1
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Teismann T, Forkmann T, Glaesmer H, Alpers GW, Brakemeier EL, Brockmeyer T, Christiansen H, Fehm L, Glombiewski J, Heider J, Hermann A, Hoyer J, Kaiser T, Klucken T, Lincoln TM, Lutz W, Margraf J, Pedersen A, Renneberg B, Rubel J, Rudolph A, Schöttke H, Schwartz B, Stark R, Velten J, Willutzki U, Wilz G, In-Albon T. Prevalence of suicidal ideation in German psychotherapy outpatients: A large multicenter assessment. J Affect Disord 2024; 351:971-976. [PMID: 38346649 DOI: 10.1016/j.jad.2024.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 01/30/2024] [Accepted: 02/07/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Suicidal ideation is a major concern in clinical practice. Yet, little is known about prevalence rates of suicidal ideation in patients undergoing outpatient psychotherapeutic treatment. Therefore, the aim of the current study is to assess the prevalence of suicidal ideation in a large sample of psychotherapy outpatients in Germany. The data analyzed in this study is taken from the KODAP-project on the coordination of data collection and analysis at German university-based research and training outpatient clinics for psychotherapy. METHODS A total of N = 10,357 adult outpatients (64.4 % female; age: M(SD) = 35.94 (13.54), range: 18-92 years of age) starting cognitive-behavioral therapy at one of 27 outpatient clinics in Germany were included in the current study. Prevalence of suicidal ideation was assessed with the Suicide Item (Item 9) of the Beck-Depression Inventory II. RESULTS Suicidal ideation was reported by 36.7 % (n = 3795) of the participants. Borderline Personality Disorder, Posttraumatic Stress Disorder, and recurrent Major Depression were the diagnoses most strongly associated with the presence and severity of suicidal ideation. LIMITATION Suicide ideation was assessed only with the respective item of the Beck Depression Inventory II. CONCLUSION Suicidal ideation is very common among adult patients who start psychotherapy in Germany. A well-founded knowledge of risk assessment in suicidal patients and suicide-specific treatment options is therefore highly relevant.
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Affiliation(s)
- T Teismann
- Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum, Germany.
| | - T Forkmann
- Clinical Psychology and Psychotherapy, Universität Duisburg-Essen, Germany.
| | - H Glaesmer
- Medical Psychology and Medical Sociology, Universität Leipzig, Germany.
| | - G W Alpers
- Otto Selz Institute & Department of Psychology, School of Social Sciences, University of Mannheim, Germany.
| | - E L Brakemeier
- Clinical Psychology and Psychotherapy, Universität Greifswald, Germany.
| | - T Brockmeyer
- Clinical Psychology and Psychotherapy, University of Goettingen, Germany.
| | - H Christiansen
- Clinical Child and Adolescent Psychology, Philipps-Universität Marburg, Germany.
| | - L Fehm
- Institute for Psychology, Humboldt-Universität zu Berlin, Germany.
| | - J Glombiewski
- Clinical Psychology and Psychotherapy of Adulthood, University of Kaiserslautern-Landau, Germany.
| | - J Heider
- Clinical Psychology and Psychotherapy of Adulthood, University of Kaiserslautern-Landau, Germany.
| | - A Hermann
- Psychotherapy and Systems Neuroscience, Justus Liebig University Giessen, Germany.
| | - J Hoyer
- Faculty of Psychology, Technische Universität Dresden, Germany.
| | - T Kaiser
- Methods and Evaluation/Quality Assurance, Freie Universität Berlin, Germany.
| | - T Klucken
- Clinical Psychology and Psychotherapy, Universität Siegen, Germany.
| | - T M Lincoln
- Clinical Psychology and Psychotherapy, Universität Hamburg, Germany.
| | - W Lutz
- Clinical Psychology and Psychotherapy, Universität Trier, Germany.
| | - J Margraf
- Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum, Germany
| | - A Pedersen
- Clinical Psychology and Psychotherapy, Kiel University, Germany.
| | - B Renneberg
- Clinical Psychology and Psychotherapy, Freie Universität Berlin, Germany.
| | - J Rubel
- Clinical Psychology and Psychotherapy of Adulthood, Universität Osnabrück, Germany.
| | - A Rudolph
- Clinical Psychology and Psychotherapy, Universität Leipzig, Germany.
| | - H Schöttke
- Clinical Psychology and Psychotherapy, Universität Osnabrück, Germany.
| | - B Schwartz
- Clinical Psychology and Psychotherapy, Universität Trier, Germany.
| | - R Stark
- Psychotherapy and Systems Neuroscience, Justus Liebig University Giessen, Germany.
| | - J Velten
- Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum, Germany
| | - U Willutzki
- Clinical Psychology and Psychotherapy, Faculty of Health, University Witten/Herdecke, Germany.
| | - G Wilz
- Counseling and Clinical Intervention, Department of Psychology, Friedrich-Schiller Universität Jena.
| | - T In-Albon
- Clinical Child and Adolescent Psychology and Psychotherapy, University of Kaiserslautern-, Landau, Germany.
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Zülke A, Röhr S, Schroeter M, Witte VA, Hinz A, Glaesmer H, Engel C, Zachariae S, Enzenbach C, Zeynalova S, Löffler M, Villringer A, Riedel-Heller SG. Early retirement and depressive symptoms – results from the population-based LIFE-Adult-Study. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- A Zülke
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Universität Leipzig
| | - S Röhr
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Universität Leipzig
| | - M Schroeter
- Max-Planck-Institut für Kognitions- und Neurowissenschaften
- Tagesklinik für kognitive Neurologie, Universitätsklinikum Leipzig
| | - VA Witte
- Max-Planck-Institut für Kognitions- und Neurowissenschaften
| | - A Hinz
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig
| | - H Glaesmer
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig
| | - C Engel
- Institut für Medizinische Informatik, Statistik und Epidemiologie, Universität Leipzig
| | - S Zachariae
- Institut für Medizinische Informatik, Statistik und Epidemiologie, Universität Leipzig
| | - C Enzenbach
- Institut für Medizinische Informatik, Statistik und Epidemiologie, Universität Leipzig
| | - S Zeynalova
- Institut für Medizinische Informatik, Statistik und Epidemiologie, Universität Leipzig
| | - M Löffler
- Institut für Medizinische Informatik, Statistik und Epidemiologie, Universität Leipzig
| | - A Villringer
- Max-Planck-Institut für Kognitions- und Neurowissenschaften
- Tagesklinik für kognitive Neurologie, Universitätsklinikum Leipzig
| | - SG Riedel-Heller
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Universität Leipzig
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Fleischer T, Ulke C, Speerforck S, Gfesser T, Mühlan H, Glaesmer H, Fegert JM, Zenger M, Ladwig KH, Beutel ME, Brähler E, Schomerus G. East vs. West: Differences in the prevalence of child maltreatment in Germany before the reunification. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- T Fleischer
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald
| | - C Ulke
- Department of Psychiatry and Psychotherapy, Leipzig University Medical Center
| | - S Speerforck
- Department of Psychiatry and Psychotherapy, Leipzig University Medical Center
| | - T Gfesser
- Department of Psychiatry and Psychotherapy, Leipzig University Medical Center
| | - H Mühlan
- Health & Prevention, Institute of Psychology, University of Greifswald
| | - H Glaesmer
- Department of Medical Psychology and Medical Sociology, University of Leipzig
| | - JM Fegert
- Department for Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm
| | - M Zenger
- Faculty of Applied Human Studies, University of Applied Sciences Magdeburg and Stendal
| | - K-H Ladwig
- Institute of Epidemiology, Helmholtz Center Munich, German Research Center for Environmental Health, Neuherberg
| | - ME Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz
| | - E Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz
| | - G Schomerus
- Department of Psychiatry and Psychotherapy, Leipzig University Medical Center
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4
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Lucht L, Höller I, Forkmann T, Teismann T, Schönfelder A, Rath D, Paashaus L, Stengler K, Juckel G, Glaesmer H. Validation of the motivational phase of the integrated motivational-volitional model of suicidal behavior in a German high-risk sample. J Affect Disord 2020; 274:871-879. [PMID: 32664028 DOI: 10.1016/j.jad.2020.05.079] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 04/26/2020] [Accepted: 05/14/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND The Integrated Motivational-Volitional (IMV) model of suicidal behavior proposes in its motivational phase that perceptions of defeat and entrapment (total, internal and external entrapment) lead to the development of suicidal ideation and that thwarted belongingness and perceived burdensomeness moderate this process. The aim of this study was to test the motivational phase of the IMV model cross-sectionally in a German sample of psychiatric inpatients. METHODS A total of 308 psychiatric inpatients (53% female) aged 18 to 81 years (M = 36.92, SD = 14.30) were included in the study and investigated within 14 days after psychiatric admission due to suicide attempt (53%) or acute suicidal crisis (47%). Statistical analyses included a mediation analysis and moderation analyses. RESULTS Results demonstrate a simple mediation of defeat via entrapment (total, internal and external entrapment) on suicidal ideation. The interaction between thwarted belongingness and perceived burdensomeness was confirmed as a motivational moderator. LIMITATIONS Limiting factors of the present study are the cross-sectional design and the retrospective assessment of suicidal ideation. CONCLUSION The main assumptions of the motivational phase of the IMV model could empirically be confirmed. Perceptions of defeat, internal and external entrapment, thwarted belongingness, and perceived burdensomeness should be taken into account with regard to prevention, risk assessment and interventions of suicidal ideation and attempts. However, future investigations based on prospective data are warranted.
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Affiliation(s)
- L Lucht
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, Leipzig 04103, Germany.
| | - I Höller
- Department of Clinical Psychology, University of Duisburg-Essen, Duisburg, Germany
| | - T Forkmann
- Department of Clinical Psychology, University of Duisburg-Essen, Duisburg, Germany
| | - T Teismann
- Mental Health Research and Treatment Center, Department of Psychology, Ruhr-University Bochum, Bochum, Germany
| | - A Schönfelder
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, Leipzig 04103, Germany
| | - D Rath
- Department of Clinical Psychology, University of Duisburg-Essen, Duisburg, Germany
| | - L Paashaus
- Department of Clinical Psychology, University of Duisburg-Essen, Duisburg, Germany
| | - K Stengler
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Helios Park Hospital Leipzig, Leipzig, Germany
| | - G Juckel
- Research Department of Neuroscience, Ruhr-University of Bochum, Bochum, Germany
| | - H Glaesmer
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, Leipzig 04103, Germany
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5
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Glaesmer H, Braehler E, Gündel H, Riedel-Heller S. FC01-05 - The association of traumatic experiences and posttraumatic stress disorder with physical morbidity in old age - a german population based study. Eur Psychiatry 2020. [DOI: 10.1016/s0924-9338(11)73518-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
ObjectiveTo examine the relationship of traumatic experiences and PTSD among a representative population sample of 1,456 German elderly (60 years and above). Several studies have suggested that PTSD, but also traumatic experiences are related to adverse health outcomes. However, many past studies are based on selected samples like combat veterans, or survivors of natural disasters. To our knowledge this is the first representative population study in the elderly.MethodsBased on self-report data and using regression analyses, we investigated the association of traumatic experiences and PTSD with several medical conditions.ResultsTraumatized subjects had a significantly increased risk for all the medical conditions under study compared to those participants without a traumatic exposure (OR = 1.37 for hypertension up to 5.12 (CI = 2.25–11.6) for cancer). There are significant associations of current PTSD with cardiovascular diseases (Angina pectoris/coronary artery disease; congestive heart failure, peripheral vascular disease) and cardiovascular risk factors (hypertension, elevated cholesterol) (OR = 1.94 for peripheral vascular disease up to 3.76 for elevated cholesterol), as well as with asthma, cancer, back pain, hard of hearing, osteoporosis, stomach problems and thyroid disorders.ConclusionsOur study delivers additional evidence for the association of traumatic stress and PTSD with impaired physical health in a general population sample in the German elderly. It underpins the importance of traumatic experiences and PTSD not only for mental health, but also for physical health as a long-term consequence.
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6
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Treudler R, Zeynalova S, Riedel-Heller SG, Zuelke AE, Roehr S, Hinz A, Glaesmer H, Kage P, Loeffler M, Simon JC. Depression, anxiety and quality of life in subjects with atopic eczema in a population-based cross-sectional study in Germany. J Eur Acad Dermatol Venereol 2020; 34:810-816. [PMID: 31838777 DOI: 10.1111/jdv.16148] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 12/04/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Atopic eczema (AE) may be associated with several mental health problems. In Germany, existing data from selected patient cohorts may lead to misestimation of the problem. OBJECTIVES We aimed to cross-sectionally determine associations of AE with depression, anxiety, quality of life (QoL) and social interactions in subjects from the population-based LIFE-Adult-Study. METHODS Subjects underwent standardized interviews (medical history) and answered standardized questionnaires [Centre of Epidemiologic studies-Depression scale (CES-D), Generalized Anxiety Disorder (GAD-7), Lubben Social Network Scale (LSNS), Short Form Health Survey (SF-8)]. We compared data from subjects with AE with those from subjects with selected other chronic/disabling diseases (cardiovascular, diabetes, cancer) and adjusted for selected sociodemographic parameters. Multivariate binary logistic regression was used for categorical variables, linear regression for continuous variables. RESULTS Out of 9104 adults included (57% female, median age 54 years), 372 (4.1%) had a history of AE. Compared with controls, subjects with AE showed higher scores for depressive symptoms (9.3% vs. 6.3%; P < 0.001) and anxiety (8.4% vs. 5.6%, P < 0.001). Odds ratio (OR) was 1.5 [CI 1.0; 2.3] (P = 0.031) for depression, which was comparable to OR in patients with a history of cancer (OR 1.6 [1-2.3], P = 0.001. OR for anxiety in AE was 1.5 [1.0; 2.2], P < 0.049, which was slightly higher than in diabetes mellitus (OR 1.2) and stroke (OR 1.4). Other than in diabetes and/or stroke, we did not find a significant association between AE and social isolation. QoL scores were lower in AE than in controls (mean 46.9 vs. 48.0, P < 0.001 for physical and 50.6 vs. 52.5, P < 0.001 for mental components). CONCLUSIONS Subjects with AE showed higher values for depression and anxiety as well as lower QoL scores compared to controls. With regard to depression, odds in AE and cancer were hardly different. Medical care of AE patients should therefore include mental health evaluation and treatment if indicated.
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Affiliation(s)
- R Treudler
- Department of Dermatology, Venerology and Allergology, UMC Leipzig, Leipzig, Germany.,LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - S Zeynalova
- LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Institute for Medical Informatics, Statistics and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany
| | - S G Riedel-Heller
- Institute of Social Medicine, Occupational Medicine, and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - A E Zuelke
- Institute of Social Medicine, Occupational Medicine, and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - S Roehr
- Institute of Social Medicine, Occupational Medicine, and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - A Hinz
- LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - H Glaesmer
- LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - P Kage
- Department of Dermatology, Venerology and Allergology, UMC Leipzig, Leipzig, Germany
| | - M Loeffler
- LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Institute for Medical Informatics, Statistics and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany
| | - J C Simon
- Department of Dermatology, Venerology and Allergology, UMC Leipzig, Leipzig, Germany.,LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany
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7
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Hallensleben N, Glaesmer H, Forkmann T, Rath D, Strauss M, Kersting A, Spangenberg L. Predicting suicidal ideation by interpersonal variables, hopelessness and depression in real-time. An ecological momentary assessment study in psychiatric inpatients with depression. Eur Psychiatry 2018; 56:43-50. [PMID: 30530103 DOI: 10.1016/j.eurpsy.2018.11.003] [Citation(s) in RCA: 94] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 11/08/2018] [Accepted: 11/09/2018] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVE To extend evidence on the short-term variability of passive and active suicidal ideation (SI) and the association with suggested proximal risk factors such as interpersonal variables (perceived burdensomeness [PB], thwarted belongingness [TB], hopelessness, and depression) in real-time. METHODS This is an observational study using a prospective design applying ecological momentary assessments (EMA). Eligible for study inclusion were inpatients with unipolar depression, current or lifetime suicidal ideation, and fluent German. Over six days, 74 participants rated their momentary level of passive and active SI, PB, TB, depressiveness, and hopelessness up to 10 times per day on smartphones. Data was collected from August 2015 to July 2017. Compliance was excellent (89.7%). RESULTS Mean squared successive differences supported temporal instability for all variables. According intra-class correlations, between 25% and 47% of variance was accounted for by within-person variability. Multilevel analysis demonstrated significant positive associations between hopelessness, depressiveness, PB, and TB with passive SI. Prospectively, hopelessness and PB remained predictors of passive SI. For active SI, hopelessness, depression, PB, and TB were significantly associated cross-sectionally. Prospectively, hopelessness, PB, and the interaction PBxTB predicted active SI. All models were controlled for previous level of SI. CONCLUSIONS This study provides further evidence on the short-term variability of SI in very short time frames implying the need of assessing SI repeatedly in clinical and research settings. The associations between interpersonal variables and passive and active SI were only partial in line with assumptions of the Interpersonal Theory of Suicide. Overall, the effects were small warranting further investigation.
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Affiliation(s)
- N Hallensleben
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Germany
| | - H Glaesmer
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Germany
| | - T Forkmann
- Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen University, Germany; Department of Clinical Psychology, University of Duisburg-Essen, Germany
| | - D Rath
- Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen University, Germany
| | - M Strauss
- Department of Psychiatry, University of Leipzig, Germany
| | - A Kersting
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Germany
| | - L Spangenberg
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Germany.
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Schönfelder A, Forkmann T, Teismann T, Rath D, Paashaus L, Glaesmer H. Welchen Einfluss haben Missbrauchserfahrungen in der Kindheit auf die Capability for Suicide? Psychother Psychosom Med Psychol 2018. [DOI: 10.1055/s-0038-1667948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- A Schönfelder
- Universitätsmedizin Leipzig, Abteilung für Medizinische Psychologie und Medizinische Soziologie, Leipzig, Deutschland
| | - T Forkmann
- Universitätsklinikum Aachen, Institut für Medizinische Psychologie und Medizinische Soziologie, Aachen, Deutschland
| | - T Teismann
- Ruhr Universität Bochum, Fakultät für Psychologie, Arbeitseinheit Klinische Psychologie und Psychotherapie, Bochum, Deutschland
| | - D Rath
- Universitätsklinikum Aachen, Institut für Medizinische Psychologie und Medizinische Soziologie, Aachen, Deutschland
| | - L Paashaus
- Ruhr Universität Bochum, Fakultät für Psychologie, Arbeitseinheit Klinische Psychologie und Psychotherapie, Bochum, Deutschland
| | - H Glaesmer
- Universitätsmedizin Leipzig, Abteilung für Medizinische Psychologie und Medizinische Soziologie, Leipzig, Deutschland
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9
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Esser P, Glaesmer H, Wittchen HU, Faller H, Koch U, Härter M, Schulz H, Wegscheider K, Weis J, Mehnert A. Posttraumatische Belastungsstörung bei Krebspatienten: Ergebnisse einer epidemiologischen Studie aus Deutschland. Psychother Psychosom Med Psychol 2018. [DOI: 10.1055/s-0038-1667921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- P Esser
- Universitätsmedizin Leipzig, Medizinische Psychologie und Medizinische Soziologie, Leipzig, Deutschland
| | - H Glaesmer
- Universitätsmedizin Leipzig, Medizinische Psychologie und Medizinische Soziologie, Leipzig, Deutschland
| | | | | | | | | | | | | | | | - A Mehnert
- Universitätsmedizin Leipzig, Medizinische Psychologie und Medizinische Soziologie, Leipzig, Deutschland
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10
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Spangenberg L, Hallensleben N, Forkmann T, Rath D, Hegerl U, Kersting A, Glaesmer H. Die Vorhersage von Suizidgedanken: Ergebnisse einer Echtzeitanalyse bei stationären Patienten mit Depression. Psychother Psychosom Med Psychol 2018. [DOI: 10.1055/s-0038-1667949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- L Spangenberg
- Universitätsmedizin Leipzig, Abteilung für Medizinische Psychologie und Medizinische Soziologie, Leipzig, Deutschland
| | - N Hallensleben
- Universitätsmedizin Leipzig, Abteilung für Medizinische Psychologie und Medizinische Soziologie, Leipzig, Deutschland
| | - T Forkmann
- Universitätsklinikum Aachen, Institut für Medizinische Psychologie und Medizinische Soziologie, Aachen, Deutschland
| | - D Rath
- Universitätsklinikum Aachen, Institut für Medizinische Psychologie und Medizinische Soziologie, Aachen, Deutschland
| | - U Hegerl
- Universitätsklinikum Leipzig Klinik und Poliklinik für Psychiatrie und Psychotherapie, Leipzig, Deutschland
| | - A Kersting
- Universitätsklinikum Leipzig, Klinik für Psychosomatische Medizin und Psychotherapie, Leipzig, Deutschland
| | - H Glaesmer
- Universitätsmedizin Leipzig, Abteilung für Medizinische Psychologie und Medizinische Soziologie, Leipzig, Deutschland
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Drixler K, Glaesmer H, Brähler E, Morfeld M, Wirtz MA. Validierung der Messung der gesundheitsbezogene Lebensqualität mittels des SF-12 Version 2.0 in einer deutschen Normstichprobe. Das Gesundheitswesen 2018. [DOI: 10.1055/s-0038-1667798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- K Drixler
- Pädagogische Hochschule Freiburg, Public Health & Health Education, Freiburg, Deutschland
| | - H Glaesmer
- Universitätsklinikum Leipzig, Abteilung für Medizinische Psychologie und Medizinische Soziologie, Leipzig, Deutschland
| | - E Brähler
- Universitätsklinikum Leipzig, Abteilung für Medizinische Psychologie und Medizinische Soziologie, Leipzig, Deutschland
- Universitätsmedizin der Johannes-Gutenberg-Universität, Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Mainz, Deutschland
| | - M Morfeld
- Universitätsklinikum Leipzig, Abteilung für Medizinische Psychologie und Medizinische Soziologie, Leipzig, Deutschland
- Hochschule Magdeburg-Stendal/Standort Stendal, Angewandte Humanwissenschaften, Stendal, Deutschland
| | - MA Wirtz
- Pädagogische Hochschule Freiburg, Institut für Psychologie, Freiburg, Deutschland
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12
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Glaesmer H, Schwerdtfeger K, Spangenberg L, Bahramsoltani M. Depressivität und Suizidalität bei Tiermedizinern in Deutschland im Vergleich mit der deutschen Bevölkerung. Psychother Psychosom Med Psychol 2018. [DOI: 10.1055/s-0038-1667950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- H Glaesmer
- Universitätsmedizin Leipzig, Abteilung für Medizinische Psychologie und Medizinische Soziologie, Leipzig, Deutschland
| | | | - L Spangenberg
- Universitätsmedizin Leipzig, Abteilung für Medizinische Psychologie und Medizinische Soziologie, Leipzig, Deutschland
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Abstract
SummaryObjective: Self-report data is increasingly gathered by electronic devices. The present study aimed at testing usability and patient acceptance of two administration modes (tablet vs. paper-pencil) in primary care patients _ 60 years. Material and methods: Two depression instruments were administered using a randomized crossover design (n = 193). Results: Patients positively evaluated the usability of the tablet (clear presentation, well manageable). Additionally, the majority of patients preferred the tablet over the paper-pencil mode (more suitable, less stressful and difficult). Tablet mode and increasing age were associated with increased response time. Age, somatic morbidity and formal education showed only weak associations with usability and acceptance. Conclusion: Socio-demographic variables such as increasing age and formal education and somatic morbidity do not lead to limitations of use. Clinical relevance: The study demonstrates high usability and acceptance of depression assessment by tablets in elderly patients.
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Kaiser M, Glaesmer H. TRAJECTORIES OF TRAUMA-RELATED DISORDERS ACROSS THE LIFE-SPAN: EVIDENCE AND CLINICAL IMPLICATIONS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- M. Kaiser
- Medical Psychology and Medical Sociology, Leipzig University, Leipzig, Germany
| | - H. Glaesmer
- Medical Psychology and Medical Sociology, Leipzig University, Leipzig, Germany
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Kuwert P, Hornung S, Freyberger H, Glaesmer H, Klauer T. [Trauma and posttraumatic stress symptoms in patients in German primary care settings]. Nervenarzt 2016; 86:807-17. [PMID: 26105160 DOI: 10.1007/s00115-014-4236-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Primary care settings have an important gatekeeping function to detect mental diseases, including trauma and posttraumatic stress disorders. OBJECTIVES To assess the prevalence of trauma and posttraumatic symptoms in a first sample of northeast German primary care patients and to evaluate the diagnostic sensitivity and specificity of the general practitioners. MATERIAL AND METHODS Traumatic experiences and posttraumatic stress disorders (PTSD) were assessed with self-rating questionnaires in a sample of N = 400 patients from 3 primary care facilities. Additionally, knowledge and diagnostic accuracy of the general practitioners were evaluated. RESULTS According to the results of the patient health questionnaire (PHQ-15) data from all patients, the majority of patients questioned showed slight to moderate stress from somatic symptoms. Of the patients with complete data 7 % (n = 25) had a complete PTSD according to the results of the questionnaire, which was also identified in the medical assessment with a sensitivity of 40 %. The stress resulting from posttraumatic symptoms was closely associated with the extent of somatic complaints. CONCLUSION Patients with a history of trauma and posttraumatic symptoms are prevalent in primary care settings. An early diagnosis by the general practitioner can help patients to receive adequate treatment. Patients with somatoform disorders in particular should be screened for trauma and posttraumatic symptoms.
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Affiliation(s)
- P Kuwert
- Abteilung für Psychosomatische Medizin und Psychotherapie, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsmedizin Greifswald am Helios Hanseklinikum Stralsund, Rostocker Chaussee 70, 18437, Stralsund, Deutschland,
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Ullrich S, Briel D, Nesterko Y, Hiemisch A, Brähler E, Glaesmer H. Verständigung mit Patienten und Eltern mit Migrationshintergrund in der stationären allgemeinpädiatrischen Versorgung. Gesundheitswesen 2016; 78:209-14. [DOI: 10.1055/s-0042-102341] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- S. Ullrich
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum Leipzig AöR
| | - D. Briel
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum Leipzig AöR
| | - Y. Nesterko
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum Leipzig AöR
| | - A. Hiemisch
- Department für Frauen und Kindermedizin, Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Leipzig AöR
| | - E. Brähler
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum Leipzig AöR
| | - H. Glaesmer
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum Leipzig AöR
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Doering BK, Nestoriuc Y, Barsky AJ, Glaesmer H, Brähler E, Rief W. Is somatosensory amplification a risk factor for an increased report of side effects? Reference data from the German general population. J Psychosom Res 2015; 79:492-7. [PMID: 26553385 DOI: 10.1016/j.jpsychores.2015.10.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Revised: 10/23/2015] [Accepted: 10/28/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The study investigates the association between somatosensory amplification and the reporting of side effects. It establishes a German version of the Somatosensory Amplification Scale and examines its psychometric properties in a representative sample of the German population. METHODS Sample size was 2.469, with 51% taking any medication. Participants answered the Somatosensory Amplification Scale, Generic Assessment of Side Effects Scale, and indicated whether they were taking any medication and the type of medication. Correlational analysis and binary logistic regression were performed. RESULTS When examining a subsample reporting both medication intake and general bodily symptoms, participants higher in somatosensory amplification rated more of their general bodily symptoms as medication-attributed side effects. However, somatosensory amplification scores were not associated with the intake of any type of medication. In the overall sample, higher somatosensory amplification scores were associated with an increased report of bodily symptoms. Additionally, participants with higher somatosensory amplification reported intake of a greater number of different medications. The psychometric properties of the translated scale were good, and previously established associations of somatosensory amplification with demographic variables (age, sex) were replicated. CONCLUSION Results suggest a possible attributional bias concomitant to somatosensory amplification which in turn may increase the reporting of side effects after medication intake.
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Affiliation(s)
- B K Doering
- Department of Psychology, University of Marburg, Germany.
| | - Y Nestoriuc
- Institute of Psychology, University of Hamburg, Germany
| | - A J Barsky
- Department of Psychiatry, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - H Glaesmer
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Germany
| | - E Brähler
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Germany; University Medical Center of the Johannes Gutenberg University Mainz, Clinic for Psychosomatic Medicine and Psychotherapy, Mainz, Germany
| | - W Rief
- Department of Psychology, University of Marburg, Germany
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Kerper LF, Spies CD, Buspavanich P, Balzer F, Salz AL, Tafelski S, Lau A, Weiß-Gerlach E, Neumann T, Glaesmer H, Wernecke KD, Brähler E, Krampe H. Preoperative depression and hospital length of stay in surgical patients. Minerva Anestesiol 2014; 80:984-991. [PMID: 24280816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND The association of depression and hospital length of stay (LOS) has rarely been examined in surgical patients outside of cardiovascular surgery. This study investigates whether clinically significant preoperative depression shows an independent association with LOS in patients from various surgical fields after adjusting for age, gender and important somatic factors. METHODS A total of 2624 surgical patients were included in this prospective observational study. Data were collected before the preoperative anesthesiological examination within a computer-assisted psychosocial self-assessment including screening for depression (Center for Epidemiologic Studies Depression Scale, CES-D). Data on peri- and postoperative somatic parameters were obtained from the electronic patient management system of the hospital six months after the preoperative assessment. RESULTS LOS of patients with clinically significant depression (N.=296; median: 5 days, interquartile range: 3-8 days) was longer than LOS of patients without depression (N.=2328; median: 4 days, interquartile range: 2-6 days) (P<0.001). A multivariate logistic regression model with the binary dependent variable 'above versus below or equal to the median LOS' revealed that the significant association between depression and LOS persisted (OR: 1.822 [95% CI 1.360-2.441], P<0.001) when simultaneously including the covariates age, gender, ASA classification, Charlson Comorbidity Index, surgical field and POSSUM operative severity rating. CONCLUSION Data suggest that the association of depression and LOS is independent of the impact of age, gender, surgical field, preoperative physical health, severity of medical comorbidity and extent of surgical procedure. Integration of depression therapy into routine care of surgical patients might be an option to improve outcomes.
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Affiliation(s)
- L F Kerper
- Department of Anesthesiology and Intensive Care Medicine, Campus Charité Mitte and Campus Virchow-Klinikum, Charité - University Medicine Berlin, Germany -
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Spangenberg L, Glaesmer H, Brähler E, Strauß B. [Use of family resources in future need of care. Care preferences and expected willingness of providing care among relatives: a population-based study]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2013; 55:954-60. [PMID: 22842889 DOI: 10.1007/s00103-012-1512-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The family is an important resource in elderly care. It is of great interest if persons who might be in need of care in the future would use this resource. Our study assessed wishes and expectations regarding family care in a representative sample of the general population (≥ 45 years, N = 1,445) using questionnaires. Logistic regressions were performed to analyze the potential impact on the willingness to use or provide family care. One quarter of the participants reported experience in family care. In case of own need 62.9% of participants would prefer care provided by relatives and 56.7% would prefer professional care. Participants are more likely to use family care if they report having relatives, are experienced in care of relatives or do not associate old age with being a burden, e.g. report low values in the image of age "being a burden/demanding". Perceived willingness of the relatives to provide care is more likely if there is little regional distance to the relatives, in male participants and if participants talked about future care with their relatives. Besides structural factors, negative images of old age might have a negative influence on the willingness to use family care. Talking about care in old age seems to have a positive impact.
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Affiliation(s)
- L Spangenberg
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Deutschland.
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Engelberg PM, Singer S, Bhaskaran K, Brähler E, Glaesmer H. Validation of the Scale for the Assessment of Illness Behavior (SAIB) in a community sample of elderly people. Arch Gerontol Geriatr 2013; 56:175-80. [PMID: 22878062 DOI: 10.1016/j.archger.2012.07.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Revised: 07/08/2012] [Accepted: 07/14/2012] [Indexed: 11/24/2022]
Abstract
The aim of this study was to evaluate the construct validity of the SAIB in a community sample of elderly people. The SAIB was administered to a large community sample representative of the German population aged 60-85 years (n=1593). The original model was assessed and then refined through confirmatory and exploratory factor analyses. Criterion validity was evaluated by comparing SAIB scores with external criteria in 3 categories: subjective health, chronic illness and health care utilization. The originally suggested five factor structure of the SAIB yielded a comparative fit index (CFI) of 0.70 and the weighted root mean square residual (WRMR) was 3.68. A shortened questionnaire with 13 items and four factors resulted in better model fit (CFI 0.97 and WRMR 1.3). Correlations between subjective health and the new scales ranged from 0.06 to 0.33. Effect sizes (Cohens d) of mean differences in factor scores between those with and without healthcare system contact varied by healthcare type, ranging from 0.05 to 0.94; effect sizes were largest in relation to contact with psychotherapy and alternative medicine practitioners. We propose a shortened version of the SAIB with a different scale structure, which resulted in better model fit with our data. Neither the original nor revised SAIB appeared to discriminate well in terms of health care use, suggesting that the illness behavior as currently conceptualized may not fully explain the increased use of healthcare in the elderly.
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Affiliation(s)
- P M Engelberg
- Department of Methods and Psychodiagnostics, University of Wuppertal, Germany.
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Noll-Hussong M, Glaesmer H, Herberger S, Bernardy K, Schönfeldt-Lecuona C, Lukas A, Guendel H, Nikolaus T. The grapes of war. Somatoform pain disorder and history of early war traumatization in older people. Z Gerontol Geriatr 2012; 45:404-10. [PMID: 22782661 DOI: 10.1007/s00391-012-0303-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Persistent pain is not a normal part of aging. Nevertheless, many older patients have long-lasting, more or less medically unexplained pain symptoms and, consequently, are often severely disabled, incur high health care costs, and have high comorbidity rates. Moreover, the effects of early traumatization, especially due to wars, and even below the level of posttraumatic stress disorder (PTSD) are apparent. However, the developmental and neurobiological underpinnings of somatoform pain disorder, especially in pain-prone elderly patients, and its correlations with a history of war traumatization even decades after the incident remain unclear. Furthermore, a management strategy for this disorder tailored to older people and their special needs is lacking. Adequate therapeutic regimens such as adjusted psychotherapeutic procedures for elderly patients can only be promoted through a better understanding of the neurobiological and biographical underpinnings of this still controversial disorder.
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Affiliation(s)
- M Noll-Hussong
- Klinik und Poliklinik fuer Psychosomatische Medizin und Psychotherapie, University of Ulm, Am Hochstr. 8, 89081, Ulm, Germany.
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Sikorski C, Riedel C, Kaiser M, Pantenburg B, Glaesmer H, Schomerus G, Brähler E, Riedel-Heller SG. Attitudes towards and Perception of Overweight and Obesity in the Public Opinion: a systematic review. Gesundheitswesen 2011. [DOI: 10.1055/s-0031-1283632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Norra C, Böcker M, Wirtz M, Glaesmer H, Brähler E, Gauggel S, Forkmann T. The new rasch-based depression screening (DESC): Evaluation and validation in different patient groups and a large German population sample. Eur Psychiatry 2011. [DOI: 10.1016/s0924-9338(11)72371-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
IntroductionComorbid depression in somatic illness is highly prevalent. However, most depression questionnaires show violation of unidimensionality and hypersensitivity of items.ObjectivesThe Depression Screening (DESC) is a new self-rating scale for the measurement of depression severity that we developed from a calibrated Rasch-homogeneous item bank (N = 367) to improve short depression assessment in patients beyond psychiatric settings.AimTo present data for both parallel forms (10 questions each) of the DESC, and to examine its Rasch model qualities in different patient groups and a representative German general population sample.MethodsPatient groups with depression, heart disease, neurological or otolaryngological disease (N = 333) were investigated with the DESC accompanied by diagnostic interviews and established depression scales. The demographic sample (N = 2509) was interviewed face to face, too. Adherence to Rasch model assumptions was determined with analysis of model fit, and further measures. Norm values were calculated.ResultsBoth DESC versions feature different but highly correlated item sets. Cut-off scores with good sensitivity (0.82, 0.81) and specificity (0.78, 0.77) for the diagnosis of an affective disorder were developed with ROC analyses. No serious Differential Item Functioning in Rasch analyses for both scales was found. In the German validation sample the Rasch dimension “depression” explained 68.5% and 69.3% respectively of the variance. Validity was determined through sufficient intercorrelations with other scales (e.g. BDI, HADS).ConclusionsOur studies support the good psychometric RASCH qualities of both DESC forms and offer important advancements in depression screening being of use for time-limited clinical and research applications.
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Brähler E, Glaesmer H, Kuwert P. Spätfolgen von Ausbombung, Vertreibung und Kriegserfahrungen–Ergebnisse einer repräsentativen Befragung. Psychother Psych Med 2009. [DOI: 10.1055/s-0029-1208170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Krannich M, Glaesmer H, Glaesmer H, Brähler E, Mewes R, Martin A, Rief W. Wie beeinflussen Somatoforme Beschwerden die Lebenszufriedenheit der Betroffenen? – Ergebnisse einer bevölkerungsrepräsentativen Befragung. Psychother Psychosom Med Psychol 2008. [DOI: 10.1055/s-2008-1061534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Böhler S, Scharnagl H, Freisinger F, Stojakovic T, Glaesmer H, Klotsche J, Pieper L, Pittrow D, Kirch W, Schneider H, Stalla GK, Lehnert H, Zeiher AM, Silber S, Koch U, Ruf G, März W, Wittchen HU. Unmet needs in the diagnosis and treatment of dyslipidemia in the primary care setting in Germany. Atherosclerosis 2007; 190:397-407. [PMID: 16546194 DOI: 10.1016/j.atherosclerosis.2006.02.025] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2005] [Revised: 01/26/2006] [Accepted: 02/02/2006] [Indexed: 11/17/2022]
Abstract
OBJECTIVES AND METHODS DETECT is a cross-sectional study of 55,518 unselected consecutive patients in 3188 representative primary care offices in Germany. In a random subset of 7519 patients, an extensive standardized laboratory program was undertaken. The study investigated the prevalence of cardiovascular disease, known risk factors (such as diabetes, hypertension and dyslipidemia and their co-morbid manifestation), as well as treatment patterns. The present analysis of the DETECT laboratory dataset focused on the prevalence and treatment of dyslipidemia in primary medical care in Germany. Coronary artery disease (CAD), risk categories and LDL-C target achievement rates were determined in the subset of 6815 patients according to the National Cholesterol Education Program (NCEP) ATP III Guidelines. RESULTS Of all patients, 54.3% had dyslipidemia. Only 54.4% of the NCEP-classified dyslipidemic patients were diagnosed as 'dyslipidemic' by their physicians. Only 27% of all dyslipidemic patients (and 40.7% of the recognized dyslipidemic patients) were treated with lipid-lowering medications, and 11.1% of all dyslipidemic patients (41.4% of the patients treated with lipid-lowering drugs) achieved their LDL-C treatment goals. In conclusion, 80.3% of patients in the sample with dyslipidemia went undiagnosed, un-treated or under-treated.
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Affiliation(s)
- S Böhler
- Institute for Clinical Psychology and Psychotherapy, Technical University of Dresden, Germany.
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Böhler S, Pittrow D, Pieper L, Klotsche J, Huppertz E, Stridde E, Jacobi F, Glaesmer H, Lehnert H, Wittchen HU. Diabetes mellitus in der primärärztlichen Versorgung: Häufigkeit von mikro- und makrovaskulären Komplikationen – Ergebnisse der DETECT Studie. DIABETOL STOFFWECHS 2006. [DOI: 10.1055/s-2006-944040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Wittchen HU, Pieper L, Glaesmer H, Böhler S, Pittrow D, Klotsche J, Jacobi F, Stalla GK, Schneider HJ, Lehnert H. Body Mass Index und abdominelle Fettleibigkeit bei diabetischen und nichtdiabetischen Hausarztpatienten: Ergebnisse der DETECT Studie. DIABETOL STOFFWECHS 2006. [DOI: 10.1055/s-2006-943883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Pieper L, Pittrow D, Böhler S, Stridde E, Huppertz E, Klotsche J, Jacobi F, Glaesmer H, Lehnert H, Wittchen HU. Prävalenz und Therapie des Diabetes mellitus in der primärärztlichen Versorgung: Ergebnisse der DETECT Studie. DIABETOL STOFFWECHS 2006. [DOI: 10.1055/s-2006-944067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Pittrow D, Glaesmer H, Pieper L, Huppertz E, Stridde E, Klotsche J, Böhler S, Jacobi F, Lehnert H, Wittchen HU. Werden Frauen mit Diabetes mellitus anders versorgt als Männer? – Ergebnisse der DETECT Studie. DIABETOL STOFFWECHS 2006. [DOI: 10.1055/s-2006-943889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Pittrow D, Huppertz E, Pieper L, Böhler S, Stridde E, Klotsche J, Jacobi F, Glaesmer H, Lehnert H, Wittchen HU. Diabetes mellitus in der primärärztlichen Versorgung: HbA1c-Werte in Abhängigkeit von Geschlecht, Alter und Diabetesdauer – Ergebnisse der DETECT Studie. DIABETOL STOFFWECHS 2006. [DOI: 10.1055/s-2006-943898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Pieper L, Wittchen HU, Glaesmer H, Klotsche J, März W, Stalla G, Lehnert H, Zeiher AM, Silber S, Koch U, Böhler S, Pittrow D, Ruf G. Kardiovaskuläre Hochrisikokonstellationen in der primärärztlichen Versorgung. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2005; 48:1374-82. [PMID: 16283123 DOI: 10.1007/s00103-005-1164-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
DETECT is a nationwide epidemiological cross-sectional and longitudinal study program in a random probability sample of 3,795 primary care settings (response rate: 60.2%). Based on a target day total assessment of n=55,518 consecutive patients (RR 93.5%) in these settings all patients underwent standardized diagnostic assessment, using self-reporting, clinical interview and laboratory measures. DETECT aims at describing the point prevalence and comorbidity of coronary heart disease (CHD), hyperlipidaemia, arterial hypertension and diabetes mellitus and at identifying the behavioural, clinical, laboratory and psychological risk factors associated with these conditions. A random subset of patients (n=7,519) also completed an extensive standardized laboratory screening program and a 12-month follow-up investigation. Findings reveal a high prevalence of hypertension (36.3%), dyslipidaemia (29.1%), diabetes mellitus (14.6%) and CHD (12.4%) in primary care as well as their close association among each other. The study describes for the first time in greater detail the prevalence of specific disorders and the frequency of high-risk constellations in primary care and allows for the evaluation of various risk scores.
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Affiliation(s)
- L Pieper
- Institut für Klinische Psychologie und Psychotherapie, Technische Universität Dresden, Germany
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Wittchen HU, Glaesmer H, März W, Stalla G, Lehnert H, Zeiher AM, Silber S, Koch U, Böhler S, Pittrow D, Ruf G. Cardiovascular risk factors in primary care: methods and baseline prevalence rates--the DETECT program. Curr Med Res Opin 2005; 21:619-30. [PMID: 15899112 DOI: 10.1185/030079905x38187] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES DETECT is an epidemiological study in primary care to examine (a) the prevalence rates and comorbidity of diabetes mellitus, hypertension, hyperlipidaemia and coronary heart disease (CHD), and associated conditions; (b) the frequency of behavioural and clinical risk factors for onset and progression; (c) the 12-month course and outcome; and (d) the met and unmet needs for these patients. METHODS Three-stage, cross-sectional clinical-epidemiological study with a prospective-longitudinal component in a nationally representative sample of N = 3795 primary care settings [response rate (RR): 60.2%] and N = 55518 patients (RR: 95.5%). Patients completed a standardized assessment, including questionnaires for patients and the physician and diagnostic screening measures (i.e. blood pressure, heart rate, body mass index and waist circumference assessments). A subsample of patients (N = 7519) also completed a standardized laboratory screening program and was followed-up after 12 months. Data were weighted to adjust for non-response, regional distribution and attrition. RESULTS (1) Doctors and patients sample can be regarded as representative for primary care settings in Germany. (2) The clinician-rated point prevalence of hypertension is highest (35.5%), followed by hyperlipidaemia (29.1%), diabetes (14.1%) and CHD (12.1%); prevalence rates of each disorder as well as their co-incidence rates increase markedly with age. (3) The vast majority (78%) of all patients revealed multiple (3+) behavioural and clinical risk factors. CONCLUSION The findings of DETECT underline the considerable burden for primary care doctors in managing a highly morbid patient population, with predominantly complex risk factor constellations, in routine care. Our data provide, in unprecedented detail, a basis for calculating age-, gender- and risk-group-adjusted risk-factor profiles in routine care.
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Affiliation(s)
- H-U Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technical University of Dresden, Germany.
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Stojakovic T, Schanagl H, Freisingen F, Tiran A, Pittrow D, Glaesmer H, Boehler S, Ruf G, März W, Wittchen H. T03-P-020 Routine care treatment of type 2 diabetes in germany (Detect study). ATHEROSCLEROSIS SUPP 2005. [DOI: 10.1016/s1567-5688(05)80588-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Bayer A, Klose M, Glaesmer H, Klotsche J, Pittrow D, Wittchen HU. Determinanten der Qualität der Glukosestoffwechselseinstellung in der primärärztlichen Diabetesversorgung. Gesundheitswesen 2004. [DOI: 10.1055/s-2004-833986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Glaesmer H, Bayer A, Klotsche J, Pittrow D, Lehnert H, Wittchen HU. Depressivität, Depression und Diabetes mellitus in der primärärztlichen Versorgung – Relevanz für das klinische Management? Gesundheitswesen 2004. [DOI: 10.1055/s-2004-833794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Küpper B, Krause P, Glaesmer H, Wittchen HU. Wie unterscheiden sich Risikopatienten mit Übergewicht/Adipositas in ihrem Gesundheitswissen und Verhalten von normalgewichtigen Patienten? Gesundheitswesen 2004; 66:361-9. [PMID: 15206039 DOI: 10.1055/s-2004-813226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES AND METHODS Individual health-related behaviour patterns and lifestyles are strongly associated with the risk of suffering from cardiovascular diseases. Overweight (BMI 25 to 30 kg/m(2)) and obese patients (BMI > or = 30 kg/m(2)) are at particular risk to develop these diseases. Therefore, we investigated whether these patients are more aware of health-related issues and problems than normal-weight patient with data from the HYDRA study on 45,000 subjects. RESULTS Health knowledge, problem awareness and health behaviour differed significantly among the examined patient groups (normal weight/overweight/obesity). The overweight and obese patients were aware of potential risk factors for various diseases (e. g. hypertension, diabetes); they recognized their own health-related problems and attended courses to change their problematic health behaviours more frequently. According to the patients' evaluations, however, these offers of courses are not very helpful. CONCLUSION Changing the contents and implementations of health courses seems necessary to decrease costs and improve quality in the health care system on a long-term basis.
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Affiliation(s)
- B Küpper
- Institut für Klinische Psychologie und Psychotherapie, Technische Universität Dresden.
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Glaesmer H, Künstler J, Reuter W. [Improvement of functional deficits, physical mobility and cognitive function by treatment in a geriatric day hospital]. Z Gerontol Geriatr 2004; 36:475-83. [PMID: 14685737 DOI: 10.1007/s00391-003-0151-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2003] [Accepted: 03/11/2003] [Indexed: 11/30/2022]
Abstract
OBJECTIVES AND METHODS Several studies showed the efficacy of inpatient geriatric treatment. Different outcomes were reported for geriatric patients treated in outpatient facilities. To analyze the course of rehabilitation, 312 patients (62.2% female) with a mean age of 77.2 years (SD = 7.4) in a geriatric day hospital were evaluated regarding a) changes of functional deficits and mobility, b) cognitive function and c) depression. Patients were examined with a geriatric assessment including activities of daily living, Tinetti, Timed-up and go, Mini Mental State Examination (MMSE), Clock Completion Test, Handgrip Strength-Test, Money-Counting Test and Geriatric Depression Scale (GDS) at admission and discharge. RESULTS All examined parameters had changed significantly after treatment. A clear decrease in the portion of patients with disability-related outcomes in the examined parameters (Barthel Index, Tinetti, Timed-up and go, MMSE, GDS) was demonstrated: a) the proportion of patients with a Barthel Index under 75 had decreased by 26.5%, the proportion of patients with an increased risk of falls was reduced by 27%, b) the proportion of patients with a MMSE Score less than 24 was decreased by 14.8% and c) mild effects were achieved in depression. CONCLUSIONS Day hospital geriatric treatment leads to an improvement of functional deficits, mobility and mental health of patients. The results contrast to other studies in day hospital treatment.
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Affiliation(s)
- H Glaesmer
- August-Bebel-Str. 59, 04275 Leipzig, Germany.
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Böhler S, Glaesmer H, Pittrow D, Lehnert H, Stalla GK, Zeiher AM, März W, Silber S, Wehling M, Ruf G, Reinecke A, Wittchen HU. Diabetes and Cardiovascular Risk Evaluation and Management in Primary Care: Progress and Unresolved Issues. Exp Clin Endocrinol Diabetes 2004; 112:157-70. [PMID: 15127318 DOI: 10.1055/s-2004-817927] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This review highlights established and more recently recognized risk factors for coronary heart disease (CHD) relevant for patients seen in primary care, emphasizing the key role of diabetes mellitus type 2. Recent trends in risk factor research as well as current methods of risk stratification, and new systemic markers are discussed. Beyond the need for more forceful public health strategies to improve early recognition and intervention, the necessity of an integrated comprehensive investigation of the overall characteristics of cardiovascular disease, especially in primary care patients as a prerequisite for future concerted actions is pointed out. Based on this, a large-scale epidemiological investigation focusing on CHD and diabetes in the primary care sector is suggested.
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Affiliation(s)
- S Böhler
- Institute of Clinical Psychology and Psychotherapy, Technical University of Dresden, Dresden, Germany
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Scharnagl H, Freisinger F, Tiran A, Stojakovic T, Pittrow D, Glaesmer H, Boehler S, Ruf G, Maerz W, Wittchen H. M.648 The gap between treatment guidelines and routine care treatment patterns in the management of high risk patients: Findings from the detect study. ATHEROSCLEROSIS SUPP 2004. [DOI: 10.1016/s1567-5688(04)90646-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
OBJECTIVES AND METHODS In connection with the increasing importance of chronic diseases the estimation of the prevalence of overweight and obesity becomes more and more important. Today these estimations are usually done via the Body-Mass-Index (BMI). For economic reasons BMI is often obtained by means of questionnaires or interviews. These (subjective) BMI-data show great differences to measured (objective) data. The differences between subjective and objective data and their dependence on age, gender and residence were investigated. RESULTS Subjective and objective data show significant differences. On the basis of subjective data too many persons classify themselves as underweight or normal weighted and fewer persons classify themselves as overweight and obese. Variance analysis shows significant influences of gender and age. Women underestimate their BMI more than men. With increasing age the differences also increase. CONCLUSIONS The estimation of BMI based on subjective data is inaccurate. In this way the prevalence of obesity and overweight are underestimated. That is why subjective data are not useful for clinical and epidemiological research, but it is interesting against the background of health psychology.
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Affiliation(s)
- H Glaesmer
- Graduiertenkolleg "Kostengünstige und bedarfsgerechte Versorgung im Gesundheitswesen" der TU, FU und HU Berlin.
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