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Biomedical subjects

S Priebe

Publications and source records attributed to S Priebe.

At least 19 recordsLinked to original sources
PubMed1995

Patients' assessment of treatment predicting outcome.

Using a visual analog scale, 34 schizophrenia patients receiving long-term treatment in community care rated the extent to which their treatment was right for them. We investigated whether these assessments would predict the duration of patient hospitalization during an initial followup period of 12 months and a longer followup period of 30 months. The duration of full and partial hospitalization was assessed by means of a hospitalization index. Patients who assessed their treatment more negatively had significantly higher hospitalization indices in the two followup periods. The predictive value of the patients' assessments of treatment was not explained by the influence of other variables.

Adult↗
PubMed1995

The importance of the first three days: predictors of treatment outcome in depressed in-patients.

This study investigated whether initial reactions, as shown by depressed patients and by the psychiatrist in charge within the first three days of complex hospital treatment, predicted outcome. Sixty-three patients with depressive disorders according to ICD-10 were examined. In addition to basic socio-demographic and clinical data and to baseline symptoms, psychiatrists' optimism, patients' global assessment of treatment and symptom change within the first three days were tested as predictors. The outcome criteria were both observer and self-ratings of symptoms at discharge. Psychiatrists' optimism was the best single predictor of each outcome criterion. Patients' initial subjective reactions predicted self-rated symptoms at discharge. In stepwise multiple regression analyses initial reactions contributed significantly and - in two cases - separately to the overall prediction of outcome. Patients' and psychiatrists' initial reactions in complex hospital treatment of depression are relatively good predictors of outcome and should, therefore, be monitored carefully in research and in clinical practice.

Adult↗
PubMed1995

[The user perspective studied by users of psychiatric institutions].

The perspective of users of psychiatric services has mostly been studied by professional researchers. In this study a group of users investigated subjective quality of life, assessment of psychiatric treatment and needs of other users. A special questionnaire was constructed and used. Psychiatric institutions were assessed as being on average good to satisfactory; satisfaction with different life domains was fairly good; needs for support varied very much.

Adult↗
PubMed1995

[Intimate relations and the course of psychiatric disorders in relocated patients].

In this study we investigated empirically the association between close relationships and the course of psychiatric disorders in 94 persons who moved from the GDR to West Berlin in 1989 and showed psychiatric disorders after their arrival. The patients mostly suffered from anxious and depressive symptoms accompanied by vegetative complaints. Symptoms were clearly reduced within the follow-up period (follow-up interviews after 6 months and 2 1/2 years). There were moderate correlations between family situation and the degree of symptoms. The mere existence of a partnership was not found to influence improvement. Negative change of partnership, and more quarreling was associated with a more unfavorable course of illness. Living with children was correlated with more symptoms--particularly six months after migration--and may be an additional stress factor for successful adaptation.

Acculturation↗
PubMed1995

[Subjective evaluation criteria in psychiatric care--methods of assessment for research and general practice].

Evaluation of psychiatric care is an important task in research and in routine conditions. It requires definition of criteria. Subjective criteria are, for different reasons, of increasing interest. Subjective quality of life, subjective needs for help and support and patients' assessment of psychiatric treatment are regarded as particularly relevant criteria. We present and briefly discuss instruments for assessment of these criteria, that are new at least in the German language. Results of a first cross-sectional study in a community care setting are reported. Regarding quality of life healthy groups were examined too. The findings suggest that the instruments are usefully applicable and that they may produce plausible results.

Adult↗
PubMed1994

Psychological and endocrine abnormalities in refugees from East Germany: Part I. Prolonged stress, psychopathology, and hypothalamic-pituitary-thyroid axis activity.

The influence of prolonged psychological stress on hormonal secretion was investigated in 84 East Germany refugees suffering from psychiatric disorders within 6 weeks of their arrival in West Berlin shortly before or after the fall of the Berlin Wall. Before leaving the German Democratic Republic, these patients had already experienced prolonged stress, which continued after migration. In most cases, the diagnosis was anxious-depressive syndrome with vegetative complaints and symptoms of increased arousal. Their formal DSM-III-R diagnoses (American Psychiatric Association, 1987) included adjustment disorders, depressive disorders, and anxiety disorders (the latter including posttraumatic stress disorder). Serum levels of thyroid stimulating hormone (TSH) and thyroid hormones (thyroxine, free thyroxine, triiodothyronine, and reverse triiodothyronine) were measured and compared with those of 20 healthy control subjects. TSH and all thyroid hormone concentrations were significantly reduced in the patient group. Fifty-two of the patients (62%) were in the hypothyroid range but did not show any clinical signs of hypothyroidism. These disturbances in hormonal secretion were not correlated to any psychiatric diagnosis or to the severity of acute or chronic stress. The marked abnormalities in the hypothalamic-pituitary-thyroid axis seen in these refugees differ from those reported in depression and would seem to reflect severe chronic stress rather than specific psychiatric disorders. The underlying neurochemical mechanisms remain to be investigated.

Adjustment Disorders↗
PubMed1994

Psychological and endocrine abnormalities in refugees from East Germany: Part II. Serum levels of cortisol, prolactin, luteinizing hormone, follicle stimulating hormone, and testosterone.

We investigated afternoon serum levels of cortisol, prolactin, luteinizing hormone (LH), follicle stimulating hormone (FSH), and testosterone in a group of 84 refugees who had fled from East to West Germany and suffered from psychiatric disorders within 6 weeks of their arrival in West Berlin. The mean hormone levels were compared with those of healthy control subjects. Cortisol levels were lower and LH levels were higher in the patients than in the control subjects, but only at trend levels of significance. No differences were found between the prolactin, FSH, or testosterone concentrations of the two groups. The patients with major depressive disorder (MDD) had a significantly higher mean cortisol level than the mean levels in the subgroups in whom posttraumatic stress disorder, dysthymia, and adjustment disorder were diagnosed. It can be concluded that the hypothalamic-pituitary-adrenal axis may "adapt" during severe long-term psychological stress and that long-term stress may be only one of the neurochemical mechanisms underlying the hypercortisolemia in patients with MDD.

Depressive Disorder↗
PubMed1994

[Persisting psychological disorders following harrassment because of an application to leave the GDR].

In an exploratory study we examined 40 patients, who had been exposed to harassment in the GDR because of an official application to leave and who suffered from persisting mental sequelae of that experience. On an average more than six years after termination of the stress situation in the GDR, patients showed a moderate anxious-depressive syndrome and vegetative complaints. Diagnostic classification varied; depressive disorders, posttraumatic stress disorder, somatoform and anxiety disorders were most often diagnosed. 45% of the patients stated that the symptoms were not mainly due to experiences during repression, and 43% saw a mainly positive effect of that experience on their life. The relevance of the findings is discussed briefly.

Adult↗
PubMed1994

Psychopathology and long-term adjustment after crises in refugees from East Germany.

OBJECTIVE: In this study we examined psychopathology, diagnoses, social adjustment and the course of symptoms over two and a half years in East German refugees who suffered a crisis immediately after migrating to West Berlin just prior to or shortly after the breaching of the Wall in autumn 1989. METHODS: One hundred and twenty two refugees seeking crisis intervention in a psychiatric outpatient unit after arrival were investigated. Six months later 59% and two and a half years after migration 30% of the patients were re-examined. RESULTS: The patients had been exposed to prolonged stress situations in East Germany and were suffering from anxious-depressive syndrome with vegetative complaints. Sixty patients required more than one crisis intervention during the first six months after resettlement. During the follow-up period symptoms decreased significantly. At the second follow-up interview 81% of the patients had a satisfactory job, and 89% acceptable accommodation. CONCLUSIONS: Satisfactory classification of the psychiatric disorders induced in East German refugees by prolonged stress was not possible according to the DSM-III-R criteria. Initial crises are not necessarily associated with poor long-term adjustment after migration.

Acculturation↗
PubMed1994

[Evaluation of psychiatric treatment by patients--results and problems of systematic research].

In the last three decades there has been a growing scientific interest in users' assessment of psychiatric services and treatment. The "consumer satisfaction" research found that the majority of users show a high level of global satisfaction with the treatment they are receiving. Controlled and randomized studies in different treatment settings showed that users are significantly more satisfied with partial hospitalization and community care than with standard hospital care. Only a few consistent associations were found between sociodemographic data, clinical history and assessment of treatment, while a higher degree of chopathological symptoms was always correlated with a more negative assessment of treatment. Users' assessment of treatment is not only important as an outcome criterion of treatment but can also influence the therapeutic process itself and predict outcome. The interpretation of the findings is limited by several methodological and conceptual problems. The shortcomings and the relevance of users' assessment, e.g. in regard to improvement of psychiatric care are discussed.

Clinical Trials as Topic↗
PubMed1993

The role of the helping alliance in psychiatric community care. A prospective study.

In this study, we assessed the quality of the helping alliance between patients and clinical case managers in psychiatric community care and examined its value as predictor of treatment outcome. Patients were interviewed about five different aspects of the helping alliance using simple questions and visual analogue scales. The duration and degree of hospitalization and changes in the patients' working and accommodation situations during a 20-month follow-up period were obtained as outcome criteria for 72 patients with mostly psychotic disorders receiving long-term treatment. The patients' general view of the helping alliance was quite positive. Some aspects of the helping alliance were significantly correlated with hospitalization and changes in working situation during the follow-up period, which indicated a better outcome for patients who experienced the helping alliance more positively. The findings suggest that the helping alliance may be a relevant therapeutic factor not only in psychotherapy, but also in complex psychiatric treatment settings.

Adult↗
PubMed1993

[Psychiatric disorders in emigrants. II. Follow-up over six months and attitudes of the patients].

In the first part of this study we investigated people who had left East Germany and sought psychiatric help within six weeks after their move. 94 patients were re-examined approximately six month later. Meanwhile 40% had found an adequate job and 44% satisfactory accommodation. 65% stated that some of their original hopes had remained unfulfilled in the west. However, in general patients viewed significantly fewer problems associated with integration in the West, than in the first interview. Symptoms were clearly improved according to clinical and self-ratings. Only three patients reported an overall deterioration. Sociodemographic and clinical variables as assessed in the first interview--including diagnostic classification according to ICD-9 and DSM-III-R-, allowed only a limited prediction of different outcome criteria.

Acculturation↗
PubMed1993

[Psychiatric disorders in emigrants. III. Follow-up after two and a half years].

In the first and the second part of this study we reported about first examination and a six month follow-up in patients who had left East-Germany in 1989. In this third and last part, findings of a two and a half year follow-up in 52 patients are shown. 92% of the patients reported further improvement, 87% stated to have an adequate job, and also 87% to have satisfactory accommodation. Frequency of complaints and level of psychopathological symptoms were clearly reduced. This positive change was not due to psychiatric treatment.

Acculturation↗
PubMed1992

Prediction of hospitalization within a psychiatric community care system--a five-year study.

Within a comprehensive community care system, we examined which patients became hospitalized during long-term treatment. We studied 60 consecutively admitted, and mainly chronic psychotic patients over 5 years. Full and partial hospitalizations were assessed by means of a hospitalization index. This index was significantly lower in the 2nd to 5th years after admission than in the 1st year. Sociodemographic and clinical characteristics failed to predict hospitalizations during the 1st year. Patients' age, gender and last occupational status were related to hospitalizations in the following 4 years. A better prediction of hospitalizations was allowed by treatment data obtained during the 1st year. It is suggested that long-term prognosis should be based mainly upon experience with a patient in a given care system, rather than on a patient's history and characteristics as known before treatment.

Adult↗
PubMed1992

[Evaluation of psychiatric treatment by patients--a study of assessment and stability over time].

The principal results and methodological problems of the Anglo-American research on patient's satisfaction with psychiatric treatment are summarised. This study aimed at investigating whether simple quantitative and qualitative methods to assess the patient's view of treatment yield similar results, and to which extent that view changes over time. 53 patients in a community care system were questioned on their view of treatment twice with a period of 20 months between the two interviews. Visual analogue scales and open questions were used for assessment. On the average, the patients' views of treatment as a whole and of different aspects were positive. There was no significant correlation between the patients' views at the two points of time. Patients' view was related to psychopathological symptoms and changed along with changes of symptoms over time; patients with more severe symptoms expressed a more negative view and wished more changes of treatment. Consequences of the findings for assessment of psychiatric treatment via the patients' view are discussed.

Adult↗