An observational study in Psychiatric Disorders, sponsored by Jacobs University Bremen gGmbH. Not yet recruiting at 1 site in Germany. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-09-28.
Sponsored by Jacobs University Bremen gGmbH · Observational
Mental disorders are often accompanied by health-risk behaviours, psychiatric comorbidity, and reduced functioning. TORCH investigates transdiagnostic mechanisms underlying multiple health behaviour change in adult psychiatric patients, with a focus on nicotine dependence and smoking. Based on the Compensatory Carry-Over Action Model (CCAM), the project examines self-efficacy, motivation, stress regulation, coping, and social support in relation to psychiatric symptoms and rehabilitation outcomes. Using a multimethod, naturalistic observational design, quantitative and qualitative data will be collected in inpatient and day-care psychiatry to identify mechanisms that support health behaviour change and rehabilitation.
Abstract
TORCH - Transdiagnostic Observation of Risk Factors, Craving and Health Behaviours in Psychiatric Patients
Mental disorders are frequently associated with health-risk behaviours, complex comorbidity profiles, and limitations in functional participation. However, transdiagnostic approaches systematically investigating the relationships between psychiatric comorbidity, multiple health behaviour change, and rehabilitation-related outcomes remain limited.
The TORCH project therefore investigates psychological, clinical, and behavioural mechanisms associated with health behaviours, behaviour change processes, and rehabilitation outcomes in adult psychiatric patients. The central research questions are: Which transdiagnostic factors influence multiple health behaviour changes, and how are these factors associated with psychiatric comorbidities, rehabilitation motivation, functional recovery, and social participation?
A particular focus is placed on nicotine dependence and smoking behaviour as an exemplary health behaviour and their interactions with other health-related behaviours. Based on the Compensatory Carry-Over Action Model (CCAM), the study examines the extent to which shared self-regulatory processes, including self-efficacy, motivation for change, stress regulation, coping strategies, and social support, contribute to multiple behaviour change processes. Furthermore, the study investigates how psychiatric comorbidities and symptom severity influence these mechanisms and rehabilitation-related outcomes.
The study is designed as a multimethod, naturalistic observational study conducted in an inpatient and day-care psychiatric setting. Adult patients receiving treatment at the Department of Psychiatry and Psychotherapy, Kreiskrankenhaus Prignitz, will be included. Quantitative data collection comprises standardized clinical interviews, self-report questionnaires, and non-invasive assessment procedures. Measures include nicotine dependence and craving, transdiagnostic mechanisms (including stress and coping measures), psychiatric symptom severity, and rehabilitation-related variables. In addition, qualitative data will be collected through semi-structured individual interviews, a World Café format, and open-ended questions to explore individual experiences, barriers, and resources related to multiple health behaviour changes and rehabilitation processes.
The study duration is approximately 18 months. During the first three months, study preparation, training of the research team, and implementation of study procedures will be conducted. This will be followed by a pilot phase to evaluate the feasibility of the assessment procedures, the comprehensibility of the instruments, and the implementation of the qualitative data collection procedures, with adaptations made where necessary. From month 4 to month 13, participant recruitment and quantitative as well as qualitative data collection will take place. Months 14 to 16 will focus on data preparation, statistical analyses, and qualitative analyses. The final two months will be dedicated to integrating the findings, scientific dissemination, and deriving clinical implications.
The study includes adults with nicotine dependence receiving inpatient or day-care psychiatric treatment at the Department of Psychiatry and Psychotherapy, Kreiskrankenhaus Prignitz. Eligibility requires informed consent and sufficient German language proficiency, with exclusion of individuals whose acute clinical condition or impaired decisional capacity would preclude participation.
Participants must:
be affected by nicotine dependence
Be 18 years of age or older.
Be currently receiving inpatient or day-care psychiatric treatment at the Department of Psychiatry and Psychotherapy, Kreiskrankenhaus Prignitz.
Be capable of understanding study information and providing informed consent.
Possess sufficient German language proficiency to complete assessments and interviews.
Agree to participate voluntarily.
Exclusion Criteria
Participants will be excluded if they:
Experience acute psychiatric symptoms that substantially impair informed consent capacity.
Are acutely intoxicated or experiencing severe withdrawal symptoms at the time of recruitment.
Demonstrate insufficient decisional capacity according to clinical assessment.
Do not have adequate German language proficiency.
Have any condition judged by the treating clinical team to render participation inappropriate or excessively burdensome.
Behavioral: person-centred interventions
The clinic treatment is a person-centred interventions that support smoking cessation, health promotion, rehabilitation participation, and long-term recovery among individuals with mental disorders.
BIS-15
Barratt Impulsiveness Scale (BIS) is measuring behavioral inhibition (On a scale of 1 to 4: 1-rarely/never, 2-occasionally, 3-often, 4-almost always/always).
Time frame: Timepoint 0 (baseline), Timepoint 1 (2-4 weeks later) and Timepoint 2 (approximately 1 month after discharge).
FEVER
Fragebogen zur Erfassung der Veränderungsbereitschaft (FEVER) is measuring readiness to hange / change motivation. On a scale of 1 to 5: 1-not at all applicable, 2-rather not applicable, 3-don't know/undecided, 4-rather applicable, 5-fully applicable.
Time frame: Timepoint 0 (baseline), Timepoint 1 (2-4 weeks later) and Timepoint 2 (approximately 1 month after discharge).
F-SozU K-14
F-SozU K-14 is a Social Support Questionnaire. On a scale of 1 to 5: 1-not applicable, 2-rather not applicable, 3-partly applicable, 4-applicable, 5-exactly applicable.
Time frame: Timepoint 0 (baseline), Timepoint 1 (2-4 weeks later) and Timepoint 2 (approximately 1 month after discharge).
Fagerström Test
Fagerström Test is measuring smoking behavior. Higher values mean higher consumption.
Time frame: Timepoint 0 (baseline), Timepoint 1 (2-4 weeks later) and Timepoint 2 (approximately 1 month after discharge).
SF12
SF12 is measuring functional status (description can be found here: Singh, A., Gnanalingham, K., Casey, A., \& Crockard, A. (2006). Quality of life assessment using the Short Form-12 (SF-12) questionnaire in patients with cervical spondylotic myelopathy: comparison with SF-36. Spine, 31(6), 639-643.).
Time frame: Timepoint 0 (baseline), Timepoint 1 (2-4 weeks later) and Timepoint 2 (approximately 1 month after discharge).
BSI-18
BSI-18 Is a Brief-Symptom Inventory. On a scale of 1 to 4: 1-not at all, 2, 3, 4-very strongly.
Time frame: Timepoint 0 (baseline), Timepoint 1 (2-4 weeks later) and Timepoint 2 (approximately 1 month after discharge).
BIP-Q
BIP-Q is measuring the illness perceptions. On a scale of 0 to 10: 0-no impairment at all, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10-very severe impairment.
Time frame: Timepoint 0 (baseline), Timepoint 1 (2-4 weeks later) and Timepoint 2 (approximately 1 month after discharge).
PSS
PSS is measuring perceived stress. On a scale of 1 to 5: 1-never, 2-almost never, 3-sometimes, 4-quite often, 5-very often.
Time frame: Timepoint 0 (baseline), Timepoint 1 (2-4 weeks later) and Timepoint 2 (approximately 1 month after discharge).
CHB-Q
CHB-Q (Compensatory Health Beliefs) is a subscale for substance use. On a scale of 1 to 5: 1-strongly disagree, 2, 3, 4, 5-strongly agree.
Time frame: Timepoint 0 (baseline), Timepoint 1 (2-4 weeks later) and Timepoint 2 (approximately 1 month after discharge).
QSU-G
QSU-G is a questionnaire on Smoking Urges. On a scale of 1 to 7: 1-completely true, 2, 3, 4, 5, 6, 7-not true at all.
Time frame: Timepoint 0 (baseline), Timepoint 1 (2-4 weeks later) and Timepoint 2 (approximately 1 month after discharge).
BDI2
Beck Depression Index.
Time frame: Timepoint 0 (baseline), Timepoint 1 (2-4 weeks later) and Timepoint 2 (approximately 1 month after discharge).
CHQ
Compensatory Health Belief Questionnaire (Subscale Substance Use). On a scale of 1 to 5: 1-strongly disagree, 2, 3, 4, 5-strongly agree.
Time frame: Timepoint 0 (baseline), Timepoint 1 (2-4 weeks later) and Timepoint 2 (approximately 1 month after discharge).
Rehabilitation Intentions
Rehabilitation Intentions is measuring Rehabilitation-related intentions and willingness to apply for medical rehabilitation were assessed using self-report items.
Time frame: Timepoint 0 (baseline), Timepoint 1 (2-4 weeks later) and Timepoint 2 (approximately 1 month after discharge).
Plan to share: No
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