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Biomedical subjects

S Weyerer

Publications and source records attributed to S Weyerer.

At least 37 records · Page 2Linked to original sources
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↗
PubMed1989

The use of psychiatric facilities by depressives: results of the Upper Bavarian Study.

Utilization of psychiatric facilities by noninstitutionalized persons aged 20 years and older, identified as "depressive cases", was examined. Data were based on the representative community sample of the Upper Bavarian follow-up field study with an original sample size of 1668 people. In the 5-year follow-up 1384 (83%) subjects were interviewed, while 80 subjects (4.8%) had died. The 5-year prevalence of depressive disorders, according to the definition used, was 10.3%. We analyzed which people with depressive disorders sought help from mental health professionals according to type of depressive disorder, sociodemographic data, psychosocial factors and course of disorder. The psychiatric treatment rate (in- or outpatient) was 23.9% of the depressive cases. The majority of treated persons were outpatients. Patients with the diagnosis of endogenous depression were most likely to have received psychiatric treatment. Limitation in the ability to work due to depression was the most important psychosocial factor influencing help-seeking behavior. The highest consultation rate in psychiatric facilities was obtained from the depressives who had grown up without their parents.

Adult↗
PubMed1988

Anorexia nervosa in Greek and Turkish adolescents.

Five samples of adolescents were assessed in three countries: (1) 867 Greek pupils in Munich (Germany), (2) 2,700 Greek pupils in Veria (Greece), (3) 567 girls in Ioannina (Greece), (4) 2,783 adolescents in Istanbul (Turkey), and (5) 157 adolescents in Upper Bavaria (Germany). A two-stage procedure was used for samples one, two and four using the Anorexia Nervosa Inventory for Self-rating (ANIS) for screening and a standardized interview (Structured Interview for Anorexia Nervosa and Bulimia) for personal exploration of possible cases and final case identification. Results of all samples were compared. Greek girls in Germany scored higher than Greek boys in Germany and Greek boys and girls in Germany scored lower than Greek girls in Veria in the ANIS factors figure consciousness, insufficiency, anancasm, negative effect of meals and bulimia in practically all age groups. The frequency distribution of the ANIS main factor figure consciousness was the same for both Greek samples in Greece, while the Turkish sample and the Greek sample in Munich had significantly lower scores. In the second stage the prevalence rates for anorexia nervosa according to Feighner criteria (modified for the purpose of a field study) were: 1.10% for Greek girls in Munich, 0.41% for Greek girls in Veria and 0.35% for Greeks in Ioannina. Thus, while Greek girls in Germany had lower scores in ANIS factors and other self-ratings (General Health Questionnaire) the actual rate of anorexic syndromes was highest among Greek girls in Munich. Socio-cultural influences and selection factors are discussed.

Adolescent↗
PubMed1988

Mental illness in Greek and Turkish adolescents.

Samples of 867 Greek adolescents in Munich, 2,702 Greek adolescents in Greece and 2,780 Turkish adolescents in Turkey were assessed concerning mental health in a two-stage procedure. In the first stage the General Health Questionnaire (GHQ) was used for screening. Significant age differences in the GHQ 28-item scale and most of its subscales were observed mainly for the samples in the homeland. Male adolescents had lower scores than female adolescents in the GHQ 28-item scale and its sub-scales while social class appeared to be of little influence. Significantly higher GHQ-28 scores were obtained for Greeks and Turks in their homeland as compared to Greeks in Turks in their homeland as compared to Greeks in Munich. The GHQ-28 correlations with the Anorexia Nervosa Inventory for Self-Rating were fairly high. A principal component analysis with Varimax rotation showed fairly consistent results for this age group when compared with the results of Goldberg and Hillier (1979). With the exception of the GHQ factor social dysfunction Greek adolescents in their homeland had significantly higher scores in the total GHQ-28 and its sub-scales than Greeks in Germany. Thus, our data do not confirm the acculturation-stress hypothesis. The data would be consistent with the hypothesis of selective migration which states that Greek adolescents in Germany constitute a positive selection with respect to risk for mental illness.

Acculturation↗
PubMed1988

A comparative investigation of the principal component structure of the 28 item version of the General Health Questionnaire (GHQ). 15-year-old schoolgirls in England, Greece, Turkey and West Germany.

The 28-item version of the General Health Questionnaire of 15-year-old schoolgirls obtained under identical conditions in two separate studies was subjected to principal component analysis (PCA). Varimax rotation produced different numbers of components for the different groups, but restricting the number of components to be rotated to four produced similar component structures, as supported by the coefficient of factor similarity, for both Turkish and Greek groups in their home countries and a heterogeneous non-British group in London in comparison to British girls. Different structures were obtained in schoolgirls from Greece, in Munich, and from the Indian subcontinent in London. Analysis of variance of the factor scores of a combined PCA produced significant overall group differences for all components and specific group differences for anxiety and insomnia, social dysfunction, and severe depression. Somatic symptoms and anxiety and insomnia subscales, either alone or in combination with other subscales, contributed most frequently to morbidity.

Adolescent↗