Egon Michael Haberfellner

Paracelsus Medical University Salzburg, Salzburg, Salzburg, Austria

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Publications (37)45.69 Total impact

  • Renate Stelzig-Schöler · Marc Keglevic · Egon Michael Haberfellner
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    ABSTRACT: Psychiatrische Rehabilitation hat sich in Österreich in zwei Richtungen entwickelt: Gemeindenahe Rehabilitation für Patienten mit schweren und anhaltenden psychischen Erkrankungen und „medizinische Rehabilitation“. Der folgende Artikel präsentiert historische Aspekte der Rehabilitation in Österreich, diagnostische Prinzipien und therapeutische Interventionen. Die gegenwärtige Organisation der Rehabilitation, aktuelle Probleme und zukünftige Entwicklungen werden diskutiert. Psychiatric rehabilitation in Austria is organized in two directions: Community based rehabilitation for patients with severe and persistent mental illness and “medical rehabilitation”. The following article presents historical aspects of rehabilitation in Austria, diagnostic principles and therapeutic interventions. The present system of psychiatric rehabilitation, current problems and future directions are discussed.
    No preview · Article · Apr 2009 · Psychiatrie und Psychotherapie
  • Egon Michael Haberfellner

    No preview · Article · Feb 2009 · Neuropsychiatrie: Klinik, Diagnostik, Therapie und Rehabilitation: Organ der Gesellschaft Österreichischer Nervenärzte und Psychiater
  • Egon Michael Haberfellner
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    ABSTRACT: Das Konzept der komplexen posttraumatischen Belastungsstörung (PTBS) wurde eingeführt, um die psychiatrischen Symptome einiger Patienten zu beschreiben, die nach einer extremen psychischen Traumatisierung auftreten, aber nicht die diagnostischen Kriterien der PTBS erfüllen. Dieses Manuskript präsentiert die DESNOS-Kriterien (disorders of extreme stress not otherwise specified). Argumente pro und contra die Anwendung des Konzeptes der komplexen PTBS werden diskutiert. Der Begriff der komplexen PTBS sollte klar von der Diagnose PTBS nach ICD-10 oder DSM-IV unterschieden werden, aber auch von anderen psychiatrischen Störungsbildern, insbesondere von der Borderline Persönlichkeitsstörung. Das Konzept der komplexen PTSD kann als Arbeitshypothese nützlich sein, kann einen Beitrag zum psychodynamischen Verständnis des Leidens so mancher Patienten leisten und kann auch helfen, spezifische psychotherapeutische Strategien einzusetzen. The concept of complex post-traumatic stress disorder (PTSD) was introduced to describe the psychiatric symptoms of some patients after extreme traumatisation, who do not fulfil the diagnostic criteria of PTSD. This paper presents the DESNOS criteria (disorders of extreme stress not otherwise specified). Arguments pro and contra the use of the concept complex PTSD are discussed. The term complex PTSD should not be mixed up with the diagnostic category PTSD according to ICD-10 or DSM-IV and should be clearly distinguished from other psychiatric disorders, especially from borderline personality disorder. The concept complex PTSD can be useful as a working hypothesis, can contribute to understand a patients suffering from a psychodynamic point of view and can help to establish specific psychotherapeutic strategies.
    No preview · Article · Sep 2008 · Psychiatrie und Psychotherapie
  • E.M. Haberfellner
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    ABSTRACT: Objective: Although the widespread use of atypical antipsychotics reduces patient risk for tardive dyskinesia (TD), patient information about TD is still necessary for obtaining informed consent for antipsychotic treatment. Package insert leaflets are one source of information. To find out how pharmaceutical companies inform patients about TD, we analysed leaflets for 16 antipsychotics made by 8 pharmaceutical companies. Results: Information about movement disorders was found in 15 leaflets (93%), but information about TD was given in only 5 leaflets (31 %). The risk that TD might be persistent was not mentioned at all. Discussion: Information about TD should give patients an idea of its signs and symptoms and enable them to recognize early symptoms. Patients should know that TD could be irreversible. Our analysis shows that most pharmaceutical companies do not use the package insert as a source of information about TD. Pharmaceutical companies should improve written patient information on tardive dyskinesia.
    No preview · Article · Sep 2008
  • Egon Michael Haberfellner · Sabine Zankl
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    ABSTRACT: Zusammenfassung HINTERGRUND. Unter oberösterreichischen Psychotherapeuten wurde eine Befragung durchgeführt, um deren Einstellungen zum Thema "sexuelle Kontakte in der Psychotherapie" zu erheben. METHODE. 204 Psychotherapeuten beteiligten sich an der Befragung. ERGEBNISSE. 2,5 % der befragten Psychotherapeuten waren der Ansicht, dass sexuelle Aktivitäten eine hilfreiche Intervention sein können. 22 % waren nicht informiert, dass sexueller Kontakt mit Patienten strafrechtlich verfolgt werden kann. 60 % vertraten die Meinung, dass sexuelle Kontakte nach Abschluss einer Psychotherapie unter bestimmten Umständen vertretbar sind. DISKUSSION. Nur von einzelnen Psychotherapeuten wurden eindeutig unethische Positionen vertreten. Viele Psychotherapeuten sind sich nicht darüber im Klaren, dass sexuelle Kontakte auch nach Abschluss einer Psychotherapie ethisch zu verurteilen sind. Diskussionen und Fortbildungen über diese Thematik sind dringend notwendig.
    No preview · Article · Aug 2008 · Psychotherapie Forum
  • E M Haberfellner · J Jungmayr · R Grausgruber-Berner · A Grausgruber
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    ABSTRACT: Medical rehabilitation of patients with mental disorders is new in Austria. A catamnestic study was performed to evaluate the effects of an inpatient treatment programme. 355 patients were included in the study in 2003, 262 patients (73.8%) were evaluated after one year. The sample included patients with "severe mental illness" (about 25%) as well as patients with neurotic disorders. Patients' symptoms and quality of life had improved. The effect sizes admission-dismissal were between 0.17 and 0.62, the effect sizes after one year were between 0.10 and 0.25. Duration of sick leave was 20.5 weeks in the year before rehabilitation and 6.5 weeks in the year after rehabilitation. Duration of hospitalization was three weeks before versus 1.5 weeks after rehabilitation. Patients who had been employed at admission had a good chance to remain on the job (65.8%). Disease-related factors did not predict treatment outcome. A medical rehabilitation concept showed positive therapy outcomes for patients with severe mental illness as well as for patients with neurotic disorders.
    No preview · Article · Jul 2008 · Die Rehabilitation
  • Egon Michael Haberfellner

    No preview · Article · Jun 2008 · Psychiatrie und Psychotherapie
  • Egon Michael Haberfellner
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    ABSTRACT: Die Schluckangst ist charakterisiert durch Schwierigkeiten beim Schlucken von festen Nahrungsmitteln, Flüssigkeiten oder Tabletten, begleitet durch intensive Angst, eingeschränktes Essverhalten und manchmal auch sekundären Gewichtsverlust. Das Auftreten der Schluckangst wird durch bestehende Angststörungen begünstigt und oft durch Verschlucken ausgelöst. Die Schluckangst wird nicht selten als Essstörung fehldiagnostiziert. Ein typischer Fall, die klinischen Besonderheiten dieser Störung und therapeutische Überlegungen werden vorgestellt. Swallowing phobia is characterized by difficulty swallowing solid food, liquids or pills, accompanied by intense anxiety, restricted eating behaviour and sometimes secondary weight loss. The occurrence of swallowing phobia is facilitated by the presence of pre-existing anxiety disorders and often appears after an episode of choking on food. Swallowing phobia is often misdiagnosed as eating disorder. A typical case of swallowing phobia and the clinical features of the disorder and therapeutic considerations are presented.
    No preview · Article · Jun 2008 · Psychiatrie und Psychotherapie

  • No preview · Article · Jun 2008 · Die Rehabilitation
  • Egon Michael Haberfellner
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    ABSTRACT: In Austria vehicle drivers impaired by drugs or alcohol have to undergo a psychiatric examination. Drivers who are not accused for impaired driving have to undergo a psychiatric examination too if they are suspected to be alcohol - or drug addicted. Public health officers decide on the need to refer to psychiatric examination. 145 drivers suspected to be alcohol - or drug addicted had been referred to the author for psychiatric examination between January 2002 and August 2005. The records of these patients were examined for the following criteria: the reason for psychiatric examination (accident, impaired driving, others), the pattern of substance using, abnormal laboratory testing (urine test, lever function test, carbohydrate-deficient transferrin). Alcohol consumers/abusers and drug consumers/abusers were compared. Alcohol consumers/ abusers (n=75) had regularly been penalized for impaired driving (86.7%) or for accidents (26.7%) and 88% had consumed alcohol regularly (once a week or more). Only few drug consumers/abusers (n = 86, mostly cannabis) had been penalized for impaired driving (7%), none had an accident and 69.8% had consumed illicit drugs once a week or more. In the vast majority of these cases other reasons than impaired driving caused authorities action. Laboratory tests were abnormal in 37.3% of alcohol consumers/abusers and in 4.7% of drug consumers/abusers indicating ongoing substance use. Although the increasing use of cannabis and amphetamines is a problem, our data indicate that still alcohol is by far the most dangerous psychotropic substance for traffic safety. Authorities seem to overestimate the risk for road safety associated with illicit drug use.
    No preview · Article · Feb 2008 · Neuropsychiatrie: Klinik, Diagnostik, Therapie und Rehabilitation: Organ der Gesellschaft Österreichischer Nervenärzte und Psychiater
  • Egon Michael Haberfellner

    No preview · Article · Jan 2008 · Neuropsychiatrie: Klinik, Diagnostik, Therapie und Rehabilitation: Organ der Gesellschaft Österreichischer Nervenärzte und Psychiater
  • Egon Michael Haberfellner · Sabine Zankl

    No preview · Article · Jan 2008 · Psychotherapie Forum
  • E M Haberfellner
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    ABSTRACT: Sexual dysfunction is a well-known side effect of many antidepressants. Obtaining accurate data on sexual dysfunction from clinical trials is difficult because of methodological problems. This paper reviews the assessment and reporting of sexual dysfunction in clinical trials. 79 randomized double-blind studies comparing efficacy and tolerability of new antidepressants in major depressive disorder were included. Papers were searched for the methodology of adverse event assessment and for any information on treatment-emergent sexual dysfunction. 74.7% of the reviewed studies relied on spontaneous reports, 17.7% on non-specific side-effect checklists and only 7.6% on specific assessment instruments. 31.6% of the reviewed studies reported sexual dysfunction as a side effect of antidepressant treatment. Detailed information on the kind of sexual dysfunction based on DSM-IV terminology was provided by only 10.1% of the papers. More recent studies published in 2000 or later reported sexual dysfunction more often (48.6%) than studies published before the year 2000 (18.2%). The specific assessment of sexual dysfunction should be adopted as a part of the safety and tolerability assessment in clinical trials. Future research is needed to elaborate the advantages and disadvantages of the available instruments for the assessment of sexual dysfunction.
    No preview · Article · Oct 2007 · Pharmacopsychiatry

  • No preview · Article · Dec 2006 · Psychiatrische Praxis
  • Egon Michael Haberfellner · Hans Rittmannsberger

    No preview · Article · Jun 2006 · Psychiatrische Praxis
  • Egon Michael Haberfellner · Hans Rittmannsberger

    No preview · Article · May 2006 · Psychiatrische Praxis
  • E M Haberfellner · H Rittmannsberger
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    ABSTRACT: Patients can provide appropriate and legally valid consent to treatment with antipsychotics only if they received adequate information on the risk of tardive dyskinesia (TD) and have the capacity to give informed consent. Eighty-seven patients in a psychiatric practice undergoing treatment with antipsychotics were interviewed for their level of information regarding TD and were subsequently provided with additional information on TD as needed. Three months after provision of this information, the interview was repeated. Though 82% of the patients had read the patient information leaflet and 44% had already received previous information, only 17% were found to be informed. The proportion of informed patients increased to 72% at the second interview. Among patients remaining uninformed despite previous information, a statistically significant higher proportion of elderly patients and patients with marked psychopathological impairments was found. Schizophrenic patients' knowledge on TD is low. With appropriate oral information being provided patients' knowledge can be considerably improved in the short run.
    No preview · Article · Apr 2006 · Der Nervenarzt
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    ABSTRACT: The study was intended to evaluate the therapeutic and healthcare services utilized by 116 former long-stay patients after an average of 42.9 months of deinstitutionalization during a follow-up time of (1/2) year and to calculate the costs thus incurred. 116 patients and their caregivers were interviewed during a period of 6 months using the German version of the Client Sociodemographic and Service Receipt Inventory. On average, 3.3 institutions/facilities were contacted per patient, most often by younger patients living in group homes and least often by patients in psychiatric nursing homes. During the 6-month follow-up time costs of euro 14,665 were incurred per patient. Of these costs, 87.2 % were for the residential facilities. The costs of outpatient care accounted for 41.4 % of the costs that would have been incurred for inpatient care in a psychiatric hospital. Deinstitutionalization of psychiatric long-stay patients in Upper Austria provided for considerable reductions in costs while maintaining a high quality of care.
    No preview · Article · Apr 2006 · Psychiatrische Praxis
  • E. M. Haberfellner · H. Rittmannsberger
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    ABSTRACT: Background Patients can provide appropriate and legally valid consent to treatment with antipsychotics only if they received adequate information on the risk of tardive dyskinesia (TD) and have the capacity to give informed consent. Methods Eighty-seven patients in a psychiatric practice undergoing treatment with antipsychotics were interviewed for their level of information regarding TD and were subsequently provided with additional information on TD as needed. Three months after provision of this information, the interview was repeated. Results Though 82% of the patients had read the patient information leaflet and 44% had already received previous information, only 17% were found to be informed. The proportion of informed patients increased to 72% at the second interview. Among patients remaining uninformed despite previous information, a statistically significant higher proportion of elderly patients and patients with marked psychopathological impairments was found. Conclusions Schizophrenic patients’ knowledge on TD is low. With appropriate oral information being provided patients’ knowledge can be considerably improved in the short run.
    No preview · Article · Mar 2006 · Der Nervenarzt
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    ABSTRACT: The aim of this study was to assess the needs for care of 116 former long-stay patients during the first 42.9 months after discharge. Patients and mental health professionals rated needs using the "Berliner Bedürfnisinventar" (Berlin Needs for Care Inventory). Out of a total of 16 needs areas, patients reported a mean number of 7.6 needs, therapists reported 10 needs. Patients with lower global functioning scores showed a significantly lower number of needs, while patients living in psychiatric nursing homes and patients with learning disabilities had a significantly higher number of needs. In most areas, agreement between patients' and therapists' assessment was good to moderate. In most areas the rate of unmet versus total needs was above 90 %. Patients received help almost exclusively from institutions or mental health services. The care needs of discharged patients were generally met and placement in institutions was considered appropriate.
    No preview · Article · Feb 2006 · Psychiatrische Praxis