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Biomedical subjects

C Buddeberg

Publications and source records attributed to C Buddeberg.

At least 55 records · Page 3Linked to original sources
PubMed1998

Sense of coherence--a protective factor for depression in rheumatoid arthritis.

OBJECTIVE: A stress-vulnerability model of depression was investigated in patients with rheumatoid arthritis (RA). Antonovsky's Sense of Coherence (SOC) was examined as a factor protecting against depression. METHOD: Relationships between sociodemographic factors, disease activity, functional impairment, pain, depression, and SOC were assessed using multivariate methods in a cross sectional sample of 89 consecutive outpatients with RA. RESULTS: Increased prevalence of depression was associated with low SOC and high self-rated pain levels, but not with other factors assessed. By multiple regression analysis, independent contributions to depression were observed for SOC (23% of variance) and for pain (24% of variance), but not functional impairment or disease activity. CONCLUSION: Comprehensive models of adjustment in RA need to include protective factors such as SOC, in addition to pain and other pathological variables. SOC may be helpful in identifying individuals with RA who are particularly vulnerable to depression, who may be helped by focused psychological interventions such as cognitive therapy.

Adaptation, Psychological↗
PubMed1997

[Psychiatric comorbidity and psychosocial markers in patients before heart, liver or lung transplantation].

Organ transplant operations are regularly carried out in Switzerland at 6 transplantation centres. Between January 1995 and October 1996, 119 patients at Zurich University Hospital completed a semistructured psychiatric interview and the Transplant Evaluation Rating Scale (TERS). Inclusion criteria comprised all indications for organ transplant. Diagnostic evaluation was according to ICD-10. Of the 44 women and 75 men (mean age 40.2 years), 48 required a heart transplantation (HTPL), 37 a liver transplantation (LETPL), and 34 lung transplantation (LUTPL). 39 patients (32.8%) had one, and 15 (12.6%) 2 current psychiatric disorders. 65 of the 119 patients (54.6%) were without a current psychiatric disorder. The candidates for lung transplantation were the most psychologically healthy (68% had no psychiatric disorder). Approximately half of the heart and liver patients had at least one psychiatric disorder. The LETPL group had the highest prevalence of psychiatric comorbidity, with organic brain disorders present in a third of the patients. A quarter of all patients had stress disorders, panic disorder or a somatoform disorder. Full criteria for an affective disorder were not met by any patient. 61% enjoyed good to excellent family and social support, 29% had an unresolved conflict, and 11% had strong conflicts. Earlier coping behaviour appeared to be good to excellent in 57%, sufficient in 37%, and poor in 6%. Estimated compliance rate was found to be complete in 87%, partial or involving problems in 12% and unsatisfactory in 1%. We conclude that in transplant candidates psychiatric disorders and psychosocial problems are frequent and must be considered regularly during evaluation and the transplantation process. The results of this analysis and 3 case examples and the results of the study show the clinical importance of a detailed psychiatric and psychosocial examination as part of the evaluation of patients about to undergo life-saving organ transplant operations.

Adaptation, Psychological↗
PubMed1997

Psychosocial predictors of long-term success of in-patient pulmonary rehabilitation of patients with COPD.

Studies of the long-term outcome of pulmonary rehabilitation have measured quality of life (QOL) mainly as disease-specific functional impairment, but long-term effects on overall satisfaction with health or life have not yet been adequately evaluated. Furthermore, the influence of personality traits on the long-term outcome of pulmonary rehabilitation have not so far been examined. The following questions were studied: 1) What are the short- and long-term effects of a rehabilitation programme on lung function (forced expiratory volume in one second as percentage of predicted (FEV1 % pred)), on satisfaction with life (defined as quality of life), and on health satisfaction (HS)? 2) Are there physical or psychosocial predictors for the success of pulmonary therapy? In this prospective clinical study, baseline data (FEV1 % pred, arterial oxygen tension (Pa,O2), QOL, HS, dyspnoea, coping scales) were studied at entry (t1); follow-up on discharge (t2); and 1 yr after hospitalization (t3) in 54 consecutive patients (mean age 64 yrs) with chronic obstructive pulmonary disease (COPD). Complete data were obtained at follow-up on 32 subjects. FEV1 % pred improved from 42% (t1) to 52% (t2) (p<0.001) but dropped to 46% at t3 (t1-t3: p<0.05). QOL improved significantly during hospitalization but dropped to initial levels 1 yr after discharge. A significant increase in health satisfaction during hospitalization was maintained at follow-up. Improvements in lung function were greater in patients with higher QOL scores on entry; subjects with the greatest tendency to use wishful thinking as a coping strategy had less improvement. In conclusion, the effects of pulmonary rehabilitation on lung function and health satisfaction are positive and enduring. Quality of life and coping have an effect on the long-term outcome of pulmonary rehabilitation, probably as expressions of patients' personality traits.

Adaptation, Psychological↗
PubMed1997

Reference to psychiatric consultation in the discharge letter of general hospital inpatients.

OBJECTIVE: The consultation-liaison psychiatrist is frequently confronted with the consultees' lack of adherence to the consultants' recommendations. The aim of this study was to investigate the question if and how the C-L psychiatrist's diagnoses and recommendations are mentioned in the consultee's final medical report and thus communicated to the physician responsible for the aftercare. METHOD: Psychiatric consult reports of a consecutive sample of 144 patients of the departments of neurology, internal medicine, and gynecology and obstetrics at the University Hospital of Zurich were compared to the content of the respective discharge letters. RESULTS: Some kind of information about the psychiatric consultation was found in 84 percent of the discharge letters (consultation as such: 71.5%; psychiatric diagnosis: 66.7%; recommendations: 76.2%. Length of stay, timing of the consultation, length of the consult report and type of recommendation correlated significantly with the mention of psychiatric aspects in the final medical report. Psychotropic medication and psychiatric hospitalization were the recommendations most reliably mentioned. CONCLUSIONS: Psychiatric consultation seems to be taken seriously by attending physicians and is communicated in a high percentage to the physicians responsible for the aftercare. Nevertheless, in patients where active post-discharge management is needed the C-L psychiatrist should actively manage referral to outpatient settings and/or instruct primary care providers.

Adult↗
PubMed1996

Psychosocial aspects of accidental injuries--an overview.

This paper reviews the current "state of the art" with regard to psycho-traumatological issues in accidentally injured patients. A MEDLINE search (1985-1995) yielded a total of 135 references, out of which 60 publications were selected and reviewed. The body of knowledge about the psycho-social effects of serious injuries caused by accidents seems to be still limited. There are indications that accidents leave many patients suffering from not only the physical consequences but also considerable psychological problems. A frequent clinical manifestation of such problems is post-traumatic stress disorder (PTSD), but depression, anxiety and the somatoform disorder have also been observed, possibly even more frequently. There have been substantial discrepancies in epidemiological data in the literature, partially because the samples analyzed so far have not been homogeneous enough. It is also obvious that studies have been devoted almost exclusively to disorders and handicaps following (and occasionally prior to) the traumatic event. Seldom has the study focused on patient resources: practically no studies exist on the effects of protective psycho-social factors on the healing process following accidental injuries. More research is needed in order to be able to make predictions on the expected healing of patients during the acute stage of treatment following an accident. These future studies should deliver information on identifying high-risk patients who would require specific psycho-social intervention.

Accidents↗
PubMed1996

Are coping strategies related to disease outcome in early breast cancer?

A consecutive series of 107 women with early breast cancer were investigated for coping strategies and disease outcome 5 to 6 years after primary surgical treatment (mastectomy or lumpectomy). Coping was assessed several times during a 3-year investigation period by the Zurich and Freiburg Questionnaires of Coping with Illness (ZQCI, FQCI). Data analysis revealed no significant correlations between coping strategies and the target variable "death from breast cancer". However, significant relations were found between postsurgical tumour size (p < or = 0.01), positive histological node status (p < or = 0.01) and death from breast cancer. The results of a discriminant analysis also indicated that somatic parameters are more important for the course of breast cancer disease than psychological aspects of coping. The role of psychosocial variables for the outcome of cancer disease remains unclear and further studies in this field are necessary.

Adaptation, Psychological↗
PubMed1996

Suicidal behavior in Swiss students: an 18-month follow-up survey.

Suicidal behavior and its relationship with other mental disturbances was assessed in an epidemiological study of 1937 Swiss adolescents aged 14 to 19 years. During the most recent 12 months, 27.5% of the females and 16.1% of the males reported suicidal ideation, while 3.3% of the girls and 1.0% of the boys reported suicidal ideation. Suicidality was significantly correlated with physical and mental impairment, alcohol and drug abuse. Of the total epidemiological sample, 475 students (24.5%) were reassessed 12 and 18 months later. Of this follow-up sample, 37 females (12.4%) and 10 males (5.6%) described suicidal ideation as a continuing problem. They revealed significantly more psychiatric symptoms than nonpersistent ideators. Three girls (1.0%) and one boy (0.6%) reported suicide attempts during the follow-up period of 18 months. Only one out of six of the ideators of both sexes received psychiatric treatment. The findings indicate that transient suicidal ideation is common in adolescents. Persistent suicidal behavior appears to be a sign of severe social and psychological disturbances and is associated with serious physical and mental impairment. There is a high risk of completed suicide for youths who demonstrate persistent suicidal ideation, and far more substantial prevention efforts should be designed and implemented to address the circumstances of these youths.

Adolescent↗
PubMed1996

Epidemiology of eating behaviour and weight distribution in 14- to 19-year-old Swiss students.

A sample consisting of 1944 Swiss students of both sexes was investigated with regard to distribution over weight categories based on BMI age percentiles and eating behaviour (EAT-26) in relation to age, sex and socio-economic status (SES). In addition, the relationship between BMI and Eating Attitudes Test scores was analysed. More subjects than expected were found to be in the obese weight categories. No clear effect of age and sex on the distribution of the sample across the five BMI classes was observed. There was an inverse relationship between BMI and socio-economic status. On the EAT scale girls scored twice as high as boys. Age had no effect on the EAT scores in females, although it did in males. Socio-economic status and EAT scores were inversely associated. Three risk categories based on the EAT scores were described: EAT 0-9 = no risk (77.5% girls, 93.0% boys), EAT 10-19 = low risk (14.1% girls, 5.5% boys), and EAT > or = 20 = high risk (8.3% girls, 1.5% boys). With regard to both aspects, weight and eating behaviour, female students showed more disturbed eating behaviour and fewer instances of deviation from normal weight. In male subjects there were more deviations from normal weight than instances of disturbed eating behaviour.

Adolescent↗
PubMed1996

Relationship between disturbed eating behavior and other psychosomatic symptoms in adolescents.

BACKGROUND: There has been relatively little research on subthreshold eating disorders and factors which might promote their transition to eating disorders. METHODS: A sample consisting of 1,944 Swiss adolescents of both sexes, 14-19 years of age, was investigated for eating behavior (EAT-26), psychological (SCL-90-R) and physical symptoms (GSCL-C). In addition, the relationship between eating behavior and other psychosomatic symptoms was analyzed. RESULTS: The results revealed significantly higher scores for females than males on all except one scale of the questionnaires. Three categories of disturbed eating behavior based on the EAT scores were described: EAT 0-9 = not disturbed (77.5% girls, 93.1% boys), EAT 10-19 = moderately disturbed (14.1% girls, 5.5% boys), and EAT > or = 20 = severely disturbed (8.3% girls, 1.5% boys). With regard to the three aspects, eating habits, psychosomatic symptoms and suicidality a significant correlation between disturbed eating behavior and concurrent psychological and physical symptoms was found in female but not in male subjects. CONCLUSIONS: The results emphasized that disordered eating behavior has to be seen as part of a broader psychopathological syndrome, especially in young women.

Adolescent↗
PubMed1996

[Is inpatient rehabilitation of patients with chronic obstructive lung disease (COPD) useful? Results of a prospective 1-year follow-up study].

Success of inpatient therapy for patients with chronic obstructive pulmonary disease (COPD) has been assessed in a prospective study of 54 patients (mean age = 63.8y). During hospital stay (mean duration = 27.6d) FEV1% of predicted improved from 42.5% on admission to 51.9% on discharge (p < 0.001). Quality of Life (QoL) (p < 0.05) and Health Satisfaction (p < 0.001) improved significantly. The 22 drop-outs revealed a significantly more depressive coping strategy but did not differ from the remaining 32 patients regarding lung function, sociodemographic data and QoL. One year after the hospital stay the remaining 32 patients showed a still improved FEV1% (46.4%, p < 0.05) and Health Satisfaction (< 0.05) but QoL scores relapsed to entry levels. Better pulmonary long-term effects were achieved by patients with high QoL scores on entry; subjects that tended most to wishful thinking as a coping strategy had worse pulmonary outcome.

Adaptation, Psychological↗
PubMed1995

[Psychosocial aspects of the climacteric].

Medicine has till now payed less attention to psychosocial aspects of the menopause than to the hormonal changes of woman in this period of life. The climacteric woman is characterized in the language of the organ-medicine by faulty terms. The lack of hormones is considered to be a disease which has to be treated. The tendency to medicalize the menopause is in contradiction to the results of recent prospective studies. These studies show that pre- and postmenopausal complaints are less severe than they are often described. Psychosocial risk factors before and during the climacteric phase favour the development of psychic and psychosomatic symptoms. The climacteric period of life has to be seen as a vulnerable time of life which should be considered in the treatment of menopausal women.

Climacteric↗
PubMed1995

[Gynecologic examination: perceptions, fears and expectations of polyclinic patients].

OBJECTIVE: What kind of expectations, desires and fears do patients have concerning the pelvic examination, and is it possible to improve the procedure? METHODS: We asked 1,061 women of our gynecological outpatient clinic using a questionnaire. RESULTS: 48% said that the pelvic examination caused no problem at all, while nearly every third patient felt tense and uncomfortable. 75% of the women wanted explanations during the examination, which had to be carried out in the absence of a third person in 46%. The same percentage said that it did not matter. 53% had no preference of gender concerning the examiner, 37% preferred a female doctor and 10% gave preference to a male one. CONCLUSIONS: The pelvic examination, which is mainly associated with reluctance and discomfort of the patient, does not seem to be experienced like this by almost half of our patients. It is easily possible to ameliorate the procedure, for example by explaining the findings during the examination and by complying with the gender preferences of the patients as much as possible.

Adolescent↗
PubMed1995

[Causal attributions and coping with illness by breast cancer patients: results of a longitudinal study].

The present 3-year longitudinal study investigated the relationship between causal attribution and coping mechanism. Data were collected in a group of 66 breast cancer patients by self-report questionnaires. Three issues were addressed: 1. How do the patients explain the cause of their illness? 2. Do the subjective causes change over the course of three years? 3. What kind of relationship can be found between the causal attributions and the coping mechanism of the patients? Results showed a predominance of psychological attribution. Only little statistical prove could be found for changes between the four ratings. Analysing the individual data of the patients however revealed changing perceptions for about half the patients. A relationship between psychological attribution and depressive coping and problem solving as well were found.

Adaptation, Psychological↗