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Biomedical subjects

A Heerlein

Publications and source records attributed to A Heerlein.

14 recordsLinked to original sources
PubMed2000

[Cross cultural psychometric comparison of major depression in Chile and Germany].

BACKGROUND: Depressive symptoms and personality features of patients with mood disorders are supposed to have a strong variability in cross cultural studies. The clinical profile, the outcome and the treatment response seem to be different across the world. AIM: To investigate the differences and similarities of major depressive disorders in Chile and Germany. MATERIAL AND METHODS: Sixty seven Chilean and German depressive inpatients, without comorbidity on axis I or II were studied. Diagnosis of depression was based on DSM IV and ICD 10 criteria for major depression. Symptomatology was assessed using the self reporting questionnaire (SRQ-20), the Symptom checklist-90-revisited (SCL 90-R), the Beck inventory for Depression (BDI), and the Hamilton scale for depression (HAM-D). Personality was assessed with the Munich Personality Scale. RESULTS: Only the SRQ-20 shows significantly higher tendency towards depression among Chilean patients. At the personality level, Chileans exhibited higher scores in extroversion, neuroticism, esoteric and isolating tendencies. CONCLUSIONS: These results help to understand differences and similarities between depressive syndromes across cultures. They suggest that the relation between symptomatology, some personality traits and severe major depression has little variability across cultures.

Adult↗
PubMed1998

Personality patterns and outcome in depressive and bipolar disorders.

Personality traits and disorders have a strong influence on the course and outcome of depressive and bipolar disorders. Studies of the influence of personality disorders (PD) and some PD clusters on outcome of mood disorders are controversial and suggest that more specific assessment of underlying traits or dimensions is needed. Utilizing the Munich Personality test (MP-T) scales of von Zerssen, this study tries to identify specific personality traits that may influence the outcome and clinical course of unipolar endogenous depression and bipolar disorder. Six unipolar depressives and 6 bipolar patients, according to DSM III-R and ICD 10 criteria, were assessed with the MP-T self- and family-reporting scales. Three years later, their outcome scores were correlated with the corresponding premorbid personality profile. Preliminary results show that introversion has a negative effect on outcome of unipolar melancholic depression, while extraversion, esoteric tendencies and rigidity have a positive influence. Neuroticism has a negative influence on outcome of bipolar disorder, but not on unipolar endogenous depression. Data from the literature suggest that neuroticism, hostility and social dysfunction seem to have a negative prognostic value only for nonendogenous depressives and bipolar disorder, thus supporting the notion that the diagnostic distinction between bipolar disorder, endogenous and nonendogenous depression is relevant to prognostic discussions. These observations help to understand the differences between depressive syndromes and their relationship to prognosis, but also to comprehend the role of personality in clinical and theoretical research of mood disorders.

Adult↗
PubMed1998

On the validity of the Beck Depression Inventory. A review.

The present review discusses validity aspects of the Beck Depression Inventory (BDI) on the basis of meta-analyses of studies on the psychometric properties. Shortcomings of the BDI are its high item difficulty, lack of representative norms, and thus doubtful objectivity of interpretation, controversial factorial validity, instability of scores over short time intervals (over the course of 1 day), and poor discriminant validity against anxiety. Advantages of the inventory are its high internal consistency, high content validity, validity in differentiating between depressed and nondepressed subjects, sensitivity to change, and international propagation. The present paper outlines agreements and contradictions between the various studies on the BDI and discusses the potential factors (composition of the subject sample, statistical procedures, point in time of measurement) accounting for the variance in their results. The Beck Depression Inventory (BDI) is world-wide among the most used self-rating scales for measuring depression. Since the test construction in 1961, the test has been employed in numerous (more than 2,000) empirical studies. The present review will only consider those investigations which are primarily concerned with the validity or the psychometric properties of the BDI. Since most studies are oriented along the criteria of the classical test theory, our review will discuss to what extent the BDI meets these criteria.

Depressive Disorder↗
PubMed1997

Measuring treatment outcome by the Beck Depression Inventory.

The construct validity of the Beck Depression Inventory (BDI) in measuring treatment outcome is assessed in 103 psychiatric inpatients. In this context, construct validity means that the BDI measures the same construct in repeated measurement and that the change scores can be explained by treatment effects. In confirmatory factor analyses, only the first factor proved to be stable. In accordance with other studies, the sensitivity to therapeutic change in long-term intervals of several weeks could be confirmed. Significant changes in a short-term interval of 1 day in the non-endogenously depressed patients indicate an overreactivity of the BDI to change which cannot be explained by treatment effects or mood changes.

Adjustment Disorders↗
PubMed1996

[Tolerance of ambiguity in endogenous psychoses from the transcultural viewpoint].

This study tries to determine the relationship between intolerance of ambiguity and different psychiatric disorders classified according to DSM-III-R criteria in two different countries. Inpatients from the psychiatric department of the Universidad de Chile and the psychiatric department of the University of Heidelberg (Germany) with uniplar, bipolar or schizophrenic disorders, as well as normal controls in both cultures completed the Kischkel Intolerance of Ambiguity Scale. The group of unipolar depressive inpatients showed significantly higher scores in both samples. Among the Chilean schizophrenic patients, differences between unipolar and bipolar disorders were seen only in the Chilean sample. Differences between unipolar depressive and schizophrenic patients were evident in the German sample only. The psychopathological and nosological significance of these findings in unipolar depressives is discussed.

Adult↗
PubMed1993

[ICD-10 and DSM IV: towards a confluence?].

The author discusses the discrepancies and convergencies of DSM IV and ICD 10 in diagnostic classification. A brief historical analysis shows a tendency to find more similarities between both taxonomic systems. Next a descriptive discussion of both systems reveals significant differences between the ICD and DSM systems if considering organizational and methodological aspects. A comparative analysis of diagnostic criteria shows similarities between both systems in the majority of clinical diagnostical categories.

Humans↗
PubMed1991

[Discrepancy between clinical depression and psychometric depression].

Convergencies and discordances among three different strategies for the psychometric evaluation of depressively (self-report inventories, objective or external questionnaires, and verbal content analysis) are discussed. Twenty-one inpatients with a major depressive disorder, and 21 inpatients with a non-endogenous depression were assessed with different instruments. While an external assessment of depressiveness coincided with both clinical and diagnostical criteria, depressiveness as assessed with self-report inventories, and verbal content showed lesser scores among patients with endogenous depression (n-21): Such patients assessed themselves as "less depressive" than patients with dysthymic disorder (n-21), even when admitted at a mental hospital. Results suggest that any assessment--as far as endogenous depression is concerned--should be basically performed by means of external evaluation questionnaires.

Depressive Disorder↗
PubMed1991

[Intolerance of ambiguity in affective and schizophrenic disorders].

In a study of determine the relationship between intolerance of ambiguity and different psychiatric disorder classified according to DSM-III and DSM-III-R criteria, 68 inpatients, 46 outpatients at the Psychiatric Clinic of the University of Heidelberg und 25 normal subjects completed the Kischkel Intolerance of Ambiguity Scale as well as other psychometric instruments. The group of unipolar depressive inpatients showed significantly higher scores than the control group and the schizophrenic group. Among the outpatients without clinical symptoms the group of unipolar depressives also showed significantly higher scores than the control group and the schizoaffective group. No differences were found between unipolar and bipolar individuals. Intolerance of ambiguity did not show no significant correlations with age, depressivity or anxiety scores. The meaning of this 'intolerance of ambiguity' among unipolar depressive patients is discussed.

Adult↗
PubMed1989

[Alexithymia and affective expression in endogenous and non-endogenous depression].

Clinical observations and psychopathological reports on patients with endogenous depression suggested a high frequency of alexithymic characteristics in these patients. 21 inpatients with unipolar endogenous depression and 21 inpatients with neurotic-reactive depression, classified according to ICD-9 and DSM-III criteria, were assessed with the content analysis method of Gottschalk-Gleser and the Beth Israel Alexithymia Questionnaire (BIAQ) as well as other questionnaires at two points of time. The gorup with unipolar endogenous depression showed significantly less separation anxiety, diffuse anxiety, total anxiety, hostility directed inward, total hostility and depressivity at both points of time. The endogenous depression group showed significantly higher scores in the BIAQ than the group with neurotic depression. The specifity of alexithymia in psychosomatic patients, its high frequency and the significance of this phenomenon in endogenous depression are discussed.

Adjustment Disorders↗
PubMed1986

Verbal measures of anxiety and hostility under monological and dialogical conditions. A study on a mixed patient sample.

Anxiety and hostility scores (Gottschalk-Gleser method of verbal content analysis) were studied in a mixed patient sample comprising psychosomatic, functional, and neurotic patients under two speech-eliciting conditions: monological and dialogical. Hostility scores did not differ between conditions. Mutilation, diffuse and total anxiety scores were significantly higher in interview than in monologue. In this condition, separation anxiety was expressed more often. Some intercorrelations between variables were found in both conditions, mostly involving hostility, while others hold either for monological or interview data. Factor analysis disclosed different factor structures for the two conditions. An interaction between speech-eliciting condition and diagnostic subgroup is suggested. The implications of these findings for descriptive psychiatric research are discussed.

Adolescent↗
PubMed1986

Content category analysis of affective expression in irritable bowel, duodenal ulcer and anxiety disorder patients.

This paper reports on verbal content analysis measures (Gottschalk-Gleser method) of anxiety and hostility in duodenal ulcer, irritable bowel and generalized anxiety disorder patients, who were also administered the Eysenk Personality Inventory (EPI), and Beck and Zung depressiveness scales. Irritable bowel patients expressed significantly more death anxiety than the other groups in a 5-min free speech sample, while anxiety disorder patients scored highest on hostility directed inwards. In the whole sample, EPI neuroticism scores correlated with depressiveness scores and hostility measures appeared intercorrelated. Factor analyses with Varimax rotation revealed a similar clustering of variables. Results tend to suggest that irritable bowel patients are closer to anxiety disorder than to duodenal ulcer ('psychosomatic') patients in terms of intensity and patterning of affect expression.

Adolescent↗
PubMed1984

Affective expression in organic and functional gastrointestinal disease.

Verbal affective expression and psychometric variables were studied in a group of 5 duodenal ulcer and 6 irritable bowel patients. The aim was to assess the relevance of the alexithymia contruct to the distinction between both groups. Irritable bowel patients exhibited higher scores on Zung's depressiveness scale. Alexithymia scores were significantly higher for duodenal ulcer patients. Regarding verbal affective expression a discrimination was possible between both groups in the scale of hostility directed inward. Ulcer patients expressed less affect. These findings suggest that a distinction is possible at the behavioral level between patients with functional vs. patients with organic gastrointestinal illness, thus rendering the concept of alexithymia relevant to this nosological categorization.

Adult↗
PubMedDate not supplied

Premorbid personality aspects in mood and schizophrenic disorders.

This study examines premorbid personality traits from a self-reported and family-reported perspective on a group of unipolar major depression (n = 27), bipolar (n = 21), and schizophrenic (n = 16) recovered inpatients, and a control group (n = 21). Using the Munich Personality Test (MP-T Scales) of von Zerssen for self-reporting and family-reporting personality traits, and the Kischkel scale for the measurement of "intolerance of ambiguity," we found more "rigidity," less "esoteric tendencies," and more "intolerance of ambiguity" among unipolar depressive patients. Schizophrenic patients showed more esoteric tendencies and less "extraversion." Results confirm the hypothesis supported by many authors regarding a particular personality structure in unipolar major depression characterized by rigidity and ambiguity intolerance. This personality pattern for unipolar depressives seems to be different from the depressive personality disorder proposed by DSM-IV. Schizophrenic individuals differ by means of their self- and family-reported extraversion. Clinical and theoretical implications of these findings are discussed.

Adult↗