Psychotherapie Psychosomatik Medizinische Psychologie最新文献

Objective: In recent years, psychotherapists have been increasingly confronted with the challenge of meeting treatment needs efficiently with limited time resources and at the same time achieving stable treatment success in the long term. One way to address this is to integrate Internet-based interventions (IBI) into outpatient psychotherapy. While there is a lot of research on IBI based on cognitive-behavioral therapy, little is known about the same for psychodynamic treatment models. Therefore, the question will be answered as to what specific online modules would need to look like that psychodynamic psychotherapists would use in their outpatient practice to support their regular face-to-face therapies.

Methods: In this study, 20 psychodynamic psychotherapists were asked about their requirements on the content of online modules that could be integrated into outpatient psychotherapy, using semi-structured interviews. The transcribed interviews were analyzed using Mayring's qualitative content analysis.

Results: Results showed that some psychodynamic psychotherapists already use exercises or materials which could be transferred into the online format. In addition, general requirements about online modules emerged, such as an easy handling or a playful character. At the same time, it became clear when and with what kind of patient groups online modules would be integrated into psychodynamic psychotherapy.

Discussion: The interviewed psychodynamic psychotherapists considered it an attractive approach to offer online modules as a supplement to psychotherapy and in a broad spectrum of content. They gave practical advice for the design of possible modules, both on the level of general handling and regarding concrete contents, words, and ideas.

Conclusion: The results contributed to the development of online modules for use in routine care, the effectiveness of which will be investigated in a randomized controlled trial in Germany.

With the onset of public life restrictions in the COVID 19 pandemic in March 2020, freelance professional musicians were exposed to significant pandemic-related restrictions in exercising their profession. Due to the particular working conditions, this professional group was already considered high at risk in terms of mental health before the pandemic. The present study investigates the level of mental distress among professional musicians during the pandemic in relation to basic mental health needs and help-seeking behaviour. In July and August 2021, psychological distress was measured in a nationwide sample of N=209 professional musicians using the ICD-10 Symptom Checklist (ISR). In addition, the extent to which the musicians' basic psychological needs are met and whether they would seek professional psychological help was determined. Compared to various control groups before and during the pandemic, professional musicians showed significantly higher levels of psychological symptoms than the general population before and during the pandemic. Regression analyses support the assumption that pandemic-related changes in the basic psychological needs of pleasure or displeasure avoidance, self-esteem enhancement or self-esteem protection and attachment have a significant influence on the expression of depression symptoms. The musicians' help-seeking behaviour, on the other hand, decreases with an increase in depression symptoms. Due to the high overall psychological stress among freelance musicians, there is a need for action, especially in the provision of specially adapted psychosocial support services.

The training of the present work was designed based on the study by Demarzo and colleagues (2017), in which a four-week mindfulness-based intervention showed a similar effectiveness as the eight-week mindfulness-based stress reduction training. A sample of 120 participants was divided into an experimental group (n=80) and a control group (n=40) which filled out questionnaires about their mindfulness (Mindful Attention and Awareness Scale (MAAS)) and life satisfaction (Fragebogen zur allgemeinen Lebenszufriedenheit (FLZ), Kurzskala Lebenszufriedenheit-1 (L-1)) at two measurement times. It was shown that the mindfulness ability of the experimental group increased after the training and differed significantly (p=0,05) both from the first measurement point and from the control group at both measurement points. The same was true for life satisfaction, which was measured using a multi-item scale.

Background: Patients with mental disorders have a high need for support during the peripartum period. Only few outpatient services have specialized on parents with mental disorders. This study assesses a newly established outpatient unit.

Methods: We analyzed the population utilizing the outpatient service for parents with psychiatric disorders (N=279) at the psychiatric university hospital of Charité at St. Hedwig-hospital in Berlin, Germany, from June 2017 until December 2021.

Results: The service was mainly utilized by individuals with affective disorders, a higher education and good compliance. Patients with migration background started psychotherapy less often.

Discussion: The data indicate a good acceptance of a specialized outpatient unit for parents with psychiatric disorders; however, it was mainly utilized by individuals with a higher socioeconomic status and less commonly by individuals with severe mental illness. More specialized treatment units for parents would be desirable.

Purpose: Rehabilitation success is directly reflected in individual symptom reduction and indirectly in sociomedical benefits. The findings on the extension of measures to increase rehabilitation success are controversial. Treatment duration does not seem to be a sufficient predictor of rehabilitation success. Long periods of sick leave may contribute to chronification of mental illness. The study examined the relationship between the duration of sick leave before psychosomatic rehabilitation (less vs. more than 3 months) with different depression severity at the start of rehabilitation (below vs. above clinical relevance) and (un)indirect rehabilitation success. For this purpose, 1612 rehabilitants aged 18-64 years, 49% women, who completed psychosomatic rehabilitation at the Oberharz Rehabilitation Centre in 2016 were examined.

Methods: Individual symptom reduction was mapped by the Reliable Change Index (consid-ered as a good estimator of true change) from pre/post test scores of the BDI-II. Periods of sick leave before rehabilitation and insurance/contribution periods one to four years after rehabilitation were taken from the accounts of Deutsche Rentenversicherung Braunschweig-Hannover. Multiple hierarchical regression, repeated measures 2-factorial ANCOVAs, planned contrasts, were calculated. Age, gender and rehabilitation duration were statistically controlled.

Results: A multiple hierarchical regression showed incremental variance clarification in symptom reduction for patients who were on sick leave for less than three months before rehabilitation (4%) and for those who started rehabilitation with clinically relevant depression (9%) with medium and large effect sizes, (respectively f²=0,22 and 0,73). Repeated-messures 2-factorial ANCOVAs showed, more contributions/contribution periods for patients with a short period of sick leave before rehabilitation in each year after rehabilitation, with small effect size (η_p ²=0,03 and 0,02). Patients starting rehabilitation with low depression severity showed more insurance but not more contribution periods in the same period (η_p ²=0,01).

Conclusion: Duration of incapacity for work before rehabilitation appears to be an important pa-rameter for (un)direct rehabilitation success. Future studies should further differentiate and evaluate the effect of early admission within the first months of sick leave in psychosomatic rehabilitation measures.

Objective: In Germany, 3.3 million people in need of care are cared for at home. More than half (54%) of informal caregivers estimate their own stress as high or very high [1]. Coping strategies, including dysfunctional ones, are used to cope with stress. These bear the risk of negative health consequences. The aim of this study is to assess the frequency of dysfunctional coping strategies among informal caregivers and to identify protective and risk factors for these unfavorable coping mechanisms.

Methods: A cross-sectional study with N=961 interviewed informal caregivers in Bavaria was conducted in 2020. Dysfunctional coping strategies (substance use and abandonment/avoidance) were assessed. Additionally, subjective stress, positive aspects of caregiving, caregiving motives, characteristics of the caregiving situation as well as caregivers' cognitive evaluation of the care situation and their subjective assessment of available resources (based on the Transactional Stress Model) were recorded. Descriptive statistics were used to explore the frequency of dysfunctional coping behavior. Linear regressions were run, after statistical precondition testing, to investigate which predictors can be identified for dysfunctional coping.

Results: 14.7% of respondents reported using alcohol or other substances at least some of the time in difficult situations, and 47.4% of respondents had given up dealing with the care situation. Subjective caregiver burden (p<0.001), the motive to care out of obligation (p=0.035), and resources for manageability of the caregiving situation rated as insufficient (p=0.029) were identified as risk factors for dysfunctional coping in a significant overall model with medium fit (F (10)=16.776; p<0.001).

Discussion and conclusion: Dysfunctional coping concerning the stress related to the caregiving situation is not uncommon. The most promising target for intervention is subjective caregiver burden. This is known to be reduced by the use of formal and informal help [2, 3]. However, this requires overcoming the problem of low rates of use of counseling and other support services [4]. Newer digital promising approaches to this are being developed [5, 6].