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ABSTRACT: Objective: Relatives of persons with schizophrenia have an essential role in informal caregiving. This may result in a high level of burden. Aim of the study was to investigate, if the frequency of unmet needs among relatives caring for schizophrenia patients increases the risk for burden among these relatives.Methods: 135 relatives of patients with schizophrenia or schizoaffective disorder were investigated by means of the "Involvement Evaluation Questionnaire" (IEQ) and the "Carer's Needs Assessment for Schizophrenia" (CNA-S).Results: Multiple linear regression analyses showed positive associations between the frequency of caregivers' unmet needs and the IEQ-subscores "tension" and "worrying". Further, the IEQ-subscore "worrying" was significantly lower among caregivers of outpatients than among caregivers of inpatients or day hospital patients. The IEQ-subscore "urging" was significantly associated with patient's negative symptoms.Conclusion: Unmet needs among caring relatives have negative effects on their burden. Further, the patients' type of treatment setting (inpatient, outpatient, day hospital) seems to predict caregivers' burden.
Psychiatrische Praxis 09/2012; 39(7):339-44. · 1.64 Impact Factor
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ABSTRACT: Da Depressionen von nichtpsychiatrischen Ärzten oft übersehen werden, wurde der regelmäßige Einsatz von Screeninginstrumenten
für Depressionen vorgeschlagen. Um die routinemäßige Verwendung von Screeninginstrumenten empfehlen zu können, müssen aber
einige Voraussetzungen zutreffen. Die Kriteriumsvalidität, eine dieser Voraussetzungen, wird anhand der vorliegenden Literatur
einer genaueren Betrachtung unterzogen. Es zeigt sich, dass die Kennwerte der Kriteriumsvalidität nicht problemlos von ambulanten
auf stationäre Patienten übertragen werden können. Die in letzter Zeit wiederholt vorgeschlagenen Kurz-Screeninginstrumente,
bestehend aus ein oder zwei Fragen, dürften im Gegensatz zu den üblichen längeren Screeninginstrumenten nicht ausreichend
valide sein. Außerdem führen die beschriebenen Kurz-Screeninginstrumente im klinischen Alltag zu einem Mehraufwand für Diagnostik
und erzielen daher keine Zeitersparnis.
Since depression is often not recognized by nonpsychiatric physicians, the regular use of screening instruments for depression
has been suggested. Several prerequisites must be fulfilled before the routine use of screening instruments can be recommended.
Some aspects of the criterion validity, which is one of these prerequisites, are reviewed here on the basis of published studies.
The validity indices attained from studies among outpatients must not be applied for nonpsychiatric hospital inpatients. Recently,
several authors suggested the use of very brief screening tools for depression consisting of only one or two questions, but
the validity indices of these very brief screening tools are markedly lower than those of normal screening instruments for
depression. Furthermore, these very brief screening tools lead to a dramatically higher number of patients who must be assessed
for depression by their physicians. Thus, these tools do not save time in everyday clinical work.
Psychosomatik und Konsiliarpsychiatrie 04/2012; 1(2):144-153.
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ABSTRACT: Depression is a very common mental disorder which often results in relevant negative consequences ranging from impaired quality of life to an increased suicide rate. Unfortunately, non-psychiatric physicians frequently under-diagnose and under-treat depression. Nevertheless, sometime the diagnosis "depression" is used for mentally well and other mental disorders (i.e. sometimes depression is over-diagnosed). Screening tools were suggested to improve the recognition of mental disorders in everyday clinical work. Studies have shown that the criterion validity of usual screening questionnaires such as the Geriatric Depression Scale (GDS) is sufficient, while very short questionnaires consisting of one or two questions must not be used because of high misclassification rates. A meta-analysis of randomized trials of screening for depression indicate that screening for depression is probably effective when it is coupled with additional activities such as educational programs for primary care physicians.
Psychiatria Danubina 12/2011; 23(4):406-11. · 0.44 Impact Factor
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Johannes Wancata
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ABSTRACT: Demographic change calls for increased efforts in dementia research.
A systematic analysis of a German-speaking psychiatric journal was performed.
18.2 % of all papers published in were related to dementia and cognition.
Dementia is a main issue; only papers regarding schizophrenia were more common. Health service research is largely lacking.
Psychiatrische Praxis 10/2011; 38(7):345-7. · 1.64 Impact Factor
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ABSTRACT: While the General Health Questionnaire (GHQ) has an excellent screening performance among outpatients and in the community, its accuracy to detect mental disorders among non-psychiatric inpatients was reported to be lower. The aim of the present study was to compare the criterion validity of different scoring methods, i.e. the Bimodal scoring, Likert scoring, Modified Likert scoring and Chronic scoring, of the 30-, 20- and 12-item version of the GHQ.
The GHQ was available from 511 inpatients recruited from surgical, medical, gynaecological and physical rehabilitation wards. The Clinical Interview Schedule was performed for psychiatric case-identification and was used as external care criterion.
Sensitivities of all versions were between 0.612 and 0.701, and specificities between 0.601 and 0.759. The Overall Misclassification Rate (OMR) varied for the Bimodal and the Modified Likert scoring method between 0.257 and 0.281, for the Likert and the Chronic scoring method between 0.325 and 0.386. Overall, the Bimodal and the Modified Likert scoring method showed significantly better specificity and OMR than the Likert and the Chronic scoring method, while we could not find any differences for sensitivity.
Overall, the Bimodal and the Modified Likert scoring method seem to be more accurate than the Likert and the Chronic scoring method. Nevertheless, due to the high misclassification, none of these versions can be recommended for routine screening among non-psychiatric inpatients.
Social Psychiatry 07/2011; 46(7):635-41. · 2.05 Impact Factor
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ABSTRACT: History shows that the discussion concerning coercive measures against mentally ill is as old as psychiatry itself. The dilemma of psychiatry lies in its double role - having both a therapeutic and a regulatory function. Violence against sick and disabled people conflicts with the ethical principles of helping professions. This, however, is where the danger lies: that the violent parts of psychiatric work - which in the opinion of experts cannot be entirely avoided - are repressed or seen as taboo and are therefore more difficult to control. Comparisons between EU countries of the nature, frequency and duration of coercive measures are difficult because of the heterogeneity of regulation and differences in established practice. Scientific examination of this issue seems to be insufficient. There are only a few studies on important issues such as how patients rate these measures. An open and thorough debate about the meaning and meaninglessness of coercion and violence in psychiatric treatment would be necessary to prevent "routine violence" or the excessive use of force against the mentally ill.
Neuropsychiatrie: Klinik, Diagnostik, Therapie und Rehabilitation: Organ der Gesellschaft Österreichischer Nervenärzte und Psychiater 01/2011; 25(1):44-50. · 1.38 Impact Factor
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Neuropsychiatrie: Klinik, Diagnostik, Therapie und Rehabilitation: Organ der Gesellschaft Österreichischer Nervenärzte und Psychiater 01/2011; 25(2):57-8. · 1.38 Impact Factor
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Psychiatrische Praxis 10/2010; 37(7):317-8. · 1.64 Impact Factor
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Neuropsychiatrie: Klinik, Diagnostik, Therapie und Rehabilitation: Organ der Gesellschaft Österreichischer Nervenärzte und Psychiater 01/2010; 24(4):221-3. · 1.38 Impact Factor
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ABSTRACT: The purpose of the present study was to assess the needs of dementia patients using the German language version of the Camberwell Assessment of Need for the Elderly (CANE) and to investigate the internal consistency of German language.
A sample of 45 dementia patients was investigated using the German CANE. Data were collected from family caregivers.
Most dementia patients showed a multitude of problems. In most cases, support was provided more frequently from informal caregivers than from social or medical services. Internal consistency ranged between 0.797 and 0.900 (Cronbach's Alpha).
The high frequency of problems indicates the importance of long-term planning of services for dementia patients. The internal consistency of the German CANE was sufficiently high.
Neuropsychiatrie: Klinik, Diagnostik, Therapie und Rehabilitation: Organ der Gesellschaft Österreichischer Nervenärzte und Psychiater 01/2010; 24(3):182-9. · 1.38 Impact Factor
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ABSTRACT: Are authors of German language psychiatric journals more often male or female? Are there gender differences regarding scientific topics?
Analysis of publications of two German-language journals (Neuropsychiatrie, Psychiatrische Praxis) for the period 2008-2009.
We could not find any gender differences concerning the number of first authors, but the number of male co-authors was nearly double as high as of female co-authors. Qualitative research methods were used more often by female researchers, but there were no significant differences regarding scientific topics.
Overall, we found fewer gender differences than expected concerning authorship.
Neuropsychiatrie: Klinik, Diagnostik, Therapie und Rehabilitation: Organ der Gesellschaft Österreichischer Nervenärzte und Psychiater 01/2010; 24(4):267-74. · 1.38 Impact Factor
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ABSTRACT: This paper gives an overview on the epidemiology of social phobia. About 4.5% of the adult general populations suffer from social phobia, i.e. it is the most frequent of all anxiety disorders. Social phobia is clearly more frequent among women than among men. About the half of all individuals with social phobia suffer from any comorbid mental disorders. Reviews show a large variability between single studies, probably due to methodological differences. Several population surveys indicate that a marked proportion of those with social phobia do not receive adequate treatment.
Psychiatria Danubina 12/2009; 21(4):520-4. · 0.44 Impact Factor
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ABSTRACT: Are assessment instruments used for social psychiatry research in German-language countries in agreement with international scientific standards?
Analysis of assessment instruments mentioned in publications of two German-language journals.
Most studies concerning social psychiatry used assessment instruments developed previously and for the majority data about their validity and reliability are available. The fact that most of the instruments were originally published in English indicates that they are internationally used.
Most assessment instruments mentioned in German-language papers meet with international scientific standards.
Psychiatrische Praxis 11/2009; 36(8):368-72. · 1.64 Impact Factor
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ABSTRACT: In order to evaluate the effectiveness of the WPA campaign "Open the Doors - against Stigma and Discrimination because of Schizophrenia", five years upon completion of the campaign, a comparative study was performed to assess the possible changes in the general public's attitudes towards schizophrenia.
Representative population survey, based on a Quota-sampling (n = 988); face-to-face interviews with standardized questionnaires.
The results of this study were somewhat sobering, with 22.3 % of the population not having any associations with the term "schizophrenia", 81.3 % not wanting to be further informed about the illness, and 64.1 % agreeing with the statement that patients suffering from schizophrenia are dangerous; compared to the survey in 1998, there was a significant increase within this category. Furthermore, an increase of social distance towards this group of patients has also been noted.
It is to be asked whether a short intervention can change people's profound attitudes.
Psychiatrische Praxis 10/2009; 36(7):327-33. · 1.64 Impact Factor
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Prisca Weiser,
Thomas Becker,
Carolin Losert,
Köksal Alptekin,
Loretta Berti,
Lorenzo Burti,
Alexandra Burton,
Mojca Dernovsek,
Eva Dragomirecka,
Marion Freidl, [......],
Roxana Marginean,
David McDaid,
Maya Mladenova,
Povl Munk-Jørgensen,
Alexandru Paziuc,
Petronela Paziuc,
Stefan Priebe,
Katarzyna Prot-Klinger, Johannes Wancata,
Reinhold Kilian
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ABSTRACT: People with mental disorders have a higher prevalence of physical illnesses and reduced life expectancy as compared with the general population. However, there is a lack of knowledge across Europe concerning interventions that aim at reducing somatic morbidity and excess mortality by promoting behaviour-based and/or environment-based interventions.
HELPS is an interdisciplinary European network that aims at (i) gathering relevant knowledge on physical illness in people with mental illness, (ii) identifying health promotion initiatives in European countries that meet country-specific needs, and (iii) at identifying best practice across Europe. Criteria for best practice will include evidence on the efficacy of physical health interventions and of their effectiveness in routine care, cost implications and feasibility for adaptation and implementation of interventions across different settings in Europe. HELPS will develop and implement a "physical health promotion toolkit". The toolkit will provide information to empower residents and staff to identify the most relevant risk factors in their specific context and to select the most appropriate action out of a range of defined health promoting interventions. The key methods are (a) stakeholder analysis, (b) international literature reviews, (c) Delphi rounds with experts from participating centres, and (d) focus groups with staff and residents of mental health care facilities.Meanwhile a multi-disciplinary network consisting of 15 European countries has been established and took up the work. As one main result of the project they expect that a widespread use of the HELPS toolkit could have a significant positive effect on the physical health status of residents of mental health and social care facilities, as well as to hold resonance for community dwelling people with mental health problems.
A general strategy on health promotion for people with mental disorders must take into account behavioural, environmental and iatrogenic health risks. A European health promotion toolkit needs to consider heterogeneity of mental disorders, the multitude of physical health problems, health-relevant behaviour, health-related attitudes, health-relevant living conditions, and resource levels in mental health and social care facilities.
BMC Public Health 02/2009; 9:315. · 2.00 Impact Factor
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ABSTRACT: To assess the extent to which persons suffering from schizophrenia are treated by psychotherapy in Austria
A questionnaire was sent to all psychotherapists who were registered according to the Austrian law for psychotherapy
5741 questionnaires were mailed and 1683 (29.3%) were returned. Of the answering psychotherapists 59% had done psychotherapy with a person suffering from schizophrenia before. 47% treated at least one client with a schizophrenic disorder during the last year. The methods applied by psychotherapists who had treated schizophrenic persons before were psychodynamic psychotherapy (30%), humanistic psychotherapy (35%), systemic psychotherapy (25%), behavior therapy (13%) and eclectic psychotherapy (25%). 59% of the participating psychotherapists stated that they would be willing to treat (further) persons suffering from schizophrenia. Most (84%) participants considered a special qualification for the psychotherapeutic treatment of schizophrenic persons as necessary, but 70% said that this topic was not covered sufficiently during training for psychotherapy.
Among Austrian psychotherapist there is considerable interest in treatment of schizophrenic persons. There is a gap between the recommended treatments for schizophrenia according to EBM criteria and everyday practice.
Neuropsychiatrie: Klinik, Diagnostik, Therapie und Rehabilitation: Organ der Gesellschaft Österreichischer Nervenärzte und Psychiater 01/2009; 23(4):235-43. · 1.38 Impact Factor
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ABSTRACT: This paper gives an overview on the epidemiology of social phobia. About 4.5% of the adult general populations suffer from social phobia, i.e. it is the most frequent of all anxiety disorders. Social phobia is clearly more frequent among women than among men. About the half of all individuals with social phobia suffer from any comorbid mental disorders. Reviews show a large variability between single studies, probably due to methodological differences. Several population surveys indicate that a marked proportion of those with social phobia do not receive adequate treatment. Key words: social phobia – epidemiology – prevalence – incidence -psychiatric health care ZUSAMMENFASSUNG Diese Publikation gibt eine Übersicht über die Epide-miologie der Sozialphobie. Etwa 4,5% der Allgemeinbevöl-kerung leidern unter Sozialphobie. Insofern ist sie die häufigste Angststörung. Sozialphobie kommt bei Frauen deutlich häufiger als bei Männern vor. Etwa die Hälfte aller Personen mit Sozial-phobie leidern auch unter einer anderen psychischen Erkran-kung. Übersichtsarbeiten haben gezeigt, dass die Ergebnisse zwischen den einzelnen Studien deutlich differieren, was ver-mutlich in einem beträchtlichen Ausmaß mit methodischen Unterschieden zwischen den Studien zu tun hat. Eine Reihe bevölkerungsbezogener Studien berichtet, dass ein relevanter Anteil der an Sozialphobie Erkrankten nicht die erforderlichen Behandlungen erhält.
01/2009; 21:520-524.
