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Biomedical subjects

S Weyerer

Publications and source records attributed to S Weyerer.

At least 19 recordsLinked to original sources
PubMed1995

Economic factors and the rates of suicide in Germany between 1881 and 1989.

The potential consequence of economic stress most frequently cited in the literature of medical sociology is the increase in the rate of suicide, it probably being the most valid and reliable indicator of collective mental health. To assess the probability of such being the consequence of current economic realignment in the Federal Republic of Germany, we deemed it promising to evaluate the extent to and manner in which economic factors have to date affected the frequency of suicide in Germany. The current study analyzed the effects of four economic variables (growth of the economy, average real income, unemployment and frequency of bankruptcy) on the rates of suicide in Germany from 1881 to 1989. We set the commencement date of the period analyzed as early as possible to include long-term developments as well as the effects of different moderator variables. The annual fluctuations of all four variables, in conformity with our hypothesis, correlated both in the period preceding World War II as well as in the postwar period with those in the rates of suicide. The strongest correlations held for the rate of unemployment and for the frequency of bankruptcy in times of obvious social disintegration coupled with diminished state safeguards against unemployment. Our hypothesis that the effects of economic factors would more strongly influence the rates of suicide by men as opposed to women could not be corroborated.

Cross-Sectional Studies↗
PubMed1994

Testing Durkheim's theory of suicide: additional results from Germany.

In a recent study of 14 European countries, Lester (1993), using inference statistical techniques, confirmed Durkheim's (1897) observation that lower birth rates were associated with higher suicide rates in 1870 and 1980. Due to changes in national boundaries, Germany was excluded from these analyses. Among the federal states of Germany, Bavaria most suitably lends itself to a study of the relationship between suicide and familial integration over time. A long-term analysis of the years between 1865 and 1980 reveals a prominent reciprocal relationship (r = -0.87; P < 0.001) between rates of suicide and birth in Bavaria. Marriage rates, on the other hand, correlate only minimally (r = -0.19 ns) with rates of suicide. Our results accord with Durkheim's view that unlike birth rates, higher marriage rates per se are only slightly associated with suicide rates.

Birth Rate↗
PubMed1994

Prevalence of insomnia in elderly general practice attenders and the current treatment modalities.

This study aimed to assess the prevalence and treatment modalities of elderly practice attenders. A total of 330 patients aged over 65 years were investigated with a questionnaire in general practice. To assess insomnia, operationalized diagnostic criteria according to DSM-III-R were applied. Twenty-three percent of the elderly patients suffered from severe, 17% from moderate and 17% from mild insomnia. More than 80% of the patients reported suffering from insomnia for 1-5 years or longer, which indicates a chronic course. Elderly patients showed unrealistic expectations concerning duration of sleep and spend more time in bed than they realistically can expect to sleep. More than half of the elderly patients reported habitual daytime napping. Sleep-disturbed elderly patients did not differ significantly from good sleepers in their habit of taking daytime naps, but even when taking daytime naps, good sleepers slept significantly longer than the sleep-disturbed patients. A significant association was found between insomnia and mental disorders, i.e., depression and organic brain syndrome according to the diagnosis of the general physician. In about half of the cases the primary care physician was not aware that the elderly patient suffered from severe insomnia. More than half of the elderly severe insomniacs took prescribed hypnotics habitually, mainly benzodiazepines.

Aged↗
PubMed1994

Physical exercise and psychological health.

For individuals who are just beginning to exercise, the very unfit, the elderly and persons suffering from psychiatric disorders, low intensity activity has important potential psychological benefits. Several studies indicate that mental health can be improved by low- or moderate-intensity activity. In 2 studies it could be demonstrated that aerobic exercise plus counselling was more effective in the treatment of depressive disorders than counselling alone. Cross-sectional community studies clearly reveal that after controlling for potential sociodemographic and health-related confounding variables the risk of depression is significantly higher for physically inactive individuals compared with regular exercisers. No final conclusions can be drawn from longitudinal field studies on the predictive value of physical activity on the degree of depressive symptoms. Several biological and psychological hypotheses have been proposed to explain the association between physical activity and mental health, however, there is still a lack of an integrated theoretical model.

Exercise↗
PubMed1994

Social risk factors in schizophrenia.

In analyzing the relationship between social factors and schizophrenia one can distinguish two research strategies. Studies can focus on individual differences or the aggregate level. Several investigations indicate that social factors, e.g., low socioeconomic status, single status, ethnic group, are significantly associated with the prevalence of schizophrenia. To explain this relationship most investigators favor the hypothesis of social selection rather than a social causation. This view is also supported by an ecological study of the incidence of psychiatrically treated schizophrenic disorders in the city of Mannheim.

Cross-Sectional Studies↗
PubMed1994

Sleep onset insomnia, sleep maintaining insomnia and insomnia with early morning awakening--temporal stability of subtypes in a longitudinal study on general practice attenders.

The present study investigated the temporal stability of insomnia patterns during a 4-month study period, classifying insomnia as sleep-onset insomnia, sleep-maintaining insomnia or insomnia with early morning awakening. In a longitudinal study design, 2,512 general practice attenders were investigated at the time of the first inquiry (T1) with a questionnaire. Four months later (T2), all patients complaining of difficulties in initiating and/or maintaining sleep and/or early morning awakening (n = 328) were again contacted by mail and received the same questionnaire as at T1. According to the reported symptoms, patients were assigned to the different subtypes of insomnia. The diagnosis at T1 was then compared with the diagnosis at T2 4 months later. Only about half of all patients who complained of difficulties in initiating sleep at T1 still exclusively reported sleep-onset insomnia 4 months later, whereas the remaining patients were distributed to different subtypes. The stability of sleep-maintaining insomnia and insomnia with early morning awakening was even lower. Comorbidity with a somatic or psychiatric disorder at T1 and change in hypnotic treatment did not account for the instability of the respective subgroup of insomnia. These findings illustrate that cross-sectional studies focusing on subtypes of insomnia, e.g. sleep-onset insomnia, may lead to erroneous results.

Adolescent↗
PubMed1993

Prevalence and treatment of insomnia in general practice. A longitudinal study.

The aim of the study was to assess prevalence and treatment modalities of insomnia in general practice. To investigate the course of insomnia, a longitudinal study design was adopted. Two thousand five hundred and twelve patients (age 18-65 years) were investigated with a questionnaire in general practice (T1). Four months later (T2) and again 2 years later (T3) a questionnaire was sent to all patients who had complained about severe insomnia at the time of the first inquiry. To assess insomnia, operationalized diagnostic criteria were applied (DSM-III-R). Eighteen point seven percent suffered from severe, 12.2% suffered from moderate and 15% suffered from mild insomnia. In the course of 2 years insomnia appeared as a chronic health problem. A high comorbidity of severe insomnia was found with chronic somatic and psychiatric disorders, especially with depression. Of the severely insomniac patients, 23.9% used prescribed hypnotics habitually, mainly benzodiazepines. The use of prescribed hypnotics remained rather stable during the whole study period. More than half of the patients reported a daily use of the hypnotics for 1-5 years or longer, but only 22% of the severely insomniac patients reported at the time of the third inquiry a significant improvement of insomnia due to the administration of sleeping pills. Thus, the long-term administration of benzodiazepine hypnotics seems to be an inadequate treatment strategy in chronic insomnia. Whether the occurrence of rebound insomnia after benzodiazepine withdrawal may be one of the main factors for chronic hypnotic use requires discussion.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

The impact of availability, attraction and lethality of suicide methods on suicide rates in Germany.

Substantial fluctuations have prevailed in both the rate and particular methods of suicide in the Federal Republic of Germany during the past 40 years. The current study examines the extent to which the availability, attraction and lethality of particular methods of suicide affect suicide rates. A close relationship existed in the period from 1949 and 1989 between the peaks of the suicide rate and the percentage of low threshold suicide methods according to De Catanzaro, whereby suicide in this context is understood to mean suicide by shooting or intake of solid, liquid or gaseous poisons. Our hypothetically expected lesser compensation between high and low threshold methods for women was confirmed. Between 1963 and 1976 the rate of suicide committed using domestic gas receded dramatically. Within the same period, however, the rate of suicide committed using other poisons rose accordingly.

Adolescent↗
PubMed1993

Effects of physical inactivity on all-cause mortality risk in Upper Bavaria.

The effect of physical activity on all-cause mortality was examined using a representative random sample of 1,536 persons (15 years and older) in three communities in Upper Bavaria. 27.0% of the respondents reported regular and 26.2% occasional physical exercise. During the 5-year follow-up 5.1% (n = 79) of the original sample died. Using a logistic regression model, the relation between physical activity and mortality was measured by the odds ratio, with subjects reporting regular physical activity as the reference group. Crude mortality risk was significantly higher among the physically inactive (men: 3.97; women: 4.36) but not among respondents practising occasionally (men: 1.67; women: 1.24). After adjustment for potential confounding variables (age, social class, physical and mental health), the mortality risk was elevated but not statistically significant for the physically inactive (men: 1.76; women: 1.51) and for the group practising occasionally (men: 1.50; women: 1.14).

Adolescent↗
PubMed1993

[Methodology in psychiatric epidemiologic research].

Crucial epidemiological variables are described: incidence, prevalence, and relative risk. Of primary importance to comparison of rates of illness and testing hypotheses as to its causes and course are the exact identification and definition of mental disorders. In recent years a variety of screening instruments for assessing both general mental impairment and specific mental disorders have been developed. The methodological standards demanded of a good screening instrument are discussed, namely, the identification of all actual cases of illness (as far as possible) without too many false positive findings among the healthy persons examined.

Cross-Sectional Studies↗
PubMed1992

The high incidence of psychiatrically treated disorders in the inner city of Mannheim. Susceptibility of German and foreign residents.

In earlier investigations in the city of Mannheim we examined the spatial distribution of the incidence of treated mental disorders in 1965 and 1974-80. In studying the ecology of psychiatric disorders over time, it is important to consider major demographic developments. In Mannheim between the mid-sixties and 1980 the most striking demographic change was the increase of foreign residents, whose proportion almost trebled during this period. In this study we test the hypothesis whether the excess morbidity in the inner city where housing conditions are relatively poor and the percentage of foreign residents is far above average can be explained by the high proportion of immigrants, mainly from Turkey, living there. Due to motivational and administrative factors, most immigrant workers being recruited on the basis of good physical and mental health, the age-adjusted incidence of treated psychiatric disorders between 1974 and 1980 among the German population exceeded that of foreign residents. The high concentration of psychiatric disorders in the inner city is due solely to the German and not to the foreign residents. The most plausible explanation for this is provided by the segregation hypothesis. Individuals with vulnerable personalities tend to move to socially disorganized districts of the city. Furthermore, the health status of those Germans who left areas of poor environmental conditions was probably better in comparison to those who remained in the inner city.

Cross-Cultural Comparison↗
PubMed1992

Physical inactivity and depression in the community. Evidence from the Upper Bavarian Field Study.

In the Upper Bavarian Field Study a representative community sample of 1,536 persons (from 15 years of age and upwards) was interviewed by research psychiatrists. Twenty-seven percent of the respondents reported taking regular and 26.2% occasional physical exercise. Physical inactivity as well as depression were significantly associated with the female gender, increasing age, low socioeconomic status and the presence of a somatic disorder. Using a logistic regression model, the relation between physical activity and depression was measured by the odds ratio with subjects reporting regular physical activity as the reference group. Cross-sectional analysis revealed that after controlling for potential confounder variables the odds ratio for depression was, at 3.15, significantly higher for the physically inactive compared to the regular exercisers. The odds ratio for the group practising occasionally (1.55) was also elevated but not statistically significant, 87.3% of the subjects who participated in the baseline study were reinterviewed five years later. In contrast to the cross-sectional findings, low physical activity at wave 1 was not a risk factor for developing depression at wave 2.

Adolescent↗
PubMed1991

Psychiatric and physical illness, sociodemographic characteristics, and the use of psychotropic drugs in the community: results from the Upper Bavarian Field Study.

In the Upper Bavarian Field Study a total of 1536 persons (15 years and older) were interviewed by research psychiatrists. 8.1% of all respondents took a psychotropic drug during the 7 days prior to the interview. The consumption rate among women was about three times as high as that for men. The use of psychotropic drugs increased with age. No consistent pattern was found with respect to social class. According to psychiatric/physical health status the highest consumption rate (29.4%) was found among those suffering solely from psychiatric disorders. The simultaneous occurrence of both psychiatric and physical disorder did not increase the risk of drug taking (21.4%). Less than 5% of the healthy respondents and of those suffering solely from a physical disorder used psychotropic drugs. A large proportion (63.0%) of those with previous psychiatric in- and outpatient treatment received psychotropic medication, as well as those suffering from schizophrenia (66.7%), affective psychoses (52.6%) and anxiety disorders (50.0%). The higher consumption of psychotropic drugs among women could not be explained by higher psychiatric or physical morbidity or the fact that women consult primary care physicians more frequently than do men. Controlling for co-morbidity and annual consultation of family physicians, significant sex differences in the consumption of psychotropic drugs persist.

Adolescent↗
PubMed1991

Prevalence and treatment of insomnia in the community: results from the Upper Bavarian Field Study.

In the Upper Bavarian Field Study a total of 1,536 persons (15 yr of age and older) were interviewed by research psychiatrists. The prevalence of insomnia (last 7 days) identified with the aid of the Clinical Interview Schedule (CIS) was 28.5% (mild: 15.0%; moderate/severe: 13.5%). For both sexes sleep disorders increased with age. The female preponderance of insomnia was mainly associated with the middle and older age groups. In contrast to other psychiatric disorders, sleep disturbances were not associated with social class. Moderate/severe insomnia was strongly related to psychiatric diagnoses, the use of psychiatric in- and outpatient services and general hospitals. It also constituted a significant burden for the primary-care physicians, whereby the average annual consultation rate among mild (10.61) and moderate/severe insomniacs (12.87) was significantly higher compared to that for those without sleep disorders (5.25). A total of 33.7% of the insomniacs were treated with hypnotic and/or other psychotropic drugs during the week prior to the interview, whereby the drug consumption among moderate/severe insomniacs (48.5%) was significantly higher than that of mild insomniacs (20.4%).

Adolescent↗
PubMed1989

The stability of the ecological distribution of the incidence of treated mental disorders in the city of Mannheim.

In 1965, Häfner et al. (1969) conducted an ecological study of the incidence of treated mental disorders in the industrial city of Mannheim. They found large variations in incidence rates in 20 urban areas: excess morbidity in the socially disorganized areas located mainly in the city center, and low rates in areas on the outskirts. This study incorporates additional data from the Cumulative Psychiatric Case Register established in Mannheim in 1973. It focuses on the short- and long-term stability of the spatial distribution of mental disorders comparing the year 1965 with the period 1974-80, and analysing the individual years from 1974-80. Despite marked changes between 1965 and the seventies (the increase in the number of guest workers; the development of extensive building and urban renewal programs; the establishment of the Central Institute of Mental Health and several community psychiatric services after 1975), the ecological correlation remained relatively high (r = 0.79). Prior to the establishment of the Central Institute of Mental Health, the spatial distribution of mental disorders in the year 1974 was also very similar to that in 1965 (r = 0.73). In general, the study revealed a highly stable ecological distribution of treated mental disorders not only on a long-term basis, but also for the individual years from 1974 to 1980.

Cross-Sectional Studies↗
PubMed1989

Psychiatric disorders and diabetes--results from a community study.

In the Upper Bavarian Field Study a total of 1536 persons (15 years and older) were interviewed by research psychiatrists. The prevalence of diabetes (ICD 250) identified by the interviewer and/or the primary care physician was 4.0%. Since the number of diabetics among the younger age groups was relatively low (n = 7) and in order to obtain a more homogeneous study group, only those over the age of 55 were considered in further analysis. Diabetics were compared with a control group of persons with another chronic medical condition of similar clinical severity and a control group without a somatic disorder. The sex- and age-adjusted prevalence of psychiatric disorders identified with the aid of the Clinical Interview Schedule was significantly higher among diabetics (43.1%) and persons with other chronic medical conditions (50.7%) in comparison to the healthy control group (26.2%). The difference was mainly due to mild psychiatric disorders and those suffering from depression. No statistically significant association was found between diabetes and moderate to severe mental disorders, the use of psychotropic drugs and previous psychiatric treatment.

Adolescent↗
PubMed1989

Spatial concentration of the incidence of treated psychiatric disorders in Mannheim.

The spatial concentration of the incidence of treated psychiatric disorders in Mannheim was determined in 2 ways. The first, the classical zone model according to Neller (1), distinguishes an inner, intermediate and outer zone. This concept was applied to data from an ecological study conducted by Häfner et al. (2) in 1965 and to those derived from the Cumulative Psychiatric Case Register for the years 1974-1980. For the second period of time we developed, in addition, a factor ecological concept. The 23 districts of Mannheim were divided into 5 areas that were as homogeneous as possible in terms of segregation and density. There was a marked increase in the concentration index for schizophrenia in the inner zone, as well as for neuroses and personality disorders between 1974-1980 as compared with 1965. There were strong concentrations in the inner zone during both periods of study for the diagnosis of alcoholism and drug addiction. Although in 1965 there was a visible concentration trend in the inner zone for affective psychoses, it had almost vanished between 1974-1980. Using the factor ecological classification we demonstrated that, with the exception of affective psychoses and neurotic depression, all diseases concentrate in the city areas that, besides being centrally located, are characterized by high population density, poor housing conditions, low social status of the residents and where foreign nationals were segregated in the 1970s.

Adolescent↗