Biomedical subjects

K Fritzsche

Publications and source records attributed to K Fritzsche.

At least 19 recordsLinked to original sources

PubMed2007

[Need for and use of a university clinic mental health liaison service].

BACKGROUND: Little is known about the complex decision-making process involving recognition of psychosocial stress, its diagnosis, and psychotherapeutic intervention within the framework of a psychosomatic consulting and liaison service. PATIENTS AND METHODS: Psychosocial stress was recorded using a psychometric questionnaire for 392 patients on admission to hospital, the estimated need of psychotherapeutic treatment, and the application of a psychosomatic liaison service. RESULTS: Of the examined patients, 44% presented with at least one mental disorder requiring treatment according to ICD-10 criteria. According to the expert opinions, a need for psychotherapeutic treatment was present in 41%, while 54% were themselves motivated for at least one of the psychotherapeutic treatments offered. Psychotherapy was actually received by 35% of the patients. While mental disorders and emotional distress were significant predictors of the need for treatment as rated by experts, they played no genuine role in determining indication or whether a patient accepts the use of psychotherapy CONCLUSION: Psychotherapeutic interventions in the liaison service are not always effective or related to the indication.

Adolescent↗

PubMed2004

Relationship between psychosocial distress, treatment need and use of psychotherapeutic interventions within a psychosomatic liaison service in hematological oncology.

BACKGROUND: Psychosocial distress is common in patients with hematological malignancies in the acute phase of the disease. The aim of the study was to evaluate the treatment need and the realization of psychotherapeutic interventions of a routine psychosomatic liaison service delivery in hematological oncology. PATIENTS AND METHODS: 72 patients of the transplantation ward and of the general hematological oncological ward were consecutively included in the study. Assessments involved both self- and observer rating instruments. RESULTS: The need for psychotherapeutic treatment was 38 or 49%, depending on patients' or professional's view, respectively. 39% of the patients underwent psychotherapeutic treatment. But there was a great discrepancy between the treatment need estimated by observer and patients and the actual psychotherapeutic interventions. CONCLUSIONS: The utilization of psychotherapeutic interventions seems to be subject to a complex interaction between patient's need, 'objective' psychosocial distress and institutional conditions. The results highlight the importance of need for better identification of patients with psychosocial distress and better targeting of psychotherapeutic treatment.

Attitude to Health↗

PubMed2003

[Psychosomatic liaison service in neurology. Accordance between need for psychotherapeutic interventions and their realization].

The study addresses the realization of psychotherapeutic interventions in the framework of an integrated psychosomatic liaison service in neurology. Eighty-four patients from one unit at the Department of Neurology of the University of Freiburg, Germany, underwent structured psychodiagnostic interviews and filled in self-rating instruments to evaluate mental disorders, psychosocial distress, ways of coping, and quality of life. Motivation and the need for treatment were estimated by both patients and a liaison psychotherapist. Using ICD-10-F criteria, mental and behavioral disorders were diagnosed in 35% of the cases. Thirty-seven percent of the patients desired psychological support. Actual intervention occurred in 27%, with a mean consultation rate of 3.7 sessions. There was only slight agreement between the estimated need for treatment and the interventions actually performed. The realization of psychotherapeutic interventions was subject to a complex interaction between patient needs, "objective" psychosocial distress, and institutional factors. Differentiation between primary medical care and psychotherapy was difficult.

Adult↗

PubMed2003

Need and use of psychotherapeutic interventions within a psychosomatic liaison service in neurology.

OBJECTIVES: The study addresses the evaluation of psychosocial distress, the need for care as determined by a psychotherapist and patients, and the realization of psychotherapeutic interventions within a routine psychosomatic liaison service. MATERIAL AND METHODS: A total of 84 patients from one unit at the Department of Neurology of the University of Freiburg, Germany, underwent a structured psychodiagnostic interview and filled out self-rating instruments to evaluate mental disorders, psychosocial distress, ways of coping strategies and quality of life. The need for treatment and the motivation of patients were estimated by both patients and a liaison psychotherapist. RESULTS: Using ICD-10-F criteria, mental and behavioral disorders were diagnosed in 35% of cases. Professional assessment indicated a need for psychotherapeutic treatment in 37% of patients; actual intervention occurred in 27%. Only slight agreement was found between the estimated need for treatment and the interventions actually performed. CONCLUSIONS: The realization of psychotherapeutic interventions is subject to a complex interaction between the needs of a patient, the "objective" psychosocial distress of the patient, and institutional factors. About 10% of the hospitalized patients considered in the study need continuous psychotherapeutic treatment.

Adult↗

PubMed2001

Perceptual phenomena after unilateral arm amputation: a pre-post-surgical comparison.

Painful and non-painful phantom phenomena occur frequently after amputations but are rarely investigated in the perioperative stage. The goal of the present study was the assessment of phantom phenomena, pain and changes in primary somatosensory cortex prior to and after upper limb amputation. Two patients who suffered from metastatic carcinoma were examined 2 days prior to and 7 days after the amputation of an arm using comprehensive psychometric assessments and neuroelectric source imaging. Both patients reported phantom limb pain that was similar to their pre-amputation pain. In one patient, reorganization of the mouth area into the deafferented hand area took place immediately after the amputation. In the other patient reorganization had occurred prior to the amputation possibly related to non-use of the arm several years prior to the amputation.

Aged↗

PubMed2001

[The effects of psychotherapy on Crohn's disease patients--results of a randomized multicenter study].

In a prospective multicenter study of Crohn disease patients, the influence of psychotherapy on the course of the disease and on psychosocial variables (anxiety, depression, life satisfaction and data of the PSKB) was studied. Psychodynamic oriented psychotherapy was provided in addition to a standardized medical treatment and took place during the first year of the two-year observation period. 108 of 488 patients were recruited and randomly assigned to the psychotherapy and the control group. 84 patients completed the somatic and 81 the psychosocial follow up. 23% of the control group and 30% of the psychotherapy group showed episode-free courses, 29% and 17% respectively underwent surgery (worst outcome group). The ranking and comparisons of the disease course showed no significant difference (p = 0.125) between psychotherapy and control group. The psychosocial variables also showed no differences between these groups. Subjectively, the patients report favourable effects to psychotherapy.

Adolescent↗

PubMed2001

Psychosomatic liaison service in dermatology. Need for psychotherapeutic interventions and their realization.

BACKGROUND: Empirical investigations examining the psychosocial distress and need for care of dermatology patients are rare. Little is known about the use of psychotherapeutic interventions in routine care. OBJECTIVE: To evaluate the psychosocial distress of dermatological inpatients, the need for psychotherapeutic interventions and their realization in the framework of a psychosomatic liaison service. METHODS: 86 patients from one unit at the University Dermatology Clinic in Freiburg underwent psychodiagnostic interviews and completed self-rating instruments, elucidating mental disorders, psychosocial distress, coping methods, quality of life, treatment motivation and psychotherapeutic interventions. RESULTS: Using ICD-10 criteria, mental and behavioral disorders were diagnosed in 46%; most frequent were mood and anxiety disorders. Professional assessment indicated a need for psychotherapeutic treatment in 51%, while 28% of the patients wished for psychotherapy; actual intervention occurred in 38%. CONCLUSIONS: The need for psychotherapeutic treatment can only be handled within the framework of a liaison service in close collaboration with care givers.

Adult↗

PubMed2000

[Somatisizing patients. Concrete recommendations for a stepwise therapy in general practice].

Patients with physical symptoms but no detectable organic substrate often present a challenge for the family doctor. The therapeutic approach discussed herein focuses on the development of a psychosomatic model of the problem. In this step-by-step approach, the patient's subjective understanding of, and attitude towards, his illness and its treatment are established, alternative psychosomatic models of disease based on a consideration of psychophysiological interactions are worked out jointly with the patient, and, finally, thought is given to the current complaints within the context of the patient's personality and life situation. The basis for successful treatment is an empathic and sound doctor-patient relationship based on trust that gives the patient the feeling that he and his problem are being taken seriously. The prerequisite for the use of such a program is appropriate training in basic psychosomatic care.

Aged↗

PubMed2000

[Psychotherapeutic and psychosocial therapy in general practice. Results of demonstration project on quality management in psychosocial primary care].

Since 1987, psychosocial primary care (PPC) provided by General Practitioners, are reimbursed by German health insurances. The aim of the psychosocial primary care is to improve recognition and treatment of mental disorders in the primary care sector. As a part of a eight-center national demonstration program on quality management in the outpatient services, General Practitioners (n = 191) from 5 regions participated in the study. 1341 treatment episodes of patients with predominately psychosocial strain were documented. Differences between psychosocial strain, treatment and outcome were determined by analyses of variance. Men and patients beyond the age of 65 were underrepresented. Psychosocial treatments were offered more often to those patients, who had the highest level of anxiety and depression. Patients with physical illness, with pain and without psychological attribution to the illness belief were offered less psychosocial interventions and reached a worse outcome. The study outcome helps to improve training programs as to recognition and treatment of psychosocial problems in primary care. Male and generally elderly patients with somatic symptoms and lack of psychological attribution need a special psychosocial intervention to improve the outcome.

Adult↗

PubMed2000

[Primary psychosomatic management in general practice. Results of a German nationwide demonstration project of quality assurance].

In the frame of a national demonstration program, psychosocial care of patients with psychological and psychosomatic problems were assessed. General practitioners (n = 191) from six regions participated in the study. 1341 treatment episodes of patients with predominately psychosocial symptoms were documented. Anxiety (62%), depression (51%) and marital/family conflicts (44%) were the most frequent symptoms. Somatic treatment and psychosocial intervention were offered equally. Patients with psychosocial treatment achieved better results. Partners and family members were rarely integrated into therapy. The procedures employed to improve outcome were quality circles, family-orientated case conferences, consultation services and collaborative groups.

Combined Modality Therapy↗

PubMed1999

[Management of mental health and primary care. Development and evaluation of a training program based on the PLISSIT approach].

Deficits in current approaches of psychosomatic and psychiatric education for general practitioners are reviewed. A skill-based training was developed in line with the four step counseling approach of the "PLISSIT" approach: The GP helps in first step ("permission") the patient to accept his problem and assesses informations about causing and maintaining factors of his symptomatology. In the second step he should provide information about the disorder and reverse misunderstanding and passivity (Limited Information). The GP's should develop preliminary strategies for change in the third step ("coping strategies", "symptom management", "special suggestions") and preparate the intensive phase of therapy as the last step. First results of the evaluation of the training program are presented demonstrate the effectiveness and acceptance of the education program.

Disease Management↗

PubMed1999

Psychosocial care by general practitioners--where are the problems? Results of a demonstration project on quality management in psychosocial primary care.

OBJECTIVE: Since 1987, psychosocial services have been a part of the primary care setting in Germany. In the framework of an eight-center national demonstration program, problems in the diagnosis and therapy of psychosocial problems and psychosomatic disorders were assessed. Methods to improve quality were also implemented. METHOD: General practitioners (n = 191) from six regions participated in the study. One thousand three hundred and forty-one treatment episodes of patients with predominantly psychosocial symptoms were documented. Differences between psychosocial strain, treatment, and outcome were determined by analyses of variance. RESULTS: Anxiety (62%), depression (51%), and marital/family conflicts (44%) were the most frequent symptoms. Psychosocial treatment was offered more often to those patients who had the highest level of anxiety and depression. Patients with pain and without a psychological attribution to their illnesses were offered less psychosocial treatment and suffered worse results. Partners and family members were rarely integrated into therapy. The procedures employed to improve outcome were quality circles, family-oriented case conferences, consultation services, and collaborative groups. CONCLUSIONS: These initial results are promising. A process of internal quality management has been initiated. Some of the physicians still resist documenting the data. Patients with somatic symptoms without psychological attribution may need special psychosocial interventions to improve their outcomes.

Adolescent↗

PubMed1997

[Contents of a "basic psychosomatic management" curriculum. Results of a 4-year concomitant evaluation].

The results of evaluations proceeding the educational seminar "Psychosomatic Primary Care" in South Baden are presented and analyzed. From 1991 to 1995, approximately 450 physicians took part in these courses. From critical feedback and suggestions for improvement obtained from participants following each course, recommendations for future seminars pertaining to content, structure, process, didactic and evaluation are presented.

Adult↗

PubMed1991

[Psychomotor development of children at risk with special reference to prenatal, intrapartum and postnatal hypoxia].

In a prospective study the psychomotor development of an unselected collective of high risk newborn infants up to the end of the second year of life was examined. The proof of hypoxia was performed with the erythrocytic density test (EDT). The value of EDT showed a decline with the age of life, and it was independent of gestational age or of birthweight only at the first point of determination (cord blood, first or second day of life). Significant connections between the level of light red blood cells and the children's development could not be demonstrated, although the probability to develop psychomotor disabilities increased in the newborn with a positive value of EDT. The diagnostic value of EDT showed the best results for intrapartum and postnatal hypoxia. The highest specificity was calculated with 38.0%, if the sensitivity is 80.0%. In conclusion of these results it's not to be recommended to use the EDT alone for the prediction of individual prognosis of children.

Child Development↗

PubMed1991

[Pigeon coryza--ornithosis--pigeon breeder's lung].

The published informations on the entities pigeon coryza and ornithosis are reviewed. On the basis of own experiences and experimental data obtained in the Landesveterinäruntersuchungsamt Koblenz, pigeon coryza apparently is a symptom rather than a clearly defined disease. Finally pigeon breeder's lung is discussed in front of the background of own observations and recommendations to be of allergic origin.

Animals↗

PubMed1990

Production of unsaturated polyesters by Pseudomonas oleovorans.

Pseudomonas oleovorans was grown separately on 3-hydroxy-6-octenoic acid and 3-hydroxy-7-octenoic acid as the only carbon source and under ammonium nutrient-limiting conditions to produce storage polyesters. The polyesters produced contained mainly unsaturated C8 units. Small amounts of both the saturated and the unsaturated C6 units were also present, but only about 1% of the saturated 3-hydroxyoctanoate units was detected. The polyester obtained from 3-hydroxy-6-octenoic acid, which was a mixture of the cis and trans isomers, also contained units with cis and trans double bonds. The weight average molecular weights of the polymers produced were in the range of 339,000-383,000 as determined by g.p.c. relative to polystyrene, with Mw/Mn ratios of 1.8-2.1. The mechanism of PHA formation from n-octene previously reported is discussed in relation to the present results, and the two were found to be in good agreement.

Culture Media↗

PubMed1990

Bacterial polyesters containing branched poly(beta-hydroxyalkanoate) units.

Pseudomonas oleovorans was grown on mixtures of methyloctanoates with n-octanoate. Polymers were also obtained from organisms grown on pure 7-methyloctanoate, but not from pure 5- or 6-methyloctanoate. The polyesters obtained from 7-methyloctanoate and from its mixtures with n-octanoate contained units with the methyl branches in the pendant group, as did the copolymers from the mixtures of 5- and 6-methyloctanoate with n-octanoate. The methyl branched repeating units contained two diastereomers, and the 13C-n.m.r. spectra of these polymers indicated that the 5-methyloctanoate units had a higher content of one of the two isomers, but not in the 6-methyloctanoate units. The weight average molecular weights of the copolyesters produced were in the range of 220,000 to 410,000, with Mw/Mn ratios of 1.7 to 1.9.

Caprylates↗

PubMed1990

[The genesis of permanent growth of the beak wattle of a wattle-type pigeon].

Variation in size of warts located on the beak of wattle-pigeons represents a dominant trait of this breed. Excessive growth to extraordinary size in two breeds (barbs and carriers), in addition to a large beak, can cause losses due to the inability of the parents to feed the offspring properly. In older birds, respiration is impeded and the field of vision is limited. This permanent growth in barbs and carriers could not be attributed neither to an infection with papovaviruses, nor to the overexpression of the retroviral c-src-protooncogen. This finding, in conjunction with the genetic analysis, underlines that this prominent trait is genetically determined.

Animals↗