Search PubMed⌕ Search

Biomedical subjects

H C Deter

Publications and source records attributed to H C Deter.

32 records · Page 2Linked to original sources
PubMed1997

Prediction of low body weight at long-term follow-up in acute anorexia nervosa by low body weight at referral.

OBJECTIVE: The authors investigated the hypothesis that in acute anorexia nervosa a low body weight predicts a poor weight prognosis for the future. METHOD: The body mass indexes at referral of 272 female patients were examined in relation to the body mass indexes of these patients after a mean follow-up of 9.5 years. RESULTS: The overall correlation between body mass indexes at referral and at follow-up was r = 0.33. Despite this low correlation, the 100 patients with body mass indexes less than 13 kg/m2 at referral had low weights at long-term follow-up. Eleven of the 12 deceased patients were among these 100 patients, as were 24 of the 46 surviving patients whose body mass indexes were 17.5 kg/m2 or less at follow-up. CONCLUSIONS: For patients with anorexia nervosa, a body mass index less than 13 kg/m2 at referral indicates a substantial risk for chronic anorexia nervosa and death related to emaciation.

Acute Disease↗
PubMed1997

[Body image disturbances in patients with anorexia nervosa 12 years after clinical consultation].

Of 103 patients with anorexia nervosa, 50 women and 5 men were followed-up on the average 11.8 year after clinical presentation with a differentiated method for body awareness according to Askevold. A considerable number of women with body image disturbances, however, largely corresponded to those of a healthy female control group. Both the male anorexia nervosa patients and the healthy male controls had normal findings. Applying to touch-induced stimulus, the body assessment indices only increased in former male anorexia patients but remained the same in female anorexia patients, while they clearly normalized in the sense of a realistic assessment in the two healthy control groups. Surprisingly, there was only little correlation between the visually measured body perception disorder and the self (EDI) and expert assessment (Sianex) at the time of follow-up (exception: the EDI scale 3 [dissatisfaction with one's own body). The global expert rating of body image disturbances at clinical presentation was important as a predictor for the severity of anorexia nervosa after 12 years. The findings were discussed under methodological and clinical aspects.

Adult↗
PubMed1996

Preliminary results of a differentiated emotion-stimulating interview in patients with essential hypertension as compared with inpatients of a psychosomatic unit and normal controls.

BACKGROUND: The question of psychophysiologic reaction specificity is still controversial. METHODS: Blood pressure and heart rate were measured for different emotional effects induced during a semistandardized interview. RESULTS: Generally, a stronger increase in blood pressure was observed in hypertensive patients than in inpatients of a psychosomatic unit and normal controls. Differences related to various phases of the stress interview (regarding feelings of aggression, rage and anger, professional situation) were statistically significant as compared to controls, not only in hypertensives but also in the inpatients of a psychosomatic unit. CONCLUSIONS: The results are discussed with respect to the specificity theory of Alexander.

Adult↗
PubMed1994

[Long-term follow-up: methodologic aspects in the interpretation of follow-up results. A presentation exemplified by anorexia nervosa].

Long-term follow-up investigations contribute to our knowledge and understanding of illnesses, their prognosis and the effectiveness of treatments. In the evaluation and interpretation of results of long-term follow-up studies many conceptual and methodological aspects have to be considered. Using the example of long-term follow-up investigations of anorexia nervosa some of the most important issues are discussed in a more general framework.

Adolescent↗
PubMed1994

[Do patients with anorexia nervosa return to psychological health? results of a 12-year follow-up of 103 patients].

In a long-term follow-up study over 12.7% (range 9-19) years, 16 of 103 patients with anorexia nervosa died. 92% of the survivors were followed up personally, 7% only indirectly. The paper presents the psychological changes assessed by means of the Anorexia Nervosa Symptom Score in the course of the disorder. At the time of catamnesis, the psychic condition of the patients was furthermore evaluated in more detail by procedures of independent assessment (DSM III-R, Impairment-Score (IS), Confidant Rating) as well as by using different instruments of self-assessment (Eating Attitude Test, Eating Disorder Inventory, Social Network Questionnaire). In a case conference taking into account all relevant findings, 40.1% of the patients were found to be healthy, 30.4% were considered to still show severe psychic disorders, and 29.4% were rated as desolate. These results suggest that part of the patients become psychicalls healthy again. Altogether, however, the long-term prognosis of anorexia has to be regarded as rather poor.

Adaptation, Psychological↗
PubMed1993

[Psychodiagnostic follow-up of patients with Crohn disease during intensive internal medicine treatment].

The present study includes 40 patients with Crohn's disease who underwent an internal and psychodiagnostic examination over a period of 5 to 8 weeks. On the average, there were only minor psychic symptoms were recorded in the psychodiagnostic instruments. The fewest symptoms were seen in the recurrence-free interval, a moderate number at the beginning of intermittent inpatient treatment and the largest number of symptoms in patients transferred to a psychosomatic department. While decreasing significantly from high levels under internal intensive care and at the beginning of inpatient depth-analysis-based psychotherapy, symptoms of depression and anxiety dropped only slightly from initially low levels in outpatients. In addition, there were first changes in the patients personality profile during psychotherapy. The findings are discussed under diagnostic and therapeutic aspects.

Adaptation, Psychological↗
PubMed1991

Patterns of self-definition of asthma patients and normal persons in the Freiburg Personality Inventory.

The concept of the specificity of psychosomatic diseases (Alexander) is being differentiated at the time. In order to clarify some aspects of this problem, we want to investigate whether types of self-rating of normal persons differ from those of patients with bronchial asthma. In a second step we shall examine whether those types of self-rating can be found also in expert rating and third the differences between the two groups concerning their help-seeking behavior. For the purpose of this investigation the data of 135 patients with bronchial asthma (who had been investigated at the Heidelberg University Medical Department between 1979 and 1982) and of 330 persons of the Mannheim Cohort Study (who are a representative sample of the average urban population) have been reanalyzed. By means of the Freiburg Personality Inventory (FPI) data cluster analyses have been done. Evaluated by a group of 5 (5-cluster solution) the patterns of self-rating of patients with bronchial asthma do not differ significantly from those of normal persons. They had a high correlation to the expert rating and to other social-medically important outer criteria. The results indicate that the specificity of psychosomatic patients in relation to normal persons is not very convincing in a pattern of self-rating on the level of the FPI. Therefore, further research in this field seems to be necessary.

Adult↗
PubMed1991

[Social support and its relation to physical and emotional findings in Crohn's disease patients].

It was the aim of the present study to identify correlations between social, psychological and physical findings in 57 unselected patients with Crohn's disease from a gastroenterological outpatient department. Social support was registered using the confidant rating and the social network using a network questionnaire. Additional internal-medical and psychodiagnostic test instruments were used for a specific description of the sample. Anxieties, depressive moods and emotional lability were significantly less pronounced in patients with a confidant than in those without or with a less supportive partner. And the former also seemed to be more able to adequately cope with the disease than the patients of the other groups. With respect to the physical findings, the differences between the groups were less pronounced: Nevertheless, patients who were supported by a partner tended to show lower activity levels for Crohn's disease (Best index) than the others. The results obtained by the network questionnaire were less specific but altogether confirmed the results of the confidant rating. The study confirms the results of comparable investigations done in other clinical patient groups. The construct of social support is discussed critically with respect to psychoanalytical and family-dynamic concepts.

Adaptation, Psychological↗
PubMed1989

[Differentiation of the long-term effects of inpatient psychosomatic therapy of patients with anorexia nervosa].

In a catamnestic study of 103 anorexia nervosa patients treated at the university medical clinic in Heidelberg between 1970 and 1980, 51 patients were personally evaluated after 3, 6 years using a multi-dimensional system of criteria that covered 30 different symptom areas. There was a clear improvement with regard to constipation, vomiting, and the abuse of laxatives, various laboratory parameters, psychic symptoms, and vocational situation. Secondary amenorrhea, psychic suffering, and overly strong emotional ties to the family, however, were still found among two-thirds of the patients. Long-term success of treatment was found to correlate closely with an early age both for the onset of the disorder and for the beginning of treatment. Reduction of physical symptoms by the time of the post-examination was closely related to the extent of the family therapy carries out. In general, males appeared to benefit from treatment more than did female patients. Cluster analysis revealed that of four groups of patients studied, only one group could be called healthy; anorexia nervosa symptoms persisted to varying degrees in the other groups. Psychological testing using the PEF brought to light the following relationships: The greater the degree of illness at the time of the catamnestic study, the stronger the patient's tie to his/her own family, the greater the concern with physical appearance, the more achievement oriented, and the greater the aversion to playful activity.

Adaptation, Psychological↗
PubMed1986

Cost-benefit analysis of psychosomatic therapy in asthma.

The effectiveness of psychosomatic therapy for asthma patients is difficult to prove. We tried to solve this problem in a new way by means of a cost-benefit analysis. To draw up such an analysis, we selected 22 patients capable of working out of a total of 57 patients with asthma bronchiale at the Heidelberg Medical Hospital, who were interested in participating for one year in a psychosomatic coping group therapy. These 22 patients were divided into two groups. The distribution of the relevant individual parameters in both groups was similar. We subjected the patients to three medical and psychodiagnostic examinations: one before treatment was started, a second after the first year of treatment and a third one and a half years later. Additional data were gathered from health insurance organisations and General Practitioners. Despite the bad prognoses of our patients, those treated, when compared to the untreated patients, had a significant reduction in the number of working days lost and a considerable decrease in the number of working days hospitalized. The savings resulting from these reductions were compared with the sum expended for group therapy; we found a cost-benefit ratio of 1:5. These results indicate that a cost-benefit analysis may be very helpful in evaluating the effectiveness of some psychosomatic treatment techniques. Moreover, coping group therapy completes the medical standard therapy of patients with bronchial asthma and is thus a means of reducing the high medical treatment costs of asthma patients.

Adaptation, Psychological↗
PubMed1986

[Catamnestic results of 64 patients--5 years following inpatient psychosomatic treatment].

The present study is an attempt at evaluating with clinocosomatic, psychodiagnostic, and sociologic instruments the alterations achieved by (psychodynamically oriented) psychosomatic in-patient therapy. Out of a total of 64 patients who in 1975 had undergone treatment for an average period of two months 46 (i. e. 76.7 per cent) were available for re-examination after a five-year interval. In two thirds of the patients the various complaints and the general autonomic instability had receded. The psychical and social situation had improved for between two thirds and three fourths of all re-examined patients both in their own opinion and in that of other people. Correspondingly there was a significant reduction in consultations at the physician's as well as days of disability and days of hospitalization per year. Factors contributing to a favourable diagnosis were: low age of the patient, short duration of complaint, substantial stress induced by the disease, and long-term in-patient treatment.

Adult↗
PubMed1983

Group therapy for asthma patients: a concept for the psychosomatic treatment of patients in a medical clinic--a controlled study.

Asthma patients pose special problems as far as the medical supervision, danger of symptoms and the course of the disease are concerned. Some 90 asthma patients were registered for the treatment in the Heidelberg Medical Clinic. 31 patients who were interested in taking part were randomized into 3 groups: two treatment group consisted of the exchange of information, discussion sessions on the illness as well as 'autogenic training' or 'functional relaxation'. The third group was the control group. Before and after treatment the patients were submitted to a thorough examination both of lungs and other internal organs as well as from the psychodiagnostical point of view. The average age of the patients was 43.5 years and the average duration of illness 16.8 years. Nevertheless, the treatment group's sympathomimetics use was significantly reduced by 1 year of treatment (p less than 0.05); the use of steroids decreased as well. The number of visits of the general practitioner also decreased. These results support the conclusion that psychosomatic group therapy can make an important contribution to the treatment of asthma patients. Body therapy practised in 'autogenic training' and 'functional relaxation' seems to be another important healing factor for the treatment in addition to the discussion sessions and the exchange of information.

Adolescent↗
PubMedDate not supplied

Anorexia nervosa in a long-term perspective: results of the Heidelberg-Mannheim Study.

The long-term outcome of 84 anorexia nervosa patients was studied over a period of 12 years using global clinical ratings and differential physical findings in addition to standardized psychometric measurements. An unusual polarization into good and fatal outcomes was found, with a high recovery rate of 54% and a high mortality rate of 11%. When psychiatric and somatic comorbidity and psychosocial functioning were included in the assessment, the recovery rate was only 41% after 12 years. Clear cases of anorexia decreased steadily from 100% at clinical presentation to 67% after 2 years, 40% after 4 years, and 23% after 6 years. There was almost no further decline after the ninth year of follow-up (17%). Purging, physical symptoms, advanced age at clinical presentation, and a high social status were predictors for an unfavorable course. About 22% of the patients had suffered a relapse after remission. At first presentation, they were young and had a short duration of illness but showed severe psychiatric disorders. Results are discussed in terms of methodological and clinical issues involved in the long-term follow-up of anorexia nervosa patients.

Adult↗