Biomedical subjects

C Buddeberg

Publications and source records attributed to C Buddeberg.

At least 37 records · Page 2Linked to original sources

PubMed2001

How different from pacemaker patients are recipients of implantable cardioverter-defibrillators with respect to psychosocial adaptation, affective disorders, and quality of life?

OBJECTIVE: To assess differences in psychosocial adaptation, quality of life, and incidence of affective disorders between patients with pacemakers and those with implantable cardioverter-defibrillators (ICDs). DESIGN: Patients aged 40-70 years who underwent a first pectoral implantation of a pacemaker or an ICD system were studied. All subjects were asked to complete the hospital anxiety and depression scale (HAD), the short form general health survey (SF-36), and a specially designed device related questionnaire. Data analysis was performed for three patient groups: pacemaker (n = 76), ICD patients who received therapeutic shocks (n = 45), and ICD patients who did not receive shocks (n = 31). RESULTS: There were no differences between the three patient groups in HAD scores or in any of the SF-36 subscales or summary ratings. Probable depressive disorder (depression score > 10) was observed in 5.2%, 6.5%, and 6.6%, and probable anxiety disorder (anxiety score > 10) in 13.1%, 9.7%, 13.3% of the pacemaker, non-shocked ICD, and shocked ICD patients, respectively. There were no sex differences. However, patients in the shocked ICD group were more likely than those in the other groups to report limitations in their leisure activities, to perceive their device as a "life extender," and to admit anxiety about battery depletion and technical problems. Forty per cent of shocked ICD patients would be interested in joining a support group. CONCLUSIONS: Despite having distinctly different medical histories and treatments, patients with pacemakers and ICDs responded similarly to validated tools of health status assessment. ICD patients who had received shocks perceived their device as prolonging their life and had greater anxiety about technical problems. Their endorsement of the potential benefits of a support group warrants further investigation.

Adaptation, Psychological↗

PubMed2001

[Communication competence in ultrasound examination in pregnancy].

INTRODUCTION: 293 physicians in the German-speaking part of Switzerland were questioned about their practices of providing information during prenatal ultrasound examinations. Physicians were asked both how they provide information about the examination procedure itself as well as how they inform the pregnant woman if a fetal anomaly is detected. METHOD: In January 2000, a questionnaire was mailed to a sample of 500 physicians with a specialized qualification in pregnancy ultrasound examinations. The response rate was 59.2%. RESULTS: 90.1% of the physicians reported that they offer information consultations for routine ultrasound examinations. 50.2% mentioned in their answers to an open question that the screening for fetal anomalies is a component of their consultation. Female physicians mentioned this aspect significantly more often than male physicians. Regarding difficulties in the communication of a diagnosis of fetal malformation, the physicians reported most frequently the excessive strain on the pregnant woman, but also their own feelings of helplessness. The subjective emotional stress was considered as high; female physicians with experience of motherhood reported the highest levels of stress. CONCLUSIONS: Screening for fetal anomalies is a difficult and often neglected subject when providing information on prenatal ultrasound examinations. The communication of the diagnosis of a fetal anomaly is not only emotionally stressful for the parents, but also for the physicians and requires high levels of communication competence. These communication aspects should be considered in the training for ultrasound examinations during pregnancy.

Adult↗

PubMed2001

Incidence and prediction of posttraumatic stress disorder symptoms in severely injured accident victims.

OBJECTIVE: This study was designed to assess the incidence of posttraumatic stress disorder (PTSD) in severely injured accident victims and to predict the presence of PTSD symptoms at a 12-month follow-up. METHOD: A longitudinal, 1-year follow-up study was carried out with 106 consecutive patients with severe accidental injuries who were admitted to the trauma surgeons' intensive care unit at a university hospital. Patients were interviewed within 1 month and 12 months after the accident. Assessments included an extensive clinical interview, the Impact of Event Scale, the Clinician-Administered PTSD Scale, the Sense of Coherence questionnaire, and the Freiburg Questionnaire of Coping With Illness. RESULTS: A total of 13.4 days (SD=6.6) after the accident, five patients (4.7%) met all criteria for PTSD with the exception of the time criterion. A total of 22 other patients (20.8%) had subsyndromal PTSD. At the 1-year follow-up, two patients (1.9%) had PTSD, and 13 (12.3%) had subsyndromal PTSD. Multiple regression analysis explained 34% of the variance of PTSD symptoms 12 months after the accident. Biographical risk factors, the sense of a death threat, symptoms of intrusion, and problem-oriented coping each contributed significantly to the predictive model. CONCLUSIONS: In severely injured accident victims who were healthy before experiencing trauma, the incidence of PTSD was low. One-third of the variance of PTSD symptoms at 1-year follow-up could be predicted by mainly psychosocial variables.

Accidents↗

PubMed2000

[Psychological comorbidity and quality of life of patients with morbid obesity and requesting gastric banding].

Bariatric surgical operations are well established in the treatment of morbid obesity. In this study, 79 consecutive applicants for laparoscopic gastric banding (60 females with a mean BMI of 47.4 kg/m2 and 19 males with a mean BMI of 48.9 kg/m2, mean age 39.6 years) were examined preoperatively by structured psychiatric interview and questionnaire. GOAL AND QUESTIONS: The aim of the study was to determine physical and psychological symptoms, specific eating problems, life satisfaction and incidence of psychiatric comorbidity, as well as the relations between psychological and psychosocial markers on the one hand, and demographic and somatic parameters on the other. RESULTS: Most patients displayed multiple somatic symptoms and diseases, in particular orthopaedic problems, exertion dyspnoea, hyperlipidaemia, hypertension, diabetes mellitus or sleep apnoea. The averages of all psychometric scales (General Symptomatic Index of Symptom Checklist [SCL-90-R], anxiety and depression states of the Hospital Anxiety and Depression Scale [HADS]) were higher than normal. General life satisfaction and satisfaction with health (FLZM) were low. Eating behaviour in both sexes was characterised by marked irritability, disinhibition and ravenousness. Binge eating was common, 27% reporting binges at least weekly and only 37% no binges at all. 46% were found to suffer from at least one psychiatric disorder, while half had an eating disorder with frequent bingeing and loss of control. 6.3% were diagnosed with atypical bulimia, 15.2% had an adaptational disorder and 10% a personality disorder. The HADS scales did not correlate with BMI or other somatic factors and the correlation between the SCL-90-R and BMI was low (r = 0.36, p = 0.01). However, patients with psychiatric disorders had significantly higher BMIs and higher averages on all scales except overall life satisfaction. There was no direct relation between psychosocial and sociodemographic variables (educational level, living alone). CONCLUSION: Morbidly obese patients desiring laparoscopic gastric banding display many physical and psychological symptoms with a higher preference for psychiatric (especially eating) disorders. Since there is no close relationship between psychosocial and somatic aspects in this group of patients, routine psychiatric evaluation appears to be of importance.

Adult↗

PubMed2000

[Inpatient rehabilitation in inpatients with chronic obstructive lung diseases (COPD): effect on physical capacity for work, psychological wellbeing and quality of life].

Success of inpatient rehabilitation for patients with chronic obstructive pulmonary disease (COPD) was assessed in a prospective study of 39 patients (mean age = 71 years). Six months after hospital stay (mean duration 22.4 days), physical endurance as assessed by the 6-minute walk distance remained unchanged. Subjective health measures improved (SF36 21 vs 29%; p < 0.05), MRC-dyspnoea was reduced (2.61 vs 2.19; p < 0.05) and measures of global quality of life also improved (56.1 vs 67.5; p < 0.05). Meanwhile, anxiety symptoms were reduced (7.7 vs 6.0; p < 0.05); no changes in depression scores were observed (6.8 vs 6.2; p = 0.271). A novel visual method to assess the burden of suffering, PRISM (Pictorial Representation of Illness and Self Measure), was applied for the first time in COPD patients. PRISM scores improved significantly (6.3 vs 12.2; p < 0.001). In conclusion, inpatient pulmonary rehabilitation improved subjective physical health measures and reduced anxiety levels.

Aged↗

PubMed2000

[Curriculum module for health promotion. Results of a controlled intervention study in 2 high schools].

The effects of health-promotion lessons carried out in two senior high schools in the canton of Zurich were investigated in a controlled intervention study. The lessons were developed by teachers and students and integrated into regular school lessons. Of particular interest were effects on school climate, school stress experienced by students and their physical and psychological well-being. Students in the intervention and control schools were assessed with a comprehensive questionnaire three times over a period of 18 months. Health-promotion lessons took place in the intervention school between t1 and t2 (12 month interval). Results showed that participation in a structured research project with repeated assessments led to a critical evaluation of school climate and school stress. At the same time that students were more critically judging the school environment, their physical and psychological problems lessened. Results were the same in both schools, that is, there was no specific intervention effect. Presumably, participation in a prospective study with repeated assessments acted as a sensitisation and mobilisation of resources in adolescents. The study showed the possibilities for health promotion, however it also indicated conflicts between the duty of teaching and psychosomatic prevention strategies.

Adolescent↗

PubMed2000

[Psychosocial aspects of the change of life].

In organ medicine the climacteric woman is frequently characterised by terms indicating a defect. The lack of hormones is viewed as an illness that requires treatment. The trend towards medicalizing the menopausal and postmenopausal years conflicts strongly with recent findings in psychosomatic research. Prospective studies show that pre- and postmenopausal complaints are considerably less severe than often described. Menopause represents a phase in life with an increased psychosocial vulnerability. This increased vulnerability and lowered resilience should be taken into account when treating menopausal women.

Body Image↗

PubMed2000

[Psychosomatic health promotion in adolescents. An intervention study in 2 high schools].

AIMS: The effects of health-promotion lesson modules on teaching climate, school stress and physical and psychological well-being were investigated in a controlled intervention study in two high schools. The lesson plans were developed jointly by teachers and students and integrated into normal classroom teaching. METHODS: Three questionnaire assessments were carried out with students in the intervention and control schools. Health promotion lessons were implemented in the intervention school between T1 and T2 (an interval of 12 months) and evaluated by participants after completion. RESULTS: Indicated that the modules were positively appraised and that participation in a longitudinal study led to a more critical evaluation of the teaching climate and school stress. A decrease in physical and psychological symptomatology ran in parallel with increases in critical appraisal of the school environment. This pattern of results was found in both schools, i.e., no intervention effect could be demonstrated. CONCLUSIONS: It is likely that participation made the adolescents more sensitized to individual and interactional problems as well as led them to mobilize their own resources. The health-promotion activities supported a participatory/interactive relationship between teachers and students which in turn resulted in systemic structural changes. It can be assumed that these factors will have long-term positive effects on the well-being of the participants.

Adolescent↗

PubMed2000

[School climate and psychological symptoms--correlations between school stress, sense of coherence and physical-psychological impairment in high school students].

The research project "Health Promotion and School Culture" investigated associations between school climate, school stress, sense of coherence and physical/psychological symptoms in high school students. 565 students, aged 15 to 20 from two high schools (Gymnasium) in the canton of Zurich took part in the study. Assessment measures included questionnaires on school climate (FUK 7-10), school stress, sense of coherence (SOC-13), physical (GBB-24) and psychological symptomatology (SCL-90-R, ADS-K). 166 of the students also participated in a standardised psychiatric interview (DIA-X). Results revealed significant associations between 1. school climate and school stress, 2. biographical risk and protective factors and sense of coherence, 3. school stress and sense of coherence, and 4. school-stress and sense of coherence on the one side and symptomatology on the other. The results are discussed in terms of Karasek and Theorell's (1990) three dimensional stress model. Finally, the need for health promotion in school, especially in classes of high school, is addressed.

Adolescent↗

PubMed2000

Early psychological reactions to life-threatening injuries.

OBJECTIVE: To assess the prevalence of posttraumatic stress symptoms and coping patterns in severely injured accident victims; to study correlations between injury severity and psychosocial variables and the presence of posttraumatic stress symptoms; and to analyze intensive care unit (ICU) personnel's global clinical appraisals in relation to patient characteristics. DESIGN: A study of critically ill accident victims assessed within one month of the trauma. SETTING: ICU of the traumatology department at the University Hospital, Zurich. PATIENTS: 121 consecutive patients with accidental injuries (mean Injury Severity Score, 21.8; mean Glasgow Coma Scale score, 14.4) admitted to the ICU between January 1996 and June 1997, aged 18-68 yrs. Patients with severe head injuries, attempted suicides, and victims of physical assault were excluded. MEASUREMENTS: Extensive clinical interview, Impact of Event Scale, Clinician-Administered Posttraumatic Stress Disorder Scale, social support, life events, biographical protective and risk factors, Sense of Coherence questionnaire, Freiburg Questionnaire of Coping with Illness. RESULTS: 13.7 (SD, 6.8) days after the accident, 5 patients (4.1 %) met all criteria for posttraumatic stress disorder with the exception of the time criterion. A further 24 patients (19.9%) had subsyndromal posttraumatic stress disorder. Posttraumatic psychiatric symptomatology did not correlate with objective injury criteria, but rather with pretrauma variables (female gender, biographical risk and protective factors, life events), the patients' subjective appraisal of the severity and threat of the accident, their general attitude toward life ("sense of coherence"), and their current coping strategies. Surgeons' and nurses' global clinical appraisals did not correlate with injury severity or with the patients' coping strategies. CONCLUSIONS: Trauma surgeons and ICU personnel should pay special attention to the strains and stressors their patients have been exposed to when recording case histories and to the level of their patients' psychosocial adaptation before the trauma.

Adaptation, Psychological↗

PubMed2000

[Sexuality in the second half of the life span].

Compared to other research areas of sexology, the state of knowledge regarding sexual behavior and experiences in middle and older age is rather poor. This is due to not only the continuing taboo placed on questions regarding sexuality of elderly people, but also to limited understanding of factors influencing the sexual realm. The present review presents findings on sexuality in the second half of the life span from a number of differing disciplinary perspectives. Focus is on gender differences in sexual life and the influence of critical life events on sexuality in women in the second half of the life span. Apart from restrictive social norms and individual personality factors, physiological changes during the menopause can also have an effect on sexuality. The special situation of elderly women without partners and changes in partnership sexuality during this phase of the life span are discussed. Some recommendations for the field of gynecology are derived from a multidisciplinary approach.

Age Factors↗

PubMed2000

[Psychological aspects of ultrasound examinations during pregnancy].

The acceptability of ultrasound examinations during pregnancy has been documented in many studies. Yet there is little empirical evidence for the postulated psychological benefits of ultrasound examinations. Although seeing the baby is most often rated as a moving experience, there are no proven long-term effects of ultrasound visualization on bonding with the fetus or on pregnant women's health-related maternal behaviour. There is evidence to support the notion that attenuated anxiety and stress immediately following the examination are likely artefactual - a reflection of increased anxiety before real-time scan. Review of the literature indicates no evidence as to whether antenatal detection of fetal abnormalities leads to improvement in coping or only prolongs the phase of psychological stress and mourning. This articles provides an overview of current research on psychological effects of prenatal ultrasound examination.

Adaptation, Psychological↗

PubMed1999

[Assessment and treatment of transsexualism].

Transsexualism, a gender identity disorder, is manifested by a strong and persistent cross-gender identification and the desire to adapt the body to the preferred sex by hormonal and surgical sex reassignment. The etiology of gender identity disorder is not known. Treatment takes place gradually in phases in a interdisciplinary setting (psychiatry, endocrinology, gynecology and surgery). In Switzerland, in contrast to other European countries, there is no special legislation to regulate the change of the name and personal status.

Adult↗

PubMed1999

[Personality of patients with somatoform disorders].

36 patients of a medical outpatient clinic with cardiopulmonary and gastrointestinal somatoform complaints were interviewed two times at an interval of one year about physical symptoms, personal characteristics and need for professional assistance. The investigated patients felt more depressed than a normal cohort of comparable age. In 25% of the tests a disorder of personality according to ICD-10 was diagnosed. Anxious/depressive and obsessive/compulsive personality traits were predominant. Patients with suspected personality disorder felt more disturbed by a somatoform disorder, had more diffuse complaints and suffered more from symptoms of exhaustion. They were less satisfied with the obtained treatment but did on an average not demand more medical help than patients without personality disorders. The results are discussed with regard to the importance to treat patients with somatoform disorders and to the prognosis of the further course of disease.

Adolescent↗

PubMed1999

Characteristics of psychiatric emergencies and the choice of intervention strategies.

The aim of this study was to describe the sociodemographic, contextual and clinical characteristics of a consecutive sample of 3611 psychiatric emergency visits to a Swiss university general hospital, and to investigate their associations with different intervention strategies. All consultations were documented by a questionnaire covering sociodemographic and diagnostic data as well as information about the consultation and the disposition decision. In a total of 1093 cases (30.3%) no further emergency intervention was required, in 1287 cases (35.6%) patients were offered out-patient crisis intervention, and in 1231 cases (34.1%) patients were hospitalized. Social integration and the presence of an easily recognizable precipitating stressor were associated with referral to out-patient crisis intervention. In logistic regression analyses, referral by the police or by health professionals (in contrast to self-referral or referral by relatives), current diagnosis of a psychotic disorder, and previous hospitalizations were the most powerful predictors of hospitalization. The presence of a precipitating stressor related to the patient's social network decreased the likelihood of hospitalization. The findings indicate a need for facilities offering brief admission, allowing for extended emergency assessments.

Adult↗

PubMed1998

[Cool, clever, established--variations on anxiety defenses in today's society].

Anxiety is a psycho-biological phenomenon, psychologically manifested in feelings of constrainment, threat, and vulnerability; and physically in evidence of increased sympathetic tone. Three phenomenologically different forms of anxiety can be distinguished (real anxiety, existential anxiety, neurotic anxiety). Existential anxiety is based on four themes: self-development, self-submission, change and finality. Anxiety and anxiety defences are a part of human existence. Every culture develops its own rituals for defending against anxiety. Three variations of anxiety defence are described which typically appear in affluent societies: coolness, cleverness and happiness. These strategies are, depending on the situation, sensible and advantageous in dealing with, perceiving, overcoming and defending against existential anxieties.

Adaptation, Psychological↗

PubMed1998

[Sexual dysfunctions with antidepressive drugs--results of a physician survey].

In a survey throughout Switzerland 7.455 general practitioners and psychiatrists were mailed a questionnaire addressing topics in sexual medicine with regard to antidepressant medication, 940 completed questionnaires (response rate 12.5%) were evaluated. 77.6% of the responders agree that knowledge in sexual medicine is important or very important. Only one half of the physicians judge their competence in sexual medicine as fair or good. There are differences in sexual history taking between general practitioners and psychiatrists; the latter addressing more frequently sexual medicine related questions. Sexual dysfunction before and during therapy with antidepressants is observed less frequently than reported in other studies. Only half of the physicians counsel their patients when sexual dysfunction occur during therapy. Treatment strategies of antidepressant induced sexual side effects are rarely seen. The results emphasize the importance of knowledge and competence in sexual medicine for general practitioners and psychiatrists, both showing interest in continuing education on this topic.

Antidepressive Agents↗

PubMed1998

Prevention of disturbed eating behaviour: a prospective intervention study in 14- to 19-year-old Swiss students.

Subsequent to an epidemiological study on eating behaviour in adolescents, a prospective study was carried out to examine the effect of health promotion lessons on disturbed eating behaviour. From the original sample (t1, n = 1944), a subgroup of 314 students of both sexes, 14-19 years of age, was selected. Participants came from a total of 20 classes in which a high percentage of students exhibited disturbed eating behaviour. Ten classes were then randomly selected to receive health promotion lessons (intervention group, high-risk; IGHR), while the other 10 classes served as controls (control group, high-risk; CGHR). The Eating Attitudes Test (EAT-26), the Giessen Physical Complaint List for Children and Adolescents (GSCL-C) and the Self-Report Symptom Check-List (SCL-90-R) were administered shortly before (t2) and 3 months after (t3) the interventions. The three health promotion lessons dealt with issues concerning beauty ideals, gender differences in psychosexual maturation and body awareness, healthy eating behaviour, physiology of nutrition, early symptoms of eating disorders and therapeutic approaches. The data analyses revealed an improvement on all three symptom scales for both groups between t2 and t3, but there were no significant differences between the IGHR and CGHR groups. When data from high-scoring female participants only were analysed (HRf-IGHR and HRf-CGHR), the multivariate analysis revealed a significant interaction between time and group (15.2% of variance explained). Our experiences in implementing health promotion lessons that conveyed knowledge about eating disorders and addressed physical and psychological issues in a more general way indicated that these interventions can be carried out in schools, and may contribute to increases in physical and psychological well-being in a high-risk population of adolescents.

Adolescent↗