Biomedical subjects

S Priebe

Publications and source records attributed to S Priebe.

At least 73 records · Page 4Linked to original sources

PubMed1997

The quality of life of patients with paranoid schizophrenia in London and Berlin.

This study compared the subjective and objective quality of life and needs of patients with paranoid schizophrenia between inner city areas in Berlin (69 patients) and London (75 patients). Quality of life was assessed by means of the Lancashire Quality of Life Profile (German version Berliner Lebensqualitatsprofi), and need was quantified using the Camberwell Assessment of Need (German version Berliner Bedurfnisinventar). The hypotheses tested were that although Berlin patients may rate more highly on objective quality of life measures, the subjective quality of life would be similar as patients would judge their quality of life against their local expectations. The findings supported the first part of the hypothesis as on the objective measures the Berlin group was significantly better off financially and in living conditions, and had significantly fewer material needs. However, despite having more severe psychopathology, the Berlin groups' scores on global subjective quality of life were also higher. On particular life domains, subjective quality of life did not always reflect objective measures and sometimes went in the reverse direction. We concluded that the relationship between subjective and objective quality of life is complex, and great caution must be exercised in making quality of life comparisons between different cultures.

Adolescent↗

PubMed1997

[Psychosocial characteristics and attitudes of clients of day care centers and contact and counseling facilities].

Within the last 20 years, many day-care centers (Tagesstätten = TSn) and drop-in centers (Psychosoziale Kontakt- und Beratungsstellen = KBSn) have been set up in Germany. Although these institutions are widespread, there are hardly any empirical studies on the characteristics of their users or on their effects. In this study, 100 patients in TSn and KBSn in Berlin were examined. Social characteristics, psychopathology and attitudes of the patients were investigated. Almost all patients had been in psychiatric hospitals before. The current psychopathology varied greatly and was moderate on average. Two-thirds of the patients were pensioners, most of them living alone with just a few or no friends. Contact with other people and structured day activities were most often mentioned as positive aspects by the patients. The most frequent negative aspect was annoyance by fellow users. Patients in TSn were significantly younger and had higher scores on BPRS subscale anergia. In other variables, there was little difference between patients in the two institutions. The results suggest that both institutions--as intended--care for chronic mentally ill patients with poor social integration. For these patients they provide some compensations for a insufficient social network. Limitations and consequences of the findings are briefly discussed.

Adult↗

PubMed1997

[Suicide rates in a community psychiatric service system].

Reduction of the elevated suicide rates in psychiatric patients remains an important aim of psychiatric treatment. There has been an ongoing discussion on the question of whether the increased tendency to transfer long-term psychiatric patients from inpatient care to community psychiatric care might go along with increased suicide rates. In our community care system we found an age- and sex-adjusted suicide rate 40 times as high as in the general population in the period between 1973 and 1993. Within the first 4 years suicide rates were significantly elevated. All suicides had the diagnosis of chronic schizophrenia or schizoaffective psychosis. In the non-schizophrenic group no suicide occurred during treatment. Our study shows that in community psychiatric care suicide rates in schizophrenic patients are significantly increased whereas suicide rates is non-schizophrenic patients may be decreased.

Adolescent↗

PubMed1997

[Disturbances of body experience in schizophrenic patients].

Disturbances of body experience in schizophrenia patients occur frequently. They vary phenomenologically and lack exact and distinct definitions. Their theoretical and clinical relevance remains widely unclear. This review summarises the literature on clinically relevant symptoms such as coenaesthesis and body hallucinations, disturbances of pain perception, out-of-body-experiences, dysmorphophobia and self-injuries or self-mutilation. Empirical studies on the concepts of body schema, body concept and body cathexis are reported. Many of these studies have serious methodological shortcomings. The correlation of disturbances of body experience with other psychopathology is considered. Standardised methods for assessing these disturbances are listed. Effects of body-oriented psychotherapy have been suggested, but not empirically tested. Finally, the possible relevance of further research in this field is discussed.

Body Image↗

PubMed1997

[Psychiatric disorders after political imprisonment in the Soviet occupation zone and in the GDR from 1945-1972].

In an exploratory study, 54 persons, were examined who were imprisoned--for at least six months--for political reasons first in the Soviet Occupation Zone and/or later in the German Democratic Republic (East Germany) between 1945 and 1972. Conditions of imprisonment included means that may be classified as psychological torture. Biographical data, experiences of imprisonment, factors helpful for coping, and influence of imprisonment on the persons' life were investigated in a semistructured interview. Symptoms were self-rated on a combined form of the von Zerssen Complaints List, psychiatric disorders were assessed in the computerised WHO composite International Diagnostic Interview. In 29 persons no psychiatric disorder was diagnosed. In 25 persons mostly anxiety disorders and depressive disorders were found. 21 of the latter reported that the onset of symptoms was during imprisonment or within a one-year period following it. Many persons had some symptoms of post traumatic stress disorder while only one fulfilled all criteria for diagnosing it. Only a few variables were significantly correlated with the severity of self-rated symptoms or with the existence of a psychiatric disorder. The shared variance was limited. Former prisoners with a better vocational integration had less often a psychiatric disorder and fewer symptoms. When interviewes stated some positive implications of imprisonment for their life thereafter and when they had more social contacts, this was also associated with a lower severity of self-rated symptoms.

Aged↗

PubMed1997

Long-term mental sequelae of torture in Iran--who seeks treatment?

In this study, we investigated long-term mental sequelae of torture in Iran and explored differences between treatment seekers and nontreatment seekers. Thirty-four torture victims suffering from enduring mental sequelae and now living in Germany were examined. According to DSM-III-R, depressive, anxiety, and somatoform disorders were diagnosed with a high degree of comorbidity and with posttraumatic stress disorder (PTSD) being the most frequent diagnosis. Treatment seekers had a higher level of psychopathology, particularly the PTSD symptoms of intrusion and increased arousal, and a poorer knowledge of German. They reported different ways of coping. The differences found between the two groups may reflect more or less successful adaptation to conditions in the host country and contribute to the motivation to seek treatment.

Acculturation↗

PubMed1997

Does quality of life differ in schizophrenic women and men? An empirical study.

In our study of 617 schizophrenic patients, we tested the hypothesis that women have a better objective and subjective quality of life than men. Better social integration of women was confirmed. Objective conditions had a significant but quantitatively small impact on satisfaction with specific life domains. Better social integration did not, however, lead to more satisfaction among schizophrenic women. Satisfaction with life in general was better predicted by satisfaction in different life domains than by objective circumstances. Predictors of satisfaction with life were not equal for both sexes. Rather than confirming quantitative differences in subjective quality of life, our data support the existence of gender-specific processes and contexts of subjective valuation.

Adult↗

PubMed1997

[Social psychiatry and social aspects of psychiatry--on the historical applications of the concepts].

In German language the two terms "Soziale Psychiatrie" and "Sozialpsychiatrie" are used without any clear distinction. In this paper a historical analysis of the connotations of the two terms is made while underlying concepts are not considered. In the 19th century the words social and medicine were connected. At the beginning of the 20th century the terms "Soziale Psychiatrie" and "Sozialpsychiatrie" appeared in German as synonyma. In Germany-unlike, for instance, in the USA-ideas of segregation of the mentally ill and of eugenics were also regarded as "Soziale Psychiatrie". In difference to this connotation "Soziale Psychiatrie" described intentedly ideological positions in the 70's, while a certain of area of research was rather associated with "Sozialpsychiatrie". Finally, a more precise use of the terms is suggested for current discussions.

Community Psychiatry↗

PubMed1997

[Quality of life, needs and treatment evaluation of long-term hospitalized patients. Part II of the Berlin Deinstitutionalization Study].

OBJECTIVE: Objective living situation, subjective quality of life, need for care, and assessment of treatment of long-term hospitalised patients were investigated. METHODS: 237 patients from 6 hospitals were examined using standardised instruments. RESULTS: Patients' satisfaction was generally relatively high, but varied greatly in subgroups and individuals. Patients were most satisfied with personal safety in the hospital and least satisfied with the expectation to live in the hospital for a long time. Therapists assessed clearly more needs for care in the patients than the patients did themselves. Statistical analysis revealed significant correlations between the subjective quality of life in different domains, the number of needs stated and plausible determining factors. CONCLUSIONS: Findings reflecting patients' living situation in the hospital are very heterogeneous. In respect of subjective evaluation criteria, there is little space for improvement in the future.

Activities of Daily Living↗

PubMed1996

[Treatment of post-traumatic stress disorder].

PTSD is a frequent subject of empirical psychiatric research. There is, however, little knowledge about the efficacy of treatment methods. In this review, general therapeutic guidelines and common components of different psychotherapies are described. Approaches of behaviour, cognitive, psychodynamic and hypnotherapy are outlined. Controlled studies show the reduction of intrusive PTSD-symptoms in behaviour therapy. Effects of psychodynamic therapy on avoidance symptoms have been demonstrated in one study. Family and group therapy are described, their efficacy has not been empirically tested yet. The need to integrate different concepts and models is emphasized. Special guidelines in the treatment of victims of political persecution are summarized. In pharmacotherapy positive effects on partial PTSD-symptoms has been shown in particular for SSRI-antidepressants. Pharmacotherapy may be a useful addition to psychotherapy. Fixed guidelines for the treatment of PTSD can not be set up yet.

Combined Modality Therapy↗

PubMed1996

[What needs following treatment have long-term schizophrenic patients? The problem of self- and external assessment of "needs"].

Needs for help and support were examined in 153 schizophrenic patients who had been being hospitalized for more than 6 months. In an operationalized and systematic way, needs as viewed by patients and their therapists were assessed using the Berliner Bedürfnis Inventar. In general as well as regarding single domains of life therapists stated significantly more needs than the patients; the agreement between patients' and therapists' views was very low. Frequency of needs as expressed by the patients was correlated with self-rated complaints, but not with observer ratings of psychopathology. Needs were mostly met by medical and social institutions according to the patients' statements. Patients reported more often than their therapists that adequate help and support was not provided in some areas despite an existing need. Clinical and research implications of the findings are discussed.

Female↗

PubMed1996

Homologous and homeologous intermolecular gene conversion are not differentially affected by mutations in the DNA damage or the mismatch repair genes RAD1, RAD50, RAD51, RAD52, RAD54, PMS1 and MSH2.

Mismatch repair (MMR) genes or genes involved in both DNA damage repair and homologous recombination might affect homeologous vs. homologous recombination differentially. Spontaneous mitotic gene conversion between a chromosome and a homologous or homeologous donor sequence (14% diverged) on a single copy plasmid was examined in wild-type Saccharomyces cerevisiae strains and in MMR or DNA damage repair mutants. Homologous recombination in rad51, rad52 and rad54 mutants was considerably reduced, while there was little effect of rad1, rad50, pms1 and msh2 null mutations. DNA divergence resulted in no differential effect on recombination rates in the wild type or the mutants; there was only a five to 10-fold reduction in homeologous relative to homologous recombination regardless of background. Since DNA divergence is known to affect recombination in some systems, we propose that differences in the role of MMR depends on the mode of recombination and/or the level of divergence. Based on analysis of the recombination breakpoints, there is a minimum of three homologous bases required at a recombination junction. A comparison of Rad+ vs. rad52 strains revealed that while all conversion tracts are continuous, elimination of RAD52 leads to the appearance of a novel class of very short conversion tracts.

Amino Acid Sequence↗

PubMed1996

Mental health care systems and their characteristics: a proposal.

The last 30 years have seen a significant growth in health service evaluation literature in the field of mental health. Much of the best of this research has taken the form of random control trials of an experimental service against "standard' or generic care. Interpretation of these results has ben hampered by incomplete and inconsistent approaches to describing the experimental services, and often inadequate or completely non-existent characterization of the control service. In addition, the health care system in which the treatment programme is embedded is known to have important consequences for outcome. A proposal is advanced for a structured service description as a routine component for health services research reporting. Two worked examples are given, and a number of areas of ambiguity are highlighted.

Delivery of Health Care↗

PubMed1996

[Duration of treatment and case cost in different inpatient psychiatric facilities in Berlin].

In this study length of stay and costs per case were examined in three different types of psychiatric hospitals: Psychiatric departments in general hospitals and psychiatric hospitals each liable to provide in-patient care for a defined catchment area, and psychiatric departments in general hospitals without such liability. Data basis were all hospital treated cases in Berlin West that are covered by general insurance. Length of stay and costs differed significantly depending on the type of psychiatric hospital as well as on diagnoses, way of referral and age of patients. Psychiatric departments with catchment area have the shortest length of stay and lowest costs per case. This is independent of age, gender, way of referral and diagnosis of the patients. Influence of each factor is quantified.

Adolescent↗

PubMed1996

[Clinical characteristics of long-term hospitalized patients. Part I of the Berlin Deinstitutionalization Study].

The Berlin Deinstitutionalization Study investigates effects of the planned reduction of psychiatric hospital beds in Berlin prospectively. In the beginning cross-sectional survey all adult psychiatric patients from two and a half districts, who had been hospitalized for more than 6 months, were examined. The total sample was 422 patients. Treatment situation and needs for nursing care are reported. The primary diagnosis according to ICD-10 was organic disorder (incl. Korsakov's syndrome) in 70 patients and mental retardation in 61. Psychopathology and social disabilities were examined in 237 of the remaining 291 patients. On average, psychopathology and disabilities were moderate. A cluster analysis classified three groups. When patients should be discharged, special protective measures might be necessary only for the two smaller groups (together 31%).

Adolescent↗

PubMed1996

[Subjective quality of life of patients with chronic schizophrenia].

The main results of quality of life research in sociology and social psychology and the findings of psychiatric studies on subjective quality of life are summarized. The present study examined subjective quality of life in patients with chronic schizophrenia in different treatment settings (n = 318/ICD 10:F20). The satisfaction scales of the instrument used (Berliner Lebensqualitätsprofil) are shown to have adequate consistency coefficients. Psychopathological variables accounted for more variance than demographic and illness-related characteristics and features of objective quality of life. Negative schizophrenic symptoms were not of particular concern, and anxiety/depression scores did not interact with satisfaction ratings in different settings. Two of nine domains (living situation and mental health) and the total scores showed significant differences between patients in different settings. The degree of contrast between in- and out-patients seemed to be influenced by the current length of stay of the in-patients. In addition to cross-sectional studies, there is a need for further examination of differences in subjective quality of life and in treatment effects in longitudinal studies, which should make use of panel designs.

Activities of Daily Living↗

PubMed1996

[Body image of patients with acute paranoid schizophrenia. A follow-up study].

In the light of the heterogeneous literature on disturbances of body image in schizophrenic patients, we examined body schema, body concept and body cathexis, their changes during hospital treatment and their correlations with psychopathology in 38 patients with acute paranoid schizophrenia. The image-marking method according to Askevold, the Body Distortion Questionnaire, a visual-analogue scale on body cathexis and psychopathometric scales were applied. Body schema was also investigated in 27 healthy controls. On average, patients underestimated the size of their lower extremities, indicating a centralized body schema. They accurately assessed proximal fixed points. Underestimation was significantly correlated with anxiety, overestimation with grandiosity. Body schema and body concept were relatively independent from each other and from body hallucinations. Disturbances of body perception were reduced significantly, but not completely, during the time from admission to discharge. The results confirm and clarify some findings in the literature on a distorted perception of body size and support theories on body perception in schizophrenia.

Acute Disease↗

PubMed1996

[Quality of life as a planning and evaluation criterion in psychiatric management].

In sociology and psychology, quality of life and subjective well-being have been being relevant constructs and subject of empirical research for several decades. Results of this research are reviewed, and findings of the more pragmatic specific studies on quality of life in the mentally ill are summarised. Although subjective quality of life may be influenced by various factors, it stands as an own important criterion. Finally, some open questions for empirical research, for theoretical studies and for public discussion are mentioned. These questions should be addressed before a decision can be made as to which extent quality of life is a useful criterion for the planning and evaluation of mental health care.

Forecasting↗