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Biomedical subjects

H J Rumpf

Publications and source records attributed to H J Rumpf.

At least 19 recordsLinked to original sources
PubMed2000

[Lifetime prevalence of mental disorders in general adult population. Results of TACOS study].

The present paper reports lifetime prevalence rates of mental disorders in the 18- to 64-year-old general population of a northern German region. A representative random sample from registration office files of 4,075 individuals was examined in personal interviews using the fully standardized and computerised "Munich Composite International Diagnostic Interview" (M-CIDI). The response rate was 70.2%. Individuals were classified according to the DSM-IV. Substance use disorders were most frequent with 25.8% followed by anxiety (15.1%), somatoform (12.9%), affective (12.3%), and eating disorders (0.7%). Disorders other than substance use were more frequent in women and less frequent in men. A trend toward less psychiatric morbidity exists in individuals with higher educational level, higher income, and those who are married or reside in rural communities. Of all individuals affected by mental disorders, 42% fulfilled the criteria for at least one additional disorder. The results are discussed against the background of selected previous studies.

Adult↗
PubMed2000

Prevalence of alcohol consumption, abuse and dependence in a country with high per capita consumption: findings from the German TACOS study. Transitions in Alcohol Consumption and Smoking.

BACKGROUND: The aim of the Transitions in Alcohol Consumption and Smoking (TACOS) project is to investigate substance use and use disorders in the adult general population in a region of the under-researched north of Germany, focussing on smoking and alcohol consumption. In this study, the design and quality assurance provisions of the baseline cross-section of the longitudinal project are described. Prevalence rates of alcohol use disorders, consumption pattern, and the nature of their association are also analysed with regard to preventive strategies. METHOD: A random sample of 4075 participants, aged 18 to 64 and drawn from residents registration office files, was interviewed with a DSM-IV adapted version of WHO CIDI. Fieldwork resulted in a response rate of 70.2% and an unbiased database with regard to demographic characteristics. RESULTS: Low lifetime prevalence of alcohol use disorders (4.5% abuse, 3.8% dependence) and hazardous consumption (13.2% lifetime; 6.0% 12-month) was found compared to southern regions of Germany and US American data. In contrast, we found a comparatively high percentage of moderate alcohol uses. Male subjects are more affected by lifetime alcohol use disorders (abuse OR 8.3, 95% CI 5.3-13.2; dependence OR 4.3, 95% CI 2.8-6.4). The association between alcohol use disorders and alcohol consumption pattern revealed a weaker relation for alcohol abuse compared to dependence. CONCLUSION: National and regional drinking habits and norms have to be considered as a significant source of variance, supporting the need for European epidemiological research on substance use in addition to US American activities, and emphasising the advantages of community-based preventive measures. An evaluation of public recommendations for safe limits of alcohol consumption and prevention targets referring to average consumption is indicated. There is also a need for a clear distinction between alcohol abuse and dependence.

Adult↗
PubMed2000

Prevalence, quality of life and psychosocial function in obsessive-compulsive disorder and subclinical obsessive-compulsive disorder in northern Germany.

BACKGROUND: Despite the worldwide relevance of obsessive-compulsive disorder (OCD) there are considerable differences in prevalence rates and gender ratios between the studies and a substantial lack of prevalence data on subclinical OCD. Moreover, data on quality of life and on psychosocial function of subjects with OCD and subclinical OCD in the general population are missing to date. METHODS: German versions of the DSM-IV adapted Composite International Diagnostic Interview were administered to a representative sample of 4075 persons aged 18-64 years living in a northern German region. Specific DSM-IV based criteria for subclinical OCD were used. RESULTS: The life-time prevalence rates for OCD and subclinical OCD were 0.5% and 2%, respectively. Twelve month prevalence rates were 0.39% and 1.6%, respectively. The gender female:male ratio was 5.7 in OCD and 1.2 in subclinical OCD. In various measures of psychosocial function and quality of life, OCD and subclinical OCD were significantly impaired. However, subclinical OCD subjects did not visit mental health professionals more often than controls. CONCLUSION: Due to different epidemiological characteristics subclinical OCD might represent a syndrome distinct from OCD which is also associated with significant impairments in personal and interpersonal functions and in quality of life.

Adolescent↗
PubMed2000

Studies on natural recovery from alcohol dependence: sample selection bias by media solicitation?

AIMS: To assess the selection bias of recruiting participants in studies on natural recovery from alcohol dependence through media solicitation. DESIGN: Two samples with different recruitment strategies are compared. SETTING: Media solicitation and general population. PARTICIPANTS: Sample 1 consists of 176 alcohol-dependent individuals remitted without formal help and recruited through media solicitation, sample 2 consists of 32 natural remitters derived from a representative general population study with a sample size of 4075 respondents and a response rate of 70.2%. MEASUREMENTS: Several triggering mechanisms and maintenance factors of remission were assessed in a personal interview using standardized questionnaires. FINDINGS: Results of logistic regression analyses show that media-solicited subjects were more often abstinent in the last 12 months, were more severely dependent, were less satisfied with eight life domains prior to remission and showed higher scores in a coping behaviour measure. Besides these major differences from the multivariate analysis, media subjects revealed more health problems prior to remission, experienced more social pressure to change drinking behaviour, and showed differences in reasons for not seeking help. CONCLUSIONS: Media solicitation leads to a sample selection bias in research on natural recovery from alcohol dependence. When measures to foster self-change are derived from such studies, findings from representative samples have to be considered.

Female↗
PubMed2000

[Health behavior of smokers--results of the TACOS (Transitions in Alcohol Consumption and Smoking) Study].

The German TACOS Project (Transitions in Alcohol Consumption and Smoking) provided an opportunity to examine the patterns of health behaviours (nutrition, physical activity, alcohol consumption) of current smokers, ex-smokers and non-smokers with special regard to different degrees of severity of nicotine dependence. Data were collected in the adult general population of Lübeck and 46 surrounding communities, resulting in a representative sample of 4075 individuals. In this sample, 37.3% were current smokers, 22.5% were ex-smokers, 25.0% of smokers were severely nicotine-dependent. As in other empirical investigations, current smokers had an unhealthy lifestyle in general. Smokers compared to ex-smokers and non-smokers consumed unhealthy foods more frequently, reported less physical activity and were more likely to consume hazardous levels of alcohol. Special attention was paid to comparing different degrees of severity of nicotine dependence. A high degree of nicotine dependence was associated with poor health behaviours. Data show that smoking, unhealthy nutrition, lack of physical activity, and hazardous levels of alcohol consumption occur in combination and that unhealthy behaviour patterns vary according to the severity of nicotine dependence. The presence of multiple unhealthy behaviours requires special secondary preventive interventions for smokers. The association of these combined health hazards must be controlled in determining the independent health risk due to one of these factors.

Adolescent↗
PubMed2000

Gender differences in natural recovery from alcohol dependence.

OBJECTIVE: Data from epidemiological research reveal that most alcohol dependent individuals recover without professional treatment. Little is known, however, about individuals remitting from alcohol dependence without formal help, and almost no data are available with respect to gender differences in natural recovery. METHOD: Women (n = 38) and men (n = 106) who remitted from alcohol dependence according to DSM-IV without utilization of formal help (treatment or self-help groups) are compared. A standardized interview assessed reasons for not seeking help, and triggering mechanisms and maintenance factors of remission. RESULTS: Compared with male subjects, female subjects, prior to remission, experienced lower extents of social pressure to change drinking behavior, drove less often under the influence of alcohol, revealed less satisfaction with different life domains and reported a higher impact of health problems on the remission process. Female subjects also informed fewer individuals about their former drinking problems. CONCLUSIONS: Female and male natural remitters differ in factors that trigger the process as well as the maintenance of natural remission.

Adult↗
PubMed2000

Maintenance factors of recovery from alcohol dependence in treated and untreated individuals.

BACKGROUND: Research on natural recovery from alcohol dependence has focused mainly on triggering mechanisms of the remission process. Only a few studies have considered maintenance factors of natural recovery. METHODS: In the present study, 93 natural remitters and 42 self-help group participants were compared. Both groups remitted from alcohol dependence according to DSM-IV criteria. Several alcohol-related variables and maintenance factors of the remission process were assessed in a personal interview by using standardized questionnaires. RESULTS: Logistic regression analysis that focused on maintenance factors showed that, independent from direct self-help group context, self-help group attendees informed more individuals about their former alcohol problems and sought social support more often as a coping strategy to deal with craving. No further group differences could be identified. CONCLUSIONS: Self-help group participants revealed a higher social engagement to maintain their recovery. Besides this major difference, data support the assumption that more commonalities than differences exist within successful recoveries from alcohol dependence, independent of help-seeking status.

Adaptation, Psychological↗
PubMed1998

[Length of stay of patients with alcohol abuse or alcohol dependence in internal medicine and surgery].

To determine the length of stay (LOS) of alcoholic and non-alcoholic patients, all consecutive admissions to medical and surgical departments of a general hospital in Lübeck, Germany, were registered over a period of six months. The study sample comprised 625 medical and 661 surgical patients aged 18 to 64 years, 42% female. Alcohol abuse and dependence were detected using an expert interview (Schedules for Clinical Assessment in Neuropsychiatry, SCAN). The median LOS of patients with alcohol abuse or dependence was equal to that of the other patients (Z = 9 days). Differences occurred in the surgical clinic where alcohol abusers as well as alcohol dependent patients stayed longer than the others. There was significant trend in the medical clinic towards longer LOS for alcohol abusers and shorter LOS for alcohol dependent patients compared to the other medical patients respectively. Patients suffering from infections, tumors or gastrointestinal diseases had significantly increased LOS if having an alcohol problem. In conclusion, there is no general elongation of LOS in alcoholic patients. Differences occur if single departments or somatic or psychiatric subgroups of patients are regarded. However, high concentrations of alcohol-related diseases in these settings stress the importance of preventative measures.

Adolescent↗
PubMed1998

Previous help seeking and motivation to change drinking behavior in alcohol-dependent general hospital patients.

To assess the suitability of implementing secondary prevention approaches for alcohol abuse and dependence in the general hospital, it is worth examining how many problem drinkers are detected in this setting for the first time and whether these individuals are motivated to change their drinking behavior. In a representative general hospital sample (N = 1167), subjects were detected by a two-step diagnostic procedure including screening instruments and a diagnostic interview during a period of 6 months on all medical and surgical wards. Of alcohol-dependent patients, 38.2% had received no help in their lifetime and 70.8% did not seek help in the year prior to admission. According to the stages of change model of Prochaska and DiClemente the minority (10.9%) of subjects detected as alcohol dependent for the first time were not considering changing their drinking behavior (precontemplation stage); 84.8% were either in the contemplation or action stage. Previous help seeking showed no significant relationship with the stages of change.

Adult↗
PubMed1998

Differences between hospital patients with alcohol problems referred for counselling by physicians' routine clinical practice versus screening questionnaires.

AIMS: To test the hypothesis that screening for alcohol-related disorders in a general hospital with questionnaires generates a target group of patients for alcohol counselling which differs from patients referred by physicians' routine clinical practice. DESIGN: A prospective study with follow-up after 12 months. SETTING: Medical and surgical wards of a general hospital. PARTICIPANTS: A sample of 298 patients detected by screening questionnaires (CAGE, MAST) was compared with a sample of 87 patients referred by physicians. MEASUREMENTS: The main measurements were a diagnostic interview (SCAN), two questionnaires to estimate the severity of dependence and the motivation to change drinking behaviour (RCQ, LAS), and socio-demographic variables. Outcome criteria were utilization of remedial programmes, decreases in hazardous and excessive drinking and abstinence rates. FINDINGS AND CONCLUSIONS: Patients referred by physicians were more often separated and unemployed, were more likely to be alcohol-dependent and to be more severely dependent, had a higher rate of alcohol-related diseases as reasons for admission, were more often motivated to change drinking behaviour, had a higher participation rate in remedial programmes and more often exhibited improvements in drinking behaviour compared with the sample identified by screening questionnaires. However, there was evidence of improvements in drinking in both samples. Data show that while screening reaches a less problematic sample with lower motivation to change, it is a worthwhile activity which extends the spectrum of patients eligible for brief interventions.

Adolescent↗
PubMed1998

Screening questionnaires in the detection of hazardous alcohol consumption in the general hospital: direct or disguised assessment?

OBJECTIVE: The aim of this study was to compare the validity of two direct screening questionnaires, the CAGE and MAST, in the detection of hazardous alcohol consumption with a disguised assessment by using the Trauma Scale in a poststratified general hospital sample. METHOD: Surgical and medical inpatients (N = 1,379) completed the three questionnaires. Hazardous alcohol consumption was defined by criteria derived from a World Health Organization study and assessed using self-reported quantity and frequency. RESULTS: The sensitivity of the Trauma Scale was not significantly different compared to the CAGE and MAST, whereas the direct questionnaires were higher in specificity and overall accuracy (p < .0001). In male surgical patients the detection rate of the Trauma Scale was higher compared to the CAGE (p < .05). Thirteen percent of subjects with hazardous levels of alcohol consumption were detected by the Trauma Scale only. In female surgical patients, the Trauma Scale, when used as an additional tool, does not improve the detection of hazardous drinkers. CONCLUSIONS: Because of the low specificity, indirect assessment using a history of trauma cannot be recommended as a screening instrument in a general hospital setting. Despite a high number of false positives, the Trauma Scale may serve as an additional tool in conjunction with direct questionnaires when high sensitivity is desired.

Alcohol Drinking↗
PubMed1998

Prevalence of alcohol dependence and abuse in general practice.

The aim of this study is to deliver representative epidemiological data about the prevalence of alcohol abuse and dependence in general practices in an urban area. In 12 general practices at Luebeck, a Northern German city with 220,000 inhabitants, a total of 929 patients (aged between 14 and 75 years) were screened using the CAGE and the Short Michigan Alcoholism Screening Test. If one of these screening questionnaires or the General Practitioners' assessment of the patient indicated an alcohol problem, the patient underwent a standardized diagnostic interview using the alcohol section of the Schedules for Clinical Assessment in Neuropsychiatry. The prevalence rates according to ICD-10 or DSM-III-R were 3.5% for alcohol abuse and 7.2% for alcohol dependence, the sex ratio was 1:2.8 (female:male). These results are compared with previous findings, and general epidemiological implications of this study are discussed.

Adolescent↗
PubMed1998

[Stages of motivation to change in smokers of the general population].

Secondary preventive measures to reduce cigarette smoking can be effective only if the motivation to change in the target population is taken into account. A useful model to match interventions to the readiness to change differentiates five stages: precontemplation, contemplation, preparation, action, and maintenance. In the USA, general population studies showed that 40% of smokers were in the precontemplation and contemplation stage, respectively, and 20% were in the preparation stage. In Germany, no data according to the distribution of stages among smokers are available; however, such data are necessary to plan population-based interventions. Data with respect to nicotine use, nicotine dependence, and the stages of change were assessed in a representative sample of 4075 respondents in Luebeck, a northern German city, and 46 adjoining communities in a face-to-face interview. The response rate was 70.2%. In this sample, 37.3% were cigarette smokers. Of those smokers with at least one attempt to reduce or quite smoking in the past, 76.4% were in the precontemplation, 17% in the contemplation, and 6.6% in the preparation stage. Including individuals without an attempt to reduce or quit smoking, 95.3% can be allocated to the precontemplation or contemplation stage. Nicotine-dependent smokers were in higher stages compared to smokers without dependence. Severity of dependence was not related to the stages of change. Data demonstrate that common smoking cessation programmes that require the individuals' readiness to change are inappropriate for 95% of the population. Stage-matched interventions are introduced and discussed in the paper. Compared to data from the USA smokers in Germany are more likely to be in early stages of change. Policy-based public health measures are necessary to change these findings.

Adolescent↗
PubMed1997

Development of a screening questionnaire for the general hospital and general practices.

The purpose of this study was to develop a sensitive as well as brief screening questionnaire by combining the well-known instruments CAGE and the Michigan Alcoholism Screening Test (MAST) in detecting patients with alcohol dependence or abuse in general hospitals and general practices. The number of items was reduced by means of logistic regression and item analysis based on data of 1,167 consecutive admissions of a general hospital who completed both questionnaires. Further data were derived from a sample of 774 patients from 10 randomly selected general practices. A solution with nine items was validated in a second sample of 436 hospital inpatients. In all three samples, cases screening positive were interviewed using the Schedules for Clinical Assessment in Neuropsychiatry to provide ICD-10 and DSM-III-R or DSM-IV diagnosis. In addition, 103 subjects with negative screening results were interviewed in the second general hospital sample. On grounds of the data of all three samples, a solution of seven items was chosen. This instrument comprises two CAGE and five MAST questions (Leubeck Alcohol Dependence and Abuse Screening Test; LAST) and was significantly higher in sensitivity than CAGE and SMAST. Data were robust in all three samples. It is concluded that the LAST is an optimized instrument for use in general hospital and general practice.

Adolescent↗
PubMed1995

[Coping pattern and adjustment in multiple sclerosis].

A questionnaire (FKV/LIS) was used to study the coping process in 210 patients with multiple sclerosis. By cluster analysis of five coping modes, patients could be divided into two groups of approximately the same size: cluster 1 presented with higher values for "active coping; self-affirmation; religiousness" and lower values for "depression" and "trivialization". In cluster 2, on the other hand, values were higher for "depression" and "trivialization" whereas values were lower for "active coping; self-affirmation; religiousness". Patients in cluster 1 were significantly more contented with life. Mean age and mean duration of illness were higher in cluster 1, suggesting a time-dependent change in the coping process with improvement in adaptation in the course of the disease. The extent of social support was higher in cluster 1. The consequences for psychological intervention are discussed.

Adaptation, Psychological↗
PubMedDate not supplied

Motivation to change drinking behavior: comparison of alcohol-dependent individuals in a general hospital and a general population sample.

The general hospital would be especially suited to initiate interventions if hospitalized alcohol-dependent individuals were particularly motivated to change their drinking behavior. This study compares the readiness to change of alcohol-dependent persons in the general hospital and the general population. Stages of change according to the model of Prochaska and DiClemente [6] are assessed using the Readiness to Change Questionnaire (RCQ) in two representative samples: 118 alcohol-dependent subjects admitted to a general hospital (sample 1) and 50 alcohol-dependent individuals in the general population (sample 2). In sample 1, alcohol-dependent persons were identified in 1167 consecutive admissions using screening questionnaires and a diagnostic interview (SCAN). In sample 2, alcohol dependence was assessed in 4075 individuals using a German version of CIDI. The distribution of stages of change differed significantly (p < 0.0001) between the groups, revealing a shift towards higher stages in the hospital subjects. Logistic regression analysis revealed that the stages of readiness to change and age contributed in predicting whether subjects belonged to the general hospital or the general population sample. Findings suggest that the general hospital is a suitable site to initiate interventions for alcohol-dependent individuals.

Adult↗