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Biomedical subjects

K Köhle

Publications and source records attributed to K Köhle.

At least 19 recordsLinked to original sources
PubMed2006

Emotional stress and subjective body experience of heart transplantation candidates.

We studied subjective complaints, psychological symptoms, and subjective appraisal of their body of 54 heart transplantation candidates at the time of admission to the waiting list using standardized psychological tests (GBB24, SCL-90-R, FBeK). The results of GBB24 and SCL90-R indicated high scores of strain before transplantation. In the FbeK, patients assessed their own body as worse than the normal population on all scales. Male patients displayed significantly higher scores of strain than women, but there was no difference in assessing their own bodies. The considerable scores of strain indicate the need for psychosomatic and psychotherapeutic interventions in a significant subgroup of patients.

Anxiety↗
PubMed2004

[Predictors and mechanisms of tinnitus distress - a longitudinal analysis].

BACKGROUND: The available cross-sectional and retrospective evidence does not provide a clear answer to the question whether the multiple psychological problems and disturbances found in patients with chronic decompensated tinnitus are cause or consequence of the tinnitus. The present research took a longitudinal approach to examine this question. METHOD: Psychopathological symptoms, personality, socio-demographical variables and otological features were assessed in 48 patients which had suffered from tinnitus for a period of no longer than 4 weeks. Six months after first assessment 92 % of the original sample (n = 44) were re-examined. 34 of these patients displayed chronic tinnitus. Univariate and multiple regression analyses were conducted in order to identify variables at first assessment which predicted tinnitus distress at second assessment for the 34 patients with chronic tinnitus. RESULTS: Tinnitus attributed sleep disturbance, anxiousness, and life satisfaction, each assessed at first investigation, independently predicted tinnitus distress at second assessment six months later. These three variables together predicted 56 % of the variance of tinnitus distress at second assessment. CONCLUSIONS: Our results support the model that the symptom tinnitus may develop on the basis of an enhanced psychophysiological tension and become a condensational core of preexisting psychological distress as a facilitatory process. Our results suggest that early psychotherapeutic interventions in patients at risk may prevent decompensation.

Adaptation, Psychological↗
PubMed2003

[Patients' subjective experiences after liver transplantation].

AIM: To study prospectively a cohort of patients in the first year after liver transplantation (LTx) with respect to their subjective experiences and their clinical condition. METHODS: Sixteen non-selected, consecutive patients (9 male) of the Clinic of Visceral Surgery of Cologne University were interviewed between 4 and 12 months after orthotopic LTx by narrative interviews. The interviews were audiotaped and transcribed according to standard international rules. We analysed the content of the interviews according to Grounded Theory and performed an ideal type analysis based on case comparison. RESULTS: Nine patients (56.25 %) had a mental disorder according to ICD-10. Patients' subjective experiences of the transplantation could be grouped into five ideal types: the successful, the grateful, the help-seeking, the vulnerable, and the special patient. These ideal types were found to be of a dimensional pattern when re-assessed at single-case level, i. e. individual patients fulfilled criteria of these ideal types to different degrees. CONCLUSIONS: Our patients perceive LTx predominantly as successful therapy for terminal liver disease. They use different coping strategies to come to terms with the considerable impact of transplantation. Each strategy implies specific risk profiles which have to be kept in mind when dealing clinically with LTx patients.

Adult↗
PubMed2001

Comorbidity of diabetes mellitus and eating disorders: a follow-up study.

OBJECTIVE: There is increasing evidence that the coexistence of diabetes and eating disorders (ED) leads to poor glycemic control and an increased risk of long-term complications. METHODS: In a questionnaire- and interview-based study, a sample of 36 out of originally 38 (94.7%) diabetic patients with an ED (type-1: n=13, type-2: n=23) was assessed after a period of about 2 years in order to determine the course of EDs, body mass index (BMI), glycemic control, and psychiatric symptomatology. RESULTS: Five patients (13.9%) of the total sample showed full remission for at least 12 consecutive weeks. Twenty-two patients (61.6%) showed no change in the diagnosis of the ED. Four patients (11.1%) shifted from subclinical to clinical EDs and five patients (13.9%) vice versa. Of the eight patients who went on to psychotherapy, only one patient (12.5%) showed full remission. Emotional distress of type-2 diabetics was considerably higher compared to type-1 diabetics, which was rather low at baseline. Except interpersonal distrust as one ED-related variable, no significant change of any psychological variable could be observed in the type-1 diabetic sample during follow-up. Of the 13 type-1 diabetic patients with an ED, five patients deliberately omitted insulin in order to lose weight. These patients showed a more serious psychopathology with regard to each measured psychological variable, a higher BMI, and worse metabolic control compared to those without insulin omission. Type-2 diabetics showed a significant increase in drive for thinness and body dissatisfaction. No considerable change could be observed with regard to BMI, glycemic control, and depressive and global psychiatric symptomatology in either diabetic subsample during follow-up. CONCLUSION: EDs tended to persist over time with a considerable shift within the different types of EDs. Insulin-purging in type-1 diabetics was associated with enhanced psychopathology, higher BMI, and worse metabolic control. Both mean body mass and ED-related symptoms such as "drive for thinness" and "body dissatisfaction" increased in the average obese type-2 diabetic sample, illustrating the vicious circle of low self-esteem, enhanced restraint eating, and binge eating in weight control measures.

Adult↗
PubMed2000

Relationship of weight and eating disorders in type 2 diabetic patients: a multicenter study.

OBJECTIVE: Previous work suggested that the degree of psychiatric symptomatology evidenced in overweight individuals was related to the severity of binge eating problems and not related to the severity of overweight. In a multicenter study, we investigated the relationship between weight and eating disorders (EDs) in a sample of type 2 diabetic patients. METHODS: Three hundred twenty-two patients with type 2 diabetes were stratified to various weight categories. Glycemic control, eating and body-related psychological problems, self-esteem, depressive, and general psychopathology of diaetic patients with and without an ED were compared. RESULTS: Eighty-one percent of all type 2 diabetic patients were overweight or obese. Prevalence rates of EDs ranged from 6.5% to 9.0%. Binge eating disorder was the most diagnosed ED. There was a strong relationship between body mass index (BMI) and eating disturbance-related variables and a weak or no relationship between BMI and depression or general psychopathologic variables. Patients with an ED showed a greater psychopathology compared to patients without an ED. The diagnosis of an ED did not seem to have a specific influence on glycemic control. CONCLUSIONS: Our results in a type 2 diabetic sample indicate that weight might have an impact on body and eating-related psychological distress in type 2 diabetic patients, but is of minor or no importance for depressive symptomatology, lower self-esteem, and general psychiatric symptomatology. Type 2 diabetic patients with an ED, however, suffer from considerable psychiatric symptomatology.

Analysis of Variance↗
PubMed1999

[Use and costs of psycho-oncological liaison services].

The extent to which patients took advantage of psychosocial consultation services in two clinics for internal and oncological disorders was documented over a period of four and a half years to establish, for the sake of future planning, whether there was a demand for psychosocial intervention. During the first year of treatment, consultations between a member of the psychosocial staff and any one patient averaged a total of 13 hours (2 sessions a week, each lasting 28 mins). The number of sessions depended most of all on objectifiable stress factors related to the course of disease or treatment. From records of both directly patient-oriented and team-oriented staff activities, we calculated the staffing requirements and costs of offering a psychosomatic consultation service within the framework of intensive internal-oncological medical care.

Adaptation, Psychological↗
PubMed1999

[Problem-based teaching and learning. An opportunity for medical psychology, psychosomatic medicine and psychotherapy?].

All proposals for a reform of the study of medicine recommend problem-based teaching and learning methods. The rapid increase in the number of medical faculties abroad offering experimental courses along these lines is an indicator of their usefulness. The results of empirical research also suggest that departments of medical psychology, psychosomatic medicine and psychotherapy should participate more closely in the introduction and exploration of the advantages of this didactic approach.

Problem-Based Learning↗
PubMed1999

[Can problem-based learning help medical students to assimilate knowledge? Evaluation of a first semester course in medical psychology].

Before the introduction of problem-based teaching and learning schemas, careful consideration must be given to the system devised for the evaluation of results. In the framework of a problem-based first-semester tutorial in medical psychology, certain interdisciplinary skills of prime importance to a doctor were tested to establish whether they were learnt more effectively by this approach than by traditional training methods. The experimental group was found to rank higher than controls in the following behavioural capacities: precise casework; differentiated approach to further treatment of patients; the ability to form hypotheses and to test them critically.

Education, Medical↗
PubMed1998

Comorbidity of diabetes and eating disorders. Does diabetes control reflect disturbed eating behavior?

OBJECTIVE: This multicenter study was designed to explore the prevalence of clinical and subclinical eating disorders (EDs), the extent of intentional omission of insulin and oral antidiabetic agents, and its relationship to glycemic control in an inpatient and outpatient population of men and women with type 1 and type 2 diabetes. RESEARCH DESIGN AND METHODS: Data have been collected from 12 diabetes medical centers in two German cities. In a questionnaire and interview-based study, a sample of male and female patients (n = 341 type 1, n = 322 type 2) was assessed for the following eating disorders: anorexia nervosa, bulimia nervosa, binge eating disorder, and eating disorder not otherwise specified. For lack of interview data of several patients meeting the screening criteria, prevalence ranges were calculated. RESULTS: The overall prevalence range of current EDs was 5.9-8.0% (lifetime prevalence 10.3-14.0%). When patients were stratified according to type 1 and type 2 diabetes, there was no difference in prevalence of EDs. However, the distribution of the EDs was different in both types of diabetes, with a predominance of binge eating disorder in the type 2 diabetes sample. Type 1 (5.9%) and type 2 (2.2%) diabetic patients reported deliberate omission of hyperglycemic drugs (insulin or oral agents) in order to lose weight. Compared with control subjects, neither the presence of EDs nor insulin omission influenced diabetic control. CONCLUSIONS: There seems to be no difference in prevalence rates of EDs in both types of diabetes; however, distribution of EDs is different. The findings suggest that neither EDs nor insulin omission are necessarily associated with poor control of glycemia. Binge eating disorder seems to precede type 2 diabetes in most patients and could be one of the causes of obesity that often precedes type 2 diabetes.

Adolescent↗
PubMed1995

[Neuropsychiatric performance of HIV-infected patients].

AIM: Can neuropsychic impairment which is clinically observed in the case of HIV-infected patients be objectivized, and what is the relationship to somatic features caused by the disease? PATIENTS AND METHOD: 65 HIV-infected men with no history of drug-addiction were examined by means of a test battery which monitored the functions memory/concentration and speed of response. The probands were then compared to a healthy control group which was parallelized with respect to age, sex and education. Immune status, HIV and AIDS associated symptoms as well as educational diseases were checked for their connection with neuropsychic impairment. RESULTS: Compared to healthy persons HIV patients presented significant deficits with respect to memory and concentration but showed no reduction of speed of response. Significant correlation could be determined with only one somatic feature: Half of the patients who had lost more than 10% of their body weight during the preceding three months suffered from clinically relevant memory and concentration disorders. CONCLUSIONS: 1. The massive memory and concentration disorders impair and isolate the patients and can have considerable job-related consequences. 2. Measures preventing loss of weight should be initiated as early as possible. 3. Training sessions, e.g. nutritional consultation, must take the patients' deficits with respect to concentration and memory into consideration. 4. Possible connections between loss of weight and changes in brain metabolism should be examined. 5. Future studies should determine whether measures weight increase coincide with an improvement of memory and concentration.

AIDS Dementia Complex↗
PubMed1995

[An consultation concept for integrating psychosomatic medicine in gynecology].

This paper is meant to survey the results of an interdisciplinary concept of psychosomatic patient treatment carried out for two years at the Department of Gynaecology and Obstetrics of the University of Cologne. This integral programme offers a psychosomatic consultation hour taking place once a week at the Department of Gynaecology and Obstetrics. Each first consultation is attended both by a psychosomatic specialist and a gynaecologist. The hypothesis underlying this new programme, which supposes that the integration of the psychosomatic treatment into the everyday routine of the clinic would make it easier for the patients to find access to psychological help, has proved right in view of the experience made so far. In comparison to the former counselling concept, the newly established gynaecologic-psychosomatical programme has increased the attendance by 300%. Thanks to the integrated consultation hour the way of seeing gynaecological problems in a psychosomatic context has increased considerably within the clinic itself so that these problems can now often be solved directly between gynaecologist and patient without making use of the offered consultation hour. Experiences made so far prove that the psychosomatic consultation hours are a valuable contribution to the diagnostic and therapeutic spectrum of the Department of Gynaecology and Obstetrics.

Abortion, Induced↗
PubMed1990

Interaction of DnaK with ATP: binding, hydrolysis and Ca+2-stimulated autophosphorylation.

The autophosphorylation of DnaK from Escherichia coli using ATP as phosphate donor is markedly stimulated by Ca+2 and to a lesser degree by Mn+2. Mg+2 and other divalent ions are without effect in this reaction. Lanthanum, an agonist/antagonist of Ca+2, is also effective in stimulating the autophosphorylation. In contrast, Mg+2 but not Ca+2, markedly stimulates the hydrolysis of ATP catalyzed by DnaK. Also at 0 degrees, ATP forms a stable complex with DnaK without hydrolysis that is independent of cations. About 15% of the DnaK in E. coli is associated with membrane vesicles where it also can be phosphorylated in the presence of Ca+2.

Adenosine Triphosphate↗
PubMed1989

[Research schools of pharmacy. 4. Heinrich A. Beckurts (1855-1929) and his students. The history of pharmaceutical science: 37].

In 1886 Heinrich A. Beckurts was appointed Professor of pharmaceutical Chemistry at Braunschweig. He was one of the most important teachers of pharmacy there and a good director of his institute. The scientific programme is represented by 146 papers an 52 dissertations; main roots were research of plants (phytochemical) and researchs for pharmacopoeias. Beckurts had 2000 students, 52 made their doctor-graduate under Beckurts and five are becoming professor. The research conditions in the pharmaceutical Institute Braunschweig were good and the research school of Bekkurts has an important public and social recognition, also Beckurts work provided the basis of the modern study for pharmacy.

Germany↗