0000000000255561
AUTHOR
Sven Olaf Hoffmann
Die neurotische Depression - Eine Krankheit ohne Diagnose oder eine Diagnose ohne Glossar?/ Neurotic depression – a disease without a diagnosis or a diagnosis without a glossary?
With the transition from ICD-9 to ICD-10 the diagnosis of neurotic depression was omitted. Freyberger showed that this diagnosis in the ICD-10 was replaced mainly by the diagnoses of dysthymia, recurrent depression and depressive episode (with this ranking of frequency). A renowned German psychiatrist criticized this change as replacing an unsubstantiated dichotomic with an unsubstantiated dimensional model. The same was the case with the change from DSM-II to DSM-III: Torgersen criticized here that the heterogeneous diagnosis of neurotic depression was basically replaced by the similarly heterogeneous diagnosis of major depression. The underlying rationale behind the omission of the tradit…
A New Approach To The Identification Of Cognitive Conflicts In The Repertory Grid: An Illustrative Case Study
Abstract The concept of cognitive conflicts and its relation to the success of psychoanalytically oriented psychotherapy are discussed. According to this model of therapy, patients should achieve insight into their conscious as well as unconscious conflicts. Therefore in the present study we assumed that demonstrable cognitive changes would occur over treatment for chronic pain, as measured by Kelly's (1955) Repertory Grid Test. Grids were analyzed with regard to conflicts on the basis of the concept of unbalanced triads. A triad may be described as unbalanced when logical inconsistencies can be demonstrated on the basis of a correlative comparison of three corresponding construct pairs. Co…
Psychodynamische Psychotherapie bei chronischem Schmerz
Basis einer psychodynamischen Psychotherapie chronischer Schmerzpatienten sind zunachst eine umfangreiche Diagnostik und Differenzialdiagnostik, insbesondere auch hinsichtlich der Erfassung atiopathogenetisch bedeutsamer Faktoren. Daruber hinaus steht zu Beginn aktueller Behandlungskonzepte die Vorbereitung des Patienten auf die Behandlung durch Informationen zum Krankheitsbild, Erfassung seines subjektiven Krankheitsmodells, seiner Behandlungserwartung und die Motivationsprufung bzw. —forderung im Vordergrund. Insbesondere bei Patienten mit somatoformer Schmerzstorung konzentriert sich die Behandlung inhaltlich auf den kommunikativen Aspekt der Symptomatik und eine zunehmende Schmerz-Affek…
Eine vergleichende Untersuchung zum Reizdarmsyndrom bei konsekutiven Patienten zweier internistischer Ambulanzen
OBJECTIVES We investigated the nature of illness behavior and the meaning of emotional deficiencies during childhood in patients with irritable bowel diseases (IBS). DATA A consecutive study in two tertiary referral centers was conducted with 48 patients suffering from irritable bowel diseases (IBS) and 91 patients with inflammatory bowel disease (IBD). METHODS The diagnosis of IBS was made by following the Manning criteria, a positive diagnosis of IBD was established through physical, endoscopic and radiologic examinations and was confirmed histologically. Psychological data were obtained by structured psychiatric interviews and psychological self-report measures (GBB). RESULTS We found th…
Wie einheitlich ist die psychodynamisch/psychoanalytisch-orientierte Psychotherapie?
Psychodynamische Psychotherapie bezeichnet Therapieformen, deren gemeinsames Merkmal der Bezug zur psychoanalytischen Theorie ist. Es wird versucht, Kennzeichen einer ubergreifenden psychodynamischen Therapie zu bestimmen – soweit dies bei der weitgespannten theoretischen und klinischen Vielfalt moglich ist. Die beiden Grundpositionen der konfliktorientierten versus supportiven psychodynamischen Therapie reichen in die „Allgemeine Psychotherapie” hinein. Trotz der Notwendigkeit eines gemeinsamen bio-psycho-sozialen psychotherapeutischen Handlungsrahmens wird die Moglichkeit einer „Allgemeinen Psychotherapie” kritisch beleuchtet.
Psychosoziale Risiko- und Schutzfaktoren in Kindheit und Jugend als Prädisposition für psychische Störungen im Erwachsenenalter
Longitudinal and well-controlled cross-sectional studies have shown that numerous psychosocial stress factors in childhood and youth affect psychic health in the long term. The significance of compensatory protective factors has also been well documented in various studies. An overview of this work is presented: the factors which need to be clarified and taken into consideration in the diagnosis of psychic disorders have been summarized and critically analyzed on the basis of the results of more recent studies of the significance of sexual traumatization.
Quality of Life and Health in Patients with Urinary Diversion: A Comparison of Incontinent versus Continent Urinary Diversion
Objective: To compare the quality of life and health in patients with incontinent and continent urinary diversions, in correlation with the initial diagnosis, diversion-related symptoms, psychological status and employment status. Materials and Methods: 81 patients (64% male and 36% female) with a mean age of 55 years (18-65 years) were included in this retrospective study. A total of 27 had an incontinent urinary diversion (group A) and 54 a continent diversion (group B). The initial diagnosis was malignant tumor in 75% (n = 61) and nontumor disease in 25% (n = 20). A structured interview and psychometric instrument assessment of the quality of life as well as somatic and psychological sym…
Stationäre verhaltenstherapeutisch-psychodynamische Kombinationsbehandlung
In der Psychosomatischen Klinik des Mainzer Universitatsklinikums werden Patienten bestimmter Diagnosegruppen mit einer Kombination aus psychodynamischen und verhaltenstherapeutischen Therapiekonzepten behandelt. Diese modellhafte Kombination beider Verfahren wird bei Patienten mit Zwangsstorungen und Angststorungen angewendet und im folgenden am Beispiel eines Patienten mit einer Agoraphobie und einer narzistischen sowie selbstunsicher-abhangigen Personlichkeitsstorung beschrieben. Das Behandlungskonzept beruht auf der Annahme, das zumindest eine Subgruppe von Patienten von einer Kombinationsbehandlung mehr profitiert als von einem der genannten Therapieverfahren alleine. Auf der Ebene der…
Impaired Health-Related Quality of Life in Inflammatory Bowel Diseases Psychosocial Impact and Coping Styles in a National German Sample
The purpose of this study is to give a detailed survey of the disease-specific and generic quality of life (HRQOL) of adult patients suffering from inflammatory bowel disease (IBD) in Germany.1322 patients suffering from IBD were examined in a cross-sectional study. A questionnaire assessing disease-specific and generic quality of life, coping, and hopelessness was sent to members of the German Crohn/Colitis association.Compared to the general population, the generic HRQOL in IBD patients is significantly reduced. Active coping has a negative influence on patients' generic physical HRQOL during an active phase (beta = -0.31), while this association is not present in the case of patients in …
Fragebogen zur Messung der psychosozialen Belastungen bei chronisch-entzündlichen Darmerkrankungen (FBCED): Konstruktion und Evaluation
The "Inflammatory Bowel Disease Stress Inventory (IBD-SI)" measures a broad spectrum of disease-specific every day stress factors in patients with inflammatory bowel disease (IBD). Based on a multistage factor analysis on 300 CED patients, the final form comprises 32 items assigned to 8 different domains: depressed mood, doctor-patient relationship, anxiety about loss of bowel control, occupational impairment, worries about deteriovation, stress from medical treatment, impairment of sexuality/partnership and physical complaints. In addition, a global stress score can be obtained. The reliability values of the 8 subscales with 4 items each indicate a good internal consistency (alpha = 0.76 -…
Pelvic Exenteration: Effects of Surgery on Quality of Life and Body Image—A Prospective Longitudinal Study
Abstract Objectives. The goal of this study was to evaluate the impact of reconstructive and nonreconstructive surgical procedures on quality of life and body image for women who undergo pelvic exenteration. Methods. Twenty-eight patients were assessed in a prospective study with a preoperative semistructured interview and an objective assessment (T1). Interviews and questionnaires were repeated 4 (T2) and 12 (T3) months postoperatively. The women were divided into groups with two, one, or no ostomies. A separate comparison was made of women with and without vaginal capacity. Quality of life was defined in terms of five categories according to the definition of health proposed by the World …
Vom Sinn des Verfahrenskonzepts und der Verfahrensvielfalt – und warum das Baukasten-System in der Psychotherapie nicht funktioniert
Why the concept of distinct psychotherapeutic approaches is indispensable - and why the tool box concept of psychotherapy cannot work Background: In Germany, the official psychotherapy guidelines are oriented towards the model of distinct psychotherapeutic approaches. Within the German health care system this also applies to the training in psychotherapy. Some critics, however, are presently pleading in favour of abolishing the model of distinct psychotherapeutic approaches, which also implies to abolish the concept of the so called "Richtlinienverfahren" in Germany - approaches of psychotherapy which proved to be efficacious and whose costs are reimbursed by the insurance companies. Object…
„Phobischer Schwankschwindel”
Due to the results of an interdisciplinary study on patients with vertigo as the chief symptom and on the background of psychodynamic theories concerning anxiety disorders the term of phobic postural vertigo (Brandt & Dieterich 1986) is discussed. It becomes obvious that phobic postural vertigo is a generalizing term which encompasses different forms of psychogenic vertigo. The authors plead for a more differentiated diagnosis and subgroup oriented classification of vertigo caused by psychiatric disorders.
Risikofaktoren und protektive Faktoren f�r die Neurosenentstehung
Eine erste Ubersicht zu Risikofaktoren und protektiven Faktoren in der biographischen Entwicklung fur spatere psychische und psychosomatische Erkrankungen im Erwachsenenalter wird vorgestellt. Offene Fragen in bezug auf die Datenerhebung sowie deren Gewichtung und Evaluation werden angesprochen.
Prevalence of psychiatric disorders in an onset cohort of adults with type 1 diabetes
Previous studies indicate a high prevalence of psychiatric disorders in adults with type 1 diabetes mellitus. The aim of our study was to determine if newly diagnosed adults with type 1 diabetes already have an elevated rate of psychiatric disorders at the beginning of their physical illness.The authors consecutively recruited 313 newly diagnosed, adult inpatients with type 1 diabetes (age 17-40 years) from 12 hospitals. A national, representative population sample of 2046 persons of a similar age range served as the reference group. Psychiatric disorders were measured in both groups using structured interviews that provided diagnoses according to DSM-IV.There was a point prevalence of 12.5…