Ist Mathematik eine Sprache?

Ohne Zusammenfassung     

Ist die Logik eine deduktive theorie?

Ohne Zusammenfassung     

Station?re Psychotherapie und Medien

Background

According to several studies the application of different media in inpatient psychotherapy and psychiatry has proven to be a useful and effective addition to conventional methods of intervention. This study is the first to catalogue the current spread of media in inpatient treatment as well as the evaluations of media-supported interventions by therapists and patients.

Sample and method

In a representative survey conducted in all psychiatric and psychosomatic clinics in North-Rhine/Westphalia (response: 40 psychologists/doctors and 289 patients from 39 clinics) media equipment, usage of media in different areas, evaluation of and satisfaction with the media usage were measured by a questionnaire which was constructed especially for this purpose.

Results

A widespread usage and acceptance of media could only be found in some areas. The study identified large differences in equipment standards and media usage depending on the type of media, the area of usage and the specific clinic.

Conclusion

Recommendations for the further development and optimization of media usage in inpatient psychotherapy are derived from the results of this study.     

Psychodynamik und Psychotherapie psychotischer St?rungen

This article gives a review of the options for psychodynamic treatment of patients with psychoses. The various settings for individual treatment as well as group and family therapy will be presented with a special emphasis on modified analytical long-term therapy. For a psychodynamic understanding, which is the basis for this treatment, the most important psychoanalytical models for psychotic disorders will be presented. In addition the current empirical results of non-explicit psychodynamic-oriented research will be referred to, which emphasize the significance of traumatic events in the early phases of life and the importance of narrative elements, whereby the psychodynamic approach experiences both complementation and confirmation.     

Psychotherapie zwischen Narrativ und Qualit?tssicherung

Two important books and a psychotherapeutic quality study published in 2011 serve as background for the examination of the polar conditions that determine psychotherapeutic work: the laws of the narrative, i.e. of relating, which provides the contents of the psychotherapeutic work and quality assurance as the canon of the scientific, politically correct and governmental controls of psychotherapeutic practice. The narrative is a composition formally characterized by a course scheme and in terms of contents as an enactment of the first person narrator and a narrated first person. Different from daydreams it seeks public attention and the listener in order to evoke concern and identification. It transports wishes, anxiety, fulfillment and catastrophes. The narrative is the phenomenology of speech logic and interpersonal coherence and can be linked to different theories, above all psychoanalytical ones. For psychotherapy it opens the world of the ??I??, with its conflicts, assessments and stabilizing efforts in the interpersonal context. Quality control is also a scientifically based steering of practical work which is increasingly being manifested in psychotherapy as well as in medicine and other areas of life. A study of the Techniker Krankenkasse (Technical Health Insurance) concluded in May 2011, confirms the uselessness of time-consuming and costly control procedures in psychotherapy and emphasizes the importance of good training and further education, for which the study has attested a high quality for Germany.     

zu: Ist die logik eine deduktive Wissenschaft?

Ohne Zusammenfassung     

Psychotherapie, Globalisierung, Hartz?IV

The mental effects of globalization, the economic crisis and unemployment must not be underestimated. In general they have to be looked upon as a complex system of structural traumatization which is causing severe psychological mental disorders, such as depression. Not only that, a psychotherapist has to pay particular attention to this. More than in physical illnesses the psychotherapist has to be solidly united with the patient, which might also result in political action.     

Störungsspezifische, personenspezifische und kulturspezifische Psychotherapie

Zusammenfassung Unsere Bemühungen effektive und geeignete Psychotherapieformen auszuarbeiten, sollten über die Beschäftigung mit spezifischen Störungen hinausgehen. Sie sollten auch den spezifischen persönlichen Eigenschaften der Patienten gerecht werden, die unter diesen Störungen leiden und die auch Kämpfe, Lebenskrisen und Belastungen zu bewältigen haben, die nicht so leicht in unsere Nosologie der Störungen hineinpassen. Außerdem müssen zusätzlich die spezifischen Charakteristika der kulturellen Traditionen des Patienten beachtet werden, da wir sonst den latenten Gefahren einer kulturellen Missionierung ausgesetzt sind, die unsere Fähigkeit, ihnen wirksame therapeutische Beziehungen anzubieten, einschränkt.RedaktionJ. Eckert, Hamburg(Koordin. Herausgeber)     

Ist die Naturphilosophie eine abgelegte Gestalt des modernen Geistes?

Ohne Zusammenfassung     

Kopfschmerz: Pharmakotherapie? und/oder Psychotherapie? und/oder sonstige Therapie?

Zusammenfassung  Der Kopfschmerz ist ein h?ufiges Leiden, das sich vor allem auch beim praktischen Arzt, und nicht nur beim Facharzt, findet (5 % in der Allgemeinpopulation). Der Kopfschmerz hat mehrfache Ausformungen und Mitursachen-Faktoren. Es ist daher kontraproduktiv, hierbei nur auf eine Art der Behandlung oder eine Ursache abzuzielen. Nur in der multifaktoriellen Betrachtungsweise unter gezieltem Einsatz sinnvoller therapeutischer Kombinationen wird man mit dieser Crux der Patienten und der ?rzte bestm?glich weiterkommen. Es werden immer noch Problempatienten übrig bleiben. Diese müssen psychotherapeutisch begleitet werden. Man darf sie nicht in die Hoffnungslosigkeit und/oder den Abusus versinken lassen, sondern muss immer wieder versuchen, Weiteres zu probieren, und sie auf dem therapeutischen Pfad zu halten (Abb. 1a).      

Evidenzbasierte Psychotherapie der Panikst?rung mit und ohne Agoraphobie

From the evidence reported in the recent guidelines [Heinrichs et al. (2009) Evidenzbasierte Leitlinie zur Psychotherapie der Panikst?rung mit und ohne Agoraphobie. Hogrefe, G?ttingen] the following conclusions can be drawn with respect to the treatment of panic disorder with or without agoraphobia, as well as for agoraphobia without panic disorder:

1. Every psychotherapy should be preceded by suitable diagnostics and a case formulation.
2. The effectiveness of every psychotherapy should be evaluated with well established measures.
3. For the treatment of panic disorder without agoraphobia, cognitive behavioral treatment (CBT) and applied relaxation have been shown to be effective (evidence grade 1).
4. For panic disorder with agoraphobia, CBT, combination treatment (CBT plus medication), as well as panic-focused psychodynamic psychotherapy in the outpatient setting have shown short-term effectiveness (evidence grade 1). Longer lasting effects have been documented for CBT (evidence grade 1).
5. For agoraphobia without panic disorder, CBT with a focus on situational exposure can be recommended (evidence grade 1).

     

Ist psychodynamische Kurztherapie eine wirksame Behandlungsform bei psychischen Störungen?

To test the efficacy of short-term psychodynamic psychotherapy (STPP) in specific psychiatric disorders, a meta-analysis of more recent studies was performed. Its importance is grounded on the inconsistent results of previous meta-analyses regarding short-term psychodynamic psychotherapy (STPP) and the controversial discussion regarding the efficacy of psychodynamic therapy in general. In a computer-based search, studies of STPP published between 1970 and 2004 were identified. Studies of interpersonal therapy were excluded and rigorous inclusion criteria were applied. Seventeen studies fulfilled these criteria. Effect sizes were calculated for target problems, general psychiatric symptoms, and social functioning. In order to examine the stability of outcome, effect sizes were assessed separately for end of therapy and for follow-up assessment. The effect sizes of STPP were compared to those of waiting list control patients, treatments as usual, and of other forms of psychotherapy. STPP yielded significant and large pre-post effect sizes, which were not only stable, but tended to increase at follow-up. The effect sizes of STPP significantly exceeded those of waiting list and treatments as usual, but no differences were found between STPP and other forms of psychotherapy. STPP proved to be an effective treatment in different psychiatric disorders. However, further research of STPP in specific psychiatric disorders is needed, including a study of the active ingredients of STPP. Effectiveness studies should be included.     

Response und Non-Response in der station?ren Psychotherapie depressiver Patienten

Background

Poor outcome of psychotherapeutic treatment has not yet been sufficiently investigated. It is assumed that approximately 25–30% of patients are treatment non-responders and about 5–10% suffer deterioration.

Study design and methods

The therapeutic success of a total of 2,323 consecutively admitted inpatients with a depressive episode (F32.0-2, F33.0-2) was evaluated by using different strategies based on self ratings at admission and at discharge, i.e. the Beck depression inventory II (BDI-II) and the brief symptom inventory (BSI). In intention to treat (ITT) and completer analyses various measures of therapy success were compared (e.g. statistical significance, effect sizes and clinical significance).

Results

Effect sizes were 1.59 (BDI-II) and 0.86 (BSI) for the ITT sample and 1.64 and 0.89 for the completer sample. Analyses using criteria of clinical significance resulted in response rates of 75.5% (BDI-II) and of 68.7% (BSI) for completer analyses and remission rates of 62.2% (BDI-II) and of 40.8% (BSI). Non-Response rates, also including minor responders, varied between 23.4% (BDI-II) and 27.4% (BSI). Deterioration was observed in only 1% (BDI-II) and 3.9% (BSI) of the patients.

Discussion

The results demonstrate that about two thirds of depressive patients show clinically significant improvements within a multimodal, primarily psychotherapeutic inpatient setting, whereas the rates of deterioration are lower than expected. The aim for the future should be to identify poor or minor response as early as possible in order to optimize treatment.     

Werden Psychotherapeuten,Psychiater oder die Psychotherapie stigmatisiert?

Background

In the last decades much has been found out about the stigmatization of persons with mental illnesses. Recently, a potential stigmatization of psychologists, psychiatrists and psychotherapy has been debated.

Aim

The question should be answered whether there is any scientific evidence for stigmatization of psychologists, psychiatrists and psychotherapy by using the conceptualization of stigma as brought forward by Link and Phelan (Ann Rev Sociol 2001; 27:363–385).

Material and methods

For the systematic literature search in 2013 a databank search was carried out in Web of Science using the search terms stigma or discrimination or stereotypes or prejudice AND psychiatrist or psychotherapist or psychotherapy or mental health professional. A total of 2013 publications were identified which were systematically arranged according to the title and abstract with respect to the relevance for the question whether psychotherapy or associated professional groups are stigmatized. Only four of the articles were considered to be relevant. After advice from experts six further relevant articles could be found which did not appear in the databank search.

Results

The review found evidence for both positive and negative stereotypes but not for other components of the stigmatization process.

Conclusion

At present there is no evidence for a stigma related to psychotherapy or to the professions of psychotherapists and psychiatrists.