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Fleischer T, Ulke C, Kummetat J, Speerforck S, Brähler E, Schomerus G. Wahrnehmung von Wende und Lebensqualität. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- T Fleischer
- Universität Leipzig, Medizinische Fakultät, Klinik und
Poliklinik für Psychiatrie und Psychotherapie, Leipzig,
Deutschland
| | - C Ulke
- Universität Leipzig, Medizinische Fakultät, Klinik und
Poliklinik für Psychiatrie und Psychotherapie, Leipzig,
Deutschland
| | - J Kummetat
- Universität Leipzig, Medizinische Fakultät, Klinik und
Poliklinik für Psychiatrie und Psychotherapie, Leipzig,
Deutschland
| | - S Speerforck
- Universität Leipzig, Medizinische Fakultät, Klinik und
Poliklinik für Psychiatrie und Psychotherapie, Leipzig,
Deutschland
| | - E Brähler
- Universitätsmedizin der Johannes Gutenberg-Universität
Mainz, Klinik und Poliklinik für Psychosomatische Medizin und
Psychotherapie, Mainz, Deutschland
| | - G Schomerus
- Universität Leipzig, Medizinische Fakultät, Klinik und
Poliklinik für Psychiatrie und Psychotherapie, Leipzig,
Deutschland
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Wicke FS, Ernst M, Otten D, Werner A, Dreier M, Brähler E, Tibubos AN, Reiner I, Michal M, Wiltink J, Münzel T, Lackner KJ, Pfeiffer N, König J, Wild PS, Beutel ME. The association of depression and all-cause mortality: Explanatory factors and the influence of gender. J Affect Disord 2022; 303:315-322. [PMID: 35176339 DOI: 10.1016/j.jad.2022.02.034] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 12/29/2021] [Accepted: 02/13/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND The association of depression with mortality and the significance of explanatory factors, in particularly gender, have remained an issue of debate. We therefore aimed to estimate the effect of depression on all-cause mortality, to examine potential explanatory factors and to assess effect modification by gender. METHODS We used Cox regression models to estimate the effect of depression on mortality based on data from the Gutenberg Health Study, which is a prospective cohort study of the adult population in the districts of Mainz and Mainz-Bingen, Germany. Baseline assessment was between 2007 and 2012. Effect modification by gender was measured on both additive and multiplicative scales. RESULTS Out of 14,653 participants, 7.7% were depressed according to Patient Health Questionnaire 9 (PHQ-9), and 1,059 (7.2%) died during a median follow-up of 10.7 years. Depression elevated the risk of mortality in men and women in age-adjusted models (HR: 1.41, 95%-CI: 1.03-1.92; resp. HR: 1.96, 95%-CI: 1.43-2.69). Adjustment for social status, physical health and lifestyle covariates attenuated the effect and in the fully-adjusted model the hazard ratio was 0.96 (95%-CI: 0.69-1.33) in men and 1.53 (95%-CI: 1.10-2.12) in women. For effect modification by gender, the measure on multiplicative interaction was 0.68 (95%-CI 0.44-1.07) and on additive interaction was RERI=-0.47 (95%-CI -1.24-0.30). LIMITATIONS The PHQ-9 is a single self-report measure of depression reflecting symptoms of the past two weeks, limiting a more detailed assessment of depression and course of symptoms, which likely affects the association with mortality. CONCLUSIONS Depression elevates mortality by multifactorial pathways, which should be taken into account in the biopsychosocially informed treatment of depression. Effect modification by gender was not statistically significant.
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Affiliation(s)
- F S Wicke
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany.
| | - M Ernst
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - D Otten
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - A Werner
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - M Dreier
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - E Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - A N Tibubos
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - I Reiner
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - M Michal
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - J Wiltink
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - T Münzel
- Center for Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - K J Lackner
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - N Pfeiffer
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - J König
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - P S Wild
- Preventive Cardiology and Preventive Medicine - Center for Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; Center for Thrombosis and Hemostasis, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - M E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
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Mühlan H, Hahm S, Altweck L, Brähler E, Schmidt S. In der Sprache vereint? Analysen zum Differential Item Functioning in Abhängigkeit von ost- vs. westdeutscher Sozialisation am Beispiel der Erfassung ressourcenorientierter Konstrukte. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- H Mühlan
- Lehrstuhl Gesundheit & Prävention, Universität Greifswald
| | - S Hahm
- Lehrstuhl Gesundheit & Prävention, Universität Greifswald
| | - L Altweck
- Lehrstuhl Gesundheit & Prävention, Universität Greifswald
| | - E Brähler
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin Mainz
| | - S Schmidt
- Lehrstuhl Gesundheit & Prävention, Universität Greifswald
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Berth H, Zenger M, Stöbel-Richter Y, Brähler E. Westwärts und nicht vergessen. Innerdeutsche Migration und psychosoziale Folgen 1990 - 2020. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- H Berth
- TU Dresden, Medizinische Fakultät Carl Gustav Carus, Psychosoziale Medizin und Entwicklungsneurowissenschaften, Forschungsgruppe Angewandte Medizinische Psychologie und Medizinische Soziologie
| | - M Zenger
- Hochschule Magdeburg-Stendal, Fachbereich Angewandte Humanwissenschaften - Rehabilitationspsychologie
| | - Y Stöbel-Richter
- Hochschule Zittau/Görlitz, Fakultät Management- und Kulturwissenschaften
| | - E Brähler
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie
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Fleischer T, Ulke C, Speerforck S, Gfesser T, Mühlan H, Glaesmer H, Fegert JM, Zenger M, Ladwig KH, Beutel ME, Brähler E, Schomerus G. East vs. West: Differences in the prevalence of child maltreatment in Germany before the reunification. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- T Fleischer
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald
| | - C Ulke
- Department of Psychiatry and Psychotherapy, Leipzig University Medical Center
| | - S Speerforck
- Department of Psychiatry and Psychotherapy, Leipzig University Medical Center
| | - T Gfesser
- Department of Psychiatry and Psychotherapy, Leipzig University Medical Center
| | - H Mühlan
- Health & Prevention, Institute of Psychology, University of Greifswald
| | - H Glaesmer
- Department of Medical Psychology and Medical Sociology, University of Leipzig
| | - JM Fegert
- Department for Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm
| | - M Zenger
- Faculty of Applied Human Studies, University of Applied Sciences Magdeburg and Stendal
| | - K-H Ladwig
- Institute of Epidemiology, Helmholtz Center Munich, German Research Center for Environmental Health, Neuherberg
| | - ME Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz
| | - E Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz
| | - G Schomerus
- Department of Psychiatry and Psychotherapy, Leipzig University Medical Center
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Klein E, Zenger M, Tibubos A, Ernst M, Reiner I, Schmalbach B, Brähler E, Beutel M. Loneliness and its relation to mental health in the general population: Validation and norm values of a brief measure. Journal of Affective Disorders Reports 2021. [DOI: 10.1016/j.jadr.2021.100120] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
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Wirtz MA, Schulz A, Brähler E. Confirmatory and bi-factor analysis of the Short Form Health Survey 8 (SF-8) scale structure in a German general population sample. Health Qual Life Outcomes 2021; 19:73. [PMID: 33658031 PMCID: PMC7931558 DOI: 10.1186/s12955-021-01699-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 02/04/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The SF-8 is a short form of the SF-36 Health Survey, which is used for generic assessment of physical and mental aspects of health-related quality of life (HRQoL). Each of the 8 dimensions of the SF-36 is covered by a single item in the SF-8. The aim of the study was to examine the latent model structure of the SF-8. METHOD One-, two- and three dimensional as well as bi-factor structural models were defined and estimated adopting the ML- as well as the WLSMV-algorithm for ordinal data. The data were collected in a German general population sample (N = 2545 persons). RESULTS A two- (physical and mental health) and a three-dimensional CFA structure (in addition overall health) represent the empirical data information adequately [CFI = .987/.995; SRMR = .024/.014]. If a general factor is added, the resulting bi-factor models provide a further improvement in data fit [CFI = .999/.998; SRMR = .001]. The individual items are much more highly associated with the general HRQoL factor (loadings: .698 to .908) than with the factors physical, mental, and overall health (loadings: -.206 to .566). CONCLUSIONS In the SF-8, each item reflects mainly general HRQoL (general factor) as well as one of the three components physical, mental, and overall health. The findings suggest in particular that the evaluation of the information of the SF-8 items can be validly supplemented by a general value HRQoL.
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Affiliation(s)
- M A Wirtz
- Research Methods, Institute of Everyday Culture, Sports and Health, University of Education Freiburg, Kunzenweg 21, 79117, Freiburg, Germany.
| | - A Schulz
- Research Methods, Institute of Everyday Culture, Sports and Health, University of Education Freiburg, Kunzenweg 21, 79117, Freiburg, Germany
| | - E Brähler
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany.,Clinic for Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Abstract
AbstractBackgroundEmpirical studies on migration and mental health of migrants are still rare. In Germany they are often characterised by low sample sizes and are limited to certain diseases and geographical areas (old federal states). The comparability of their results is limited. Nonetheless, the assessment of migrants’ health is necessary for adequate medical and psychosocial care for this target group.AimTo provide data on mental health of migrants from Poland and from Vietnam in Germany. Methods: We have assessed a random sample of migrants from Poland (n=140) and from Vietnam (n=88) using the Giessen Subjective Complaints List – 24 (GSCL-24) and the Hospital Anxiety and Depression Scale (HADS). Additionally we asked migrants about their knowledge of health care institutions in case of psychosocial problems, their demands and the existing barriers to health care utilisation.ResultsMigrants from Poland and Vietnam have a higher general score of complaints of physical ill-health and higher anxiety and depression values than Germans. Psychosocial and medical institutions are visited less.ConclusionFurther analytical studies are needed to clarify health differences between these groups. Migrants are a heterogeneous group and only group-specific investigations will clarify associations between countries of origin, health status and use of health care institutions.
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Tibubos AN, Zenger M, Schmalbach B, Beutel ME, Brähler E. Measurement invariance, validation and normative data of the Jenkins Sleep Scale-4 (JSS-4) in the German general population across the life span. J Psychosom Res 2020; 130:109933. [PMID: 31951963 DOI: 10.1016/j.jpsychores.2020.109933] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 01/09/2020] [Accepted: 01/11/2020] [Indexed: 01/20/2023]
Abstract
OBJECTIVE As sleep disorders have become a major concern in public health, there is strong need for a brief and sound measure for sleep problems. The purposes of the study were to 1) evaluate factor structure and measurement invariance, 2) validate the scale based on sociodemographic data and distress, and 3) provide norm values for the general population. METHODS In a representative survey of the German population N = 2515 participants (14 to 95 years) filled in the 4-item Jenkins Sleep Scale (JSS-4), sociodemographic questions and the Brief Symptom Inventory-18 (anxiety, depression, somatic symptom load). The JSS-4 was analyzed by principal component analysis, confirmatory and multi-group confirmatory factor analyses. A multiple-indicator-multiple-cause model was tested to investigate the relationship of the JSS-4 to distress and sociodemographic variables. RESULTS The one-factor structure of JSS-4 was confirmed. Given the heterogeneity of facets of sleep problems captured in the four items, internal consistency of the JSS-4 was remarkably high. The JSS-4 was strictly invariant across both sexes, and partially strictly invariant across income groups and individuals living with or without a partner. With regard to the full age range, it showed partial scalar invariance. CONCLUSION Female sex, higher age, living without a partner, lower education, lower income and increased distress were associated with more sleep problems. Calculated normative data of sleep problems allow comparisons of JSS-4 scores stratified by sex and age.
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Affiliation(s)
- A N Tibubos
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
| | - M Zenger
- Faculty of Applied Human Studies, University of Applied Sciences Magdeburg and Stendal, Stendal, Germany; Integrated Research and Treatment Center (IFB) Adiposity Diseases - Behavioral Medicine, Medical Psychology and Medical Sociology, University of Leipzig Medical Center, Leipzig, Germany.
| | - B Schmalbach
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
| | - M E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
| | - E Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
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Drixler K, Glaesmer H, Brähler E, Morfeld M, Wirtz MA. Validierung der Messung der gesundheitsbezogene Lebensqualität mittels des SF-12 Version 2.0 in einer deutschen Normstichprobe. Das Gesundheitswesen 2018. [DOI: 10.1055/s-0038-1667798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- K Drixler
- Pädagogische Hochschule Freiburg, Public Health & Health Education, Freiburg, Deutschland
| | - H Glaesmer
- Universitätsklinikum Leipzig, Abteilung für Medizinische Psychologie und Medizinische Soziologie, Leipzig, Deutschland
| | - E Brähler
- Universitätsklinikum Leipzig, Abteilung für Medizinische Psychologie und Medizinische Soziologie, Leipzig, Deutschland
- Universitätsmedizin der Johannes-Gutenberg-Universität, Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Mainz, Deutschland
| | - M Morfeld
- Universitätsklinikum Leipzig, Abteilung für Medizinische Psychologie und Medizinische Soziologie, Leipzig, Deutschland
- Hochschule Magdeburg-Stendal/Standort Stendal, Angewandte Humanwissenschaften, Stendal, Deutschland
| | - MA Wirtz
- Pädagogische Hochschule Freiburg, Institut für Psychologie, Freiburg, Deutschland
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Scharschmidt D, Preiß S, Brähler E, Fischer T, Borkenhagen A. [Body experience and self-esteem after minimally invasive skin rejuvenation : Study of female patients using botulinum toxin A and/or dermal fillers]. Hautarzt 2017; 68:959-967. [PMID: 29052749 DOI: 10.1007/s00105-017-4066-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND More and more people worldwide and also in Germany are using botulinum toxin type A (BoNT-A) and hyaluronic acid injections for skin rejuvenation. OBJECTIVE Study on body image and self-esteem of women with BoNT-A and/or hyaluronic acid filler treatment. MATERIAL AND METHODS A total of 145 women who requested BoNT-A and/or hyaluronic acid injections completed a survey comprised of the body dysmorphic disorder questionnaire, the Rosenberg self-esteem scale and questionnaires on the attitudes and motives on measures for optimization of the body and demographic features. Using this instrument data on the body image and self-esteem as well as attitudes and motives for utilization of minimally invasive skin rejuvenation were collated. RESULTS Female users of minimally invasive skin rejuvenation showed an overall higher socioeconomic status and an above average high monthly income. They lived in a partnership more often in comparison to women of equal age living in Berlin. The users of BoNT-A and/or hyaluronic acid fillers showed no conspicuous differences in body image and self-esteem. They showed a moderately positive attitude to body optimization procedures and 91% achieved their standard weight with a body mass index (BMI) of ≤25 kg/m2 in comparison to 56% of German women in the same age range (25 to ≥75 years old). CONCLUSION In the first study of body image and self-esteem in users of BoNT‑A and/or dermal fillers in German women, the users showed no signs of body dysmorphic patterns or disorders of self-esteem.
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Affiliation(s)
- D Scharschmidt
- Praxis Berlin, Haut-und Lasercentrum Berlin-Potsdam, Richard-Strauss-Str. 27, 14193, Berlin, Deutschland
| | - S Preiß
- Klinik für Plastische Brust- und Rekonstruktive Chirurgie, Städt. Krankenhaus Dresden-Neustadt, Dresden, Deutschland
| | - E Brähler
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin Mainz, Mainz, Deutschland
| | - T Fischer
- Praxis Berlin, Haut-und Lasercentrum Berlin-Potsdam, Richard-Strauss-Str. 27, 14193, Berlin, Deutschland
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Abstract
BACKGROUND DSM-5 introduced a fundamental revision of the category of somatoform disorders, which resulted in the new somatic symptom disorder (SSD) and related disorders. However, prognostic validity of SSD remains unclear, while other classification proposals, such as bodily distress disorder (BDD) or polysymptomatic distress disorder (PSDD), might be promising alternatives for the new ICD-11. Therefore, the comparison of the different approaches concerning long-term prognosis of disorder-relevant factors is of special interest. METHOD In a longitudinal design (baseline, 1-year, and 4-year follow-up), the three proposals (SSD, BDD, PSDD) were compared in an age-representative sample of the German general population (N = 321). To this end, the baseline sample was divided into three independent pairs of groups (with/without SSD, with/without BDD, with/without PSDD). It was tested how well each approach differentiated with regard to medium- and long-term healthcare utilization, number of symptoms, and impairment. RESULTS Criteria for BDD distinguished best with regard to future healthcare utilization resulting in a large-sized effect (f = 0.44) for the difference between persons with and without BDD, while SSD and PSDD revealed only medium-sized effects (f = 0.28 and f = 0.32) between subjects with and without diagnosis. The three proposals distinguished equally well with regard to future subjective impairment (between f = 0.39 and f = 0.41) and the number of reported symptoms (between f = 0.77 and f = 0.83). CONCLUSION In accordance with our data regarding prognostic validity, the current draft of the WHO group is based on the BDD proposal. However, existing limitations and weaknesses of the present proposal for the ICD-11 are further discussed.
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Affiliation(s)
- S Schumacher
- Division of Clinical Psychological Intervention,Freie Universität Berlin,Berlin,Germany
| | - W Rief
- Department of Clinical Psychology and Psychotherapy,University of Marburg,Marburg,Germany
| | - K Klaus
- Department of Clinical Biopsychology,University of Marburg,Marburg,Germany
| | - E Brähler
- Department of Medical Psychology and Medical Sociology,University of Leipzig,Leipzig,Germany
| | - R Mewes
- Department of Clinical Biopsychology,University of Marburg,Marburg,Germany
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Mehnert A, Hartung T, Friedrich M, Vehling S, Brähler E, Härter M, Keller M, Schulz H, Wegscheider K, Weis J, Koch U, Faller H. One in two cancer patients is significantly distressed: Prevalence and indicators of distress. Psychooncology 2017; 27:75-82. [DOI: 10.1002/pon.4464] [Citation(s) in RCA: 243] [Impact Index Per Article: 34.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 05/24/2017] [Accepted: 05/29/2017] [Indexed: 01/09/2023]
Affiliation(s)
- A. Mehnert
- Department of Medical Psychology and Medical Sociology; University Medical Center Leipzig; Leipzig Germany
| | - T.J. Hartung
- Department of Medical Psychology and Medical Sociology; University Medical Center Leipzig; Leipzig Germany
| | - M. Friedrich
- Department of Medical Psychology and Medical Sociology; University Medical Center Leipzig; Leipzig Germany
| | - S. Vehling
- Department and Outpatient Clinic of Medical Psychology; University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - E. Brähler
- Department of Medical Psychology and Medical Sociology; University Medical Center Leipzig; Leipzig Germany
- Department of Psychosomatic Medicine and Psychotherapy; Universal Medical Center Mainz; Mainz Germany
| | - M. Härter
- Department and Outpatient Clinic of Medical Psychology; University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - M. Keller
- Division of Psychooncology, Department for Psychosomatic and General Clinical Medicine; University Hospital Heidelberg; Heidelberg Germany
| | - H. Schulz
- Department and Outpatient Clinic of Medical Psychology; University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - K. Wegscheider
- Department of Medical Biometry and Epidemiology; University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - J. Weis
- Department of Psychooncology; UKF Reha gGmbh University Clinic Center Freiburg; Freiburg im Breisgau Germany
| | - U. Koch
- Department and Outpatient Clinic of Medical Psychology; University Medical Center Hamburg-Eppendorf; Hamburg Germany
- Deanery; University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - H. Faller
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, and Comprehensive Cancer Center Mainfranken; University of Würzburg; Würzburg Germany
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Rose DM, Seidler A, Nübling M, Latza U, Brähler E, Klein EM, Wiltink J, Michal M, Nickels S, Wild PS, König J, Claus M, Letzel S, Beutel ME. Associations of fatigue to work-related stress, mental and physical health in an employed community sample. BMC Psychiatry 2017; 17:167. [PMID: 28476149 PMCID: PMC5420158 DOI: 10.1186/s12888-017-1237-y] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Accepted: 02/10/2017] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND While work-related fatigue has become an issue of concern among European employees, the relationship between fatigue, depression and work-related stressors is far from clear. The purposes of this study were (1) to determine the associations of fatigue with work-related stressors, severe medical disease, health behavior and depression in the working population and (2) to determine the unique impact of work-related stressors on fatigue. METHODS We used cross-sectional data of N = 7,930 working participants enrolled in the Gutenberg Health Study (GHS) from 2007 to 2012 filled out the Personal Burnout Scale (PBS) of the Copenhagen Psychosocial Questionnaire (COPSOQ), the PHQ-9, and a list of work-related stressors. RESULTS A total of 27.5% reported increased fatigue, esp. women, younger persons with a lower social status and income, smokers, severely medically ill, previously and currently depressed participants. Fatigue was consistently associated with severe medical disease, health behavior and depression, which need to be taken into account as potential confounders when analyzing its relationship to work-related strains. Depression was consistently associated with work-related stressors. However, after statistically partialling out depression, fatigue was still significantly associated with work-related stress. CONCLUSIONS Fatigue as an indicator of allostatic load is consistently associated with work-related stressors such as work overload after controlling for depression. The brief Personal Burn-out Scale is suitable for assessing work-related fatigue in the general population.
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Affiliation(s)
- D. M. Rose
- grid.410607.4Institute of Teachers’ Health, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - A. Seidler
- 0000 0001 2111 7257grid.4488.0Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - M. Nübling
- FFAW, Freiburg Research Centre for Occupational Sciences, Freiburg, Germany
| | - U. Latza
- 0000 0001 2220 0888grid.432860.bFederal Institute for Occupational Safety and Health (BAuA), Berlin, Germany
| | - E. Brähler
- grid.410607.4Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - E. M. Klein
- grid.410607.4Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - J. Wiltink
- grid.410607.4Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - M. Michal
- grid.410607.4Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - S. Nickels
- grid.410607.4Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - P. S. Wild
- grid.410607.4Department of Medicine 2, Preventive Cardiology and Preventive Medicine, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany ,grid.452396.fGerman Center for Cardiovascular Research (DZHK), partner site RhineMain, Berlin, Germany ,grid.410607.4Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - J. König
- grid.410607.4Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - M. Claus
- grid.410607.4Institute of Teachers’ Health, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - S. Letzel
- grid.410607.4Institute of Occupational, Social and Environmental Health, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - M. E. Beutel
- grid.410607.4Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
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Hartung TJ, Brähler E, Faller H, Härter M, Hinz A, Johansen C, Keller M, Koch U, Schulz H, Weis J, Mehnert A. The risk of being depressed is significantly higher in cancer patients than in the general population: Prevalence and severity of depressive symptoms across major cancer types. Eur J Cancer 2016; 72:46-53. [PMID: 28024266 DOI: 10.1016/j.ejca.2016.11.017] [Citation(s) in RCA: 161] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Revised: 11/14/2016] [Accepted: 11/15/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND Depression is a common co-morbidity of cancer that has a detrimental effect on quality of life, treatment adherence and potentially survival. We conducted an epidemiological multi-center study including a population-based random comparison sample and estimated the prevalence of depressive symptoms by cancer site, thereby identifying cancer patients with the highest prevalence of depression. PATIENTS AND METHODS We included 4020 adult cancer inpatients and outpatients from five distinct regions across Germany in a proportional stratified random sample based on the nationwide cancer incidence and a comparison group consisting of 5018 participants. Both groups reported depressive symptoms by filling in the Patient Health Questionnaire (PHQ-9). In multivariate analyses adjusted for age and sex, we calculated the odds of being depressed. RESULTS Out of 5818 eligible patients, 69% participated (51% women, mean age = 58 years). We estimated that one in four cancer patients (24%) is depressed (PHQ-9 ≥ 10). The odds of being depressed among cancer patients were more than five times higher than in the general population (OR, 5.4; 95% CI, 4.6-6.2). Patients with pancreatic (M = 8.0, SD = 5.0), thyroid (M = 7.8, SD = 6.3) and brain tumours (M = 7.6, SD = 4.9) showed the highest prevalence, whereas patients with prostate cancer (M = 4.3, SD = 3.8) and malignant melanoma (M = 5.3, SD = 4.3) had the lowest levels of depressive symptoms. CONCLUSION Our results help clinicians identify cancer patients in need of psychosocial support when navigating in the growing survivor population.
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Affiliation(s)
- T J Hartung
- Department of Medical Psychology and Medical Sociology, Section of Psychosocial Oncology, University Medical Center Leipzig, Leipzig, Germany.
| | - E Brähler
- Department of Medical Psychology and Medical Sociology, Section of Psychosocial Oncology, University Medical Center Leipzig, Leipzig, Germany; Department of Psychosomatic Medicine and Psychotherapy, Universal Medical Center Mainz, Mainz, Germany
| | - H Faller
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, and Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany
| | - M Härter
- Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Hinz
- Department of Medical Psychology and Medical Sociology, Section of Psychosocial Oncology, University Medical Center Leipzig, Leipzig, Germany
| | - C Johansen
- Department of Medical Psychology and Medical Sociology, Section of Psychosocial Oncology, University Medical Center Leipzig, Leipzig, Germany; Oncology Clinic, 5073 Rigshospitalet, University of Copenhagen, Denmark; Unit of Survivorship, The Danish Cancer Society Research Center, Copenhagen, Denmark
| | - M Keller
- Division of Psychooncology, Department for Psychosomatic and General Clinical Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - U Koch
- Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Deanery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - H Schulz
- Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - J Weis
- Department of Psychooncology, UKF Reha gGmbh University Clinic Center Freiburg, Freiburg, Germany
| | - A Mehnert
- Department of Medical Psychology and Medical Sociology, Section of Psychosocial Oncology, University Medical Center Leipzig, Leipzig, Germany
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Götze H, Brähler E, Gansera L, Schnabel A, Gottschalk-Fleischer A, Köhler N. Anxiety, depression and quality of life in family caregivers of palliative cancer patients during home care and after the patient's death. Eur J Cancer Care (Engl) 2016; 27:e12606. [PMID: 27859889 DOI: 10.1111/ecc.12606] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2016] [Indexed: 11/27/2022]
Abstract
We examined psychological parameters in family caregivers of palliative cancer patients before and after the death of the patients. Caregivers' data about depression and anxiety (Hospital Anxiety and Depression Scale), quality-of-life (Short Form-8 Health Survey), and social support (Oslo Social Support Scale) were collected at the beginning of home care (t1) and 2 months after the patient had died (t2). Regression models were employed to examine factors related to depression and anxiety in the bereaved caregivers. We interviewed 72 relatives, who were the primary caregiver of a patient. One-third (31.9%) of caregivers had high anxiety levels and 29.2% had high depression levels (t1, cut-off = 10). At t2, anxiety and depression had decreased significantly. There were no changes in quality-of-life over time. At both points of assessments, quality-of-life was lower than in the general population. Relevant factors for higher anxiety and depression in the bereaved caregivers were high levels of distress at t1, insufficient social support and low physical function. Bereaved caregivers were particularly depressed when they had been the spouse of the patient. Healthcare professionals should consider social isolation of caring relatives both during homecare and afterwards. Thus, it seems to be important to routinely offer support to spouses.
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Affiliation(s)
- H Götze
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - E Brähler
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany.,Department of Psychosomatic Medicine and Psychotherapy, Universal Medical Center Mainz, Mainz, Germany
| | - L Gansera
- Department of Psychiatry, Psychosomatics and Psychotherapy, HELIOS Park-Klinikum Leipzig, Leipzig, Germany
| | - A Schnabel
- Leipziger Palliativgesellschaft, Palliative Care Service (SAPV), Leipzig, Germany
| | - A Gottschalk-Fleischer
- Department of Internal Medicine, Muldentalkliniken, Medical Hospital Wurzen, Wurzen, Germany
| | - N Köhler
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
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Ullrich S, Briel D, Nesterko Y, Hiemisch A, Brähler E, Glaesmer H. Verständigung mit Patienten und Eltern mit Migrationshintergrund in der stationären allgemeinpädiatrischen Versorgung. Gesundheitswesen 2016; 78:209-14. [DOI: 10.1055/s-0042-102341] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- S. Ullrich
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum Leipzig AöR
| | - D. Briel
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum Leipzig AöR
| | - Y. Nesterko
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum Leipzig AöR
| | - A. Hiemisch
- Department für Frauen und Kindermedizin, Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Leipzig AöR
| | - E. Brähler
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum Leipzig AöR
| | - H. Glaesmer
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum Leipzig AöR
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Doering BK, Nestoriuc Y, Barsky AJ, Glaesmer H, Brähler E, Rief W. Is somatosensory amplification a risk factor for an increased report of side effects? Reference data from the German general population. J Psychosom Res 2015; 79:492-7. [PMID: 26553385 DOI: 10.1016/j.jpsychores.2015.10.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Revised: 10/23/2015] [Accepted: 10/28/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The study investigates the association between somatosensory amplification and the reporting of side effects. It establishes a German version of the Somatosensory Amplification Scale and examines its psychometric properties in a representative sample of the German population. METHODS Sample size was 2.469, with 51% taking any medication. Participants answered the Somatosensory Amplification Scale, Generic Assessment of Side Effects Scale, and indicated whether they were taking any medication and the type of medication. Correlational analysis and binary logistic regression were performed. RESULTS When examining a subsample reporting both medication intake and general bodily symptoms, participants higher in somatosensory amplification rated more of their general bodily symptoms as medication-attributed side effects. However, somatosensory amplification scores were not associated with the intake of any type of medication. In the overall sample, higher somatosensory amplification scores were associated with an increased report of bodily symptoms. Additionally, participants with higher somatosensory amplification reported intake of a greater number of different medications. The psychometric properties of the translated scale were good, and previously established associations of somatosensory amplification with demographic variables (age, sex) were replicated. CONCLUSION Results suggest a possible attributional bias concomitant to somatosensory amplification which in turn may increase the reporting of side effects after medication intake.
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Affiliation(s)
- B K Doering
- Department of Psychology, University of Marburg, Germany.
| | - Y Nestoriuc
- Institute of Psychology, University of Hamburg, Germany
| | - A J Barsky
- Department of Psychiatry, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - H Glaesmer
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Germany
| | - E Brähler
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Germany; University Medical Center of the Johannes Gutenberg University Mainz, Clinic for Psychosomatic Medicine and Psychotherapy, Mainz, Germany
| | - W Rief
- Department of Psychology, University of Marburg, Germany
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Riegel B, Broicher W, Wegscheider K, Andresen V, Brähler E, Lohse AW, Löwe B. Quality of life one year post-Shiga toxin-producing Escherichia coli O104 infection--a prospective cohort study. Neurogastroenterol Motil 2015; 27:370-8. [PMID: 25581112 DOI: 10.1111/nmo.12503] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 12/03/2014] [Indexed: 02/08/2023]
Abstract
BACKGROUND In 2011, a major outbreak of hemolytic-uremic syndrome (HUS) and bloody diarrhea related to infections from Shiga toxin-producing Escherichia coli O104 (STEC) occurred in Germany. While previous research has focused on the medical components of this disease, we aimed to investigate the course of health-related quality of life (HrQoL) over 12 months including somatic and psychosocial risk factors. Furthermore, the influence of chronic fatigue (CF) on HrQoL was examined. METHODS A prospective cohort study with n = 389 patients completing self-report scales at baseline, after 6 months (participation rate: 79%) and after 12 months (participation rate: 77%). The courses of physical and mental HrQoL over the 12 month period were calculated by employing general linear mixed models. KEY RESULTS While the physical component score of HrQoL reached a score comparable to the general population, the mental component score remained below average 12 months after STEC infection. Female gender, prior psychiatric disorder, and prior traumatic events were risk factors for a worse HrQoL course after 12 months, while social support was identified to be protective. CF was associated with low HrQoL. In addition, the somatic symptom burden remained persistently high. CONCLUSIONS & INFERENCES Our results show high somatic and psychosocial burden in patients 12 months after STEC infection. We recommend considering the risk factors and protective factors of poor HrQoL early in the treatment of STEC or similar diseases. Patients who are suffering from persisting somatic symptoms, CF, and impaired HrQoL may require specific aftercare.
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Affiliation(s)
- B Riegel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf, and Schön Klinik Hamburg Eilbek, Hamburg, Germany
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Häuser W, Schmutzer G, Henningsen P, Brähler E. Chronische Schmerzen, Schmerzkrankheit und Zufriedenheit der Betroffenen mit der Schmerzbehandlung in Deutschland. Manuelle Medizin 2014. [DOI: 10.1007/s00337-014-1152-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Eichhorn S, Kuhnt S, Giesler JM, Schreib M, Voelklin V, Brähler E, Ernst J, Mehnert A, Weis J. [Structural and process quality in outpatient psychosocial cancer counselling centres. evaluating a major funding programme of the "Deutsche Krebshilfe e.V."]. Gesundheitswesen 2014; 77:289-95. [PMID: 25268412 DOI: 10.1055/s-0034-1377030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND In 2007, the German Cancer Aid ("Deutsche Krebshilfe e.V.") initiated and funded a programme in 28 selected cancer counselling centres in Germany attempting to both promote and strengthen quality assured psychosocial cancer counselling as well as to ensure long-term financing. The accompanying evaluation programme aims to collect structural data of the institutions and to evaluate processes of quality assurance within the sample of cancer counselling centres. METHODS On the basis of structured research within scientific databases and internet, as well as with the support of experts, characteristics of structural quality of cancer counselling centres were identified. Structural data were collected using a self-developed questionnaire and a semi-structured interview during the on-site visitations of the institutions. RESULTS The results show homogeneity in some fields of structural quality such as individual psycho-oncological and social counselling, human resources, room facilities, quality assurance, diagnostics, documentation and public relations. Structural quality of the investigated centres appears more heterogeneous with regard to aspects such as availability and accessibility, barrier-free access, group support offers (counselling, sports, arts, etc.) as well as cooperation, financing and written mission statements. CONCLUSION The investigated cancer counselling centres ensure mainly good minimum standards according to structural quality of cancer counselling. There is potential for further optimisation including cooperation, quality assurance, room facilities and being differentiated in terms of conceptual content and working concepts. Further achievements on quality assured cancer counselling can use the presented data as a basis for describing minimum standards and obligatory quality criteria.
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Affiliation(s)
- S Eichhorn
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Sektion Psychosoziale Onkologie, Universität Leipzig, Leipzig
| | - S Kuhnt
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Sektion Psychosoziale Onkologie, Universität Leipzig, Leipzig
| | - J M Giesler
- Institut für Reha-Forschung und Prävention, Klinik für Tumorbiologie, Freiburg
| | - M Schreib
- Institut für Reha-Forschung und Prävention, Klinik für Tumorbiologie, Freiburg
| | - V Voelklin
- Institut für Reha-Forschung und Prävention, Klinik für Tumorbiologie, Freiburg
| | - E Brähler
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Sektion Psychosoziale Onkologie, Universität Leipzig, Leipzig
| | - J Ernst
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Sektion Psychosoziale Onkologie, Universität Leipzig, Leipzig
| | - A Mehnert
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Sektion Psychosoziale Onkologie, Universität Leipzig, Leipzig
| | - J Weis
- Institut für Reha-Forschung und Prävention, Klinik für Tumorbiologie, Freiburg
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Kerper LF, Spies CD, Buspavanich P, Balzer F, Salz AL, Tafelski S, Lau A, Weiß-Gerlach E, Neumann T, Glaesmer H, Wernecke KD, Brähler E, Krampe H. Preoperative depression and hospital length of stay in surgical patients. Minerva Anestesiol 2014; 80:984-991. [PMID: 24280816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND The association of depression and hospital length of stay (LOS) has rarely been examined in surgical patients outside of cardiovascular surgery. This study investigates whether clinically significant preoperative depression shows an independent association with LOS in patients from various surgical fields after adjusting for age, gender and important somatic factors. METHODS A total of 2624 surgical patients were included in this prospective observational study. Data were collected before the preoperative anesthesiological examination within a computer-assisted psychosocial self-assessment including screening for depression (Center for Epidemiologic Studies Depression Scale, CES-D). Data on peri- and postoperative somatic parameters were obtained from the electronic patient management system of the hospital six months after the preoperative assessment. RESULTS LOS of patients with clinically significant depression (N.=296; median: 5 days, interquartile range: 3-8 days) was longer than LOS of patients without depression (N.=2328; median: 4 days, interquartile range: 2-6 days) (P<0.001). A multivariate logistic regression model with the binary dependent variable 'above versus below or equal to the median LOS' revealed that the significant association between depression and LOS persisted (OR: 1.822 [95% CI 1.360-2.441], P<0.001) when simultaneously including the covariates age, gender, ASA classification, Charlson Comorbidity Index, surgical field and POSSUM operative severity rating. CONCLUSION Data suggest that the association of depression and LOS is independent of the impact of age, gender, surgical field, preoperative physical health, severity of medical comorbidity and extent of surgical procedure. Integration of depression therapy into routine care of surgical patients might be an option to improve outcomes.
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Affiliation(s)
- L F Kerper
- Department of Anesthesiology and Intensive Care Medicine, Campus Charité Mitte and Campus Virchow-Klinikum, Charité - University Medicine Berlin, Germany -
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Pechmann C, Petermann F, Brähler E, Decker O, Schmidt S. [Resilience and psychological impairment in adulthood: the impact of age and social inequality]. Psychother Psychosom Med Psychol 2014; 64:354-63. [PMID: 24760411 DOI: 10.1055/s-0034-1368729] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
In a cross-sectional study the influence of social inequality on resilience and psychological distress was investigated in a sample of N=4 142 adults. A social stratum was created, including education, financial income and job-status, as well as age (≥ 25 years). Multivariate analysis of variance (MANOVA) showed influences of gender, social status and age on resilience (RS-11) and psychological distress: depression (PHQ-2), anxiety (GAD-7), life satisfaction (FLZ(M)). In contrast to the most continuous influence of the social background in women across any age-group, older males (≥ 65 years) were not affected by their social background. In both sexes members of the social underclass had the lowest resilience. The results indicate the need for specific intervention as to prevention.
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Affiliation(s)
- C Pechmann
- Zentrum für Klinische Psychologie und Rehabilitation, Universität Bremen
| | - F Petermann
- Zentrum für Klinische Psychologie und Rehabilitation, Universität Bremen
| | - E Brähler
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig
| | - O Decker
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig
| | - S Schmidt
- Fachbereich Wirtschaft und Medien, Psychology School, Hochschule Fresenius, Köln
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Köhler N, Friedrich M, Gansera L, Holze S, Thiel R, Roth S, Rebmann U, Stolzenburg JU, Truss MC, Fahlenkamp D, Scholz HJ, Brähler E. Psychological distress and adjustment to disease in patients before and after radical prostatectomy. Results of a prospective multi-centre study. Eur J Cancer Care (Engl) 2014; 23:795-802. [PMID: 24661440 DOI: 10.1111/ecc.12186] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2014] [Indexed: 11/29/2022]
Abstract
The aim of this prospective multi-centre study was to evaluate the level of psychological distress (PD) and adjustment to disease in patients who underwent radical prostatectomy. Furthermore, the impact of urinary incontinence and erectile dysfunction on PD was assessed. Anxiety, depression and PD were evaluated using the Hospital Anxiety and Depression Scale in 329 prostate cancer patients before surgery as well as 3, 6 and 12 months after surgery. These results were compared with those of a male German general population reference group. Adjustment to disease was assessed using the Perceived Adjustment to Chronic Illness Scale. Patients reported low levels of PD at all points of assessment similar to population norms of age-matched German men. Persistent PD was seen in about 8% of the patients and 20% had PD at least two of the measurement points. Relevant predictors for PD after surgery were urinary symptoms and baseline PD. Adjustment to disease was highest before surgery and had significantly reduced at 3 and 6 months after surgery. In general, men are resilient to the experience of localised prostate cancer and adjust well psychologically after surgery. However, between 8% and 20% of patients could possibly benefit from mental health support.
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Affiliation(s)
- N Köhler
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
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Ernst J, Brähler E, Weißflog G. [Patient involvement in medical decision making--an overview on patient preferences and impacting factors]. Gesundheitswesen 2014; 76:187-92. [PMID: 24408309 DOI: 10.1055/s-0033-1361150] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The involvement of patients in medical treatment decisions has been intensively discussed for several years. The present review article is concerned with the patient participation in medical decision making mainly in the field of oncology. Also discussed are methodological aspects of the measurement of patient involvement and the theoretical approach of shared decision -making. The preference to be involved in decisions is expressed from 16-50% of the patients and depends on socio-demographic and disease-related variables. Positive impact of patient participation is observed essentially as short-term effects and for psychosocial outcome criteria. Further research should consider the methodological aspects and focus on dyadic concepts and various dimensions of patient involvement. It is also important to focus on evaluation of the decision and on the possible (long time) effects in terms of recovery, progression of disease, psychosocial consequences and economic impact.
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Affiliation(s)
- J Ernst
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Psychosoziale Onkologie, Universität Leipzig, Leipzig
| | - E Brähler
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig, Leipzig
| | - G Weißflog
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Psychosoziale Onkologie, Universität Leipzig, Leipzig
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Beutel ME, Weißflog G, Leuteritz K, Wiltink J, Haselbacher A, Ruckes C, Kuhnt S, Barthel Y, Imruck BH, Zwerenz R, Brähler E. Efficacy of short-term psychodynamic psychotherapy (STPP) with depressed breast cancer patients: results of a randomized controlled multicenter trial. Ann Oncol 2013; 25:378-84. [PMID: 24347520 DOI: 10.1093/annonc/mdt526] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND There is a lack of trials of psychodynamic treatments of depression in breast cancer patients. The purpose of this trial was to determine the efficacy of short-term psychodynamic psychotherapy (STPP) in non-metastatic breast cancer patients diagnosed with depression, one of the most frequent mental comorbidities of breast cancer. PATIENTS AND METHODS In a multicenter prospective trial, 157 breast cancer patients with comorbid depression were randomized to either individual STPP (intervention group, N=78) or 'treatment as usual' (control group, TAU, N=79). As our primary outcome measure, we hypothesized a higher rate of remission defined as no diagnosis of depression (Structured Clinical Interview for DSM-IV) and reduction in depression score by at least 2 points (Hospital Anxiety and Depression Scale, HADS-D) in STPP versus TAU at treatment termination. Secondary outcomes mainly refer to quality of life (QoL). RESULTS In the intention to treat (ITT) analysis, 44% of the STPP group achieved highly significantly more remission than TAU (23%). STPP treatment (OR=7.64; P<0.001) was the strongest predictor for remission post-treatment; time was also significant (OR=0.96; P<0.05). A high effect favoring STPP (d=0.82) was observed for the HADS-D score post-treatment (secondary outcome). Regarding further secondary outcomes (QoL), analyses of covariance yielded main effects for group (favoring STPP with an effect size of at least d=0.5) for global QoL, role, emotional and social functioning, pain, treatment side-effects, breast symptoms and upset by hair loss. CONCLUSIONS STPP is an effective treatment of a broad range of depressive conditions in breast cancer patients improving depression and functional QoL. Findings are limited by the drop-out rate (∼1/3) and delayed post-treatment assessments. Future trials may consider stepped-care approaches, tailored to patients' needs and requirements in the acute treatment phase.
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Affiliation(s)
- M E Beutel
- Department for Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz
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Csöff RM, Brähler E, Lindert J. [Anxiety and depressive symptoms and exposition towards violence in the general older population (between 60 and 84 years) in Germany - results from a cross-sectional study]. Gesundheitswesen 2013; 76:e23-31. [PMID: 24142371 DOI: 10.1055/s-0033-1355407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Depression and anxiety are important public health challenges in the general older population in Germany. Exposition towards violence/abuse in old age has been widely neglected as a risk factor for anxiety and depression among the older population. METHODS The ABUEL study (“Abuse of the Elderly in Europe”) is a cross-sectional study of people between 60 and 84 years living in Stuttgart. Anxiety and depression are assessed with the “Hospital Anxiety and Depression Scale” (HADS). We assessed 1) socio-demographic variables and 2) exposition towards violence in the past 12 months as independent variables. RESULTS The results indicate that violence exposition in the past 12 months is a risk factor for anxiety (OR: 2.25, 95% CI: 1.32–3.84) and depression (OR: 2.27, 95% CI: 1.27–4.04) among the elderly population in Germany. Anxiety is associated with female gender (OR: 3.18, 95% CI: 1.62–6.25). Anxiety and depression are associated with times of unemployment in the life course. CONCLUSION Our data suggest that exposure to violence in old age should be assessed to allow targeted prevention and intervention programmes.
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Affiliation(s)
- R-M Csöff
- Abteilung für Public Health, Evangelische Hochschule Ludwigsburg, Ludwigsburg
| | - E Brähler
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig, Leipzig
| | - J Lindert
- Abteilung für Public Health, Evangelische Hochschule Ludwigsburg, Ludwigsburg
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Weißflog G, Ernst J, Szkoda A, Berger S, Stuhr C, Herschbach P, Book K, Brähler E. [Patient satisfaction in oncological aftercare--differential results of gender aspects in doctor-patient dyads]. Gesundheitswesen 2013; 76:306-11. [PMID: 24046159 DOI: 10.1055/s-0033-1347257] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The aim of this study was to explore the role of gender of the physician and gender of the patient in explaining differences in patient satisfaction. MATERIAL AND METHODS Overall, 1,130 patients were assigned to one of 4 possible physician-patient sex dyads and were interviewed with a questionnaire about their patient satisfaction. RESULTS Female patients in a dyad with a female physician were most satisfied with the overall judgment of practice visit and the inclusion of life situation in comparison to all other dyads. Male patients in a dyad with a male physician were least satisfied. CONCLUSION In the future, the specific role of patient-physician dyads has to be considered more in the assessment of subdimensions of patient satisfaction.
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Affiliation(s)
- G Weißflog
- Department für Psychische Gesundheit, Medizinische Psychologie & Medizinische Soziologie, Medizinische Fakultät Universität Leipzig
| | - J Ernst
- Department für Psychische Gesundheit, Medizinische Psychologie & Medizinische Soziologie, Medizinische Fakultät Universität Leipzig
| | - A Szkoda
- Department für Psychische Gesundheit, Medizinische Psychologie & Medizinische Soziologie, Medizinische Fakultät Universität Leipzig
| | - S Berger
- Department für Psychische Gesundheit, Medizinische Psychologie & Medizinische Soziologie, Medizinische Fakultät Universität Leipzig
| | - C Stuhr
- Onkologisches Zentrum, Klinik für Internistische Onkologie/Hämatologie, Klinikum St. Georg gGmbH, Akademisches Lehrkrankenhaus der Universität Leipzig
| | - P Herschbach
- Roman-Herzog-Krebszentrum (RHCCC), Comprehensive Cancer Center, Klinikum rechts der Isar, Technische Universität München
| | - K Book
- Roman-Herzog-Krebszentrum (RHCCC), Comprehensive Cancer Center, Klinikum rechts der Isar, Technische Universität München
| | - E Brähler
- Department für Psychische Gesundheit, Medizinische Psychologie & Medizinische Soziologie, Medizinische Fakultät Universität Leipzig
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Ebenhan K, Leuteritz K, Barthel Y, Beutel ME, Papsdorf K, Weissflog G, Brähler E. Children and Employment - Resource or Stressors after Breast Cancer? Geburtshilfe Frauenheilkd 2013; 73:792-799. [PMID: 24771933 PMCID: PMC3858982 DOI: 10.1055/s-0033-1350704] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2012] [Revised: 06/10/2013] [Accepted: 07/04/2013] [Indexed: 10/26/2022] Open
Abstract
Introduction: Breast cancer patients suffer clinically relevant levels of psychological stress because of their disease. Various factors can affect the level of stress experienced. This study aimed to investigate the relationship between the level of psychological stress and employment and children, including time since diagnosis. Material and Methods: A randomised clinical study was done of 724 breast cancer patients aged between 18 and 65 years; all were in the curative stage of disease and had been diagnosed 0-12 months previously. Patients were investigated for their levels of psychological stress (anxiety and depression) using the Hospital Anxiety and Depression Scale (HADS). The relationship between anxiety and depression and the variables "employment", "parenthood" and "time since diagnosis" were investigated, using univariate and multivariate analysis. Results: Patients with a longer time since diagnosis (4-12 months) were found to have lower levels of anxiety (6.28) compared to patients who had been diagnosed only 0-3 months previously (7.24; p < 0.01). There was no unambiguous relation between parenthood and anxiety. The age of the children was crucial. Even when results were controlled for patient age, the anxiety levels of women with children below the age of 16 years were significantly higher (7.84) compared to patients without children (6.42) or patients whose children were older than 16 years (6.87; p = 0.04). Women who were not employed had significantly higher levels of depression compared to all other participants in the study (p = 0.02). No reciprocal effects were found between investigated variables. Conclusion: We found a differentiated relationship between the variables "time since diagnosis", "employment" and "children" and the level of psychological stress experienced by breast cancer patients. When determining the level of psychological stress in the 1st year after diagnosis, particular attention should be paid to patients who are not employed and patients with children below the age of 16 years.
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Affiliation(s)
- K Ebenhan
- Department für Psychische Gesundheit, Abteilung für Medizinische Psychologie und Medizinische Soziologie , Universitätsklinikum Leipzig AöR, Leipzig
| | - K Leuteritz
- Department für Psychische Gesundheit, Abteilung für Medizinische Psychologie und Medizinische Soziologie , Universitätsklinikum Leipzig AöR, Leipzig
| | - Y Barthel
- Department für Psychische Gesundheit, Abteilung für Medizinische Psychologie und Medizinische Soziologie , Universitätsklinikum Leipzig AöR, Leipzig
| | - M E Beutel
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Klinik und Poliklinik für Psychosomatische Medizin , und Psychotherapie, Mainz
| | - K Papsdorf
- Universitätsklinikum Leipzig AöR, Klinik und Poliklinik für Strahlentherapie und Radioonkologie, Leipzig
| | - G Weissflog
- Department für Psychische Gesundheit, Abteilung für Medizinische Psychologie und Medizinische Soziologie , Universitätsklinikum Leipzig AöR, Leipzig
| | - E Brähler
- Department für Psychische Gesundheit, Abteilung für Medizinische Psychologie und Medizinische Soziologie , Universitätsklinikum Leipzig AöR, Leipzig
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Gumz A, Brähler E, Heilmann VK, Erices R. [Burnout, work disruptions, interpersonal and psychosomatic problems--degree-specific comparison of students at a German university]. Gesundheitswesen 2013; 76:147-50. [PMID: 23780858 DOI: 10.1055/s-0033-1347218] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
In the context of the public debate on psychological strain among students, the prevalence of burnout, procrastination, test anxiety, other work disruptions, interpersonal problems and psychic symptoms were analyzed depending on academic degree. The data of 358 college students (of Leipzig University) were examined. The academic degree had only a marginal effect on burnout- and work disruptions-related variables. In terms of interpersonal problems and psychic symptoms, differences between students were identified, depending on the academic degree. Diploma students reported many complaints, whereas undergraduates aspiring for a State Examination, were comparatively less affected. Knowledge of the population-specific psychological load is useful in order to develop preventive and therapeutic measures.
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Affiliation(s)
- A Gumz
- Institut und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Hamburg-Eppendorf
| | - E Brähler
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig, Leipzig
| | - V K Heilmann
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig, Leipzig
| | - R Erices
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Institut für Geschichte und Ethik der Medizin, Erlangen
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Ernst J, Berger S, Weißflog G, Schröder C, Körner A, Niederwieser D, Brähler E, Singer S. Patient participation in the medical decision-making process in haemato-oncology--a qualitative study. Eur J Cancer Care (Engl) 2013; 22:684-90. [PMID: 23731258 DOI: 10.1111/ecc.12077] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2013] [Indexed: 10/26/2022]
Abstract
Cancer patients are showing increased interest in shared decision-making. Patients with haematological illnesses, however, express considerably less desire for shared decision-making as compared with other oncological patient groups. The goal of the current project was to identify the reasons for the lower desire for shared decision-making among patients with haematological illness. We conducted qualitative, semi-structured interviews with 11 haematological patients (39-70 years old) after the beginning of therapy concerning the course and evaluation of medical shared decision-making. The patients were often overwhelmed by the complexity of the illness and the therapy and did not want to assume any responsibility in medical decision-making. They reported a great deal of distress and very traditional paternalistic role expectations with regards to their health care providers, which limited the patients' ability to partake in the decision-making process. In contrast to the socio-cultural support for many other oncological diseases, haematological diseases are not as well supported, e.g. there is a lack of self-help materials, systematic provision of information and support groups for patients, which may be related to a lower empowerment of this patient population. Results show the limits of patient participation in the context of highly complicated medical conditions. In addition to already researched preferences of the physicians and patients for shared decision-making, future research should pay greater attention to the process and other variables relevant to this aspect of the doctor-patient relationship.
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Affiliation(s)
- J Ernst
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany.
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Spangenberg L, Glaesmer H, Brähler E, Strauß B. [Use of family resources in future need of care. Care preferences and expected willingness of providing care among relatives: a population-based study]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2013; 55:954-60. [PMID: 22842889 DOI: 10.1007/s00103-012-1512-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The family is an important resource in elderly care. It is of great interest if persons who might be in need of care in the future would use this resource. Our study assessed wishes and expectations regarding family care in a representative sample of the general population (≥ 45 years, N = 1,445) using questionnaires. Logistic regressions were performed to analyze the potential impact on the willingness to use or provide family care. One quarter of the participants reported experience in family care. In case of own need 62.9% of participants would prefer care provided by relatives and 56.7% would prefer professional care. Participants are more likely to use family care if they report having relatives, are experienced in care of relatives or do not associate old age with being a burden, e.g. report low values in the image of age "being a burden/demanding". Perceived willingness of the relatives to provide care is more likely if there is little regional distance to the relatives, in male participants and if participants talked about future care with their relatives. Besides structural factors, negative images of old age might have a negative influence on the willingness to use family care. Talking about care in old age seems to have a positive impact.
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Affiliation(s)
- L Spangenberg
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Deutschland.
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Geue K, Richter R, Buttstädt M, Brähler E, Singer S. An art therapy intervention for cancer patients in the ambulant aftercare - results from a non-randomised controlled study. Eur J Cancer Care (Engl) 2013; 22:345-52. [DOI: 10.1111/ecc.12037] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2012] [Indexed: 11/26/2022]
Affiliation(s)
- K. Geue
- Department of Medical Psychology and Medical Sociology; University of Leipzig; Leipzig
| | - R. Richter
- Institute for Clinical Psychology and Psychotherapy; Technical University Dresden; Dresden
| | - M. Buttstädt
- Department of Medical Psychology and Medical Sociology; University of Leipzig; Leipzig
| | - E. Brähler
- Department of Medical Psychology and Medical Sociology; University of Leipzig; Leipzig
| | - S. Singer
- Department of Epidemiology; University of Mainz; Mainz; Germany
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Engelberg PM, Singer S, Bhaskaran K, Brähler E, Glaesmer H. Validation of the Scale for the Assessment of Illness Behavior (SAIB) in a community sample of elderly people. Arch Gerontol Geriatr 2013; 56:175-80. [PMID: 22878062 DOI: 10.1016/j.archger.2012.07.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Revised: 07/08/2012] [Accepted: 07/14/2012] [Indexed: 11/24/2022]
Abstract
The aim of this study was to evaluate the construct validity of the SAIB in a community sample of elderly people. The SAIB was administered to a large community sample representative of the German population aged 60-85 years (n=1593). The original model was assessed and then refined through confirmatory and exploratory factor analyses. Criterion validity was evaluated by comparing SAIB scores with external criteria in 3 categories: subjective health, chronic illness and health care utilization. The originally suggested five factor structure of the SAIB yielded a comparative fit index (CFI) of 0.70 and the weighted root mean square residual (WRMR) was 3.68. A shortened questionnaire with 13 items and four factors resulted in better model fit (CFI 0.97 and WRMR 1.3). Correlations between subjective health and the new scales ranged from 0.06 to 0.33. Effect sizes (Cohens d) of mean differences in factor scores between those with and without healthcare system contact varied by healthcare type, ranging from 0.05 to 0.94; effect sizes were largest in relation to contact with psychotherapy and alternative medicine practitioners. We propose a shortened version of the SAIB with a different scale structure, which resulted in better model fit with our data. Neither the original nor revised SAIB appeared to discriminate well in terms of health care use, suggesting that the illness behavior as currently conceptualized may not fully explain the increased use of healthcare in the elderly.
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Affiliation(s)
- P M Engelberg
- Department of Methods and Psychodiagnostics, University of Wuppertal, Germany.
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Hinz A, Brähler E, Möde R, Wirtz H, Bosse-Henck A. Anxiety and depression in sarcoidosis: the influence of age, gender, affected organs, concomitant diseases and dyspnea. Sarcoidosis Vasc Diffuse Lung Dis 2012; 29:139-146. [PMID: 23461077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Heightened degrees of anxiety and depression are often found in patients suffering from sarcoidosis, but the reasons for that are unclear. Furthermore, age and gender differences of anxiety and depression in sarcoidosis have not been reported with reference to normative data. OBJECTIVES The aim was to test age and gender differences of anxiety and depression in a large sample, and to examine the influence of affected organs, concomitant diseases and dyspnea. METHODS 1197 German patients diagnosed with sarcoidosis were examined, using the Hospital Anxiety and Depression Scale (HADS) and the MRC dyspnea scale. RESULTS Patients suffering from sarcoidosis were significantly more anxious and depressed than the general population. This effect was especially strong in young age groups. The number of affected organs, the number of concomitant diseases and the degree of dyspnea significantly predicted anxiety and depression scores in univariate analyses. Among the affected organs, muscles, nerves, and bones most significantly contributed to depression. Sleep apnea, restless legs syndrome, and arterial hypertension were associated with anxiety as well as depression. In multivariate analyses including age and gender, however, only dyspnea and the number of concomitant diseases remained predictors of anxiety and depression scores. CONCLUSIONS The analysis of mental distress should take into account comparisons with normative values. Young patients deserve special social support. Dyspnea proved to be an important symptom in the prediction of anxiety and depression.
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Affiliation(s)
- A Hinz
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany.
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Götze H, Perner A, Gansera L, Brähler E. ["One cannot just look at the clock" - interviews with family doctors on ambulatory palliative care of tumour patients]. Gesundheitswesen 2012; 75:351-5. [PMID: 22886338 DOI: 10.1055/s-0032-1321753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
GOAL OF THE STUDY In the study "possibilities and limits of ambulatory palliative care" there was a survey with family doctors about their own subjective views of ambulatory palliative care. The different parameters of home care, the role of caring relatives as well as burdening and supporting factors for family doctors occupied the focus in these interviews. METHODS With the help of the results from 9 qualitative interviews, a questionnaire was compiled and sent by post to all family doctors within 50 km (N=427). For analysis questionnaires were available from N=89 family doctors. Statements about various areas of outpatient palliative work were collected with Likert scales and open questions. RESULTS The personal overloads of the care-giving relatives, the inadequate payment and their own time pressures for the family doctors were the main obstacles in home care of palliative patients. On the other hand the family doctors considered as supporting factors for an ambulatory care: a good pain and symptom management, a high satisfaction of the patients and a good teamwork between the caring service and other people taking part in the care. CONCLUSION In order to minimise the time overload of family doctors and to focus the psycho-social distress of the caring relatives the expansion of non-medical offers should be supported, e. g., ambulatory hospice services and consultative forms of care by psychologists and religious personnel.
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Affiliation(s)
- H Götze
- Department für Psychische Gesundheit, Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig.
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Sikorski C, Luppa M, Brähler E, König HH, Riedel-Heller SG. Obese children, adults and senior citizens in the eyes of the general public: Results of a representative study. Gesundheitswesen 2012. [DOI: 10.1055/s-0032-1322100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Abstract
The amendment of legal care consultations in the context of the long-term care insurance law (2008) has broadened recent consulting practice within the action range of the nursing care insurance in Germany. The informational needs and consulting requests of the clients were not investigated so far. Our aim was to examine information needs and consulting requests of those in need of care and their informal carers.The consulting requests of visitors of 2 open citizen events were documented by the use of a semi-structured questionnaire. Content analysis following Mayring (2008) was used for data analysis.158 consulting discussions were documented, from which 177 consulting requests were formed. The consulting requests can be divided in 4 main categories: (1) inquiry about the care system [56/32%], (2) inquiry about individual access to care offers [43/24%], (3) inquiry about regional care suppliers [43/24%], (4) situation- and disease-specific inquiries [35/20%].Inquiries about local suppliers of care and situation- and disease-specific inquiries outweigh the number of inquiries about the care system in general. Furthermore, our results show that the informational needs of those in need of care do not only refer to the scope of care insurance law, but to additional social security codes.
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Affiliation(s)
- W Nickel
- Department für Psychische Gesundheit, Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig.
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Stöbel-Richter Y, Brähler E, Zenger M. Arbeitslosigkeit, psychische Belastung und körperliche Beschwerden – Ergebnisse einer Repräsentativerhebung. Gesundheitswesen 2011. [DOI: 10.1055/s-0031-1283650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Stöbel-Richter Y, Zenger M, Brähler E, Berth H. In welchem Kontext stehen Arbeitslosigkeit und Familiengründung? Gesundheitswesen 2011. [DOI: 10.1055/s-0031-1283651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Sikorski C, Riedel C, Kaiser M, Pantenburg B, Glaesmer H, Schomerus G, Brähler E, Riedel-Heller SG. Attitudes towards and Perception of Overweight and Obesity in the Public Opinion: a systematic review. Gesundheitswesen 2011. [DOI: 10.1055/s-0031-1283632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Hiemisch A, Kiess W, Brähler E. Psychische Arbeitsbelastung an einer Universitätskinderklinik – Ergebnisse einer Umfrage zum Belastungserleben und der resultierenden Mitarbeitergesundheit. Klin Padiatr 2011; 223:236-41. [DOI: 10.1055/s-0031-1271812] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Norra C, Böcker M, Wirtz M, Glaesmer H, Brähler E, Gauggel S, Forkmann T. The new rasch-based depression screening (DESC): Evaluation and validation in different patient groups and a large German population sample. Eur Psychiatry 2011. [DOI: 10.1016/s0924-9338(11)72371-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
IntroductionComorbid depression in somatic illness is highly prevalent. However, most depression questionnaires show violation of unidimensionality and hypersensitivity of items.ObjectivesThe Depression Screening (DESC) is a new self-rating scale for the measurement of depression severity that we developed from a calibrated Rasch-homogeneous item bank (N = 367) to improve short depression assessment in patients beyond psychiatric settings.AimTo present data for both parallel forms (10 questions each) of the DESC, and to examine its Rasch model qualities in different patient groups and a representative German general population sample.MethodsPatient groups with depression, heart disease, neurological or otolaryngological disease (N = 333) were investigated with the DESC accompanied by diagnostic interviews and established depression scales. The demographic sample (N = 2509) was interviewed face to face, too. Adherence to Rasch model assumptions was determined with analysis of model fit, and further measures. Norm values were calculated.ResultsBoth DESC versions feature different but highly correlated item sets. Cut-off scores with good sensitivity (0.82, 0.81) and specificity (0.78, 0.77) for the diagnosis of an affective disorder were developed with ROC analyses. No serious Differential Item Functioning in Rasch analyses for both scales was found. In the German validation sample the Rasch dimension “depression” explained 68.5% and 69.3% respectively of the variance. Validity was determined through sufficient intercorrelations with other scales (e.g. BDI, HADS).ConclusionsOur studies support the good psychometric RASCH qualities of both DESC forms and offer important advancements in depression screening being of use for time-limited clinical and research applications.
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Wiltink J, Gläsmer H, Canterino M, Wölfling K, Knebel A, Kessler H, Brähler E, Beutel ME. Emotionsregulation in der Allgemeinbevölkerung - Bevölkerungskennwerte des Emotion Regulation Questionnaire (ERQ). Psychother Psych Med 2011. [DOI: 10.1055/s-0031-1272451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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