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Schneider G, Stumpf A, Burgmer M, Broecker P, Volmering L, Ständer S. Are patients with chronic pruritus more susceptible to social stress than healthy controls? An experimental case-control study. Br J Dermatol 2018; 179:1174-1176. [DOI: 10.1111/bjd.16735] [Citation(s) in RCA: 7] [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] [Indexed: 11/26/2022]
Affiliation(s)
- G. Schneider
- Department of Psychosomatics and Psychotherapy; University Hospital Münster, Münster; Germany
- Center for Chronic Pruritus; University Hospital Münster, Münster; Germany
| | - A. Stumpf
- Department of Psychosomatics and Psychotherapy; University Hospital Münster, Münster; Germany
| | - M. Burgmer
- Department of Psychosomatics and Psychotherapy; University Hospital Münster, Münster; Germany
| | - P. Broecker
- Department of Dermatology and Venereology; University Hospital Münster, Münster; Germany
| | - L. Volmering
- Department of Psychosomatics and Psychotherapy; University Hospital Münster, Münster; Germany
| | - S. Ständer
- Center for Chronic Pruritus; University Hospital Münster, Münster; Germany
- Department of Dermatology and Venereology; University Hospital Münster, Münster; Germany
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Schneider G, Stumpf A, Burgmer M, Volmering L, Broecker P, Ständer S. Relations between a standardized experimental stressor and cutaneous sensory function in patients with chronic pruritus and healthy controls: an experimental case-control study. J Eur Acad Dermatol Venereol 2018; 32:2230-2236. [PMID: 29706009 PMCID: PMC6585676 DOI: 10.1111/jdv.15030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 03/28/2018] [Indexed: 11/28/2022]
Abstract
Background While chronic pruritus (CP) is a frequent symptom, many aspects of its underlying pathophysiological mechanisms still need elucidation. Research on sensory cutaneous function and on the influence of stress has been conducted mainly in patients with atopic dermatitis but is lacking for patients with CP. Objective To assess whether a standardized social stressor influences cutaneous sensory function in patients with CP in comparison with healthy controls (HC). Methods Case–control study; 33 CP and 30 HC were submitted to the standardized quantitative sensory testing protocol before and after the Trier Social Stress Test and 1 h later. Intraepidermal nerve fibre density (IENFD) was determined. Results Mechanical pain sensitivity and mechanical detection thresholds were significantly higher in CP than in HC, and mechanical detection thresholds increased more in CP than in HC over the three measurements. In both groups, cold pain threshold increased and heat pain threshold decreased from before to after the stress test and remained constant 1 h later. Only in CP, almost all QST tests induced at least a small amount of pruritus, which was not significantly altered by the stress test. IENFD in pruritic skin was significantly reduced in CP when compared to healthy controls. Conclusion Peripheral thermal sensory function was not altered in CP despite reduced IENFD in lesional skin, but we could demonstrate central sensitization processes specifically in CP and influences of an acute stressor inducing more sensitivity to thermal pain in both groups.
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Affiliation(s)
- G Schneider
- Department of Psychosomatics and Psychotherapy, University Hospital Münster, Münster, Germany.,Center for Chronic Pruritus, University Hospital Münster, Münster, Germany
| | - A Stumpf
- Department of Psychosomatics and Psychotherapy, University Hospital Münster, Münster, Germany
| | - M Burgmer
- Department of Psychosomatics and Psychotherapy, University Hospital Münster, Münster, Germany
| | - L Volmering
- Department of Psychosomatics and Psychotherapy, University Hospital Münster, Münster, Germany
| | - P Broecker
- Department of Dermatology, University Hospital Münster, Münster, Germany
| | - S Ständer
- Center for Chronic Pruritus, University Hospital Münster, Münster, Germany.,Department of Dermatology, University Hospital Münster, Münster, Germany
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Eich W, Bär KJ, Bernateck M, Burgmer M, Dexl C, Petzke F, Sommer C, Winkelmann A, Häuser W. [Erratum to: Definition, classification, clinical diagnosis and prognosis of fibromyalgia syndrome : Updated guidelines 2017 and overview of systematic review articles]. Schmerz 2017; 31:620. [PMID: 28884194 DOI: 10.1007/s00482-017-0244-8] [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: 11/27/2022]
Affiliation(s)
- W Eich
- Abteilung Innere Medizin II (Allgemeine Innere Medizin und Psychosomatik), Universitätsklinikum Heidelberg, Im Neuenheimer Feld 410, 69210, Heidelberg, Deutschland.
| | - K-J Bär
- Klinik für Psychiatrie und Psychotherapie, Friedrich-Schiller-Universität Jena, Jena, Deutschland
| | - M Bernateck
- Zentrum für Schmerzmedizin Hannover, Hannover, Deutschland
| | - M Burgmer
- Klinik für Psychosomatik und Psychotherapie, Universitätsklinikum Münster, Münster, Deutschland
| | - C Dexl
- Deutsche Fibromyalgie Vereinigung, Seckach, Deutschland
| | - F Petzke
- Schmerzmedizin, Klinik für Anästhesiologie, Universitätsmedizin Göttingen, Göttingen, Deutschland
| | - C Sommer
- Neurologische Klinik, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - A Winkelmann
- Klinik und Poliklinik für Orthopädie, Physikalische Medizin und Rehabilitation, Klinikum der Universität München, München, Deutschland
| | - W Häuser
- Innere Medizin I, Klinikum Saarbrücken gGmbH, Saarbrücken, Deutschland
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Technische Universität München, München, Deutschland
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Eich W, Bär KJ, Bernateck M, Burgmer M, Dexl C, Petzke F, Sommer C, Winkelmann A, Häuser W. Definition, Klassifikation, klinische Diagnose und Prognose des Fibromyalgiesyndroms. Schmerz 2017; 31:231-238. [DOI: 10.1007/s00482-017-0200-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Egger N, Wild B, Zipfel S, Junne F, Konnopka A, Schmidt U, de Zwaan M, Herpertz S, Zeeck A, Löwe B, von Wietersheim J, Tagay S, Burgmer M, Dinkel A, Herzog W, König HH. Cost-effectiveness of focal psychodynamic therapy and enhanced cognitive-behavioural therapy in out-patients with anorexia nervosa. Psychol Med 2016; 46:3291-3301. [PMID: 27609525 DOI: 10.1017/s0033291716002002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Anorexia nervosa (AN) is a serious illness leading to substantial morbidity and mortality. The treatment of AN very often is protracted; repeated hospitalizations and lost productivity generate substantial economic costs in the health care system. Therefore, this study aimed to determine the differential cost-effectiveness of out-patient focal psychodynamic psychotherapy (FPT), enhanced cognitive-behavioural therapy (CBT-E), and optimized treatment as usual (TAU-O) in the treatment of adult women with AN. METHOD The analysis was conducted alongside the randomized controlled Anorexia Nervosa Treatment of OutPatients (ANTOP) study. Cost-effectiveness was determined using direct costs per recovery at 22 months post-randomization (n = 156). Unadjusted incremental cost-effectiveness ratios (ICERs) were calculated. To derive cost-effectiveness acceptability curves (CEACs) adjusted net-benefit regressions were applied assuming different values for the maximum willingness to pay (WTP) per additional recovery. Cost-utility and assumptions underlying the base case were investigated in exploratory analyses. RESULTS Costs of in-patient treatment and the percentage of patients who required in-patient treatment were considerably lower in both intervention groups. The unadjusted ICERs indicated FPT and CBT-E to be dominant compared with TAU-O. Moreover, FPT was dominant compared with CBT-E. CEACs showed that the probability for cost-effectiveness of FTP compared with TAU-O and CBT-E was ⩾95% if the WTP per recovery was ⩾€9825 and ⩾€24 550, respectively. Comparing CBT-E with TAU-O, the probability of being cost-effective remained <90% for all WTPs. The exploratory analyses showed similar but less pronounced trends. CONCLUSIONS Depending on the WTP, FPT proved cost-effective in the treatment of adult AN.
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Affiliation(s)
- N Egger
- Department of Health Economics and Health Services Research,Hamburg Center for Health Economics (HCHE), University Medical Center Hamburg-Eppendorf,Hamburg,Germany
| | - B Wild
- Department of General Internal Medicine and Psychosomatics,Heidelberg University Hospital,Heidelberg,Germany
| | - S Zipfel
- Department of Psychosomatic Medicine and Psychotherapy,University Hospital Tübingen,Tübingen,Germany
| | - F Junne
- Department of Psychosomatic Medicine and Psychotherapy,University Hospital Tübingen,Tübingen,Germany
| | - A Konnopka
- Department of Health Economics and Health Services Research,Hamburg Center for Health Economics (HCHE), University Medical Center Hamburg-Eppendorf,Hamburg,Germany
| | - U Schmidt
- Section of Eating Disorders,Department of Psychological Medicine,King's College London,London,UK
| | - M de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy,Hannover Medical School,Hannover,Germany
| | - S Herpertz
- Department of Psychosomatic Medicine and Psychotherapy,LWL-University Clinic Bochum, Ruhr-University Bochum,Bochum,Germany
| | - A Zeeck
- Department of Psychosomatic Medicine and Psychotherapy,University Hospital Freiburg,Freiburg,Germany
| | - B Löwe
- Department of Psychosomatic Medicine and Psychotherapy,University Medical Center Hamburg-Eppendorf, and Schön Klinik Hamburg-Eilbek,Hamburg,Germany
| | - J von Wietersheim
- Department of Psychosomatic Medicine and Psychotherapy,University Hospital of Ulm,Ulm,Germany
| | - S Tagay
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR Hospital Essen, University of Duisburg-Essen,Essen,Germany
| | - M Burgmer
- Department of Psychosomatics and Psychotherapy,University Hospital Münster,Münster,Germany
| | - A Dinkel
- Department of Psychosomatic Medicine and Psychotherapy,Klinikum rechts der Isar, Technische Universität München,Munich,Germany
| | - W Herzog
- Department of General Internal Medicine and Psychosomatics,Heidelberg University Hospital,Heidelberg,Germany
| | - H-H König
- Department of Health Economics and Health Services Research,Hamburg Center for Health Economics (HCHE), University Medical Center Hamburg-Eppendorf,Hamburg,Germany
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Zeeck A, Hartmann A, Wild B, De Zwaan M, Herpertz S, Burgmer M, von Wietersheim J, Resmark G, Friederich HC, Tagay S, Dinkel A, Loewe B, Teufel M, Orlinsky D, Herzog W, Zipfel S. How do patients with anorexia nervosa "process" psychotherapy between sessions? A comparison of cognitive-behavioral and psychodynamic interventions. Psychother Res 2016; 28:873-886. [PMID: 27808005 DOI: 10.1080/10503307.2016.1252866] [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] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE Patients' processing of psychotherapy between sessions ("inter-session process" (ISP)) has been repeatedly shown to be related to outcome. The aim of this study was to compare ISP characteristics of cognitive-behavioral vs. psychodynamic psychotherapy in the treatment of anorexia nervosa (AN) and their relation to outcome. METHODS Data of 106 patients participating in a randomized-controlled trial who received either 40 sessions of enhanced cognitive-behavioral therapy (CBT-E) or focal psychodynamic therapy (FPT) were analyzed. The ISP was measured with the Inter-session Experience Questionnaire (IEQ). Three outcome classes were distinguished: full recovery, partial recovery, and still fulfilling all AN criteria. RESULTS Patients receiving CBT-E reported more on "applying therapy" in the initial and the final treatment phase compared to FPT patients. In terms of process-outcome relations, higher levels of "recreating the therapeutic dialogue between sessions," "recreating the therapeutic dialogue with negative emotions" as well as "applying therapy with negative emotions" in the final phase of treatment predicted negative outcome in FPT, whereas overall higher levels of negative emotions predicted negative outcome in CBT-E. CONCLUSIONS In outpatient treatment in AN, the processing of therapy as measured by the IEQ showed surprisingly few differences between CBT-E and FPT. However, different ISP patterns were predictive of outcome, pointing to different mechanisms of change.
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Affiliation(s)
- A Zeeck
- a Department of Psychosomatic Medicine and Psychotherapy , University Medical Center Freiburg , Freiburg , Germany
| | - A Hartmann
- a Department of Psychosomatic Medicine and Psychotherapy , University Medical Center Freiburg , Freiburg , Germany
| | - B Wild
- b Center for Psychosocial Medicine, Department of General Internal Medicine and Psychosomatics , Heidelberg University Hospital , Heidelberg , Germany
| | - M De Zwaan
- c Department of Psychosomatic Medicine and Psychotherapy , University Medical Center Hannover , Hannover , Germany
| | - S Herpertz
- d Department of Psychosomatic Medicine and Psychotherapy , LWL-University Medical Center of the Ruhr-University Bochum , Bochum , Germany
| | - M Burgmer
- e Department of Psychosomatic Medicine and Psychotherapy , University Medical Center Münster , Münster , Germany
| | - J von Wietersheim
- f Department of Psychosomatic Medicine and Psychotherapy , University Medical Center Ulm , Ulm , Germany
| | - G Resmark
- g Department of Psychosomatic Medicine and Psychotherapy , University Medical Center Tübingen , Tübingen , Germany
| | - H-C Friederich
- h Department of Psychosomatic Medicine and Psychotherapy , University Medical Center Düsseldorf , Düsseldorf , Germany
| | - S Tagay
- i Department of Psychosomatic Medicine and Psychotherapy , University Duisburg-Essen , Duisburg , Germany
| | - A Dinkel
- j Department of Psychosomatic Medicine and Psychotherapy , University of Technology München , München , Germany
| | - B Loewe
- k Institute and Outpatient Clinic for Psychosomatic Medicine and Psychotherapy , University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - M Teufel
- g Department of Psychosomatic Medicine and Psychotherapy , University Medical Center Tübingen , Tübingen , Germany
| | - D Orlinsky
- l Department of Comparative Human Development , University of Chicago , Chicago , IL , USA
| | - W Herzog
- b Center for Psychosocial Medicine, Department of General Internal Medicine and Psychosomatics , Heidelberg University Hospital , Heidelberg , Germany
| | - S Zipfel
- g Department of Psychosomatic Medicine and Psychotherapy , University Medical Center Tübingen , Tübingen , Germany
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- a Department of Psychosomatic Medicine and Psychotherapy , University Medical Center Freiburg , Freiburg , Germany
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Sundermann B, Burgmer M, Pogatzki-Zahn E, Gaubitz M, Stüber C, Wessoleck E, Heuft G, Pfleiderer B. Funktionelle Konnektivität schmerzrelevanter Hirnregionen bei Patienten mit rheumatoider Arthritis – ein möglicher Biomarker? KLIN NEUROPHYSIOL 2013. [DOI: 10.1055/s-0033-1337295] [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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Burgmer M, Pfleiderer B, Maihöfner C, Gaubitz M, Wessolleck E, Heuft G, Pogatzki-Zahn E. Cerebral mechanisms of experimental hyperalgesia in fibromyalgia. Eur J Pain 2011; 16:636-47. [DOI: 10.1002/j.1532-2149.2011.00058.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2011] [Indexed: 01/07/2023]
Affiliation(s)
- M. Burgmer
- Department of Psychosomatics and Psychotherapy; University Hospital Münster; Münster; Germany
| | - B. Pfleiderer
- Department of Clinical Radiology; University Hospital Münster; Münster; Germany
| | - C. Maihöfner
- Department of Neurology; University Hospital Erlangen; Erlangen; Germany
| | - M. Gaubitz
- Interdisciplinary Diagnostics and Therapy; University Hospital Münster; Münster; Germany
| | - E. Wessolleck
- Clinic for Laryngology, Rhinology and Otology; Hannover Medical School; Hannover; Germany
| | - G. Heuft
- Department of Psychosomatics and Psychotherapy; University Hospital Münster; Münster; Germany
| | - E. Pogatzki-Zahn
- Department of Anesthesiology and Intensive Care; University Hospital Münster; Münster; Germany
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Burgmer M, Gaubitz M, Konrad C, Wrenger M, Hilgart S, Heuft G, Pfleiderer B. Volumetrische Differenz der grauen Hirnsubstanz des cingulo-frontalen Kortex und der Amygdala bei Patienten mit Fibromyalgia- Eine Grundbedingung für die zentrale Schmerzaugmentierung? Psychother Psychosom Med Psychol 2008. [DOI: 10.1055/s-2008-1061550] [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: 10/21/2022]
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Burgmer M, Pogatzki-Zahn E, Gaubitz M, Heuft G, Pfleiderer B. Atypische Aktivierungen des zentralen Schmerzsystems bei Patienten mit Fibromyalgia in Erwartung eines Schmerzreizes. Psychother Psychosom Med Psychol 2008. [DOI: 10.1055/s-2008-1061548] [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: 10/21/2022]
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Wrenger M, Lange C, Langer M, Heuft G, Burgmer M. Der Einfluss der prämorbiden psychischen Verfassung auf die Entwicklung einer Posttraumatischen Belastungsstörung oder anderer psychischer Störungen nach einem Unfall. Psychother Psychosom Med Psychol 2007. [DOI: 10.1055/s-2007-970730] [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: 10/21/2022]
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Wrenger M, Lange C, Langer M, Heuft G, Burgmer M. Prädiktoren für den Erfolg der beruflichen Reintegration nach unfallbedingten Traumata. Psychother Psych Med 2007. [DOI: 10.1055/s-2007-970731] [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: 10/21/2022]
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Burgmer M, Pogatzki-Zahn E, Gaubitz M, Heuft G, Pfleiderer B. Atypische Deaktivierung der Amygdalae bei Patienten mit Fibromyalgie während experimenteller Schmerzreizung. Psychother Psychosom Med Psychol 2007. [DOI: 10.1055/s-2007-970631] [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: 10/21/2022]
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Burgmer M, Konrad C, Jansen A, Kugel H, Heuft G, Knecht S. Atypische Hirnaktivität bei Beobachtung von Bewegung bei Patienten mit dissoziativer Bewegungsstörung. Psychother Psych Med 2006. [DOI: 10.1055/s-2006-934237] [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: 10/23/2022]
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Braunheim M, Lange C, Burgmer M, Langer M, Raschke MJ, Heuft G. PTSD-Prävalenz nach Unfällen in Abhängigkeit vom Erhebungszeitpunkt des Traumakriteriums (Kriterium A). Psychother Psychosom Med Psychol 2004. [DOI: 10.1055/s-2004-822474] [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: 10/18/2022]
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Lange C, Burgmer M, Braunheim M, Langer M, Raschke MJ, Heuft G. Prädiktoren für die Entwicklung einer posttraumatischen Belastungsstörung. Psychother Psychosom Med Psychol 2004. [DOI: 10.1055/s-2004-819831] [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: 10/18/2022]
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Burgmer M, Lange C, Braunheim M, Langer M, Raschke MJ, Heuft G. Häufigkeit und Prädiktoren für die Entwicklung von posttraumatischen, depressiven oder ängstlichen Symptomen in den ersten Tagen nach einem Unfall. Psychother Psychosom Med Psychol 2004. [DOI: 10.1055/s-2004-819780] [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: 10/18/2022]
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Gerken J, Burgmer M, Lange C, Braunheim M, Langer M, Raschke MJ, Heuft G. Validität der revidierten Fassung der Impact of Event-Skala (IES-R) an einem Kollektiv von Unfallverletzten. Psychother Psychosom Med Psychol 2004. [DOI: 10.1055/s-2004-819795] [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: 10/18/2022]
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Lange C, Seidel E, Burgmer M, Wetz HH, Heuft G. Der Einfluss psychosozialer Faktoren auf die Prothesenakzeptanz und den Rehabilitationsverlauf nach einer Amputation. Psychother Psychosom Med Psychol 2004. [DOI: 10.1055/s-2004-822525] [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: 10/18/2022]
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Burgmer M, Lange C, Braunheim M, Langer M, Raschke MJ, Heuft G. Häufigkeit und Prädiktoren für die Entwicklung von posttraumatischen, depressiven oder ängstlichen Symptomen in den ersten Tagen nach einem Unfall. Psychother Psychosom Med Psychol 2004. [DOI: 10.1055/s-2004-822475] [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: 10/18/2022]
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Lange C, Seidel E, Burgmer M, Wetz HH, Heuft G. Der Einfluss psychosozialer Faktoren auf die Prothesenakzeptanz und den Rehabilitationsverlauf nach einer Amputation. Psychother Psychosom Med Psychol 2004. [DOI: 10.1055/s-2004-819830] [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: 10/18/2022]
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Braunheim M, Lange C, Burgmer M, Langer M, Raschke MJ, Heuft G. PTSD-Prävalenz nach Unfällen in Abhängigkeit vom Erhebungszeitpunkt des Traumakriteriums (Kriterium A). Psychother Psychosom Med Psychol 2004. [DOI: 10.1055/s-2004-819779] [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: 10/18/2022]
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Lange C, Burgmer M, Braunheim M, Langer M, Raschke MJ, Heuft G. Prädiktoren für die Entwicklung einer posttraumatischen Belastungsstörung. Psychother Psychosom Med Psychol 2004. [DOI: 10.1055/s-2004-822526] [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: 10/18/2022]
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Gerken J, Burgmer M, Lange C, Braunheim M, Langer M, Raschke MJ, Heuft G. Validität der revidierten Fassung der Impact of Event-Skala (IES-R) an einem Kollektiv von Unfallverletzten. Psychother Psychosom Med Psychol 2004. [DOI: 10.1055/s-2004-822490] [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: 10/18/2022]
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Abstract
A new depressive entity called the "Sisi syndrome," named in reference to the former empress of Austria, was introduced by a drug company in 1998. Their advertising campaign presents information about nosology, symptoms, and recommended therapy. We review the relevant literature about this syndrome and are not able to confirm the statements about it. The lack of scientific proof of it as an independent entity of depression stands in contrast to the widespread media coverage in Germany, which was organized by a public relations company. Therefore, we discuss new kinds of marketing strategies ("disease mongering") by drug companies and conclude with some preventive recommendations.
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Affiliation(s)
- M Burgmer
- Klinik und Poliklinik für Psychosomatik und Psychotherapie, Universitätsklinikum Münster, Domagkstrasse 22, 48149 Münster.
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Abstract
Diagnosis related groups (DRGs) will be introduced in Germany in 2003 as a basis for hospital funding in all areas except for psychiatry and psychotherapeutic medicine. The following article provides an overview of the use of alternative casemix-systems in the treatment of patients with mental disorders. Overall, DRGs and alternative systems have proven to be poor predictors of resource consumption due to the high variation in the length of stay and the variable treatment opportunities. Therefore, a DRG-system must include the possibility of coded therapeutic treatments, analogous to the procedures used in surgical DRGs, in order to integrate psychiatry and psychotherapeutic medicine into a DRG-based payment system.
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Affiliation(s)
- M Burgmer
- Klinik und Poliklinik für Psychosomatik und Psychotherapie, Universitätsklinikum Münster.
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Burgmer M, Jessen F, Freyberger HJ. Polythetic diagnostic approach to the borderline personality disorder. the valency of the single criterion in the concept of professional therapists. Psychopathology 2000; 33:119-24. [PMID: 10773769 DOI: 10.1159/000029132] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The present study addresses the question whether the polythetic approach of ICD-10 and DSM-IV is useful in clinical practice for the diagnosis 'Borderline' personality disorder (BPD). A questionnaire containing all individual criteria for the 9 personality disorders and the schizotypal disorder used by the ICD-10, completed by the DSM-IV criteria for the BPD not covered by the ICD-10, was developed. Eight hundred therapists were asked to mark the importance of every single criterion for forming the diagnosis or for ruling out BPD. Our data analysis of the received questionnaires performed a rankscore based on an altered calculation of the mean value. The criteria which described the patients' instability in relationship and mood, and identity disturbances were seen as the most important features for the diagnosis of BPD. The criterion of cognitive disturbances, newly introduced in DSM-IV, was not felt to be a major clinical feature. In conclusion, our study reflects the results of other authors in the sense that a single criterion cannot be considered pathognomonic for BPD, but has greater importance and a higher priority in establishing the diagnosis BPD. This should be taken into account to reconsider the polythetic concept in favor of a hierarchical approach with core criteria.
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Affiliation(s)
- M Burgmer
- Clinic for Psychotherapy and Psychosomatics, University of Essen, Germany.
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Burgmer M, Freyberger HJ. [The operational diagnostic approach of the borderline personality disorder. An interview of psychiatrists and psychologists according to their concept of the syndrome]. Nervenarzt 1999; 70:250-5. [PMID: 10231812 DOI: 10.1007/s001150050429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Despite the diagnostic criteria of the ICD-10 and DSM-IV, the term borderline has been used in a non-specific way for a long time. For our investigation we constructed a questionnaire, which contained the ICD-10 diagnostic criteria for the borderline personality disorder (BPD), plus the criteria for the other personality disorders and for the schizotype disorder. The two additional criteria for the BPD used by the DSM-IV were added. 800 psychiatrists and psychologists were asked to mark all criteria, which they thought were typical for the BPD. By using the operational diagnostic approach for ICD-10 and DSM-IV a disorder was diagnosed from each of the 162 received questionnaires based on the marked criteria. 92.0% of the questionnaires contained marked criteria for the diagnosis of the BPD by ICD-10 and 96.3% by DSM-IV. In addition each questionnaire contained up to eight other diagnosis. This is a sign for the difficulty to separate the BPD from other personality disorders or the schizotype disorder by using operationalized criteria. Looking at the lack of specificity of the operational diagnostic systems for personality disorders, e.g. for the BPD which has been discussed by many authors for years, modification of the diagnostic systems should be considered.
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Affiliation(s)
- M Burgmer
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Rheinischen Friedrich-Wilhelms-Universität, Bonn
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