[Psychiatric services in the Federal Republic of Germany. Major aspects from the survey on the situation of psychiatry in the Fedral Republic of Germany].
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Adolescent↗
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Efficacy of prescription-eligible digital health applications for depression and generalized anxiety disorder in Germany: a systematic review and meta-analysis.
In Germany, prescription-eligible digital mental health applications (DiGA) were introduced in 2020 as promising interventions to address, among others, depression and anxiety disorders, two of the most prevalent mental health conditions worldwide. Despite growing interest in DiGAs, their overall efficacy remains uncertain. This study aimed to systematically evaluate and quantify the efficacy of prescription-eligible digital interventions for depression and generalized anxiety disorder by synthesizing evidence from randomized controlled trials (19 trials; total N = 4,078; pooled mean age = 38.7 years, SD = 12.1). Here we show that prescription-eligible digital applications for depression and generalized anxiety disorder reduce symptom severity compared with control conditions. For depression, effects were observed both immediately after the intervention (number of apps = 5; k = 17; SMD = - 0.49; 95% CI - 0.65 to - 0.32) and at follow-up (number of apps = 1; k = 4; SMD = - 0.35; 95% CI - 0.46 to - 0.29), while evidence for generalized anxiety disorder was limited due to a small number of available studies (number of studies = 2). These findings support the integration of evidence-based digital tools into mental health treatment strategies in Germany. However, the available evidence is currently dominated by a small number of applications, particularly Deprexis, and should therefore not be interpreted as equally representative of all DiGAs currently listed for depression in Germany. The findings also highlight methodological limitations of current research and underscore the need for real-world evaluations, which address not only efficacy but also the effectiveness, content, quality and implementation.
Generalized Anxiety Disorder↗
Statistical survey of gynecological laparoscopy/pelviscopy in Germany till 1977.
By mailing, 1.365 questionnaires to gynecologists, 265,900 laparoscopies/pelviscopies were reported in 682 questionnaires (49.2%) by anonymous answer. These had been performed by 380 gynecologists (hospitals) between 1949 and 1977 in Germany. 302 gynecologists who answered the questionnaires (44.2%) are not using the endoscopic technique. Till the end of 1977 in Germany monopolar high-frequency current was used in 52%, bipolar high-frequency current was used in 42%, and modern endocoagulation was used in 25% for the purposes of hemostasis. 240 hospitals (63%) are mainly using pelviscopes of 5--8 mm diameter, 124 hospitals (33%) are using laparoscopes of 11 mm diameter. All together 949 (3.56%) complications had occurred which necessitated 690 laparotomies (2.59%). Cause of these complications were damages to vessels and burns by high-frequency current. 24 (0,09%) deaths were reported which had occurred during or following the intervention, that is one death for 11,000 pelviscopies. Mortality due to this method can be itemized as follows: 13 deaths (0.09%) in 140,977 (53%) diagnostical laparoscopies/pelviscopies, 3 deaths (0.08%) in 37,639 (14.2%) diagnostical-operative pelviscopies, 8 deaths (0.09%) in 87,284 (32.8%) sterilizations. Since 1974, however, the mortality rate is smaller than 1 : 100,000. Since 1973 every year 30,000 to 35,000 pelviscopies were registered in Germany; no deaths in 1974, 1976 and 1977.
Electrocoagulation↗
Education and professional training of biomedical engineers in West Germany.
The health service and educational systems, together with industry and research centres, are the primary institutions involved in the development of the bio-engineering profession in West Germany. Since industry and research institutions in West Germany are similar in structure to those in other countries, for the purposes of international comparison only the health service and educational systems are described. The questions "how many bioengineers are needed?" and "how many should be trained?", were the motivation for a professional field analysis commissioned by the German Society for Biomedical Engineering. This commission found a need for about seven thousand bioengineers and biotechnicians in West Germany. It is shown, however, that there are actually very few positions open, and some measures to create more positions are discussed.
Biomedical Engineering↗
[Statistical survey on laparoscopy in gynaecology up to 1977 in the Federal Republic of Germany (author's transl)].
1385 questionaires were sent to gynaecologists in West Germany. 682 (49.2%) were answered anonymously. 302 answers (44.2%) revealed that the gynaecologists did not do endoscopy. 265.900 pelviscopies or laparoscopies were included in the statistics. The laparoscopies or pelviscopies were done from 1949--1977 by 380 gynaecologic surgeons or gynaecological departments. In Germany to the end of 1977 unipolar high frequency current was used for hemostasis in 52%, bipolar high frequency current in 42%, and modern endocoaglation in 25% of the departments. In 240 departments (63%) the five to 8 mm. pelviscope was used. In 124 department (33%) the 11 mm. laparoscope was used. In the total of the cases 949 (3.56/1000) complications occurred. These required 690 laparotomies (2.59/1000). The cause of the complications were injuries to vessels or high frequency current burns. A total of 24 (0.09/1000) deaths or 1 death per 11,000 pelviscopies was reported. The operative mortality was 13 deaths (0.09/1000) in 140,977 (53%) purely diagnostic pelviscopies or laparoscopies, 3 deaths (0.08/1000) in 37,639 (14.2%) combined diagnostic and operative pelviscopies and 8 deaths (0.09/1000) in 87,284 (32.8%) laparoscopic tubal ligations. Since 1974 the operative mortality is less than 1:100,000. Since 1973 approximately 30--35,000 pelviscopies are done yearly in West Germany.
Electrocoagulation↗
Psychosurgery on sex offenders and sexual "deviants" in West Germany.
About 70 men have undergone a stereotaxic hypothalamotomy in West Germany for sexual behaviors. In most cases the nucleus ventromedialis (Cajal) has been unilaterally destroyed. The question of whether this kind of psychosurgery shoudl be legally controlled is being discussed by both scientists and the public in West Germany. The justification for this psychosurgery is taken from a theoretical basis which is at least questionable and which stems from a biologically truncated and therefore limited perspective on human sexuality. An inspection of the published reports shows that the indication for surgery was based on questionable scientific and clinical grounds and practically excluded psychotherapeutic and sociotherapeutic aspects. In the authors' opinion stereotaxic hypothalamotomy can in no way be regarded as an unquestioned, applicable method of therapy. We consider it essential that this surgery be suspended at least as long as the possible therapeutic effectiveness and the possible adverse side effects remain unclear.
Germany, West↗
Decrease in incidence of hepatitis A infections in Germany.
The hypothesis of a decline in the incidence of hepatitis A infections in Germany in recent decades was confirmed by determining the prevalence of hepatitis A antibody (anti-HAV) in sera collected in 1965 and in 1975 under the same conditions in North Germany. The prevalence of anti-HAV correlated with the year of birth and was independent of the time of serum sampling. The force of infection fell from 0.04 in 1945 to 0.005 in 1965 as judged from a catalytic epidemic model with a sigmoidal decrease.
Adolescent↗
The historical development of modern virus research in Germany, especially in the Kaiser-Wilhelm-/Max-Planck-Society, 1936--1954.
This is lecture on the historical development of modern virus research in Germany to introduce a symposium dedicated to Prof. Werner Schäfer, Tübingen, on the occasion of his 65th birthday. The author was set the task of relating from his memories the beginning of modern virus research in Germany. This research has, since 1936, essentially taken place in the Kaiser-Wilhelm/Max-Planck-Society and in 1954 led to the founding of the Max-Planck-Institute for Virus Research in Tübingen, an institute which to the present day owes its scientific reputation in considerable part to the activity of Werner Schäfer. Since the author personally experienced and participated in the Institute's development from 1936-1954, his remarks are predominantly influenced by personal recollections, which have been sharpended by a renewed study of old records in the 'Library and Archive of the History of the Max-Planck-Gesellschaft', Berlin-Dahlem.
Academies and Institutes↗
The teaching of medical ethics in the Federal Republic of Germany.
Eduard Seidler sets his discussion of the teaching of medical ethics in the Federal Republic of Germany against an historical background. Immediately after the Second World War the freshness of the memory of the 'Nuremberg Medical Trials' influenced the way in which moral dilemmas were treated in Germany. At the present time no systematic instruction in medical ethics is provided in either undergraduate or postgraduate or continuing medical education. As a result of this, an inquiry was set up in 1977/78. Questionnaires were sent out with a view to collecting information on how subjects referring to medical ethics are treated during medical training. The inquiry showed that no special discipline can claim to be the only competent one for medical ethics, but that everyone has something to contribute. Dr Seidler concludes by stating that basic curricula related to the problems of medical ethics would have to be developed and should be carried on continuously within the training programme.
Curriculum↗
First year of ongoing invasive Haemophilus influenzae type b outbreak among middle-aged people who use drugs and people who experience homelessness in Hamburg, Germany, September 2024 to August 2025.
We report an ongoing outbreak of invasive Haemophilus influenzae type b (Hib) disease among people who use drugs (PWUD) and people experiencing homelessness (PEH) in Hamburg, Germany. Between 1 September 2024 and 31 August 2025, 20 adult Hib cases were reported. The cases were either residents of Hamburg (16/20) or stayed in Hamburg during the exposure period (4/20). Whole genome sequencing identified a link between 18 cases (median age 50 years (range 26-77); six female, 12 male, three died). An epidemiological link (i.e. drug consumption in the open drug scene) could be established for 15 of the 18 cases. Control measures included post-exposure chemoprophylaxis for close contacts (n = 4), vaccination offers (n = 69 doses administered by 31 August 2025) and an information campaign targeting PWUD, PEH and staff members of addiction support centres. We describe the first Hib outbreak among adults in Europe and document drug use and homelessness as suspected risk factors. Based on these findings, national vaccination recommendations issued by the Standing Committee on Vaccination in Germany (STIKO) were updated to include vaccination and post-exposure prophylaxis recommendations in outbreak settings for PWUD and PEH. Control measures are currently being evaluated and expanded.
Humans↗
Babesia microti: morphology, distribution and host relationship in Germany.
A short review has been given about recent studies on Babesia microti in natural animal host's near Munich (Southern Germany). An infected area has been studied in order to elucidate the outdoor relationship between the local strains and their preferred hosts, the European field vole Microtus agrestis. The seasonal variation of the parasites prevalence in voles shows a rise in the early summertime (71% of the catches infected). Roundish forms predominate in the erythrocytes. Multiplication never takes place by binary fission, but in "Maltese cross" form or budding-like. Normally the parasite is enveloped with a simple elementary membrane only, as shown by electron microscopy. The arthropod host is still not identified, infections of human beings not observed. This is the first finding and full description of B. microti in Germany.
Animals↗
The structure of urban mortality. A methodological study of Hannover, Germany. Part I.
An analysis is made of the association between density factors and the profile of cause specific death rates in small areas (Bezirke) of Hannover, Germany, in 1968-69. Evaluation of urban ecological methods and logic is done to determine the plausibility of making meaningful statements about cause specific death risks due to areal attributes. Efforts are made to develop an appropriate multiple indicator structural equation model to determine if underlying patterns of mortality can be discerned. Evidence is found that measures of crowding, apart from classical density, predict a general mortality component.
Germany, West↗
Red-cell uridine-5-monophosphate kinase (UMPK): formal genetics, linkage analysis and population genetics from southwestern Germany.
In a population sample from southwestern Germany the frequency of UMPK1 was estimated to be 0.949. The segregation of the children's phenotypes is in agreement with the formal model: 2 common alleles UMPK1 and UMPK2 at an autosomal locus. Data on linkage relations are referred.
Adult↗
Investigations on the polymorphism of glyoxalase I (EC 4.4.1.5) in the population of Hessen, Germany.
The phenotypes of glyoxalase I (GLO) were determined in a random population from Hessen (Germany) by high-voltage agarose gel electrophoresis. The gene frequencies in 1150 unrelated individuals were 0.4391 for GLO1 and 0.5609 fro GLO2. Rare phenotypes were not observed. The segregation of phenotypes in 50 families and 32 mother-child combinations supports the assumed autosomal codominant inheritance. The possibility of a simultaneous typing for GLO, esterase D (EsD), and carbonic anhydrase2 (CA2) on one gel is discussed.
Carbonic Anhydrases↗
A comparison of staphylococcal nasal carrier rates in Germany and Poland.
Frequencies of different staphylococcal nasal carrier classes were studied in groups of students of nursing and of laboratory personnel in Cologne, West Germany, and in Krakow, Poland, by six consecutive samplings of their nasal vestibules. The general number of persistent carriers of S. aureus appeared to be lower than in previous studies, paralleling the diminished numbers of staphylococcal infections in populations. Differences in numbers of persistent carriers between the Cologne and Krakow groups were probably related to the incidence and types of S. aureus in the environment.
Adolescent↗
Hepatitis A-virus particles in stools of patients from a natural hepatitis outbreak in Germany.
During a hepatitis outbreak in Southern Germany 27 nm particles were visualized by immune electron microscopy in stools of two patients. These particles were sereologically identical or similar to hepatitis A-virus particles identified in the USA. The buoyant density of these particles was 1.34 g/cm3 as shown by cesium chloride density centrifugation. The particles were first observed in small numbers in a stool obtained 11 days, and in large numbers in stools obtained 6 and 7 days before the onset of jaundice. Few particles were seen on the day of the onset of jaundice and none thereafter. In both patients a sereoconversion to hepatitis A-virus as judged by immune electron microscopy could be demonstrated.
Disease Outbreaks↗
The efficacy of modified psychodynamic psychotherapy for patients with schizophrenia-spectrum disorders in Germany: a prospective, single-centre, assessor-blinded, parallel-group, randomised controlled trial.
BACKGROUND: People with schizophrenia-spectrum disorders have difficulties in interpersonal functioning that remain insufficiently addressed by standard care. Despite long-standing clinical use, psychodynamic psychotherapy has little empirical support compared with other psychosocial treatments for people with schizophrenia-spectrum disorders. We evaluated the efficacy of Modified Psychodynamic Psychotherapy for Schizophrenia (MPP-S), a manualised treatment tailored to the interpersonal vulnerability characteristic of this population, plus treatment as usual (TAU), compared with TAU alone. METHODS: This prospective, single-centre, assessor-blinded, parallel-group, randomised controlled trial was conducted at the Psychiatric University Hospital of the Charité at St Hedwig Hospital in Berlin, Germany. Participants were outpatients aged 18-64 years who were diagnosed with schizophrenia or schizoaffective disorder and exclusion criteria included organic brain disorder, somatic illness affecting cerebral function, and current or past alcohol or illicit drug misuse requiring addiction-specific treatment. Participants were randomly assigned 1:1 in blocks of ten to MPP-S (minimum 30 sessions) plus TAU or TAU alone. Outcome assessors were masked, but participants and therapists were not. The primary outcome was psychosocial functioning, measured using the Mini International Classification of Functioning, Disability and Health Rating for Limitations of Activities and Participation in Psychological Disorders (Mini-ICF-APP) and evaluated at baseline and prespecified post-treatment (24 months) and follow-up (36 months) assessments. Analyses followed the intention-to-treat principle. Linear mixed models were used to analyse incomplete longitudinal data under a missing-at-random assumption. People with lived experience were not formally involved in the design, conduct, or reporting of this study. This trial was preregistered at ClinicalTrials.gov (NCT02576613) and is complete. FINDINGS: From Oct 12, 2015, to Dec 7, 2021, 130 participants (57 [44%] female and 73 [56%] male) were randomly assigned to either MPP-S plus TAU (n=65) or TAU alone (n=64). One participant withdrew consent to data analysis. Regarding the primary outcome of psychosocial functioning, linear mixed models showed significant group-by-time interactions favouring the intervention: estimated marginal means indicated adjusted between-group differences in Mini-ICF-APP scores of -3·45 (95% CI -5·51 to -1·40; p=0·0011) at 24 months and -4·07 (-6·19 to -1·94; p=0·0002) at 36 months. The frequency of adverse events was similar between groups. There were three serious adverse events: two participants died by suicide (one in the MPP-S plus TAU group who did not start psychotherapy and one in the TAU alone group) and one participant in the MPP-S plus TAU group was admitted to a forensic hospital. INTERPRETATION: MPP-S added to TAU could improve psychosocial functioning compared with TAU alone. Our findings suggest efficacy and possible long-term benefits of psychodynamic psychotherapy for schizophrenia-spectrum disorders and indicate its potential role alongside other psychotherapeutic and psychosocial treatments. FUNDING: Berlin Institute of Health, Deutsche Gesellschaft für Psychoanalyse, Psychotherapie, Psychosomatik und Tiefenpsychologie, International Psychoanalytic University Berlin, and Köhler-Stiftung.
Humans↗
[Incidence of infant tuberculosis in Germany during the first year after cessation of unselected BCG vaccination (author's transl)].
At the end of May 1975, BCG vaccine was withdrawn from the market in the Federal Republic of Germany, because a newly introduced vaccine had given rise to untoward reactions. Neonatal vaccination practically ceased. The results of a survey by questionnaire, undertaken on behalf of the Vaccination Committee of the German Society for Social Paediatrics, are reported. From 1.9.1975 to 31.8.1976 the incidence of tuberculosis in the first year of life had already doubled compared with the reported annual rate in both 1973 and 1974. Almost all cases were due to infection by adults not thought to be infectious. It is recommended that indications for "selective vaccination" should be broadened and the results of longer exposure time of unvaccinated children be awaited before any stoppage of general vaccination is decided upon.
Age Factors↗