Biomedical subjects

Matthias C Angermeyer

Publications and source records attributed to Matthias C Angermeyer.

At least 19 recordsLinked to original sources

PubMed2007

Familiarity with mental illness and approval of structural discrimination against psychiatric patients in Germany.

Structural discrimination against psychiatric patients may occur as a result of distribution of resources in the health system. We examine whether familiarity with mental illness, which reduces discrimination on the individual level, also moderates the approval of structural discrimination in health care funding. We conducted a representative survey of the German population (N=5025) in 2001 using a fully structured personal interview, including a measure of preferences for the allocation of health resources and an assessment of familiarity with mental illness. The approval of structural discrimination was inversely related to the individual's familiarity with mental illness in depression and, to a lesser extent, in schizophrenia. This relationship was absent for alcoholism and generally weak for contacts to mentally ill persons outside one's own family. Strategies successful in reducing individual discrimination are thus not necessarily suitable for combating structural discrimination and need to be tailored to their specific target.

Adult↗

PubMed2006

Validity of the EQ-5D in assessing and valuing health status in patients with schizophrenic, schizotypal or delusional disorders.

PURPOSE: The EQ-5D is a generic questionnaire generating a health profile and a single index score for health-related quality of life. This study aimed to analyse the discriminative ability and validity of the EQ-5D in patients with schizophrenic, schizotypal or delusional disorders. SUBJECTS AND METHODS: One hundred sixty-six patients with schizophrenic, schizotypal or delusional disorders (ICD-10 F2) completed the EQ-5D. Measures of quality of life (WHOQOL-BREF), utility (TTO), subjective (SCL-90R) and objective (PANSS, CGI-S) psychopathology, and functioning (GAF, GARF, SOFAS, HoNOS) provided comparison. Discriminative ability was analysed by assessing frequency distributions of EQ-5D scores. Validity of the EQ-5D self-classifier was analysed by assessing differences in related other scores grouped by response levels of EQ-5D items. Validity of the visual analogue scale (EQ VAS) and the EQ-5D index (UK social tariff) was analysed by assessing their correlation with all other scores. RESULTS: Seventy-nine percent of respondents reported problems in at least one of the EQ-5D dimensions (anxiety/depression 57%, usual activities 45%, pain/discomfort 44%, self-care 29%, mobility 22%). The mean EQ VAS score/EQ-5D index was 65.7/0.71. The four most frequently reported EQ-5D health states covered 45% of all respondents. For almost all EQ-5D dimensions, different response levels were associated with significantly different scores of measures used for comparison. Correlation of EQ VAS score and EQ-5D index were largest with scores of subjective measures (SCL-90R: -0.50 and -0.73; WHOQOL mental subscore 0.62 and 0.58; always P<0.001). DISCUSSION AND CONCLUSION: The EQ-5D showed a moderate ceiling effect and seems to be reasonably valid in this patient group.

Adult↗

PubMed2006

[Impact of structure and context on utilization of socio-psychiatric services in Saxony--a multi-level-analysis].

OBJECTIVE: To analyse the influence of structural (service) aspects and context (catchment area) variables on the individual use of socio-psychiatric services in Saxony. METHOD: Data collected in 34 services were used. For the analysis of the variance components a multi-level model with random effects was computed using data at two levels ([1] client, and [2] service/catchment area). RESULTS: Service use was substantially influenced by structural/context factors which accounted for a proportion of 10 to 50 % of the variance depending on the (sub-)group of users included in the analysis. The impact of service structure and context on service use was particularly strong in the subgroup of service users with very high service utilisation.

Adult↗

PubMed2006

[Department of Psychiatry, Centre for Psychiatry, Psychatrium--trends and changes in the names for mental health care institutions in Germany in the 20th century].

This paper investigates trends in the history of names for psychiatric institutions in Germany in the 20 (th) century. Professional lobbyism as well as efforts to fight stigmatisation of mentally ill patients form the background for name changes. The replacement of the term "Heil- Und Pflegeanstalt" ("Institution for the Cure and Care") by "Krankenhaus" ("hospital") in the 1950s/1960s, when through the introduction of modern psychopharmaceuticals psychiatry finally got acknowledged as an equal medical discipline and at the same time broke with the dreadful heritage of Nazi psychiatry, was a major step. The unity of the hospital itself and complimentary mental health care institutions is often expressed by "Zentrum" ("centre") as is the preservation of the patients' ties and their reintegration into the community by "Soziale Psychiatrie".

Germany↗

PubMed2006

Nursing home staff training in dementia care: a systematic review of evaluated programs.

BACKGROUND: We reviewed studies of in-service interventions for caregivers of persons with dementia in nursing homes published between 1990 and 2004. The aim was to obtain an overview of the evaluated interventions and to characterize their methodological quality. METHODS: A thorough literature search was conducted, including searching electronic databases for selected intervention studies and previous reviews. Selected studies were summarized and compared along certain categories, and methodological quality was assessed. RESULTS: A total of 21 studies were identified, mostly published in the United States. Most were of poor methodological quality. Although nearly all reported positive effects, their results must be interpreted cautiously due to methodological weaknesses. Extensive interventions with ongoing support successfully demonstrated sustained implementation of new knowledge. Owing to methodological weaknesses and a lack of follow-up evaluations, little or no evidence existed for the efficacy or, particularly, the transfer of knowledge in simpler interventions when reinforcing and enabling factors were not present. CONCLUSION: On an international and, particularly, on a national level a lack of evaluated in-service training programs for caregivers in homes for people with dementia is apparent. Methodological weakness is common. This study highlights the need for well-defined methodologically improved studies, providing conclusive evidence of the effects of intervention types to help improve the quality of dementia care.

Aged↗

PubMed2006

Public beliefs about the causes of mental disorders revisited.

When the lay public is asked to prioritize their causal beliefs for a vignette depicting either schizophrenia or depression, psychosocial causes are most popular for depression, but a large proportion of respondents prefers biological causes for schizophrenia. Recognition of the vignette as mental illness enhances the likelihood to endorse brain disease as a cause and reduces choices of certain psychosocial causes.

Attitude to Health↗

PubMed2006

Cost-of-illness studies of depression: a systematic review.

BACKGROUND: Depression is a very common disease with substantial economic consequences. This paper reviews all published cost-of-illness studies of depression worldwide. METHODS: A systematic search of cost-of-illness studies of depression in the databases MEDLINE, Web of Science, Cochrane Library, and PSYNDEXplus was conducted. Identified studies were classified by their basic characteristics. Costs reported were inflated in original currency to the year 2003 and then converted into US-dollar using purchasing power parities (US$ PPP). Additionally, national-costs were converted in costs per case and per inhabitant. RESULTS: 24 papers with notable methodical differences were identified and classified by their basic characteristics. Summary estimates from the studies for the average annual costs per case ranged from $1000 to $2500 for direct costs, from $2000 to $3700 for morbidity costs and from $200 to $400 for mortality costs. The basic quantity of interest in COI-studies of depression was stated. LIMITATIONS: Methodical differences limited comparison substantially. CONCLUSIONS: Depression is associated with a high economic burden. Conducting COI-studies of depression along the line noted in the review could help provide the opportunity to expose differences in costs associated with different approaches to disease management.

Cost of Illness↗

PubMed2006

The EQ-5D in alcohol dependent patients: relationships among health-related quality of life, psychopathology and social functioning.

OBJECTIVE: The EQ-5D, a short generic health-related quality of life (HRQOL) questionnaire, can derive preference-based index scores (e.g. EQ VAS, British and German EQ-5D indices) for economic evaluation. This study examined if the EQ-5D could be a valid measure describing and valuing HRQOL in alcohol dependent individuals. METHODS: In a sample of 103 individuals diagnosed with alcohol dependence (ICD-10 F10.2), we compared the EQ-5D against a quality of life measure (WHOQoL-BREF), a utility scale (TTO), measures of psychopathology (SCL-90R, CGI-S) and measures of social functioning (GAF, GARF, SOFAS, HoNOS). RESULTS: The response rate to EQ-5D dimensions was > 98%. Twelve percent of the individuals indicated "extreme problems" in at least one dimension. Different response levels in the dimension "anxiety/depression" were associated with largest effect sizes (absolute value(d)) of differences in mean scores of the WHOQoL-BREF domain "mental" (absolute value(d) = 1.17), the SCL-90R scales "obsessive-compulsive" (absolute value(d) = 1.15), "depression" (absolute value(d) = 1.16), "anxiety" (absolute value(d) = 1.10) and "GSI" (absolute value(d) = 1.09) indicating a similarity between the underlying constructs; concerning the dimensions "self-care", "usual activities", "pain/discomfort" and "mobility" effect sizes were generally lower (0.74 < absolute value(d) < 1.07) or insignificant. The EQ-5D VAS score (mean 58.0), the British EQ-5D index (mean 0.74) and the German EQ-5D index (mean 0.85) showed moderate correlations with other scales (0.28 < r < 0.60). CONCLUSION: Seventeen out of 30 hypothesized relationships between similar constructs of the EQ-5D and measures used for comparison were confirmed, possibly favoring EQ-5D's validity. However, the EQ-5D showed a moderate ceiling effect. Further confirmatory research is needed to support the EQ-5D suitability for economic evaluation in alcohol dependent populations.

Activities of Daily Living↗

PubMed2006

Incident dementia cases and mortality. Results of the leipzig Longitudinal Study of the Aged (LEILA75+).

Mortality caused by dementia has mainly been examined in population-based studies relying on prevalent cases. This study aims to investigate the impact of incident dementia on mortality as well as to identify factors influencing the course of dementia and those predicting early death in demented individuals. A representative community sample of 1,692 individuals aged 75 years and over was examined by neuropsychological testing in a four-wave study. Data were analyzed with the Cox proportional hazards model after making necessary adjustments for potential covariates. At the third follow-up 51% of the incident demented and 19% of the participants without dementia had died. The mean survival time was 3.1 years (95% CI = 2.8-3.4) for the demented subjects and 4.0 years (95% CI = 3.9-4.0) for those without dementia (p < 0.001). In the total sample, the relative risk of dying after developing dementia was estimated to be 2.4 (95% CI = 1.6-3.6) with age, sex, education, co-morbidity, and institutionalization being taken into consideration. Those persons with incident dementia who died had a more severe dementia. Population-based studies relying on incident cases are especially valuable in describing course and outcome of dementia. Studies relying on prevalent cases and clinical samples tend to overestimate mortality and propose course-modifying factors that are challenged by studies relying on incident cases.

Aged↗

PubMed2006

Limitations in activities of daily living and instrumental activities of daily living capacity in a representative sample: disentangling dementia- and mobility-related effects.

A representative sample of the Leipzig population aged 75 years and older showed 61.8% of the participants with relevant deficits in their capacity for independent living, according to a combined activities of daily living/instrumental activities of daily living (ADL/IADL) scale. The quantity and quality of care needed almost exponentially increases above 85 years of age. Looking at potential reasons for ADL/IADL limitations, 44% of variance in single ADL/IADL activities and 75% of the combined ADL/IADL sum score could come from a minimal set of predictor variables. Most important are dementia- or mobility-related declines, but living conditions also explain small but significant amounts of variance. These seem initially impressive, yet analyses showed about half the explained variances shared among the mobility and dementia indicators, limiting the use not only of ADL/IADL sum scores but of many single ADL/IADL items as well. Before deriving specific conclusions from variations in ADL/IADL instruments, one must note that the data suggest that interpretations of covariations--whether for health/mobility or dementia--are useful and substantial only if both indicators/predictors are verified. The information given captures the mobility- and dementia-related variance if ADL/IADL items, facilitating more specific scale developments.

Activities of Daily Living↗

PubMed2006

Subjective quality of life of patients with obsessive-compulsive disorder.

BACKGROUND: Obsessive-compulsive disorder (OCD) is the fourth most frequent diagnosis in psychiatry. Patients with OCD suffer from obsessive thinking and compulsive behavior, which impact their everyday life negatively. OBJECTIVE: Subjective quality of life (QoL) in patients with OCD was examined and compared to the general German population and to patients with schizophrenia. METHODS: Seventy-five patients, aged 21-72, with OCD (ICD 10 F42.0-F42.2) were recruited from the outpatient clinic for anxiety disorders at the Department of Psychiatry of the University of Leipzig. By means of the WHOQOL-BREF, QoL was assessed in patients with OCD in a representative sample of patients with schizophrenia and in a sample of the general population of Saxony/Germany. RESULTS: Compared with the general population, QoL in patients with OCDs was lower in all domains of the WHOQOL-BREF. Unexpectedly, QoL in patients with OCDs was lower in the domains "psychological well-being" and "social relationships" when compared with schizophrenia patients. CONCLUSIONS: OCD has a substantial adverse effect on patients' subjective QoL, which may be even greater than the adverse effect of schizophrenia. Therefore, it will be necessary to include interventions in the treatment of OCD aimed at improving residual deficits in psychosocial functioning and QoL.

Adolescent↗

PubMed2006

Relationship between parental bonding and mood disorder in six European countries.

The linkage between adverse parental child-rearing styles and the occurrence of mood disorders in adulthood has been investigated in a number of studies from different countries and cultural backgrounds. However, as direct cross-cultural comparisons hardly exist, little is known about cultural variations of this relationship. The European Study of the Epidemiology of Mental Disorders (ESEMeD) is a cross-sectional study in a stratified multi-stage random sample of 21,425 adults (18 years or older) from the general population of six European countries (Belgium, France, Germany, Italy, Netherlands, and Spain). Parental child-rearing styles were measured by means of a short form of the Parental Bonding Instrument (PBI) in 8,232 of the respondents. Based on the extraction and confirmation of a three-factor model of the PBI in a previous study, the association between parental bonding and mood disorders was studied by computing hierarchical nested multiple logistic regression models. The relationship between parental child-rearing styles and mood disorders was mostly homogeneous across the six countries. The PBI dimensions maternal and paternal care had the strongest associations with mood disorders. A significant association of overprotection was observable only for the mother. There was no significant relationship between authoritarianism and the occurrence of mood disorders. In the European countries studied, the association between parental child-rearing styles and the occurrence of mood disorders appears not to be culture-dependent. It would be of interest to assess whether this also holds for the rest of Europe and non-European countries.

Adolescent↗

PubMed2006

Is mortality increased in mildly cognitively impaired individuals? A systematic literature review.

Numerous studies have focused on the effect of mild cognitive impairment in elderly people. However, the impact of mild cognitive impairment on mortality has rarely been considered so far. This paper reviews recent work on mild cognitive impairment and its mortality risk. Relevant articles were identified by a systematic search of the literature published since 1990 using the databases PubMed, Web of Science and PSYNDEXplus, bibliographies of articles identified and of earlier reviews. Those studies were considered which predominantly included persons aged 65 and over and which relied on population-based samples. Thus only eight studies could be identified. In general, the relative risk (RR) for subjects with mild cognitive impairment according to different concepts in comparison to non-affected persons varies from 1.0 to 1.9. However, only few studies are available, and a comparison of the literature is problematic, due to variations in criteria and methodology.

Aged↗

PubMed2006

Quality of life of relatives of patients with obsessive-compulsive disorder.

BACKGROUND: Obsessive-compulsive disorder (OCD) affects the lives of both patients and their relatives. Clinical observations suggest that family members of patients with OCD are involved in the patients' rituals, often impairing their own everyday life. OBJECTIVE: The objective of this study was to compare the quality of life (QoL) of relatives of patients with OCD with that of the general German population. METHODS: Seventy-four relatives (29 parents, 33 spouses, 8 children, and 4 siblings) of patients with OCD (International Statistical Classification of Diseases, 10th Revision F42.0-F42.2) were recruited from the outpatient clinic for anxiety disorders of the University of Leipzig Department of Psychiatry. The WHOQOL-BREF, a self-administered questionnaire developed by the World Health Organization, assessed QoL. These findings were compared with the QoL of a representative sample of the general German population. RESULTS: Compared with that of the general population, the QoL of relatives of patients with OCD was significantly lower in the domains physical well-being, psychologic well-being, and social relationship. CONCLUSIONS: Obsessive-compulsive disorder has an adverse effect on the subjective QoL of relatives of patients with OCD. Therefore, these findings suggest that professionals working with relatives must focus not only on the care given to persons with an illness but also on their relatives' situation and personal QoL.

Adaptation, Psychological↗

PubMed2006

Public attitudes towards mental patients: a comparison between Novosibirsk, Bratislava and German cities.

PURPOSE: It is commonly assumed that reforms in the sector of psychiatric care have contributed to reducing the stigma attached to mental illness. In order to examine whether a relation between the psychiatric care set-up and stigmatisation of the patients exists we compared public attitudes towards mental patients in three countries at differing stages of progress in psychiatric reform. METHODS: Population surveys on public attitudes towards mental patients were conducted in Novosibirsk (Russia) and Bratislava (Slovakia). The data were compared with those from a population survey that had recently been carried out in Germany. In all three surveys the same sampling procedure and fully structured interview were used. Public attitude towards mental patients was elicited using a perceived devaluation-discrimination measure. RESULTS: Psychiatric patients face considerable rejection in all three locations in question. Overall, the degree of perceived devaluation and discrimination was similar in all countries with a significant, but marginal tendency towards stronger devaluation of mental patients in Germany. CONCLUSION: Our results do not support a strong relationship between psychiatric reform and mental illness stigma.

Adolescent↗

PubMed2006

Influence of newspaper reporting on adolescents' attitudes toward people with mental illness.

BACKGROUND: Numerous studies have established proof of selective media reporting about the mentally ill, with the majority of the reports focusing almost exclusively on violence and dangerousness. A handful of studies found that there is an association between negative media portrayals and negative attitudes toward people with mental illness. However, empirical evidence of the impact of newspaper reports about mentally ill people on readers' attitudes is very scarce. AIMS: To examine the impact of a newspaper article linking mentally ill persons with violent crime and the impact of an article providing factual information about schizophrenia on students' attitudes toward people with mental illness. METHOD: A total of 167 students aged 13-18 years were randomly assigned one of two articles. A period of 1 week before and 3 weeks after reading the newspaper article, they were asked to complete a self-administered questionnaire for the assessment of their attitudes toward mentally ill people. RESULTS: Respondents who read the article linking mentally ill persons with violent crime displayed an increased likelihood to describe a mentally ill person as dangerous and violent. Conversely, respondents who read the informative article used terms like 'violent' or 'dangerous' less frequently. The desire for social distance remained virtually unchanged at follow-up in both groups. CONCLUSION: Two potential approaches to break the unwanted link between negative media reporting and negative attitudes are suggested. First, an appeal to media professionals to report accurate representations of mental illness. And second, an appeal to the adults living and working with adolescents to provide opportunities to discuss and reflect on media contents.

Adolescent↗

PubMed2006

Preferences of the public regarding cutbacks in expenditure for patient care: are there indications of discrimination against those with mental disorders?

BACKGROUND: Increasing costs for patient care may necessitate financial cuts in the health-care budget. Our aim is to examine whether the public prefers cuts for psychiatric rather than medical conditions and how resource allocation preferences are related to illness beliefs and attitudes. METHOD: A telephone survey involving German adult population was conducted in 2004 (n = 1012). Participants were presented with a list of nine medical and mental diseases including alcoholism, depression, schizophrenia, Alzheimer's disease, cancer, diabetes, rheumatism and AIDS, and were asked to name three conditions where they would prefer to see health-care resources cut. For all conditions we asked about personal attitudes and illness beliefs. RESULTS: People were more willing to have financial resources cut for psychiatric than for medical conditions, with resources for alcoholism having the least public backing. Alzheimer's disease was rated more favourably compared to other mental disorders. Generally, the perception of the severity of a disease was associated with resource allocation decisions, favouring those conditions that were considered to be severe. Mental diseases evoked a far greater desire for social distance than most medical diseases which had considerable influence on resource allocation preferences. The perception of personal responsibility had, in contrast, only limited effect on resource allocation decisions. It varied considerably in the case of psychiatric conditions but was not fundamentally different among medical and mental diseases. Personal susceptibility, treatment effectiveness and the perceived life-threat posed by a disease also had limited effects. CONCLUSION: According to public resource allocation preferences psychiatric patients are at risk of being structurally discriminated within the health-care system.

Adolescent↗

PubMed2006

Serotonin transporter imaging with [123I]beta-CIT SPECT before and after one year of citalopram treatment of obsessive-compulsive disorder.

BACKGROUND: Two thirds of patients with obsessive-compulsive disorder (OCD) respond to treatment with selective serotonin reuptake inhibitors (SSRIs). The neurobiological mechanisms of SSRI action and failure to respond to SSRI treatment remain to be elucidated. OBJECTIVES: The aim of this pilot study was to quantify changes in the availability of serotonin transporter (SERT) in the course of SSRI treatment and to relate these changes to improvements of clinical symptoms. METHODS: Ten patients with OCD were investigated at baseline and 5 of them after 1 year of SSRI treatment with citalopram 60 mg per day using brain single photon emission computed tomography and [123I]beta-CIT. Specific-to-nondisplaceable [123I]beta-CIT binding ratios (V3'') were calculated in SERT-rich brainstem, midbrain and thalamus using a magnetic resonance imaging-based region of interest (ROI) analysis. Symptom severity was evaluated with the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). RESULTS: V3'' differed significantly between pretreatment and follow-up scans in all three brain regions, thalamus, midbrain as well as in brainstem. In thalamic ROI, differ ences in SERT availability and Y-BOCS ratings correlated. In midbrain, a trend toward a significant association was found. In brainstem, no relationship was revealed. CONCLUSIONS: Higher occupancy of SERT by citalopram seems to be associated with better clinical response after 1 year of SSRI treatment of patients with OCD.

Adult↗