Biomedical subjects

H J Rumpf

Publications and source records attributed to H J Rumpf.

At least 19 recordsLinked to original sources

PubMed2003

Gender differences in unipolar depression: a general population survey of adults between age 18 to 64 of German nationality.

BACKGROUND: Several studies from different epidemiological backgrounds have shown that unipolar depression is more prevalent in females than in males. This study examines gender differences in depression in a sample of 4075 probands recruited representatively from the general population in the northern German epidemiological catchment area of Lübeck. METHODS: Probands were interviewed with M-CIDI by lay interviewers. RESULTS: Being married only seems to increase the female depression risk when having children, while higher education reduced female excess; both male and female risk for depression raised sharply in separated, divorced and widowed probands. Not being employed was associated with an increased risk in male depression whereas in females risk was nearly unchanged. The gender ratio increased with the minimum number of depressive symptoms. Female excess was not reduced by a higher degree of subjective impairment or melancholic features. Females also predominated in longer episode durations. Female excess in the total group emerged beginning from adolescence with a tendency for a male excess in the prepubescent ages. No birth cohort effect was observed. LIMITATIONS: The cross-sectional design of this study precluded causal analysis of reported associations and some retrospective assessments are error-prone because of recall bias. CONCLUSIONS: We support previous findings of variations in gender differences in depression, however observed social parameter influences underline the need for a more detailed analysis of subgroups and underlying psychological mechanisms.

Adolescent↗

PubMed2002

[Relationship between subjectively perceived working conditions and alcohol consumption: results of the TACOS study].

The purpose of this investigation was to examine the relationship between subjectively perceived working conditions and alcohol consumption based on a stress coping model. The investigation is part of the study 'Transitions in Alcohol Consumption and Smoking' (TACOS), a representative general population survey in a Northern German region. The current evaluation includes 2,471 working individuals, aged 18-64 years. Data with regard to alcohol consumption were collected via the 'Munich Composite International Diagnostic Interview' (M-CIDI). The three scales of the 'Normative and Subjective Assessment of working analysis' (NUSA) Contents of work, Physical work conditions and Intensity of work gathered differentiated information on subjectively perceived working conditions. The ANOVA results show that alcohol consumption does not account for variance in the scales of subjective working conditions. Further correlation and regression analyses do not reveal a relationship between the scales of NUSA and the quantity of drinking.A substantial relationship between subjectively perceived working conditions and moderate alcohol consumption, alcohol abuse or alcohol dependence could not be established. The reported results appear to indicate complex and multifactorial associations between subjectively perceived working conditions and alcohol consumption. Implications for alcohol prevention in worksite environments are discussed.

Adaptation, Psychological↗

PubMed2001

Screening for mental health: validity of the MHI-5 using DSM-IV Axis I psychiatric disorders as gold standard.

Short screening questionnaires for mental health are useful tools for research and clinical practice, e.g. they could play a major role in detecting patients with psychiatric disorders in primary care. The present study tests the validity of the five-item Mental Health Inventory (MHI-5) screening test using DSM-IV Axis I diagnoses as a gold standard and analyzes its performance in different diagnostic groups. A random sample was drawn from the resident registration office files in northern Germany. Personal interviews with a response rate of 70% were conducted. Of the sample, 4036 respondents filled in the MHI-5. DSM-IV diagnoses were assessed using the Munich Composite International Diagnostic Interview (M-CIDI). The area under the receiver operating characteristics curve (AUC) of 0.72 in identifying any DSM-IV Axis I disorder (except substance use) is not satisfying. The MHI-5 revealed best performance for mood (AUC: 0.88) followed by anxiety disorders (AUC: 0.71). Sensitivity and specificity were poor for somatoform and substance use disorders, especially in cases without comorbid mood or anxiety disorder. The power to detect mood and anxiety disorders of the MHI-5 was better for the 4-week compared with the 12-month diagnoses. The MHI-5 can be recommended to screen for mood disorders. Data have to be confirmed for primary care settings.

Adolescent↗

PubMed2001

Lifetime-comorbidity of obsessive-compulsive disorder and subclinical obsessive-compulsive disorder in Northern Germany.

OBJECTIVE: Inspite of the worldwide relevance of obsessive-compulsive disorder (OCD), there is a substantial lack of data on comorbidity in OCD and subclinical OCD in the general population. METHODS: German versions of the DSM-IV adapted Composite International Diagnostic Interview were administered to a representative sample of 4075 persons aged 18-64 years, living in a northern German region. RESULTS: In both genders, high rates of comorbid depressive disorders were found in OCD and subclinical OCD, whereas somatoform pain disorder was only associated with OCD. In female subjects, OCD was additionally associated with social and specific phobias, alcohol, nicotine and sedative dependence, PTSD and atypical eating disorder. CONCLUSION: Due to low comorbidity rates, subclinical OCD seems to represent an independent syndrome not restricted to the presence of other axis-I diagnoses. Comorbidity patterns show a disposition to anxiety and to depressive disorders in OCD and subclinical OCD. A broad association with obsessive-compulsive spectrum disorders could not be confirmed in our general population sample.

Adult↗

PubMed2001

Factors influencing remission from alcohol dependence without formal help in a representative population sample.

AIMS: To analyse factors related to remission without formal help by using a representative sample and standardized instruments. DESIGN: Two groups of untreated alcohol-dependent subjects were compared. SETTING: General population survey. PARTICIPANTS: Thirty-two subjects fully remitted without formal help (NFH) and 26 current alcohol-dependent individuals (CAD) according to DSM-IV drawn from a representative general population sample in northern Germany (response rate: 70.2%, n = 4075). MEASUREMENTS: Data focusing on the 2 years prior to remission from NFH were compared with past-year data from CAD. Groups were compared on variables found to be associated with remission without formal help in previous research. FINDINGS: Logistic regression analysis revealed that individuals remitted from alcohol-dependence without formal help reported a higher non-physiological severity of alcohol dependence, less social pressure to quit drinking and more incidents of driving while intoxicated. Furthermore, they tended to report more satisfaction with work and financial situation and were more likely to live in a stable partnership. CONCLUSIONS: Findings support the concept of psychosocial resources as important enabling factors in remission from alcohol dependence without formal help. Implications for brief interventions are discussed.

Adolescent↗

PubMed2001

[Therapeutic goals in psychological medicine--state of research and development of a standardized self-rating instrument].

From the patient's as well as from the therapist's point of view goals of therapy undoubtedly play an important role in all fields of psychological medicine (psychiatry, psychotherapy, psychosomatic medicine). On the other hand, there is a substantial lack of systematic i.e. empirical studies on this issue. Giving an overview on the available scientific literature we start by characterising therapeutic goals as a secondary psychological construction. Therapeutic goals and their multiple associations and different aspects of psychotherapy are discussed. However, a variety of definitions of therapeutic goals, often influenced by the therapeutic orientation of the authors, make it difficult to integrate concepts and to compare findings. Hence, we focus on those results which were found in relation to general concepts, i.e. beyond specific theoretical approaches. Furthermore, we discuss the pros and cons of individual measures of therapeutic goals compared with standardised self-rating instruments. Finally, we underline the lack of studies on therapeutic goals in the psychiatric sphere and report on some results of our own pilot study on the Personal Goals Questionnaire in psychiatric inpatients.

Humans↗

PubMed2001

The association between degree of nicotine dependence and other health behaviours. Findings from a German general population study.

BACKGROUND: To investigate the association between degree of nicotine dependence and unhealthy nutrition, lack of physical activity, and hazardous alcohol drinking. METHODS: Data with respect to cigarette and alcohol consumption, nutrition, and physical activity was collected in a representative general population sample (N = 4.075). RESULTS: Smokers with high compared to moderate and low degrees of nicotine dependence consume unhealthy foods more frequently, report less physical activity and more hazardous alcohol drinking. CONCLUSION: From a public health point of view, special secondary preventive interventions for smokers with high nicotine dependence and additional unhealthy behaviours are necessary.

Adolescent↗

PubMed2001

Future directions of research on "natural recovery".

Explore the source record for details and available documents.

Alcoholism↗

PubMed2000

[Lifetime prevalence of mental disorders in general adult population. Results of TACOS study].

The present paper reports lifetime prevalence rates of mental disorders in the 18- to 64-year-old general population of a northern German region. A representative random sample from registration office files of 4,075 individuals was examined in personal interviews using the fully standardized and computerised "Munich Composite International Diagnostic Interview" (M-CIDI). The response rate was 70.2%. Individuals were classified according to the DSM-IV. Substance use disorders were most frequent with 25.8% followed by anxiety (15.1%), somatoform (12.9%), affective (12.3%), and eating disorders (0.7%). Disorders other than substance use were more frequent in women and less frequent in men. A trend toward less psychiatric morbidity exists in individuals with higher educational level, higher income, and those who are married or reside in rural communities. Of all individuals affected by mental disorders, 42% fulfilled the criteria for at least one additional disorder. The results are discussed against the background of selected previous studies.

Adult↗

PubMed2000

Prevalence of alcohol consumption, abuse and dependence in a country with high per capita consumption: findings from the German TACOS study. Transitions in Alcohol Consumption and Smoking.

BACKGROUND: The aim of the Transitions in Alcohol Consumption and Smoking (TACOS) project is to investigate substance use and use disorders in the adult general population in a region of the under-researched north of Germany, focussing on smoking and alcohol consumption. In this study, the design and quality assurance provisions of the baseline cross-section of the longitudinal project are described. Prevalence rates of alcohol use disorders, consumption pattern, and the nature of their association are also analysed with regard to preventive strategies. METHOD: A random sample of 4075 participants, aged 18 to 64 and drawn from residents registration office files, was interviewed with a DSM-IV adapted version of WHO CIDI. Fieldwork resulted in a response rate of 70.2% and an unbiased database with regard to demographic characteristics. RESULTS: Low lifetime prevalence of alcohol use disorders (4.5% abuse, 3.8% dependence) and hazardous consumption (13.2% lifetime; 6.0% 12-month) was found compared to southern regions of Germany and US American data. In contrast, we found a comparatively high percentage of moderate alcohol uses. Male subjects are more affected by lifetime alcohol use disorders (abuse OR 8.3, 95% CI 5.3-13.2; dependence OR 4.3, 95% CI 2.8-6.4). The association between alcohol use disorders and alcohol consumption pattern revealed a weaker relation for alcohol abuse compared to dependence. CONCLUSION: National and regional drinking habits and norms have to be considered as a significant source of variance, supporting the need for European epidemiological research on substance use in addition to US American activities, and emphasising the advantages of community-based preventive measures. An evaluation of public recommendations for safe limits of alcohol consumption and prevention targets referring to average consumption is indicated. There is also a need for a clear distinction between alcohol abuse and dependence.

Adult↗

PubMed2000

Prevalence, quality of life and psychosocial function in obsessive-compulsive disorder and subclinical obsessive-compulsive disorder in northern Germany.

BACKGROUND: Despite the worldwide relevance of obsessive-compulsive disorder (OCD) there are considerable differences in prevalence rates and gender ratios between the studies and a substantial lack of prevalence data on subclinical OCD. Moreover, data on quality of life and on psychosocial function of subjects with OCD and subclinical OCD in the general population are missing to date. METHODS: German versions of the DSM-IV adapted Composite International Diagnostic Interview were administered to a representative sample of 4075 persons aged 18-64 years living in a northern German region. Specific DSM-IV based criteria for subclinical OCD were used. RESULTS: The life-time prevalence rates for OCD and subclinical OCD were 0.5% and 2%, respectively. Twelve month prevalence rates were 0.39% and 1.6%, respectively. The gender female:male ratio was 5.7 in OCD and 1.2 in subclinical OCD. In various measures of psychosocial function and quality of life, OCD and subclinical OCD were significantly impaired. However, subclinical OCD subjects did not visit mental health professionals more often than controls. CONCLUSION: Due to different epidemiological characteristics subclinical OCD might represent a syndrome distinct from OCD which is also associated with significant impairments in personal and interpersonal functions and in quality of life.

Adolescent↗

PubMed2000

Studies on natural recovery from alcohol dependence: sample selection bias by media solicitation?

AIMS: To assess the selection bias of recruiting participants in studies on natural recovery from alcohol dependence through media solicitation. DESIGN: Two samples with different recruitment strategies are compared. SETTING: Media solicitation and general population. PARTICIPANTS: Sample 1 consists of 176 alcohol-dependent individuals remitted without formal help and recruited through media solicitation, sample 2 consists of 32 natural remitters derived from a representative general population study with a sample size of 4075 respondents and a response rate of 70.2%. MEASUREMENTS: Several triggering mechanisms and maintenance factors of remission were assessed in a personal interview using standardized questionnaires. FINDINGS: Results of logistic regression analyses show that media-solicited subjects were more often abstinent in the last 12 months, were more severely dependent, were less satisfied with eight life domains prior to remission and showed higher scores in a coping behaviour measure. Besides these major differences from the multivariate analysis, media subjects revealed more health problems prior to remission, experienced more social pressure to change drinking behaviour, and showed differences in reasons for not seeking help. CONCLUSIONS: Media solicitation leads to a sample selection bias in research on natural recovery from alcohol dependence. When measures to foster self-change are derived from such studies, findings from representative samples have to be considered.

Female↗

PubMed2000

[Health behavior of smokers--results of the TACOS (Transitions in Alcohol Consumption and Smoking) Study].

The German TACOS Project (Transitions in Alcohol Consumption and Smoking) provided an opportunity to examine the patterns of health behaviours (nutrition, physical activity, alcohol consumption) of current smokers, ex-smokers and non-smokers with special regard to different degrees of severity of nicotine dependence. Data were collected in the adult general population of Lübeck and 46 surrounding communities, resulting in a representative sample of 4075 individuals. In this sample, 37.3% were current smokers, 22.5% were ex-smokers, 25.0% of smokers were severely nicotine-dependent. As in other empirical investigations, current smokers had an unhealthy lifestyle in general. Smokers compared to ex-smokers and non-smokers consumed unhealthy foods more frequently, reported less physical activity and were more likely to consume hazardous levels of alcohol. Special attention was paid to comparing different degrees of severity of nicotine dependence. A high degree of nicotine dependence was associated with poor health behaviours. Data show that smoking, unhealthy nutrition, lack of physical activity, and hazardous levels of alcohol consumption occur in combination and that unhealthy behaviour patterns vary according to the severity of nicotine dependence. The presence of multiple unhealthy behaviours requires special secondary preventive interventions for smokers. The association of these combined health hazards must be controlled in determining the independent health risk due to one of these factors.

Adolescent↗

PubMed2000

Gender differences in natural recovery from alcohol dependence.

OBJECTIVE: Data from epidemiological research reveal that most alcohol dependent individuals recover without professional treatment. Little is known, however, about individuals remitting from alcohol dependence without formal help, and almost no data are available with respect to gender differences in natural recovery. METHOD: Women (n = 38) and men (n = 106) who remitted from alcohol dependence according to DSM-IV without utilization of formal help (treatment or self-help groups) are compared. A standardized interview assessed reasons for not seeking help, and triggering mechanisms and maintenance factors of remission. RESULTS: Compared with male subjects, female subjects, prior to remission, experienced lower extents of social pressure to change drinking behavior, drove less often under the influence of alcohol, revealed less satisfaction with different life domains and reported a higher impact of health problems on the remission process. Female subjects also informed fewer individuals about their former drinking problems. CONCLUSIONS: Female and male natural remitters differ in factors that trigger the process as well as the maintenance of natural remission.

Adult↗

PubMed2000

Maintenance factors of recovery from alcohol dependence in treated and untreated individuals.

BACKGROUND: Research on natural recovery from alcohol dependence has focused mainly on triggering mechanisms of the remission process. Only a few studies have considered maintenance factors of natural recovery. METHODS: In the present study, 93 natural remitters and 42 self-help group participants were compared. Both groups remitted from alcohol dependence according to DSM-IV criteria. Several alcohol-related variables and maintenance factors of the remission process were assessed in a personal interview by using standardized questionnaires. RESULTS: Logistic regression analysis that focused on maintenance factors showed that, independent from direct self-help group context, self-help group attendees informed more individuals about their former alcohol problems and sought social support more often as a coping strategy to deal with craving. No further group differences could be identified. CONCLUSIONS: Self-help group participants revealed a higher social engagement to maintain their recovery. Besides this major difference, data support the assumption that more commonalities than differences exist within successful recoveries from alcohol dependence, independent of help-seeking status.

Adaptation, Psychological↗

PubMed1998

[Length of stay of patients with alcohol abuse or alcohol dependence in internal medicine and surgery].

To determine the length of stay (LOS) of alcoholic and non-alcoholic patients, all consecutive admissions to medical and surgical departments of a general hospital in Lübeck, Germany, were registered over a period of six months. The study sample comprised 625 medical and 661 surgical patients aged 18 to 64 years, 42% female. Alcohol abuse and dependence were detected using an expert interview (Schedules for Clinical Assessment in Neuropsychiatry, SCAN). The median LOS of patients with alcohol abuse or dependence was equal to that of the other patients (Z = 9 days). Differences occurred in the surgical clinic where alcohol abusers as well as alcohol dependent patients stayed longer than the others. There was significant trend in the medical clinic towards longer LOS for alcohol abusers and shorter LOS for alcohol dependent patients compared to the other medical patients respectively. Patients suffering from infections, tumors or gastrointestinal diseases had significantly increased LOS if having an alcohol problem. In conclusion, there is no general elongation of LOS in alcoholic patients. Differences occur if single departments or somatic or psychiatric subgroups of patients are regarded. However, high concentrations of alcohol-related diseases in these settings stress the importance of preventative measures.

Adolescent↗

PubMed1998

Previous help seeking and motivation to change drinking behavior in alcohol-dependent general hospital patients.

To assess the suitability of implementing secondary prevention approaches for alcohol abuse and dependence in the general hospital, it is worth examining how many problem drinkers are detected in this setting for the first time and whether these individuals are motivated to change their drinking behavior. In a representative general hospital sample (N = 1167), subjects were detected by a two-step diagnostic procedure including screening instruments and a diagnostic interview during a period of 6 months on all medical and surgical wards. Of alcohol-dependent patients, 38.2% had received no help in their lifetime and 70.8% did not seek help in the year prior to admission. According to the stages of change model of Prochaska and DiClemente the minority (10.9%) of subjects detected as alcohol dependent for the first time were not considering changing their drinking behavior (precontemplation stage); 84.8% were either in the contemplation or action stage. Previous help seeking showed no significant relationship with the stages of change.

Adult↗

PubMed1998

Differences between hospital patients with alcohol problems referred for counselling by physicians' routine clinical practice versus screening questionnaires.

AIMS: To test the hypothesis that screening for alcohol-related disorders in a general hospital with questionnaires generates a target group of patients for alcohol counselling which differs from patients referred by physicians' routine clinical practice. DESIGN: A prospective study with follow-up after 12 months. SETTING: Medical and surgical wards of a general hospital. PARTICIPANTS: A sample of 298 patients detected by screening questionnaires (CAGE, MAST) was compared with a sample of 87 patients referred by physicians. MEASUREMENTS: The main measurements were a diagnostic interview (SCAN), two questionnaires to estimate the severity of dependence and the motivation to change drinking behaviour (RCQ, LAS), and socio-demographic variables. Outcome criteria were utilization of remedial programmes, decreases in hazardous and excessive drinking and abstinence rates. FINDINGS AND CONCLUSIONS: Patients referred by physicians were more often separated and unemployed, were more likely to be alcohol-dependent and to be more severely dependent, had a higher rate of alcohol-related diseases as reasons for admission, were more often motivated to change drinking behaviour, had a higher participation rate in remedial programmes and more often exhibited improvements in drinking behaviour compared with the sample identified by screening questionnaires. However, there was evidence of improvements in drinking in both samples. Data show that while screening reaches a less problematic sample with lower motivation to change, it is a worthwhile activity which extends the spectrum of patients eligible for brief interventions.

Adolescent↗