descriptive and explorative statistical methods. Cohen's Kappa was used to assess the agreement between the two raters of the "SE-German Version1". The classification of the RPK/ BTZ Stengler/ Kilian/ Becker: Type and scope of SE services in RPK and BTZ facilities is carried out on the basis of a cluster analysis or, if application requirements are met, on the basis of a latent profile analysis including the items or subscales of the "SE-German Version1".

Effectiveness and cost-effectiveness of needs-based discharge planning and monitoring for people with high utilisation of the psychiatric care system
Duration: 2006 - 2008

Testing of a digital method for estimating nutrient intake in people with mental illness with regard to the overall practicability of the method
Duration: 11/2015 - 04/2016

Project management: Dipl. Annabel Sandra Müller-Stierlin, M. Sc.

Project partners:
Dr biol. hum. Nicole Scheuing, Prof. Dr Reinhard W. Holl, University of Ulm
Prof. Dr Philipp Graf, Ulm University of Applied Sciences

Ulm University staff:
Prof. Dr rer. soc. Reinhold Kilian
Dipl. Annabel Sandra Müller-Stierlin, M. Sc.
Ümmügülsüm Dinc, B. Sc.
Ramona Hiltensperger

Funding:
Junior academy of the Baden-Württemberg Health Services Research Network (MWK - Ministry of Science, Research and the Arts in Baden-Württemberg)
Medical Faculty of Ulm University

Funding amount: €49,840

Duration: November 2015 - April 2016

 

Summary:
The life expectancy of patients with mental illness is significantly reduced compared to the general population. Among other things, this can be attributed to unhealthy lifestyle habits, such as an unhealthy diet. Prevention and intervention with regard to the diet of patients with mental illness are aimed at alleviating the mental illness on the one hand, but also counteracting associated comorbidities on the other.
Valid methods for recording the nutritional behaviour of patients with mental illness are needed in order to investigate the interaction between mental illness and nutrition and, in particular, new interventions. A digital method for recording dietary behaviour using a camera phone, which has already been successfully tested on healthy subjects, may also be particularly suitable for patients with mental illness.
In the present project, the digital method is compared with other already validated techniques for recording dietary behaviour, such as a simple food diary and an elaborate weighing protocol. While the feasibility and accuracy of this new method can be tested in patients with mental illness, an insight into the nutritional behaviour of these patient groups will also be gained.
The digital method will be tested on 40 patients with an F2 diagnosis (psychoses) and 40 patients with an F3 diagnosis (affective disorders). To determine dietary behaviour, these patients will photograph their food and drink over three days and send the photos to the study team (e.g. using a standard camera phone). In addition, a conventional weighing log will be kept on one of the days and a food diary with estimated or standardised portion sizes will be completed on another day. In addition, consumption frequencies for various food categories are to be estimated. At the end of the three days, a satisfaction questionnaire relating to the measurement methods is answered. The data collection is repeated after about four weeks with the aim of recording intrapersonal fluctuations. Based on the pictures, the food diaries and the weighing logs, the foods and portion sizes are determined and transferred to a programme for determining nutritional values (DGExpert). The various data collection methods are compared in terms of feasibility and accuracy. In addition, the eating behaviour of the patients will be nutritionally assessed.
This should provide an important starting point for further research into the triad between mental illness, eating behaviour and metabolism-associated comorbidities. In a follow-up project, it is planned to investigate the effectiveness of a lifestyle intervention with regard to the alleviation of metabolism-associated comorbidities (e.g. obesity or lipidaemia) in patients with mental illness.
Based on the present project, a suitable method for recording dietary behaviour can be selected and the lifestyle intervention can also be adapted to the dietary behaviour of the patient clientele.

General practitioner care of patients with depression - reasons for treatment in their own practice or for referral
Duration: 09/2013 - 02/2015

Local coordination of the "Baden-Württemberg Health Services Research Academy"
Duration: 2011 - 2015

Project partners:
Joachim Szecsenyi, Gunter Laux, Antje Miksch, Stefanie Joos, Heidelberg University Hospital (overall coordination)
Hans-Joachim Salize, Central Institute of Mental Health, Mannheim
Joachim Fischer, Heidelberg University, Mannheim Medical Faculty
Monika Rieger, Tübingen University Hospital
Werner Vach, University of Freiburg

Collaborators University of Ulm:
Thomas Becker
Bernd Puschner (project management)
Suzanne Cosh
Sabine Loos

Funding:
Ministry of Science, Research and the Arts (MWK) in coordination with the Ministry of Labour and Social Affairs, Families and Senior Citizens

Funding amount: € 166,000 (1st and 2nd cohort, Ulm site)

Duration: 2011 - 2015

 

Summary:

The Nachwuchsakademie funds young scientists in Baden Württemberg for an 18 month period to complete a research project. At the University of Ulm, there are currently 3 young researchers with NWA funding. The NWA also provides workshops and career development opportunities to the researchers. The Universities throughout Baden Württemberg who are part of the NWA offer workshops.

Their projects cover the areas of economic analysis of health promotion programs in Primary schools, the development of software for use in economic analyses and power analyses, and an examination of how general practitioners recognise and manage depression. All 3 researchers are currently in a data collection phase and progressing well towards successful and timely completion of their projects.

In Ulm, the aim is to offer up to 3 workshops per year. The first workshop will be entitled "Scientific English writing for publication". It will be held on 26th March 2014 and will cover technical, as well as stylistic aspects of writing for publication. Future workshops are currently in the planning and development phase. There are also quarterly meetings to allow opportunities for the Ulm researchers to meet together and present their work. This also offers a forum for raising any concerns and for the researchers to meet together and provide peer supervision and support to one another. Two such meetings have been held since October 2013.

Prevalence and prevention of somatic comorbidity and health-threatening lifestyles in patients with severe mental illness
Duration: 03/2004 - 03/2005

Duration: 03/2011 - 04/2015

Summary:
While people with mental illnesses were excluded from procreation through institutionalisation and sterilisation until well into the 20th century, with the significant involvement of psychiatry, today the people concerned can ideally decide for themselves on the question of parenthood. However, as parenthood in the presence of a mental illness can be associated with considerable risks for both the person concerned and the (potential) child, it can be assumed that those working in psychiatry are caught between respecting autonomy on the one hand and caring for those affected on the other. The lack of reliable findings on the influence of pregnancy and maternity on the course of mental illness makes dealing with this difficult. At the same time, there are hardly any findings on the professional handling of the desire to have children and associated topics (e.g. family planning, human genetic counselling, pregnancy, abortion, parenthood). In view of the fact that the prevailing psychiatric discourse and the individual attitudes of professionals can have a considerable influence on how those affected deal with these issues, the aim of the planned study is to investigate the relevant psychiatric discourse using discourse analysis and meaning reconstruction methods. The focus is on the question of how the professional groups involved in psychiatric treatment (psychiatrists, psychologists, nurses, social workers) discursively deal with reproductive aspects in the treatment of mentally ill people, what subjective view they have of the desire to have children and other reproductive issues and how the ethical conflicts and dilemmas that may be associated with this are experienced and dealt with.

Publications:

  1. Krumm S, Checchia C, Kilian R, Becker T. Mental health nurses' and psychiatrists' views on addressing parenthood issues among service users. International Journal of Mental Health Nursing 2018, First published: 01 August 2018; doi.org/10.1111/inm.12525
  2. Checchia C, Badura-Lotter G, Kilian K, Becker T, Krumm S: Dealing with parenthood of psychiatric patients during inpatient treatment: possibilities and limitations from the subjective perspective of mental health professionals. Psychiatrische Praxis Psychiat Prax Psychiat Prax 2017; 44(06): 332-338.
  3. Checchia C, Badura-Lotter G, Kilian R, Becker T, Krumm S. The desire to have children and family planning of psychiatric patients from the perspective of professionals - results of a qualitative study Psychiatrische Praxis 2016, 43(8), 23-30.
  4. Krumm S, Checchia C, Badura-Lotter G, Kilian R, Becker T: The attitudes of mental health professionals towards patient's desire for children. BMC Medical Ethics 2014 15:18
  5. Badura-Lotter G, Krumm, S (2014): Desire for children and parenthood in mentally ill patients? A topography of ethical conflicts. In: Feuerstein, G. & Schramme, T. (Eds.): Ethics of the psyche. Campus.
  6. Krumm S: "Something very important in life": The desire to have children and parenthood in mental illness from two perspectives. Notch 32, 2014, no. 4, pp. 42-45.
  7. Checchia C, Badura-Lotter G, Kilian R, Becker T, Krumm S. "Does everyone actually have the right" - On the professional handling of the desire to have children and parenthood in psychiatric patients. In: Wolfersdorf M, Laux G (eds.) 9th Research Congress of the Specialist Clinics of the Bavarian Districts. Irsee Monastery 2013 Roderer Verlag Regensburg 2014
Mental health in the hospital workplace
Duration: 09/2017 - 09/2021

Summary:

The aim of the SEEGEN study is to develop and evaluate a complex intervention for health promotion in the hospital setting. In the first phase of the project, individual interventions for different target groups will be developed and implemented on a pilot basis. In the second phase of the project, the various individual interventions developed will be combined into a complex intervention. The effectiveness of these complex interventions will then be evaluated using a controlled clinical study design. An important part of the joint project is the health economic monitoring of the project, in which general findings on potential savings through workplace health promotion in hospitals are to be obtained.
The Process-Results Research section is responsible for process evaluation in the second phase of the project.
For more information , see
https://www.uni-ulm.de/med/bmbf-projekt-seegen-seelische-gesundheit-am-arbeitsplatz-krankenhaus/
www.gesundheitsforschung-bmbf.de/de/seegen-seelische-gesundheit-am-arbeitsplatz-krankenhaus-7146.php

Systematic review of meta-analyses on the efficacy of SSRI and SNRI (meta-metaanalysis)
Duration: 04/2008 - 04/2010

Supportive monitoring and disease management via the Internet
Duration: 2010 - 2013

Publication:

  1. Kordy H, Backenstrass M, Hüsing J, Wolf M, Aulich K, Bürgy M, Puschner B, Rummel-Kluge C, Vedder H (2013) Supportive monitoring and disease management through the internet: An internet-delivered intervention strategy for recurrent depression. Contemp Clin Trials 36:327-337 (IF 1.597)

Psychosocial therapies for severe mental illness
Duration: 03/2009 - 04/2011

Lost in Transition? Care situation from the perspective of mentally ill adolescents and practitioners at the interface between child- and adolescent-centred and adult-centred treatment
Duration: 12 months (start 06/2015)

Project management: Dr biol. hum. Dipl.-Psych. Sabine Loos, Department of Psychiatry and Psychotherapy II, University of Ulm, Process-Outcome Research Section

Funding: DFG Junior Researcher Academy Health Services Research

Funding reference number: LO 2164/1-1

Duration: 12 months (start: 01/06/2015)

 

Introduction:
Transition is generally described as an "intentional, planned transition of adolescents or young adults with a chronic medical problem from child-centred to adult-centred health care" (American Academy of Pediatrics 2002). Due to the sectoral separation of medical service provision in Germany, under normal circumstances the age of 18 is regarded as the point at which a transfer from child and adolescent psychiatric/psychotherapeutic care to adult care should be completed. In exceptional cases, e.g. in the case of chronic illnesses or developmental peculiarities, care in child and adolescent psychiatry/psychotherapy can also be continued until the age of 21. In the psychotherapy guidelines, there is an overlap area for the 18-21 age group for treatment by either child and adolescent psychotherapists (KJP) or psychological psychotherapists (PP). The transition represents a critical phase and a challenge both for the young people themselves, for the therapists and for the healthcare system, so as not to jeopardise the successes that may already have been achieved in treatment. Continuity of treatment is of particular importance (Alpay 2009), as its success has a significant influence on the prognosis of chronic disease progression. In contrast to the increasing need for follow-up treatment, a decline in the utilisation of treatment services can be observed internationally in this age range (Singh et al. 2010). After the age of 18 and the associated necessary transition to adult-centred treatment services, mentally ill adolescents make significantly less use of care services. Little is known about the care situation in Germany.


Objectives:
The aims of the study are to survey and analyse the experiences and views of young mentally ill patients of transitional age with regard to their already completed or pending transition to psychiatric/psychotherapeutic adult care, with special consideration of intrapersonal, interpersonal and contextual factors that influence their health behaviour and thus the decision for or against further treatment. On the other hand, practitioners will be asked about structural, setting-related and organisational factors that may favour or hinder continuing care. The results are intended to form the basis for a targeted intervention to improve the transition of adolescents and young adults with mental illnesses, taking particular account of the factors mentioned.


Method:
In an explorative-qualitative study design, six group discussions with adolescents and young adults between the ages of 16 and 25 in transition between the two care systems and four group discussions with care providers will be conducted. The transcribed text material was analysed using the reconstructive documentary method according to R. Bohnsack.


Outlook:
By involving affected patients and care providers in the development phase of an intervention to improve treatment continuity in the transition to adult-centred treatment, the project aims to use the knowledge gained from experience to develop targeted measures.

European multi-centre study (funded by the EU) to test the effectiveness of an intervention to promote medication compliance
Duration: 06/2002 - 2004

Documentation and comparison of psychiatric hospitalisation practices in rural regions of Bavaria, Baden-Württemberg and Mecklenburg-Western Pomerania
Duration: 2008 - 2010

Quality of life in old age
Standardisation of the WHOQoL-OLD and survey of QoL in different subgroups of the elderly population
Duration: 2011 - 2012

Publications:

  1. Conrad, Ines; Matschinger, Herbert; Riedel-Heller, Steffi; von Gottberg, Carolin; Kilian, Reinhold (2014): The psychometric properties of the German version of the WHOQOL-OLD in the German population aged 60 and older. In: Health Qual Life Outcomes 12 (1), p. 105. DOI: 10.1186/s12955-014-0105-4
  2. Conrad I, Uhle C, Matschinger H, Kilian R, Riedel-Heller S (2014) Quality of life of people with mild cognitive impairment. Psychiat Prax. DOI: 10.1055/s-0034-1369831