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Biomedical subjects

G Heuft

Publications and source records attributed to G Heuft.

At least 37 records · Page 2Linked to original sources
PubMed1998

Pain, coping and psychological well-being in late life.

In the present article, the relationships between pain, coping, functional capacity and psychological well-being are examined in a population of older patients (>/=60 years; n=202) treated for a variety of somatic complaints in a university-affiliated hospital. Results indicate that moderate to extreme pain is common in older patients and often occurs in several body regions simultaneously. Extreme pain in one or more body regions is associated with reduced daily functional capacity, lower values for life satisfaction and self-evaluated competence, and more negative attitudes towards the present and future. Results of a hierarchical cluster analysis reveal interindividual differences in coping approaches among older patients suffering from extreme pain; they also emphasize the importance of cognitive strategies and life-review coping. Relevance for clinical practice with older pain patients is discussed.In the present article, the relationships between pain, coping, functional capacity and psychological well-being are examined in a population of older patients (>/=60 years; n=202) treated for a variety of somatic complaints in a university-affiliated hospital. Results indicate that moderate to extreme pain is common in older patients and often occurs in several body regions simultaneously. Extreme pain in one or more body regions is associated with reduced daily functional capacity, lower values for life satisfaction and self-evaluated competence, and more negative attitudes towards the present and future. Results of a hierarchical cluster analysis reveal interindividual differences in coping approaches among older patients suffering from extreme pain; they also emphasize the importance of cognitive strategies and life-review coping. Relevance for clinical practice with older pain patients is discussed. Copyright 1998 European Federation of Chapters of the International Association for the Study of Pain.

Journal Article↗
PubMed1998

[Geriatric psychosomatic disorders and psychotherapy of the elderly. Current concept and approaches to treatment].

In a geriatric acute hospital, a minimum of 20% of the patients aged 60 or older fulfilled the case criteria for a psychogenic illness. Previously published epidemiological investigations had presented similar results. However, due to the limited theoretical training and treatment experience, psychotherapists continue to show extreme reluctance to formulate an indication for psychotherapy in elderly patients. The paper gives an overview of current concepts in development psychology for the second half of life drawing attention to the role of physical aging processes as an "organiser" of development. Sexuality in late life and approaches to dealing with chronic pain are presented as somatic-psychosomatic aspects of aging that challenge present old age stereotypes. Taking typical symptoms into consideration, a basis is established for the discussion of a differentiated therapy indication for elderly patients. Emphasis is on psychoanalytical and cognitive behavioural psychotherapy methods. Finally, perspectives of research are presented.

Aged↗
PubMed1997

[Early and differential diagnosis of 1,000 patients examined in a memory clinic].

The results from 1000 patients included in a consecutive sample of older persons showing signs of "age-related memory deficits" clearly demonstrate the necessity for a wide spectrum of differential diagnostic competence. The patients included in the study were diagnosed in succession by an interdisciplinary team of psychiatrists, neurologists, geriatric medical specialists, psychologists and gerontologists. The diagnostic process for clarification of DSM-III-R and ICD-10 criteria are discussed in detail. In all, 49.6% of the patients were diagnosed as suffering from dementia of the Alzheimer type, 31% from vascular dementia and 10% from a mixed form. In all, 12.5% of the patients were somatically ill and 31.4% displayed other psychiatric conditions, 50% of which were evaluated as being treatable with psychotherapy. The results are primarily discussed for their relevance to the reality of current treatment.

Adult↗
PubMed1997

Biographical reconstruction of WWII experience: an exploration of German remembrance.

First results of the Eldermensch-Study (N = 50) indicate that German National Socialism and the historical events associated with World War II play a central role in the oral histories of older Germans. Six distinct patterns of late life cognitive appraisal of war-time experience: survival challenge (further divided into "active" and "passive" survivorship), passive benefit, opportunism, value verification, and acceptance despite hardship are presented and discussed as structural themes in the life story. These categories not only represent interindividual differences in the appraisal of war-time experience, but often reflect contrasting patterns of personal response to the social and political circumstances of this era of German history. In addition to cohort and gender differences, divergence in locus of control orientation as well as the role of social bonding and instrumental social support are discussed. Differences revealed in the biographical interviews are further reflected in the results of standardized questionnaires.

Adaptation, Psychological↗
PubMed1996

[Individual therapy goals: on outcome documentation of inpatient psychotherapy from the patient and therapist viewpoint].

The results of a study evaluation in practicability of two newly developed documentation forms are presented. Examined are 82 inpatient treatment episodes in an already published clinical concept with different treatment settings. Parallel versions of the forms were completed by patients and therapists. The 'Erge-Doku-A-Form' allows for the naming of up to five therapy goals determined at the beginning of therapy and evaluated in relation to their achieved quality at the end of therapy. The 'Erge-Doku-B-Form' describes a variety of problem areas as well as questions related to medication and changes induced by therapy. Surprising there were a high number of 230 Individual Therapy Goals (ITG) by patients and 262 ITG by therapists which could be arranged into 89 content categories and 5 main categories. Outcome measurement shows different results. There was a significant relationship between the 'well-being', the impression of 'satisfying treatment' at the end of the inpatient period and 'success in the main ITG'. The documentation forms presented here allow an outcome-measurement depending on differential indications.

Adult↗
PubMed1995

Diagnostic concepts, multimodal and multiaxial approaches in psychotherapy and psychosomatics.

Basic questions concerning diagnostic models in psychoanalytic psychotherapy and psychosomatics are discussed in this paper. Against the background of the different areas in psychodynamic-oriented diagnoses, the advantages and disadvantages of descriptive multiaxial diagnostical models like DSM-III-R and ICD-10 are examined. These conceptual reflections have been built on the findings from participation in Germany of a great number of psychotherapeutic/psychosomatic institutions in the field trials for the assessment of the Diagnostic Criteria for Research of ICD-10, chapter V. Some of the most important issues this study has raised are discussed.

Conversion Disorder↗
PubMed1993

Content analysis of follow-up interviews with inpatient/outpatient group psychotherapy patients.

In the follow-up project of the psychosomatic clinic at the University of Heidelberg, 45 patients were interviewed who had begun group psychotherapy in a closed group over 2.5 years with an inpatient treatment period of 3 months. The follow-up interviews carried out 2-5 years after the end of the outpatient treatment period are studied by content analysis. It could be demonstrated that the content of the two main categories 'Beginning' and 'End' of the inpatient period differs very much. Two patterns of 'beginners' could be distinguished. The importance of the evaluation of the former patients' spontaneous report as involved experts for psychotherapy research is discussed.

Adult↗
PubMed1993

[Suggested personnel figures in psychotherapeutic and psychosomatic hospitals and departments providing routine care].

Though the existing independency of the psychotherapeutic and psychosomatic medicine in Germany there is the necessity of developing personnel clue numbers for this clinical specification. By the analytic method the required trade groups of the regular inpatient psychosomatic-psychotherapeutic treatment thus far and their engagement in time are investigated. In a 2. step the fields of business for physicians, psychologists, nurses, social workers, special-therapists and secretary/documentation as well as regular business for the consultation/liaison-service are defined. For a model station the concret personnel clue numbers of all named business groups are referred.

Germany↗
PubMed1993

[Psychoanalytic geriatric psychosomatic medicine--on the origin and differential therapeutic indications of acute functional somatization in the elderly].

Acute functional symptomatologies regarding elderly have thus an underestimated meaning as well for be the concerned themselves as for their surroundings and the general public. Based on outpatient or/and inpatient gerontopsychosomatic experiences of treatment with 20 patients at the age from 55 to 75 years (with an average age of 64.5 years), the author differs characteristical constellations of inner and outside reality for the elderly, which can lead to an acute functional symptomatology: 1. the activation of a psychosexual conflict which do not dependent on age 2. the conflict of being disappointed in the elderly 3. the trauma reactivation in the elderly. The differential psychogenese of those three groups is casuistically proofed and discussed from a methatheoretical point of view using the concept of nucleus conflicts (Loch 1967) and the intersection metapher of Heigl-Evers and Heigl (1984). The aim of the work is to demonstrate possibilities of gerontopsychosomatic treatment as well for massive symptomatology and to discuss the given differential indications of psychotherapy (long term analysis, analytic psychotherapy, focus therapy).

Aged↗
PubMed1992

[Elderly patients in psychosomatic psychotherapeutic institutions].

With the aid of a comparative study of the data collected in the Berlin Psychotherapy Study and the outpatient clinic of the Psychosomatic Clinic (University of Heidelberg), the allocation and utilization modalities of elderly patients with regard to psychosomatic-psychotherapeutic institutions is investigated. One important result seems to be the high rate of psychodynamically understandable triggering situations (as a measurement of psychological comprehension of the symptoms) and the consequent therapy recommendations (as a measurement of treatability) even for elderly patients. A case study will demonstrate that the danger may arise to subsume new somatic symptoms in the elderly under the aspect "multimorbidity" and thus withhold recommended psychotherapeutic treatment.

Adaptation, Psychological↗
PubMed1988

[The depression ward--a review of the current status].

New therapeutic concepts are usually developed and realised step by step. Over the past years changes occurred mainly in two ways. There is a trend to reduce the size of the psychiatric hospital as such and/or to section off certain areas by introducing specialised units. From the experience with the so called "Affective Disorder Units" or "Mood Clinics" developed the concept of a Depression Unit, first introduced in Europe for research purposes at the Psychiatric University Hospital in Basle in 1968. In Germany the first Depression Unit was established at the PLK Weissenau in 1976. Similar units followed over the years at the PLK Reichenau, Weinsberg, the BKH Günzburg, the Landesklinik Nordschwarzwald Hirsau/Calw and the Rheinische Landesklinik Bedburg-Hau, other hospitals are planning them. Existing units are described in terms of their structural organisation, staffing situation and the service they provide. The concept of the Depression Unit according to criteria laid down agreed upon in the literature is summed up, and emotional atmosphere, structural organisation, activation, and individual therapeutic measures, discussed. Advantages are mentioned such as better understanding of patients, allowing them to let go and be cared for, aimed regression, the effects of being taken along, improved communication, and a way of dealing with suicidal thoughts and depressive behavior that reduces anxiety. Disadvantages such as the danger of spoiling patients or inducing a sense of resignation both in patients and staff are discussed.

Depressive Disorder↗
PubMed1978

[Age-dependency of toluidine-blue dichroism and birefringence of fibers within the costo-chondral junction of human ribs (author's transl)].

The chondral fibers running parallel to the chondrocyte columns within die costo-chondral junction of human ribs were investigated quantitatively following standardized Toluidine blue staining by using the Leitz-Mikrospektrograph for observing the absorption spectrum, and by employing both a Berek- and a Brace-Köhler compensator for polarization measurements. Autopsy material was obtained from the ribs of 35 children and adults at the age of 0 to 22 years. Refractivity was measured in stained and unstained paraffin sections, whereas dichroism and metachromatic index (MI) of the fibers were determined in stained specimens. All three parameters showed characteristic, quantitative age-dependent variations indicating that the highest degree of molecular and structural adjustment and alignment of the fibers is already being reached at the age of 8 years. The continuously higher refractivity of the fibers with increasing age and bone maturity may be explained by a progressive loss of water by the fibers.

Adolescent↗
PubMedDate not supplied

The prevalence and differential diagnosis of subclinical depressive syndromes in inpatients 60 years and older.

BACKGROUND: Depressive syndromes that do not comply with the diagnostic criteria for specific depressive disorders are designated as 'subclinical' or 'subsyndromal' depressive syndromes. Using our own data from a clinical study, this paper outlines the significance of subclinical depressive syndromes and demonstrates the problems of differentiating between depressive and subclinical depression (SD) syndromes and organic mood disorders especially in an elderly population with medical comorbidity. METHODS: Two hundred and sixty-two patients aged 60 years and older in a general hospital were investigated, using a clinical psychiatric interview, expert ratings and self-report scales after extensive internal medical diagnostic evaluation. RESULTS: When, without further differentiation as to their origin, all symptoms required by symptom checklists according to ICD-10 were considered for the diagnosis of major depression (MD), 35.5% of the study participants fulfilled the diagnostic criteria. After differentiating for etiology of symptoms, MD was found in only 14.1%, SD was diagnosed in 17.6% and organic mood disorder in 12.2% of the study participants. In another 41 patients (15.6%), symptoms of depression not fulfilling ICD-10 criteria were classified as being of organic or drug-induced origin. SD patients were in a mean position between nondepressive and depressive patients with regard to social isolation and physical impairment; women were overrepresented in the depressive and subdepressive groups. CONCLUSIONS: SD and organic mood disorder are common and helpful diagnostic categories in the elderly. The results show that in old age there is substantial danger of confounding MD, SD and organic mood disorder, thus leading to erroneously high prevalence rates of MD and underestimations of organic mood disorder if depressive symptoms are recorded only by self-report scales or a symptom checklist. Both internal and psychosomatic-psychotherapeutic competence as well as a liaison service in general hospitals are necessary for the differential diagnosis of MD, SD and organic mood disorder in the elderly with medical comorbidity.

Age Factors↗
PubMedDate not supplied

[Inpatient focal therapeutic treatment of elderly patients--concept and initial results].

Acute neurotic and functional symptoms in the elderly are undervalued relative to the frequency. The authors demonstrate the indication criteria and an inpatient focal therapeutic treatment conception for elderly patients. The 11 patients from 50 to 68 years, treated in this setting in 1991, are characterized by sociodemographic aspects, symptoms and length of treatment. At the end of the treatment period (on an average of 8 weeks) seven patients are well recovered with regard to their symptoms, one patient is somewhat improved, and two patients are not recovered. According to a short casuistic some fundamental reflections on psychoanalytic focal therapy in the elderly are discussed.

Aged↗