Biomedical subjects

Aike Hessel

Publications and source records attributed to Aike Hessel.

8 recordsLinked to original sources

PubMed2006

[Psychological symptoms and body image in patients after surgery of congenital heart disease].

In the last 20 years the survival rate of patients with congenital heart disease has increased considerably, thus psychological consequences of living with a heart defect have attracted considerable scientific attention. In our study psychological symptoms and the body image of patients with congenital heart disease were compared with the respective scores of general population samples (age: 14 - 45 years). Psychological symptoms were measured by means of the Brief Symptom Inventory (BSI; subscales: somatization, obsessive-compulsive thoughts, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, psychoticism). Body image was assessed with the FKB-20 body image questionnaire (subscales: rejection of the body, vitality). The patient group consisted of 361 women and men with congenital heart disease. For comparisons with the BSI, a sample of 1165 subjects was available. Comparisons with the FKB-20 were performed with data from a separate survey (N = 1169). After stratification for age and gender, in females only a few differences were found for both instruments. In males higher scores were obtained for "rejection of the body", and lower ones for "vitality". This does not apply to the highest age group (36 - 45 years). For all BSI-subscales except "depression", "phobic anxiety", and "psychoticism" marked differences between patients and controls were found in males and over all age groups. In women group differences emerged on some subscales (obsessive-compulsive thoughts, interpersonal sensitivity, anxiety, hostility, and phobic anxiety), but this does not hold for all age groups. These results do not apply to patients with the severest impairments due to congenital heart disease, because their number in our study was too low.

Adaptation, Psychological↗

PubMed2005

[Utilization of the health care system due to somatoform complaints -- results of a representative survey].

OBJECTIVES: Utilization of the health care system is not determined by the presence of an organic illness, but by a multitude of interacting factors. This applies particularly to somatoform complaints and disorders, in the context of which the health care system is used very intensively and inadequately in relation to the disorder. The present paper summarizes the frequency of somatoform complaints in the general population and health care utilization due to these complaints. METHODS: On the basis of a survey carried out in 2002 for a representative population of 2089 persons (aged 14 to 92 years), the prevalence of somatoform complaints during a period of 2 years was determined. In this survey, physical complaints were defined as being somatoform when they seriously affected the person's well-being but exhibited a disparity between objective diagnostic findings and subjective experience. The psychosocial aspects were also determined. When somatoform complaints were identified, the specific utilization of the healthcare system for them was investigated. RESULTS: Somatoform complaints are very frequent in Germany: 8.3% of the population claim to suffer from clinically relevant somatoform disorders that fully meet the criteria mentioned above. The health care system is used heavily for these complaints. Within the last two years, each test person suffering from somatoform disorders consulted a physician a mean 18 times and was incapable of working for a mean of 20 days. 16% of these persons were hospitalized, 9 % received treatment at a health resort, 9 % retired, etc. DISCUSSION: The considerable utilization of health care services is an essential element of somatoform pathology and has immense medico-political relevance. The most important prerequisite for handling the 'commitment to health care system' symptom is thorough training of all physicians in the basics of somato-psycho-social medicine. This will be an important measure for cost reduction in the health care system.

Adolescent↗

PubMed2004

[Symptom Checklist SCL-27].

The Symptom-Checklist-27 (SCL-27) forms a modification of the widely used Symptom-Checklist-90-R, with the latter demonstrating considerable shortcomings in psychometric properties. The SCL-27 is designed to screen for psychiatric symptoms in patients presenting somatic complaints. It contains the six subscales depressive, dysthymic, vegetative, agoraphobic, sociophobic symptoms and symptoms of mistrust. Additionally, a global severity index (GSI-27), similar to the GSI in the SCL-90-R is available. The subscales are short, the number of items varies between four and six. Psychometric properties and reference values based on a representative German sample of more than 2000 subjects are presented for the various subscales. All subscales show sufficient internal consistency with Cronbach's alpha > or = 0.70 and for the GSI-27 alpha is = 0.93. The correlation between GSI-27 and GSI is r = 0.93. Sex-specific cut-offs are presented to identify those patients, who need further examination.

Adolescent↗

PubMed2003

Quality of life in patients with malignant choroidal melanoma after radiotherapy.

BACKGROUND: Patient-orientated endpoints have attracted little attention in patients with malignant choroidal melanoma. This study was conducted to explore the long-term effects of malignant choroidal melanoma and radiotherapy on QOL by means of a differentiated and modular QOL approach, including global QOL, social support, and mental health, in comparison with sociodemographically matched healthy controls. METHODS: A random sample of 100 outpatients treated by radiotherapy were asked by mail to take part in a psychodiagnostic study [instruments: Short-Form 36 Health-Survey (SF-36), Symptom Checklist-90-Revised, German Social Support Questionnaire]. The same instruments were applied to a healthy control group, which was matched to patients with regard to age, gender, and vocational situation. RESULTS: 93 patients (average age 61.2 years) responded at an average of 5.5 years (+/-3.7) after diagnosis. Visual acuity in the affected eye decreased considerably from diagnosis (0.49+/-0.30) to participation in the study (0.09+/-0.21). Compared with healthy controls, patients reported on average statistically significantly lower global QOL (SF-36), whereas social support and mental distress did not differ. Frequencies of clinically relevant mental distress were significantly higher in patients than in controls (35.5% vs. 16.1%). Mental distress was associated with poorer visual acuity, but not with the extent of loss of visual acuity or number of follow-up treatments. CONCLUSION: Patients with choroidal melanoma suffer from low long-term global QOL, and every third patient suffers from relevant mental distress. Regular screening for mental distress should be implemented along with psychological counseling. Additional follow-up treatment does not seem to induce mental distress.

Activities of Daily Living↗

PubMed2002

[Somatoform complaints in the German population].

The study presents the subjective responses of a representative sample of the German population (2050 subjects, aged 14 to 92 years) on the prevalence of somatoform complaints, using the SOMS (Screening for somatoform disorders) developed by Rief et al. (1997). The results show that somatoform disorders are widespread in the German population. The symptoms named most frequently were pains in the back, aching limbs, pains in the arms or legs, headaches, facial pains and sensations of fullness in the stomach. Women named more somatoform complaints than men and elderly suffered more than the young. The higher rate found in East Germany could be accounted for by the responses of the East German women. Of particular economic and political relevance is the health care utilization behaviour of this group of patients. High medical consultation frequencies and increasing drug consumption were found for a significant proportion of all patients with somatoform disorders. In apparent contradiction to these findings is the classification according to DSM-IV and ICD-10, which diagnose somatoform disorders in only 0.2%-0.4% of the population. Such low prevalence can be attributed to the restrictive diagnostic criteria applied by these systems which obscure the real frequency of somatoform syndromes requiring specific treatment.

Adolescent↗

PubMed2000

[Utilization of the health system and acceptance of psychosocial professionals]

The study presents the results of a representative survey on the utilization of the health system and subjective attitudes to the psychosocial professions, based on the responses of 2179 subjects aged 16 to 96 years. The residents of Germany frequently seek medical and non-medical help in cases of illness or health-related problems. General practitioners are consulted most of all, but medical specialists also play a significant role. Women seek professional help more than men and the demand increases with age. Comparisons between West and East Germany reflect a few persistent qualitative differences. Doctors from the psychosocial fields (psychotherapists, psychiatrists) are consulted least of all. Utilization of psychotherapy is deficient, information about the existence of the psychosocial professions is poor and acceptance of their competence relatively low. However, the high proportion of those who have sought out a psychotherapist on the advice of a doctor demonstrates the high latent readiness to accept help in this field when needed. The particular responsibility of primary doctors in influencing attitudes here is thereby underlined.

Journal Article↗

PubMedDate not supplied

[Effects of psychosomatic interventions within the consultation service of a gynecological university hospital].

The influence of psychotherapeutic interventions on the long-term course of anxiety and depression of inpatients of a Gynaecological University Hospital was examined in a prospective naturalistic provision study. All patients admitted to hospital within a year were examined regarding anxiety and depression (HADS). The patients who had conspicuous values in their questionnaires were randomly assigned to an intervention or a control group. There was a follow-up examination for them one year after the first examination. In the first examination 715 participants took part, in the follow-up examination there were 429. Women with malignant gynaecological diseases suffer more severely from anxiety (t=7.02; p<0.001) and depression (t=3.87; p<0.001) in comparison with the normal population. Women suffering from general gynaecological (t=7.75; p<0.001) and obstetrical diseases (t=5.95; p<0.001) are significantly more anxious. Whereas the anxiety in patients with general gynaecological (F=3.02; p=0.031) as well as in patients with obstetrical diseases (F=3.52; p=0.017) can be reduced significantly in the long-term by psychotherapeutic interventions, depression cannot or only slightly be influenced. This shows that low-frequent psychotherapeutic interventions with psycho-educative, supportive approaches (e. g. in the framework of psychosomatic consultation and liaison service) have positive effects on anxiety in the long run, whereas depression is to be influenced rather by long-term interventions or classic depth-psychological or behaviour therapeutic interventions.

Adult↗

PubMedDate not supplied

[Occupation of health care system because of body complaints by young people--results of a representative survey].

In a sample of adolescents between 14 and 25 years of age (n=266), drawn from a sample of 2089 representatively selected people, we found that a significant part of the adolescents suffers from physical complaints. The regions which were most frequently affected were head or face (33%), back (24%), and stomach (22%). We did not find significant influences of sociodemographic parameters like age, gender and residence on the prevalence of physical complaints in adolescents. Adolescents occupy the health care system frequently because of physical complaints. In comparison to adults, younger people suffer less from physical complaints and occupy the health care system significantly less often. It seems that somatoform complaints begin in young age, but that they do not reach their chronic form until adulthood. Early interventions are necessary to reduce individual suffering and to act in an economically responsible way.

Adolescent↗