Effekte einer psychoedukativen Kurzintervention bei akut psychotischen Menschen
2011-07, Nischk, Daniel, Gasser, Miriam, Polaine, Karin, Rusch, Johannes, Schonauer, Klaus, Rockstroh, Brigitte
Hintergrund: In der vorliegenden Studie wurde ein kurzes psychoedukatives Programm (PE) für akut psychotische Patienten evaluiert. Das PE-Programm nahm besonders Rücksicht auf die in der Akutphase vorherrschenden neuropsychologischen Defizite und fokussierte darüber hinaus auf den Austausch über gegenwärtige psychotische Symptome.
Methode: 57 Probanden mit ICD-10-Diagnosen aus dem F2-Bereich wurden randomisiert einer Kontrollgruppe (KG: TAU) oder Experimentalgruppe (EG: TAU + PE) zugewiesen und vor der Intervention (t1), danach (t2) und vier Wochen später (t3) hinsichtlich Wissenszuwachs, Einsicht und Krankheitskonzept untersucht.
Ergebnisse: Die EG wies im Vergleich zur KG einen signifikanten Wissenszuwachs und höhere globale Krankheitseinsicht zu t2 und t3 auf.
Diskussion: Auch Patienten mit relativ akuten psychotischen Symptomen können von PE profitieren, wenn die Maßnahmen neuropsychologische Einschränkungen berücksichtigen.
Stress load during childhood affects psychopathology in psychiatric patients
2008, Weber, Katja, Rockstroh, Brigitte, Borgelt, Jens, Awiszus, Barbara, Popov, Tzvetan G., Hoffmann, Klaus, Schonauer, Klaus, Watzl, Hans, Pröpster, Karl
Childhood stress and trauma have been related to adult psychopathology in different psychiatric disorders. The present study aimed at verifying this relationship for stressful experiences during developmental periods by screening stress load across life in adult psychiatric inpatients with different diagnoses compared to healthy subjects. In addition, a relationship between the amount of adverse experiences and the severity of pathology, which has been described as a 'building block' effect in posttraumatic stress disorder (PTSD), was explored for nontraumatic events in psychiatric disorders other than PTSD.
96 patients with diagnoses of Major Depressive Disorder (MDD), schizophrenia, drug addiction, or personality disorders (PD) and 31 subjects without psychiatric diagnosis were screened for adverse experiences in childhood (before the age of six years), before onset of puberty, and in adulthood using the Early Trauma Inventory and the Posttraumatic Stress Diagnostic Scale. Effects of stress load on psychopathology were examined for affective symptoms, PTSD, and severity of illness by regression analyses and comparison of subgroups with high and low stress load.
High stress load in childhood and before puberty, but not in adulthood, was related to negative affect in all participants. In patients, high stress load was related to depressive and posttraumatic symptoms, severity of disorder, and the diagnoses of MDD and PD.
Results support the hypothesis of stress-sensitive periods during development, which may interact with genetic and other vulnerability factors in their influence on the progress of psychiatric disorders. A 'dose' effect of stress load on the severity of psychopathology is not restricted to the relationship between traumata and PTSD.
Illness representations of depression and perceptions of the helpfulness of social support : comparing depressed and never-depressed persons
2010, Vollmann, Manja, Scharloo, Margreet, Salewski, Christel, Dienst, Alexander, Schonauer, Klaus, Renner, Britta
Background: Interactions between depressed persons and persons within their social network are often characterized by misunderstanding and unsuccessful social support attempts. These interpersonal problems could be fostered by discrepancies between depressed and never-depressed persons' illness representations of depression and/or discrepancies in the perceived helpfulness of supportive behaviors.
Methods: Illness representations of depression (IPQ-R) and perceptions of the helpfulness of different social support behaviors (ISU-DYA and ISAD) were assessed in 41 currently depressed persons and 58 persons without a history of depression.
Results: Never-depressed persons perceived depression as more controllable by treatment and as less emotionally impairing than depressed persons, but also as having more severe consequences. Never-depressed persons considered activation-oriented support (motivation to approach problems) as more helpful and protection-oriented support (allowance to draw back) as less helpful in comparison to depressed persons.
Limitation: Data were collected in unrelated samples of depressed and never-depressed persons.
Conclusions: Discrepancies in illness representations and perceptions of the helpfulness of social support do exist and may be the origin of problematic social interactions between depressed patients and persons within their social network. Therapeutic interventions should address the issue of conflicting perceptions and encourage depressed patients to acknowledge and discuss this topic within their social network.