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ABSTRACT: The symptom checklist-27-plus has demonstrated good psychometric properties in various samples, but clinical data have not yet been published. Data from 690 mostly young female patients with eating disorders show reliabilities ranging from acceptable to very good (Cronbachs α between 0.76 und 0.89). Data from intake and discharge show a good ability to measure change (Cohen's d between 0.27 und 1.31). At intake, patients display a very high symptom load, which has decreased significantly at discharge.
PPmP - Psychotherapie · Psychosomatik · Medizinische Psychologie 05/2013; 63(5):201-3. · 1.02 Impact Factor
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ABSTRACT: Background: Estimates about childhood abuse and neglect in various countries of the world indicate that cases of neglect outnumber cases of abuse by far. However, childhood neglect itself constitutes a neglected domain in psychological and medical research; far more articles have been published about abuse. Sampling and Methods: A ten-item questionnaire assessing childhood neglect was administered to two surveys in Poland (n = 508) and Germany (n = 500) via the internet. Results: Internal consistency was high in both countries, i.e. Cronbach's α was 0.82 in Poland and 0.88 in Germany. No distinction could be made between physical and emotional neglect. Values for neglect were similar for Polish and German men, but German women reported more neglect than Polish women. Conclusions: The Neglect Questionnaire is suitable for research in both Poland and Germany.
Psychopathology 03/2013; · 1.82 Impact Factor
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PPmP - Psychotherapie · Psychosomatik · Medizinische Psychologie 02/2013; 63(2):101-2. · 1.02 Impact Factor
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ABSTRACT: BACKGROUND: Multiple imputation is becoming increasingly popular. Theoretical considerations as well as simulation studies have shown that the inclusion of auxiliary variables is generally of benefit. METHODS: A simulation study of a linear regression with a response Y and two predictors X1 and X2 was performed on data with n = 50, 100 and 200 using complete cases or multiple imputation with 0, 10, 20, 40 and 80 auxiliary variables. Mechanisms of missingness were either 100% MCAR or 50% MAR + 50% MCAR. Auxiliary variables had low (r=.10) vs. moderate correlations (r=.50) with X's and Y. RESULTS: The inclusion of auxiliary variables can improve a multiple imputation model. However, inclusion of too many variables leads to downward bias of regression coefficients and decreases precision. When the correlations are low, inclusion of auxiliary variables is not useful. CONCLUSION: More research on auxiliary variables in multiple imputation should be performed. A preliminary rule of thumb could be that the ratio of variables to cases with complete data should not go below 1 : 3.
BMC Medical Research Methodology 12/2012; 12(1):184. · 2.67 Impact Factor
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ABSTRACT: Hereditary angioedema due to C1 inhibitor deficiency (HAE-C1-INH) is characterized by relapsing skin swellings, abdominal pain attacks, and, less frequently, potentially life-threatening laryngeal attacks.
This study determined the mortality of patients with and without the diagnosis of HAE-C1-INH and analyzed fatal laryngeal attacks.
A cohort of 728 patients from 182 families with HAE-C1-INH was evaluated for death cases by analyzing pedigrees. Detailed information on fatal laryngeal attacks in 36 patients was obtained by questioning relatives and treating physicians.
Of the 214 patients who had died, 70 asphyxiated during a laryngeal attack. Mortality by asphyxiation was higher in patients with undiagnosed HAE-C1-INH (63 cases) than in patients with diagnosed HAE-C1-INH (7 cases). The lifespan of asphyxiated patients with undiagnosed HAE-C1-INH was on average ∼31 years shorter than patients with undiagnosed HAE-C1-INH who died of other causes. Three phases were distinguished in the fatal laryngeal attacks. Phase 1, the predyspnea phase, lasted on average for 3.7 ± 3.2 hours (range, 0-11 hours). Phase 2, the dyspnea phase, lasted on average for 41 ± 49 minutes (range, 2 minutes to 4 hours). Phase 3, the loss of consciousness phase, lasted on average for 8.9 ± 5.1 minutes (range, 2-20 minutes).
The high mortality in patients with undiagnosed HAE-C1-INH underscores the need to identify these patients and diagnose their condition. The analysis of fatal laryngeal attacks gives further insight into their course, thus helping to avoid fatalities in the future.
The Journal of allergy and clinical immunology 07/2012; 130(3):692-7. · 9.17 Impact Factor
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ABSTRACT: AimHow children grow up differs from country to country. The aim of the present investigation was to compare childhood experiences,
family characteristics and psychological features during the post-World War II period in Poland and Germany.
Subject and methodsA questionnaire regarding various childhood experiences and family circumstances was administered to two samples, one each
in Poland and Germany (n = 500 each) via the Internet. Comparisons between Poland and Germany were performed using analysis of variance (ANOVA) and
χ2 tests, and logistic regressions were performed to compare the effects of risk factors.
ResultsProbands from Poland described almost all aspects of their lives, their families and their childhoods as having been better
than did probands from Germany. Risk factors for suicide attempts were childhood physical abuse, and for alcohol abuse gender
and childhood sexual abuse in both countries.
ConclusionThere is some evidence for idealisation of the past in Poland, which might be due to the fact that almost 90% of the Poles
were Christians. Germans seem to be more realistic in their views of the past but possibly deny their personal weaknesses.
KeywordsChildhood adversities–Family atmosphere–Psychometric assessment–International survey
Journal of Public Health 04/2012; 19:29-37. · 2.06 Impact Factor
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ABSTRACT: Various approaches are used to assess spirituality via questionnaires, ranging from one-dimensional scales to highly multidimensional models. For the present investigation, an—in spirituality research unorthodox —factor analytic method was chosen: principal axis analysis with oblique rotation. An item collection was examinated and cross-validated via internet. The spirituality questionnaire contains four dimensions: belief in God, search for meaning, mindfulness, and feeling of security. They present with high internal consistencies. The factorial structure of the four dimensions was confirmed. Based on the better fit of this method of extraction the authors assume that these dimensions may depict the concept of spirituality more precisely than the previously used factor analytic methods, i.e. the principal component analysis (PCA) with orthogonal rotation.
Psychology. 01/2012; 3:116-122.
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ABSTRACT: In hereditary angioedema with normal C1-inhibitor two different missense mutations of codon p.Thr328* in the coagulation factor 12 gene have been reported in some families. In this study a novel factor 12 gene mutation, the deletion of 72 base pairs (bp) (c.971_1018+24del72*), was identified in a family of Turkish origin, in two sisters with recurrent skin swellings and abdominal pain attacks and in their symptom-free father. This deletion caused a loss of 48 bp of exon 9 (coding amino acids 324* to 340*) in addition to 24 bp of intron 9, including the authentic donor splice site of exon 9. The large deletion of 72 bp was located in the same F12 gene region as the missense mutations p.Thr328Lys* and p.Thr328Arg* reported previously. Our findings confirm the association between F12 gene mutations modifying the proline-rich region of the FXII protein and hereditary angioedema with normal C1-inhibitor.
Clinical Immunology 07/2011; 141(1):31-5. · 4.05 Impact Factor
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ABSTRACT: Tooth extractions may trigger clinical symptoms of hereditary angioedema due to C1 inhibitor deficiency (HAE-C1-INH). The aim of this study was to determine how many tooth extractions were followed by symptoms of HAE-C1-INH in patients with and without preoperative short-term prophylaxis with C1 inhibitor concentrate.
Tooth extractions and clinical symptoms of HAE-C1-INH were determined from clinical record files of 171 patients with HAE-C1-INH.
Facial swelling or potentially life-threatening laryngeal edema, or both, occurred in 124/577 tooth extractions (21.5%) without prophylaxis. Similar symptoms occurred in a fewer proportion of patients undergoing extractions (16/128; 12.5%) after short-term prophylaxis with C1 inhibitor concentrate. The graded dose-response relationship was significant at P < .05.
Short-term prophylaxis with C1 inhibitor concentrate significantly reduces the risk of HAE-C1-INH symptoms after tooth extraction. In some patients, however, facial swellings and laryngeal edema symptoms may occur despite prophylaxis.
Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics 07/2011; 112(1):58-64. · 1.50 Impact Factor
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PPmP - Psychotherapie · Psychosomatik · Medizinische Psychologie 06/2011; · 1.02 Impact Factor
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ABSTRACT: Emotional parentification is considered harmful to a child's development.
A total of about 975 patients were examined at a Department of Psychosomatic Medicine and in the practices of general practitioners with regard to childhood adversities.
Emotional parentification is a risk factor for 2 symptom groups: the patients with depression and the patients with somatoform pain. While the occurrence of depression is mainly predicted by maternal emotional parentification, paternal influences are also relevant in regard to the development of somatoform pain.
Emotional parentification is an important risk factor for the occurrence of psychological and somatoform complaints in adulthood. This is especially apparent in combination with further risk factors, such as low reported values for love, sexual abuse, or being raised without a father.
PPmP - Psychotherapie · Psychosomatik · Medizinische Psychologie 05/2011; 61(8):364-71. · 1.02 Impact Factor
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ABSTRACT: The symptom checklist SCL-27 is a short, multidimensional screening instrument for mental health problems. It contains six scales: depressive, dysthymic, vegetative, agoraphobic and sociophobic symptoms; symptoms of mistrust; and a global severity index (GSI-27).
A survey of two student samples from Poland and Germany (n ∼ 400) is presented.
Most scales of the SCL-27 showed good to satisfactory reliability (i.e. Cronbach's α > 0.70). Some items displayed different characteristics in students than in non-student samples. These discrepancies can be explained partly by the particular situation students face and partly by some country-specific or language-specific aspects of the measuring instrument. Differences between Polish and German students were marginal at best; in general, the Polish students tended to assent more easily to the items of the SCL-27 than did the German students.
The SCL-27 is suitable for international comparisons. In both, Germany and Poland, students display a characteristic response pattern that differs from those of other samples. It can be applied as a separate instrument or for reanalysis of data collected with the SCL-90_R.
International Journal of Psychiatry in Clinical Practice 03/2011; 15(1):42-9. · 0.43 Impact Factor
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ABSTRACT: Hereditary angioedema due to C1 inhibitor deficiency (HAE-C1-INH) is characterized by recurrent edema attacks in various organs. The objective of the present study was to assess the efficacy and safety of weekly long-term replacement treatment with one or more injections of plasma-derived C1-INH concentrate per week (WLTC) in patients with HAE-C1-INH.
Nineteen patients with HAE-C1-INH underwent WLTC for 9 years on average. The benefits and risks were determined based on regular recording by the patients of the severity and number of attacks at the beginning and the end of the study.
All patients reported that all or most of their attacks were much less severe: the percentage of severe attacks was 93.3% without and 3.8% with treatment. In 8 of the 14 patients undergoing WLTC, the monthly number of attacks was lower at the end of the study than before the study, higher in 5 patients, and unchanged in 1 patient. The mean number of attacks per week in 6 patients (1 patient initially received weekly on-demand treatment for 2 years and then shifted to WLTC) with weekly on-demand treatment was 4.3 (SD 1.9) at the beginning and 8.0 (SD 3.1) at the end of the study.
HAE-C1-INH can be significantly improved by one or more injections of C1-INH concentrate per week. However, patients have to accept a large number of intravenous injections and, in some cases, an increase in disease activity.
International Archives of Allergy and Immunology 01/2011; 154(1):81-8. · 2.40 Impact Factor
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ABSTRACT: Suicide is one of the leading causes of death in many Western countries. An exploration of factors associated with suicidality may help to understand the mechanisms that lead to suicide. Two samples in Germany (n = 500 and n = 477) were examined via Internet regarding suicidality, depression, alcohol abuse, adverse childhood experiences, and parent-child relationships. A Graphical Markov Model was constructed from the first subsample, testing for main, quadratic and interaction effects. All effects in the model were cross-validated using the second subsample. Depression was found to be a strong predictor of suicidality; alcohol abuse was not a predictor. Both maternal and paternal love also predicted suicidality; the former had an indirect effect via depression and the latter a direct effect. Early experiences with violence showed both a direct and indirect association with suicidality. In addition to depression being a predictor for suicidality, various pathways connect suicidality with early childhood experiences.
Child Psychiatry and Human Development 10/2010; 42(2):119-33. · 1.93 Impact Factor
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ABSTRACT: What impact do the degree of somatization and the presence of a comorbid psychological disorder have on health-related quality of life in patients with pain-dominated somatoform disorders?
282 consecutive patients (57.6 %) from a total population of N=490 patients fulfilling the criteria of somatoform pain disorders were included in the study following a thorough interdisciplinary diagnostic process at a German university hospital. Structured interviews (SKIDI and SKID-II) to assess comorbid psychological disorders as well as a structured biographical interview to assess chronification factors were conducted. We employed the Screening for Somatoform Disorders form (SOMS) to discover the extent and distribution of somatic symptoms and the SF-36 to determine the health-related quality of life.
The patients exhibited a multiplicity of further somatic complaints apart from pain. 69 % had a comorbid psychological disorder. The health-related physical and psychological quality of life was clearly impaired in patients with "small", "substantial" and "pronounced" somatization. Regression analysis explained 48 % of the variance of the body-related and 35 % of the variance of the psychological quality of life: Besides the extent of somatization, older age, duration of pain-associated hospitalizations and the subjective amount of occupational impairment proved to be important. With regard to the psychological (but not the somatic) health-related quality of life, the presence of a current comorbid psychological disorder was also relevant.
Patients with pain-dominated somatoform disorders are substantially impaired in their quality of life. Because 31 % of the patients with such disorders have no additional comorbid psychic disorder and the existence of a comorbid psychic disorder impacts only the psychological domain of their health-related quality of life, the results appear to strongly support maintaining the diagnostic category of somatoform disorders in ICD-11 and DSM-V. They also support the grading of the severity of the somatization similar to the grading of depressive disorders.
Zeitschrift fur Psychosomatische Medizin und Psychotherapie 01/2010; 56(1):3-22. · 1.30 Impact Factor
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ABSTRACT: Background: Major negative life events are associated with higher suicidality. In this association, two mediating paths were hypothesized: (a) via minor negative life events and (b) via depression.Methods: Ninety-six adolescent primary care patients were recruited in clinics, a physician's office, and school nurses' offices. Results: (1) Minor negative life events were associated with depressive symptoms and suicidality. (2) Depressive symptoms were associated with suicidality. (3) Depressive symptoms mediated the association of minor negative life events with suicidality. Conclusions: Findings suggest that minor negative life events may be associated with suicidal ideation among adolescent primary care patients, and that depressive symptoms may mediate the association of minor negative life events with suicidality.
Psycho-social medicine. 01/2010; 7:Doc05.
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Psychotherapy and Psychosomatics 11/2009; 79(1):58. · 6.28 Impact Factor
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ABSTRACT: C1 inhibitor concentrate is regarded as effective and safe in treating acute attacks of hereditary angioedema caused by C1 inhibitor deficiency. This study investigated the course of disease in 3 women treated frequently with C1 inhibitor concentrate.
Three women are described who received C1 inhibitor concentrate for the treatment of acute attacks of hereditary angioedema and experienced an increase in the frequency of attacks during that treatment period. In a control group of 24 patients aged more than 60 years with hereditary angioedema, the natural course of disease was determined.
The 3 women (ages 50, 69, and 72 years) had received C1 inhibitor concentrate for 27, 18, and 22 years, respectively, for acute abdominal and skin attacks. Before this treatment, all attacks were severe. The treatment was always effective: The attacks were mild, and the duration of the attacks was shortened. During the treatment period, the number of attacks increased slowly but continuously, starting at the onset of treatment and paralleling the course of treatment. At the end of the observation period, the number of attacks increased by 4-fold, 12-fold, and 5-fold in the 3 women, respectively. No factors known to increase the frequency of attacks in hereditary angioedema were found in these patients. The control group did not show a similar increase in attacks during a comparable period of time.
A possible explanation for the increase in the frequency of attacks may lie in the large number of injections of C1 inhibitor concentrate.
The American journal of medicine 09/2009; 122(8):780-3. · 4.47 Impact Factor
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ABSTRACT: In a subgroup of hereditary angioedema (HAE) patients with normal C1-esterase inhibitor levels, HAE is caused by a Thr309Lys mutation in the coagulation factor XII (F12) gene. The aim of this study was to examine elements of the kallikrein-kinin system ('contact system') and the downstream-linked coagulation, complement and fibrinolytic systems in the plasma of six patients with HAE caused by the Thr309Lys mutation and healthy probands. Blood samples were taken from participants during the symptom-free interval between attacks. Samples were analyzed for activity and concentrations of components of the kallikrein-kinin system and linked enzyme systems. The mean FXII clotting activity was 90% in patients with the FXII mutation, and the concentration of FXIIa was 4.1 ng/ml; this did not differ from healthy probands. Mean prekallikrein amidolytic activity and high-molecular-weight kininogen clotting activity were 130 and 144%, respectively, both higher than in healthy probands. The mean kallikrein-like activity of the HAE patients was 11.4 U/l and did not differ from healthy probands. There was no difference in FXII surface activation by silicon dioxide or in kallikrein-like activity with and without activation by dextran sulfate. Contrary to the results of a recently published study, no indication that the Thr309Lys mutation causes a 'gain-of-function' of FXIIa was observed in this investigation.
Blood coagulation & fibrinolysis: an international journal in haemostasis and thrombosis 08/2009; 20(5):325-32. · 1.25 Impact Factor
