Biomedical subjects

H Matschinger

Publications and source records attributed to H Matschinger.

At least 55 records · Page 3Linked to original sources

PubMed2000

[Neuroleptics and quality of life. A patient survey].

OBJECTIVE: This paper addresses the question as to which positive effects of drug treatment on quality of life are expected by schizophrenic patients, and which negative effects should be avoided by any means. METHODS: A survey, using open-ended questions, was carried out among schizophrenic patients from all over Germany (n = 565). RESULTS: Most frequently the patients hoped for a general improvement or stabilisation of their state of health when taking medication. When asked about positive effects, almost every fourth respondent gave a somewhat paradoxical answer by stating that the medication should have less or no side effects. Less frequently, by only 15%, the calming and relaxing effect of the drugs was cited, followed by the antipsychotic effect and relapse prevention. With regard to negative effects, extrapyramidal motor symptoms ranked first with 42% of those questioned regarding them to be a restriction of their quality of life which should definitely be avoided. Second most frequently, sedation was mentioned, followed by weight gain. DISCUSSION: In the light of the introduction of so-called "atypical" neuroleptics, the implications for compliance with the treatment are discussed.

Adult↗

PubMed2000

[Depression and stigma].

AIM: Until now, the interest of stigma research in psychiatry has been predominantly focused on schizophrenia. The fact that individuals suffering from depression may also be exposed to stigmatization, on the other hand, has received little attention. METHOD: Using the scales for the assessment of perceived stigma and stigma coping developed by Link et al., 39 patients who had received in-patient treatment for a depressive episode were questioned 4-7 months after their discharge from hospital. RESULTS: 45% of the respondents reported concrete instances of stigmatization. Respondents expected to find discrimination and devaluation on the part of their environment especially with regard to their changes on the labour market. The vast majority of those questioned was in favour of keeping the fact that one had experienced a mental illness or had received psychiatric treatment to themselves. Further, our results show a tendency to avoid situations which might imply an increased risk of stigmatization. While respondents considered it important to facilitate a better understanding of mental illness on the part of their closest friends and relatives, the idea of being actively involved in educating the lay public received comparatively little support. CONCLUSION: Although individuals suffering from depression may be confronted with less rejection or resentment than schizophrenic patients or patients with substance use disorder, this does not imply that they do not have to struggle with the problem of stigmatization.

Adaptation, Psychological↗

PubMed1999

Whom to ask for help in case of a mental disorder? Preferences of the lay public.

BACKGROUND: Although socio-cultural factors have been recognised as an important predictor in shaping help-seeking behaviour, few attempts have been made in this regard to specify the nature and impact of socio-cultural factors such as attitudes and belief systems prevalent in society. METHODS: We investigated the lay public's attitudes toward help-seeking regarding psychiatric disorders, and their determinants, in a cross-sectional national survey in Germany (n = 1564), using structured interviews with vignettes depicting a person either suffering from depression or from schizophrenia. Two distinct methodological approaches (rating vs ranking) were applied. RESULTS: Public opinion considers mental health professionals helpful in treating schizophrenia but not in the treatment of depression. For depression, public opinion clearly favours the lay support system and believes in involving the family physician if the former resource is exhausted. Determinants of help-seeking recommendations were problem definition, perception of the cause of distress and anticipated prognosis, as well as resentment against mental health professionals. CONCLUSION: Our results suggest that attitudes and belief systems prevalent in society have a major impact on help-seeking behaviour, both through transmission to the person suffering from mental distress via his/her social network and through the person's own attitudes formed in the process of socialization. Implications are pointed out for the daily work of mental health care providers, health care planning and public discussion of mental health issues.

Adolescent↗

PubMed1999

Lay beliefs about mental disorders: a comparison between the western and the eastern parts of Germany.

BACKGROUND: Since the end of the Second World War the western and eastern parts of Germany have been exposed to very different social and cultural influences. It was our assumption that this should also be reflected in the beliefs about mental disorders held by the general public. METHODS: In autumn 1990, immediately after German reunification, a representative survey on lay concepts of schizophrenia and depression was carried out in both parts of Germany. In all, 2118 personal, fully structured interviews resulted in the West, 980 in the East. RESULTS: In general, there were more similarities than differences between West and East, particularly as concerns causal attributions (with psychosocial stress being most frequently seen as etiologically relevant) and treatment recommendations (with psychotherapy clearly favored over drug treatment). However, there were also some differences, most notably a stronger tendency in the West to define depressive behavior in psychiatric terms and to recommend established forms of psychiatric treatment for its management. CONCLUSIONS: Our assumption that the exposure to different cultural influences should have led to discrepant beliefs about mental disorders was only partly confirmed. Especially with regard to schizophrenia, the prevalence of the dominant stereotype hardly differed between West and East.

Adult↗

PubMed1999

Do memory complaints indicate the presence of cognitive impairment? Results of a field study.

BACKGROUND: In the context of suspected cognitive disorders, the validity of memory complaints is subject to considerable debate. This investigation documents the prevalence of memory complaints and assesses the validity of memory complaints for detecting cognitive impairment. METHODS: The sample comprises 349 randomly selected non-institutionalized individuals, aged 75 and over living in the city of Leipzig. Twenty individuals who suffer from moderate and severe dementia according to DSM-III-R were excluded. Memory complaints were measured by means of a single item question. The Mini-Mental State Examination (MMSE) and a wider range of cognitive tests which constitute the short neuropsychological battery of the SIDAM (Structured Interview for the Diagnosis of dementia of Alzheimer type, Multi-infarct dementia and dementias of other etiology according to ICD-10 and DSM-III-R) were used to test cognitive performance. RESULTS: One in three individuals aged 75 and over complained about memory deficits. The MMSE is not significantly related to memory complaints, whereas poorer performance on 2 out of 8 tests regarding specific areas of cognitive function (immediate recall, short-term memory) were found to be significantly associated with memory complaints. Despite these statistically significant associations, it is shown that memory complaints do not have diagnostic validity in detecting cognitive impairment on the individual level. CONCLUSION: Memory self-assessment should not be used as a substitute measure of cognitive performance. Initiation of further diagnostic and therapeutic steps should be based on cognitive performance testing. Relaying solely on memory complaints would miss individuals in need and allocate resources to worried but cognitively healthy persons.

Aged↗

PubMed1999

The role of referrals in diagnosing dementia at the primary care level.

BACKGROUND: Demographic changes indicating a general aging of the population suggest that the key role of general practitioners (GPs) in the diagnosis and management of dementia becomes more salient. The encouragement of GPs to collaborate with specialists is one chance to support GPs in performing a variety of functions associated with the diagnosis and management of dementia. METHOD: We used a questionnaire to investigate the role of referrals in diagnosing dementia at the primary care level and variables potentially influencing the referral behavior of German GPs (n = 563). RESULTS: Only 31% of the GPs stated that the diagnosis of dementia was made predominantly in the context of referral to a specialist. The chance that referrals were made was increased for those GPs who entertained extensive cooperative relationships with self-help groups, psychologists, or the "Alzheimer Society"/"Brain League" (odds ratio [OR] 1.74) and for those GPs who perceived a great preparedness on the part of the relatives of the patient to comply with a referral (OR 2.29) as well as who noticed a great readiness among specialists to accept patients for the diagnosis of dementia (OR 2.55). GPs whose therapeutic orientation was shaped by further training and scientific literature were more likely to refer (OR 3.54). DISCUSSION: Enhancing the liaison between GPs and specialist physicians by improving the psychogeriatric competence of GPs as well as the connection to nonmedical services is discussed.

Aged↗

PubMed1999

[Acceptance of community psychiatry reform in the population. Results of a representative study in new German federal lands].

In 1993, a representative survey on the acceptance of community psychiatric services was conducted in the New German Länder. Its results show that the prospect of a hostel or group home for psychiatric patients to be established in their neighbourhood led to a predominantly negative reaction. On the other hand, the announcement that a day centre or a sheltered workshop should be opened was met with a more positive response. Only one quarter of those questioned supported the establishment of psychiatric units at general hospitals. Hence the acceptance of community psychiatric services in the east was clearly lower that in the western part of Germany. There was a clear association between the acceptance of community psychiatry and the general attitude towards the mentally ill. When respondents had personal experience with mental disorder, they were more open-minded as regards the establishment of complementary psychiatric services.

Adult↗

PubMed1999

[Quality of life--what it means to me... Results of a survey among schizophrenic patients].

PURPOSE: In recent years numerous studies have been published on the quality of life of schizophrenic patients. However, the patients' understanding of what quality of life is about has not been given sufficient attention. METHOD: 565 schizophrenic patients from the whole of Germany were asked what quality of life meant for them. RESULTS: Aspects of quality of life which can be subsumed under the heading of social integration were cited most frequently. As for the study as a whole, the most important aspect in this context was work and employment. Health represented a second domain. More specifically, respondents cited health in general (which was the second most frequently cited overall aspect) or health with respect to their mental illness in the sense of absence of symptoms and illness-related impairments. A third domain includes various components of well-being such "joie de vivre" or independence. Psychiatric treatment was associated with quality of life only as an exception, and if so only in negative terms. DISCUSSION: The results are contrasted with a comparable survey among psychiatrists.

Adult↗

PubMed1999

[Attitude of family to neuroleptics].

PURPOSE: The present study is based on the assumption that for patients' compliance with psychotropic medication is also of importance their closest relatives' attitude towards that treatment. METHODS: In the context of a mail survey of relatives of people with schizophrenia, we asked what the relatives considered to be the most important positive and negative effects of the medication. RESULTS: As expected, the main benefit was seen in the reduction of symptoms and in the prevention of relapse. In addition, the improvement of social adaptation and the subjective quality of life of the patients were also cited as important positive effects. Beside these effects which are closely related to the treatment of the disorder, respondents mentioned effects which can help to facilitate their living together with their ill relative. Among the side effects regarded as particularly unpleasant for the patients, sedation ranked first, followed by weight gain and extra-pyramidal motor symptoms. DISCUSSION: The results are contrasted with those of a comparable study of people with schizophrenia.

Adaptation, Psychological↗

PubMed1998

Gender and attitudes towards people with schizophrenia. Results of a representative survey in the Federal Republic of Germany.

Based on the observation that the course of schizophrenia appears to be more unfavourable in men than in women, we examined whether male suffers are exposed to more negative and less positive emotional reactions and are met with a greater amount of rejection by their environment than their female counterparts. Data from a representative survey conducted in the 'old' Federal Republic of Germany during 1990 did not yield the expected gender difference with regard to emotional reactions. There were, however, some gender differences on the side of the respondents: Women expressed more feelings of anxiety and tended to show more prosocial reactions. Social distance tended to be slightly more pronounced towards men than towards women. This applied to both schizophrenia and alcoholism. The gender of the respondents, on the other hand, was of no importance for social distance.

Adolescent↗

PubMed1998

[What do you associate with the word schizophrenia? A study of the social representation of schizophrenia].

This study addresses the social representation of schizophrenia. The analysis is based on a representative survey among the population of the former East German provinces now reunified with formal West Germany as the new "Länder" of the Federal Republic, as well as on a survey among medical students at the Universities of Vienna and Leipzig. For those questioned, the most striking feature of schizophrenia was that of a "split" personality. In this context they assumed the parallel existence of two (or more) personalities in the sense of a multiple personality disorder. This metaphor is interpreted as the result of a concretisation process which is substantially supported by the representation of people with mental illness in literature and the media.

Adolescent↗

PubMed1997

Social distance towards the mentally ill: results of representative surveys in the Federal Republic of Germany.

BACKGROUND: In 1975, a special commission appointed by the German Parliament submitted its report on the desolate state of psychiatric care in the old Federal Republic of Germany including suggestions for much-needed reforms. Among them was a call for the reduction of existing prejudices against mentally ill people. This study addresses the question as to what attitude is commonly found among the general public towards the mentally ill nowadays, two decades after the first step towards reform in psychiatric care and focuses on social distance. METHODS: Between spring 1990 and the end of 1993, a total of 11 representative surveys were carried out in Germany, eight of them in the former Federal Republic, or the old Länder. RESULTS: Even today, mentally ill people are met with a great deal of rejection by the German public. Alcohol dependants are rejected most, even more so than those suffering from schizophrenia. Personal experience with mental illness is associated with a lower level of derived social distance, which may be attributed to an increase in positive emotional reactions and reduced feelings of anxiety. There is an association between a person's attitude towards the mentally ill and his/her overall value orientation. CONCLUSIONS: Although, for methodological reasons, we are not able to show a significant change in attitude in the wake of the reform in psychiatric care, our results lend support to one of the basic assumptions of community psychiatry, namely the premise that personal contact with the mentally ill can help to reduce feelings of resentment towards the latter.

Adolescent↗

PubMed1997

[Quality of life for schizophrenic patients--that is.... Results of a survey of psychiatrists].

605 German psychiatrists were asked what they consider important ingredients of the quality of life of schizophrenic patients. Most frequently, quality of life was associated with social integration. Work, social contacts and acceptance on the part of their environment were considered particularly important in this respect. The second rank was occupied by the absence of symptoms of the disorder and a sufficient capacity and fitness for work, as well as social competence to meet the demands of their social environment, and to be capable of living independently. In addition, the limitation to a minimum of suffering from the side-effects of psychopharmacotherapy was held to be relevant for the patients' quality of life. Adequate psychiatric care was least frequently regarded as a prerequisite.

Activities of Daily Living↗

PubMed1997

[Burden of relatives of chronic psychiatric patients].

UNLABELLED: This study aimed at the systematic assessment of the burden imposed on the relatives of mentally ill persons. A postal survey was carried out on a sample drawn from the members of the Federal Association of Relatives of the Mentally ill (n = 557). RESULTS: Almost one third of those questioned experienced the care for their relatives as a heavy burden, a further third said that the burden was moderate. Among the negative consequences, health impairment was cited most often. Two-thirds of the participants reported constraints on their everyday life and the organisation of their leisure time. A (partly considerable) financial burden was cited with similar frequency. Further, the illness had a negative impact on the personal relationships of the caregivers. A quarter of the sample had lost touch with other family members. The same was found with regard to contact with friends. One-third reported discrimination by their environment. CONCLUSIONS: The results emphasize the necessity of creating opportunities to relieve some of the burden on relatives.

Adult↗

PubMed1996

Lay beliefs about the causes of mental disorders: a new methodological approach.

So far, researchers have, for the most part, used lists of Likert-scaled items in their quantitative analysis of lay beliefs about the causes of mental disorders. With the help of factor analyses they have then sought to identify the independent dimensions of the attitudinal space. In contrast, it is the aim of multiple unidimensional unfolding, which shall be presented in this paper, to establish a latent dimension of the order of preference regarding the causes offered as an explanation for the development of mental disorders. Using data from a representative survey examining the attitude of the general public of the new "Länder" of the Federal Republic of Germany towards mental disorders, which was conducted during 1993, it can be shown that 11 of the 15 causal factors offered may be arranged along an unfolding scale. The centre of the scale was characterized by the item "God's will or fate". Psychosocial stress factors constituted one pole of the scale, personality disorders, the other. In between we found both external and biological influences over which the afflicted individuals had no control. Analogies to the concept of locus of control are discussed.

Borderline Personality Disorder↗

PubMed1996

The effect of diagnostic labelling on the lay theory regarding schizophrenic disorders.

On the basis of a representative survey carried out in Germany in the Autumn of 1990, hypotheses about the effect of diagnostic labelling on lay beliefs regarding schizophrenic disorders were tested. As expected, labelling the disorder as schizophrenia increased the likelihood that biological factors were considered to be aetiologically relevant, while psychosocial stress, which most often was held responsible without labelling was cited less frequently as a cause. Thus, labelling the disorder as schizophrenia can be assumed to cause lay-aetiological beliefs to more closely approximate theories predominant among psychiatric experts. In addition, both the sufferers themselves as well as their parents were less frequently held responsible for the onset of the disorder. However, with diagnostic labelling the treatment prognosis was assessed less favourably. In sum, our results do not furnish a definite argument either for or against the explicit diagnosing of schizophrenia.

Adolescent↗

PubMed1996

The effect of personal experience with mental illness on the attitude towards individuals suffering from mental disorders.

Based on the results of two population surveys conducted in Germany during 1990 and 1993, we examined to what extent personal experience with mental illness might influence attitudes towards the mentally ill. Respondents familiar with mental illness displayed prosocial reactions more frequently than those without any personal experience. They also tended to react less fearfully. There were only small differences, if any, as far as the tendency to respond with aggression was concerned. People with personal experience tended less to adopt an antipathetic and distancing attitude towards individuals suffering from mental disorders. Our results are all the more persuasive as we were able to demonstrate this relationship between personal experience with and attitude towards mental illness for two independent samples. There were indications that personal exposure to mental illness exerts a positive influence on a person's attitude towards the disorder and that our findings were not merely the results of possible selection effects, that is to say, that individuals with a more positive attitude towards the mentally ill would have been more inclined to stay in touch with the latter, therefore having greater experience with mental illness.

Adolescent↗

PubMed1996

The effect of violent attacks by schizophrenic persons on the attitude of the public towards the mentally ill.

This paper tests Scheffs proposition that selective media reporting has a reinforcing effect on the stereotype of mental illness. Based on several population surveys carried out in the "old" Federal Republic of Germany it can be shown that in 1990 there was a marked increase in desired social distance from mentally ill people immediately following violent attacks, by two individuals suffering from schizophrenia, against prominent German politicians. Both events were widely covered in the media. During the following two years expressed social distance decreased slowly. At the close of 1992, however, it was still elevated when compared with the situation in early 1990 before the first assassination attempt had occurred. There was a corresponding trend in the tendency of the public to ascribe the attributes "dangerous" and "unpredictable" to psychiatric patients. Thus, our findings do support Scheffs contention that selective reporting does indeed have an impact on the attitudes of the public as it confirms the stereotype of insanity, which has important implications for public policy issues.

Adolescent↗