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  • 1995-1999  (5)
  • Psychosomatik  (3)
  • depression
  • patient education
  • 1
    Electronic Resource
    Electronic Resource
    Psychosomatische Grundversorgung auf der Grundlage des PLISSIT-Modells Entwicklung und Evaluation einer Weiterbildungskonzeption (1999)
    Springer
    Der Nervenarzt 70 (1999), S. 54-63 
    Details
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Psychosomatische Grundversorgung ; Fortbildung ; Hausärzte ; Beratung ; Psychiatrie ; Psychosomatik ; Key words Education ; Training program ; General practioners ; Psychosomatic medicine ; Psychiatry ; Primary care ; Continuous medical education
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Deficits in current approaches of psychosomatic and psychiatric education for general practitioners are reviewed. A skill-based training was developed in line with the four step counceling approach of the „PLISSIT” approach: The GP helps in first step („permission”) the patient to accept his problem and assesses informations about causing and maintaining factors of his symptomatology. In the second step he should provide information about the disorder and reverse misunderstanding and passivity (Limited Information). The GP’s should develop preliminary strategies for change in the third step („coping strategies”, „symptom management”; „special suggestions”) and preparate the intensive phase of therapy as the last step. First results of the evaluation of the training program are presented demonstrate the effectiveness and acceptance of the education programm.
    Notes: Zusammenfassung Ausgehend von einer Analyse der Schwächen aktueller Ansätze der psychosomatischen Grundversorgung wird einerseits ein Ansatz vorgestellt, der störungsspezifisch im Rahmen eines Mehrebenenmodells pharmakologische und verbale Intervention aufeinander bezieht. Andererseits werden im Sinne eines zeitökonomisch abgestuften Vorgehens verschiedene Phasen durch das zugrundegelegte PLISSIT-Modell differenziert: In der Permission-Phase geht es um die Akzeptanzvermittlung und Problemanalyse hinsichtlich der vom Patienten geschilderten Beschwerden, in der Phase der „limited information” um die dialogische Erarbeitung eines Störungsmodells und den Aufbau einer aktiven Änderungsmotivation, in der Phase der „special suggestions” erfolgt eine konkrete Anleitung zur Selbstbeobachtung und -protokollierung des Problemverhaltens sowie die Vermittlung von Strategien zum Symptommanagement; in der letzten Phase der „intensive therapy” geht es um die Indikationsstellung und den Motivationsaufbau zur fachärztlichen bzw. fachpsychotherapeutischen Weiterbehandlung. Empirische Ergebnisse zur Evaluation des Weiterbildungskonzeptes an über 200 Teilnehmern werden referiert.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001150050400
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Risk factors of severe hypoglycaemia in adult patients with Type I diabetes – a prospective population based study (1998)
    Springer
    Diabetologia 41 (1998), S. 1274-1282 
    Details
    ISSN: 1432-0428
    Keywords: Keywords Type I diabetes ; severe hypoglycaemia ; risk factors ; hypoglycaemia awareness ; patient education ; social class ; behaviour ; attitude ; C-peptide.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The objective of this study was to identify possible risk factors of severe hypoglycaemia (SH) in a prospective population based study of adult Type I (insulin-dependent) diabetic patients. A representative sample of 684 patients (41 % women, mean ± SD age 36 ± 11, diabetes duration 18 ± 11 years), living in the district of Northrhine (9.5 million inhabitants), Germany, were examined in their homes using a mobile ambulance. A comprehensive baseline assessment of possible predictors of SH included sociodemographic and disease related variables, hypoglycaemia awareness, diabetes management, and attitudes and behavioural aspects as expressed by the patients. After a mean of 19 ± 6 months 669 (98 %) patients were interviewed about events of SH since the baseline examination. Using the multiple Cox proportional hazards model, five risk factors of SH were identified: SH during the preceding year [hazard ratio (HR) 2.7, 95 % confidence intervals (CI) 1.8–4.2], any history of SH (HR 1.9, CI 1.1–3.4), C-peptide negativity (HR 4.0, CI 1.2–12.7), social status (HR 0.8 for a difference of 5 units for a value range of 0–24, CI 0.6–0.9), and patients' determination to reach normoglycaemia (HR 0.7 for a difference of 1 unit for a value range of 1–6, CI 0.5–0.9), indicating that the lower the social status and the higher the patients' determination to reach normoglycaemia, the higher the risk of SH. After eliminating the history of hypoglycaemia from the model, impaired hypoglycaemia awareness and patients' inappropriate denial of SH as their particular problem became additional significant risk factors of SH. In conclusion, in this population based study of adult Type I diabetic patients, C-peptide negativity, a previous event of SH, patients' determination to reach normoglycaemia and social class were risk factors of SH. [Diabetologia (1998) 41: 1274–1282]
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001250051065
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Intensified insulin therapy and the risk of severe hypoglycaemia (1997)
    Springer
    Diabetologia 40 (1997), S. 926-932 
    Details
    ISSN: 1432-0428
    Keywords: Keywords Insulin therapy ; hypoglycaemia ; HbA1 c ; patient education ; centre effect.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The objectives of the present analyses were to assess the association between HbA1 c levels and severe hypoglycaemia (SH, treatment with glucose i. v. or glucagon injection) and to identify predictors of SH in a prospective multicentre trial. The study population consisted of 636 insulin-dependent diabetic patients who had participated in a structured 5-day in-patient group treatment and teaching programme for intensification of insulin therapy (ITTP) in one of 10 hospitals and who were re-examined after 1, 2, 3, and 6 years including assessment of demographic, disease and treatment related parameters, diabetes-related knowledge, behaviour, and emotional coping. At baseline, age (mean ± SD) was 27 ± 7 years, diabetes duration 9 ± 7 years and HbA1 c 8.3 ± 1.9 %. During the 6-year follow-up, the mean HbA1 c value improved to 7.6 %, and in patients with a diabetes duration of more than 1 year at entry into the study (n = 538) the incidence of SH decreased from 0.28 cases/patient/year during the year preceding the ITTP to 0.17 cases/patient/year. The patient group was divided into decile groups according to mean follow-up HbA1 c values. In each group more than 230 patient years could be analysed. Groups with mean HbA1 c values of 5.7, 7.0, 7.4, 7.7 and 8.9 % had comparable risks of SH (0.15–0.19 cases/patient/year). In a logistic regression analysis, mean HbA1 c during follow-up, a history of SH during the year preceding the ITTP, C-peptide level, emotional coping, carrying emergency carbohydrates (as assessed at the 1-year follow-up), and age at onset of diabetes were significant independent predictors of SH. The incidence of SH between centres varied between 0.05 and 0.27 cases/patient/year. In conclusion, in the present analyses no linear or exponential relationship between HbA1 c and severe hypoglycaemia could be identified by using simple group comparisons. Applying complex regression analyses, various patient-related predictors of severe hypoglycaemia were identified. [Diabetologia (1997) 40: 926–932]
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001250050769
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    Die Behandlung des atopischen Ekzems in interdisziplinärer Zusammenarbeit zwischen Dermatologie und Psychosomatik Eine Einzelfalldarstellung (1996)
    Springer
    Der Hautarzt 47 (1996), S. 628-633 
    Details
    ISSN: 1432-1173
    Keywords: Schlüsselwörter Atopisches Ekzem ; Nahrungsmittelallergie ; Psychosomatik ; Mutter-Kind-Beziehung ; Key words Atopic eczema ; Food allergy ; Psychosomatics ; Mother-child relationship
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Atopic eczema is one of the most frequent dermatological diseases, with a still increasing incidence. Although its etiopathogenesis is still not completely understood, a variety of triggering factors are known. The following case report describes the clinical course of atopic dermatitis in a 2-year-old boy in whom both IgE-mediated allergic reactions and psychological factors were involved in triggering and maintenance of skin lesions. This demonstrates how important both dermatological therapy and close cooperation with the field of psychosomatic medicine can be.
    Notes: Zusammenfassung Das atopische Ekzem zählt zu den häufigsten dermatologischen Erkrankungen mit zunehmender Inzidenz. Obwohl die Ätiopathogenese letztendlich ungeklärt ist, sind eine Vielzahl auslösender Faktoren bekannt. Anhand der Falldarstellung eines 2jährigen Kindes, bei dem sowohl IgE-vermittelte allergische Reaktionen als auch psychische Faktoren an der Auslösung und Unterhaltung der Hautveränderungen beteiligt waren, soll aufgezeigt werden, daß eine erfolgreiche Behandlung des atopischen Ekzems in vielen Fällen neben dermatologisch-allergologischen Therapieansätzen ebenso eine enge Kooperation mit dem Fachgebiet der Psychosomatik erforderlich macht.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001050050480
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    Paper (German National Licenses)
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  • 5
    Electronic Resource
    Electronic Resource
    Psychosexual counseling and specific interventions in psychogenic erectile dysfunction (1999)
    Springer
    Reproduktionsmedizin 15 (1999), S. 285-293 
    Details
    ISSN: 1434-808X
    Keywords: Schlüsselwörter Erektile Dysfunktion ; psychogene Erektionsstörungen ; Sexualtherapie ; Psychotherapie ; Psychosomatik ; Kombination psychotherapeutischer und medikamentöser Verfahren ; Key words Erectile dysfunction ; Psychogenic causes ; Sex therapy ; Psychotherapy ; Psychosomatics ; Combination therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary In the light of highly successful somatic therapies psychotherapeutic interventions in erectile dysfunction are nowadays less considered. But they are nevertheless highly effective and needed according to the psycho-somatic nature of the condition. In this article we present an etiologic framework of psychogenic erectile dysfunction as well as the diagnostic approach and therapeutic interventions. Finally we discuss the need for an increased research in the combination of psychotherapeutic and medical therapy.
    Notes: Zusammenfassung Angesichts großer Erfolge in der medikamentösen Behandlung der erektilen Dysfunktion haben psychotherapeutische Interventionen in letzter Zeit wenig Aufmerksamkeit erhalten. Doch ist bei Erektionsstörungen als psycho-physisches Gesamtgeschehen auch die Kenntnis psychologischer Faktoren für eine erfolgreiche Behandlung nötig. Die vorliegende Arbeit stellt grundlegende ätiologische Konzepte psychogener Erektionsstörungen vor, erläutert die psychologische Diagnostik und die gängigen Modelle für Sexualberatung und Sexualtherapie. Schließlich wird die Möglichkeit einer Kombination von medikamentöser und psychotherapeutischer Behandlung diskutiert.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004440050087
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    Paper (German National Licenses)
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