Biomedical subjects

Armin Hartmann

Publications and source records attributed to Armin Hartmann.

7 recordsLinked to original sources

PubMed2005

Psychotherapy in a day clinic: results of a 1.5 year follow-up.

OBJECTIVE: In a prospective, naturalistic 1.5 year follow-up study of N= 114 consecutively admitted day clinic patients efficacy of the program and predictors of outcome are evaluated. METHODS: Patients had severe neurotic disturbances and personality disorders. Interviews and questionnaires (SCL-90-R, EDI) were used for evaluation at admission, discharge and follow-up. RESULTS: From 79.8% of the patients information could be obtained. In the main diagnostic categories between 30 to 50% of the patients showed complete remissions at follow-up. Patients at least kept improvements at follow-up. The rating of the "transition phase" after discharge was predictive for outcome. The group of patients that rated this phase as difficult showed higher levels of psychopathology at admission. CONCLUSIONS: It is possible to treat severely disturbed patients in a psychotherapeutic day clinic with good and lasting effects. A more disturbed group of patients needs special help to cope with the transition into the outpatient situation.

Adaptation, Psychological↗

PubMed2004

[Inter-session-processes].

We do not know much about how patients internalize, remember or use psychotherapeutic experiences between psychotherapy sessions and how they use them for change. What happens with in-session-experiences after a session ("inter-session-process") is of main importance for outcome. The inter-session-process describes the work on psychotherapy between sessions. Although inter-session-processes are a central element connecting psychotherapy process and outcome, they remain a neglected area of research. Previous studies examined individual outpatient settings only. This paper gives an overview over theory, instruments for measurement, previous studies and relevance of inter-session-processes for the field of psychotherapy research.

Humans↗

PubMed2004

Attachment representation and illness behavior in somatoform disorders.

Somatoform disorders are characterized by high health care utilization and conflictual interactions with health care providers. The aim of the present study was to explore whether patterns of insecure attachment are a prominent feature of somatoform disorder. In addition, the links between insecure attachment and health care utilization were evaluated. Thirty-seven patients with an International Classification of Diseases, 10th Revision diagnosis of somatoform disorders and 20 healthy control subjects matched for age, sex, and education were administered the Adult Attachment Interview. Psychological symptoms and health care utilization were assessed using various self-report measures. There was a clearly higher incidence of insecure attachment in the somatoform group compared with the nonclinical control subjects. In the somatoform group, dismissing attachment occurred approximately twice as frequently as the preoccupied pattern of attachment. The results provide evidence for an association between health care utilization and insecure attachment. Insecure attachment in somatoform disorder may underlie problems in interpersonal functioning and in health care behavior.

Adolescent↗

PubMed2004

Rapid generation of detailed loss of heterozygosity profiles for routine diagnosis of gliomas.

Aberrations in the genomes of gliomas seem to correlate well with clinical parameters. Pertinent studies, however, rely on highly sophisticated methods, they require large amounts of high-quality sample material and/or they demand profound analytical expertise. Consequently, molecular tumour analysis has not yet been widely implemented in routine laboratory applications. We have developed an easy-to-perform approach for the rapid derivation of a detailed loss-of-heterozygosity profile from individual gliomas. DNA of PCR quality is extracted in a one-step procedure from routinely obtained material. A microsatellite-based marker set is used to detect the deletion status of genomic regions (i) with established diagnostic relevance, (ii) recurrently found deleted in gliomas, or (iii) generally associated with tumour suppressor activity. The complete profile comprises 25 regions and is generated from 64 markers multiplexed into 18 reactions. Illustratively, we present findings from an anaplastic oligodendroglioma; the molecular data for this tumour allow refined diagnostic and prognostic statements that could not be derived from histology alone. Our approach should prove useful in the routine diagnosis of gliomas. Simultaneously, research data for many highly relevant regions are generated in a comparatively simple and inexpensive way.

DNA, Neoplasm↗

PubMed2003

[The Intersession Questionnaire--an inventory for the measurement of patients' processing of psychotherapy between sessions].

In the intervals between psychotherapy sessions, patients often make use of the experiences that they have during sessions with their therapists, but these "intersession processes" (ISP) have been largely neglected in psychotherapy research. This study presents a German version of the Intersession Experience Questionnaire (IEQ, Orlinsky et al. ) called the Inter-Session-Fragebogen (ISF). The ISF was used to study a total of 3.778 intersession intervals in 249 therapy episodes involving 229 patients. The factor structure of the ISF appears to be stable over therapy (up to 25 or even 50 sessions), and also over therapy settings (outpatient, day clinic, inpatient). Just as in the original American samples, there were evidently cross-culturally invariant factors like "Recreating the therapeutic situation", "Applying therapy," and "Relationship fantasies". The emotional qualities of ISP are assessed by two independent factors, called "Remoralizing emotions" and "Negative emotions" (regarding therapy). Differences between therapy settings are evident concerning intensity and trajectories of the factor scores over time.

Emotions↗

PubMed2002

Psychosocial primary care - what patients expect from their General Practitioners A cross-sectional trial.

BACKGROUND: Psychosocial Primary Care (PPC) is a model of service delivery for patients with mental disorders and psychosocial problems which was established in Germany in 1987. This study was performed as part of the evaluation of a PPC training program. We investigated patients' expectations of the psychosocial treatment offered by GPs trained in PPC. METHODS: Ten general practitioners trained in PPC were randomly selected. Two hundred and twenty patients were surveyed in the waiting room regarding their expectations concerning psychological treatment. RESULTS: Eighty-five per cent of patients could envisage making use of psychosocial treatments. Counselling by the GP was considered most important (65%). Fifty-four per cent of patients indicated that there was sufficient counselling, but further distinctions revealed dissatisfaction with both the extent and content of the counselling. Lack of time was the most frequent reason (53%) cited for insufficient counselling. A willingness to discuss the psychological aspects of illness was exhibited by between 55% (current illness) and 79% of patients. Two-thirds of patients believed that discussing psychological aspects and counselling by the doctor could exert a healing effect or contribute to symptomatic improvement in physical illnesses. Younger patients and patients with experience in psychotherapy expected referral to mental health services. CONCLUSIONS: Primary care patients desire and accept psychological treatment from their GP. Training in psychosocial competence in primary care should be offered more frequently.

Adult↗

PubMed2002

[Partial hospitalisation -- indication and characteristic aspects of the setting, shown by the example of the day clinic in Freiburg/Germany].

Until now, in comparison to psychiatric day clinics, there is only a limited amount of psychotherapeutic day clinics which offer an intense, multimodal treatment on a psychodynamic basis comparable to that of inpatient settings. We present the example of the day clinic in Freiburg to discuss characteristic aspects of the setting and criteria for indication. Preliminary empirical results indicate, that even severely disturbed patients can be adequately treated. The combination of an intense therapy program with the daily involvement in the outside reality has substantial advantages for some groups of patients and eases the transition at discharge.

Day Care, Medical↗