Biomedical subjects

M Driessen

Publications and source records attributed to M Driessen.

42 records · Page 3Linked to original sources

PubMedDate not supplied

The course of anxiety, depression and drinking behaviours after completed detoxification in alcoholics with and without comorbid anxiety and depressive disorders.

We studied the associations between comorbid anxiety and depressive disorders in treated alcoholics, the course of current anxiety and depression during the early and late post-detoxification periods, and drinking behaviours after discharge. Lifetime psychiatric comorbidity was assessed in 100 alcoholics using the Composite International Diagnostic Interview (CIDI). Three subgroups defined as group DA (comorbid depressive and anxiety disorders, n = 15), group A (anxiety disorder only, n = 23), and group NO (no comorbid disorder, n = 62) were studied. Beginning 21 +/- 13 days after cessation of drinking, state anxiety (STAI-X1), trait anxiety (STAI-X2) and depression (BDI) were assessed once per week (t1 to t4) and once more 6 months after discharge (t5, n = 68). The severity of psychopathology decreased during the first 4 weeks after detoxification in all subgroups. However, trait anxiety remained at higher levels in both the comorbid subgroups from t1 to t4. In the follow-up sample, 60.5% of the non-comorbid subjects remained abstinent, but only 26.7% of all comorbid patients and only 12.5% of those with comorbid depressive disorder plus severe current trait anxiety or depression at t1. Independent of their comorbidity status, relapsers at t5 had already reported more trait anxiety than abstainers at t1. We conclude that severe trait anxiety persisting after 3 weeks of abstinence, comorbid depressive and/or anxiety disorders, and combinations of these with moderate or severe current anxiety and depressive states represent the greatest risks of relapse and therefore may indicate a treatment need.

Adult↗

PubMedDate not supplied

Impaired serum cortisol stress response is a predictor of early relapse.

AIMS: to investigate a possible association of cortisol stress response during early abstention with relapse. METHODS: Thirty-six alcohol-dependent males, half of them with a comorbid anxiety disorder, and 15 healthy controls were exposed to a standardized psychosocial stress test. Thirty-one of the patients were assessed for relapse 6 weeks after discharge. RESULTS: The relapsers showed almost no cortisol responses in the stress test. Comorbid anxiety disorder influenced neither stress response nor relapse. CONCLUSIONS: During early abstention from alcohol, reduced stress-responsivity of the hypothalamo-pituitary-adrenocortical axis seems to be connected to early relapse.

Adult↗

PubMedDate not supplied

Motivational intervention: an individual counselling vs a group treatment approach for alcohol-dependent in-patients.

AIMS: The present study aimed to evaluate whether individual counselling for alcohol-dependent patients in three sessions is as effective as a 2-week group treatment programme as part of an in-patient stay in a psychiatric hospital which was to foster motivation to seek further help and to strengthen the motivation to stay sober. Of particular importance was the external validity of the results, i.e. a 'normal' intake load of in-patients in detoxification and a wide variety of motivation to stop drinking were to be investigated. METHODS: Subjects eligible for the study were all patients with alcohol problems admitted to a psychiatric hospital, but without psychosis, as the main diagnosis, and with a maximum of 10 detoxification treatments in the past. A randomized-controlled trial was conducted with 161 alcohol-dependent in-patients who received three individual counselling sessions on their ward in addition to detoxification treatment and 161 in-patients who received 2 weeks of in-patient treatment and four out-patient group sessions in addition to detoxification. Both interventions followed the principles and strategies of motivational interviewing. RESULTS: Six months after intervention, group-treatment patients showed a higher rate of participation in self-help groups; however, this difference had disappeared 12 months after treatment. The abstinence rate among the former patients did not differ between the two intervention groups. CONCLUSION: Group treatment may lead to a higher rate of participation in self-help groups, but does not increase the abstinence rate 6 months after treatment.

Alcoholism↗

PubMedDate not supplied

A new rating scale for the assessment of the alcohol-withdrawal syndrome (AWS scale).

A new rating scale for the quantitative assessment of the alcohol-withdrawal syndrome (AWS) was developed from the CIWA-A scale by item analysis based on the data from 132 alcoholic patients. The clinical evaluation of this AWS scale in a second sample of 256 alcoholic patients showed that it adequately assessed the course and severity of the AWS. The AWS scale provides data for a rational strategy of therapy for the AWS by rating mental and somatic symptoms on different scales. In particular, the mental subscale allows prediction of a complicated AWS. Subjects with an AWS score > or = 10 at admission have a higher risk of becoming delirious than those with a lower score (46.6% vs 2.8%; P < 0.001). In order to minimize the prescription of drugs with abuse potential, such as diazepam and clomethiazole, a structured treatment programme of in-patient alcohol detoxification based on the AWS score was also developed. The comparison revealed that, in the second sample, which was treated following this protocol, the number of cases given medication was lower and the amount of clomethiazole prescribed per patient was less.

Adult↗

PubMedDate not supplied

[Chronic renal failure: predictors of good adjustment to disease and treatment].

N = 109 patients with chronic renal failure were studied referring to somatic, psychological and social parameters, which are often discussed in psychonephrology. N = 25 of the patients were in the status of compensated retention, n = 43 were undergoing hemodialysis and n = 41 lived after transplantation. At the same time the treating physicians were asked to judge different criterias referring to the adaptation of the patients to the disease and treatment. Using a discriminant analysis, we were successful in predicting the quality of adaption in 75-85% using the patient variables. The results show, that each of the three treatment groups is to be considered separately, although some variables seem to have a generally strong prediction power: Serum level of Calcium, psychosomatic complaints and the extent of depressive disorder. Some aspects for further prospective studies and for the practical treatment are shown.

Adaptation, Psychological↗

PubMedDate not supplied

[Psychotherapy in general practice of physicians and psychologists].

This study tries to reveal the epidemiology of outpatient psychotherapy in practices in a defined northern area of Germany (Schleswig-Holstein, 2.66 Mill. inhabitants) by a postal questioning of all medical (n = 242) and psychological (n = 45) psychotherapists registered. Psychotherapy was defined as enclosing at least 10 meetings. 54.7% of the questionnaires were returned to us. An analysis on this database showed that 8310 adult patients were psychotherapeutically treated within one year (0.3% of the population). On the base of different epidemiological studies the treatment prevalence widely differed from 3.9 to 31.9%. The majority of diagnoses were reactive disorders or neuroses (52.8%) and psychosomatic disorders (24.3%). Patients out of middle and upper social classes, with higher educational levels, and from urban areas (> 100 000 inhabitants) were more likely to be treated than others. This trend was significantly more apparent in psychologists than in physicians.

Adult↗