Biomedical subjects

Rüya-Daniela Kocalevent

Publications and source records attributed to Rüya-Daniela Kocalevent.

3 recordsLinked to original sources

PubMed2006

[Standardized diagnosing: computer-assisted (CIDI) diagnoses compared to clinically-judged diagnoses in a psychosomatic setting].

BACKGROUND: Within the past two decades, there has been an increasing trend towards the use of empirically-based, standardized instruments to diagnose mental disorders. The purpose of this study was to investigate the congruence between clinically-derived and standardized computerized diagnoses using the Composite International Diagnostic Interview (CIDI) in a psychosomatic setting. PATIENTS AND METHODS: N = 230 inpatients treated at the Department of Psychosomatic Medicine, Charité Berlin, were diagnosed for mental disorders by experienced clinicians and by the CIDI according to the diagnostic criteria of ICD-10 and DSM-IV. RESULTS: Congruence between computerized and clinically-derived diagnoses for all mental disorders was fair to poor (kappa = 0.0 - 0.33). The diagnostic congruence of somatoform (F45), anxiety (F40 - 41), depressive (F32 - 34), eating (F50) and dissociative disorders (F44) and disorders due to psychoactive substance use (F10 - 19) was fairly low (kappa = 0.19 - 0.33). Diagnostic congruence of diagnoses of reactions to severe stress (F43) and obsessive compulsive disorders (F42) was particularly poor (kappa = 0.0 - 0.01). CONCLUSION: Overall diagnostic congruence between computerized and clinical diagnostics was unsatisfactory. Thus, the validity of computer-assisted standardized interviews - like the CIDI - is questionable in a psychosomatic setting.

Adult↗

PubMed2006

[Evaluation of the effectiveness of psychosomatic in-patient treatment on the basis of subjective and objective criteria].

OBJECTIVES: The effectiveness of psychosomatic in-patient treatment was evaluated using patients' subjective health ratings and objective data provided by health insurance companies. Associations between subjective and objective criteria were investigated. METHODS: 318 patients participated in the study. They completed questionnaires on physical complaints, moods and everyday functioning upon hospital admission, at discharge and at one-year follow-up. Insurance companies provided data for 140 of these patients (44 %). Sick leave and the utilization of in-patient treatment were assessed for a period of two years before and two years after psychosomatic treatment. RESULTS: As expected, subjective health status improved. The utilization of in-patient treatment decreased in both years after treatment compared to the year before. Sick leave increased in the first year after treatment but decreased significantly below the base level in the second year after treatment. Self-efficacy expectations and being employed were found to be predictors for long-term reduction in the length of in-patient treatment. Subjective and objective criteria were only slightly correlated. CONCLUSIONS: Sick leave and utilization of in-patient treatment were found to increase considerably in the year before psychosomatic treatment. Therefore, pre-post differences over the entire period were only marginal. The change in subjective criteria was more immediate, while changes in some objective parameters were delayed. Both subjective and objective criteria should be included in outcome studies.

Activities of Daily Living↗

PubMed2005

Autodestructive syndromes.

BACKGROUND: The phenomenon 'autodestructive behaviour' is becoming an increasingly serious disease and cost factor in a wide range of medical fields. The present paper presents a survey of the literature on autodestructive behaviour, excluding psychotic, substance-induced or organic brain disorders. Starting out with a conceptual overview, the paper goes on to look into the epidemiology of autodestructive behaviour and the forms in which it manifests itself. METHOD: A literature search was conducted in Medline, Psycinfo and Psyndex using the search terms 'artifact', 'artificially induced', 'autodestructive', 'self-mutilation', 'factitious', 'self-harm', 'self-induced', 'self-inflicted', 'self-injuring' and 'self-mutilation' for the period from 1977 to 2003. RESULTS: Five of a total of 18 empirical studies describe the simultaneous occurrence of direct and indirect forms of autodestructive behaviour. Reported prevalence rates range from 0.032% to 9.36%. The ratio of females to males was found to be 2:1 (average age: 31.5 years; SD: 9.3 years); in contrast, the gender ratio was reversed for Munchausen's syndrome. The case history data presented are patchy and differ in terms of their priorities. We found a large number of codiagnoses, which seems to indicate that personality and dependence disorders, or substance misuse, are characteristic of both direct and indirect forms of autodestructive behaviour. CONCLUSIONS: The task at hand is to use a yet-to-be-developed nomenclature and adequately operational diagnostic criteria to work out standardised survey instruments that do justice to the heterogeneity of this disorder complex.

Comorbidity↗