Biomedical subjects

Matthias C Angermeyer

Publications and source records attributed to Matthias C Angermeyer.

At least 91 records · Page 5Linked to original sources

PubMed2004

Schizophrenia: problems of separation in families.

BACKGROUND: In the past, family relationships of people with schizophrenia have mainly been investigated from a clinical viewpoint. The perspective of family development has generally been overlooked in this area of research. AIM: This paper reports a study exploring problems of development and detachment in families with an adult child with schizophrenia. METHOD: Using in-depth interviews, 51 parents of people with schizophrenia were questioned about their living situations and relationships with patients. FINDINGS: Spatial separation from the family home was often complicated or even prevented entirely, with patients permanently living in their parents' household or in the same neighbourhood. Many patients remained dependent on their parents' emotional, practical and financial support. Typically, the parent-child relationship was re-intensified, often with a concurrent loss of social contacts outside the family. From a biographical point of view, schizophrenia often caused problems for families by making parenthood permanent and lifelong parental support necessary. Many parents had to revise their expectations of both their ill child's development and their own personal plans. CONCLUSION: From the viewpoint of family psychology, schizophrenia is a serious obstacle to development that affects both patients and their parents. Family-related support should increasingly take into account the issue of the difficult detachment of patients from their parents.

Adaptation, Psychological↗

PubMed2004

Coping strategies used by the relatives of people with obsessive-compulsive disorder.

BACKGROUND: Obsessive-compulsive disorder (OCD) is a destructive mental illness that alters the lives of both patients and their relatives. Many investigations have described the coping strategies of relatives of patients with schizophrenia, depression and other psychiatric disorders, but there have been no studies reported about coping strategies and OCD. AIM: The aim of this paper is to report an investigation into experiences of burden in relatives of patients with OCD, and the coping strategies they had developed. METHOD: Narrative interviews with 22 family members of patients with OCD were analysed using a grounded theory approach. FINDINGS: Relatives described different burdens and developed different strategies to cope with these. While parents tried to educate their ill children, spouses focused on the patient's resources. The attempts of family members to cope with patients with OCD included assisting in rituals, opposing the symptoms and supporting patients in dealing with the illness. CONCLUSION: Implications for clinical practice to support these relatives are discussed.

Adaptation, Psychological↗

PubMed2004

The stigma of mental illness: patients' anticipations and experiences.

BACKGROUND: There are studies that either deal with the stigmatization patients anticipate or with patients' concrete stigmatization experiences. Up until now, however, research is short of studies that investigate both aspects of subjective stigmatization simultaneously. AIMS: This study aims at investigating to what extent patients with schizophrenia or depression anticipate and experience stigmatization and how this is influenced by the type of mental disorder and the social environment. METHOD: A total of 210 patients with schizophrenia or a depressive episode were interviewed, one half living in a city and the other in a small town. RESULTS: Most of the patients expect negative reactions from the environment, particularly as concerns the access to work. Concrete stigmatization experiences were most frequently reported in the domain of interpersonal interaction. Even though schizophrenia patients and patients with depression anticipated stigmatization similarly frequently, the former reported concrete stigmatization experiences more frequently than the latter. Conversely, patients living in a small town anticipated stigmatization more frequently than patients from the city, even though both had actually experienced stigmatization at a similar rate. CONCLUSION: The results underline the necessity to differentiate between anticipated and experienced stigmatization. This is highly relevant for planning interventions aimed at reducing the stigma of mental disorder.

Adult↗

PubMed2003

Patients' and their relatives' causal explanations of schizophrenia.

BACKGROUND: Previous studies with schizophrenia patients and their relatives which have been carried out in the western part of Germany and in Austria have demonstrated a strong tendency towards assuming psychosocial stress as a cause of schizophrenia. The question arises as to whether patients with schizophrenia and their relatives in the eastern part of Germany (former German Democratic Republic) share these beliefs. METHODS: Problem-centered interviews were conducted with 100 schizophrenia patients living in the catchment area of the university hospital who were in psychiatric outpatient treatment. Thirty-six relatives were also interviewed at the same time. RESULTS: Both patients and relatives most frequently reported psychosocial stress as a cause of the illness. Sixty-two per cent of the patients and 86 % of the relatives reported more than one cause. However, the majority of them did not explicitly link these causes to one another. DISCUSSION: Similarities between the results of this study and those of previous studies prevail. However, there are some differences with regard to the role attributed to socialisation and society. Whereas there is a stronger tendency to hold the family responsible for the illness in the West, in the East the social conditions are more frequently considered to be of etiological relevance. Inconsistencies between patients' and relatives' beliefs and the results of psychiatric research on the causes of schizophrenia suggest a need to provide specific psychoeducation for both.

Adolescent↗

PubMed2003

Social representations of major depression in West and East Germany--do differences still persist 11 years after reunification?

BACKGROUND: In a population survey that was carried out in 1990, differences between the former Federal Republic of Germany and the German Democratic Republic were observed with regard to the social representation of depression. Back then, we predicted that in a few years these differences would have reduced. To test this hypothesis, a second survey was conducted in 2001. METHOD: In 1990, a representative survey was carried out in both parts of Germany. A total of 3,098 personal, fully structured interviews were completed, 2,118 in West Germany and 980 in East Germany. The survey was repeated in 2001 using the same measures. This time, 5,025 interviews were conducted, 4,005 in West Germany and 1,020 in East Germany. RESULTS: While in 1990 there had been numerous differences between the two parts of Germany with regard to the social representation of depression, in 2001 most of these differences had disappeared. Lay concepts of depression held by interviewees from East Germany have assimilated to those held by interviewees from West Germany. In both parts of Germany, a marked change in favor of biological conceptualizations of depression was observable, with heredity and brain disease more frequently being seen as a cause in 2001. CONCLUSION: The hypothesis that the differences between lay concepts of depression that were prevalent in West and East Germany in 1990 would have reduced by 2001 was supported by our results. Our study shows that cultural processes, such as the process of acculturation that took place in Germany between 1990 and 2001, have an effect on the social representation of mental disorders.

Acculturation↗

PubMed2003

Public beliefs about schizophrenia and depression: similarities and differences.

OBJECTIVE: Stigma research in psychiatry has mainly focused on mental illness per se. However, recent studies suggest that considerable differences exist between the various disorders. Therefore, we set out to examine similarities and differences of the public's conceptions of schizophrenia and major depression. METHODS: In the spring of 2001, a representative survey was carried out in Germany involving individuals of German nationality who were at least 18 years old and who were living in private households (n = 5,025). RESULTS: Both disorders have in common that they are identified by the majority of the public as an indication of mental illness, that acute stress is most frequently endorsed as cause, that from most respondents a poor natural course is expected which contrasts with a remarkably favorable treatment prognosis, and that people suffering from the two disorders most frequently evoke pity and a desire to help. The perception of dangerousness is closely associated with increased fear and anger, and decreased pity. One of the most notable differences between the two disorders is that while in the case of schizophrenia, labeling as mental illness primarily affects respondents' emotional reactions negatively, in the case of major depression a positive effect prevails. People with schizophrenia are, by far, more frequently considered as dangerous and unpredictable. They evoke more fear while people with major depression evoke more pro-social reactions. CONCLUSION: The described similarities and differences of public beliefs and attitudes with regard to schizophrenia and major depression have important implications for the planning of anti-stigma programs and may help to develop more tailor-made interventions.

Adult↗

PubMed2003

Courtesy stigma--a focus group study of relatives of schizophrenia patients.

BACKGROUND: Stigmatization of people with mental illness has been investigated in numerous studies. Little research, however, has been done to explore how relatives of people with schizophrenia perceive and experience stigmatization and how they can fight such stigmatization. METHOD: Aiming to explore stigma from the perspective of relatives of people with schizophrenia, focus group interviews were conducted with 122 members of advocacy groups from different parts of Germany. Focus group sessions were tape- and video-recorded and transcribed. Transcripts were coded using an inductive method, generating categories (domains) from the material. RESULTS: The analysis of focus group data shows that, contrary to previous research findings, discrimination and disadvantages encountered by relatives of schizophrenia patients reach far beyond the spheres of direct social interaction and access to social roles. Our study revealed two additional domains in which relatives encounter stigmatization: structural discrimination and public images of mental illness. Furthermore, psychiatry has been identified as one important source of stigma. Relatives also suggested numerous anti-stigma interventions. These can be grouped into five main categories: communication measures, support for the ill and their relatives, changes in mental health care, education and training, and control and supervision. DISCUSSION: Based on our findings,ways of how relatives of schizophrenia patients and mental health professionals can fight against stigma are discussed.

Adult↗

PubMed2003

Subjective experiences of stigma. A focus group study of schizophrenic patients, their relatives and mental health professionals.

Schizophrenia has been found to be one of the most stigmatising conditions. To the present, most research on stigma related to mental illness has drawn conclusions on the adverse reactions faced by people with schizophrenia from studies on public attitudes or analogue behavioural studies. The views of those exposed to the stigmatising reactions, however, has largely been absent. Aiming to explore stigma from the subjective perspective of people with schizophrenia, a focus group study was carried out at the four centres involved in the WPA Global Programme against Stigma and Discrimination because of Schizophrenia in Germany. In order to get a comprehensive picture of how stigma affects the lives of schizophrenic patients, collateral information was sought from relatives and mental health professionals. The focus groups enquired about concrete stigmatisation experiences of the patients and incidences of stigma witnessed by the other two groups. Focus group sessions were tape-recorded and transcripts were coded using an inductive method. Results reveal four dimensions of stigma: interpersonal interaction, structural discrimination, public images of mental illness and access to social roles. Examples are given for the views of patients, relatives and mental health professionals on each of the four stigma types. The consequences for conceptualisations of stigma and the development of effective strategies to reduce stigma and discrimination because of schizophrenia are discussed.

Attitude to Health↗

PubMed2003

Indicators of empowerment and disempowerment in the subjective evaluation of the psychiatric treatment process by persons with severe and persistent mental illness: a qualitative and quantitative analysis.

Empowerment and disempowerment is studied in terms of the way persons with long and persistent schizophrenia evaluate their psychiatric outpatient treatment. One hundred persons with the diagnosis of schizophrenia (ICD-10 F 20.0) were interviewed about their perceptions and evaluation of the treatment process by means of problem-focused interviews. Transcribed interviews were subjected to qualitative content analysis. Relationships among the categories of the qualitative content analysis were analyzed by means of a homogeneity analysis. The latent dimension extracted by the homogeneity analysis could be interpreted as a quantitative measure of an empowered or a disempowered perception of the treatment process. As a result of the qualitative content analysis it was found that a majority of participants tend to describe their treatment as reduced to drug treatment and that they tend to notice only positive medication effects rather than mixed medication effects or positive effects of conversation and that they feel helpless or indifferent rather than actively involved in the treatment process. The impact of socio-demographic, clinical, and treatment characteristics on the participants' location on a latent dimension called "empowerment" was examined by means of multiple regression analysis. General life satisfaction, negative symptoms and getting depot medication were positively associated with a more disempowered perception of the treatment process whereas positive symptoms, getting antidepressant medication and being treated in an outpatient clinic instead of a private practice were associated with a more empowered perception.

Adult↗

PubMed2003

Subjective burden over 12 months in parents of patients with schizophrenia.

This is a follow-up study aimed at investigating subjective burden in parents of patients with schizophrenia during a 12-month period. Using a narrative interview technique, parents were questioned regarding the subject of illness-related burden; follow-up interviews were conducted after 6 and 12 months, respectively. Forty-seven interview sets were examined with the aim of determining different types of burden development. The analysis yielded the following six developmental types: (1). constantly high level of burden; (2). increased burden; (3). reduced burden; (4). shifting burden; (5). preeminence of other burdens; and (6). constantly low level of burden. In general, changes in the parents' burden level are closely interconnected with the illness curve of the patients, with 40% of the study participants experiencing a constantly high level of burden during the course of the study. The results suggest that parents of continuously and severely affected patients are overloaded with their long-term caring tasks. Particularly for these extremely strained parents, practical and psychologic assistance should be provided.

Adaptation, Psychological↗

PubMed2003

[Between assistance and opposition: relatives' coping strategies with obsessive-compulsive patients].

OBJECTIVE AND METHOD: The aim of this study was to investigate the coping strategies of relatives of patients with obsessive-compulsive disorder. 22 narrative interviews were analysed by a Grounded Theory approach. RESULTS: While parents in our investigation often try to educate their ill children, spouses focus on resources of the patient. Children seem to take a parent-role in interaction with the ill father or mother. DISCUSSION: Family members try to support patients in dealing with the illness. Therefore, different strategies to cope with OCD are developed, ranging between assisting in rituals and opposition to the symptoms.

Adaptation, Psychological↗

PubMed2003

[Shame, embarrassment and trouble...relatives of patients with OCD describe stigma experiences in every-day life].

BACKGROUND: There are numerous studies on the stigma of mental illness. However, the subjective stigma experiences of patients with obsessive-compulsive disorder and their relatives have, so far not been investigated. METHOD: Narrative interviews with 22 family members of patients with OCD were carried out as part of a study on the burden of mental illness on the family. Experience of stigma was analysed as an aspect of subjective burden using a grounded theory approach. RESULTS: Different areas of life could be described, in which stigmatization is anticipated or experienced by family members of patients with OCD. Concealing is a relevant strategy for the members in dealing with the illness. DISCUSSION: Stigmatization can be minimized by impartially handling the illness and cooperation of patients, their relevant others and professionals.

Adaptation, Psychological↗

PubMed2003

[Organic depressive disorder caused by Cushing's syndrome--case report].

We report a case of 35-year old female patient with recurrent depressive disorder and Cushing's syndrome. MRI of the brain revealed a microadenoma of the pituitary gland. After neurosurgery the serum levels of cortisol went back to normal and the clinical and mental state of the patient improved rapidly. Depressive episodes require additional diagnostics to exclude somatic etiology.

Adenoma↗

PubMed2003

[The German version of the Community-Attitudes-Toward-the-Mentally-Ill (CAMI) inventory].

OBJECTIVE: The German version of the Community Attitudes toward the Mentally Ill (CAMI) inventory developed by Taylor and Dear (1981) is presented. METHOD: The questionnaire was applied in a mail survey which was conducted in 3 small towns in Germany. RESULTS: At the item level surprisingly positive attitudes toward people with mental illness were found. The factor analysis with the 40 Likert-scaled items yielded 4 dimensions (exclusion, integration, benevolence, social control) which account for 46 % of the total variance. As in previous studies, age had a negative effect and the level of education a positive effect on public attitudes, while the gender of the respondents had only a small effect. Familiarity with mental illness did not have an effect as important as in previous studies. CONCLUSION: There is a close correspondence between the German version and the original version of the CAMI-inventory.

Adolescent↗

PubMed2003

[Coping strategies in spouses of schizophrenic patients].

OBJECTIVE: The study was carried out to explore the coping behaviour of spouses of schizophrenic patients. METHODS: 28 in-depth interviews were analysed with a view to discover the spouses' ways of dealing with illness-related burden. RESULTS: Most spouses reported problem-focussed coping strategies, such as information seeking and crisis planning. Release-focussed coping strategies, such as relaxation activities, time-out and temporal disengagement, are likely to be used when the situation is perceived as unchangeable and spouses feel that they have to look after themselves as well. In the long-term, cognitive-emotional strategies are of great importance, aimed at the re-appraisal of the spouses' mental illness and a greater sense of self-efficacy in dealing with acute and everyday burden. CONCLUSION: Spouses' coping strategies not only have a strong influence on their perception of burden, but also on marital satisfaction and on their commitment to the affected spouse.

Adaptation, Psychological↗

PubMed2003

[The stigma of mental illness from the patient's view--an overview].

QUESTION: This study provides an overview of the research on subjective stigmatization of mentally ill people. METHOD: All articles on this topic that have been published since the mid 1980 were analyzed. RESULTS: Mentally ill people are exposed to stigmatization in many ways. The anticipated and experienced stigmatizations as well as their attempts chosen for coping have fatal effects on their social relationships, their working situation, and their quality of life. The same is true for the emotional well-being and the self-esteem of the ill. In addition, the fear of stigmatization has a negative effect on the help seeking behavior and the compliance of the ill with the psychiatric treatment. CONCLUSION: Efforts aimed at reducing stigmatization of mentally ill people should not be confined to fighting the discrimination objectively existing, but should also take into consideration the subjective stigma experiences of the persons affected.

Adaptation, Psychological↗

PubMed2003

[The presentation of depression in German daily newspapers].

OBJECTIVE: According to results of the latest research, the state of knowledge of the German population regarding depressive disorders has improved during the last years. The question arises to what extent the print media have contributed to this development. METHOD: All editions of three German dailies--Sueddeutsche Zeitung (SZ), Frankfurter Allgemeine Zeitung (FAZ) and Bild Zeitung (BZ)--published in the first months of each quarter in 1990 and 2000 were analysed. All articles that were identified using the search key *depress* were included. A full text search was carried out, except for the editions of SZ and FAZ from the year 2000 which are available on CD-ROM. Using a coding system specifically designed for this study, a quantitative content analysis was carried out taking into consideration both formal and contents-related aspects. RESULTS: None of the three newspapers investigated helps to promote better understanding of depressive disorders. A comparison between 1990 and 2000 shows that there has been no development towards a more adequate representation of depression in any of the dailies examined. When aspects of the illness are mentioned it is mostly in the form of speculations over etiological factors. Rarely published articles that are rather confusing for lay people mostly report details taken out of their context. The term "depression" is often used metaphorically. Among the few descriptions of people with depression, negative aspects prevail. CONCLUSION: The image of depression as a serious mental illness can hardly be developed by reading the newspapers investigated. The improvement in lay people's state of knowledge cannot be attributed to a more adequate representation of depression in the daily newspapers examined.

Depressive Disorder↗

PubMed2003

[Stigma as perceived by schizophrenics and depressives].

QUESTION: The goal of this study is to investigate the stigma of mental illness from the perspective of the persons directly affected by it. METHOD: 210 patients with schizophrenia or major depression were questioned about anticipated and concrete stigmatization experiences, using a questionnaire especially developed for this study. RESULTS: Most of the patients expected negative reactions from the environment. Three quarters were convinced that their job application would be rejected when it became known that they are mentally ill. Almost two thirds felt apprehensive that others would avoid them due to their illness. There is hardly any difference between schizophrenia and depressive patients' assessment of stigmatization of mentally ill people. Concrete stigmatization experiences were most frequently reported in the domain of interpersonal interaction. Second comes the distorted picture of mentally ill people that is depicted in the media and experienced as hurtful by the patients. The obstacles to access social roles (partnership, work, etc.) perceived by the patients come third. Participants least frequently mentioned structural discrimination, i. e. disadvantages regarding psychiatric treatment or rehabilitation measures. Contrary to anticipated stigmatization, there are differences between the two diagnostic groups when it comes to concrete stigmatization experiences. Schizophrenia patients more frequently report that others would avoid contact with them and that the access to social roles was especially complicated for them. They also seemed to be more exposed to structural discrimination than depressive patients. CONCLUSION: Based on the results of this study, ways are discussed of how stigmatization and discrimination of mentally ill people can be reduced.

Adaptation, Psychological↗