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G Heuft

Publications and source records attributed to G Heuft.

At least 19 recordsLinked to original sources
PubMed2006

[Anxiety and depression after loss of a lower limb].

A good number of psychosocial-, disease-, and disability-related variables influence the adaptation process after the loss of a lower limb. In this case psychological problems, as a result of a failed adaptation process, are common. Of the 75 patients examined who had an amputation of a lower extremity 27% showed increased depression and 25% increased anxiety scores; 18.3% showed higher than normal scores in both categories. Regression analysis showed that in addition to pain reception poor acceptance of the prosthesis is an important predictive factor for the development of psychological disorders and diseases like anxiety and depression. Therefore, measures for psychological diagnostics and care should be initiated soon after the amputation to prevent psychological abnormalities. Here interdisciplinary management and cooperation of the professions involved in the care of the patient are recommended.

Adolescent↗
PubMed2006

Psychological factors in prurigo nodularis in comparison with psoriasis vulgaris: results of a case-control study.

BACKGROUND: It has been suggested that psychological factors such as repressing anger and altruistic interpersonal behaviour may play a role in the aetiology of chronic itching in prurigo nodularis (PN). Whether these issues are specific for PN or are also common in other chronic skin diseases, e.g. psoriasis, has not been investigated until now. OBJECTIVES: To investigate psychosomatic problem areas and psychiatric comorbidity in patients with PN in comparison with patients with psoriasis. METHODS: Ninety-four patients with PN and 91 patients with psoriasis were administered the Hospital Anxiety and Depression Scale, Toronto Alexithymia Scale, State-Trait Anger Expression Inventory, Inventory of Interpersonal Problems, Screening for Somatoform Disorders and the Whiteley Index for hypochondriasis. RESULTS: After Bonferroni post hoc adjustment, the metrical scales demonstrated no significant differences between patients with PN and those with psoriasis. There was only a tendency to less 'anger-out' and to less autocratic/dominant and more insecure/submissive behaviour in the patients with PN. Patients with PN were, in general, comparable with those with psoriasis with regard to alexithymia, somatization symptoms, hypochondriasis, anxiety and depression, with 18% cases of anxiety and 22% cases of depression. CONCLUSIONS: The hypotheses formulated in the literature on the specific aetiology of PN could not be proven for the majority of patients with PN in our study. Concerning their psychopathology, patients with PN were comparable with those with psoriasis. Therefore the clinical management of PN should include psychosomatic assessment.

Adult↗
PubMed2006

Psychosomatic cofactors and psychiatric comorbidity in patients with chronic itch.

BACKGROUND: While psychosomatic factors may be involved in eliciting as well as coping with chronic itch, psychiatric comorbidity often goes unrecognized in dermatological patients. AIM: To record psychiatric illness, psychiatric and psychotherapeutic pretreatment, and psychotherapy indication in dermatology inpatients with pruritus. METHODS: A consecutive sample of 109 dermatology inpatients with the symptom of pruritus were examined by interviews with consecutive ratings by experts (using psychiatric ICD-10 diagnoses, the Global Assessment of Functioning Scale and the Impairment Score) and self-assessment using the the Eppendorf Itch Questionnaire. RESULTS: In > 70% of the pruritus patients, 1-6 psychiatric diagnoses could be demonstrated. In > 60%, psychotherapeutic or psychiatric treatment was recommended. In contrast, almost 90% of the patients had had no previous psychotherapeutic experience. CONCLUSION: As psychiatric comorbidity in dermatology inpatients suffering from chronic itch is high, dermatology departments should aim for an improvement of their psychosomatic consultation and liaison services.

Adult↗
PubMed2004

[Comorbidity of mental and internal medical disorders in inpatients treated at the clinic for technical orthopedics].

Due to the severity of their clinical picture and their shattered sense of physical inviolability that almost always is associated with their condition as well as their changed physical appearance, inpatients being treated at the clinic for technical orthopedics frequently exhibit comorbid mental disorders. This article examines these mental health comorbidities. The proportion of adjustment disorders in this group was shown to be noticeably higher than in a comparative group of outpatients attending a psychosomatic/psychotherapeutic clinic. Furthermore, diabetes mellitus proved to be another statistically significant organic comorbidity in the patients treated at the clinic for technical orthopedics. This article discusses the extent to which the chronicity of this disease affects the psychosomatic diagnoses but also the course of the treatment in the clinic for technical orthopedics. In conclusion, this article emphasizes the need for close interdisciplinary management for this highly selected patient group because of the high rates of comorbidity.

Chi-Square Distribution↗
PubMed2004

[Changes of a sample of aged > or = 60 years of age in-patients after five years: results from the ELDERMEN-Study].

METHOD: The ELDERMEN Study, which was funded by the German Research Association, comprises baseline assessment during 1994-1997 and a second assessment during 2000-2002. A total of 261 in-patients participated in an extensive examination at baseline assessment and were contacted again five years later. RESULTS: Five years after baseline assessment, 135 former participants had deceased, 29 newly fulfilled exclusion criteria. Of the 97 individuals who matched the study's inclusion criteria at the second assessment, 74 participated in the second evaluation. Baseline assessment revealed no significant differences between participants at second assessment and those persons who refused the second participation. However, participants in the extensive examination and longitudinal design were a positive selection when compared to the whole baseline sample. DISCUSSION: Because of increasing morbidity and mortality, longitudinal gerontological studies have to deal with the problem of selective diminishment of the sample, which can endanger the validity and generalizability of results. The problem has to be dealt with by careful documentation and evaluation of selectivity effects. We focus on the problems of longitudinal studies in gerontologic research and examine the longitudinal development of a sample of geriatric in-patients aged > or = 60 years.

Aged↗
PubMed2003

[Diagnosis related groups in psychiatry and psychotherapy--alternatives to DRGs].

Diagnosis related groups (DRGs) will be introduced in Germany in 2003 as a basis for hospital funding in all areas except for psychiatry and psychotherapeutic medicine. The following article provides an overview of the use of alternative casemix-systems in the treatment of patients with mental disorders. Overall, DRGs and alternative systems have proven to be poor predictors of resource consumption due to the high variation in the length of stay and the variable treatment opportunities. Therefore, a DRG-system must include the possibility of coded therapeutic treatments, analogous to the procedures used in surgical DRGs, in order to integrate psychiatry and psychotherapeutic medicine into a DRG-based payment system.

Diagnosis-Related Groups↗
PubMed2003

[The "Sisi syndrome": a new form of depression?].

A new depressive entity called the "Sisi syndrome," named in reference to the former empress of Austria, was introduced by a drug company in 1998. Their advertising campaign presents information about nosology, symptoms, and recommended therapy. We review the relevant literature about this syndrome and are not able to confirm the statements about it. The lack of scientific proof of it as an independent entity of depression stands in contrast to the widespread media coverage in Germany, which was organized by a public relations company. Therefore, we discuss new kinds of marketing strategies ("disease mongering") by drug companies and conclude with some preventive recommendations.

Advertising↗
PubMed2003

[Influence of psychic comorbidity on the treatment process of patients with diabetic foot ulcer].

Until now there are only few studies with small samples dealing with psychosocial aspects of patients with diabetic foot ulcer. The main interest concerns the quality of life of these patients. By reviewing the literature and our own clinical experience, the influence of psychic comorbidity on the treatment process will be demonstrated. Mobility and hospitalization are also related to problems of coping with diabetic foot ulcer and psychosocial problems (e.g., job, partnership, and social support). Therefore, disease management programs for patients with diabetes mellitus types I and II should include psychosomatic-psychotherapeutic diagnostics. The necessity for interdisciplinary work between orthopedics and psychosomatics is discussed.

Adaptation, Psychological↗
PubMed2002

[Resource allocation and justice in distribution of services in medical management of elderly patients].

This paper presents the most important arguments in medical allocation based on an analysis of the relevant literature. The main arguments of rationing scarce medical resources are scrutinized. Especially the use of age limit considerations are critically reviewed. The discussion takes place against a backdrop of aggravating pressure on old people as cost factors. As a basis for further discussion, the authors give a brief history of theories of justice in philosophy. Finally minimum requirements for a constructive and responsible discussion are stated.

Aged↗
PubMed2001

[Coping with illness and psychotherapy for patients after amputation].

Psychology is often neglected or glossed over in most works dealing with the rehabilitation of the amputee. Treating the psychological and social problems faced by the amputee often has more significance for his-satisfaction with life than the quality of the surgery or the nature of his prosthetic device. In the following paper, a complex model for the biopsychosocial adaptation after amputation is presented. In this model, the important diagnostic criteria in interaction with specific individual coping strategies are formulated, which explain the difficult psychosocial adaptation. Professional diagnosis and further indication are necessary on an individual basis. The main goal of every intervention is the psychic stabilization of the patient by taking into account his personal resources. Because of the complex somatic, social, and psychic problems which arise after an amputation, thorough cooperation between specialists is recommended.

Adaptation, Psychological↗
PubMed2001

[Diagnostic control. Psychiatric comorbidity in patients of technical orthopedic units].

Because of the new hospital finance law a DRG (Diagnosis Related Groups) controlled discount liquidation under consideration of the medical impairment becomes necessary. In this paper the importance of a correct and complete description of the psychic comorbidity for the development of German-Refined-DRGs (GR-DRGs) in the orthopedic field is described. Therefore we analysed data of orthopedic in-patients, who are diagnosed by consultation of the clinic for psychosomatics and psychotherapy. A psychic comorbidity (ICD-10 Chapter F (V)) was diagnosed by 95% of the consulted patient. 30% of the patients showed difficulties in coping with their disease. 40% suffered from chronical psychoneurotic patterns and conflicts, which can be explained (a) as consequence of a difficult psychosocial adaptation by chronic disease or after an amputation (b) as basic mental disorders (c) as cause of the orthopaedic complications. Therefore the number of indications for a psychotherapeutic or psychiatric treatment is very high. The knowledge about a psychic comorbidity can--beside financial aspects--help the team on the orthopaedic station in the treatment of difficult patient.

Adaptation, Psychological↗
PubMed2001

[Treatment outcome of inpatient psychosomatic rehabilitation of elderly patients].

Empirical data about the different effects of a specific inpatient psychotherapeutic intervention for elderly patients (over 55 years) are presented in this study. An analysis of sub-units presented four different groups of elderly patients with different psychotherapy effects. Three of four groups showed significant reduced stress in self-rated well-being and depression, only one group had no significant effects one year after the inpatient psychotherapy. Because the patients of this group describes themselves at the beginning of the treatment as "quite normal", significant effects in outcome are hardly to be expected. For a better understanding of this group, other-rated information is necessary. Implications for changing the treatment are discussed.

Aged↗
PubMed1999

[Significance of trauma reactivation in old age].

Psychic symptoms by psychic traumas are fundamentally different from those caused by psychodynamic conflicts or cognitive behavioral conceptualizations. For the purposes of a discriminating psychotraumatology, there is the need to differ traumas by their etiology. Adults suffering not immediately after a specific trauma from a posttraumatic stress disorder (PTSD) can develop a trauma reactivation 30 or more years after the trauma by demands of the somatic process of aging. It is discussed that the possibility of being helpless in the face of the somatic aging process could reactivate the traumatic dynamic. Need is stressed to differ trauma reactivation from retraumatization. Psychotherapeutic possibilities of trauma reactivation in old age are discussed.

Adult↗
PubMed1999

[The degree of Objective Health Burden (OHB) - an expert assessment of the impairment caused by somatic illnesses in geriatric medicine].

The degree of Objective Health Burden (OHB) is an expert assessment of the impairment caused by somatic illnesses. It allows an overall clinical rating of the severity of a patient's somatic condition, considering all available information, not only the content or number of diagnoses. The rating on a five point scale is demonstrated with clinical examples. Interrater-reliability is satisfactory, being at least 0.74. External criteria indicate the OHB's validity. As the OHB is easy to comprehend and to employ, it is suitable for broad clinical application in geriatric basic assessment as well as for scientific purposes.

Adaptation, Psychological↗
PubMed1999

[Not Available].

Psychosomatic aspects of the normal aging process are not discussed by the international literatur nor psychotherapeutic treatment strategies with functional disorders or somatization disorders. By creating the concept "gerontopsychosomatics" 1990 in Germany there is an increasing interest for the implications of the somatic aging process in the second half of adult life span. In order to a competent evaluation of the different therapy indications during the diagnostic process the importance of training in gerontopsychosomatics is stressed.

Development↗
PubMed1999

[Not Available].

The paper examines differences between cases of psychogenic illness and noncases with regard to sociodemographic and health-related variables, coping and biographical reconstructions, evaluating their significance for psychic health in old age. A consecutive sample of 156 patients aged >60 treated for a variety of internal medical complaints in an acute geriatric hospital were examined with the help of comprehensive somatic diagnostics, the Impairment Score (IS), self-evaluation scales and a semistructured biographical interview. 27.5% (n = 43) of the study participants were classified as cases of psychogenic illness. 22 (14.1%) of them fulfilled diagnostic criteria for depressive disorder. Depressive patients were physically more impaired, reported rare and less satisfying social contacts and different coping strategies than the other study participants. With regard to their biographical reconstructions, cases reported more experienced bürden and less experienced support. In discrimination analysis, 78.4% of the study participants were correctly classified as cases vs. non-cases of psychogenic illness by one biographical variable and two coping strategies. Results are discussed as risk factors or protective factors for psychic health in old age considering their clinical relevance.

Biography↗
PubMed1999

[Psychogenic impairment and current feelings in the elderly. Which options are offered by the biographical perspective?].

In the Eldermen study funded by the German Research Association (DFG), a consecutive sample of patients, aged > or = 60 (n = 120) and being treated for a variety of internal medical complaints in an acute geriatric hospital were examined with the help of comprehensive somatic diagnostics, standardised questionnaires, and a semi-structured biographical interview. The study investigates the relationship between burdensome and supportive biographical experiences and the extent of psychogenic impairment as well as aspects of feeling tone and self-concept in later life. For the degree of psychogenic impairment (Impairment Score. IS; Schepank 1995), subjectively experienced burdens and support were found to be more relevant than "objective" burdens. As expected, subjective burdens consistently experienced over several life phases, particularly in association with limited experienced support, were found to be associated with greater psychogenic impairment and a higher "case risk" in later life. However, the patients with the highest values for current life satisfaction as well as a more positive self-concept were not those patients who never experienced more burdens than support in their biographies, but rather those who experienced more burden than support in one life phase. The results are presented in relation to models of learning theory and object relation theory and discussed for their clinical relevance.

Aged↗