Biomedical subjects

Matthias C Angermeyer

Publications and source records attributed to Matthias C Angermeyer.

At least 55 records · Page 3Linked to original sources

PubMed2005

The effects of antipsychotic treatment on quality of life of schizophrenic patients under naturalistic treatment conditions: an application of random effect regression models and propensity scores in an observational prospective trial.

The study examines the effect of different types of antipsychotic treatment on the health related quality of life (HRQL) of people with schizophrenia under naturalistic outpatient treatment conditions. In a prospective study design, 307 schizophrenic patients were followed over a period of 2.5 years. HRQL, clinical characteristics, and type of antipsychotic medication were assessed five times every 6 months. HRQL was assessed by the SF-36. Random effect regression models were computed for the SF-36 mental (MCS) and physical (PCS) component scores. Propensity scores were included in the regression models to reduce a possible sample selection bias. Monotherapeutic treatment with new atypical neuroleptic drugs had a more positive effect on the mental health related quality of life (MCS) in comparison to treatment with polypharmacological treatment but not with oral conventional antipsychotics. Monopharmaceutical treatment with depot-antipsychotic drugs had a more positive effect on the physical health related quality of life (PCS) in comparison to polypharmacological treatment. Study results indicate that atypical antipsychotic drugs are not superior to conventional antipsychotics with regard to the effect on QOL. However, monopharmaceutical treatment can be assumed to be more effective in improving mental and physical related QOL than polypharmaceutical treatment.

Adolescent↗

PubMed2005

What is schizophrenia? Secondary school students' associations with the word and sources of information about the illness.

Young people are generally assumed to be less prejudiced toward people with schizophrenia than are adults. This article presents findings from a survey of 293 secondary school students in Germany, exploring their associations with the word schizophrenia and sources of information. Results indicate that the majority of young people appear either rather well informed or totally lacking information about schizophrenia. Findings are discussed in view of their implications for effective antistigma interventions and mental health education.

Adolescent↗

PubMed2005

[Everyday burden of mentally ill people's spouses -- client orientated approaches in relatives' support].

OBJECTIVE: Regarding clinical practice groups for relatives of mentally ill people mostly are conceptualized depending on the type of disorder the patient is suffering from. However, results of research on burden of caregivers indicate aspects of burden which do not seem to be associated with the patients' disorder. METHOD: As part of a study on the burden of caregiving to mentally ill family members in-depth interviews as well as diary writing over a 12 weeks period were carried out with 6 spouses of patients suffering from schizophrenia or depression. RESULTS: Differences in the burden of caregiving do not seem to be related to the type of the patients' diagnosis. Aspects of partnership dominated the interviews and diary writing of the spouses. In all cases substantial parts of experienced burden are related to the spouses' efforts to share mastering of the illness with the patient. CONCLUSIONS: The hypothesis of specific aspects regarding the type of the patients' disorder related to spouses caregiver burden can not be supported by the results of this study. However, our results seem to encourage aspects of relationship within the development of support programs for relatives of mentally ill people.

Adult↗

PubMed2005

[Employment of professional help by patients with obsessive-compulsive disorders].

BACKGROUND: Several studies have investigated the pathway to psychiatric care. There are no results available for OCD. METHODS: Therefore, 23 patients with OCD were recruited among individuals seeking treatment at our university hospital outpatient clinic for anxiety and obsessive-compulsive disorders. All patients underwent a semistructured interview aimed at investigating their individual pathways to psychiatric care, to their experiences in the health system and to the first appearances of the psychiatric disorder. RESULTS: Those affected often trivialize and normalize the first symptoms of OCD. Also, in many cases, family members of OCD-patients do not understand the first symptoms of OCD. Contrary to patients with depression and anxiety disorder, OCD-patients often choose psychiatrists as their first professional contact. DISCUSSION: The first symptoms of the disorder must be diagnosed at an early stage in order to provide the patients with the acknowledged therapy for OCD.

Adult↗

PubMed2005

[Effects of interventions to improve compliance with antipsychotic medication in people suffering from schizophrenia-results of recent reviews].

BACKGROUND: Non-compliance (or non-adherence) with antipsychotic pharmacotherapy occurs frequently. In addition, there is overwhelming evidence that it constitutes a major risk factor for psychotic relapse. Compliance substantially affects course and treatment of schizophrenia. During the last decades, a large body of research on compliance with antipsychotic medication has been accumulated. METHOD: The authors provide an overview of meta-analyses. Reviews published since 1990 on effects of interventions aiming at increasing compliance with medication in people suffering from schizophrenia are summarized. RESULTS: We found eight reviews which reported empirical findings on the efficacy and effectiveness of interventions with the goal of improving compliance. Interventions have shown limited (psychoeducation) to moderate (cognitive-behavioral and combined interventions) effects. Other relevant findings are summarized and discussed.

Antipsychotic Agents↗

PubMed2005

[Is there a connection between right-wing extremism and social distancing from mentally ill people? Results from a representative survey among the adult German population].

OBJECTIVE: There are indications of a link between right-wing extremist orientation and attitudes towards people with mental illnesses. Social distance is used to investigate this. METHOD: In 2002, a representative survey was conducted among the German adult population (n = 2089). Social distance was measured using a question from the European values surveys. Right-wing extremist attitudes were measured with a scale developed by Niedermayer and Faller. RESULTS: Only a marginal link between right-wing extremism and social distance towards people with mental illnesses was found which, moreover, showed an inconsistent pattern. DISCUSSION: It would be premature to conclude from this "negative" finding that a right-wing extremist orientation has no influence on the attitude towards people with mental illnesses, especially in the light of only one form of discrimination being investigated here.

Adolescent↗

PubMed2005

[The stigma of mental illness: concepts, forms, and consequences].

OBJECTIVE: Persons with mental illness frequently encounter public stigma and may suffer from self-stigma. We aim to clarify the concept of mental illness stigma and discuss important consequences for people with mental illness. METHOD: A search of scientific literature on mental illness stigma was conducted with a focus on conceptually relevant empirical studies. RESULTS: After giving a conceptual overview of stigma, we elaborate on the consequences of stigma, focussing on self-stigma/empowerment, coping behaviour, fear of stigma as a barrier to using health services, and on structural discrimination. Main strategies to reduce stigma -- protest, education, and contact -- are discussed. CONCLUSIONS: Stigma is of central importance to persons with mental illness, both to how they experience their illness and its consequences and whether they use available health services. Well-designed anti-stigma initiatives will help to diminish the impact of mental illness stigma.

Adaptation, Psychological↗

PubMed2005

[The direct costs of depressive disorders in Germany].

OBJECTIVE: The purpose of this study was to estimate the direct costs of depression in Germany from the social perspective. METHODS: The data came from the European Study of the Epidemiology of Mental Disorders (ESEMeD), in which a representative sample of 3555 non-institutionalised adults aged 18 years or older was interviewed in Germany. Using the most recent version of the Composite International Diagnostic Interview (WMH-CIDI), 131 persons with a 12-month prevalence of major depression, minor depression and dysthymia were identified. These patients reported their mental health care consumption of the last 12 months retrospectively, which was valued by prices of 2002. RESULTS: The average direct costs for treating depressive disorders were 686 EUR per patient and year. The total direct costs of depression in Germany was estimated at approximately 1.6 billion EUR. CONCLUSIONS: Because the sample was restricted to the non-institutionalised population, calculated costs may be underestimated. The costs per inhabitant in Germany exceed those reported by studies from the United Kingdom but are lower than those reported for the USA.

Adult↗

PubMed2005

[Measuring preferences for depressive health states].

OBJECTIVE: The purpose of this study was to analyse the construct validity and the concurrent validity of the EuroQol instrument (EQ-5D self-classifier, EQ VAS and EQ-5D indices), time trade-off (TTO) and contingent valuation (willingness-to-pay) for preference-based valuation of depressive health states. METHODS: A survey of a representative sample (N = 3522) of the non-institutionalised population aged 18 and above in Germany was conducted using the EQ-5D, TTO and contingent valuation as well as the SF-12 questionnaire. Construct validity was analysed by comparing 130 respondents in whom 12-month prevalence for major depression, minor depression, or dystimia according to DSM-IV was identified based on a version of the Composite International Diagnostic Interview (WMH-CIDI) to respondents without depressive disorders. Concurrent validity was analysed by assessing the correlation between these measures in the group with depressive disorders. RESULTS: In the group with depressive disorders, problems in all EuroQol dimension except for mobility were significantly more frequent, and mean values of all analysed preference measures except for willingness-to-pay were less favourable than in the group without depressive disorders (EQ VAS score 67 vs. 78; EQ-5D index [VAS] 83 vs. 94; EQ-5D index [TTO] 0.81 vs. 0.91; TTO 0.89 vs. 0.95; always p < 0.001). In the group with depressive disorders, EQ VAS score and EQ-5D indices were significantly correlated one with another (ranging from r = 0.63 to r = 0.92) as well as with the mental and the physical component scale of the SF-12 (ranging from r = 0.26 to r = 0.45) and with willingness-to-pay (ranging from r = - 0.20 to r = - 0.22); besides, willingness-to-pay was significantly correlated with TTO (r = - 0.46). CONCLUSIONS: The results of this study point to the construct validity and concurrent validity of preference measures in patients with depressive disorders.

Activities of Daily Living↗

PubMed2005

[The regional budget for mental health care: a new approach to combine inpatient and outpatient care].

OBJECTIVE: Due to increasing health care expenditures the discussion about advantages and disadvantages of new methods for resource allocation in mental health care has been intensified. A promising model is the Regional Budget for Mental Health Care, which is currently being examined in Schleswig-Holstein. The present paper describes first experiences with the new resource allocation model. BASIC CONDITIONS: An annual budget, provided for the treatment of a fixed number of patients, makes it possible to reduce inpatient capacity in favour of improved community-integrated approaches for the treatment of acute psychiatric illness. RESULTS: In a first step inpatient capacity will be reduced by 8 percent. By the end of 2007 capacity for hospital day care shall be increased by 87 percent and a home treatment will be implemented. The previous working method, orientated to treatment setting, will be replaced by an approach specialized in diagnostic groups. CONCLUSIONS: The Regional Budget could improve the continuity and flexibility of patient care. Service providers become motivated to treat in a way, which with little resource consumption achieves a long lasting health status improvement. For health insurances the Regional Budget is an opportunity to limit cost increases.

Ambulatory Care↗

PubMed2005

["What is a bipolar disorder?" Results of a representative survey of the German population].

AIM: To explore to what extent the lay public knows that the term bipolar disorder denotes a mental disorder. METHOD: In January 2005, a telephone survey was conducted among a random sample of the German population (n = 1006). Out of four options given, respondents were asked to select the one they considered to be the correct explanation of what is meant by bipolar disorder. RESULTS: Most of the respondents (61%) believed that bipolar disorder is just another term for the melting of the polar ice caps, only 4.6 % associated it with mental illness. DISCUSSION: The question arises as to whether it makes sense to use a diagnosis which the lay public associates with everything but a mental illness. Since it is impossible to erase the term bipolar disorder from the psychiatric terminology, it seems necessary to increasingly propagate this term among the lay public.

Adult↗

PubMed2005

[Prevention -- a topic in social-psychiatric research?].

OBJECTIVE: Currently, substantial effort is made to establish prevention as one of the main parts of the German health care system. In this context we investigated the current role of prevention in social-psychiatric research. METHODS: We analysed original papers published in the journal Psychiatrische Praxis in the years 2003-2004 by computer-aided full text analysis. RESULTS: 16.5 % of the studies mentioned prevention, in one fourth of these, prevention was the main topic. Subject of these papers were suicide prevention in psychiatric patients, relapse prevention in mentally ill offenders, and prevention of acute confusional state after hip surgery. Most of the work was dedicated to tertiary prevention, followed by secondary prevention. Two papers mentioned primary preventive aspects and only one report was dedicated to primary prevention as a main topic. CONCLUSIONS: Although early diagnosis and intervention as well as rehabilitation of mental disorders are main topics of social psychiatry, only few reports relate explicitly to prevention. The role of social psychiatry in primary prevention has to be defined.

Community Psychiatry↗

PubMed2005

[Is there currently a boom of stigma research in psychiatry?].

OBJECTIVE: Recently, there has been a growing awareness among psychiatrists of the stigma of mental illness. In numerous countries programs aimed at reducing stigmatization and discrimination because of mental illness have been launched. The question arises as to what extent the increasing interest in stigma has stimulated research in this area. METHOD: A search for papers on stigma of mental illness that have been published in scientific journals since 1990 has been carried out, using different search strategies. RESULTS: During the 1990 s, there is a marked increase of articles dealing with the stigma of mental illness. There is no indication of an end of this trend. DISCUSSION: Despite more research we are still far from understanding the stigma process in detail. This, however, is the prerequisite for developing successful anti-stigma interventions.

Cross-Sectional Studies↗

PubMed2005

The stigma of mental illness in Germany: a trend analysis.

BACKGROUND: While there are some indications that the mental health literacy of the public has improved within recent years, the findings concerning its attitudes towards the mentally ill are quite inconsistent. AIMS: The aim of this study is to examine whether any changes have taken place in Germany over the last decade regarding the stigmatisation of mentally ill people. METHOD: In 2001, a representative population survey was carried out among the German adult population, using the same sampling procedure and the same measure for the assessment of perceived stigma as in a previous survey that had been conducted in 1990. RESULTS: Our findings suggest that in 2001, the German public was somewhat less inclined to believe that former mental patients are exposed to stigmatisation than a decade ago. While this holds especially true for the devaluation of patients, the picture is more mixed for discrimination. The trend towards less perceived stigmatisation is particularly pronounced among people who are familiar with psychiatric treatment. CONCLUSIONS: Since a substantial amount of perceived stigma still persists, further efforts to reduce the stigma attached to mental illness are needed.

Adolescent↗

PubMed2005

Causal beliefs and attitudes to people with schizophrenia. Trend analysis based on data from two population surveys in Germany.

BACKGROUND: It is a widely shared belief that an increase in mental health literacy will result in an improvement of attitudes towards people with mental illness. AIMS: To examine how the German public's causal attributions of schizophrenia and their desire for social distance from people with schizophrenia developed over the 1990s. METHOD: A trend analysis was carried out using data from two representative population surveys conducted in the Lander constituting the former Federal Republic of Germany in 1990 and 2001. RESULTS: Parallel to an increase in the public's tendency to endorse biological causes, an increase in the desire for social distance from people with schizophrenia was found. CONCLUSIONS: The assumption underlying current anti-stigma programmes that there is a positive relationship between endorsing biological causes and the acceptance of people with mental illness appears to be problematic.

Adolescent↗

PubMed2004

Familiarity with mental illness and social distance from people with schizophrenia and major depression: testing a model using data from a representative population survey.

OBJECTIVES: The main purpose of this study is to examine whether the relationship between familiarity with mental illness and stigmatizing attitudes about mental illness, which had been observed in a previous study based on a sample of community college students (Psychiatr. Serv. 52 (2001) 953), can be replicated using data from a representative population survey. METHODS: In spring 2001, a representative survey was carried out in Germany (n=5025). A personal, fully structured interview was conducted which began with the presentation of a vignette depicting someone with either schizophrenia or major depression. Respondents were asked to respond to measures assessing familiarity, perception of dangerousness, fear, and social distance. Path analysis with manifest variable structural modeling techniques was applied to test the model used in the previous study. RESULTS: Despite differences in methods, most findings of the previous study were replicated. Respondents who were familiar with mental illness were less likely to believe that people with schizophrenia or major depression are dangerous. Weaker perceptions of dangerousness corresponded closely with less fear of such people, which in turn was associated with less social distance. The effect of familiarity was somewhat pervasive: respondents who reported to be familiar with mental illness expressed a less strong desire for social distance. There is also a relatively strong relationship between perceived dangerousness and social distance. CONCLUSIONS: Our findings fully support the notion that approaches to social change which increase the public's familiarity with mental illness will decrease stigma.

Adolescent↗

PubMed2004

Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys.

CONTEXT: Little is known about the extent or severity of untreated mental disorders, especially in less-developed countries. OBJECTIVE: To estimate prevalence, severity, and treatment of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) mental disorders in 14 countries (6 less developed, 8 developed) in the World Health Organization (WHO) World Mental Health (WMH) Survey Initiative. DESIGN, SETTING, AND PARTICIPANTS: Face-to-face household surveys of 60 463 community adults conducted from 2001-2003 in 14 countries in the Americas, Europe, the Middle East, Africa, and Asia. MAIN OUTCOME MEASURES: The DSM-IV disorders, severity, and treatment were assessed with the WMH version of the WHO Composite International Diagnostic Interview (WMH-CIDI), a fully structured, lay-administered psychiatric diagnostic interview. RESULTS: The prevalence of having any WMH-CIDI/DSM-IV disorder in the prior year varied widely, from 4.3% in Shanghai to 26.4% in the United States, with an interquartile range (IQR) of 9.1%-16.9%. Between 33.1% (Colombia) and 80.9% (Nigeria) of 12-month cases were mild (IQR, 40.2%-53.3%). Serious disorders were associated with substantial role disability. Although disorder severity was correlated with probability of treatment in almost all countries, 35.5% to 50.3% of serious cases in developed countries and 76.3% to 85.4% in less-developed countries received no treatment in the 12 months before the interview. Due to the high prevalence of mild and subthreshold cases, the number of those who received treatment far exceeds the number of untreated serious cases in every country. CONCLUSIONS: Reallocation of treatment resources could substantially decrease the problem of unmet need for treatment of mental disorders among serious cases. Structural barriers exist to this reallocation. Careful consideration needs to be given to the value of treating some mild cases, especially those at risk for progressing to more serious disorders.

Adult↗

PubMed2004

Factors contributing to frequent use of psychiatric inpatient services by schizophrenia patients.

BACKGROUND: Although present findings about frequent users of psychiatric inpatient services vary from study to study, some potentially important predictors of frequent use were extracted. The purpose of this study was to examine the potentially contributory factors of frequent use of psychiatric inpatient services by schizophrenia patients and to test the influence single factors have in an overall model. METHODS: A total of 307 schizophrenia patients were interviewed five times with intervals of 6 months. Data were collected about service receipt and health care costs, strength of primary diagnosis and comorbidities, as well as about patients' needs for care and satisfaction with care. Patients with three or more psychiatric admissions within a 30-month period were defined as frequent users. RESULTS: According to this criterion, 12% of the study population were frequent users. Compared with ordinary users, these patients accounted for significantly higher costs in hospital- and community-based care. Important predictors for frequent use of psychiatric inpatient services were the number of previous hospitalizations and current scores of psychopathology. In addition, a longitudinal analysis showed the importance of social factors for the use of psychiatric inpatient care. Therefore, a number of the frequent users' multiple admissions could also be caused by social problems. CONCLUSIONS: The mental health system should, thus, provide well-directed community-based resources, which give frequent users support to solve their social problems.

Adolescent↗