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Biomedical subjects

M C Angermeyer

Publications and source records attributed to M C Angermeyer.

At least 73 records · Page 4Linked to original sources
PubMed2001

["(...) sometimes I have doubts about myself, when I'm not doing well". Effect of an ambulatory psychoeducational group program from the subjective perspective of patients with schizophrenic illnesses].

PURPOSE: Aim of the study is an analysis of the patients' evaluation of the impact of a psychoedukative group program for patients with schizophrenia in outpatient treatment, which was part of the project "Integrated Treatment of Schizophrenia". METHOD: Problem-focussed interviews were carried out with 30 randomly selected participants of the psychoeducative group programme. Interviews were fully transcribed and analysed by means of qualitative content analysis. RESULTS: With the exception of two persons all patients made a very positive assessment of their participation at the psychoeducative programme. The quality of the information received and the possibilities of exchanging experiences with other patients during the group sessions were mentioned by most of the participants as reasons for this positive assessment. Although only few patients reported on changes of their illness behaviour due as a result of psychoeducation, most of them underlined that that the increase of their illness-related wisdom as well as the exchange of illness experiences with other patients helped them to cope somewhat better with their illness. CONCLUSION: Psychoeducative group programmes contribute to the improvement of patients quality of life even if they have no measurable impact on illness behaviour or compliance. Hence, such group programmes should be integrated into outpatient services even if there is no evidence of a direct impact on relapse rates or cost savings.

Adult↗
PubMed2001

[Etiology of schizophrenia from the viewpoint of the patient].

OBJECTIVE: According to a quantitative study on causal beliefs patients with functional psychoses favour psychosocial over biological explanations. They also tend to endorse a multicausal concept. The aim of this study is to try to replicate these findings using semiqualitative methods. METHODS: Problem-centered interviews were conducted with 78 schizophrenic patients consecutively discharged from inpatient or dayhospital treatment. RESULTS: As in the previous study, patients provided more frequently psychosocial explanations. Biological causes were relatively rarely mentioned--mostly in response to suggestions of the interviewer. In addition, they were rather brief and not very elaborated. By contrast to the previous study, hardly any indications for a multicausal concept could be observed. DISCUSSION: Patients' beliefs are contrasted with the results of psychiatric research on the causes of schizophrenia.

Adult↗
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

["It may be somewhat more demanding sometimes, but also more interesting". Psychiatrists evaluate the impact of psychoeducation on outpatient treatment of schizophrenia].

PURPOSE: Aim of the study is the analysis of the psychiatrists' evaluation of the impact of a psychoeducative group programme on patients with schizophrenia and schizoaffective disorders, which was part of the project "Integrated Treatment of Schizophrenia". METHOD: Semi-structured interviews were carried out with 20 psychiatrists involved in outpatient treatment of patients who participated in the psychoeducative programme. Interviews were analysed by means of qualitative content analysis. RESULTS: For some patients psychiatrist noticed positive changes of the awareness for early signs of psychosis, the illness behaviour and their attitudes regarding their disorder. Although only some of the psychiatrists believe that psychoeducation has a direct impact on the reduction of relapse rates and the necessity of inpatient episodes, most of them regard the observed effects as an important improvement of the patients' ability to cope with their disorder. CONCLUSIONS: The effectiveness of psychoeducational programmes should not only be assessed by their impact on the reduction of relapse rates and health service cost but also by its contribution to the patients' quality of life. The integration of psychoeducational programmes into existing outpatient services seems to be an important task of future service planning.

Acute Disease↗
PubMed2001

[Causal beliefs of schizophrenic patients].

RESEARCH QUESTION: Aim of the study is to investigate whether the preference of schizophrenic patients for psychosocial causal explanations found in a previous study carried out in Hamburg can be observed elsewhere. Further aim of the study was to find out how stable patients' causal attributions are over time. Finally, we were interested to know to what degree patients' beliefs reflect those held by the general public. METHOD: Using an inventory comprising 15 items, we inquired about 105 schizophrenic patient's aetiological ideas at the time of discharge from hospital from inpatient or daycare treatment at 4 psychiatric hospitals in Germany. Follow-ups were carried out 3 months and 6 months later. RESULTS: Psychosocial factors, especially psychosocial stress, were most frequently held responsible for the onset of the illness. The possibility that biological factors might play a role in the causation of schizophrenia was considered more rarely by the patients. There were practically no regional variations as concerns aetiological beliefs. The tendency to endorse psychosocial stress factors was more pronounced among patients as compared with the general public. In total the causal beliefs proved to be quite stable over a time period of 6 months. DISCUSSION: Patients' causal beliefs are compared with findings of psychiatric research, and possible ways to bridge the gap between the two are discussed.

Adult↗
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

[Who, What, How much, Where? - an analysis of publications by German authors on sociopsychiatric issues in scientific journals].

OBJECTIVE: Stimulated by Finzen's critical appraisal of the actual situation of social psychiatric research in Germany an analysis of recent publications of German authors on social psychiatric topics was carried out. METHOD: Covering the years 1998 - 2000, 70 scientific journals from psychiatry and related disciplines were systematically analysed. RESULTS: A substantial proportion of research in social psychiatry is concentrated on a small number of research institutions. In German journals of general psychiatry papers dealing with social psychiatric topics are rarely found. By contrast in international, particularly in European journals the proportion of papers on social psychiatric topics originating from German authors is quite high as compared to papers on other topics. Applied research, especially research on mental health services, dominates the field. By contrast, basic research on social psychiatric issues is underrepresented. Studies using qualitative methods are almost missing. While, as traditionally, the research interest is still particularly focussed on schizophrenia, there are a number of papers dealing with other disorders, mainly with substance abuse disorders and affective disorders. DISCUSSION: The critique raised by Finzen is to a large extent supported by the results of our study. However, we still hesitate to agree with his pessimistic prognosis for the future of social psychiatric research in Germany.

Authorship↗
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↗