Psychotherapie Psychosomatik Medizinische Psychologie最新文献

Amyotrophic lateral sclerosis (ALS) is associated with elevated distress, but evidence on psychosocial interventions is limited. We tested the feasibility of a psychotherapy for palliative cancer patients in ALS patients.We applied CALM (Managing Cancer and Living Meaningfully), an effective psychodynamic short-term therapy for advanced cancer patients, within a pre-post study among patients with ALS. We provided patient flow and formal treatment information. Based on the treatment protocols, the therapist reflected on the applicability of the treatment structure, specifics in the psychosocial work with ALS patients and suggestions for treatment modification.Among 15 eligible patients, five participated. Three patients completed the treatment, two patients provided complete study data. The trial was prematurely stopped due to issues in feasibility. Six (22%) sessions were conducted via telephone, 10 (37%) were attended by family caregivers. The structure showed limited applicability largely because fear-laden topics including suffering and death were extensively avoided. Compared to palliative cancer patients, ALS patients fluctuated more strongly in their psychological and physical symptom burden and were more strongly distressed by disease-related practical issues. Recommendations included a multi-professional team, booster sessions and a direct support for caregivers.A psychotherapy effective for cancer patients showed features that limit its applicability among ALS patients. Some of these limitations are treatment-inherent and thus hard to adapt. Rather than modifying the program, we suggest to develop a specific supportive psychotherapeutic intervention within a participatory approach.

The aim of this qualitative study is to investigate the views of hospitalized dermatology patients on a psychosomatic early detection measure.This qualitative study comprises a nurse-led psychosomatic screening followed by consultation on dermatology wards at the University Medical Center Hamburg-Eppendorf, Germany. For an initial screening, the Patient Health Questionnaire-4 (PHQ-4) was used by nurses during patient admission. All patients were interviewed once during their inpatient stay and once at least four weeks after discharge. The interviews were analyzed using thematic analysis.Nine patients (M=50.1 years; 4 women, 5 men; 18-84 years) who were positively screened for depressive symptoms or anxiety using the Patient Health Questionnaire-4 as part of a psychosomatic screening process were recruited for the study. Qualitative analysis identified seven themes, including appreciation of holistic care, stigma, barriers to psychological treatment and the structure of the screening process. In general, all patients appreciated the additional psychosomatic care, but also pointed out some barriers, such as long waiting times for therapy and stigmatization of psychosomatic illnesses.The qualitative results underline the positive attitude of dermatologically treated inpatients towards psychosomatic screening as an early detection measure in somatic care: On the one hand, the holistic care approach was welcomed, on the other hand, the combination of early detection measures and subsequent psychosomatic consultation was appreciated. Stigmatization of psychosomatic illness and systemic barriers were seen as challenges. Future studies should increase the sample size and extend the research question to other disciplines.

Many of those who were politically persecuted in the GDR still suffer from the health, economic and psychosocial consequences to this day. Little research has been carried out into the after-effects of the state's deliberate stigmatization, through which people were assigned negative stereotypes, socially excluded and politically delegitimized. It can be assumed that structural stigmatization processes in particular continue to exist in institutional practices after the system change. Discrimination and different treatment of those affected can have far-reaching consequences, particularly in healthcare. In addition to a theoretical introduction to stigma research, the question of the extent to which those affected are still exposed to structural disadvantages in the healthcare system, what hurdles they experience and how they perceive them will be explored.As part of the qualitative study, 20 guided interviews with a high narrative component were conducted, transcribed in terms of content and semantics and then analysed using MAXQDA software and grounded theory methodology.The results make it clear that those affected by GDR injustice anticipate or experience structural stigmatization in the context of healthcare. In addition to the perception of general care problems, specific hurdles and requirements resulting from the experience of injustice in the GDR were described. In particular, competence barriers are mentioned in contact with professionals. Individual consequences for those affected can be seen on a psychological, emotional and behavioral level.The results make it clear that the health burdens experienced by those affected cannot be attributed solely to the injustice experienced in the GDR, but can also be exacerbated by the structural stigmatisation processes currently experienced in healthcare. Limitations and practical implications are discussed.There is an urgent need to sensitize professionals to these connections, also with regard to intersectional attributions of characteristics.

Following the ruling of the Federal Constitutional Court, the number of assisted suicides in Germany has been increasing. However, the psychological and psychosocial burden experienced by relatives in this context remains insufficiently explored. This study aims to examine specific stress factors and the motivations for seeking support from a specialized counseling center for relatives of individuals who are considering or have undergone assisted suicide.This cross-sectional study analyzes baseline data from relatives (N=23). In addition to sociodemographic characteristics, the study examines psychological stress factors, decision-making processes, and concerns of the relatives, as well as the illnesses and motives for assisted suicide of the individuals seeking to end their lives. Depressive symptoms were assessed using the Patient Health Questionnaire. Data were collected through structured questionnaires and qualitative free-text responses, which were analyzed using qualitative content analysis.The majority of relatives (83%) sought support during the period preceding the assisted suicide, particularly when a fixed date for the death had already been set. Among the participants, 30.4% exhibited moderate depressive symptoms, while 47.8% showed mild depressive symptoms. Key stress factors included ambivalent feelings between offering support and maintaining distance, moral conflicts, uncertainty about one's own role, anticipatory grief, and navigating the planning process leading up to the assisted suicide, including the day of death. Additionally, relatives reported experiencing social stigmatization and difficulties discussing assisted suicide with others. The most commonly cited reasons for assisted suicide among the individuals seeking to end their lives were the desire for control over their own death, fear of dying in an undignified manner, and loss of autonomy.The results showed that family members of individuals who choose assisted suicide are exposed to significant emotional distress. In particular, anticipatory grief and the awareness of a predetermined time of death led to a complex emotional experience marked by feelings of guilt and helplessness. Moreover, there is a high need for counseling, especially regarding emotional processing, legal uncertainties, and social support after the loss.These findings highlight the considerable emotional burden experienced by those close to individuals who undergo assisted suicide and emphasize the need for targeted psychosocial support. Future research should further explore effective counseling approaches to address anticipatory grief, moral conflicts, and social stigmatization in this context.

For many psychotherapists, the suicide of a patient is accompanied by strong emotional and professional effects. The aim of the present study was to investigate the processing of such an event by affected practitioners.An online study was conducted with a focus on various potentially influencing factors, such as the subsequent receipt of supervision, the (professional) exchange with team colleagues and friends, as well as the anticipated predictability and avoidability of patient suicide. It was also analyzed to what extent the level of experience of the practitioners and the age of the suicidal person had an effect on the stress experienced by the practitioners after a patient suicide. The Impact of Event Scale (IES-R) was used as a key indicator of the stress experience.The study involved n=117 practicing practitioners, predominantly psychological and medical psychotherapists and psychotherapists in training. A key finding of this study was that female (p<0.001) and less experienced (p=.018) practitioners reported a significantly higher level of distress after a patient suicide.An important implication for practice is that prospective psychotherapists should be better prepared for possible patient suicides as part of their training. Furthermore, the data situation and the state of research on this topic should be expanded, particularly in German-speaking countries.

ALS is a terminal illness that places significant burden on caregivers due to the intensive care demands. Little research exists on the specific design of psychological support programs for caregivers of ALS patients. This study aims to identify psychosocial needs of caregivers, specific therapeutic topics and structural requirements for tailored support programs.The study is based on a subset of qualitative data from a participatory mixed-methods observational study. Semi-structured, one-hour interviews were conducted with caregivers of ALS patients, either online or in person. The transcripts were analyzed using Mayring's qualitative content analysis.Four caregivers participated in the study. They reported a high need for psychological support, especially immediately following the diagnosis. Key themes included emotional relief through dialogue with psychologists, strategies for emotion regulation, and fostering self-care. Practical needs highlighted the importance of clear guidelines for caregiving organization, assistance with medical devices, and the development of supportive programs to help manage life and plan for the future during challenging circumstances. Participants emphasized that support programs should be flexible, easily accessible, and personalized. Individual sessions with the option of in-person or online formats were preferred. Caregivers highlighted the necessity of continuous support throughout the disease trajectory, particularly during critical phases.The results of our study highlight the psychosocial challenges faced by caregivers of ALS patients. The findings emphasize the need for comprehensive support systems that address both the emotional and practical needs of caregivers.

Societal pressure to conform to prevailing beauty standards remains a key factor in the development of body dissatisfaction and eating disorders. The Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ-4R) is an internationally established instrument to assess internalized beauty ideals and perceived pressure to meet these ideals. A validated German-language version has not yet been available. Therefore, the aim of this study was to evaluate the psychometric properties of the gender-specific German versions of the SATAQ-4R.An online study was conducted to examine the factor structure, reliability, and construct validity of the German version of the SATAQ-4R. A total of N=670 participants (n=461 female, n=200 male, n=4 non-binary */agender *, n=5 other or unclear gender identity) were included in the study, with a subsample (n=399) being re-examined to assess test-retest reliability.Confirmatory factor analyses indicated a moderate model fit for the proposed factor structure. The internal consistencies ranged from acceptable to very good, and the test-retest reliability can also be considered acceptable. Further, the SATAQ-4R showed significant positive correlations with measures of eating disorder symptoms and drive for thinness, and significant negative correlations with drive for muscularity and self-esteem.Overall, the German translation of the SATAQ-4R represents a reliable and valid instrument to assess internalized beauty ideals and perceived pressure to conform to these ideals, and can thus be recommended for use in both research and practice.

This article examines the challenges and opportunities arising from the increasing digitization of data in medical research and care, focusing on psychosomatics. The aim is to shed light on the advantages and disadvantages of collecting, standardizing, evaluating, and using extensive health data, for example, for Artificial intelligence (AI) applications. The article highlights patient consent using "broad consent" as a central aspect. In the context of digital sovereignty, it is crucial to focus on and empower both patients and practitioners. This is the only way to ensure that the future of psychosomatic medicine is shaped by all involved in a value-based and responsible manner.

More than 35 years after the fall of the Berlin Wall, there is still a lack of representative data on the various forms of SED injustice in former East Germany. There is also a lack of answers to the question how those affected by SED injustice differ from those not affected related to psychosocial characteristics, which forms of repression occurred together and which groups of those affected can be differentiated. This is important for creating a clearer understanding of the repression during the SED dictatorship and deriving implications for further reprocessing and dealing with the past in the coming years.In a representative cross-sectional study in former East Germany a total of N=3011 individuals (response rate 45%) were surveyed between May and September 2022. First, group differences between those affected and those not affected by SED injustice were calculated for psychosocial variables. Next information provided on repression was evaluated using a latent class analysis for younger respondents who did not experience the GDR themselves, and for older respondents who were socialized in the GDR (cutoff point: date of birth January 1st, 1980). Subsequently, further analyses of group differences between the class solutions were performed.Those affected by SED injustice exhibit more anxiety, depression and somatic symptoms than those who were not affected. GDR socialization appears to be associated with more psychological symptoms and less trust in institutions, especially among those affected by SED injustice. The class analyses revealed a two-group solution for the younger respondents and a four-group solution for the older ones. The groups differed in terms of personal proximity to the repression and the total number of reported repressions. The groups showed further differences with regard to resilience factors. No group differences were found related to mental health.On the one hand, interventions should focus on the mental health of all people affected by SED injustice. On the other hand, group-specific measures should be taken into account, as e. g. interventions on (re)building trust in institutions. The reprocessing of SED injustice still plays a key role today.