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T Middelboe

Publications and source records attributed to T Middelboe.

18 recordsLinked to original sources
PubMed2005

Depression and chronic obstructive pulmonary disease (COPD). Impact on survival.

OBJECTIVE: To determine if the presence of depression in patients suffering from chronic obstructive pulmonary disease (COPD) would have an independent impact on mortality. METHOD: Prospective evaluation of the impact of depression according to the ICD-10 criteria for depression. Cox proportional hazards regression was used to evaluate the independent impact of depression after controlling for significant univariate clinical predictors in the data set. Consenting out-patients (n = 49) who meet the criteria for COPD between September 1997 and September 1998. There were no age limits (range: 53-90 years). The sample was 67% female. Survival status at follow-up after a mean of 803 days was measured. RESULTS: At follow-up, 16 patients had died. Depression significantly reduced the mortality risk at follow-up (hazard ratio, 0.30; 95% confidence interval, 0.10-0.93; P = 0.037). The impact of depression remained after control for forced expiratory volume during the first second (FEV1), the only multivariate significant predictor of mortality in the data set (hazard ratio, 0.27; 95% confidence interval, 0.09-0.84; P = 0.024). CONCLUSION: Depression in out-patients suffering from COPD appears to be an independent protector for mortality. Additional studies in larger samples are needed to replicate this finding and to determine possible underlying pathogenetic mechanisms.

Aged↗
PubMed2002

Living situation, subjective quality of life and social network among individuals with schizophrenia living in community settings.

OBJECTIVE: To investigate the relationships between characteristics of the living situation in the community and subjective quality of life and social network among community-based individuals with schizophrenia. METHOD: A total of 418 individuals with schizophrenia from 10 sites were interviewed with regard to quality of life, psychopathology, social network and needs for care. Characteristics of the living situation investigated were: living alone or not, living with family or not, and having an independent or a sheltered housing situation. RESULTS: An independent housing situation was related to a better quality of life concerning living situation and living with the family to a better quality of life concerning family relations. An independent housing situation was associated with a better social network regarding availability and adequacy of emotional relations. CONCLUSION: People with schizophrenia with an independent housing situation have a better quality of life associated with more favorable perceptions of independence, influence, and privacy. Their social network is better irrespective of whether they live alone or not, or with family or not.

Activities of Daily Living↗
PubMed2001

Predictors of social relations in persons with schizophrenia living in the community: a Nordic multicentre study.

BACKGROUND: Deinstitutionalisation has led to persons with serious mental illness spending most of their time outside psychiatric institutions. Not much is known about their social life. The paper presents the results of structured interviews with non-institutionalised persons with schizophrenia about treatment, care and social network. The network data are analysed from three perspectives: finding predictors of the number and of the quality of social contacts, and establishing the respective variables that characterise persons with high, and those with low, scores on both the quantity and quality dimensions of social integration. METHODS: Random samples of persons with schizophrenia receiving outpatient services in ten psychiatric centres in the four Nordic countries were interviewed. The following instruments were used: Interview Schedule for Social Interaction (ISSI), Camberwell Assessment of Needs, Lancashire Quality of Life Profile, General Assessment of Functioning (GAF) and Brief Psychiatric Rating Scale (BPRS), in addition to a checklist covering the utilisation of different services. The ISSI provided the main data for this paper. A restricted number of possible predictors were used in General Linear Model (GLM) factorial analysis and discriminant analysis. RESULTS: A total of 418 persons took part in the study. The overall participation rate was 55%. Social integration in terms of number of contacts was related to a high GAF score, few BPRS negative and hostility symptoms, having contact with user organisations and living in urban (in contrast to rural) areas. Availability of emotional relations was predicted by female sex, low scores on the BPRS hostility dimension, high GAF score, having contact with one's family more than once a month, and living in urban areas. Work, adequate leisure activities and GAF score discriminated between the best and worst integrated groups. CONCLUSIONS: Living in urban areas, being female, having a high GAF score and low scores on hostility predicted better integration in terms of number of contacts and emotional relations.

Adult↗
PubMed2001

The Nordic Study on schizophrenic patients living in the community. Subjective needs and perceived help.

In a community sample of 418 persons diagnosed with schizophrenia, subjective needs and perceived help was measured by the Camberwell Assessment of Need (CAN). The mean number of reported needs was 6.2 and the mean number of unmet needs 2.6. The prevalence of needs varied substantially between the need areas from 3.6% ('telephone') to 84.0% ('psychotic symptoms'). The rate of satisfaction estimated as the percentage of persons satisfied with the help provided within an area varied between 20.0% ('telephone') and 80.6% ('food'). The need areas concerning social and interpersonal functioning demonstrated the highest proportion of unmet to total needs. In a majority of need areas the patients received more help from services than from relatives, but in the areas of social relations the informal network provided substantial help. In general the patients reported a need for help from services clearly exceeding the actual amount of help received. In a linear regression model symptom load (BPRS) and impaired functioning (GAF) were significant predictors of the need status, explaining 30% of the variance in total needs and 20% of the variance in unmet needs. It is concluded that the mental health system fails to detect and alleviate needs in several areas of major importance to schizophrenic patients. Enhanced collaboration between the care system and the informal network to systematically map the need profile of the patients seems necessary to minimise the gap between perceived needs and received help.

Activities of Daily Living↗
PubMed2001

Comparison of key worker and patient assessment of needs in schizophrenic patients living in the community: a Nordic multicentre study.

OBJECTIVE: The present study is part of a Nordic multicentre study investigating the life and care situation of community samples of schizophrenic patients. The specific aim of the present part of the study was to examine the agreement between patients and their key worker concerning the presence of met and unmet needs in a number of life domains, and help or support given in these domains. METHOD: The comparisons were based on 300 matched pairs of assessments of need using the Camberwell Assessment of Need interview. RESULTS: The results showed that key workers identified slightly more needs, 6.17 vs. 5.76, a significant difference. There was a moderate or better agreement on the presence of a need in 17 of 22 life domains investigated, but in only 11 life domains concerning the presence of an unmet need. Disagreement concerning whether the patient was given the right kind of help or support was even more substantial. CONCLUSION: It is concluded that key workers and patients disagree particularly concerning unmet needs and that this is potentially related to a number of factors associated with the key worker and patient. It is also concluded that further research is needed to increase the knowledge concerning the sources of this disagreement if need assessment is to become a valid basis for service planning and individual treatment planning.

Adult↗
PubMed2001

Ward atmosphere in acute psychiatric in-patient care: patients' perceptions, ideals and satisfaction.

OBJECTIVE: To investigate the relationship between patients' perception of the real and ideal ward atmosphere and their satisfaction. METHOD: Patients filled in the Ward Atmosphere Scale (WAS, Real and Ideal Form) and a satisfaction questionnaire. Patient characteristics were derived from clinical assessments. RESULTS: WAS ratings were almost independent of patient characteristics. Patients in locked wards perceived more anger and aggression and patients subjected to coercive measures perceived less autonomy and practical orientation. Patient satisfaction was predicted by higher scores on the WAS Relationship- and System Maintenance dimensions, explaining 41% of the variance. In particular support, order and organization predicted satisfaction. Except from the areas of anger/aggression and staff control, patients gave the 'ideal' ward higher ratings on all subscales. The perceived gap between the 'ideal' and 'real' ward explained 45% of variance in satisfaction. CONCLUSION: Patients' perception of ward atmosphere is a clinically meaningful measure appearing to be a strong predictor of satisfaction.

Acute Disease↗
PubMed1999

Predictors of subjective quality of life in schizophrenic patients living in the community. A Nordic multicentre study.

As part of a Nordic multi-centre study investigating the life and care situation of community samples of schizophrenic patients the aim of the present part of the study was to examine the relationship between global subjective quality of life and objective life conditions, clinical characteristics including psychopathology and number of needs for care, subjective factors such as satisfaction with different life domains, social network, and self-esteem. A sample of 418 persons with schizophrenia from 10 sites was used. The results of a final multiple regression analysis, explaining 52.3% of the variance, showed that five subjective factors were significantly associated with global subjective quality of life, together with one objective indicator, to have a close friend. No clinical characteristics were associated with global subjective quality of life. The largest part of the variance was explained by satisfaction with health, 36.3% of the variance, and self-esteem, 7.3% of the variance. It is concluded that the actual relationship between objective life conditions and subjectively experienced quality of life still remains unclear. Furthermore, it seems obvious that personality related factors such as self-esteem, mastery and sense of autonomy also play a role in the appraisal of subjective quality of life, which implies that factors like these are important to consider in clinical and social interventions for patients with schizophrenia in order to improve quality of life for these persons.

Adult↗
PubMed1998

A housing support programme for the mentally ill: need profile and satisfaction among users.

Housing support has become an integrated part of the community psychiatric service during the past years. In this study, the need profile, satisfaction rates and clinical characteristics of the users of a housing support programme in Copenhagen are described. Among the 45 residents interviewed, schizophrenia was by far the dominant diagnosis. The Camberwell Assessment of Needs procedure revealed a total of 8.3 needs, including 3.4 unmet needs per resident, within the 22 need areas investigated. The needs were most prevalent within the areas of psychological and social functioning. Agreement between residents and staff on the presence of needs was generally low. Satisfaction rates were moderate to high, and a substantial proportion of the residents reported their general quality of life to be improved during participation in the programme. The type of support provided seemed to fit important need areas, suggesting that the programme is appropriate.

Adult↗
PubMed1997

[Group homes for the mentally ill I. A description of access and residents].

In a cross-sectional study, we assessed social and psychiatric characteristics of 71 residents in the group home programme for the mentally ill in Copenhagen. The majority suffered from long-term functional or organic psychosis, dominated by anxiety and residual symptoms of schizophrenia. Social functioning was impaired to a moderate degree. Emotional and social support were among the main functions of the staff. More than 60% regarded the group home as a temporary residence, but the length of stay varied between a few months and 5.7 years. All residents were treated in the local outpatient psychiatric service. This type of housing support should be regarded as an important part of a comprehensive community care service.

Adult↗
PubMed1997

[Group homes for the mentally ill II. Resident satisfaction and experience of support].

The aim of this cross-sectional study was to evaluate aspects of user satisfaction and subjective change in functional status of 71 long-term mentally ill group home residents in Copenhagen. Satisfaction rate varied between 52 and 89%, and though distress caused by fellow residents was seen in 76%, around 80% also experienced some degree of reciprocal supportive relationship with the others. More than half of the residents would prefer to live alone, with a partner or a friend. General life satisfaction was improved in 72%, and improved status within various life domains was reported in 32-78%. The group homes represent a large potential for improving functional status in the severely mentally ill.

Adult↗
PubMed1997

Coping strategies among the long-term mentally ill: categorization and clinical determinants.

The aim of this study was to explore strategies for coping with symptoms in 98 long-term mentally ill patients. The following characteristics of the strategies were investigated: level, effectiveness, target symptom and problem orientation. In addition, we studied the association between measures of coping and psychopathology. An average of 3.8 coping strategies per patient was reported, and strategies involving behavioural change were most common (48%), followed by changes in socialization (24%) and in cognitive control (15%). Coping efforts were most commonly directed towards non-psychotic symptoms. A high load of general and affective symptoms, few negative symptoms and a high level of illness awareness predicted the total number of coping strategies. Separate analysis of active and passive strategies, including increased and decreased socialization, respectively, revealed very different patterns of clinical predictors. These results are discussed with reference to community-care programmes.

Activities of Daily Living↗
PubMed1997

Prospective study of clinical and social outcome of stay in small group homes for people with mental illness.

BACKGROUND: Small group homes operating according to the principles of supported housing have, during the past five years, become a cornerstone of the housing services for the long-term mentally ill in Copenhagen. METHOD: During a 2.5-year period, 47 long-term mentally ill persons were examined at the time of entry to a group home programme. Residents' psychopathology, social integration, mastery and quality of life were measured by structured interviews, including the Present State Examination (PSE-10); and their social functioning was recorded by interview with the staff. Forty-four of the residents were re-examined at follow-up after a mean of 1.1 years using the same instruments. Data on hospitalisation were obtained through the Danish Psychiatric Case Register. RESULTS: Eighty-three per cent of the residents remained in the programme during the first year. They showed a significant improvement in subjective quality of life, PSE total score, social integration, functioning and hospitalisation index. The number of reciprocal supportive contacts in the social network increased. Lower baseline PSE total score was associated with adherence to the programme, and the improvement in quality of life during their stay was predicted by reduction in symptoms and improvement in social integration. CONCLUSIONS: A rehabilitation strategy of supplementing standard psychiatric treatment with a programme of small supportive group homes improves the quality of life, psychosocial functioning and community tenure of the long-term mentally ill.

Adult↗
PubMed1995

[Symptoms of depression in cancer patients undergoing chemotherapy].

Symptoms of depression and anxiety were measured in a prospective follow-up study of 36 cancer patients before and during chemotherapy by means of the Hamilton rating scales and the Melancholia Scale. These scales proved useful in the examined population. Moderate or severe depression was seen in almost half of the patients before chemotherapy, but this figure decreased during follow-up. The symptomatology resembled that of primary depression, and the brief rating scales for depression seemed suitable for screening purpose. Problems in identifying morbid states of anxiety and depression are discussed.

Adult↗
PubMed1994

Depressive symptoms in cancer patients undergoing chemotherapy: a psychometric analysis.

Depressive psychopathology was measured in a prospective follow-up study of 36 cancer patients. The psychometric properties of the Hamilton rating scales for depression and anxiety and the Melancholia Scale were examined. The scales proved useful, indicating that the symptomatic structure of depression in cancer patients is rather identical to that seen in primary depression. Depressive states were found in about 40% of patients before the start of chemotherapy. The frequency of intermediate and high scores on the depression scales showed a low to moderate decrease after 6 months. Aspects of depression in the medically ill are discussed, and screening routines suggested.

Adaptation, Psychological↗
PubMed1989

[Posttraumatic stress disorder. 1. Background].

This article gives a review of the theoretical and clinical conditions in the posttraumatic stress disorder (PTSD), a diagnosis which was introduced in 1980. Investigations suggest a definite relationship between the traumata and the subsequent stress disturbances while the roles played by premorbid factors and the paratraumatic happenings are still not elucidated. The conditions is common after violent traumata. The subsequent course tends to be chronic although the prognosis in many cases in which rapid intervention is instituted is good. Greater awareness of the occurrence of PTSD is recommended.

Humans↗
PubMed1989

[Posttraumatic stress disorder. 2. Therapy and clinical examples].

The principles of short-term psychotherapy for the posttraumatic stress disorder are summarized. A review is presented of psychopharmacological treatment of the posttraumatic stress disorder (PTSD). The case histories of three patients with PTSD are briefly mentioned.

Aged↗