Psychosoziales Gesundheitsmanagement im Betrieb

After presenting basic prevention concepts, preventive and rehabilitative tasks and initiatives in work places will be presented. It is pointed out that especially the promotion of psychosocial resources both at individual and organizational levels is a central issue in prevention. As the next step the basic principles of health management are described and relevant psychosocial topics and procedures are outlined. The different elements of a systematic process of health management and the implementation and evaluation of procedures are shown. It is demonstrated that such developments can only have a chance in an enterprise if they have quality assurance and are supported by all important protagonists of the organization. This is especially true concerning the management, because without their acceptance of such measures it is not possible to implement them.     

Psychotherapie erh?hter Aggressivit?t

Results of a therapeutic use study on processes and outcomes of individual psychotherapy of patients with dominant symptoms of aggressive and antisocial behaviour are presented. General and differential psychotherapies were implemented by experienced psychotherapists in an unselected sample of 30 males with conduct disorders, specific adjustment disorders, impulse disorders and antisocial personality disorders. Diagnoses and evaluations were made with reference to ICD-10, patient histories and psychometric instruments. Post-treatment follow-up was implemented 5 years after treatment termination. The results point at (1) the limited value of psychometric instruments for diagnosis and evaluation, (2) the value of systematic variation in psychotherapeutic processes including frequencies of sessions and alternation of therapists and (3) positive psychotherapeutic outcome referring to subjective as well as objective outcome criteria. Suggestions for the treatment of strong aggressiveness in psychotherapeutic practice are given.     

?Du sollst dir kein Bildnis machen��

??The Progress in Spirituality??, a short section of Freud??s last major work ??Moses and Monotheism?? (1939) received special attention when his daughter read it on his behalf in 1938 at the last International Psychoanalytical Congress before the Second World War in Paris: it was almost like reading the will of the founder of psychoanalysis. ??The Progress in Spirituality?? is an implicit reflection on the core of psychoanalysis and its technique of eliminating vision. The image of God reflected there??the establishment of Jewish monotheism, of a nameless, aniconic, abstract God and the ethical demands imposed by him??exhibits all the characteristics of a cultural revolution in which all the existing traditions were thrown away. In it seems hidden what was for Freud the mysterious feature in the Jewish tradition. Through the prohibition of images Mosaic monotheism enforced a higher level of intellectuality and encouraged introspection. In the psychoanalytical setting the prohibition of images seems to reappear in the form of the ??cultural memory??. The denial demanded of the patient and the renunciation of instincts demanded from both corresponds to ??The Progress in Spirituality?? in which Freud??s Moses finds his culmination point.     

Pharmakotherapie der Begleitdepression

Depressive St?rungen geh?ren bei Allgemeinkrankenhauspatienten zu den h?ufigsten psychischen St?rungen. Sie haben oft negative Auswirkungen auf die Prognose und die Behandlung k?rperlicher Erkrankungen. Selbst für den routinierten und erfahrenen Arzt stellt die antidepressive Pharmakotherapie depressiver Patienten mit somatischen Krankheiten oftmals eine besondere Herausforderung dar. In diesem Kontext gilt es in der Regel, unerwünschte Arzneimittelwirkungen bei Komedikation mit anderen Pharmaka – wie zum Beispiel den Wirkverlust eines zuvor in stabilen Erhaltungsdosen verabreichten Medikaments oder ein erh?htes Risiko für die Entwicklung von Arzneimittelnebenwirkungen – zu vermeiden.     

Das Messie-Syndrom

Messie ist abgeleitet von mess (englisch für Chaos, Unordnung). Betroffene, die als Messies bezeichnet werden, leiden darunter insbesondere im privaten Bereich keine zeitliche und / oder r?umliche Ordnung herstellen oder halten zu k?nnen. Eine eindeutige diagnostische Zuordnung ist bis jetzt nicht m?glich. Je nach Auspr?gungsgrad und Leidensdruck kommen verschiedene therapeutische Ma?nahmen zur Anwendung: Hilfestellung, Coaching, Selbsthilfegruppen, Psychotherapie (kognitive Verhaltenstherapie) und medikament?se Therapie (selektive Serotonin-Wiederaufnahmehemmer).     

Psychische Faktoren gastrointestinaler Erkrankungen

The list of potential or proven associations between psychological and intestinal functions in healthy subjects and in patients with functional and organic bowel disorders demonstrates that although these associations are manifold they are to a large extent incompletely understood, primarily of academic interest and not yet ready to be integrated into everyday clinical practice. However, of immediate practical relevance are psychotherapeutic as well as psychopharmacological approaches. It is, however, required that clinicians, both medical and psychological, are aware of the mechanisms of regulation of intestinal functions through central (CNS) and peripheral (ENS) neural circuits.     

Psychoanalytisch-orientierte Fokaltherapie der Depression bei Krebskranken

Emotional distress connected to a cancer disease may result in comorbid mental and especially depressive disorders. Although psychodynamic therapy is one of the most frequently applied forms of psychotherapy of depression in cancer patients there is a lack of empirical studies which meet the criteria of evidence-based psychotherapy research. This is especially true with regard to randomized controlled trials of psychodynamic psychotherapy. As far as we know no manual for psychodynamic treatment of cancer patients has yet been published. In this article a manual for a 20-session short-term psychodynamic treatment is presented. The treatment is based on Luborsky’s supportive-expressive (SE) therapy. The SE treatment manual of depressions in cancer patients presented here is an adaptation of the general SET manual as well as the SE manual for depression. In the first part the general principles of SE therapy are presented. In the second part a manual specifically adapted to the treatment of depressive cancer patients is described. The treatment manual is presently being used in a large-scale randomized controlled multi-centered study comparing short-term psychodynamic psychotherapy and treatment as usual.     

Inhaltsdeutung und Prozessdeutung

In successful psychotherapy pathogenic psychological contents (e.g. thoughts, dreams, emotions, perceptions of the body, etc.) are subject to an emotional process of transformation. This process can be observed, described and conceptualized independently of the contents at work in the particular case. Interestingly, several non-linear properties of this process of self-organization become apparent by clinical observation. Typical patterns can be discerned in the interplay of the various levels of representation (physical, emotional, cognitive), in the regulation of emotional intensity, and in the alternating prominence of negative and positive emotional material (bipolar pattern). The transformation process has rhythmic, almost musical, qualities. This paper describes this processual pattern, discusses various psychoanalytical process models, and proposes a process-oriented therapeutic method. In this type of process-oriented therapy, to the traditional interpretation of contents interpretations of the process are added, whenever necessary.