Der Nervenarzt
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Although instances of amok are very rare, they have captured media and political attention following several occurrences in German schools. Mental health professionals are increasingly faced with threat assessment in order to help prevent such tragedies. Since the base rate of amok is low and current risk assessment lacks empirical foundations, the likelihood of false-positive results is high. ⋯ The focus should not be risk assessment but risk management since most of the mass murderers are in need of some type of psychiatric intervention prior to the massacre. In contrast, compulsory admission and involuntary treatment are only justified if the threats occur in the context of a diagnosed mental disorder. Prospective research approaches that integrate psychopathological and neurobiological methods are urgently needed.
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Multicenter Study
[Guideline compliance in the treatment of schizophrenic patients. Introduction of a computer-assisted treatment pathway].
The goal of S3 Guidelines for the Treatment of Schizophrenia was to improve the care of patients with schizophrenic psychoses. However, the publication of guidelines alone does not ensure their consistent implementation. The use of treatment pathways represents one possible approach to help implement the complex treatment recommendations contained in the S3 Guidelines. The first computer-assisted treatment pathway for patients with schizophrenic psychoses was successfully incorporated into the everyday routine of psychiatric hospitals. The aim of the present study was to systematically analyse the impact of this measure on guideline compliance. ⋯ Developing computer-assisted treatment pathways based on S3 Guidelines and incorporating them into existing hospital information systems is feasible and well accepted by users. The initial effects on guideline compliance are mostly positive, but not strongly so. Moreover, there was a reduction in duration of hospital stay. Disease-related factors such as disease severity appear to compromise guideline compliance.