Sexualdelinquenz bei Schizophrenie

Studies suggest a complex relationship between schizophrenia and sexually offensive behaviour. This study aimed to preserve first findings of sex offence features and behaviours exhibited by psychotic men in Germany. Furthermore a typology of the schizophrenic offender group was developed. A comparative trial design was used to differentiate the psychotic and non psychotic offender group. A checklist was developed and applied to the records of 64 male restricted hospital order in-patients in Berlin with an index conviction for a contact sex offence against a woman. Social isolation, antisocial behaviour, psychosexual variables and adverse childhood experiences are found for schizophrenic and sexual offenders in general. Different sexual offensive behaviours appeared in the schizophrenic subgroups. Negative symptoms of schizophrenia as well as antisocial traits had a great impact on schizophrenic sexual offending. A heterogeneous group of psychotic offenders can be supposed.     

Die bewegte Seite der Schizophrenie

For more than 100 years multiple motor abnormalities have been described in schizophrenic patients in the various stages of the disease. These include a variety of quantitative and qualitative dysfunctions, which are now seen as trait markers of the disease. There are good arguments for assigning, describing and investigating motor dysfunctions as an independent category, in addition to cognitive, positive and negative core symptoms of schizophrenia, not least in order to develop treatment methods.     

Eine erfolgreiche Behandlung der Schizophrenie

Die Patientin Judith*, auf die alle – auch die engsten – Diagnosekriterien der Schizophrenie ohne Zweifel und über lange Zeitr?ume zutreffen, ist nach nun 15-j?hrigem Krankheitsverlauf weiterhin in Behandlung. Sie konnte nach Diagnose und Therapie ihrer Erkrankung den Pflichtschulabschluss und ein Studium schaffen und arbeitet nun erfolgreich in einem akademischen Beruf. Diese Kasuistik schildert, wie wichtig eine vertrauensvolle Arzt-Patienten-Beziehung im Behandlungsverlauf schizophrener Menschen ist und zeigt, wie eine Kombination aus glücklichen Umst?nden, Psychotherapie und Pharmakotherapie zu einem sehr günstigen Therapieergebnis führen kann. Mir selbst wurde durch diese Patientin eine optimistischere Sichtweise dieser schweren psychiatrischen Erkrankung erm?glicht.     

Metaphysik und Schizophrenie. Eine vergleichende psychologische Studie

Ohne Zusammenfassung     

Psychotherapie bei Depression

Due to significant limitations in mental and physical being, social relationships, and working and functional abilities, prevention and treatment of depressive disorders—predicted to be the most common disorder in 2030—are of particular importance. In the S3 guideline Unipolar Depression, psychotherapy has gained in significance for the acute treatment of unipolar depression. It is noteworthy that psychotherapy is in general recommended as monotherapy or in combination in all degrees of severity of depression. The lasting effects of longer-term psychotherapies are often underestimated. A reflection of the current body of evidence based on the empirical research paradigm and its impact on clinical practice is presented.     

Alexithymie bei Neurodermitis

Background

The study shows correlations between atopic dermatitis (AD) and alexithymia. Furthermore it examines their influences on skin-related quality of life.

Patients and methods

A total of 62 adult AD patients were compared with a control group (n=62) of skin healthy persons. Alexithymia (Toronto Alexithymia Scale-20, TAS-20) and impairment of the skin-related quality of life (Dermatology Life Quality Index, DLQI) were assessed as well as duration, severity [patients?? self-evaluation based on scoring of atopic dermatitis (SCORAD)] and onset of AD.

Results

The prevalence of alexithymia (TAS-20 ??61) in AD patients was 22.6% (control group 4.9%). Problems with identifying feelings (TAS-20 scale) and also the severity of AD were significant predictors for the impairment of skin-related quality of life.

Conclusions

Atopic dermatitis patients showed a prevalence of alexithymia (22.6%) similar to diseases found in the field of psychosomatic and psychiatric patients (Leweke & Bausch 2009). From a psychotherapeutic point of view the study may provide a further reason for the observance of mental features in AD treatment. A possible indication for a specific psychotherapy in atopic dermatitis is discussed.     

Symptomattributionsstile bei Hypochondrie

Background

Somatic symptom attributions are of central importance in cognitive-behavioral models of the development, maintenance and treatment of hypochondriasis. However, the mode of symptom attribution has rarely been systematically investigated in these patients. Is a somatic mode of symptom attribution indeed specific for hypochondriasis and furthermore, how strongly is it associated with “doctor shopping”, a typical behavioral consequence of hypochondriasis?

Patients and methods

In this study 88 hypochondriacal, 52 depressive and 52 healthy persons were asked to complete the symptom interpretations questionnaire and several standardized symptom questionnaires. They also took part in two structured clinical interviews for the diagnosis of hypochondriasis and various other psychological disorders according to DSM-IV.

Results

Somatic symptom attributions were associated specifically with hypochondriasis, while normalizing attributions characterized persons with low health anxiety. When examined as predictors in multiple regression models, in particular somatic attributions and the total of somatoform complaints predicted the intensity of health anxiety (R ²?=?0.69) and “doctor shopping” (R ²?=?0.48).

Conclusion

In the cognitive-behavioral treatment of hypochondriasis, patients should be encouraged to test normalizing explanations as alternatives to habitual somatic attributions of somatic disturbances.     

Ressourcenaktivierung bei Patienten

Background

Starting from Klaus Grawe’s draft of a general psychotherapy, the patient’s resources and resource-activating interventions have received increasing attention in empirical research.

Objective

The effectiveness of standardized writing instructions for the activation of patients’ resources before participating in internet chat aftercare groups for psychosomatic patients was examined.

Method

In a randomized controlled trial writing instruction for the activation of patients’ resources was given in 52 out of 102 internet chat aftercare sessions. The effects of this minimal intervention on the patients’ activity and the number of positive emotion words expressed during the chat session were examined. Additionally, the effects on patients’ self-esteem, attachment, orientation, control and well-being after the group sessions were assessed.

Results

Patients reported higher levels of self-esteem, orientation, control and well-being after chat sessions with a resource-activating intervention. No differences between intervention and control groups were detected on the text-based variables activity and number of positive emotion words.

Conclusions

Standardized minimal interventions for the activation of patients’ resources seem to be promising for enhancing the effectiveness of therapeutic Internet chat groups.     

Verhaltensmedizin bei HIV-Infektion

Zusammenfassung Unsere Studien über asymptomatische, mit dem "human immunodeficiency virus" (HIV) infizierte homosexuelle Männer zeigen, dass kognitiv-behaviorales Stressmanagement (CBSM) ein geeignetes Mittel ist, die durch die Mitteilung eines positiven HIV-Befundes verursachte psychische Belastung zu reduzieren und zugleich einige immunologische Parameter zu modifizieren. Aus neueren Studien über HIV-infizierte Männer mit Prä-Aids-Symptomatik geht hervor, dass CBSM beitragen kann: a) Dysphorie, Angst und Stresssymptome zu lindern; b) Kortisol und Noradrenalin zu reduzieren und die Testosteronwerte zu erhöhen; c) die Zahl der Antikörper gegen einige Herpes-Viren zu reduzieren und zugleich die Zahl der T-zytotoxischen/Suppressorzellen (CD8) und der naiven T-Helfer- (CD4-) Lymphozyten aufrechtzuerhalten. Vorläufige Daten unserer neuesten Studien weisen darauf hin, dass mit CBSM die Viruslast bei Männern, die hoch aktive antiretrovirale Therapie erhalten, reduziert werden kann.Aus dem Englischen übersetzt von Dipl.-Psych. Erika Nemény, Berlin und Prof. Dr. Ulrike Ehlert, Zürich