Mitteilungen der DGPPN Nervenarzt 2007 · 78: 836–837 DOI 10.1007/s00115-007-2321-1 © Springer Medizin Verlag 2007 Redaktion U. Voderholzer, Freiburg J. Zielasek, Düsseldorf S. Rudolf, Lübeck W. Gaebel, Düsseldorf

1. European Conference on Schizophrenia Research – Perspectives from European Networks Düsseldorf 26.- 28. September 2007 Im September dieses Jahres star- werden. „Wir freuen uns, dass die tet das Kompetenznetz Schizo- meisten der eingeladenen interphrenie (KNS) eine Kongress- nationalen Experten ihre TeilReihe zur Schizophrenie-For- nahme bereits zugesagt haben“, schung, die zukünftig alle zwei so der Sprecher des KompetenzJahre stattfinden soll. Professor netzes Schizophrenie. Wolfgang Gaebel, Sprecher des Eine zukunftsweisende BeKNS: „Es freut mich sehr, dass sonderheit dieses Kongresses unsere Initiative auch von den stellt der Aspekt des europäFachgesellschaften unterstützt ischen Netzwerk-Gedankens dar. wird. Sowohl die Weltgesellschaft Ähnlich wie das Kompetenznetz für Psychiatrie WPA respektive Schizophrenie gibt es in anderen deren Sektion Schizophrenie als europäischen Staaten nationale auch die Ge-meinschaft Europä- Netzwerke, die sich der Erforischer Psychiater AEP und die schung von Schizophrenie oder Deutsche Gesellschaft für Psych- spezieller Fragestellungen zu dieiatrie, Psychotherapie und Ner- sem Krankheitsbild verschrieben venheilkunde DGPPN treten als haben. Nicht nur um die DatenCo-Sponsor auf.“ basis klinischer Studien zu erhöDas Programm der diesjäh- hen, wären eine paneuropäische rigen Veranstaltung wird sich Zusammenarbeit und ein regelzum einen mit der Frage nach mäßiger fachlicher Austausch der Validität von derzeitig ge- wünschenswert. Deshalb werbräuchlichen Diagnosesyste- den sich Vertreter europäischer men vor dem Hintergrund neu- Netzwerke im Rahmen des Konerer Forschungserkenntnisse zur gresses zu einem Workshop zuNeurobiologie und Psychopa- sammenfinden, um u.a. über zuthologie befassen. Zum anderen künftige Kooperationen zu spresollen die Ergebnisse des KNS chen. Entsprechend soll die Euround anderer europäischer For- pean Conference on Schizophreschungsnetzwerke insbesondere nia Research eben solchen Forzu den Themen Früherkennung schungsnetzwerken in Zukunft und Frühbehandlung psycho- ein Forum bieten. tischer Erkrankungen sowie BeAber auch die nachrückende handlung von erstmals schizo- Forschergeneration soll auf diephren Erkrankten in der Zusam- sem Kongress des KNS eine Plattmenschau vorgestellt und mit in- form finden. Nachwuchswissenternationalen Experten diskutiert schaftler erhalten daher die Ge-

836 | 

Der Nervenarzt 7 · 2007

legenheit, ihre Forschungsprojekte Experten und der Fachöffentlichkeit zu präsentieren. Auch junge Forscher auf dem Gebiet der Schizophrenie wurden herzlich eingeladen, Beiträge beim Programmkomitee einzureichen, über deren Annahme und die Art der Präsentation – Freier Vortrag oder Poster (geführte Postersessions) – das Programmkomitee nun im Laufe des Julis entscheidet. Gerade die Förderung von Nachwuchswissenschaftlern ist ein erklärtes Ziel des KNS. Deshalb schreibt das Kompetenznetz jährlich den „Aretaeus-Preis für Nachwuchsförderung“, der mit 5000 Euro dotiert ist, aus. Damit zeichnet das KNS hervorragende wissenschaftliche Leistungen von Nachwuchswissenschaftlern auf dem Gebiet der empirischen Schizophrenieforschung aus. Die diesjährige Preisverleihung erfolgt im Rahmen der Eröffnungszeremonie der „European Conference on Schizophrenia Research“. Im Anschluss an den internationalen Kongress findet am

Samstag, den 29. September bereits zum 5. Mal die diesjährige Informationsbörse Schizophrenie zum Thema „Psychose und Sucht“ statt.

1. European Conference on Schizophrenia Research – Perspectives from European Networks

26. - 28. September 2007 Haus der Ärzteschaft Tersteegenstraße 9, 40474 Düsseldorf

Nähere Informationen:

Kompetenznetz Schizophrenie Tel. 0211-922-2770 oder [email protected] bzw. www.schizophrenianet.eu

Pressekontakt

Kompetenznetz Schizophrenie Dr. Viktoria Toeller Wissenschaftskommunikation & Öffentlichkeitsarbeit Tel.: 0211-922-2773 FAX 0211-922-2780 [email protected]

Grußwort von Prof. Gaebel

Anlässlich der WPA-Thematikkonferenz „Coercive treatment in psychiatry: a comprehensive review“ Vom 6. bis 8. Juni 2007 fand auf Anregung eines europäischen Forschungskonsortiums (www.eunomia-study.net) eine von der World Psychiatric Association (WPA) unterstützte Konferenz zum Thema „Zwangsbehandlung in der Psychiatrie“ („coercive treatment“) statt. Das Programm umfasste mehr als 40 Symposien und Workshops, in denen epidemio-

logische, klinische, ethische, kulturelle, rechtliche und politische Aspekte verschiedener Zwangsmaßnahmen und insbesondere die Sichtweise der betroffenen Patientinnen und Patienten diskutiert wurde. Herr Prof. Gaebel, der Präsident der DGPPN, hat anlässlich dieser Tagung ein Grußwort gehalten, welches nachfolgend hier wiedergegeben ist.

Mitteilungen der DGPPN Dear Professor Mezzich, dear Professor Kallert, dear colleagues, ladies and gentlemen, following Professor Kallert´s definition for the EUNOMIA project, coercive treatment in psychiatry includes the involuntary admission to a psychiatric hospital or ward as well as the administration of measures such as seclusion, restraint and forced medication. It is a subject which attracts much interest from professionals and the public. Some historic aspects may also play a role. In Germany, during the time of the Third Reich, mentally ill persons became victims of the euthanasia program or were sterilized against their will in eugenic programs. While forced sterilization may have been the most gruesome type of „coercive treatment“, the killing in the euthanasia program went far beyond this. Although it does not play a role today anymore, we must not forget this. In the early 1970s, a review committee of the German Bundestag – the „Psychiatry Enquete“ - reviewed practices in German clinical psychiatry. As a consequence, decentralization and dehospitalization were the cornerstones of the following decades. Such historical, legal or political implications may have laid a foundation for the public interest in coercive psychiatric treatment. However, today, the interest also has to do with opinions and prejudices of both professionals and the public regarding the frequency of coercive admissions in psychiatric institutions and true or supposed mandatory treatment practices in psychiatry. It also has to do with cultural traditions of separating the mentally ill, this being part of the general stigma attached to individuals with mental illnesses. It has also to do with fears about being treated against one´s will, it has to do with fears about a change of one´s personality due to pharmacologic treatment or with fear about being imprisoned against

one´s will in a psychiatric instiThe German Society of Psychtution. iatry, Psychotherapy and Nervous The matter is complicated by Diseases (DGPPN), whose greethe fact that different countries tings I may today extend as its have different rules and regulati- president to the organiz-ers and ons for coercive treatment. Legis- contributors of this conference, is lation in Germany regarding co- honoured to support the World ercive measures in psychiatry and Psychiatric Association in its efmedicine in general has been re- fort to address these important formed with an emphasis on the questions. Our society is curimportance of the presence of rently in the process of develoa severe mental illness with en- ping an evidence-based guidesuing acute danger to others or line regarding aggressive behavithe patient himself as prerequi- or in psychiatry, and a task force sites, a formal decision by an in- is preparing guidelines regarding dependent judge, and the opti- the admission situation in psychon of appeals against judicial de- iatric hospitals. Thus, we are eacisions including legal counsel- ger to learn from our colleagues ling as further safeguards. Also, from abroad and we will incorsuch decisions are subject to ter- porate the evidence which will be mination after preset time peri- gathered during the conference ods. Together, these measures ap- in our therapeutic guidelines for pear to guarantee a decision pro- mental disorders. cess which balances the interests Let me also adress some ethiof all parties involved in this pro- cal questions which arise. What cess. do we do with a person, whose However, from a more global mental disorder precludes inforperspective, the political abuse of med consent to treatment or hospsychiatry in oppressive political pital admission, for example in an systems is still a matter of debate. acute suicidal crisis? Or how shall Also, the frequency and kinds we treat a patient who endangers of coercive treatments vary wi- others or himself because of padely between countries. In Ger- ranoid ideation? There is a cermany, we had a recent scientific tain tendency in nearly all socidiscussion about rising absolu- eties to use coercive measures in te numbers of forced admissions such situations. But does coercive but constant relative ratios com- seclusion in a psychiatric institupared to the total number of ad- tion already include the permismissions to psychiatric hospitals. sion to treat the patient? Not in This discussion brought to light our country. On the other hand: that we need more reliable epide- Is it not inhumane to not treat a miological data, but also metho- patient? Paternalistic or custodial dological questions arose. One approaches are generally looked very important aspect is quality upon as obsolete. Even the decontrol regarding coercive treat- cision of a patient against treatments. Many German psychia- ment must be respected, but what tric hospitals have included rules does that imply for the psychiatto regulate coercive measures in rist as a medical expert and his or their quality management pro- her identity as a medical doctor grams. A benchmarking survey whose prime task is to help peoin Germany in 2004 by Steinert ple? Does it mean in certain cases and colleagues showed that the that we as medical doctors allow number of coercive measures is a depressive patient to follow his/ inversely correlated with the pre- her suicidal ideas? But how free sence of hospital guidelines re- is the patient´s will in cases of segarding violent patient behavi- vere mental disorders – if we do or. This suggests that improving not question a human free will althe guidelines in psychiatric hos- together, as some neuroscientists pitals may reduce the necessity to do? Such and other questions use coercive treatment. touch the heart of the identity of the psychiatric profession.

In this context, the WPA conference on coercive treatment is not only timely but also warranted by the fact that informed consent and shared decision making are the ultimate goal of all our efforts to help people with mental disorders. The psychiatrist is the medical expert to answer some of the urgent questions mentioned above. One major aspect of this conference is that medical professionals and researchers, experts in ethics, policy makers, users of mental health care and their family members, come together. Thus, this conference offers the unique opportunity to share views and experiences, learn about scientific evidence, and lay the foundation for future research in this area of clinical psychiatry, but also for an improved understanding of the diverse aspects of coercive treatment. All psychiatrists and psychotherapists - but also psychosomatic specialists, psychologists and other professionals in the field must learn to stand up for their specialty and their patients. We must emphasize our diagnostic and therapeutic fields of excellence and continue to develop our biopsychosocial approach to mental disorders including the aspects of a „Psychiatry for the Person“ which is an emphasis of the WPA. Correspondingly, the DGPPN under my presidency has named the identity of our specialty in diagnosis and therapy as the central topic for the next annual conferences of the DGPPN. In the name of the DGPPN Diseases, I thank the organizers of the WPA conference of coercive treatment for bringing together such an important programm adressing very challenging questions for German and world psychiatry. I wish this conference great success, for the benefit of our patients and of our profession. Univ.-Prof. Dr. med. W. Gaebel President of the Society of Psychiatry, Psychotherapy and Nervous Diseases Der Nervenarzt 7 · 2007 

| 837