Biomedical subjects

M C Angermeyer

Publications and source records attributed to M C Angermeyer.

At least 55 records · Page 3Linked to original sources

PubMed2002

[Age- and education-specific reference values for the cognitive test of the SIDAM (Structured interview for the diagnosis of dementia of the Alzheimer type, multi-infarct dementia and dementias of other etiology according to ICD-10 and DSM-IV)].

The SIDAM (Structured Interview for the diagnosis of Dementia of the Alzheimer type, Multi-infarct dementia and dementias of other etiology according to ICD-10 and DSM-IV) is a standardized interview for the diagnosis of dementia. It can also be used as a screening instrument for the diagnosis of different syndromes of dementia and mild cognitive impairment. At present there is no age- or education-specific standardization. This report presents age- and education-specific norms for the cognitive assessment of the SIDAM, obtained in a population-based sample of elderly people aged 75 and over (n=1001).

Age Factors↗

PubMed2002

[Adaptation of a dementia test for use in visually handicapped persons exemplified by SIDAM (Structured Interview for the Diagnosis of Alzheimer disease, Multi-Infarct Dementia and Dementias of other Etiology)].

In epidemiological field studies on the prevalence and incidence of dementia, the problem of cognitive testing of visually impaired individuals is rarely discussed. In the Leipzig Longitudinal Study of the Aged (LEILA 75+) a version of the SIDAM (SIDAM-Structured Interview for the Diagnosis of dementia of the Alzheimer type, Multi-infarct dementia and dementias of other etiology) for the visually impaired was employed from which all items requiring image processing had been omitted (SIDAM-blind). In order to be able to interpret the test results, the final scores for the full SIDAM were estimated by linear transformation of the scores in the blind-version. The method of linear transformation is based on certain theoretical assumptions which are examined in this paper. Linear transformation of scores has proved to be a valid procedure only for individuals with high cognitive performances. Thus, an evaluation of estimated scores based on the norms for the original SIDAM has limitations. Consequently, age-specific norms for the SIDAM-blind are presented. Sensitivities and specificities for different cut-off points used to discriminate between demented and non-demented vision-impaired individuals are given.

Aged↗

PubMed2002

Mild cognitive impairment--a review of prevalence, incidence and outcome according to current approaches.

OBJECTIVE: Mild cognitive impairment is associated with an increased risk of developing dementia. However, agreement needs to be reached on clearly specified diagnostic criteria for mild cognitive impairment. The present paper critically reviews the different constructs of mild cognitive impairment on the basis of the available empirical evidence. METHOD: All published papers on mild cognitive impairment during the last 15 years on Medline and other databases were reviewed. RESULTS: Age-specific prevalence and incidence rates according to the different constructs as well as the prognostic significance of the different constructs concerning the development of dementia are reported. Furthermore, a brief summary of recent research on possible risk factors for a negative course of mild cognitive impairment is provided. CONCLUSION: As there is no construct to date that pools all efforts of defining mild cognitive impairment, the review provides suggestions for an agreement on constructive terminology and research practice.

Aging↗

PubMed2002

[Financial burden on spouses of patients suffering from schizophrenia, depression or anxiety disorder].

The aim of this study was to compare financial burden of spouses, whose relative suffers from schizophrenia, depression or anxiety disorder. 151 spouses filled in the questionnaire about illness related expenses and financial loss. Additionally they estimate their subjective burden according to these experienced costs. Direct cash expenditures on behalf of the patients' illness were reported by 66 % spouses. In the sampling the amount of spent money did not differ statistically, however spouses of patients with anxiety disorder emphasised experiencing financial strain and described more often subjective economic disadvantages. Although most spouses of patients with psychiatric disorders experience illness related financial disadvantages, these costs were usually not considered as serious problem or as burdensome. Based on a subjective hierarchy of burdens financial problems can be regarded as less important for spouses of patients with mental illness. Thus, not only the material, but also the immaterial costs of care giving spouses should be taken into consideration when planning health policy decisions.

Adult↗

PubMed2002

[Emil Kraepelin's work at the Silesian Provincial Psychiatric State Hospital in Leubus].

Emil Kraepelin (1856-1926) worked as surgical resident physician at Leubus (Lubiaz) Psychiatric State Hospital (asylum) in Silesia from August 1884 to April 1885. The asylum had been founded in a converted monastery as recommended by Johann Gottfried Langermann (1768-1832). Its first superintendent was Moritz Gustav Martini (1794-1875). Although no primary documents concerning Kraepelin's stay at Leubus could be found in the archives, the secondary sources and Kraepelin's own publications offer a good perspective on his Leubus period. Thus, his ground-breaking psychopathological study of confusion is based on patients observed at Leubus. Furthermore, it was here that his work on the major paper on falsifications of memory was begun. Kraepelin also finished the second part of his study "On the psychology of the comic" and wrote a postscript to his paper on the validity of Weber's law regarding light sensations. Since the then superintendent Wilhelm Alter (1843-1918) did not object to his residents doing scientific work, Kraepelin encouraged the voluntary resident physician Max Salomon (1860-?) to write a thesis on double-thinking. He also devoted a great deal of his time to writing reviews and to research in experimental psychology. Kraepelin's time at Leubus, similar to his Dresden period, are but a transitional phase for his final return to the university which he had left temporarily because he was disappointed and frustrated by the lack of career opportunities that suited his needs.

Germany↗

PubMed2002

[Does caring for a schizophrenic family member increase the risk of becoming ill? Psychological and psychosomatic troubles in caregivers of Schizophrenia patients].

OBJECTIVE: The aim of this study was to investigate to what extent caregivers of schizophrenia patients suffer from psychiatric and psychosomatic symptoms themselves; furthermore, whether there are differences between parents and spouses. METHOD: 51 parents and 52 spouses of people with schizophrenia were interviewed regarding psychiatric and psychosomatic troubles using standardized questionnaires and diagnostic methods. RESULTS: A considerably increased prevalence of depressive disorders was found compared to the level in the general population. As well as mothers and wives, caregivers of patients with severe impairments of psycho-social functioning were particularly affected. The severity of the patient's disease and the caregiver's mental problems are significant predictors of psychosomatic complaints in parents and spouses. In addition, caregivers visit physicians more frequently, in particular family doctors, psychiatrists and psychotherapists. DISCUSSION: The results support the hypothesis that the burden carried by caregivers of severely affected schizophrenia patients increases their risk of becoming ill, which, as a consequence, leads to a greater use of medical resources. Specific offers of health care and advice on preventative measures appear to be necessary in order to preclude health impairments to caregivers as early as possible.

Adult↗

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↗

PubMed2002

Two hundred years of psychiatry at Leipzig University: an overview.

The University of Leipzig boasts a long tradition in the field of psychiatry. In 1811 J.C.A. Heinroth was appointed as the first professor of psychiatry in Europe. In 1877 brain researcher P. Flechsig inherited his chair, but did not significantly contribute to the progress of this speciality. His first assistant was E. Kraepelin. Flechsig's successors, O. Bumke and P. Schröder, included psychological as well as sociogenetic topics in their research. The latter did pioneering work for the institutionalization of child and adolescent psychiatry. After the destruction of the hospital in 1943, R. A. Pfeifer re-organized its operation, and he also made remarkable contributions to the study of the angiostructure of the brain. With D. Müller-Hegemann, who had a major influence on German psychotherapy, the social psychiatric era began, and it was successfully continued under B. Schwarz, K. Weise and the hospital's present head, M. C. Angermeyer. Under Angermeyer the institutional basis of the clinic has been improved to include, among its other services, a day clinic and an optionally open-closed ward.

Education, Medical↗

PubMed2001

Self-perceived social integration and the use of day centers of persons with severe and persistent schizophrenia living in the community: a qualitative analysis.

BACKGROUND: The study examined how persons with severe and persistent schizophrenia perceive their social integration and how particular types of social integration are related to the use of day centers and patient clubs. METHODS: Problem-focused interviews on self-perceived social integration and the use of day structuring services were done with 100 persons with an ICD-9 diagnosis of schizophrenia living in Leipzig. Transcribed interviews were subjected to computer-aided qualitative content analysis. RESULTS: Results of the qualitative content analysis show that the study participants can be classified in five different groups according to their self-perceived degree of social integration. The use and the subjective meaning of existing day structuring services was found to be associated with the type of self-perceived social integration. CONCLUSION: The heterogeneous ways persons with chronic schizophrenia organize their social lives lead to different kinds of needs for support. In order to meet the needs of the whole spectrum of patients this heterogeneity must be taken into account in the process of service planning.

Activities of Daily Living↗

PubMed2001

[Need for help and nursing care in the elderly of the new German territories: results of a Leipzig long-term study of the elderly population (LEILA75+)].

In a representative sample of the Leipzig population age 75 and older 61.8% of the participants showed relevant deficits in their capacity of independent living as assessed by a combined ADL/IADL scale. According to a staging model of care as promoted by Schneekloth and coworkers, 17% of the sample was in need of care. Especially, mobility-related instrumental activities of daily living (IADL) such as shopping, cleaning and visiting are affected, but also basic activities (ADL) such as climbing stairs, walking or taking a shower/bath. Each of these activities created problems for more than 45% of the participants. Between 18 and 33% of the sample even regarded it as impossible to carry out these activities. Expectedly, the percentages of assistance needed with ADLs/IADLs appeared to be strongly age-related with exponential increases beyond the age of 85. Beyond effects of sampling and life expectancy, significantly more women suffered from decreases in their capacity of independent living. Community-dwelling elderly on average had a 10% higher rate of problems with ADLs/IADLs as compared to German reference data from the studies on "Chances and Limits of Independent Living in Old Age"; the rate of institutionalized participants, who regarded it impossible to carry out these activities, was even higher by about 30%. As discussed by Schneekloth et al., data from the LEILA study support the hypothesized pattern that ecological disadvantages under both community-dwelling as well as insitutionalized living conditions lead to higher percentages of elderly in the former East German states who are in need of care. As a consequence and although more disabled, elderly seem to stay longer under community-dwelling living conditions and move even more disabled into an institutionalized form of living.

Activities of Daily Living↗

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

Patients' and relatives' assessment of clozapine treatment.

BACKGROUND: Subjective evaluations by schizophrenic patients and their relatives of clozapine treatment were assessed as part of an exploratory study. METHODS: A problem-centred interview was carried out with 80 patients at discharge from in-patient or day-hospital treatment. Views of 46 relatives on the treatment were also assessed. RESULTS: In addition to expected effects (improvement of or stabilisation of one's state of mental health, antipsychotic effects), patients surprisingly often highlighted the calming and relaxing effect of clozapine as well as improved sleep as particularly positive. While more than half of the respondents expected a worsening of their condition if they stopped taking medication, only every fifth patient feared a relapse. Among the negative effects, fatigue and sedation were cited by far the most often. The absence of extrapyramidal side effects was clearly noted as an advantage of clozapine. Only 10% of those questioned were aware of the risks for the haemotopoetic system associated with the drug. Differences were found between patients' and relatives' assessments particularly with regard to the negative effects. CONCLUSIONS: Patients and relatives frequently hold specific and distinct views on clozapine treatment. These views should be considered when patients and relatives are informed and when compliance is addressed.

Adult↗

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

["The illness has totally changed our lives"--stress in partners of schizophrenic patients at the onset of illness].

OBJECTIVE AND METHOD: The aim of this study was to investigate how spouses of schizophrenic patients experience the onset of the disease. Based on the narrative analysis of 23 in-depth interviews, the article highlights different aspects of this stressful life event. RESULTS: The first episode of a schizophrenic disorder leads to severe distress in the spouse of the patient. Emotions of fear, despair and loss of control are especially pronounced if spouses feel that neither their information about the disease nor their supportive resources are sufficient. The illness is often viewed as an existential threat to marriage and family life. DISCUSSION: Supportive services for spouses of schizophrenic patients should be offered very closely to the onset of schizophrenia, because the situation is especially burdensome in this period. Interventions should meet the particular needs of spouses. In addition to information about the illness and coping strategies intervention programs should consider issues which are relevant for partnership and parenting roles.

Adaptation, Psychological↗

PubMed2001

[Stress of family caregivers of psychiatric patients. Developmental trends, concepts and results of research].

OBJECTIVE: A review of the findings in the research literature on the effect of mental illness on other members of the patient's family is provided. This article critically examines the research to date with special reference to the conceptual and operational definitions of burden and methodological issues. RESULTS: The burdens of caring for a patient at home are considerable throughout different patient groups. Relatives' experience of burden is influenced by their cognitive appraisal of the situation and their psychosocial resources of coping with it. Research findings suggest that information and support provided by clinicians can alleviate caregiver burden, although it has been used too rarely in clinical routine. CONCLUSIONS: Finally, the review identifies advances made in this line of research in recent years and highlights areas that need further attention in future research work. Systematic research of families' responses to and management of mental illness should move beyond the more global concept of family and address the great diversity among families with mentally ill relatives. Furthermore, given the lack of consensus regarding the theoretical conceptualizing of the burden concept a new framework with reference to stressrelated research is suggested.

Adaptation, Psychological↗

PubMed2001

[Etiology of schizophrenia from the viewpoint of family].

OBJECTIVE: In a former quantitative study on relatives' beliefs about the causes of functional psychoses a preference for psychosocial explanations was found. There were also indications of an inclination towards a multicausal concept. The aim of this study is to try to replicate these findings using semi-qualitative methods. In addition, we are interested in knowing to what extent the causal beliefs of relatives are similar to those of the patients. METHOD: Problem-centered interviews were conducted with 31 relatives of schizophrenic patients. A computer-assisted qualitative content analysis was carried out with the transcripts of the interviews. RESULTS: As in the previous study, relatives showed a strong propendency to endorse psychosocial explanations. However, among only one third a multicausal concept could be observed. The causal beliefs of relatives and patients were quite similar. DISCUSSION: The findings are discussed with reference to the concept of subjective illness theory and the concept of social representations.

Adult↗