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Matthias C Angermeyer

Publications and source records attributed to Matthias C Angermeyer.

At least 109 records · Page 6Linked to original sources
PubMed2003

[Madhouse, asylum, retreat, specialist hospital - on the genesis and history of names for psychiatric institutions in Germany until the beginning of the 20th century].

This paper analyses the history of names for psychiatric institutions in the German language. When scientific, medical psychiatry came into being in the late 18 (th) century, names with negative connotations such as "Narrenhaus" or "Tollhaus" (approximating to the English word "madhouse") were substituted by the then neutral "Irrenhaus" and later in the 19 (th) century by "Irrenanstalt". Soon, however, this new term became associated with negative connotations, making it unsuitable as a reflection of the many improvements made both in the treatment and the public image of psychiatric service users. Changes in word form such as "Heilanstalt", "Pflegeanstalt" and "Heil- und Pflegeanstalt" better reflect the character of the institutions. Objections to the word "Anstalt" (institution) were not acknowledged until the 20 (th) century when the term "Fachkrankenhaus" ("specialist hospital") was introduced. Before then the German word "Klinik" was reserved for university hospitals, the first of which was founded in 1878. The history of names for psychiatric institutions reflects both changes in the treatment of the mentally ill and the attempts made above all by psychiatrists to face and overcome stigmatisation of their clients.

Germany↗
PubMed2003

[Current topics of social-psychiatric research in German speaking countries: a content analysis of scientific journals].

AIM: The paper is aimed at investigating what the actual topics of social-psychiatric research in German speaking countries are. METHOD: German and international journals covering psychiatry and adjacent disciplines were screened for articles dealing with social-psychiatric topics. All in all, 426 relevant articles were identified and subjected to a content analysis. RESULT: Almost one third of all articles was dealing with research on mental health services. Another research area that was strongly represented was epidemiology. By contrast, articles devoted to the study of psycho-social causes of mental disorders and psycho-social determinants of its course were rather rare. DISCUSSION: Possible reasons for the observed trends in social-psychiatric research are discussed. Potential risks for social psychiatry resulting from a too one-sided emphasis on health service research are pointed out.

Austria↗
PubMed2003

Determinants of the public's preference for social distance from people with schizophrenia.

OBJECTIVE: To examine the extent to which the public's desire for social distance from people with schizophrenia is influenced by beliefs about the disorder and stereotypes about those suffering from it. METHODS: In spring 2001, we carried out a representative survey of individuals of German nationality aged 18 years and over (n = 5025). Each subject was given a fully structured interview that began with the presentation of a vignette. RESULTS: Both labelling and beliefs about the disorder's causes and prognosis, as well as the perception that those suffering from it are unpredictable and dangerous, had an impact on the public's desire for social distance. However, the latter proved to be more important. As expected, respondents who identified the disorder depicted in the vignette as mental illness, those who blamed the individual for its development, and those who anticipated a poor prognosis expressed a stronger desire for social distance. Endorsing biological factors as a cause was also associated with increased social distance. CONCLUSIONS: Our findings have important implications for interventions aimed at reducing stigma and discrimination related to schizophrenia. Targeting the stereotype of unpredictability and dangerousness appears to be particularly important.

Adolescent↗
PubMed2003

Mild cognitive impairment: prevalence and incidence according to different diagnostic criteria. Results of the Leipzig Longitudinal Study of the Aged (LEILA75+).

BACKGROUND: Although mild cognitive impairment is associated with an increased risk of developing dementia, there has been little work on its incidence and prevalence. AIMS: To report age-specific prevalence, incidence and predictive validities for four diagnostic concepts of mild cognitive impairment. METHOD: A community sample of 1045 dementia-free individuals aged 75 years and over was examined by neuropsychological testing in a three-wave longitudinal study. RESULTS: Prevalence rates ranged from 3% to 20%, depending on the concept applied. The annual incidence rates applying different case definitions varied from 8 to 77 per 1000 person-years. Rates of conversion to dementia over 2.6 years ranged from 23% to 47%. CONCLUSIONS: Mild cognitive impairment is frequent in older people. Prevalence, incidence and predictive validities are highly dependent on the diagnostic criteria applied.

Aged↗
PubMed2002

Depressive disorders in spouses of mentally ill patients.

BACKGROUND: According to the literature on stress and coping, the burden of caregiving to a mentally ill partner might have an impact on the mental health of the spouse. METHOD: As part of a study on the burden of caregiving to mentally ill family members, a structured psychiatric interview (DIA-X-M-CIDI) was conducted with spouses of patients suffering from depression, anxiety disorders, or schizophrenia (n = 151). RESULTS: Covarying with the partner's gender and the severity of the patient's illness a significantly increased prevalence of depressive disorders could be found. CONCLUSION: Psychiatric patients' partners are at a high risk of developing a depressive disorder. It appears necessary to develop special interventions for spouses reducing stress and the risk of getting depressed.

Adult↗
PubMed2002

Adaptation of dementia screening for vision-impaired older persons: administration of the Mini-Mental State Examination (MMSE).

In epidemiologic field studies on the prevalence and incidence of dementia the problems associated with the cognitive testing of visually impaired individuals are rarely discussed. In the Leipzig Longitudinal Study of the Aged (LEILA 75+) a version of the Mini-Mental State Examination for the visually impaired (MMSE-blind) was employed from which all items requiring image processing had been omitted. To be able to interpret the test results and include vision-impaired individuals in the field study, the scores for the full MMSE were estimated by conducting linear transformation of the scores obtained on the MMSE-blind. The method of linear transformation is based on certain theoretical assumptions that are examined in this article. Linear transformation of scores has proved to be a valid procedure only for individuals with very high or very low cognitive performance. Thus, evaluation of the estimated full MMSE scores based on the norms for the original MMSE is not recommended. A blind version of the MMSE with age- and education-specific norms that has been validated as a screening tool for dementia is therefore presented.

Aged↗
PubMed2002

[Behavioral Group Therapy for Patients with OCD and Family Members].

PROBLEM: Behavioral group therapy program is presented of patients with OCD and the involvement of their significant others. First experiences of evaluation are reported. METHOD: 20 patients (10 women, 10 men) diagnosed with OCD were treated in a 16-session behavioral group therapy which included the involvement of 17 family members in selected sessions. The behavioral group therapy program involved cognitive restructuring, behavior exposure to anxiety-evoking stimuli and the discussion about the family system. Y-BOCS and a self-rating scale for the assessment of treatment benefit were used as outcome measures. RESULTS: In this study, Y-BOCS scores reduced from a mean of 24 before therapy to 19,8 after therapy. Patients and their significant others agreed on the general benefit from the group therapy and the level of understanding of individual problems. Family members in particular appreciated that they had learned more about coping strategies regarding OCD-symptoms.The majority of patients and their significant others would recommend behavioral group therapy to other affected people. CONCLUSIONS: Behavioral group therapy can be effective in reducing OCD-symptoms. Inclusion of family members in behavioral group therapy may be advantageous, because they can assist the patients during their treatment. This form of treatment may become an attractive and cost-effective alternative to conventional group settings.

Adolescent↗
PubMed2002

[Prognosis of schizophrenia from the viewpoint of patients and relatives. An explorative study].

OBJECTIVE: This study is aimed at exploring what schizophrenic patients and their closest relatives expect the further course of the illness will be like and how it can be influenced. METHOD: Problem-centered interviews were conducted with 31 schizophrenic patients and their closest relatives at discharge from hospital treatment. The verbatim transcripts of the interviews were analyzed by means of structuring qualitative content analysis. RESULTS: Most frequently, the respondents expected an improvement of the illness or they were unsure whether the actual recovery from psychosis will persist or whether a further relapse will occur. Less frequently, the respondents were sure that this will be the case or that the illness will take a chronic, eventually deteriorating course. The majority was convinced that the course of the illness can be influenced, by psychiatric treatment as well as by the patients themselves. As concerns the social situation in the near future, particularly changes of the occupational status were hoped for. CONCLUSION: The assessment of the prognosis of the schizophrenic illness by most patients and relatives appears quite realistic. Rather than considering themselves as helpless victims they see opportunities for influencing the further course of the illness. This should have a positive influence on the readiness to use mental health service and to comply with treatment recommendations.

Adult↗
PubMed2002

[Financial burden on caregivers of schizophrenic patients: a comparison between parents and spouses].

OBJECTIVE: The aim of this study was to compare financial burden of parents and spouses, whose relative is suffering from schizophrenia. The first article (part I) draws attention to quantitative analysis. METHOD: 51 parents and 52 spouses filled in the questionnaire about illness related expenses and financial loss; additionally they were asked to estimate the experienced burden on a subjective dimension. RESULTS: Direct cash expenditures on behalf of the patients' illness were reported by 63 % spouses and 69 % parents. Above all, the patient's reduced ability to work was seen as main cause for long-term loss of family income. In general economic disadvantages were not considered as burdensome. DISCUSSION: Although most parents and spouses of schizophrenic patients experience illness related financial disadvantages, it seems that these costs were usually not defined as serious problem. For a better understanding of this finding further analysis of the subjective perspective on perceived financial burden is needed (see part II).

Adult↗
PubMed2002

[Financial burden on caregivers of schizophrenic patients: a comparison between parents and spouses].

OBJECTIVE: Part II of this study will explore more accurately, how caregivers of schizophrenic patients perceive the financial burdens of the disease. METHOD: 42 In-depth-interviews with parents and spouses of schizophrenic patients were analysed using a qualitative-interpretative technique. RESULTS: When talking about their living situation, caregivers tended to keep away from the topic of financial charges; often they played down objective financial disadvantages or didn't assess them as burdensome. Considerable financial burdens were reported by parents of young patients still living in the parents' household and by spouses in families with very low income. DISCUSSION: Financial burdens are usually superimposed by other problems of the caregivers, such as dealing with acute episodes and sorrow about the future. Thus, not only the material, but also the immaterial costs of caregivers should be taken into consideration when taking health policy decisions.

Adaptation, Psychological↗
PubMed2002

[Caregivers' views of the treating psychiatrists: coping resource or additional burden?].

OBJECTIVE: This study aimed at investigating how caregivers of schizophrenic patients perceive the contact with mental health professionals and which are the key factors for their satisfaction or dissatisfaction. METHOD: 42 in-depth interviews were analysed with a view to discover the caregivers' experiences with psychiatric treatment. RESULTS: The analysis of the interview data showed three fundamental areas in which caregivers perceive the contact with psychiatrists as supportive or troublesome: 1. the information about the disease and the treatment, 2. the long-term cooperation with the caregivers, and 3. the general way of behaving towards the caregivers and the patients. Caregivers' attitudes towards psychiatry are strongly influenced by positive and negative experiences they have had in these three fields. DISCUSSION: The widespread criticism of caregivers is caused by dissatisfaction with central areas of psychiatric practice. Optimal treatment and consulting conditions, from the caregivers' perspective, can only be approximately achieved. However, psychiatrists, patients, and caregivers should stay in close contact in order to meet the needs of the caregivers, such as being informed, being taken seriously and being involved in the treatment.

Adaptation, Psychological↗
PubMed2002

[Heavy users of inpatient psychiatric services].

OBJECTIVE: This paper describes the extent of heavy use of inpatient psychiatric services. It reveals predictors of heavy use. METHODS: 969 users of inpatient psychiatric services in the city of Leipzig were identified based on health insurance data. RESULTS: 16,7 % of the patients had at least 3 admissions and were classified as heavy users. They accounted for 36,4 % of the total inpatient cost. Patients suffering from schizophrenia or a comorbidity with personality disorders had a higher risk to be a heavy user. The kind of facility and the way of discharge were also predictors for heavy use. CONCLUSIONS: Further qualitative analyses should identify reasons for heavy users to utilize inpatient services and find out other opportunities of care for these patients.

Adolescent↗
PubMed2002

[Heavy users of psychiatric care].

OBJECTIVE: This paper reviews findings and problems of heavy users research. METHODS: The German- and English language literature about "heavy users" and relevant border areas was analyzed. RESULTS: Heavy users are patients who consume a disproportionate share of medical services. The characteristics of heavy users are inhomogeneous. Social problems, denial of illness, non-compliance, comorbid personality disorders and substance misuse contribute significantly to heavy use. Future studies should define heavy use illness-related. More research is needed to clarify whether heavy use of special services is adequate to the patients situation. CONCLUSIONS: Heavy users should be identified early, in order to offer them alternative services, which better fulfil the patients specific conditions and prevent an inadequate heavy use of expensive services.

Case Management↗
PubMed2002

[Social-psychiatric research in german-speaking countries].

OBJECTIVE: This study aims at outlining the development of social-psychiatric research in German-speaking countries between 1975 and 2001. METHOD: All original articles dealing with social-psychiatric issues, with appeared in Psychiatrische Praxis in the years 1975 - 1977, 1981 - 1983, 1987 - 1989, 1993 - 1995 and 1999 - 2001 were analysed. RESULTS: Mental health care research clearly dominated social-psychiatric research in the period investigated. While in the beginning, most papers were devoted to the conceptualisation and description of psychiatric services, in recent years more studies on outcome evaluation and quality assurance were published. The number of articles on the subjective perspective of patients and relatives has increased constantly. Topics such as treatment satisfaction, subjective illness theory, and subjective quality of life enjoy growing interest. The same holds for stigmatisation of mentally ill people. By contrast, studies investigating psycho-social influences on the development and the course of mental disorders are still very rare. DISCUSSION: The results are discussed against the backdrop of the development of psychiatry in the period investigated.

Community Psychiatry↗
PubMed2002

Subjective illness theory and antipsychotic medication compliance by patients with schizophrenia.

This study investigates subjective illness theories of patients with schizophrenia, how they define their health problem, what they assume causes their illness and which course of illness they expect. The predictive value of those theories for patients' compliance with antipsychotic medication is tested. A problem-centered interview was conducted with 77 schizophrenic patients at discharge from inpatient or day hospital treatment. All patients were on clozapine treatment. Interviews were analyzed by means of computer-assisted content analysis. In addition, potential determinants of compliance were assessed using the 9th version of the Present State Examination, the UKU side effect rating scale, a checklist for patients' evaluations of the effect of psychotropic drugs, and a helping alliance scale. Compliance with medication was assessed by interviewing patients at discharge and three months later. Only slightly more than one half of the patients considered themselves mentally ill. They tended to endorse psychosocial causes more frequently as compared with biological causes. Slightly more than 25% of the patients each expected an improvement of the illness, a reoccurrence of the acute psychosis, or a chronic course. Whereas the quality of the helping alliance, delusion of grandiosity, and attitude toward psychotropic drugs proved to have an influence on patients' compliance with antipsychotic treatment, the three components of subjective illness theory (definition as mental illness, assumed etiology, and prognosis) did not have a statistically significant influence. Subjective illness theories vary in patients with schizophrenia. Although they might reflect different styles of coping with the illness, there is no evidence that they directly determine compliance with medication. Patients' views of the helping alliance and attitudes toward drugs should be considered in predicting compliance with antipsychotic medication.

Adolescent↗
PubMed2002

Living with a schizophrenic patient: a comparative study of burden as it affects parents and spouses.

Based on the analysis of 42 in-depth interviews, this article highlights different aspects of the subjective burden experienced by parents and spouses of patients suffering from schizophrenia. The onset of a schizophrenic disorder and acute episodes during the later course of the disease lead to considerable emotional distress for the patients' caregivers. In everyday life with the patient, parents and spouses experience a comparatively less dramatic chronic burden, which nevertheless can severely affect their living situation and well-being. Caregivers often feel disappointed and dissatisfied with the information and cooperation offered by psychiatric institutions. Parents and spouses perceive the caregiver burden differently, although there are some apparent similarities. The study reveals that the symptoms of a schizophrenic disorder as well as different family roles contribute to the subjective burden of parents and spouses. Supportive assistance for schizophrenic patients' caregivers should address their particular needs more adequately.

Adaptation, Psychological↗
PubMed2002

A comparison of methods to handle skew distributed cost variables in the analysis of the resource consumption in schizophrenia treatment.

BACKGROUND: Transformation of the dependent cost variable is often used to solve the problems of heteroscedasticity and skewness in linear ordinary least square regression of health service cost data. However, transformation may cause difficulties in the interpretation of regression coefficients and the retransformation of predicted values. AIMS OF THE STUDY: The study compares the advantages and disadvantages of different methods to estimate regression based cost functions using data on the annual costs of schizophrenia treatment. METHODS: Annual costs of psychiatric service use and clinical and socio-demographic characteristics of the patients were assessed for a sample of 254 patients with a diagnosis of schizophrenia (ICD-10 F 20.0) living in Leipzig. The clinical characteristics of the participants were assessed by means of the BPRS 4.0, the GAF, and the CAN for service needs. Quality of life was measured by WHOQOL-BREF. A linear OLS regression model with non-parametric standard errors, a log-transformed OLS model and a generalized linear model with a log-link and a gamma distribution were used to estimate service costs. For the estimation of robust non-parametric standard errors, the variance estimator by White and a bootstrap estimator based on 2000 replications were employed. Models were evaluated by the comparison of the R2 and the root mean squared error (RMSE). RMSE of the log-transformed OLS model was computed with three different methods of bias-correction. The 95% confidence intervals for the differences between the RMSE were computed by means of bootstrapping. A split-sample-cross-validation procedure was used to forecast the costs for the one half of the sample on the basis of a regression equation computed for the other half of the sample. RESULTS: All three methods showed significant positive influences of psychiatric symptoms and met psychiatric service needs on service costs. Only the log- transformed OLS model showed a significant negative impact of age, and only the GLM shows a significant negative influences of employment status and partnership on costs. All three models provided a R2 of about.31. The Residuals of the linear OLS model revealed significant deviances from normality and homoscedasticity. The residuals of the log-transformed model are normally distributed but still heteroscedastic. The linear OLS model provided the lowest prediction error and the best forecast of the dependent cost variable. The log-transformed model provided the lowest RMSE if the heteroscedastic bias correction was used. The RMSE of the GLM with a log link and a gamma distribution was higher than those of the linear OLS model and the log-transformed OLS model. The difference between the RMSE of the linear OLS model and that of the log-transformed OLS model without bias correction was significant at the 95% level. As result of the cross-validation procedure, the linear OLS model provided the lowest RMSE followed by the log-transformed OLS model with a heteroscedastic bias correction. The GLM showed the weakest model fit again. None of the differences between the RMSE resulting form the cross- validation procedure were found to be significant. DISCUSSION: The comparison of the fit indices of the different regression models revealed that the linear OLS model provided a better fit than the log-transformed model and the GLM, but the differences between the models RMSE were not significant. Due to the small number of cases in the study the lack of significance does not sufficiently proof that the differences between the RSME for the different models are zero and the superiority of the linear OLS model can not be generalized. The lack of significant differences among the alternative estimators may reflect a lack of sample size adequate to detect important differences among the estimators employed. Further studies with larger case number are necessary to confirm the results. IMPLICATIONS: Specification of an adequate regression models requires a careful examination of the characteristics of the data. Estimation of standard errors and confidence intervals by nonparametric methods which are robust against deviations from the normal distribution and the homoscedasticity of residuals are suitable alternatives to the transformation of the skew distributed dependent variable. Further studies with more adequate case numbers are needed to confirm the results.

Adolescent↗