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Biomedical subjects

F Lamprecht

Publications and source records attributed to F Lamprecht.

At least 19 recordsLinked to original sources
PubMed2004

Social and health adjustment of bulimic women 7-9 years following therapy.

OBJECTIVE: To examine the long-term social adaptation and long-term follow-up of bulimic women after therapy. METHOD: Eighty women with bulimia nervosa were investigated 7-9 years after the beginning of either conflict-oriented in-patient therapy or systemic out-patient therapy. Data was gathered through interviews and patient questionnaires. RESULTS: At the time of follow-up, 28.9% still had DSM-III-R bulimia, 10.1% suffered from subthreshold bulimia or anorexia (EDNOS), 61.2% did not suffer from any DSM-III-R eating disorder. Compared with statistics on the normal population, the social adaptation of the women was quite good with regard to work, household and living conditions. Some dimensions representing probable aetiological factors (i.e. restrictions of intake, feelings of ineffectiveness) showed a delayed reaction to therapy. CONCLUSION: Long-term outcome of bulimia nervosa may be expected to be moderately good. During therapy, greater attention should be paid to characteristics of the disorder less responsive to treatment.

Adaptation, Psychological↗
PubMed2003

[Stigmatization and quality of life of patients with psoriasis and atopic dermatitis].

BACKGROUND AND OBJECTIVE: Psoriasis and atopic dermatitis patients are often influenced by the psychosocial consequences of their skin diseases. In order to assess these experiences reliably, the stigmatization feeling and the quality of life of these patient groups were studied. PATIENTS/METHODS: The short form of the "Questionnaire on Experience with Skin Complaints" (QES) was validated in a sample of 463 in-patients with psoriasis and atopic dermatitis. In addition, the Dermatology Life Quality Index (DLQI) was ascertained. RESULTS: The dimensions "impairment of self-esteem and withdrawal", "rejection experienced", "concealment", and "composure" of the QES could be confirmed by factor analysis. As expected, middle high correlations between the QES and the DLQI were found in both patient groups. However, the stigmatization experience and the quality of life were not significantly different in a subgroup of psoriasis and atopic dermatitis patients with comparable sociodemographic characteristics. CONCLUSIONS: The short form of the QES with 23 items is a valid instrument for the examination of social and psychic burdens of psoriasis and atopic dermatitis patients. The recording of the stigmatization feeling and of the quality of life determines different, supplementary aspects of the illness-related stress of patients with chronic skin diseases.

Adolescent↗
PubMed2001

Levels of circulating CD8(+) T lymphocytes, natural killer cells, and eosinophils increase upon acute psychosocial stress in patients with atopic dermatitis.

BACKGROUND: Different exogenous and endogenous provocation factors such as mental stress are hypothesized as being relevant in the pathophysiology of atopic dermatitis (AD). OBJECTIVE: The purpose of this study was to examine the effects of acute psychological stress on illness-specific immunologic parameters in AD. Patients with psoriasis and healthy volunteers were investigated in parallel. METHODS: Patients with AD (n = 15), patients with psoriasis (n = 15), and control subjects (n = 15) were exposed to mental stress lasting 10 minutes (public speaking, mental arithmetic). In vitro analyses were done 1 hour before, immediately after, and 1 hour after stress exposure. Vital parameters (blood pressure, heart rate) and plasma noradrenaline concentrations were determined to prove the effects of mental stress on the individuals. Lymphocytes were phenotypically analyzed by flow cytometry. RESULTS: The results indicate a higher ability of CD8(+) T lymphocytes to react to stress, including the subpopulations of CD8(+)/CD11b(+) T lymphocytes and eosinophils in patients with AD compared with healthy volunteers. The increases in the subpopulation of CD8(+)/CD11b(+) T lymphocytes on psychological stress were higher in the patients with AD and psoriasis than in healthy control subjects. Significant stress-induced changes of natural killer cells were revealed for all 3 groups. CONCLUSION: The results suggest that psychological stress has different immunologic effects in patients with AD than in patients with psoriasis and healthy men.

Acute Disease↗
PubMed2000

[Illness-related stress in psoriasis vulgaris. Validation of the "Psoriasis Daily Stress Inventory"].

BACKGROUND AND OBJECTIVE: Illness specific stress plays an important part in the daily life of psoriatic patients. Until now for the measurement of relevant aspects of daily stress only the "Psoriasis Life Stress Inventory" (PLSI) of Gupta & Gupta exists; with the "Psoriasis-Alltagsstress-Inventar" (PAI), a German version of the PLSI is presented and its psychometric properties are discussed. PATIENTS/METHODS: 385 in-patients completed the PAI. The internal validity was examined by factor analysis. Moreover, the correlations between the PAI total score and sociodemographic parameters (ANOVA) and extent of skin involvement (multiple regression) were determined. RESULTS: The PLSI score proves to be sufficiently independent of age, sex, age at onset, and general extent of skin involvement. However, affections of the hands, the lower abdomen and the genitals show a strong influence on the total score. We found marked interrelations with the stigmatization feeling ("Questionnaire on Experience with Skin Complaints" QES, Schmid-Ott et al. 1998). CONCLUSIONS: The results suggest that the PAI is a useful and psychologically relevant questionnaire for psoriatic patients.

Adult↗
PubMed2000

[Drug and psychological therapies in chronic subjective tinnitus. Meta-analysis of therapeutic effectiveness].

A metaanalysis on pharmacological and psychological treatment reports was conducted in order to evaluate the overall effectiveness of these treatment conditions in chronic tinnitus. A totality of 109 treatment studies published between 1976 and 3/1995 and meeting minimal inclusion criteria was located, but only 24 studies reporting sufficient information could be analyzed. The methodological quality of the studies was evaluated by a coding scheme, and the resulting index of effectiveness has been weighted by this standard as well as by sample size. Effect sizes of pharmacological studies were ES = 1.27 and by this higher than the ones for psychological studies with ES = 0.88. This finding is attenuated by high (unspecific) placebo effects of ES = 0.65 in pharmacological studies compared to ES = 0.10 in psychological studies. In general, patients from psychological studies further improve after treatment in cases where catamnestic measurements have been conducted.

Anesthetics, Local↗
PubMed2000

[Concept for a health care economic evaluation of short- and long-term costs and effectiveness parameters of an expanded ambulatory psychosomatic rehabilitation program].

There are only few ambulatory rehabilitation concepts for mothers with psychosomatic disorders (prevalence 5%). Also, only little is known about the evaluation of these programmes. This study compares the socioeconomic evaluations of an ambulatory rehabilitation programme with a post-assistance programme and one without a post-assistance programme. The superior programme should be determined by weighing all relevant costs and benefits. The intensive phase of the ambulatory rehabilitation programme consists of an eight-week treatment with group, single, body and art therapy. The post-assistance programme spans a period of nine-months with 36 sessions of psychoanalytic group therapy. The evaluation of both programme alternatives is made by with the evaluation tool of socioeconomic analyses. For consideration and pricing of costs all direct medical costs, direct non-medical costs and indirect costs are being monitored. Outcomes assessment is realised by cost-effectiveness analysis, cost-utility analysis and cost-benefit analysis. Utilisation of the health care system is being assessed with questionnaires. Measurements are being performed at the beginning and the end of the rehabilitation programme and three, six, nine and twelve months later. Mothers with children aged six years and younger and suffering from various psychosomatic disorders were included in this study. The costs identified for the rehabilitation programme are DM 5571.10 (intensive care and post-assistance programme) and DM 1512.40 (intensive care) per patient. Further progress of the study will show if future cost will differ between the two alternatives. For the comparison of both alternatives all costs will be linked with outcomes. It remains to be seen that additional costs of the post-assistance programme will be compensated with positive outcomes. A sensitivity analysis will show if variation of assumptions will influence the cost-benefit-ratio of the different alternatives.

Adult↗
PubMed1999

Validity study for the stigmatization experience in atopic dermatitis and psoriatic patients.

A central experience of patients with atopic dermatitis and psoriasis is the feeling of stigmatization. This can be estimated by the "Questionnaire on Experience with Skin Complaints" (QES), based on the "Feelings of Stigmatization Questionnaire" by Ginsburg & Link. This study was designed to evaluate the psychometric properties of the QES, especially the validity of this questionnaire, and to supply more information about the stigmatization experiences of patients with atopic dermatitis and psoriasis. Three groups of patients were analysed: 76 with atopic dermatitis, 81 and 217 with psoriasis, respectively. The comparison of subgroups with different affected regions revealed that the genital region is especially relevant for the stigmatization experience in these patients. In addition, the feeling of stigmatization (estimated by the QES) is relatively independent of the different dimensions of the "Trier Scales of Coping with Diseases", except for the depressive coping style "Rumination" measuring a high amount of inner concern with the afflicting disease. It can be concluded that the QES is a valid and reliable instrument for examining the stigmatization experience of patients with atopic dermatitis and psoriasis.

Adaptation, Psychological↗
PubMed1998

[Medical and non-medical ambulatory psychotherapy in the Hannover area. A specialty, school and sex related comparison].

The result of an investigation of 128 from 283 (45.2%) medical and psychological psychotherapists established in the city of Hannover is presented. The aim of the study is to characterize the situation of psychotherapeutical care not only by the number of psychotherapists in relation to inhabitants but also by the working time spent for psychotherapy. Besides we found gender, school of psychotherapy and professional experience as factor influencing the patients waiting time for beginning a psychotherapy. In contrast to other studies, the number of medical and psychological psychotherapists is not different, nevertheless the psychotherapeutical care in Hannover is not ensured.

Adolescent↗
PubMed1998

Stress-induced endocrine and immunological changes in psoriasis patients and healthy controls. A preliminary study.

BACKGROUND: Clinical observations suggest that psychological stress can induce exacerbation of psoriasis. It is hypothesized that these stress effects on the course and outcome of psoriasis are caused by neuroendocrine modulation of immune functions. Therefore we investigated the cardiovascular, endocrine and immunological response to a laboratory stressor in psoriasis patients and healthy controls. METHODS: Untreated (n = 7) and PUVA-treated (n = 4) psoriatics and healthy controls (n = 7) were exposed to a brief laboratory stressor (public speaking and mental arithmetic). Heart rate and blood pressure, catecholamine, cortisol, and DHEA plasma concentration, as well as distribution of T and NK lymphocytes were analyzed before, immediately after and 1 h after stress exposure. RESULTS: Heart rate and blood pressure increased in all three groups during stress exposure with the most pronounced changes in PUVA-treated patients. Psoriasis patients displayed higher adrenaline values but diminished cortisol and DHEA plasma concentrations compared to controls. NK cell numbers (CD16+, CD56+), but not T lymphocyte subsets, increased immediately after stress exposure in untreated patients and controls. This effect was significantly diminished in PUVA-treated patients. CONCLUSIONS: The data of this pilot study indicate an enhanced stress-induced autonomic response and diminished pituitary-adrenal activity in psoriasis patients. PUVA treatment seems to interfere with the cardiovascular and NK cell response to acute psychological stress. Future studies will analyze the stress-induced neuroimmunological mechanisms in psoriatics in more detail.

Adult↗
PubMed1998

Psychosomatic medicine and primary care in Germany.

The development and training in psychosomatic medicine in Germany are presented. This branch of medicine emphasizes the biopsychosocial understanding of disorders, and psychological, particularly psychoanalytic, methods are used. The outcome of treatment studies are awaited to clarify their role in the medical services of Germany.

Curriculum↗
PubMed1998

[Psychotherapy research--how it should (not) be done. An expert reanalysis of comparative studies by Grawe et al. (1994)].

22 psychotherapy outcome studies used in the Bernese meta-analysis by Grawe, Donati and Bernauer (1994) for a treatment comparison between behavioural and psychoanalytic-psychodynamic treatment concepts were reanalysed by 12 expert psychotherapy researchers independent of each other. Three clinical criteria served as basic criteria for the assessment of the methodological quality of the 22 comparative studies: treatment dosage, therapists' competence or expertise, and an adequate realisation of the intended treatment concept. The expert ratings were then compared with an evaluation of an assessment of a research team from the University of Ulm and with the one from the Bernese research team. Contrary to the Bernese meta-analysis, both the experts and the Ulm research group conclude that only 5 or 8 of the 22 studies, respectively, could be accepted for a relatively fair comparison between the treatments under study. Out of the 5/8 studies, none could be considered fully suitable for a treatment comparison, at the most only moderately suitable. These remaining 5 or 8 studies, respectively, do not prove superiority of one treatment over the other. Hence, the "Dodo Bird Verdict" stands up under scrutiny.

Behavior Therapy↗
PubMed1997

[Inpatient treatment of a patient with large duodenal diverticulum and psychogenic vomiting--somatic and psychosomatic approach].

The inpatient psychotherapy of a female patient with a large duodenal divertivulum and psychogenic vomiting is described. The specifics of the inpatient treatment setting necessary for change are presented thereby demonstrating to be helpful for these kind of patients with previous negative experiences of somatic and psychotherapeutic treatment.

Combined Modality Therapy↗
PubMed1997

[Illness experience and treatment seeking behavior of psoriasis patients].

We analyzed how psoriasis patients sought professional help and correlated it to their illness attitudes and feeling of stigmatization. Semi-structured interviews of 400 patients were reanalyzed to identify homogeneous groups concerning initial reactions at first manifestations of the disease. Four groups ("isolated", "stigmatized", "socially supported" and "non-stigmatized" patients) were found and cross-tabulated with five resulting groups of a second cluster-analysis concerning the "style" of the seeking behaviour of professional and paraprofessional help and medical measures against the psoriasis ("multi-users", "arranged mini-users", "waiting-room patients", "optimists" and "self-therapists"). We were able to describe typical courses of illness behaviour depending on the initial reaction. The results are discussed with regard to the desirable identification of problematic patients within professional care units.

Adaptation, Psychological↗
PubMed1997

[Sense of coherence and psychosomatic treatment outcome. An empirical study of salutogenesis].

According to Aaron Antonovsky's model of salutogenesis health protective resources by him conceptualised as "sense of coherence" (SOC) determine decisively the ability to recuperate. We investigate the relationship between treatment outcome and the sense of coherence measured by the SOC questionnaire at the beginning (n = 81), during the inpatient treatment phase and 6 month later (n = 70). For testing the psychometric qualities we obtained additional data from the outpatient department (n = 461). SOC-Score increased significantly during inpatient treatment. Outcome of treatment could not be predicted by the initial SOC, but we found a highly significant relation between an increase in the SOC value and a decrease in complaints (SCL-90-R, r = .81). In our opinion, the application of the SOC in psychosomatic patients is restricted, because there is a high overlap with psychic complaints (i.e. anxiety, depression).

Adaptation, Psychological↗
PubMed1996

Dimensions of stigmatization in patients with psoriasis in a "Questionnaire on Experience with Skin Complaints'.

BACKGROUND: Stigmatization is a central experience of patients with psoriasis with a broad psychic and social impact. OBJECTIVE: The purpose of this study is to identify the dimensions of stigma experience by a Questionnaire on Experience with Skin Complaints (QES; 'Fragebogen zum Erleben von Hautbeschwerden'). METHODS: 187 in-patients with psoriasis were examined with the QES, an adopted and extended (German) version of the Feeling of Stigmatization Questionnaire by Ginsburg and Link. A factor analysis of the questionnaire was conducted and the construct validity was evaluated. RESULTS: Five factors were found: 'self-esteem', 'retreat', 'rejection', 'composure' and 'concealment'. Self-esteem, retreat and rejection are mainly influenced by 'problematic regions' affected by psoriasis, rejection also by 'visible parts' and retreat also by 'invisible regions'. The influences of age, age at onset and sex on the stigma experience are small but significant. CONCLUSIONS: The QES proved to be an economical and reliable psychometric instrument to differentiate the stigma experience of psoriasis patients.

Adolescent↗
PubMed1996

[Psychosomatic medicine between explanation and understanding].

Explanatory and hermeneutic concepts in psychosomatic medicine are frequently discussed in a controversial manner. Inherent in an explanatory concept is a patient ideally visualized as a separated object, hereby trying to imitate principles in physics, which have dominated this discipline during the 19th century. However with the development of the quantum theory it became obvious that the observer cannot be separated from the object of his observation. The limitation of historical causation became clear and circular relationships at different levels for instance at the cellular level or at the sociological level were taken into account. The human being seen as an open system with selforganizing potentiality can now be described with semiotic terms at all the different organizational levels. Th.v. Uexküll has described this in his 'Situationskreis'-model. A case presentation is given to illustrate these more theoretical remarks.

Activities of Daily Living↗