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Biomedical subjects

M C Angermeyer

Publications and source records attributed to M C Angermeyer.

At least 109 records · Page 6Linked to original sources
PubMed1999

[Attitude of family to clozapine].

AIM: Evaluations of clozapine treatment by relatives of schizophrenic patients were assessed as part of an exploratory study and compared with the patients' own assessment. METHOD: 46 relatives of individuals suffering from schizophrenia were questioned by means of a problem-centred interview. RESULTS: In addition to the positive effects on the schizophrenic illness, relatives strikingly often pointed out the calming, sleep-improving effect of clozapine. As opposed to the patients, the majority of relatives were well aware of the risks associated with discontinuing the drug treatment. Both patients and relatives complained about the sedative effect and the increased need for sleep associated with clozapine treatment. However, diverging evaluations were given with regard to hypersalivation, anticholinergic effects, and weight gain. Relatives were more concerned about possible organ damage occurring as a long-term effect than the patients. Further, indications were found that relatives were more worried by the risk of haematotoxic effects resulting from clozapine treatment than the patients. It could be said that, among the relatives, there was a slightly greater awareness of the advantages of clozapine treatment in comparison with conventional neuroleptics than there was with the patients. CONCLUSION: The importance of relatives' views in the effort to secure adequate neuroleptic treatment despite the current economic restrictions should not be under-estimated.

Adult↗
PubMed1999

["Rather overweight and mentally present...". Patients evaluate clozapine].

OBJECTIVE: Subjective evaluations by schizophrenic patients 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. RESULTS: In addition to expected effects (improvement or stabilisation of one's state of mental health, antipsychotic effects), patients surprisingly often highlighted clozapine's calming and relaxing effect as well as improved sleep as particularly positive. While more than half of the respondents expected a worsening of their condition in case they stopped taking their 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 every tenth of those questioned was aware of the risks for the haemotopoietic system associated with the drug. With regard to the obligatory blood tests, a surprisingly large number of patients was indifferent or stated that they had no opinion on the matter. DISCUSSION: Possible implications for patient information and compliance will be discussed.

Adolescent↗
PubMed1999

[Gerontopsychiatric competence is in demand. The current psychopharmacologic treatment practice in homes for the aged and nursing homes].

OBJECTIVE: A growing proportion of residents of residential and nursing homes is mentally ill and subject to intensive pharmacotherapy. This study presents data on the use of psychotropic drugs use in residential and nursing homes for the elderly in the new Länder. METHOD: The psychotropic drug use of 560 residents of 4 old-people's homes in Leipzig (Germany) was reviewed and analysed descriptively. RESULTS: Half of the population of residential and nursing homes receives psychotropic drug treatment, a substantial part with 2 or more drugs a day. Middle- and long-acting benzodiazepines were prescribed strikingly often and used for long-term treatment. Antidepressants, taken regularly by 3.6% of the nursing homes residents and 2.6% of the residential home residents, are considered to be under-used. The introduction of new substances (e.g. atypical neuroleptics, SSRI's) which might be more appropriate in vulnerable and multimorbide elderly persons was found to be delayed. CONCLUSIONS: The treatment of mental disorders in residential and nursing homes lags far behind the "state of the art" and demonstrates the need for gerontopsychiatric input into institutional care for the elderly.

Aged↗
PubMed1998

The psychiatric epidemiology of violent behaviour.

This paper reviews the current state of the debate on the relationship between mental disorder and violent behaviour. Starting from the discussion of methodological approaches to assessing a possible association, the most important studies carried out on the issue in recent years are discussed. Their results concur in supporting the assumption that there is a moderate but reliable association between mental disorder and violence. However, this does not imply that people with mental illness are generally more likely to commit violent acts than members of the general population. An elevated risk of violent behaviour is only evident for specific psychiatric diagnoses and symptom constellations. For schizophrenia and other psychotic disorders, a significant increase in the likelihood to commit violent acts is reported. Substance use disorders and antisocial personality disorder, however, represent a markedly higher risk for violent behaviour. The article further discusses possible determinants of violent behaviour such as psychotic symptoms and comorbidity with substance abuse and considers who is at particular risk of becoming a target of violent acts.

Comorbidity↗
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↗
PubMed1998

[Mentally ill patients--a danger?].

This paper reviews the current state of the debate on the relationship between mental disorder and violent behaviour. Starting from the discussion of methodological approaches to assessing a possible association, the most important studies carried out on the issue in recent years are discussed. Their results concur in supporting the assumption that there is a moderate but reliable association between mental disorder and violence. However, this does not imply that people with mental illness are generally more likely to commit violent acts than members of the general population. An elevated risk of violent behaviour is only evident for specific psychiatric diagnoses and for particular symptom constellations. For schizophrenia and other psychotic disorders, a significant increase in the likelihood to commit violent acts is reported. Substance use disorder and antisocial personality disorder, however, represent a markedly higher risk for violent behaviour. The article further discusses possible determinant of violent behaviour such as psychotic symptoms and comorbidity with substance abuse, and considers who is at particular risk of becoming a target of violent acts.

Comorbidity↗
PubMed1998

["Out of the picture"--self-evaluation of the occupational status of chronic schizophrenic patients in united Germany].

PURPOSE: This study is based of the documentation of drastic changes in the vocational life of chronically schizophrenic individuals in the New German Länder. With the political and economic transition since 1989, the employment rate of those suffering from chronic schizophrenia dropped from 50% to 7%. Currently most of them receive a disability pension. METHOD: Using a qualitative study design, we addressed the question as to what extent the disability pension can substitute for occupation of those in question. 45 chronically schizophrenic patients who are currently in outpatient treatment were interviewed to understand the role of work and disability pension in their lives. RESULTS: Positive and negative aspects of work and disability pension and their interaction as seen by the participants in our study are described. In a life of discontinuity disability pension offers a security which most of our interviewees would not like to give up. Other needs, however, especially the need for social integration, are not met by disability pension. A part-time job beyond sheltered facilities would offer them the possibility to benefit from the positive psycho-social function of work without challenging their security. Implications for vocational rehabilitation are discussed.

Adult↗
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↗
PubMed1996

Public attitude towards psychiatric treatment.

Past research on help-seeking behaviour and compliance among the mentally ill has mainly been focused on the examination of individual and structural determinants, while the impact of the socio-cultural context has been largely neglected. To examine this impact, we conducted a representative survey among German citizens who were eligible to vote. By means of vignettes describing different mental disorders we recorded the lay public's preferences for various treatment methods, together with their subjective reasons for voicing these particular preferences. While we found that psychotherapy was generally held in high esteem by the lay public, psychopharmacotherapy was rejected by the vast majority of respondents. This pattern was observed for all of the mental disorders included in our survey. While the public's image of psychotherapy is largely determined by popular views on psychoanalysis, public opinion about psychotropic drugs is strongly influenced by characteristics associated with tranquillizers. Among the different psychotherapeutic approaches, psychoanalysis is the preferred method among respondents in the western part of Germany, while the lay public in the eastern part tends to endorse group therapy. Finally, our research showed a considerable difference between the conceptions held by the lay public and those of psychiatric experts with regard to the adequate treatment of mental disorders. This, in turn, should not be without consequence for help-seeking behaviour and patient compliance.

Adolescent↗
PubMed1996

Relatives' beliefs about the causes of schizophrenia.

Based on a representative survey among the members of German and Austrian associations of relatives of mentally ill people, this paper examines the beliefs commonly held by relatives of persons suffering from schizophrenia concerning the causes of this disorder. A comparison of the information gathered in the course of this survey with the results of a representative survey conducted among the general public in Germany shows that relatives will usually look to biological factors when searching for the cause of schizophrenia, while the general public tends to cite psychosocial factors, especially stress-related factors, in order to explain the development of this illness. We attribute this discrepancy to relatives' greater exposure to the knowledge of psychiatric experts as well as their having to deal with their own feelings of guilt.

Adult↗