Biomedical subjects

H Matschinger

Publications and source records attributed to H Matschinger.

At least 37 records · Page 2Linked to original sources

PubMed2002

Depression and quality of life: results of a follow-up study.

BACKGROUND: Although there is sufficient evidence that the quality of life of people suffering from depression is reduced hardly anything is known about their quality of life after the remission of a depressive episode. AIMS: We therefore set out to study the quality of life of patients with depression (ICD-10 F32, F33) one, four and seven months after discharge from hospital. For comparison, a random sample of the general population was studied in addition. METHOD: Quality of life was assessed by means of the WHOQOL-100, a self-administered questionnaire developed by WHO. RESULTS: Although, shortly after discharge, quality of life of patients whose depression remitted was better than that of patients with persisting depression it was still slightly worse than that of the general population. During the subsequent six months, there was no further improvement of quality of life, i.e. even at the end of the follow-up period there was a slight lack of quality of life, especially as concerns the level of independence, spirituality/religion/personal beliefs and physical health. CONCLUSIONS: Thus, what already had been reported based on the objective assessment of quality of life, namely that depression implies a persisting impairment of social functioning and living conditions, can be replicated to some extent from the point of view of the patients themselves.

Adult↗

PubMed2001

[Determinants of psychotropic drug utilization in homes for the elderly and in nursing homes].

A large proportion of the residential and nursing home population is mentally ill. The causes for increased prescription of psychotropic drugs other than mental disorders have been discussed. This study presents data on the role of the individual's characteristics and institutional conditions on psychotropic drug use in residents of residential and nursing homes. Therefore the psychotropic drug use of 4 old-people's homes in Leipzig (Germany) was reviewed. Sociodemographic characteristics and a number of behavioral patterns of the residents were examined. Regression analysis revealed associations of age, gender and certain behavioral patterns (e.g., agitation, insomnia with nightly disturbances) and psychotropic drug use. Beyond that, psychotropic drug use varied among the 4 institutions' practices. Further research should be aimed at gaining insight into the interplay of these individual and institutional influences on psychotropic drug use in order to develop specific interventions to optimize treatment.

Aged↗

PubMed2001

What to do about mental disorder--help-seeking recommendations of the lay public.

OBJECTIVE: Sociocultural factors have been recognized as an important predictor in shaping help-seeking behaviour. METHOD: We investigated attitudes of the lay public toward help-seeking for mental disorders in a population survey (n = 1,564) conducted in the new Laender of Germany. After presenting a vignette depicting a person either with major depression or with schizophrenia (DSM-III-R), we inquired about help-seeking recommendations. employing a qualitative approach. RESULTS: The lay support system plays an significant role in initially dealing with mental disorders. However, help-seeking recommendation differed for depression and schizophrenia. In depression, support from the lay system was more often considered. In schizophrenia, public opinion favoured the expert system. If primary suggestions fail the expert system is clearly favoured regardless of the disorder in question. CONCLUSION: Lay public's opinion has to be taken into account of in mental health care planning to make services more acceptable to the consumer and their social network.

Adolescent↗

PubMed2001

[Attitude of the elderly to the etiology of memory disorders].

PURPOSE: The early recognition of dementia assumes increasing importance. Lay beliefs on the causes of loss of memory play a major part in this regard as they have shown to determine help-seeking behaviour. METHOD: 720 persons aged 75 or older were questioned on their beliefs on the causes of cognitive deficits in the context of the Leipzig Longitudinal Study of the Aged (LEILA 75+). RESULTS: Almost one-third of the respondents mentioned exclusively biological causes, vascular lesions coming first. One quarter of those questioned ascribed memory deficits to non-biological factors. Every tenth person suspected that they result from a combination of both. One quarter of the elderly did not know any answer. DISCUSSION: The results are contrasted with outcomes of epidemiological dementia research. It is argued that increasing and better quality information of the public are urgently required.

Aged↗

PubMed2001

[European standardization and German language adaptation of scales for collection of outcomes and costs of treatment for patients with severe mental disorders].

For the evaluation of the effectiveness of psychiatric service systems internationally standardised instruments for the assessment of the outcome and the costs of psychiatric and psychosocial treatment and care are increasingly needed. Beside the measurement of objective facts there is a growing importance of the consideration of the subjective perspective of patients and relatives. In the research project "Cost-effectiveness analysis of psychiatric service systems in the European comparison" of the Research association for Public Health in Saxony, developments were worked out, in close cooperation with the BIOMED-2 project "European Psychiatric Services: Inputs Linked to Outcome Domains and Needs", German versions of five European standardized instruments for the assessment of needs for care, treatment satisfaction, burden of care on relatives, quality of life and service costs. The psychometric properties of the instruments were tested within the framework of a longitudinal study with 307 patients with the diagnosis of schizophrenia. As a result of this study, German versions of all relevant European instruments for psychiatric service evaluation are now available.

Cost-Benefit Analysis↗

PubMed2001

[Distress in parents of patients suffering from schizophrenia of affective disorders].

PURPOSE: The present study aims at investigating to what extent relatives of individuals suffering from mental illness experience caregiver burden. Hypotheses are formulated on the basis of stress theory and are tested on a sample of family members. METHOD: Relatives organised in the German and Austrian relatives' associations were questioned by means of mail surveys. Only parents (n = 509) of patients with schizophrenia or affective disorders were included in the study. RESULTS: The majority of those questioned expressed the opinion that the burden experienced through caring for the patient interferes with their own state of health. Among the negative consequences of care-giving cited, health burden ranked first, followed by restrictions in the fields of leisure, employment/career and finances. For the respondents, the average sum score of the Zerssen list of complaints [1] was clearly increased in comparison with the standard values for the general population. Among the symptoms cited, brooding, inner unrest, irritability, insomnia, fatigue as well as neck and shoulder pains were mentioned most frequently. No gender or diagnosis-related differences were found with regard to the extent of burden experienced. Interaction effects could be demonstrated in that fathers of schizophrenic patients differ significantly from mothers of schizophrenic patients as well as from fathers of children with affective disorders. CONCLUSIONS: Further research is called for as relatives of people with mental disorders seem to represent a high-risk group. On the basis of our data, it can be assumed that these relatives differ from the general population in their utilisation of medical or rehabilitation services.

Austria↗

PubMed2001

The utilization of antidepressants in community-dwelling and institutionalized elderly--results form a representative survey in Germany.

Given its widespread occurrence and consequences, old-age depression has to be regarded as a major public health problem. Drug treatment has been proven effective in the majority of elderly individuals suffering from depression. This study presents pharmacoepidemiological data regarding the use of prescribed antidepressants and those purchased over the counter in the elderly. Furthermore, it links the data to simultaneously assessed depressive symptomatology. A representative survey on the utilization of prescription and over-the-counter antidepressant drugs and depressive symptomatology in community-dwelling (n = 1193) and institutionalized elderly individuals (n = 470) aged 75 and over was conducted in an urban region of Germany. Antidepressant use was found to be remarkably low (synthetic antidepressants: 2.2% of community dwelling individuals, 3.6% of institutionalized individuals; phytopharmaca containing hypericum perforatum: 4.2% of community dwelling individuals, 2.8% of institutionalized individuals). Two-thirds of the individuals treated with synthetic antidepressants received tri- and tetracyclic drugs, which were given at lower dosages than recommended for depression treatment. Selective serotonin reuptake inhibitors (SSRIs) were introduced in community-dwelling individuals only; none of the individuals cared for in residential and nursing homes received SSRIs. Only a minority of individuals with depressive symptoms were treated with antidepressants. The data suggests underutilization of antidepressants in the elderly, in which institutionalized elderly seem especially disadvantaged. The results call for increased efforts to discuss mental health issues in the public and to share scientific knowledge about symptoms, course and treatment options for depression. Furthermore, geronto-psychiatric competence of medical professionals, especially GPs, has to be systematically developed.

Aged↗

PubMed2001

[Instruments for the economical evaluation of psychiatric service systems: methodological foundations of the European standardisation and the German adaptation].

OBJECTIVE: In the project "Cost-effectiveness of psychiatric service systems. A European comparison" a German version of instruments for the assessment of needs for services (CAN-EU), service satisfaction (VSSS-EU) relatives' burden of care (IEQ-EU) and costs of psychiatric services (CSSRI-EU) was developed in close cooperation with the EPSILON Study group. METHOD: The English original versions of the instruments were translated into German and a back-translation into the original language was carried out by a second translator. The back-translation was screened by the first author of the original version. The German versions of all instruments were tested for comprehensibility and practicability by means of focus groups. The internal consistency of all instruments were tested on a representative sample of 307 patients with schizophrenia according to ICD-10 F20. Test-retest reliability and inter-rater reliability was tested by a sub-sample of 50 patients. RESULTS: Psychometric properties of the translated instruments will be presented and discussed. CONCLUSIONS: Statistical methods for the assessment of the reliability coefficients were identical with those of the EPSILON study, therefore the psychometric properties of the German version of the CAN-EU are directly comparable with the other European versions of the instrument.

Adolescent↗

PubMed2001

[The standardized assessment of the need for treatment and support in severe mental illness: the development and testing of the German version of the Camberwell assessment of Need-EU].

OBJECTIVE: The development and the psychometric testing of the German version of the Camberwell Assessment of Need-EU will be presented. METHOD: The internal consistency of the subscales total needs, met needs and unmet needs was tested by the application of the CAN-EU on a representative sample of 307 patients with schizophrenia according to ICD-10 F20.0. Test-retest-reliability and inter-rater-reliability was tested with a sub-sample of 41 patients. RESULTS: The internal consistency and the test-retest-reliability of the German version of the CAN-EU is satisfying and slightly higher in comparison with the other European versions. The inter-rater-reliability is also satisfying but smaller in comparison with the other European versions. CONCLUSIONS: In general, the psychometric properties of the German version of the CAN-EU are satisfying but the lower inter-rater-reliability in comparison with the other European versions suggests that more precise coding rules for the German version of the CAN-EU must be formulated to improve the inter-rater agreement of the instrument.

Adult↗

PubMed2001

[German adaptation of the client sociodemographic and service receipt inventory - an instrument for the cost of mental health care].

AIM: Psychiatric health services research has to consider health economic points of view more than before as a result of the present-day financial problems in our health care system. Therefore an instrument was developed, which is suitable for the evaluation of cost of mental health care in Germany. METHOD: The Client Sociodemographic and Service Receipt Inventory (CSSRI-EU), which was developed in the UK, was adapted to the German situation and for the first time used in a cost-effectiveness-analysis of mental health care. The adaptation process of the instrument and the practical application are explained and pros and cons considered. RESULTS: The German adaptation of the CSSRI-EU has proven effective in practical application. The instrument offers feasible solutions for many problems with the cost of mental health care. The instrument can be used for the calculation of direct and indirect costs and gives information about service utilization and medication profiles of the clients. CONCLUSION: The German adaptation of the CSSRI-EU is a feasible instrument for the evaluation of the cost of mental health care in Germany.

Cost-Benefit Analysis↗

PubMed2001

[The German adaptation of the Verona Service Satisfaction Scale: an instrument for patients' satisfaction with mental health care].

UNLABELLED: The German Adaptation of the Verona Service Satisfaction Scale: An Instrument for Patients' Satisfaction with Mental Health Care. AIM: Measuring effectiveness and quality of care became an important topic in psychiatry. Considering that objective criteria were not sufficient in the past, the subjective perspective gained growing interest. Client satisfaction is an important variable to evaluate psychiatric care. Patient satisfaction can influence treatment outcome as well as it determines the psychiatric system itself. METHOD: The Italian original version of the Verona Service Satisfaction Scale (VSSS-54) was translated and adapted to the German language. The instrument has been tested in the project "Cost-effectiveness of psychiatric service systems". The process of development, the psychometric testing and the practical application of the German version will be presented in this paper. Additional advantages and disadvantages are discussed. RESULTS: As psychometric properties of the instrument correspond to conventional standards, they are comparable with the results of an international study. The drop out of items cannot be controlled, therefore analysing the data is difficult. CONCLUSION: Although the VSSS shows various methodological limitations, it is at the moment an appropriate instrument for measuring patient satisfaction in the German language.

Cost-Benefit Analysis↗

PubMed2001

[The assessment of burden on relatives of mentally ill people: the German version of the involvement evaluation questionnaire (IEQ-EU)].

AIMS: The German Version of the Involvement Evaluation Questionnaire (IEQ-EU), developed for the assessment of burden on relatives of mentally ill people will be presented. Also the results of the reliability analysis will be presented. METHOD: After translation and adaptation of the Dutch version of the IEQ-EU into German, the instrument was tested in the study "Cost-effectiveness of psychiatric service systems". RESULTS: The internal consistency was tested on a sub-sample of 138 relatives and the Test-Retest-Reliability on a sub-sample of 37 relatives. The internal consistency (Cronbachs alpha) is moderate or good and slightly lower in comparison with the other European versions. With the exception of one subscale the results for the intraclass correlation coefficient are equal to the European versions. CONCLUSIONS: The IEQ-EU is an instrument with moderate or good psychometric properties. It covers all important domains, is easy to understand and not time-consuming.

Caregivers↗

PubMed2001

[The analysis of the cost structures of the treatment of schizophrenia by means of standardized assessment instruments].

OBJECTIVE: Aims of the study are the analysis oft the structures and influence factors causing direct costs of schizophrenic diseases by means of international standardized assessment instruments. METHOD: Annual costs of treatment were assessed for a sample of 258 patients with the diagnosis of schizophrenia (ICD-10 F20) by means of the German version of the CSSRI. For the analysis of cost variance a regression model was computed using functional level (GAF), symptoms (BPRS 4.0), needs for care (CAN), service satisfaction (VSSS) and subjective quality of life (LQoLP) as predictors. RESULTS: The average yearly treatment costs for the study sample were 12 726,- DM. Costs for sheltered accommodation and for psychiatric inpatient treatment were found to be the largest elements of the entire costs followed by the costs for ambulant medications. Results of the regression analysis show that illness history, the severity of symptoms and the need for care explain the greatest proportion of variance. CONCLUSIONS: The standardized instruments developed in the project enable a systematic and international comparable assessment of the costs in the treatment of schizophrenic diseases. Furthermore the instruments allow to explain 38 % of the cost variance. The impact of the severity of symptoms under statistical control of the functional impairment and the needs for care suggests that an effective reduction of symptoms could lead to savings in the entire treatment costs. However, the great influence of the illness history and, irrespective of the functional impairment, the need for care show that the possibilities for cost savings in the treatment of schizophrenia are generally low.

Adolescent↗

PubMed2001

Quality of life--as defined by schizophrenic patients and psychiatrists.

The aim of the study is to explore what schizophrenic patients understand by quality of life and what psychiatrists think quality of life may be like for schizophrenic patients. A survey was carried out among schizophrenic patients and psychiatrists from the whole of Germany. There are similarities and differences between the two: while both schizophrenic patients and psychiatrists recognised the importance of work, social relationships, family and independence for quality of life, patients thought about it more in terms of standard of living and lifestyle, whereas the psychiatrists' concept of quality of life was more illness-oriented encompassing the absence of handicaps and disabilities due to the illness and emphasising the importance of appropriate professional help and self-help. In order to facilitate the dialogue between psychiatrists and patients it is important to be aware of these differences.

Adult↗

PubMed2001

Prevalence of dementia according to DSM-III-R and ICD-10: results of the Leipzig Longitudinal Study of the Aged (LEILA75+) Part 1.

BACKGROUND: The prevalence of dementia diagnosis according to ICD-10 and DSM-III-R in population surveys remains poorly understood. AIMS: To report and compare prevalence rates according to DSM-III-R and ICD-10. METHOD: A population-based sample (n=1692, age 75+years) was investigated by a Structured Interview for Diagnosis of Dementia of Alzheimer Type, Multiinfarct Dementia and Dementia of other Aetiology according to DSM-III-R and ICD-10 (SIDAM). RESULTS: Whereas 17.4% (95% CI=15.9-19.5) of individuals aged 75+ years suffer from dementia according to DSM-III-R, only 12.4% (95% CI=10.6-14.2) are diagnosed as having dementia according to ICD-10. The results revealed lower ICD-10 rates in all investigated age groups. The largest differences appear in the oldest of the elderly. CONCLUSIONS: The ICD-10 sets a higher threshold for dementia diagnosis. Larger differences in the eldest age groups might reflect difficulties in applying case definitions, especially in those beyond 90 years old.

Age Distribution↗

PubMed2001

Incidence of dementia according to DSM-III-R and ICD-10: results of the Leipzig Longitudinal Study of the Aged (LEILA75+), Part 2.

BACKGROUND: The impact of different case definitions on incidence rates remains unclear. AIMS: To compare incidence rates of dementia according to DSM-III-R and ICD-10. METHOD: A two-wave community study was conducted (n=1692, age 75+ years follow-up period 1.6 years). Cognitive function was assessed by the Structured Interview for Diagnosis of Dementia of Alzheimer Type, Multiinfarct Dementia and Dementia of other Aetiology according to ICD-10 and DSM-III-R (SIDAM). RESULTS: The annual incidence rate for dementia by applying different case definitions was found to be quite similar (DSM-III-R: 47.4 (95% CI=36.1-61.2) per 1000 person-years; ICD-10: 45.8 (95% CI=35.0-59.0) per 1000 person-years). Age-specific incidence rates increase steeply with age. CONCLUSIONS: The impact of different case definitions on incidence rates of dementia appears limited if case definitions and case-finding procedures at baseline and follow-up are applied consistently.

Age Distribution↗

PubMed2000

[Subjective memory loss--a sign of cognitive impairment in the elderly? An overview of the status of research].

According to the growing clinical interest in early indicators of dementia, numerous studies have examined the association between subjective memory complaints and cognitive performance in old age. Their results are contradictory. In this paper, studies carried out over the last 10 years are compared with regard to the study design and the assessment instruments used. The results are discussed with particular reference to the diagnostic validity of subjective memory complaints. The majority of case-control studies and cross-sectional studies of non-representative samples could not demonstrate an association between subjective memory complaints and cognitive performance. Most field studies of larger representative population samples, however, have come to the opposite conclusion. A consistent assessment of these statistically significant associations against the background of diagnostic validity showed that memory complaints cannot be taken as a clear clinical indicator for cognitive impairment. Subjective memory complaints may reflect depressive disorders and a multitude of other processes, of which an objective impairment of cognitive performance is just one aspect. As a consequence, an inclusion of subjective memory complaints as a diagnostic criterion for the diagnosis of "mild cognitive disorder" according to ICD-10 is not justified.

Aged↗

PubMed2000

[Information and support needs of the family of psychiatric patients].

AIM: This study aimed at the systematic assessment of the educational and service needs among relatives of psychiatric patients. METHOD: A postal survey was carried out on a sample drawn from the members of the associations of relatives of mentally ill people in Germany and Austria. Data collected from parents (n = 509) and spouses (n = 54) of patients with schizophrenia or affective disorders were analysed. RESULTS: More than half of the participants expressed the need for more support and complained of not having enough opportunities to relieve the burden imposed on them. Further, families have a strong desire for more information about the disorder as well as practical advice concerning how to cope with the patient. CONCLUSIONS: The results document the great need for services among families and the need for enhancement of quality of care and negotiated partnership between families and professionals.

Adult↗