Biomedical subjects

M C Angermeyer

Publications and source records attributed to M C Angermeyer.

At least 91 records · Page 5Linked to original sources

PubMed2000

[Dementia patients in general practice--results of a survey].

In line with the current demographic trends, the number of elderly suffering from dementia is increasing. GPs have a key position in dealing with these patients at the primary care level. Different aspects of care for patients suffering from dementia provided in general practice in Germany were assessed by means of a questionnaire (n = 563). The results highlight the role of GPs in the delivery of medical and psychosocial care. However, diagnosing dementia seems challenging and co-operation could be improved. Three fourths of the GPs diagnose vascular dementia more often than Alzheimer's disease, which is contrary to what is known from epidemiological findings. One third refers patients to a specialist on a regular basis for establishing the diagnosis. Only 4% of the German GPs entertain co-operative relationships with the "Alzheimer society" and the "Brain league". Consequences for improving these for patients with dementia and their families are discussed.

Aged↗

PubMed2000

Are cognitively impaired individuals adequately represented in community surveys? Recruitment challenges and strategies to facilitate participation in community surveys of older adults. A review.

BACKGROUND: Dementia is the most important age-related disorder and subject to a substantial body of epidemiological research. However, field work in elderly populations faces special challenges which may reduce response rates and invalidate survey results. Therefore, this paper will review more recent prevalence studies of dementia to examine how recruitment issues and their influence on the study outcome have been addressed. METHODS: Field studies of the elderly with the main focus on prevalence of dementia published over the last 10 years will be systematically reviewed. The review concerns sampling frames, ways to include institutionalised individuals, response rates and strategies to deal with special challenges of field work in elderly populations such as mortality, fragility and sensory impairment. Furthermore, papers were evaluated regarding the extent to which recruitment outcomes were discussed. RESULTS: The literature is characterised by a disregard of recruitment issues to a varying extent. Mortality, functional dependency and sensory impairment (all positively related to dementia) are barely taken into account in the study design and rarely discussed. As a consequence, cognitively impaired individuals are likely to be underrepresented in most community studies. CONCLUSION: Strategies to deal with special challenges of field work in the elderly in a systematic manner and to facilitate participation in population surveys of the elderly are crucial and will be outlined. Communication on recruitment issues is essential to improve the validity of study outcomes.

Adult↗

PubMed2000

Schizophrenia and violence.

OBJECTIVE: The relationship between schizophrenia and violence is studied from a psychiatric and a public health perspective. METHOD: All epidemiological studies which have been published since 1990 are reviewed. RESULTS: Despite differences in the methodological approaches chosen the studies reviewed concur in supporting the assumption that there is a moderate but significant association between schizophrenia (or more generally psychotic disorders) and violence. However, compared with the magnitude of risk associated with substance abuse and personality disorders, that associated with schizophrenia or other major mental disorders is small. In addition, the elevated risk to behave violently appears to be limited to particular symptom constellations. The evidence available so far suggests that the proportion of violent crimes committed by people suffering from a severe mental disorder is small. There is no unambiguous evidence of an increase of violent acts committed by severely mentally ill people in general and people suffering from schizophrenia in particular during recent years. Strangers appear to be at an even lower risk of being violently attacked by someone suffering from severe mental disorder than by someone who is mentally healthy. CONCLUSION: While the assessment of relative risk is of great interest for psychiatric researchers who are trying to identify factors which may increase or decrease the risk of violent behaviour among the mentally ill, which in turn may provide some clues as to how to intervene best in order to reduce the risk, the attributable risk is of special interest for the public since it informs about the risk of becoming victim of a violent act committed by someone who is suffering from a mental disorder.

Adult↗

PubMed2000

[Information and support needs of the family of psychiatric patients].

AIM: This study aimed at the systematic assessment of the educational and service needs among relatives of psychiatric patients. METHOD: A postal survey was carried out on a sample drawn from the members of the associations of relatives of mentally ill people in Germany and Austria. Data collected from parents (n = 509) and spouses (n = 54) of patients with schizophrenia or affective disorders were analysed. RESULTS: More than half of the participants expressed the need for more support and complained of not having enough opportunities to relieve the burden imposed on them. Further, families have a strong desire for more information about the disorder as well as practical advice concerning how to cope with the patient. CONCLUSIONS: The results document the great need for services among families and the need for enhancement of quality of care and negotiated partnership between families and professionals.

Adult↗

PubMed2000

[Neuroleptics and quality of life. A patient survey].

OBJECTIVE: This paper addresses the question as to which positive effects of drug treatment on quality of life are expected by schizophrenic patients, and which negative effects should be avoided by any means. METHODS: A survey, using open-ended questions, was carried out among schizophrenic patients from all over Germany (n = 565). RESULTS: Most frequently the patients hoped for a general improvement or stabilisation of their state of health when taking medication. When asked about positive effects, almost every fourth respondent gave a somewhat paradoxical answer by stating that the medication should have less or no side effects. Less frequently, by only 15%, the calming and relaxing effect of the drugs was cited, followed by the antipsychotic effect and relapse prevention. With regard to negative effects, extrapyramidal motor symptoms ranked first with 42% of those questioned regarding them to be a restriction of their quality of life which should definitely be avoided. Second most frequently, sedation was mentioned, followed by weight gain. DISCUSSION: In the light of the introduction of so-called "atypical" neuroleptics, the implications for compliance with the treatment are discussed.

Adult↗

PubMed2000

[Standardized documentation system for the complementary sector of psychiatric care. Development and trial in Saxony].

The necessity for a standardized documentation system for the complementary sector of psychiatric care is pointed out, and the goals and requirements to be met are debated. The test-version of such a documentation system (abbrev. BADO-K) is shown. It consists of modules for the assessment of client-centered data, and for the documentation of the treatment process in various facilities. Furthermore, a module of questionnaires and instruments for assessing outcome variables (e.g. quality of life) is integrated. The principles for using the paper-pencil-version and the EDP-version are outlined and discussed with regard to the legal regulations concerning the protection of personal data. Finally, possibilities and limitations of the presented documentation system are discussed. It is argued that the BADO-K is an useful instrument for evaluating the process and outcome of community psychiatric care.

Community Mental Health Services↗

PubMed2000

[Schizophrenia and the quality of life].

This paper discusses opportunities and constraints for psychiatry to exert an influence on the quality of life of people suffering from schizophrenia. Using the example of neuroleptic drug treatment, the opportunities to both positively and adversely affect quality of life by means of psychiatric treatment are illustrated. De-institutionalisation was used as an example for demonstrating the effect of the quality of mental health services. The fact that efforts on the part of professional helpers to achieve improvements in their patients' quality of life are constrained by existing economic and socio-cultural conditions is shown by discussing the stigmatization of people with schizophrenia and their situation on the labour market.

Humans↗

PubMed2000

[Ecologic distribution of mental disorders in urban areas. Review of six decades of ecologic research in psychiatry].

In 1939, Robert Faris and Warren Dunham published their pioneering work on "Mental disorders in urban areas". They investigated the distribution of mental disorders in Chicago. In the following decades, a number of studies using a similar design were carried out in various cities in the United States and in Europe, which largely replicated Faris' and Dunham's findings. The concentration of most psychiatric disorders in certain problem areas indicates the existence of a relationship between their distribution and unfavorable social conditions. However, the intention of ecological studies to find strong evidence for the psycho-social cause of mental disorders, especially of schizophrenia, failed. In schizophrenia, social selection leading to a particular spatial distribution of schizophrenic patients as a consequence of their illness or premorbid condition seems to be the most important factor. Rather than making a substantial contribution to the search for the causes of mental disorders as has been assumed up to now, identifying high risk areas of psychiatric disorders may serve as a rational basis for service planning and the allocation of resources.

Asia↗

PubMed2000

[Public image of psychiatry. Results of a representative poll in the new federal states of Germany].

RESEARCH PROBLEM: The readiness to use psychiatric services is, among other things, determined by the image of psychiatry held by the public. METHOD: A representative survey of the adult population in the new German Länder was carried out, part of which was the assessment of what people associated with the term "psychiatry" and of their idea of a psychiatric hospital. RESULTS: Psychiatric hospitals, in particular the large-scale mental institutions, shape the dominant image of psychiatry among the public. In this, the custodial or repressive character of psychiatry is the central constituent of the public's representation. DISCUSSION: The chances that a positive change of the public's ideas toward more informed images and attitudes might be achieved appear to be slim as long large scale institutions, though with a new appearance, continue to exist.

Adolescent↗

PubMed2000

[Depression and stigma].

AIM: Until now, the interest of stigma research in psychiatry has been predominantly focused on schizophrenia. The fact that individuals suffering from depression may also be exposed to stigmatization, on the other hand, has received little attention. METHOD: Using the scales for the assessment of perceived stigma and stigma coping developed by Link et al., 39 patients who had received in-patient treatment for a depressive episode were questioned 4-7 months after their discharge from hospital. RESULTS: 45% of the respondents reported concrete instances of stigmatization. Respondents expected to find discrimination and devaluation on the part of their environment especially with regard to their changes on the labour market. The vast majority of those questioned was in favour of keeping the fact that one had experienced a mental illness or had received psychiatric treatment to themselves. Further, our results show a tendency to avoid situations which might imply an increased risk of stigmatization. While respondents considered it important to facilitate a better understanding of mental illness on the part of their closest friends and relatives, the idea of being actively involved in educating the lay public received comparatively little support. CONCLUSION: Although individuals suffering from depression may be confronted with less rejection or resentment than schizophrenic patients or patients with substance use disorder, this does not imply that they do not have to struggle with the problem of stigmatization.

Adaptation, Psychological↗

PubMed1999

Whom to ask for help in case of a mental disorder? Preferences of the lay public.

BACKGROUND: Although socio-cultural factors have been recognised as an important predictor in shaping help-seeking behaviour, few attempts have been made in this regard to specify the nature and impact of socio-cultural factors such as attitudes and belief systems prevalent in society. METHODS: We investigated the lay public's attitudes toward help-seeking regarding psychiatric disorders, and their determinants, in a cross-sectional national survey in Germany (n = 1564), using structured interviews with vignettes depicting a person either suffering from depression or from schizophrenia. Two distinct methodological approaches (rating vs ranking) were applied. RESULTS: Public opinion considers mental health professionals helpful in treating schizophrenia but not in the treatment of depression. For depression, public opinion clearly favours the lay support system and believes in involving the family physician if the former resource is exhausted. Determinants of help-seeking recommendations were problem definition, perception of the cause of distress and anticipated prognosis, as well as resentment against mental health professionals. CONCLUSION: Our results suggest that attitudes and belief systems prevalent in society have a major impact on help-seeking behaviour, both through transmission to the person suffering from mental distress via his/her social network and through the person's own attitudes formed in the process of socialization. Implications are pointed out for the daily work of mental health care providers, health care planning and public discussion of mental health issues.

Adolescent↗

PubMed1999

Lay beliefs about mental disorders: a comparison between the western and the eastern parts of Germany.

BACKGROUND: Since the end of the Second World War the western and eastern parts of Germany have been exposed to very different social and cultural influences. It was our assumption that this should also be reflected in the beliefs about mental disorders held by the general public. METHODS: In autumn 1990, immediately after German reunification, a representative survey on lay concepts of schizophrenia and depression was carried out in both parts of Germany. In all, 2118 personal, fully structured interviews resulted in the West, 980 in the East. RESULTS: In general, there were more similarities than differences between West and East, particularly as concerns causal attributions (with psychosocial stress being most frequently seen as etiologically relevant) and treatment recommendations (with psychotherapy clearly favored over drug treatment). However, there were also some differences, most notably a stronger tendency in the West to define depressive behavior in psychiatric terms and to recommend established forms of psychiatric treatment for its management. CONCLUSIONS: Our assumption that the exposure to different cultural influences should have led to discrepant beliefs about mental disorders was only partly confirmed. Especially with regard to schizophrenia, the prevalence of the dominant stereotype hardly differed between West and East.

Adult↗

PubMed1999

Do memory complaints indicate the presence of cognitive impairment? Results of a field study.

BACKGROUND: In the context of suspected cognitive disorders, the validity of memory complaints is subject to considerable debate. This investigation documents the prevalence of memory complaints and assesses the validity of memory complaints for detecting cognitive impairment. METHODS: The sample comprises 349 randomly selected non-institutionalized individuals, aged 75 and over living in the city of Leipzig. Twenty individuals who suffer from moderate and severe dementia according to DSM-III-R were excluded. Memory complaints were measured by means of a single item question. The Mini-Mental State Examination (MMSE) and a wider range of cognitive tests which constitute the short neuropsychological battery of the SIDAM (Structured Interview for the Diagnosis of dementia of Alzheimer type, Multi-infarct dementia and dementias of other etiology according to ICD-10 and DSM-III-R) were used to test cognitive performance. RESULTS: One in three individuals aged 75 and over complained about memory deficits. The MMSE is not significantly related to memory complaints, whereas poorer performance on 2 out of 8 tests regarding specific areas of cognitive function (immediate recall, short-term memory) were found to be significantly associated with memory complaints. Despite these statistically significant associations, it is shown that memory complaints do not have diagnostic validity in detecting cognitive impairment on the individual level. CONCLUSION: Memory self-assessment should not be used as a substitute measure of cognitive performance. Initiation of further diagnostic and therapeutic steps should be based on cognitive performance testing. Relaying solely on memory complaints would miss individuals in need and allocate resources to worried but cognitively healthy persons.

Aged↗

PubMed1999

The role of referrals in diagnosing dementia at the primary care level.

BACKGROUND: Demographic changes indicating a general aging of the population suggest that the key role of general practitioners (GPs) in the diagnosis and management of dementia becomes more salient. The encouragement of GPs to collaborate with specialists is one chance to support GPs in performing a variety of functions associated with the diagnosis and management of dementia. METHOD: We used a questionnaire to investigate the role of referrals in diagnosing dementia at the primary care level and variables potentially influencing the referral behavior of German GPs (n = 563). RESULTS: Only 31% of the GPs stated that the diagnosis of dementia was made predominantly in the context of referral to a specialist. The chance that referrals were made was increased for those GPs who entertained extensive cooperative relationships with self-help groups, psychologists, or the "Alzheimer Society"/"Brain League" (odds ratio [OR] 1.74) and for those GPs who perceived a great preparedness on the part of the relatives of the patient to comply with a referral (OR 2.29) as well as who noticed a great readiness among specialists to accept patients for the diagnosis of dementia (OR 2.55). GPs whose therapeutic orientation was shaped by further training and scientific literature were more likely to refer (OR 3.54). DISCUSSION: Enhancing the liaison between GPs and specialist physicians by improving the psychogeriatric competence of GPs as well as the connection to nonmedical services is discussed.

Aged↗

PubMed1999

[Acceptance of community psychiatry reform in the population. Results of a representative study in new German federal lands].

In 1993, a representative survey on the acceptance of community psychiatric services was conducted in the New German Länder. Its results show that the prospect of a hostel or group home for psychiatric patients to be established in their neighbourhood led to a predominantly negative reaction. On the other hand, the announcement that a day centre or a sheltered workshop should be opened was met with a more positive response. Only one quarter of those questioned supported the establishment of psychiatric units at general hospitals. Hence the acceptance of community psychiatric services in the east was clearly lower that in the western part of Germany. There was a clear association between the acceptance of community psychiatry and the general attitude towards the mentally ill. When respondents had personal experience with mental disorder, they were more open-minded as regards the establishment of complementary psychiatric services.

Adult↗

PubMed1999

[Quality of life--what it means to me... Results of a survey among schizophrenic patients].

PURPOSE: In recent years numerous studies have been published on the quality of life of schizophrenic patients. However, the patients' understanding of what quality of life is about has not been given sufficient attention. METHOD: 565 schizophrenic patients from the whole of Germany were asked what quality of life meant for them. RESULTS: Aspects of quality of life which can be subsumed under the heading of social integration were cited most frequently. As for the study as a whole, the most important aspect in this context was work and employment. Health represented a second domain. More specifically, respondents cited health in general (which was the second most frequently cited overall aspect) or health with respect to their mental illness in the sense of absence of symptoms and illness-related impairments. A third domain includes various components of well-being such "joie de vivre" or independence. Psychiatric treatment was associated with quality of life only as an exception, and if so only in negative terms. DISCUSSION: The results are contrasted with a comparable survey among psychiatrists.

Adult↗

PubMed1999

[Development of a standardized documentation system for outpatient non-hospital based psychiatric care].

An instrument documenting the care process in in-patient psychiatric services within the German mental health care system has been developed (BADO). This paper reports on the development of a documentation system for all non-hospital based mental health services (day centres, community mental health centres, supported accommodation, work rehabilitation services for general adult psychiatric patients and people with substance misuse). The development process and the instrument (PC and paper and pencil version) are described. The documentation system (BADO-K) could be an important prerequisite for quality assurance in non-hospital based mental health care, and its structure ensures compatibility with the corresponding hospital-based documentation system.

Adult↗

PubMed1999

[Attitude of family to neuroleptics].

PURPOSE: The present study is based on the assumption that for patients' compliance with psychotropic medication is also of importance their closest relatives' attitude towards that treatment. METHODS: In the context of a mail survey of relatives of people with schizophrenia, we asked what the relatives considered to be the most important positive and negative effects of the medication. RESULTS: As expected, the main benefit was seen in the reduction of symptoms and in the prevention of relapse. In addition, the improvement of social adaptation and the subjective quality of life of the patients were also cited as important positive effects. Beside these effects which are closely related to the treatment of the disorder, respondents mentioned effects which can help to facilitate their living together with their ill relative. Among the side effects regarded as particularly unpleasant for the patients, sedation ranked first, followed by weight gain and extra-pyramidal motor symptoms. DISCUSSION: The results are contrasted with those of a comparable study of people with schizophrenia.

Adaptation, Psychological↗