Swiss Archives of Neurology, Psychiatry and Psychotherapy

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Maggie Phillips, Claire Frederick, Hrsg.: Handbuch der Hypnotherapie bei posttraumatischen und dissoziativen Störungen

by C. Scharfetter

Swiss Arch. Neurol. Psychiatry Psychother. 2003, 154(6), 296; https://doi.org/10.4414/sanp.2003.01406 - 1 Jan 2003

Abstract

Die beiden Autorinnen, eine psychologische und eine psychiatrische Psychotherapeutin, beschenken uns mit einem sehr guten, schönen, reifen und sympathischen Buch zur «Heilung des geteilten Selbst» (d.i. das Original von 1995) [...]
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Rainer Tölle, Klaus Windgassen: Psychiatrie einschliesslich Psychotherapie

by C. Scharfetter

Swiss Arch. Neurol. Psychiatry Psychother. 2003, 154(6), 296; https://doi.org/10.4414/sanp.2003.01405 - 1 Jan 2003

Abstract

Die neue, 13.Auflage des altbewährten, von vielen Berufsgruppen benützten Lehrbuches liegt vor: zuerst Schulte und Tölle, dann jahrelang Tölle, nun Tölle und Windgassen mit Beiträgen zur Kinder- und Jugendpsychiatrie von Lempp und du Bois [...]
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F. Müller-Spahn, J. Margraf: Wenn Spielen pathologisch wird

by M. Gmür

Swiss Arch. Neurol. Psychiatry Psychother. 2003, 154(6), 295-296; https://doi.org/10.4414/sanp.2003.01404 - 1 Jan 2003

Abstract

Interessenunabhängigkeit ist das höchste Gebot von Wissenschaftlichkeit [...]
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Rainer Krause: Allgemeine Psychoanalytische Krankheitslehre, Band 1: Grundlagen, Band 2: Modelle

by H. Böker

Swiss Arch. Neurol. Psychiatry Psychother. 2003, 154(6), 295; https://doi.org/10.4414/sanp.2003.01403 - 1 Jan 2003

Abstract

Die «Allgemeine Psychoanalytische Krankheitslehre » von Rainer Krause hat sich seit der Ersterscheinung (1997/1998) bereits einen festen Platz in der psychoanalytischen und psychotherapeutischen Weiterbildung erobert [...]
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Open AccessBook Review

Hendrik Berth, Friedrich Balck, Hrsg.: Psychologische Tests für Mediziner

by E. Hurwitz

Swiss Arch. Neurol. Psychiatry Psychother. 2003, 154(6), 294; https://doi.org/10.4414/sanp.2003.01402 - 1 Jan 2003

Abstract

Beschrieben werden 120 Testverfahren nach einem einheitlichen Raster, welches in etwa dem entspricht, was im Standardwerk von Brickenkamp (Handbuch psychologischer und pädagogischer Tests,Hogrefe,Göttingen 2002) angewendet wird [...] Full article

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Alice Holzhey-Kunz: Das Subjekt in der Kur. Über die Bedingungen psychoanalytischer Psychotherapie

by A. R. Bodenheimer

Swiss Arch. Neurol. Psychiatry Psychother. 2003, 154(6), 294-295; https://doi.org/10.4414/sanp.2003.01401 - 1 Jan 2003

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Wer sich nach monatelanger Arbeit, Schwerarbeit übrigens, verbunden mit Feinarbeit – denn nicht alle Juwelen glänzen sogleich, bisweilen müssen sie behutsam abgewischt und dann betrachtet werden – schliesslich mit dem Buch in Gänze auseinandergesetzt hat, fragt sich, warum so etwas nicht vor 30, [...] Read more.

Wer sich nach monatelanger Arbeit, Schwerarbeit übrigens, verbunden mit Feinarbeit – denn nicht alle Juwelen glänzen sogleich, bisweilen müssen sie behutsam abgewischt und dann betrachtet werden – schliesslich mit dem Buch in Gänze auseinandergesetzt hat, fragt sich, warum so etwas nicht vor 30, 40 Jahren erschienen ist [...] Full article

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News

by Karl Studer

Swiss Arch. Neurol. Psychiatry Psychother. 2003, 154(6), 293-294; https://doi.org/10.4414/sanp.2003.01400 - 1 Jan 2003

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Abstract

Im kommenden Wahljahr haben sich Politiker und Journalisten auf ein neues Thema konzentriert: Scheininvalidität, Versicherungsbetrug im Rahmen der Invalidenversicherung [...] Full article

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Sparpolitik und Psychiatrie

by D. Hell

Swiss Arch. Neurol. Psychiatry Psychother. 2003, 154(6), 292; https://doi.org/10.4414/sanp.2003.01397 - 1 Jan 2003

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Abstract

Sparen ist angesagt, gerade auch im Gesundheitswesen. Eine Kürzung der Ressourcen wirkt sich besonders gravierend in der Psychiatrie aus, die über kein finanzielles Polster verfügt, sondern in den letzten Jahrzehnten (mit wirtschaftlicher Prosperität) nur die grössten Versorgungslücken schliessen konnte Full article

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Open AccessArticle

The influence of biography, life events and chronic difficulties on depressivity during the process of inpatient treatment of depressives

by K.-E. Bühler and S. Pagels

Swiss Arch. Neurol. Psychiatry Psychother. 2003, 154(6), 284-291; https://doi.org/10.4414/sanp.2003.01396 - 1 Jan 2003

Cited by 1 | Viewed by 45

Abstract

Background: The aim of the study is to complete the findings on life events in depression by investigating the influence of chronic stress in life and of biographical factors on the course of treatment of depressive subjects. Methods: The data were assessed on [...] Read more.

Background: The aim of the study is to complete the findings on life events in depression by investigating the influence of chronic stress in life and of biographical factors on the course of treatment of depressive subjects. Methods: The data were assessed on 152 inpatients with the diagnosis of major depression (criteria of DSM-IV) diagnosed by SCID. Two thirds of the sample were females. The treatment was homogeneous for all patients participating in the study: antidepressive medication and “clinical management”. The depressive status was documented at four points in time during the treatment (beginning, after one week of inpatient treatment, after three weeks of inpatient treatment and at the end of inpatient treatment) by the depression scale of v. Zerssen (1975). At the beginning of the treatment the patients had to answer questionnaires about biographic variables (BIFA-AL, Bühler and Bardeleben), stressful life events (ILE, Siegrist and Dittmann), chronic problems (CP, Siegrist), variables for coping with diseases (FKV, Muthny) and sociodemographic variables. The duration of the inpatient treatment was another indicator for the process of treatment. Results: The mean duration of clinical treatment was 8 weeks and 2 days, at the maximum 29 weeks. Regarding the course of depression, there is a continuous and convincing decrease in the mean scores of the depression scale. Contrary to common opinion the reporting of biographical data is not significantly influenced by depressive mood and depressive cognition, i.e. a significant change in mood had no significant influence on the recalling of events and memories of events. Critical life events, chronic difficulties, neuroticism, aimrelatedness and the overall subjective stress of life events significantly influence the depressive symptoms and the duration of clinical treatment and are suitable for predicting the clinical process. A statistically significant correlation exists between the biographic dimensions on the one hand and the stress due to chronic difficulties in life and the number of stressing life events on the other hand. Conclusion: Our study explains the influence of life stress and biographic aspects on the process of inpatient treatment of depressive disorders and in addition shows a biographical predisposition for stress due to life circumstances and life events. The premorbid biography of an individual influences the sensitivity for stress and thus the risk of developing an affective disorder. The stress due to critical life events and chronic difficulties as well as biographic variables are suitable as predictors for the process of inpatient treatment of depressive disorders. Clinical relevance: If the biographic risk profile is known, preventive psychotherapeutic intervention should be undertaken to avoid the genesis of a depressive disorder by critical life events. From our findings inferences can be drawn for the psychotherapeutic treatment of depressives. Besides cognitive “restructuring” psychodynamic therapy aims at reintegration of subjective experience and enables a structural change in the conception of biography. Full article

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Psychological impairment in students: an exploratory study

by L. Michel, M. Drapeau and J.-N. Despland

Swiss Arch. Neurol. Psychiatry Psychother. 2003, 154(6), 281-283; https://doi.org/10.4414/sanp.2003.01395 - 1 Jan 2003

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Abstract

Despite numerous studies indicating that a significant proportion of students suffers from serious psychological difficulties, a widespread idea about those requesting assistance in a university-based counselling clinic is that they are by no means comparable to patients seen in other settings. The aim [...] Read more.

Despite numerous studies indicating that a significant proportion of students suffers from serious psychological difficulties, a widespread idea about those requesting assistance in a university-based counselling clinic is that they are by no means comparable to patients seen in other settings. The aim of this exploratory study was to address this contention and examine symptom severity and social adjustment in N = 16 students seen in a university-based counselling service and N = 19 students seen in an outpatient psychiatric clinic. Symptom severity was assessed using the SCL- 90R. Social adjustment was assessed using the Social Adjustment Self-rated Scale. Results show that students requesting help in the university-based clinic do not present less psychological impairment than those seen in the psychiatric outpatient setting. These findings indicate that university- based counselling services are needed in order to allow students to seek professional help on their own grounds. Because no significant difference in symptom impairment and in social adaptation was found between the two groups, it is imperative that therapists providing therapeutic help to students on the university campus have solid professional training. Full article

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Open AccessReview

Einstellung zur Sexualität vor Beginn einer antidepressiven Therapie – eine Pilotstudie

by L. Götzmann, S. Capek, M. Dutta, R. Klaghofer, W. Fuchs and C. Buddeberg

Swiss Arch. Neurol. Psychiatry Psychother. 2003, 154(6), 276-280; https://doi.org/10.4414/sanp.2003.01394 - 1 Jan 2003

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Abstract

Background: Sexual dysfunction is a possible side effect of certain antidepressants with may lead to a negative impact on quality of life and medication compliance. Therefore, in the psychiatric literature there is some advice that patients should be informed about potential side effects [...] Read more.

Background: Sexual dysfunction is a possible side effect of certain antidepressants with may lead to a negative impact on quality of life and medication compliance. Therefore, in the psychiatric literature there is some advice that patients should be informed about potential side effects before prescription of such an antidepressant. For patients with an indication for antidepressive medication the present study investigated the subjective im-portance of sexuality for them, their sexual satisfaction and whether they expected that their doctor discussed sexual issues with them. Methods: In cooperation with general practitioners and a psychiatric out-patient clinic 21 female and 16 male patients were included in the study. Questionnaires were handed out prior to the therapy with antidepressants. Results: For 76% of the female and 81% of the male patients sexuality was very important, however, almost half of them were unsatisfied with their sexual life. All women and 87% of the men expected that their doctor would address sexual issues openly. 81% of the women and 63% of the men reported no difficulties talking about sexual issues with their treating physician. Conclusion: Sexuality is an important issue for patients with an indication for antidepressive therapy. In this sense also depressive patients can be preoccu-pied with questions and sorrows concerning sexuality. Doctors should discuss sexual problems openly and inform about sexual dysfunction as a possible side effect of antidepressive medication. Full article

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Notverlegungen aus der überfüllten psychiatrischen Akutklinik

by Klaus Ernst

Swiss Arch. Neurol. Psychiatry Psychother. 2003, 154(6), 269-275; https://doi.org/10.4414/sanp.2003.01393 - 1 Jan 2003

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Abstract

Case reports: The presentation of case histories il-lustrates aspects which cannot be understood by looking at terms and figures. The wish of many patients “to finally stay here”, for instance,has been found to relate to traumatic memories of injustice, humiliation and loss of [...] Read more.

Case reports: The presentation of case histories il-lustrates aspects which cannot be understood by looking at terms and figures. The wish of many patients “to finally stay here”, for instance,has been found to relate to traumatic memories of injustice, humiliation and loss of opportunity experienced as the result of a previous “enforced removal”.Sometimes, not even careful information or trial visits at the decentralised institution can prevent patients or their relatives from regretting their consent to the transfer. Discussion: Even today, there are patients suffering from “chronic-acute” disorders who fail every attempt to release them from regional psychiatric hospitals with admission obliga-tion into social psychiatric structures.However, as our group of “remaining patients” shows, these cases have become increasingly rare. Most admitted patients are now released into their previous environment or into social psychiatric institutions in their region after a stay of days or weeks. Should the crises reoccur, they are readmitted, thus making the cooperation of clinic, semi-ambulatory and ambulatory forms of care (private practices, outpatients’ clinic, regional nursing homes, individual flats, visiting service,employment agencies) much closer and more personal. The fact that even the transferred patients figuring in our study stated that they experienced their own work as the most positive among all the care factors confirms the findings of all re-lated literature. Our cases have also shown the immense pressure relatives of chronically disturbed patients are exposed to, who, on the patient’s being discharged from the clinic, experienced a lack of further treatment or direct help to the carers. Previously, such cases often led to readmittance, today they more often result in a break in the patient’s social net. Conclusions: The main question is: how can the transfer of chronically ill patients to remote regions be avoided? The answer may be found in the private and social psychiatric services mentioned above. They are mainly known for being less expensive than treatment at a clinic. However, we must remember that a reduction in days spent at the clinic will mean an increase in chronically ill patients who will have to be treated as outpatients and whose aftercare will eventually become more expensive than treatment at a clinic; since, in the course of time, many of these outpatients will increasingly seem not so much to “ambulate” as to withdraw. If they are not regularly seen by experienced medical or social workers, with or without their consent, the lack of social contacts often threatens these patients with social isolation, loss of accommodation and even extreme impoverishment. Although such visits are expen-sive (transport cost of the daily helper), we may not reason that “we will not force anybody because we respect the wishes of those patients who do not want to come and see us”. Especially in the case of long-term patients, this seemingly liberal declara-tion may very soon turn out to be inhumane. Full article

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Open AccessReview

Notverlegungen aus der überfüllten psychiatrischen Akutklinik

by Klaus Ernst, H. H. Stassen, W. Rössler and D. Hell

Swiss Arch. Neurol. Psychiatry Psychother. 2003, 154(6), 260-268; https://doi.org/10.4414/sanp.2003.01399 - 1 Jan 2003

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Abstract

Introduction: Psychiatric hospitals being obliged to admit all urgent cases from within their region tend to become overcrowded. They are forced to displace chronic patients to decentralised psychiatric institutions often far removed from patients’ homes and rehabilitation facilities. We have asked patients and [...] Read more.

Introduction: Psychiatric hospitals being obliged to admit all urgent cases from within their region tend to become overcrowded. They are forced to displace chronic patients to decentralised psychiatric institutions often far removed from patients’ homes and rehabilitation facilities. We have asked patients and relatives about their opinions and recollections concerning these transfers from the Psychiatrische Universitätsklinik Zürich (PUK). Study samples and study methods The transferred patient: We have identified all 75 surviving patients (42 female, 33 male) who stayed at the Psychiatrische Universitätsklinik Zürich (PUK) for longer than one year before transfer to a decentralised institution (DI) and afterwards at least another full year in the decentralised institution. Today, 48 are living in a decentralised institution located at an average distance of 20 km from Zurich city (I), 16 at an average distance of 55 km (II) and 11 at an average distance of 110 km (III). The further the average distance the more advanced is the mean age of the transferred patients (I: 66, II: 75, III: 78 years of age) and the more time has elapsed since transfer (I: 1976, II: 1969, III: 1956).These figures reflect the fact that, during the last five decades, it became increasingly possible to transfer patients to institutions less remote from PUK. Only 3 of the 75 patients refused the interview. The remaining patients: For comparison we have chosen a group of patients who have been staying at PUK for an uninterrupted period of at least two years. Among the 330 patients present on 1/2/2000, there were 28 remaining patients (13 female, 15 male) fulfilling the criterion. 5 of them refused the interview. The proportion of patients who were previously acquainted with the visitor was equivalent to that of the transferred patients’ group. Like most of the transferred patients most of the remaining patients were suffering from chronic schizophrenia, but, unlike the former, linked with a generalised negativism, thus explaining their higher rate of refusal of the transhospitalisation. The interviews: In 1999 all these patients were visited by the first author. Information was gathered from semi-structured interviews with the patients, from oral and written information given by DI- and PUK-staff and (generally by telephone) from detailed memories of next of kin, relatives and friends. 53 patients of sound mnestic capacities were able to give reliable information about their transfer, and in 56 cases the relatives gave us detailed statements of their views and opinions. Statistic analyses were performed by Hans Stassen using the SAS system. Results Visits by relatives and friends and other social contacts have often been seriously hampered by transhospitalisation. The average frequency of visits decreased significantly with the increasing distance. The objective quality of care in the decentralised institutions as compared to the care received by the remaining patients in the PUK, did not show any significant difference regarding staff, psychiatric and somatic medication, paid work therapy, working hours per week, creative therapies offered and organised social activities. The subjective quality of care was rated by the patients themselves. Here the remaining patients, corresponding to their higher level of negativism, showed less satisfaction concerning all the above-mentioned components of their life in the PUK than did the transferred patients concerning their life in the decentralised institutions. In both groups the highest level of satisfaction was assigned to the patients’ own work as the best source of contentment. Patients’ judgment of their transhospitalisation: Patients’ retrospective judgment of their own transhospitalisation was worst in group DI III and mildest in group DI I. The same result, though complicated by self-reproach, was found in the group of patients’ relatives. Patients and relatives agreed in blaming transhospitalisation as a harmful measure. Full article

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Open AccessEditorial

Editorial

by Karl Studer

Swiss Arch. Neurol. Psychiatry Psychother. 2003, 154(6), 259; https://doi.org/10.4414/sanp.2003.01398 - 1 Jan 2003

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Abstract

Klaus Ernst berichtet über die Notverlegungen aus den überfüllten psychiatrischen Akutkliniken und mahnt anhand seiner langjährigen Erfahrungen und seiner Untersuchungen, dass die langzeit psychisch kranken Patienten nicht vergessen gehen, dass der Wunsch nach billigeren Lösungen der Langzeitbetreuung die Gefahr von Qualitätseinbussen in sich [...] Read more.

Klaus Ernst berichtet über die Notverlegungen aus den überfüllten psychiatrischen Akutkliniken und mahnt anhand seiner langjährigen Erfahrungen und seiner Untersuchungen, dass die langzeit psychisch kranken Patienten nicht vergessen gehen, dass der Wunsch nach billigeren Lösungen der Langzeitbetreuung die Gefahr von Qualitätseinbussen in sich birgt [...] Full article

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Swiss Arch. Neurol. Psychiatry Psychother., Volume 154, Issue 6 (01 2003) – 14 articles

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