Das chinesische Selbst

The author has been teaching psychoanalytically oriented psychotherapy in mainland China for 20 years. The paper focuses on the problem of transferring an individual-centered therapeutic theory and technique to a culture with a collectivistic and Confucian tradition. The different structures of the Western and Asian selves with their specific styles to communicate are described as well as the tendency of the Chinese to be more prone to shamefulness. Basic psychoanalytic concepts such as abstinence, therapeutic ego-splitting, the capacity for introspection and transference, as well as the traditional Confucian longing for harmony, can meet culturally immanent therapeutic problems. A specific defense constellation, the Ah-Q mentality as a result of Daoist thinking is presented. Finally, the question is raised whether technical modifications make sense in less individualized cultures.     

Psychische Gesundheit von Studierenden der Medizin

Objectives and methods

Concerning mental disorders, both physicians and alumni of medical sciences report a higher symptom load than the average population. Up to now however only a few studies have been conducted concerning the mental health of medical students. The aim of this study is to explore, whether medical students show a higher symptom load than their peers and whether there are differences concerning sex, phases of the studies and point of origin. For this survey the Patient Health Questionnaire (PHQ) was applied to 390 medical students from the University Leipzig. Their results were compared to a representative sample of peers (n=225).

Results

The analysis of variance shows significant differences between the male and female student samples on the one side and the same sex peer samples on the other. Both student samples scored significantly higher on the scales Other Anxiety Syndrome, Major Depressive Syndrome and Stress. Additionally, male students scored higher on the Other Depressive Syndrome scale and the Somatoform Syndrome scale. Further analysing the medical students sample, the females’ measures were significantly higher for the Somatoform Syndrome, Depression and Stress scales. In addition, an interaction was found between sex and point of origin.

Conclusions

Medical students report more symptoms of mental disorders than their peers. Therefore extensive prevention concepts are needed for this group.     

Der Facharzt für Psychotherapeutische Medizin

Ohne Zusammenfassung     

Dokumentation ambulanter Diagnostik in psychosomatischer Medizin und Psychotherapie

Zusammenfassung Das vorgestellte Dokumentationssystem vereint in sich die folgenden Anforderungen: Die zeitökonomische Abbildung der aktuellen Befunde, die Visualisierung der Biographie bzw. Lerngeschichte, die strukturierte Erfassung der Operationalisierten Psychodynamischen Diagnostik (OPD), die psychische und somatische Diagnostik einschließlich Rating des Beeinträchtigungsschwere-Score (BSS) und der Global Assessment of Functioning Scale (GAF) sowie die psychotherapeutisch-psychiatrischen Vorbefunde und die abschließende Indikationsstellung. Lediglich der Arztbrief, der beispielhaft dargestellt wird, wird diktiert. Eine so strukturierte Dokumentation ist patientennah, zeitökonomisch und bewährt sich an den Schnittstellen einer ambulant-stationär-ambulanten Behandlungskette. Sie ist eine ideale Basis für ein Qualitätsmanagement sowie Evaluation in der niedergelassenen Praxis, Ambulanz sowie im Konsiliardienst.      

Musik in der Medizin Edited by Hildebrand R. Teirich

Abstract

We compared differences in self-concept change across three years after short-(STG) and long-term (LTG) psychodynamic group psychotherapy, in a mixed sample of outpatients. Self-concept was assessed at baseline and three years later, using the Structural Analysis of Social Behavior Questionnaire. Vector scores Affiliation and Autonomy were primary, and the eight cluster scores–self-free, self-affirm, self-love, self-protect, self-control, self-blame, self-attack, and self-neglect–were secondary outcome measures. Within group univariate analyses showed change in LTG across three years on the vector scores Affiliation and Autonomy, while STG only changed on Autonomy. Comparisons between STG and LTG demonstrated a significantly larger improvement in Affiliation in LTG than in STG. This difference was explained by a higher improvement in the cluster scores of self-blame, self-attack, and self-neglect in LTG, dimensions that weight negatively on the Affiliation score. Patients with more serious self-neglect and harsh, punitive self-attack/self-blame may profit more in long-term than in short-term groups.     

Aktuelle Probleme der Krankenhausplanung in der Psychosomatischen Medizin und Psychotherapie

Ohne Zusammenfassung

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Standards der sozialmedizinischen Leistungsbegutachtung in der Psychosomatischen Medizin und Psychotherapie

Sociomedical problems are playing an increasingly important role in both psychosomatic medicine and psychotherapy and in psychiatry. The present article examines the standards relating to content and method in sociomedical assessments, primarily in the discipline of psychosomatic medicine and psychotherapy. The focus is on the assessment of performance, highlighting the fact that performance and performance deficits cannot primarily be derived from the medical diagnosis; instead, psychosocial variables that influence the processes of dealing with disease in particular affect the actual performance status. The article pays particular attention to aspects that aggravate or dissimulate performance competence. Finally, the principles of integrating the various findings and results that are incorporated into the assessment report are outlined.     

Der Facharzt für Psychotherapeutische Medizin: Realisierung in der Praxis

Ohne Zusammenfassung     

Norbert Paul,Medizinische Wissensbasen. Vom Wissensmodell zur Repräsentation. Ein medizintheoretischer Ansatz zur Modellierung und objectorientierten Repräsentation diagnosebezogene Domänewissens für Expertensysteme in der Medizin

Theoretical Medicine and Bioethics -