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Biomedical subjects

Ulrike Lehmkuhl

Publications and source records attributed to Ulrike Lehmkuhl.

18 recordsLinked to original sources
PubMed2006

[Family-oriented group therapy in the treatment of female patients with anorexia and bulimia nervosa--a pilot study].

OBJECTIVES: Family therapy has proven effective in the treatment of anorexia nervosa (AN) and bulimia nervosa (BN) in adolescence. While cognitive-behavioural treatment has been shown to be effective in adult patients suffering from BN, there have been few studies on the effectiveness of psychotherapy in the treatment of adolescents. Since in the majority of AN patients their illness starts in mid-adolescence, and in late adolescence in BN patients, it is crucial to develop and evaluate treatment programmes for these disorders and age groups. In view of these arguments, a programme of group psychotherapy was set up for eating-disordered patients and their parents, combining disorder-specific psychoeducational components with a family group psychotherapy approach that is more open with regard to individual treatment goals. Patients participated together with their parents in the same group. METHODS: The treatment programme was evaluated within the framework of a naturalistic single-group study design. Pre-post changes were assessed. RESULTS: 32 female patients (29 with AN, 3 with BN) and their parents took part in the treatment programme. All of the families completed the programme, which was interpreted as a high rate of acceptance. Pre-post analysis revealed a decrease in the degree of eating-disorder symptoms. CONCLUSIONS: The advantages and disadvantages of this treatment programme, as well as the limitations of the pilot study are critically discussed.

Adolescent↗
PubMed2005

[Treatment effects of parent management training for ADHD].

OBJECTIVES: The study investigated the efficacy of a programme of parent management training in groups for the parents of ADHD children that is based on a cognitive behavioural concept. METHODS: The parents of 16 ADHD children participated in group training over a ten-week period. Children were medicated with methylphenidate and received consultations. 17 other ADHD children (control group) benefited only from medication with methylphenidate plus consultation; however, their parents did not participate in any group training. In both groups, assessment was done by means of parent questionnaires: in the experimental group to assess the core symptoms of ADHD, homework problems and global problems that occur in families with ADHD; in the control group to assess only the core symptoms of ADHD. RESULTS: The training significantly reduced core symptoms of ADHD, homework problems and global problematic situations in the experimental group. In comparison to the control group, the core symptoms of ADHD decreased more strongly in the experimental group. This effect failed to reach the significance level of p < 0.05 (Mann-Whitney U-test). However, the verification with the linear model showed a significant difference between the two groups on the factor "hyperactivity index". CONCLUSIONS: Parent management training in groups was a useful adjunct in the treatment of ADHD children.

Attention Deficit Disorder with Hyperactivity↗
PubMed2005

[Evaluation with the "Psychotherapie Basisdokumentation" for Children and Adolescents: Psy-BaDo-KJ--a questionnaire for quality assurance and evaluation of psychotherapy for children and adolescents].

OBJECTIVES: Currently only few instruments exist to evaluate psychotherapy for children and adolescents (Mattejat & Remschmidt, 1993). This study presents the development of a new instrument: the "Psychotherapie Basisdokumentation für Kinder und Jugendliche: Psy-BaDo-KJ" (Winter, 2002). This instrument assesses individual therapy goals and the outcome of therapy on the basis of information from children and adolescents, parents and therapists. METHODS: We based our instrument on a questionnaire originally developed for adults: the "Psychotherapie Basisdokumentation" (Psy-BaDo, Heuft & Senf, 1998). To develop the new instrument, we conducted expert interviews that were then analysed qualitatively. Between January 2002 and June 2003 all inpatients (> or = 14 years) as well as their parents and therapists were given questionnaires. To date, data for 35 patients have been evaluated and included in the current study. The diagnoses were recorded according to ICD-10 (Remschmidt et al., 2002). RESULTS: The study shows that patients, parents and therapists usually formulate two or three individual therapy goals but with different content. While the patients mention primarily goals focussed on somatic health, the focus of parents and therapists is predominantly on psychological and mental health. According to the outcome of therapy, the level of agreement among patients, parents and therapists is high. Patients tend to be more optimistic than their parents and therapists. CONCLUSIONS: The "Psychotherapie Basisdokumentation für Kinder und Jugendliche" (Psy-BaDo-KJ) is a new instrument and can be used efficiently for quality assurance and evaluation of psychotherapy for children and adolescents.

Adolescent↗
PubMed2005

[Parental relationship from the perspectives of children, adolescents and clinicians. Development and clinical validation of the Parental-Representation-Screening-Questionnaire (PRSQ)].

The Parental-Representation-Screening-Questionnaire (PRSQ) is a new instrument designed to asses how children and adolescents evaluate their relationship with their parents. The aim of the questionnaire is to assess those aspects in the child-parent relationship that are crucial for a psychopathological risk. Conceptually, the PRSQ is based on cognitive self theory and systemic family theory. The PRSQ consists of 8 scales (36 items) for each parent: "freedom of decision", "emotional burden by the parents", "fears / overprotection", "conflict", "hostility / indifference", "aid for the parents", "punishment", and "support from the parents''. A clinic-referred consecutive sample of 152 patients of a Berlin child and adolescent psychiatry, aged 10 to 18 years, were surveyed. Adverse educational and psychosocial family factors were assessed by clinicians according to the fifths axis of the multiaxial classification system (MAS, Dilling et al. 2000). The internal reliability for 13 of the 16 scales ranges from .90 to .72. Factor analyses confirmed the factorial independence of six of the eight scales separately for mother and father. Moreover, adolescent girls reported significantly worse relations to both parents on five of the 16 scales than boys. Furthermore we found concordant correlations with the clinician's diagnosis of adverse educational and psychosocial family situations. The present results confirm the PRSQ as an economic and discriminating instrument to assess the representation of parent-child relation for clinical and for scientific purposes.

Adolescent↗
PubMed2005

[Treatment of eating disorders in adolescents--the view of a child and adolescence psychiatric hospital].

The paper presents--in the sense of clinical guidelines--reality of clinical care in a child and adolescence university hospital specialised on eating disorders. Need of a multimodal therapeutic approach is emphasized, including normalisation of weight and eating behaviour, nursing and pedagogical measures, individual, group and family therapy, completed by body therapy, art and music therapy and in case psychopharmacotherapy. Recommendations for overcoming weak spots are made.

Adolescent↗
PubMed2002

[Diagnosis related groups (DRG) in child and adolescent psychiatry: results of a prospective pilot study].

Germany faces one of the biggest 'revolutions' in the health care system. As decided by the government in cooperation with medical boards and insurances, beginning with January 1st, 2003 all inpatient treatments will be paid on the basis of adapted Australian-Refined Diagnosis Related Groups. To date, hospitals are requested to obtain prospective databases in order to cluster homogeneous diagnostic groups and calculate realistic treatment-costs. Both psychiatry and child and adolescent psychiatry are so far excluded from the introduction of DRGs. However, most experts predict extensive shifts of patients into psychiatry (i.e. with comorbid internal diseases) under the pressure of short treatments in all non-psychiatric disciplines. Therefore, changes in the payment of psychiatric treatments are inevitably. As part of the DRG pilot-study, we created a catalogue adapted to child and adolescent psychiatry, which was used for 102 consecutively treated inpatients of a child and adolescent hospital. A total of 17.019 prospectively assessed procedures were obtained. Under clinical aspects, 11 categories of 'typical' disorders were analysed. Worst predictability of treatment costs was found for obsessive-compulsive disorders, personality disorders, and eating disorders. Comorbidity and complexity of the disorder was not related to the length of hospital treatment. Implications on future payment systems in child and adolescent psychiatry are discussed.

Adolescent↗
PubMed2002

[Managing self determination and sexual violence in homes for young adults with mental handicap--report from an ongoing German model project].

This report is based upon a model project financially assisted by a grant from the German Federal Ministry for Families, Senior Citizens, Women and Youth, starting in 1999 and ending at the end of 2003. In cooperation with two disability care residential institutions, a conceptual approach and method to the questions of sexual self-determination and sexualized violence is being developed. Through qualitative methods of research e.g. focus groups, professional helpers of all hierarchies of the institution, including management, and the residents themselves, all had the chance to contribute their own opinions and experiences to the research topic. Specifically, to ensure their voice was heard, the people with mental retardation had an important impact on the questionnaire themselves. All aspects of sexuality were discussed--with notable difficulty arising in particular over the subject of sexual violence. It turned out that nonverbal communication and the interaction between the group members in the residents group were most indicative of their concerns. The staff at the nursing and living areas discussed the following topics: distance and closeness in the interaction between staff and residents, standards, reflections of their own professional attitudes, questions of legality as well as the tense topic of individual needs and tasks of the group. How those questioned described their solutions and ways of coping, and the impressions of the researchers forms the starting point for the compiled work. The initial ideas for the topics and the design of the concept are now laid out.

Adolescent↗
PubMedDate not supplied

[Substance abuse and psychiatric disorders in homeless youth].

In contrast to other countries as USA, Australia and some European countries there are no German studies concerning psychiatric disorders in runaway and homeless children and adolescents. Although the presence of street youths faces a big problem, there is a deficit of empirical data among this group for the planning of more efficient differential programming. In this pilot study we investigated male and female street adolescents among ICD-10 respectively DSM-IV criteria. The goal of this study was to build gender-specific hypotheses and to investigate the applicability and practicability of the standardised diagnostic instruments assessing psychiatric and substance-related disorders.

Adolescent↗
PubMedDate not supplied

[Impulsiveness in children with hyperkinetic syndrome].

As research on impulsive behaviour in hyperactive children has been rather neglected, this study first measured impulsivity using several instruments and then compared the outcomes. 31 boys with ADHD participated in this study as well as an equal sized male control group (mean age 9;4 years). Each subject completed two computerised tests of impulsivity: the Delay of Gratification Test (DGT) as well as the Continuous Performance Test (CPT). Additionally, the boy's impulsive behaviour was rated by two questionnaires for teachers (the Teacher Report Form, TRF, and the Conners Teacher Rating Scale, CTRS). Apart from impulsive behaviour the motor activity was measured, as the classification systems ICD-10 and DSM-IV differ on the concepts of "impulsivity" and "hyperactivity". The assessment was undertaken using a radar-actometer in order to find an association between "impulsivity" and "hyperactivity". As expected, there was a significant difference between the two groups concerning impulsive behaviour and motor activity. As opposed to that result, the correlations of the several instruments that measure impulsive behaviour were not constantly significant. The impulsivity-item on the CTRS is not associated with the CPT and correlates moderate significantly with the DGT. These results led to the development of a model that includes the construct of "impulsivity" as separate dimension of ADHD.

Aggression↗
PubMedDate not supplied

[School refusal: classification, developmental psychopathology, prognosis and therapeutic approaches].

In many cases the refusal of school is one manifestation of a complex psychiatric disorder. There is an increased comorbidity with depression, phobia and other anxiety disorders. The program of therapy should be conceptualized as multimodal. In general there is no rapid remission of the symptoms. As catamnestic studies proved, long-term consequences should be anticipated concerning the occupational integration as well as further psychiatric morbidity. Triggering and sustainable factors are heterogeneous and there is no typical psychosocial pattern.

Adolescent↗
PubMedDate not supplied

[Between environmental pollution and will of God: concepts regarding illness of Turkish and German girls].

The objective is to investigate whether there are differences between German girls and Turkish girls who have grown up in Germany regarding control attribution (locus of control) in general and control and causal attribution with regard to illness. 26 German and 39 Turkish girls between 14 and 16 years were interviewed concerning control attribution, using the Locus-of-Control-Scale (LOC) in the modified version of Schepker (1995) and the KKG (Test zu Kontrollüberzeugungen zu Krankheit und Gesundheit, Lohaus u. Schmitt 1989); concerning causes of illness, using open formulated questions and question cards. In the general score on the LOC-Scale the Turkish girls attributed significantly more externally than the German girls. No significant difference could be found in the area of control attribution with regards to health and illness with the KKG. In the interview with open formulated questions only a few differences were found. Significant differences were found when the girls were asked about individual causes of illness with the question cards and the possibility to rate them: German girls estimated causes in the area of "environment/weather/air" as significantly more important (median: German 4.5 vs. Turkish 3), while Turkish girls emphasized "supernatural powers" (median: German 1 vs. Turkish 4). In comparison only one girl mentioned the area of "supernatural power" in the open interview as a cause. In studies and in clinical interviews, causes in the areas of "supernatural powers" and "environment/weather/air" should be specifically mentioned; and the possibility to rate possible causes also seems to be advisable.

Adolescent↗