Psychotherapie Psychosomatik Medizinische Psychologie最新文献

The care of young children in institutions is typically linked to deprivation, which can negatively impact their psychological development into young adulthood. However, it remains unclear whether early experiences of deprivation also affect psychological well-being in middle and late adulthood. The East German (GDR) weekly nurseries (Wochenkrippen), in which young children and infants were cared for continuously day and night from Monday to Friday, can serve as a testbed for investigating possible long-term psychological consequences of early emotional deprivation.The study examined n=324 former Wochenkrippenkinder (children in weekly nursery care; WK, mean age=55.2 years; 76.9% female) regarding their mental health using self-report questionnaires. In addition, two control groups of former GDR citizens were assessed, a) n=89 participants who experienced day nursery care (TK) and b) n=97 participants who experienced family care only during the first three years of life (FM). A subsample (WK: n=49, TK: n=35, FM: n=44) was examined using a structured clinical interview for mental disorders (Mini-DIPS).The WK group was associated with higher scores across all outcome measures (PHQ-4, CID-S, PSS-10), even after controlling for sociodemographic variables. Regarding the Mini-DIPS, 91.8% of the WK sample met the criteria for at least one diagnosis throughout their lifetime, compared to 60.0% (TK) and 59.1% (FM). Lifetime diagnoses of social anxiety disorder, depressive disorder, and post-traumatic stress disorder were particularly common in the WK sample.Participants who experienced weekly (day and night) nursery care report a markedly higher level of burden concerning various aspects of mental health compared to participants who experienced only day nursery care and participants from exclusive family care. A possible bias due to the self-selection of study participants might limit the generalizability of the results.The results add to the current state of research on the long-lasting detrimental consequences of residential care in early childhood. In the medical history of patients with East German upbringing, special attention should be given to the assessment of possible institutional care in the first years of life.

The ongoing pathologization and criminalization of sexual and gender minorities means that LGBTQIA*individuals, due to minority stress, are significantly more likely to suffer from mental illness. A connection is made between the involvement of psychiatrists and psychotherapists in the systematic pathologization of LGBTQIA*individuals in the past and the associated implications for medical training and practice in the present.Heuristic methods of knowledge acquisition, using literature research, with a focus on the history of the (de-)pathologization of sexual and gender minorities as well as the associated historical continuities.Various examples of historical continuities in the pathologization of LGBTQIA*persons can be found. Although there has been an increased awareness of the importance of teaching aspects of diversity in medical school in recent years, there is still a need for a medical-historical examination of the pathologization of sexual and gender minorities.An "active de-pathologization" can only be achieved by dealing with the medical-psychiatric past in terms of content, including the implementation of such contents in medical education, as part of teaching medical history and the subjects of psychiatry, psychosomatic medicine, and psychotherapy, as well as in the context of courses on history taking.These reflexive processes must continue during psychiatric and psychosomatic training, and residents must be offered specific training on topics in this area.

Due to the restrictions on healthcare services during the COVID-19 pandemic, legal regulations enabled the integration of videoconferencing therapy into psychotherapeutic treatment in Germany. This study aimed to explore the experiences and attitudes of psychotherapists regarding videoconferencing therapy.Eight German psychotherapists were interviewed using a semi-structured guide. Interviews were recorded, transcribed anonymously, and analyzed using Kuckartz's qualitative content analysis.Diverse positive and negative experiences with video therapy were reported. Eight positive and six negative factors regarding video therapy were identified. The majority of psychotherapists had a positive attitude toward video therapy, with only one therapist expressing a critical stance. The therapeutic relationship was generally viewed as stable, though some therapists reported deteriorations. The results also indicate the need for improvement in videoconferencing therapy. Despite the expected increase in videoconferencing therapy, most therapists express a preference for face-to-face-therapy.Therapists suggest that video therapy can be a promising treatment method in addition to face-to-face-therapy. The influence of personal attitudes on the usage and effectiveness was evident. Contradictions and negative aspects underscore the importance of individual assessment before implementing videoconferencing therapy. The need for enhancements in videoconferencing therapy was emphasized.The experiences and attitudes of therapists can serve as a valuable foundation for advancing video therapy, for example by creating guidelines, to ensure adequate quality and address gaps in care. Future developments should focus on further enhancing the quality of this treatment modality.

Since Russia's military invasion in February 2022, approximately 1,1 million Ukrainians have sought refuge in Germany. The displacement of people due to military conflicts and wars is often accompanied by psychopathological distress. After arrival in host countries so post-migration living difficulties can further exacerbate symptoms. Attitudes toward psychotherapy may also vary. ResearchAn assessment of psychological burdens among Ukrainian refugees is necessary to identify specific needs and to provide adequate or adapted interventions.Between July 2022 and July 2024, an online survey was conducted among Ukrainian refugees living in Germany with N=151 participants. The recruitment of participants was coordinated by Goethe University Frankfurt and the University of Greifswald. Several standardized instruments were used for the survey, including the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Scale-2 (GAD-2), the International Trauma Questionnaire (ITQ), and the Post-Migration Living Difficulties Checklist (PMLD), the Inventory of Attitudes Toward Seeking Mental Health Services (IASMHS), and the Social Activity Self-Evaluation Scale (SASS).The results indicate a clinically significant level of anxiety and depressive symptoms (91,5% at least subsyndromal symptoms). A significant correlation was also found between depressive and anxiety symptoms. Both scales were significantly related to self-assessment of social activity and were associated with increased sensitivity to stigma. Furthermore, about 50% of participants exceeded the ITQ threshold for clinical significance.The study suggests elevated depression and anxiety symptoms among Ukrainian refugees, indicating the need for tailored interventions. Concerns about stigmatization should be taken into account. Post-migration stressors should also be addressed, as they may have clinical relevance despite suspended asylum processes. Further longitudinal studies with larger samples and clinical interviews are recommended for a more comprehensive understanding.

This exploratory case-control study investigated the psychological well-being of expectant fathers before, during, and after an emergency cesarean section. The aim was to determine whether these men are at a higher risk of post-traumatic stress compared to men undergoing a secondary cesarean section and what affective experiences they report retrospectively.Fathers (secondary cesarean [N=103] vs. emergency cesarean [N=52]) were retrospectively surveyed using a questionnaire developed by the Department of Medical Psychology and the Women's Clinic of the University Hospital of Ulm. The study focused on unplanned cesarean sections during the period from January 1, 2017, to June 30, 2019. The questionnaire consisted of two sections: Section A captured sociodemographic, biographic, medical, and psychometric characteristics. Section B focused on the experience of childbirth and afterward and integrated the "Positive and Negative Affect Schedule" (PANAS) and the Posttraumatic Stress Checklist 5 (PCL-5).During an emergency cesarean, fathers more frequently expressed fear for the life of their partner and child. The PANAS analysis showed that fathers in the emergency cesarean group significantly more often experienced negative emotions such as fear and restlessness. They also had higher PCL-5 scores, however, only three fathers from the emergency cesarean group and one father from the control group met the criteria for post-traumatic stress disorder. Fathers during an emergency cesarean felt less well cared for compared to the control group and rated the information about the possibility of an emergency cesarean as insufficient. After an emergency cesarean, psychological support was more often recommended but was not utilized. The majority of fathers desired a follow-up conversation with the treatment team. About one-fifth sought additional help after the birth, mostly from family or a midwife.The results of the retrospective study suggest that men experience higher psychological stress during an emergency cesarean compared to a secondary cesarean. Many fathers in the emergency group felt inadequately prepared. A postoperative discussion with the team is desired by the fathers and can be helpful in processing an emergency intervention.Expectant fathers should be thoroughly informed about potential complications before birth. Staff should be trained to also support the fathers during a emergency cesarean.

Pediatric cancer can lead to late effects and long-term impairments. Even after the end of acute treatment, challenges in daily life and psychosocial distress may persist for all family members. The aim of the current study was to investigate the experiences of parents of childhood cancer survivors after the end of acute treatment regarding returning to daily life, psychosocial stressors and coping strategies.In a qualitative study, we conducted semistructured interviews with parents of childhood cancer survivors up to 17 years of age. In total 30 parents (n=20 mothers and n=10 fathers) were interviewed regarding their experiences. Data were transcribed verbatim and analyzed with the program MAXQDA. For the analysis qualitative content analysis was used.Many parents reported changes and impairments returning to daily life after the end of acute pediatric cancer treatment. Worries regarding the health of their child and fears of relapse can be distressing especially during follow-up care examinations. Some parents also reported a support needs due to psychological distress. Facilitating aspects for coping with the disease are an open communication and leisure activities.Although daily life becomes normal with passing time, there can still be impairments and stressors for the whole family. Several recommendations for follow-up healthcare of families with childhood cancer survivors can be inferred.Next to medical follow-up care, families of childhood cancer survivors should receive psychosocial support after the end of acute treatment to help them settle in their daily life and cope with stressors.

The study investigates whether conspicuous eating behavior has increased in adolescents and adults in Germany between 2013 and 2024. The reason for this was the assumption that the frequency of such behaviors is increasing in the population, influenced by social, media and diagnostic developments. The study compares representative data from these two years in order to analyze changes in the prevalence of conspicuous eating behavior.Nationwide representative surveys were conducted for the study in 2013 and 2024. The "Eating Attitudes Test" (EAT-8) was used, a short version of the EAT26D, which has been validated for the self-reporting of conspicuous eating behavior. A total of 2527 participants were interviewed in 2013 and 2569 in 2024. The analysis includes stratification by gender and age groups and takes into account gender-specific thresholds for identifying conspicuous eating behavior.The proportion of women with conspicuous eating behavior increased from 32.1% in 2013 to 35.2% in 2024, while a decrease from 26.2% to 25.1% was recorded for men. The increase is particularly striking among women in the age groups under 20 (+9.8%) and between 50 and 59 (+7.0%). For women aged between 20 and 29, however, the frequency of conspicuous eating behavior is declining (- 4.1%). Men under 30 years of age showed a slight decline, but there was an increase of 8.5% in men over 70 years of age.Conspicuous eating behavior is still significantly more common among women in younger age groups than among men. These gender-specific differences are in line with previous findings. The increase in younger women and female adolescents in particular could reflect the after-effects of the coronavirus pandemic, as health insurance data and self-reported data from national and international online surveys suggest an increase in conspicuous eating behavior, especially during lockdowns. The heterogeneous age-group-specific findings speak in favor of a stronger age-related consideration of the risk of eating disorders in the future.Care services should increasingly target specific age groups and genders in order to effectively combat the spread of eating disorders.

Expectation and expectancies play a central role in current etiological models of functional somatic symptoms and their clinical manifestations as functional disorders, bodily distress disorder and somatic symptom disorder. Their effects have been shown with respect to symptom development, symptom persistence and treatment outcomes. Handling expectations and expectancies is therefore an important task in their prevention and management, from primary care to psychotherapy. This review presents current evidence concerning the role of expectation and expectancies in the etiology and maintenance of functional somatic symptoms, and how to address them in transdisciplinary treatment.