In the pharmacological treatment of mental disorders, gender-specific aspects are often ignored and guidelines also barely consider these aspects; however, male and female can react very differently to medications due to differences in pharmacokinetics and pharmacodynamics. This article provides an overview of gender-specific differences with a focus on the pharmacokinetics of psychotropic drugs. Furthermore, (life) phase-dependent differences are addressed considering the menstruation effect, the influence of oral contraceptives, pregnancy and menopause-related physiological alterations. Therapeutic drug monitoring (TDM) is a clinical instrument that can provide valuable contributions due to changing pharmacokinetics in order to optimize the efficacy and safety of pharmacotherapy in various phases of life.

Tic disorders are neurodevelopmental disorders characterized by involuntary motor and/or vocal expressions (tics). According to ICD-10 and ICD-11 classifications they are differentiated into transient (≤ 12 months) and chronic (> 12 months) tic disorders; the diagnosis of Tourette syndrome requires the presence of multiple motor tics and at least one vocal tic persisting for more than 1 year. Typical features of tics include onset in childhood, a premonitory urge, at least partial suppressibility and a rostrocaudal distribution. Differential diagnoses include other hyperkinetic neurological disorders as well as obsessive-compulsive symptoms, stereotypes and functional tic-like behaviors, the latter often presenting with a late, abrupt onset and predominantly complex expressions. Behavioral therapy is considered the first-line treatment for clinically relevant tics. Pharmacological treatment includes off-label use of dopamine antagonists, such as aripiprazole. Comorbidities are common and require targeted comanagement.

The International Statistical Classification of Diseases and Related Health Problems version 11 (ICD-11) represents a conceptual advance over ICD-10 in the classification of dementias. Although the syndromic classification in the chapter "Neurocognitive disorders" remains in principle unchanged, the introduction of severity levels and the central positioning of mental and behavioral symptoms enables a more precise coding of the clinical diagnoses. Furthermore, the introduction of mild neurocognitive disorder as a prodromal state of dementia is new. The clinical criteria developed by international experts, e.g., for frontotemporal dementia or Lewy body disease, are not yet sufficiently included in ICD-11. Biomarkers for the etiological diagnostics of dementia are also not mentioned, so that it is unclear which role they play in the disease classification in ICD-11. Due to the rapid development in the field of neurodegenerative diseases, regular updates would be desirable.

Work and employment have a long tradition in psychiatric psychotherapeutic treatment and are of great importance for the rehabilitation process of the people affected. Education as an essential component of promotion of rehabilitation and participation was initially given less consideration in this context, although its importance for young people is very high, particularly in connection with incipient mental illnesses.. Based on the available scientific evidence and against the background of the current health and sociopolitical challenges in Germany, opportunities for the occupational integration of people with mental illnesses are highlighted. Oriented to the sociolegal situation, some successfully implemented regional models are described as examples and the necessary implications for their nationwide transfer to the standard care context are addressed. In a future care system rehabilitation and participation support should be closely interlinked, harmonized and coordinated and form part of a regional care obligation to ensure that the treatment and participation needs of people with severe mental illness are met.

Although affective disorders are a major driver of disability worldwide, there is a lack of understanding of the mechanisms and modulating factors involved in the long-term disease trajectories.

Affective disorders are associated with an enormous disease burden, necessitating research on the mechanisms of effective treatments.

Value-based healthcare (VBHC) is a concept in health economics that aims to improve patient care through needs-oriented treatment approaches while considering the costs incurred. "Value" describes the ratio of patient-centered outcome and experience data to the costs incurred.

Effective treatment of affective disorders (AD) requires a deep understanding of the underlying neurobiological mechanisms. However, in machine-learning-based analyses, cross-sectional studies have failed to identify robust individual-level biomarkers. Research Domain A of CRC/TRR393 addresses this gap by implementing longitudinal, multimodal studies using real-time mobile assessments. Central to this effort is the identification of "inflection signals"-clinically meaningful symptom changes marking transitions from euthymia to depressive or (hypo)manic episodes. These critical windows are captured through digital phenotyping and ecological momentary assessments and followed up by in-depth neurobiological profiling. Six projects examine the dynamic interplay of behavioral, cognitive-emotional, molecular, immune, and neural mechanisms during these transitions. Project A01 validates early-warning models using digital phenotypes and machine learning. Project A02 maps structural and functional brain changes in relation to disease course and risk factors. Project A03 investigates the role of microglial immune activation in recurrent depression. Project A04 investigates neurobiological alterations after inflection signals using intensive, multimodal data acquisition conducted both in laboratory settings and in the participants' personal environments. Project A05 adds molecular and immunological profiling and integrates findings from human and animal data. Project A06 studies trajectories from bipolar at-risk states to full-blown illness. Together, these projects form the empirical foundation for mechanism-based interventions (Domain C) and theoretical modeling of symptom trajectories (Domain B).

Extended reality (XR) encompasses various immersive technologies that enhance perception with virtual elements. Previous research has focused in particular on virtual reality-assisted exposure therapy but there are currently dynamic developments in terms of both content and structure of XR research for psychotherapy.

The recurrent and often unpredictable course of affective disorders poses a critical challenge for long-term patient care. The CRC/TRR 393 consortium has established an ambitious longitudinal study, the German Mental Health Cohort (GEMCO), to systematically investigate the trajectories of symptom recurrence and remission in affective disorders. This article provides an overview of the core structural projects of the CRC/TRR 393 consortium that underpin this effort. Project S02 orchestrates the GEMCO, recruiting 1500 participants (approximately 900 with major depressive disorder, 300 with bipolar disorder, 300 healthy controls) and conducting comprehensive phenotyping, neuroimaging, and biobanking at baseline and follow-up time points. Project S01 provides an innovative mobile health infrastructure for continuous monitoring of patients' mood, behavior, and environment in real time over a 2-year period, enabling detection of early warning signs ("inflection signals") of mood episodes. Project INF implements a centralized information infrastructure, ensuring high-quality data capture, multisite data integration, and open-science data sharing. Project S03 serves as the advanced data analysis hub, developing machine learning models to predict individual illness trajectories and outcomes from the rich multimodal data. A research training group (RTG) provides funding and infrastructure for early-career scientists. Together, these structural projects establish a state-of-the-art framework for studying affective disorder trajectories, with the ultimate goal of identifying predictors and mechanisms of relapse and remission, and paving the way toward mechanism-based clinical interventions.

Memory clinics in Germany are facing major challenges due to increasing numbers of patients and the first available disease-modifying treatments for Alzheimer's disease. Capacities for counselling, biomarker-based diagnostics, drug administration and follow-up examinations must be achieved, which creates the need for modified workflows. Value-based healthcare (VBHC) aims at optimizing the value for patients (outcome in relation to costs) and can serve as a framework for a patient-oriented increase in efficacy.

In German addiction services around 40-50% of the men are fathers. Affected fathers often have difficulties in successfully realizing the fatherhood. The resulting demands can lead to changes in consumption; however, fatherhood is currently not regularly addressed as part of addiction treatment.

Antipsychotic medications (AP) are a central component in the treatment of psychotic disorders. The question arises how to balance long-term pharmacological treatment with the possibility of reduction or discontinuation (R&D). The German S3 guidelines for schizophrenia provide a general framework for R&D but concrete recommendations for practical implementation are still lacking.

Sex and gender differences in mental disorders are widespread. Posttraumatic stress disorder (PTSD) is one of the mental disorders with the largest prevalence differences between women and men.