Differences in the Psychic Representation of the Body in Bulimic and Anorexic Patients: A Study with the Body Grid

Development and use of a new form of a body grid are reported in the present article by means of comparing body perception and its distortions of 32 anorectic patients with a group of 31 bulimic patients. The body grid allows the users to discriminate the degree of body acceptance and the level of integration and dissociation tendencies of single body parts. With the body grid we are able to identify important differences in body image and “body-experience profiles” of bulimic and anorectic patients. Furthermore, with the body grid some insights into the structure of the body image are depicted in the form of a readily accessible graphic figure, making them useful for therapeutic focusing, treatment, and experience, tasks that rarely have been achieved by conventional methods like questionnaires or so-called projective tests.     

Internet als Ratgeber bei psychischen Problemen

Communication serves as an integral part of every psychotherapeutic treatment. Consequently, in the last decade modern information and communication technologies in the therapeutic context gained in importance. How important are Internet-based therapeutic information and intervention sources for potential patients and how are they appraised when already known or used? In the course of a representative study the health-related Internet use behavior of 2,411 Germans was examined. There was a focus on the usage of health-related websites and counseling services in the past and (potentially) in the future. More than one third (37.3%) of the German population and almost two thirds (63.5%) of German Internet users search for medical information on Internet. However, physicians, psychologists, pharmacists, family members and friends have a greater impact on health behavior than the Internet. Of German Internet users 54.1% are not informed about the possibilities of psychosocial online counseling. Nevertheless, they would maybe use the Internet in the future. The 2.2% who already used Internet in case of psychosocial problems are content with the service. In fact new media have not yet found their way into psychotherapy and counseling as much as in our daily lives. With regard to manifest mental disorders, Germans would prefer the conventional psychotherapeutic milieu to media-assisted kinds of treatment.     

Psychosoziale Versorgung von Krebspatienten

Objectives

The aim of this study was to determine rates of psychooncological care for cancer inpatients and outpatients under routine conditions in a large University hospital. The percentage of patients who received care was analyzed and compared with self-rated and expert rated supportive care needs.

Methods

The percentage of inpatients who received psychooncological care was calculated by comparing the number of cancer patients treated at the hospital as documented by the local tumor registry (n=1,979) with the number of patients treated by a psychooncologist in that hospital as documented by the hospital??s psychooncological consultation liaison service. The percentage of outpatients who received psychooncological care was calculated by comparing the number of incident cancer cases as documented by the local tumor registry (n=5,886) with the number of patients who received at least one consultation at the local tumor counseling centre. Supportive care needs were estimated by analyzing data of a prospective patient survey in the same hospital (n=1,803) using the Hospital Anxiety and Depression Scale and single items to determine social burden and the wish for emotional support.

Results

The results showed that 11% of inpatients and outpatients (n=234 and n=638, respectively) received psychooncological care. Social care needs were prevalent in 37% and psychological care needs in 52% of the patients during the stay in hospital and in 42% (social and psychological) 6 months later. Of the patients 41% expressed the need to see a social worker and 29% to see a psychologist. Large differences were found between patients with different tumor entities.

Conclusion

Psychooncological care delivered to cancer patients under routine conditions was below the actual rate required as estimated by screening instruments and as expressed by the patients.     

Pr?diktoren tumorassoziierter Fatigue

Fatigue is a serious cancer-related syndrome reported by cancer patients during and after treatment. Especially the impact of chronic fatigue on quality of life is substantial. The aim of this study was to identify predictors of fatigue after finishing treatment from an early stage of the cancer treatment. A sample of 551 cancer patients with heterogeneous diagnoses completed questionnaires assessing fatigue, psychological and psychosomatic data plus treatment data. The patients were recruited from an acute care hospital (t1) and the participants completed the questionnaire 2?C2.5 years after treatment (t2). Regression analysis showed that the strongest predictor of later fatigue was fatigue during the therapy. Other impact factors are radiotherapy and pain. The results suggest that the diagnosis and treatment of acute fatigue should be carried out at an early stage of cancer treatment to prevent chronic fatigue. Suitable diagnostic methods and treatment options will be presented.     

A comparison of general and illness-related locus of control in Russians, ethnic German migrants and Germans

General and illness-related locus of control play an immensely important role in the adherence and cooperation of patients in their therapy. Until now, culture-specific aspects of these subjective theories have rarely been investigated. However, in view of the growing proportion of migrants in the German population, they are becoming increasingly significant. In a project supported by the Volkswagenstiftung (Volkswagen Foundation), a total of 607 healthy people were surveyed. The sample includes 307 ethnic German migrants from the successor states of the former Soviet Union (descendents of German origin who had emigrated to Russia during the 18th and 19th centuries) and 300 native Russians in Russia. They were compared with 100 Germans (matched from a previous study). The data were collected using questionnaires entitled "Multidimensional Health Locus of Control (MHLC)" and "Illness-related Locus of Control". The ethnic German migrants differed from the Russian sample in their health beliefs and attitudes towards medicine. However, in the first 18 months after migration, hardly any changes were observed. Fatalistic factors played only a minor role. Locus of health control was associated with beliefs about recovery from myocardial infarcts and tumours. Socio-demographic variables were of varying significance in the individual cultures. Gender influences on health beliefs were different in the subsamples. The level of education had only a minor influence on health attitudes. For those individuals who were acquainted with an ill person, internal factors in treatment of myocardial infarct and external psychosocial factors in cure of cancer played a larger role.     

Elternschaft, Krebs und Kindersorgen

Background

The diagnosis of parental cancer may destabilize the whole family, parents and children as well. The Hamburg children of somatically ill parents (COSIP) intervention supports parental skills and adaptation of children to the situation. There is currently no evidence for criteria to determine which family members should be involved in the COSIP intervention, predominantly the parents (parent setting), the children (child setting) or both (family setting).

Aim of the study

Data from a multicentre study were analyzed with respect to the predominant intervention settings, the correlation between setting and aims of intervention as well as variables that predict the involvement of children in the intervention.

Material and methods

A total of 203 documented cases were analyzed. Different variables that had been documented by the therapists were included in a regression analysis model in order to identify predictive variables.

Results

In 142 cases the intervention was carried out in a specific intervention setting. In 57?% of the cases children were involved (32?% family setting and 25?% child setting). A systematic relationship between the reported intervention aims and the intervention setting was not detected. The most powerful predictor was the existence of emotional problems of children as reported by the child itself.

Conclusions

Decision-making on intervention settings should therefore take the assessment of emotional symptoms of children by the means of age-appropriate self-reporting tools into consideration. Further investigations are needed to reveal variables concerning needs, motivation and capabilities of the family members as well as institutional conditions.