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Biomedical subjects

N Sartorius

Publications and source records attributed to N Sartorius.

At least 19 recordsLinked to original sources
PubMed2006

Psychiatry in selected countries of Central and Eastern Europe: an overview of the current situation.

OBJECTIVE: To review the current status of psychiatry in selected countries of Central and Eastern Europe: Bulgaria, Croatia, Czech Republic, Hungary, Poland, Romania, Russia, Slovakia, and Slovenia. METHOD: A group of psychiatrists from the region evaluated the status of psychiatry at the end of 2004 based on data from their countries and information available on WHO homepages. RESULTS: There is a shift from traditional in-patient facilities towards out-patient and community services as evidenced by a decreasing number of hospital beds. Economic pressures affect the financing of psychiatric services, and reimbursement for novel psychotropics. Political changes were followed by updated legislation. Psychiatric training, pre-, postgraduate and continuous medical education, are gradually being transformed. Scientific output as measured by publications in peer-reviewed journals has been significantly lower than in the West. CONCLUSION: The major changes in the period of transition documented in the review pose new challenges for psychiatry.

Bulgaria↗
PubMed2005

Postgraduate training for young psychiatrists--experience of the Berlin Summer School.

BACKGROUND: Growing professional exchange between Eastern and Western European countries increases the possibilities for international postgraduate training courses and by that satisfying the need for rapid and facilitation of travel and migration in the enlarged European Union increase achieving high standards. The purpose of this study was to evaluate a summer school program that trained young Eastern European psychiatrists and to assess the impact of the program on their professional development and future activities. METHOD: We evaluated the training effect of the first 3 years of the Berlin Summer School with respect to (1) the participants' satisfaction with the topics, quality and originality of the presentations, and (2) long-term effects and implications for their professional career. All participants (N=43) filled out anonymously the evaluation form at the end of each summer school. An evaluation of long-term effects was carried out 2 years later with a questionnaire that was sent via e-mail to all former participants. RESULTS: Participants were most satisfied with practical topics such as "how to prepare a paper", "how to evaluate a paper", or "how to participate in a congress." The appreciation of the presented topics and the appreciation of courses increased in each consecutive summer school. All summer school participants reported that the course had some influence on their future career, and one fifth of the participants felt that their professional development was influenced "a lot". CONCLUSIONS: Although limited to 1 week of intensive training, a summer school program can have a longer lasting positive influence on the professional development of the participants. Participants felt that particularly the training of practical skills improved their research performance. Former participants founded an independent multicentric and multinational research group and supported national courses that were organized similar to the Berlin Summer School.

Analysis of Variance↗
PubMed2002

Attitudes about schizophrenia from the pilot site of the WPA worldwide campaign against the stigma of schizophrenia.

BACKGROUND: A series of surveys were conducted to assess the attitudes of the public, and other groups, toward those with schizophrenia. The aim of these surveys was to aid in the planning and evaluation of the WPA anti-stigma initiative in Alberta, Canada. METHOD: A questionnaire was devised and administered via telephone to over 1,200 individuals in three Alberta cities, and in paper and pencil format to 40 members of the Schizophrenia Society of Alberta and 67 medical students. RESULTS: In contrast to some earlier findings, "loss of mind" was rated to be more disabling than any other handicapping condition. In general, respondents showed a relatively sophisticated understanding of schizophrenia and a higher level of acceptance than might have been predicted. Nonetheless, this acceptance was not as high for situations where closer personal contact was likely, and fears of dangerousness continue to be associated with schizophrenia. The majority of respondents, however, felt that treatment aided those with schizophrenia, expressed support for progressive programmes for the mentally ill, and stated that they would be willing to pay higher taxes so that programming could be improved. CONCLUSIONS: The results do not support the utility of a broad approach for an anti-stigma campaign, but rather suggest a more specific focus, such as perceived dangerousness.

Adolescent↗
PubMed2001

Recovery from psychotic illness: a 15- and 25-year international follow-up study.

BACKGROUND: Poorly defined cohorts and weak study designs have hampered cross-cultural comparisons of course and outcome in schizophrenia. AIMS: To describe long-term outcome in 18 diverse treated incidence and prevalence cohorts. To compare mortality, 15- and 25-year illness trajectory and the predictive strength of selected baseline and short-term course variables. METHODS: Historic prospective study. Standardised assessments of course and outcome. RESULTS: About 75% traced. About 50% of surviving cases had favourable outcomes, but there was marked heterogeneity across geographic centres. In regression models, early (2-year) course patterns were the strongest predictor of 15-year outcome, but recovery varied by location; 16% of early unremitting cases achieved late-phase recovery. CONCLUSIONS: A significant proportion of treated incident cases of schizophrenia achieve favourable long-term outcome. Sociocultural conditions appear to modify long-term course. Early intervention programmes focused on social as well as pharmacological treatments may realise longer-term gains.

Adult↗
PubMed2001

Is pain a somatic symptom?

The grouping of symptoms into "somatic" or "physical" on the one hand and "mental", "somatoform", or "psychological" on the other are vestiges of an era in medicine when it seemed useful to divide all the phenomena of disease into two groups - one related to the soma and other to the psyche. Today, this division is becoming obsolete and is harmful. Obsolete, because we are discovering changes in the tissues or in biochemical and immunological functions of the body in people with mental disorders, and because psychological complaints are frequent in all physical illnesses. Harmful, because the labels "psychological", "psychogenic", or "somatoform" are so loaded with connotations of being simulations or complaints about nothing that patients are unlikely to recive the help they need.

Diagnosis, Differential↗
PubMed2001

The economic and social burden of depression.

Depressive disorders are a major public health problem. They occur frequently and produce severe suffering for those affected and for their families. They are ubiquitous and appear at all ages. The consequences of depressive disorders in terms of excessive mortality, disability, and secondary morbidity are grave. There are indications that the frequency of depressive disorders will increase in the years to come, for a variety of reasons, including demographic changes, extended life expectancy of people suffering from chronic physical disorders, and iatrogenic causes. The essential criterion for designating a condition as a major public health problem--that there should be an effective intervention that will diminish or eliminate the problem-has now also been met. Recent years have seen the development of a variety of new treatments that can be applied even in situations where highly specialized mental health staff are scarce. These developments make training in the use of new treatment methods of proven value and their wide application a public health priority and an ethical obligation. The presentation will discuss these issues on the basis of accumulated evidence and experience.

Comorbidity↗
PubMed2000

Public acceptance of restrictions on mentally ill people.

OBJECTIVE: To assess the influence of demographic, psychological, sociological and cultural variables on the public acceptance of restrictions on mentally ill people. METHOD: Multiple logistic regression analysis of the results of an opinion survey conducted on a representative sample in the German, French and Italian-speaking part of Switzerland. RESULTS: Public acceptance of restrictions depends on age, education and gender. The influence of demographic variables is reduced when including rigidity, anomie, social distance and contact with mentally ill people in the analysis. The cultural influence of the language region is significant. All these factors predict acceptance. Stereotypes and emotional reactions have no influence. CONCLUSION: Attitudes to mentally ill people are shaped on three distinct levels, the psychological, social and cultural, respectively. Demographic variables partly play the role of placeholders covering the underlying relationships.

Adolescent↗
PubMed1999

An assessment of the Standardized Assessment of Personality as a screening instrument for the International Personality Disorder Examination: a comparison of informant and patient assessment for personality disorder.

BACKGROUND: The International Personality Disorder Examination (IPDE) has been developed as a standardized interview for personality disorders. While it has good psychometric properties, its length makes it difficult to use in the community in population research, particularly outside psychiatric settings. The informant-based Standard Assessment of Personality (SAP), which has been in use since 1981, could serve as a valid screen to detect likely personality disordered individuals who would then receive a definitive diagnosis by IPDE. This study aimed to compare the two instruments in their capacity to detect personality disorder according to ICD-10 taxonomy and to estimate the efficiency of the use of the two together in a case-finding exercise. METHOD: Ninety psychiatric out-patients in Bangalore, India, were assessed for personality disorder using the two methods. Assessment was conducted by a pair of trained interviewers in random order and by random allocation to interviewer. RESULTS: Overall agreement between the two instruments in the detection of ICD-10 personality disorder was modest (kappa = 0.4). The level of agreement varied according to personality category, ranging from kappa 0.66 (dependent) to kappa 0.09 (dyssocial). The SAP proved to have a high negative predictive value (97%) for IPDE as the gold standard, suggesting its potential as a screen in samples where the expected prevalence of personality disorder is low. CONCLUSION: A two-stage approach to epidemiological studies of personality disorder may be practicable.

Adult↗
PubMed1999

The use of public health approaches in mental health programmes.

This paper underlines the usefulness of public health approaches to programme planning and evaluation in the field of psychiatry. The use of these approaches is illustrated by an assessment of the public health importance of depressive disorders and by a review of public health criteria for the evaluation of treatment interventions in psychiatry. The author stresses that the use of public health approaches in psychiatry is necessary because it will help in national planning and in increasing the priority which the authorities and the general public give to mental health programmes.

Evidence-Based Medicine↗
PubMed1998

The application of the International Statistical Classification of Diseases to neurology: ICD-10 NA.

Rapid advances in the clinical neurosciences in the last decade have led to considerable amplification of our ability to classify neurological diseases. For these classifications to be widely used, they must be compatible with the 'International Statistical Classification of Diseases and related health problems' (ICD) of the World Health Organization (WHO), which system is used throughout the world for classification of diseases and reasons of death. The 'Ninth' revision of the ICD (ICD-9), published in 1976, is currently in use in a number of Member States of the World Health Organization, including the United States. However, it is expected that by the end of this decade virtually all Member States will have introduced the 10th Revision of the ICD (ICD-10), published in 1992. An 'Application of ICD-10 to neurology' (ICD-10 NA) has been developed, with a specific coding system for virtually every neurological disease currently recognized. This article describes the structure and background of this work, that is offered as a definitive international classification of neurological disease to be used by clinical and research organizations, governmental and nongovernmental bodies, and for epidemiological and research purposes. It is concordant with the new and proposed classifications of subspecialty neurological organizations.

Cause of Death↗
PubMed1997

WHO Study on the reliability and validity of the alcohol and drug use disorder instruments: overview of methods and results.

The WHO Study on the reliability and validity of the alcohol and drug use disorder instruments in an international study which has taken place in centres in ten countries, aiming to test the reliability and validity of three diagnostic instruments for alcohol and drug use disorders: the Composite International Diagnostic Interview (CIDI), the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) and a special version of the Alcohol Use Disorder and Associated Disabilities Interview schedule-alcohol/drug-revised (AUDADIS-ADR). The purpose of the reliability and validity (R&V) study is to further develop the alcohol and drug sections of these instruments so that a range of substance-related diagnoses can be made in a systematic, consistent, and reliable way. The study focuses on new criteria proposed in the tenth revision of the International Classification of Diseases (ICD-10) and the fourth revision of the diagnostic and statistical manual of mental disorders (DSM-IV) for dependence, harmful use and abuse categories for alcohol and psychoactive substance use disorders. A systematic study including a scientifically rigorous measure of reliability (i.e. 1 week test-retest reliability) and validity (i.e. comparison between clinical and non-clinical measures) has been undertaken. Results have yielded useful information on reliability and validity of these instruments at diagnosis, criteria and question level. Overall the diagnostic concordance coefficients (kappa, kappa) were very good for dependence disorders (0.7-0.9), but were somewhat lower for the abuse and harmful use categories. The comparisons among instruments and independent clinical evaluations and debriefing interviews gave important information about possible sources of unreliability, and provided useful clues on the applicability and consistency of nosological concepts across cultures.

Adult↗