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Biomedical subjects

W Senf

Publications and source records attributed to W Senf.

At least 37 records · Page 2Linked to original sources
PubMed1998

Circadian plasma leptin levels in patients with anorexia nervosa: relation to insulin and cortisol.

In anorexia nervosa, underweight results from a loss of body mass due to a restricted energy intake. Circulating leptin levels have been shown to be low in the acute stage of the disorder. We studied diurnal secretion characteristics of leptin, insulin and cortisol in a study group of anorectic patients prior to refeeding, a second study group of anorectic patients after initiation of refeeding and study groups of healthy underweight and normal-weight controls. Spontaneous secretion of leptin, insulin and cortisol was measured by drawing blood samples every 2 h for 24 h. The temporal relationships between the diurnal secretion patterns of the three hormones were assessed by cross-correlation analysis in every study group. Plasma levels of leptin and cortisol were secreted with a specific circadian rhythmicity and displayed an intricate temporal relationship in anorectic patients. Semistarvation in the non-refed patients was associated with (1) exceedingly low plasma leptin levels, (2) a qualitative alteration in the circadian rhythm of leptin and cortisol levels and (3) an alteration in the temporal coupling between cortisol and leptin. In contrast, in the patients who had gained weight, leptin levels were higher; furthermore, the diurnal pattern of leptin and the temporal relationship between leptin and cortisol were similar to controls. Increments in insulin secretion preceded those of leptin by 4-6 h in both anorectic patients and in controls. Leptin levels increased 4 h prior to those of cortisol in controls and in refed patients, whereas in the non-refed patients cortisol increased prior to leptin. Thus, anorexia nervosa leads to pronounced, albeit reversible changes in the secretion dynamics of leptin and cortisol.

Adult↗
PubMed1998

Comorbidity of diabetes and eating disorders. Does diabetes control reflect disturbed eating behavior?

OBJECTIVE: This multicenter study was designed to explore the prevalence of clinical and subclinical eating disorders (EDs), the extent of intentional omission of insulin and oral antidiabetic agents, and its relationship to glycemic control in an inpatient and outpatient population of men and women with type 1 and type 2 diabetes. RESEARCH DESIGN AND METHODS: Data have been collected from 12 diabetes medical centers in two German cities. In a questionnaire and interview-based study, a sample of male and female patients (n = 341 type 1, n = 322 type 2) was assessed for the following eating disorders: anorexia nervosa, bulimia nervosa, binge eating disorder, and eating disorder not otherwise specified. For lack of interview data of several patients meeting the screening criteria, prevalence ranges were calculated. RESULTS: The overall prevalence range of current EDs was 5.9-8.0% (lifetime prevalence 10.3-14.0%). When patients were stratified according to type 1 and type 2 diabetes, there was no difference in prevalence of EDs. However, the distribution of the EDs was different in both types of diabetes, with a predominance of binge eating disorder in the type 2 diabetes sample. Type 1 (5.9%) and type 2 (2.2%) diabetic patients reported deliberate omission of hyperglycemic drugs (insulin or oral agents) in order to lose weight. Compared with control subjects, neither the presence of EDs nor insulin omission influenced diabetic control. CONCLUSIONS: There seems to be no difference in prevalence rates of EDs in both types of diabetes; however, distribution of EDs is different. The findings suggest that neither EDs nor insulin omission are necessarily associated with poor control of glycemia. Binge eating disorder seems to precede type 2 diabetes in most patients and could be one of the causes of obesity that often precedes type 2 diabetes.

Adolescent↗
PubMed1997

[Early and differential diagnosis of 1,000 patients examined in a memory clinic].

The results from 1000 patients included in a consecutive sample of older persons showing signs of "age-related memory deficits" clearly demonstrate the necessity for a wide spectrum of differential diagnostic competence. The patients included in the study were diagnosed in succession by an interdisciplinary team of psychiatrists, neurologists, geriatric medical specialists, psychologists and gerontologists. The diagnostic process for clarification of DSM-III-R and ICD-10 criteria are discussed in detail. In all, 49.6% of the patients were diagnosed as suffering from dementia of the Alzheimer type, 31% from vascular dementia and 10% from a mixed form. In all, 12.5% of the patients were somatically ill and 31.4% displayed other psychiatric conditions, 50% of which were evaluated as being treatable with psychotherapy. The results are primarily discussed for their relevance to the reality of current treatment.

Adult↗
PubMed1996

[Individual therapy goals: on outcome documentation of inpatient psychotherapy from the patient and therapist viewpoint].

The results of a study evaluation in practicability of two newly developed documentation forms are presented. Examined are 82 inpatient treatment episodes in an already published clinical concept with different treatment settings. Parallel versions of the forms were completed by patients and therapists. The 'Erge-Doku-A-Form' allows for the naming of up to five therapy goals determined at the beginning of therapy and evaluated in relation to their achieved quality at the end of therapy. The 'Erge-Doku-B-Form' describes a variety of problem areas as well as questions related to medication and changes induced by therapy. Surprising there were a high number of 230 Individual Therapy Goals (ITG) by patients and 262 ITG by therapists which could be arranged into 89 content categories and 5 main categories. Outcome measurement shows different results. There was a significant relationship between the 'well-being', the impression of 'satisfying treatment' at the end of the inpatient period and 'success in the main ITG'. The documentation forms presented here allow an outcome-measurement depending on differential indications.

Adult↗
PubMed1995

[Inpatient-ambulatory psychoanalytic group therapy, a useful concept].

Concepts of group psychotherapy are standard in contemporary inpatient psychotherapy. The effective treatment combination of both inpatient and outpatient group psychotherapy, however, is less common. The following discussion evaluates the effectiveness of inpatient-outpatient group psychotherapy as a therapeutic method as well as its applicability for standard treatment.

Adult↗
PubMed1995

[Eating disorders and diabetes mellitus].

Numerous empirical studies indicate a higher frequency of eating disorders such as anorexia or bulimia nervosa in young female diabetic patients compared to the normal population. The comorbidity of the two syndromes usually leads to a continuous metabolic disorder bearing high risks of acute metabolic failure or early microangiopathic lesions. In addition to "restraint eating" as an essential element of diabetic therapy a premorbid neurotic malformation and/or poor coping strategies are further predisposing aspects for the development of an eating disorder. The inpatient treatment of a 22 year old patient suffering from both diabetes mellitus and bulimia nervosa demonstrates the association of neurotic malformation, poor coping style and the directive function of diabetic therapy.

Adaptation, Psychological↗
PubMed1994

[Evaluative psychotherapy research: clinical relevance of psychotherapy catamnesis].

In this article we will depict the relevance of follow-up studies for evaluative psychotherapy research. Follow-up studies distinguish themselves from pure result studies in that they are clinically more meaningful as they examine the stability of psychotherapy results over a longer period of therapy-free time. The special methodical problems of follow-up studies are discussed and the minimal essentials for the research design of such studies are called for.

Follow-Up Studies↗
PubMed1993

Content analysis of follow-up interviews with inpatient/outpatient group psychotherapy patients.

In the follow-up project of the psychosomatic clinic at the University of Heidelberg, 45 patients were interviewed who had begun group psychotherapy in a closed group over 2.5 years with an inpatient treatment period of 3 months. The follow-up interviews carried out 2-5 years after the end of the outpatient treatment period are studied by content analysis. It could be demonstrated that the content of the two main categories 'Beginning' and 'End' of the inpatient period differs very much. Two patterns of 'beginners' could be distinguished. The importance of the evaluation of the former patients' spontaneous report as involved experts for psychotherapy research is discussed.

Adult↗
PubMed1993

[Suggested personnel figures in psychotherapeutic and psychosomatic hospitals and departments providing routine care].

Though the existing independency of the psychotherapeutic and psychosomatic medicine in Germany there is the necessity of developing personnel clue numbers for this clinical specification. By the analytic method the required trade groups of the regular inpatient psychosomatic-psychotherapeutic treatment thus far and their engagement in time are investigated. In a 2. step the fields of business for physicians, psychologists, nurses, social workers, special-therapists and secretary/documentation as well as regular business for the consultation/liaison-service are defined. For a model station the concret personnel clue numbers of all named business groups are referred.

Germany↗
PubMed1991

[Relation between illness manifestations and personality structure].

Associations between various psychoneurotic or psychosomatic illnesses and personality structures are investigated empirically in this paper. The investigation is based on the diagnoses of 9377 patients who came to the Psychosomatic Clinic of the University of Heidelberg as outpatients in the decade from 1979-1988. The answer to the proposed question is attempted by means of a statistical analysis of the routinely documented diagnoses. The relation can therefore only be investigated to the extent allowed by the more or less theory-oriented view-point of the participating diagnostician. The results confirm in part clinically known relations between certain aspects of illness and personality structures. They point to an almost obvious asymmetry which has been disregarded up to now in the clinical-theoretical discussion: whereas "typical" personality structures are diagnosed increasingly more often in certain illnesses, none of the personality structures proved "supportive" in the occurrence of a certain illness. The altogether weak interdependence between illness and personality structure (diagnoses) demonstrates that both diagnoses represent--at least in part--different dimensions.

Humans↗
PubMed1989

Empirical hypotheses on the psychotherapeutic treatment of psychosomatic patients in short and long-term time-unlimited psychotherapy.

In the Heidelberg Follow-Up Project, the results of psychoanalytically oriented treatment in a practice-oriented design are investigated. The patient sample is not homogeneous with regard to the diagnosis; the sample (n = 209) comprised primarily psychoneurotic and psychosomatic patients. All treatments were intended as long-term psychotherapies. The duration of therapy as well as the number of sessions actually realized may be regarded as one result of therapy. This situation, which is not quite ideal in the classical clinical experiment, allows us to develop the following empirical hypotheses: (1) The relationship between the therapeutic effort (e.g. treatment duration and number of sessions) and the results of psychotherapy can be mapped by a dose-effect model. The formal characteristics, especially the shape of the corresponding graphs, are similar for four different evaluation levels. Within the context of a dose-effect model, a treatment duration of about 2.5 years or respectively a number of sessions of about 160 seem to be most beneficial. (2) If we split up the total sample of patients into two subgroups (group 1: patients with psychoneurotic symptoms or non-chronified bodily dysfunctions; group 2: patients with psychosomatic illnesses or chronified bodily dysfunctions) and repeat the analysis, we obtain similar results for both groups of patients. The dose-effect graphs are of similar shape but differ in height. There is a slight tendency in patient group 2 that a treatment duration of up to 3.5 years may be associated with increased success rates.

Adaptation, Psychological↗
PubMed1988

Time and its relevance for a successful psychotherapy.

Time and the distribution of time have hardly been taken notice of up to the present although they are of great importance when considering the economic perspective. The present study reports on the results found between certain time parameters (e.g. total duration, total number of sessions, number of sessions per week, longer interruptions) and the outcome of psychoanalytic psychotherapies. The sample consists of 76 patients with neurotic, functional or psychosomatic diagnoses. The results support the thesis that not only the quantity of time (number of sessions, duration of therapy), but also the distribution throughout the therapy is associated with the success of therapy.

Adaptation, Psychological↗
PubMed1984

Indication in psychotherapy on the basis of a follow-up study.

The problem of indication is a central one of psychotherapy research. Unfortunately up to now only few scientific results contribute to a therapist's decision in selecting patients for a specific therapeutic setting. Thus, indication and outcome research should be combined. A critical view on traditional research strategies demonstrates that psychotherapy research should replace the ideal of normative and general rules by the rational investigation of one's own therapeutic practice. From this point of view some results of the Heidelberg Follow-Up Project of 110 psychotherapies which were started on an inpatient and continued on an outpatient basis are presented. Based on the therapeutic changes of these 110 patients the question is investigated whether the decisions of the indications correspond with the therapeutic goals of the treatment models. Moreover, the question is discussed what kind of success a specific treatment model offers for 'problem patients'.

Adaptation, Psychological↗
PubMed1983

Success and failure in psychotherapy: hypotheses and results from the Heidelberg Follow-Up Project.

Within the Heidelberg Follow-Up Project all treatments of the clinic regardless of the type of psychodynamic technique used are investigated. The outlet is both prospective and retrospective. There are four points of investigation: (1) immediately after the first contact with the hospital (2) at the beginning; (3) at the end of therapy, and (4) after a 2-year follow-up period. Immediately after the first contact with the patient a test battery (Giessen Test, Holzman Inkblot Technique, Gottschalk-Gleser Method, symptom checklist) is administered. This is repeated after a waiting period at the beginning of therapy, where in addition the therapist formulates a psychodynamic hypothesis and defines 3-5 individual treatment goals in connection with the individual pathology of the patient. At the end of the therapy the tests are repeated and the therapist assesses the success or failure of the therapy with regard to symptoms, object relations and psychodynamic change, while the patient fills out a special questionnaire dealing with his personal view of the therapy, the therapist and his own treatment experiences. The first results of about 100 combined inpatient and outpatient psychotherapies are presented (third test-round at the end of treatment). The results are discussed on the basis of the involved tests and ratings with respect to success and failure in the view of patients, therapists and independent clinical experts. Since the study is still under way, reports of the follow-up data are not yet evaluated.

Follow-Up Studies↗
PubMed1980

Determination of odour affinities based on the dose-response relationships of the frog's electro-olfactogram.

Electro-olfactograms (EOG's) recorded from the frog's olfactory epithelium for 11 substances were used to calculate dissociation constants which in turn serve as an index for the affinity between odorant and receptor site. These constants were calculated with and without a correction for the odour partition between water and air. For a homologous series of 7 n-alcohols these values decrease up to 1-heptanol. The dose-response relationships were based on the peaks of the EOG's since the peak/plateau-ratio was concentration-dependent for some of the substances.

Alcohols↗