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Biomedical subjects

Matthias C Angermeyer

Publications and source records attributed to Matthias C Angermeyer.

At least 73 records · Page 4Linked to original sources
PubMed2004

Reduced serotonin transporter-availability in obsessive-compulsive disorder (OCD).

We investigated the availability of brain serotonin transporters in 10 drug-free patients with obsessive-compulsive disorder (OCD) and age-matched healthy controls in vivo using single-photon emission computed tomography (SPECT) and the radioligand [(123)I]-2beta-carbomethoxy-3beta-(4-idiophenyl)-tropane ([(123)I]beta-CIT). For quantification of regional serotonin transporter a ratio of specific to non-specific [(123)I]beta-CIT-binding was used. The availability of serotonin transporter was calculated using regions of interests (ROI) for thalamus/hypothalamus, midbrain, brainstem (highest density of serotonin transporter) and cerebellum as a reference. The mean specific to non-specific [(123)I]beta-CIT binding ratios in the thalamic/hypothalamic ROI were 4.95 +/- 0.57 (OCD patients), and 5.48 +/- 0.87 (control group). The mean ratios in the midbrain ROI were 3.51 +/- 0.45 (OCD patients) and 4.89 +/- 1.23 (controls) and in the brainstem ROI the ratios were 2.38 +/- 0.76 (OCD patients) and 3.53 +/- 1.01 (controls). This in vivo finding of significant reduced serotonin transporter availability in midbrain/brainstem using [(123)I] beta-CIT SPECT further supports the serotonin deficit hypothesis of OCD.

Adult↗
PubMed2004

Experience of stigmatization by relatives of patients with obsessive compulsive disorder.

Patients with mental illness and their relatives experience discrimination and stigmatization in their everyday lives. The stigma of mental illness has been investigated in numerous studies. However, the subjective experiences of patients with OCD and their relatives have not been reported up until now. Narrative interviews with 22 family members of patients with obsessive-compulsive disorder were performed as part of a study on the burden and distress among the families of those with mental illness. Stigma experiences were analyzed using a grounded theory approach. Different areas of life could be described, where stigmatization is anticipated or concretely experienced by relatives of patients with OCD. Concealing is an important coping strategy for the family members interviewed. Stigmatization can be reduced by handling the illness and the co-operation of patients, their relatives, and the professionals in an unbiased manner.

Adaptation, Psychological↗
PubMed2004

The public's preferences concerning the allocation of financial resources to health care: results from a representative population survey in Germany.

OBJECTIVE: The aim of the study is to examine to what extent the public is willing to allocate financial resources to the care of people with mental disorders. METHODS: In 2001, a representative survey was conducted among the adult population of Germany (n = 5025). The respondents were asked to select three out of nine conditions for which available resources should on no account be shortened. For data analysis, multiple unidimensional unfolding was used. RESULTS: Compared with medical diseases, the respondents were far less willing to allocate financial resources to the care of people with psychiatric disorders, making a clear distinction between the two types of diseases. While familiarity with mental illness had the effect of decreasing the reluctance to spend money for psychiatric patients, the endorsement of traditional values increased it. CONCLUSION: Our findings point to both the chances and the limitations of efforts aimed at reducing the structural discrimination of people with mental illness.

Adolescent↗
PubMed2004

Public attitudes to people with depression: have there been any changes over the last decade?

BACKGROUND: A consistent finding of representative surveys that were conducted in Germany in the early 1990s was that people with depression encountered a substantial amount of stigma and discrimination. The aim of this study was to examine whether public attitudes have improved over the last decade or not. METHODS: In 2001, a representative survey was carried out among the adult population of the "old" Federal Republic of Germany using the same methodology as in a previous survey in 1990. RESULTS: Regarding emotional reactions of the respondents towards people with depression, our findings are inconsistent. While there has been an increase in the readiness to feel pity and also a slight increase in the tendency to react aggressively, the expression of fear remained unchanged. The public's desire for social distance from people with depression was as strong in 2001 as it had been in 1990. CONCLUSION: The hypothesis of a change for the better regarding public attitudes towards depressed people is not supported by our findings. Further efforts are needed to reach this goal.

Adolescent↗
PubMed2004

[The impact of antipsychotic medication on the incidence and the costs of inpatient treatment in people with schizophrenia: results from a prospective observational study].

SUBJECT: Subject of the study is the analysis of the impact of antipsychotic medication on the incidence and the costs of inpatient treatment in patients with schizophrenia. METHODS: In a prospective longitudinal study with 5 points of measurement incidence and the costs of inpatient treatment, the type of antipsychotic medication, as well as the clinical and social characteristics of 307 outpatients with the diagnosis of schizophrenia (ICD 10 F 20.0) were assessed over a period of 2.5 years. The impact of antipsychotic medication on the incidence of inpatient treatment was analysed by means of a random-effect logit model. The impact of antipsychotic medication on the costs of inpatient treatment was analysed by means of a random-effect tobit model. Selection effects were controlled by means of propensity scores. RESULTS: Patients who received antipsychotic treatment with conventional, new atypical or depot neuroleptics had a lower incidence of inpatient treatment and caused lower costs in comparison to patients without antipsychotic treatment. The same effect was found for patients who received a combined treatment with conventional and depot neuroleptics. No effects were found for clozapine or for a combination treatment with conventional and atypical neuroleptics. No significant differences between the effects of conventional, new atypical or depot-neuroleptics were found. CONCLUSION: The application of neuroleptic medication in schizophrenia treatment generally reduces the incidence and the costs of inpatient treatment. An extension of the use of clozapine or new atypical neuroleptics to all patients with schizophrenia will not generally improve the treatment effectiveness regarding to the incidence and the costs of inpatient treatment.

Adult↗
PubMed2004

[Illness related costs for spouses of patients suffering from a mental illness: results of a study with repeated measurements].

OBJECTIVE: Aim of this study is the documentation of illness-associated costs for spouses, whose relative is suffering from a mental illness. METHOD: Over a period of 12 month, 117 spouses of patients who are suffering from schizophrenia, depression or anxiety disorders repeatedly filled in a standardized questionnaire about illness related expenses and financial losses. RESULTS: 90 % of the spouses reported direct cash expenditures on behalf of the patients' illness. On average, these costs amounted to yearly expenditures of euro 1146 (range: euro 0 - 11 910). Costs did not differ significantly across types of illness and income was not found to be a significant covariate. CONCLUSIONS: Spouses reported substantial direct cash expenditures on behalf of the patients' illness. Since these expenditures varied to a large extent over the three points of measurement, repeated measurement designs seem to be a prerequisite for a reliable assessment of illness-associated costs. Since living together with a mentally ill partner is associated with an increased risk of developing a burden-related psychiatric illness for spouses themselves which may lead to double costs and double decreases in income, these aspects should be taken into consideration when planning changes in health policy.

Adult↗
PubMed2004

[Opinions on psychiatric diseases of the citizens of Novosibirsk: results of a representative study].

BACKGROUND: Citizens of Novosibirsk were questioned regarding their ideas about schizophrenia and depressive disorders, with one of the main concerns being a comparison with the ideas and attitudes of the German population. METHOD: In 2002, a representative survey (N = 745) was conducted among the adult population of Novosibirsk, using a fully structured interview that has been used in previous surveys in Germany. RESULTS: Symptoms of schizophrenia were more frequently identified as an indication of mental disorder than were depressive symptoms. Psychosocial stress and biological influences were similarly frequently seen as the cause of schizophrenia, with the former prevailing among the respondents in the case of depressive symptoms. Psychotherapy was most frequently recommended as a treatment measure, also for schizophrenia. Supposing that no treatment measures will be taken, respondents assessed the prognosis for both mental disorders negatively. Conversely, interviewees gave a positive treatment prognosis. DISCUSSION: Respondents from Germany and Novosibirsk showed similar beliefs, especially as regards the importance of biological influences and psychosocial stress and the assessment of psychotherapy as compared to psychopharmacology. However, German and Russian respondents also held differing views: a comparatively strong tendency of the Russian population to consider mental disorders as self-inflicted - an important finding that could shape future anti-stigma programs.

Adult↗
PubMed2004

[Quality of life instruments and health state preferences to assess effects of medical interventions for mentally and medically ill patients].

AIM: The assessment of quality of life with a single index, which is necessary for cost-utility analyses, causes a loss of information. Therefore the suitability of such indices for mental health and non-mental health conditions was analysed and their ability to detect effects of medical interventions was examined. METHOD: Quality of life of 18 schizophrenic patients and 26 patients with diabetes mellitus was rated three times using disease specific instruments (BELP-KF, DMLQ), visual analog scale (VAS), EQ-5D and time trade-off (TTO). RESULTS: Effects of medical interventions were only detected with the disease specific instruments and EQ-5D. Using TTO and EQ-5D, there were significant, but reverse differences in the quality of life of patients with diabetes and patients with schizophrenia. EQ-5D correlated highly with DMLQ, but lowly with BELP-KF. CONCLUSIONS: TTO and VAS were insensitive to effects of medical interventions. EQ-5D detected treatment-induced changes, but was inappropriate as a measure of quality of life in schizophrenic patients.

Attitude to Health↗
PubMed2004

[Frequent use of psychiatric inpatient services analysed from three different perspectives].

OBJECTIVE: Frequent utilization of psychiatric inpatient care was mainly analysed by quantitative methods. The present study combines quantitative with qualitative methods and discusses the results obtained from these different perspectives. METHOD: The quantitative analysis is based on data from 184 schizophrenia patients, who were observed over a period of 2(1/2) years. Twenty of the identified frequent users and 6 employees of psychiatric facilities were interviewed by means of qualitative methods as to the causes of frequent use of inpatient care. RESULTS: Predictors of frequent use identified in the quantitative study were found again in the qualitative analysis. Opportunities for alternative care for frequent users suggested by the staff of psychiatric facilities include social treatment in the community, day structuring activities and sheltered work. Patients consider work, compliance securing and better contact with office based psychiatrists to be important factors. CONCLUSIONS: Patients and staff give different priorities to their suggestions for interventions, but are, in most cases, of the opinion, that part of hospital admissions of frequent users could be avoidable by means of alternative services.

Adolescent↗
PubMed2004

[Psychiatric epidemiology in Germany].

OBJECTIVE: The paper reviews psychiatric epidemiological research in Germany focusing on studies conducted over the last two decades. METHOD: Relevant studies were identified using Medline and Psyndex databanks. RESULTS: Inspired mainly by Anglo-American research, a substantial body of studies demonstrates the constitution of psychiatric epidemiology as a research field in Germany. The paper reviews field studies in children and adolescents, in adults and the elderly concerning scope, design and methods. Also those studies regarding special populations (i. e. homeless, persons living in nursing homes) usually not covered by field studies were included. Selected results of current surveys were reported to illustrate that mental disorders are common. CONCLUSIONS: Future challenges of psychiatric-epidemiological research include (1) the provision of internationally comparable data and (2) the description of individual and contextual risk- and protective factors of mental disorders. The latter can only be achieved by employing longitudinal designs where researcher should adopt a multi-level perspective in questioning and analysis.

Adolescent↗
PubMed2004

["Understanding the mass destruction of nerve cells"].

OBJECTIVE: One important step towards an early diagnosis and treatment of dementia is the recognition and understanding of disease by the public. METHOD: Since laymen's opinion is influenced by mass media, the portrayal of cognitive disorders was analysed using four volumes of a regional newspaper ("Leipziger Volkszeitung", LVZ). RESULTS: The predominant topics were related to cause and symptoms of dementia. Memory loss was depicted as the main symptom, non-cognitive symptoms were completely neglected. Therapy options and prevention were scantily touched; if at all, the tenor was one of futility. Unfortunately, dementia was often used as a devaluating metaphor. CONCLUSIONS: In the media, scientifically sound information on dementia is rare. Supporting journalists with expert knowledge may help dementia sufferers to profit from the new developments in the field.

Aged↗
PubMed2004

[Research on public mental health in the German-speaking area].

OBJECTIVE: From the point of view of public mental health, research on mental disorders still leads a shadowy existence in the German-speaking countries. The aim of this work is to determine the state of affairs of research in this field based on the publications in scientific journals. METHOD: Including the German and international journals listed in the Science Citation Index (SCI) and the Social Science Citation Index (SSCI) for the psychosocial field, a systematic search was done for the year 2003. RESULTS: The majority of public mental health research in the German-speaking countries is focused on a few institutions only. Particularly for Germany, clear-cut regional distinctions can be found. While there is a large amount of mental health care research and attitudinal research, only a small amount of the research is focused on prevention and health economics. CONCLUSION: Our analysis indicates future avenues of research. There is legitimate hope that existing gaps will be overcome in the future.

Academies and Institutes↗
PubMed2004

[Stigmatization of mentally ill patients by the society].

In our society, people with mental illness are exposed to various forms of discrimination. In principle, individual and structural discrimination plus discrimination due so self-stigmatisation can be distinguished. All three forms of discrimination will be illustrated based on results from our own studies. Next, negative consequences of discrimination for those afflicted will be described such as lack of self-confidence and reduced subjective well-being as well as social disadvantages and disadvantages with regard to treatment and rehabilitation. Finally, using the association "Irrsinnig menschlich" ("Madly human") in Leipzig as an example, approaches to reduce discrimination of mentally ill people will be presented.

Alcoholism↗
PubMed2004

[Social psychiatry without sociology. Analysis of a scientific journal].

AIM: Psychiatry and Sociology have followed separate avenues in Germany since the mid 1970 s. The aim of this work is to investigate their present relationship by means of an analysis of a scientific journal. METHOD: All original works dealing with social psychiatric subjects and appearing in Psychiatrische Praxis in the years 2002 and 2003 were analysed. RESULTS: Sociologists appear to be a minority among the authors. Questions that are explicitly related to sociological theories were an exception, and sociological authors have hardly been quoted. CONCLUSION: Social psychiatric research in Germany is still conducted without Sociology. If social psychiatry is to gain in importance as a scientific discipline, closer cooperation with its mother discipline is imperative. As an example, the application of the rational choice theory in psychiatric research is discussed.

Community Psychiatry↗
PubMed2004

The relationship between public causal beliefs and social distance toward mentally ill people.

OBJECTIVE: The aim of this study is to investigate the nature of the relationship between public causal beliefs and social distance toward people with mental disorders, particularly schizophrenia and depression. METHOD: In total, three representative surveys were carried out in Germany, Russia and Mongolia using personal, fully structured interviews. RESULTS: Despite the subjects' different cultural backgrounds, their responses show similar trends with regard to attributing depression and schizophrenia to psychosocial causes: 'acute stress' (life event) was most frequently endorsed as the cause for these two disorders. The biological causes ('brain disease' and 'heredity') were less frequently selected for depression than for schizophrenia. Irrespective of place and type of mental disorder, endorsing biological factors as the cause of schizophrenia was associated with a greater desire for social distance, the same relationship applies to depression in half the instances. CONCLUSIONS: It would be premature to draw conclusions with regard to interventions aimed at reducing discrimination based on stigma. However, our study provides stimulus for re-considering the assumptions underlying antistigma interventions: that promulgating biological concepts among the public might not contribute to a desired reduction in social distance toward people with mental disorders.

Adolescent↗
PubMed2004

The disregarded caregivers: subjective burden in spouses of schizophrenia patients.

Although the burdens of relatives of schizophrenia patients have been the subject of numerous studies, there are hardly any publications on the living situation of the patients' spouses. The findings of this qualitative interview study of 52 spouses of schizophrenia patients are, therefore, especially noteworthy. Spouses not only face illness-specific burdens but also burdens resulting from their partnership and family roles. From a biographical point of view, schizophrenia is often evaluated by the spouse as a decisive point in life that seriously affects the couple's relationship, the family, and the spouse's own life. The chronic burdens of everyday living can profoundly reduce the quality of life and the subject's satisfaction with the partnership. Though partnerships with schizophrenia patients are at risk of breakdown and separation in many respects, they are often maintained for years. Despite the illness-related burdens, many spouses take positive stock of living together. Stable partnerships seem to be achievable when the partner's impairment is perceived as moderate or moderately severe, and when the frequency at which psychotic episodes occur is assessed as still being tolerable. Spouses who suffer from mental illness or impairment themselves often experience the partnership as an appropriate and satisfactory way of life. In these cases, the mutual understanding rooted in the subject's own experiences with the illness is important.

Adult↗
PubMed2004

The stereotype of schizophrenia and its impact on discrimination against people with schizophrenia: results from a representative survey in Germany.

This study aims at assessing the prevalence of different components of the stereotype of schizophrenia among the general public and examining their impact on the preference for social distance and the acceptance of structural discrimination--that is, imbalances and injustices inherent in legal regulations and the provision of health care. In spring 2001, a representative survey was carried out in Germany involving individuals of German nationality aged 18 years and older and living in noninstitutional settings (n = 5,025). A personal, fully structured interview was conducted, including a list of items covering the various aspects of the stereotype, a social distance scale, and items assessing respondents' agreement with structural discrimination. Among the five stereotype components, the perception of people with schizophrenia as being unpredictable and incompetent was most frequently endorsed by the public, followed by perceived dangerousness. While the desire for social distance was best predicted by these two stereotype components, holding the individual responsible for the illness was the most powerful predictor of the acceptance of structural discrimination.

Adolescent↗