Widerstandskraft im Alter: Mit Resilienz gesund alt werden

Resilienz als psychologisches Konzept ist die seelische Widerstandskraft zur Aufrechterhaltung oder Ruckgewinnung der psychischen Gesundheit wahrend oder nach widrigen Lebensumstanden. In der Resilienzforschung konzentrierte man sich lange auf die Erforschung der Entstehung und Behandlung von bereits vorliegenden Erkrankungen. Mit der Deklaration „Health for all“ (1978) der Weltgesundheitsorganisation und Antonovskys Konzept der Salutogenese (1979) vollzog sich ein grundlegender Perspektivenwechsel. Nicht nur die Frage, was den Menschen krank macht (Pathogenese), sondern insbesondere die Frage, was gesund halt (Salutogense) steht heute im Mittelpunkt der Arbeit. Die Resilienzforschung ist d…

Corrigendum to "Intervention studies to foster resilience - A systematic review and proposal for a resilience framework in future intervention studies" [Clinical Psychology Review 59 (2018) 78-100].

Randomized controlled study of early medication change for non-improvers to antidepressant therapy in major depression – The EMC trial

Patients with Major Depressive Disorder (MDD) and no improvement after two weeks of antidepressant pharmacotherapy have a high risk of treatment failure. The aim of the study was to determine whether an early medication change (EMC) strategy is superior to a guideline-based treatment in MDD patients without improvement after two weeks of antidepressant pharmacotherapy. Eight-hundred-and-eighty-nine patients with MDD were enrolled, 879 patients received the SSRI escitalopram. Of those, 192 patients had no improvement, defined as a reduction of < 20% on the Hamilton Depression Rating Scale (HAMD-17) after 14 days of treatment, and were randomly assigned to open treatment with the EMC strategy…

EPA-0703 – Performance of the hamilton depression rating subscales to predict antidepressant treatment response in the early course of treatment

Early improvement ( EI ), i.e. a symptom reduction from baseline of at least 20% after 2 weeks, has been proven to be a clinically useful predictor for later treatment outcome. In most studies EI is identified by using the sum score of the Hamilton Depression Rating Scale (HAMD). Several unidimensional subscales of the HAMD exist, which have proven to be an economic measure of treatment change. Their ability to detect onset of improvement in comparison to the full HAMD has not been researched yet. The present study investigated in patients with major depression (MD) (1) whether the HAMD subscales are a valid and economic option to predict antidepressant treatment response in the early cours…

Psychological interventions for resilience enhancement in adults

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the effects of resilience‐enhancing interventions in clinical and non‐clinical populations.

Interventionen zur Resilienzförderung bei Erwachsenen

ZusammenfassungResilienz bezeichnet die Aufrechterhaltung bzw. rasche Wiederherstellung der psychischen Gesundheit während oder nach stressvollen Lebensumständen. Aktuelle Forschungsergebnisse legen nahe, dass Resilienz dynamisch ist und trainiert werden kann. Obwohl Interventionen zur Stärkung der Resilienz häufig zur Gesundheitsförderung bei verschiedenen Zielgruppen eingesetzt werden, ist deren Effektivität jedoch kaum systematisch untersucht. Diese Übersichtsarbeit beurteilt narrativ die Ergebnisse 4 systematischer Reviews und Metaanalysen zu Resilienzinterventionen bei Erwachsenen und fasst die Evidenz aus den randomisiert-kontrollierten Primärstudien (N=44) zusammen. Insgesamt erzielt…

Psychological interventions to foster resilience in healthcare professionals.

Background Resilience can be defined as the maintenance or quick recovery of mental health during or after periods of stressor exposure, which may result from a potentially traumatising event, challenging life circumstances, a critical life transition phase, or physical illness. Healthcare professionals, such as nurses, physicians, psychologists and social workers, are exposed to various work-related stressors (e.g. patient care, time pressure, administration) and are at increased risk of developing mental disorders. This population may benefit from resilience-promoting training programmes. Objectives To assess the effects of interventions to foster resilience in healthcare professionals, t…

Early improvement of executive test performance during antidepressant treatment predicts treatment outcome in patients with Major Depressive Disorder

Executive dysfunctions frequently occur in patients with Major Depressive Disorder and have been shown to improve during effective antidepressant treatment. However, the time course of improvement and its relationship to treatment outcome is unknown. The aim of the study was to assess the test performance and clinical outcome by repetitive assessments of executive test procedures during antidepressant treatment. Executive test performance was assessed in 209 –patients with Major Depressive Disorder (mean age 39.3 ± 11.4 years) and 84 healthy controls five times in biweekly intervals from baseline to week 8. Patients were treated by a defined treatment algorithm within the early medication c…

Population-based validation of a German version of the Brief Resilience Scale.

Smith and colleagues developed the Brief Resilience Scale (BRS) to assess the individual ability to recover from stress despite significant adversity. This study aimed to validate the German version of the BRS. We used data from a population-based (sample 1: n = 1.481) and a representative (sample 2: n = 1.128) sample of participants from the German general population (age ≥ 18) to assess reliability and validity. Confirmatory factor analyses (CFA) were conducted to compare one- and two-factorial models from previous studies with a method-factor model which especially accounts for the wording of the items. Reliability was analyzed. Convergent validity was measured by correlating BRS scores …

Early improvement is a predictor of treatment outcome in patients with mild major, minor or subsyndromal depression

Abstract Background There is substantial evidence that early improvement (EI) under antidepressant treatment is a clinically useful predictor of later treatment outcome in patients with major depressive disorders. The aim of this study was to test whether EI can also be used as a predictor for treatment outcome in patients with mild major, minor or subsyndromal depression, i.e. patients, who are typically treated by general practitioners. Methods Analyses were carried out using data from 223 patients of a 10-weeks randomized, placebo-controlled trial comparing the effectiveness of sertraline and cognitive-behavioural therapy (CBT) in patients with mild major, minor or subsyndromal depressio…

Mental health and psychosocial support strategies in highly contagious emerging disease outbreaks of substantial public concern: A systematic scoping review.

Background Acute disease outbreaks such as the COVID-19 pandemic cause a high burden of psychological distress in people worldwide. Interventions to enable people to better cope with such distress should be based on the best available evidence. We therefore performed a scoping review to systematically identify and summarize the available literature of interventions that target the distress of people in the face of highly contagious disease outbreaks. Methods MEDLINE, Cochrane CENTRAL, Web of Science (January 2000 to May 7, 2020), and reference lists were systematically searched and screened by two independent reviewers. Quantitative and qualitative studies investigating the effects of psyc…

P-491 - Sensitivity to changes during antidepressant treatment: a comparison of unidimensional depression rating scales in patients with minor depression

In the efficacy evaluation of antidepressant treatments the total score of the Hamilton Depression Rating Scale (HAMD) is still regarded as the’gold standard’. Studies suggest that unidimensional subscales of the HAMD, which capture the core depressive symptoms, outperform the full HAMD regarding the detection of antidepressant treatment effects. The present study compared several unidimensional subscales of the HAMD and the Inventory of Depressive Symptomatology (IDS) regarding their sensitivity to changes in depression symptoms in a sample of patients with minor depression (MIND). Biweekly IDS-C28 and HAMD17 data from 287 patients of a 10-week randomised, placebo-controlled trial comparin…

Psychological interventions to foster resilience in healthcare students

Background Resilience can be defined as maintaining or regaining mental health during or after significant adversities such as a potentially traumatising event, challenging life circumstances, a critical life transition or physical illness. Healthcare students, such as medical, nursing, psychology and social work students, are exposed to various study- and work-related stressors, the latter particularly during later phases of health professional education. They are at increased risk of developing symptoms of burnout or mental disorders. This population may benefit from resilience-promoting training programmes. Objectives To assess the effects of interventions to foster resilience in healthc…

Intervention studies to foster resilience – A systematic review and proposal for a resilience framework in future intervention studies

Psychological resilience refers to the phenomenon that many people are able to adapt to the challenges of life and maintain mental health despite exposure to adversity. This has stimulated research on training programs to foster psychological resilience. We evaluated concepts, methods and designs of 43 randomized controlled trials published between 1979 and 2014 which assessed the efficacy of such training programs and propose standards for future intervention research based on recent developments in the field. We found that concepts, methods and designs in current resilience intervention studies are of limited use to properly assess efficacy of interventions to foster resilience. Major pro…