Suchergebnisse

'Trotz der zunehmenden gesundheitspolitischen und gesundheitsökonomischen Bedeutung psychischer Erkrankungen ist der gegenwärtige Beitrag der Soziologie zum Verständnis, zur Behandlung und zur Prävention psychischer Erkrankungen eher gering. Dies gilt insbesondere vor dem Hintergrund der Tatsache, dass das Phänomen der psychischen Krankheit bis in die zweite Hälfte des 20. Jahrhunderts ein zentraler Gegenstand soziologischer Forschung und Theorieentwicklung war und dass soziologische Konzepte und Forschungsergebnisse zeitweise einen maßgeblichen Einfluss auf die Reform der psychiatrischen Versorgung hatten. Während der zunehmende Bedeutungsverlust der Soziologie zunächst mit dramatischen Erfolgen der neurobiologischen Forschung und daraus resultierender Hoffnungen auf eine baldige medizintechnische Kontrollierbarkeit psychischer Störungen einherging, treten mittlerweile auch die Grenzen neurobiologischer Ansätze bei der Erklärung der Ursachen und bei der Behandlung psychischer Erkrankungen immer deutlicher zutage. Gleichzeitig deuten aktuelle Forschungsergebnisse darauf hin, das psychische Auffälligkeiten das Ergebnis äußerst komplexer Wechselwirkung zwischen biologischen und Umweltfaktoren bilden. Für die Soziologie psychischer Gesundheit und Krankheit ergeben sich aus diesen Erkenntnissen vielfältige Perspektiven für eine fruchtbare interdisziplinäre Forschungstätigkeit.' (Autorenreferat)

'Schichtspezifische Unterschiede gesundheitsbezogener Einstellungen und Verhaltensweisen werden häufig als Ergebnis sozialisatorischer und soziokultureller Einflüsse interpretiert. In der vorliegenden Untersuchung wird die Hypothese überprüft, daß sich derartige Unterschiede zum Teil durch gesundheitsrelevante Merkmale schichtspezifischer Lebenslagen erklären lassen. Auf der Grundlage einer 1990 in Bielefeld durchgeführten postalischen Befragung werden Zusammenhänge zwischen Indikatoren sozialer Schichtzugehörigkeit, der Wahrnehmung unweltbedingter Risikofaktoren, gesundheitsbezogenen Kontrollüberzeugungen und primärpräventiven Verhaltensweisen untersucht. Die Analyseergebnisse lassen erkennen, daß die Belastungen durch umweltbedingte Risikofaktoren in deutlichem Zusammenhang mit den Wohnbedingungen und dem Berufsstatus stehen. Die Ergebnisse verschiedener Pfadanalysen zeigen, daß Befragte ihre Möglichkeiten zur Kontrolle gesundheitlicher Risiken desto geringer einschätzen, je stärker sie sich umweltbedingten Risikofaktoren im Berufsleben und im Wohnbereich ausgesetzt sehen. Gleichzeitig wirkt sich die Wahrnehmung umweltbedingter Risikofaktoren negativ auf die Bereitschaft zur Ausübung sportlicher Aktivitäten aus. Die Bereitschaft zu einer gesundheitsbewußten Ernährung wird dagegen deutlich von den gesundheitsbezogenen Kontrollüberzeugungen beeinflußt. Befragte mit einer eher internen gesundheitsbezogenen Kontrollüberzeugung ernähren sich gesünder als Befragte mit einer eher externen Kontrollüberzeugung.' (Autorenreferat)

The aim of the study is to explore what schizophrenic patients understand by quality of life and what psychiatrists think quality of life may be like for schizophrenic patients. A survey was carried out among schizophrenic patients and psychiatrists from the whole of Germany. There are similarities and differences between the two: while both schizophrenic patients and psychiatrists recognised the importance of work, social relationships, family and independence for quality of life, patients thought about it more in terms of standard of living and lifestyle, whereas the psychiatrists' concept of quality of life was more illness-oriented encompassing the absence of handicaps and disabilities due to the illness and emphasising the importance of appropriate professional help and self-help. In order to facilitate the dialogue between psychiatrists and patients it is important to be aware of these differences.

Background: Spouses of people with mental disorder experience various forms of objective and subjective burden. This should negatively affect their quality of life. However, until now no single study has addressed this question. Aims: To investigate the quality of life of spouses of people with schizophrenia, depression or anxiety disorders. Method: Spouses of patients suffering from schizophrenia (n 1/4 45), depression (n 1/4 49) and anxiety disorders (n 1/4 39) were consecutively recruited from out-patient services in the city of Leipzig. Quality of life was assessed by means of the WHOQOL-BREF, a self-administered questionnaire developed by the World Health Organisation. Results: Compared with the general population, the quality of life of the spouses of mentally ill people was lower in the domains 'psychological well-being' and 'social relationships'. There was a significant association between the patient's functional level and the spouse's quality of life. Conclusions: Better treatment, professional support and participation in self-help and advocacy groups may help to improve the quality of life of spouses of mentally ill people.

Background: Physical comorbidities and substance use are commonly reported in patients with mental disorders. Aim: To examine somatic comorbidity in patients with substance use disorders (SUD) compared to patients with mental disorders but no SUD. Methods: Lifetime prevalence data on mental and physical health status were collected from inpatients in 12 mental health care facilities in five different countries. Differences in somatic comorbidity were examined by means of logistic regression analysis controlling for age and gender. Results: Of 2,338 patients, 447 (19%) had a primary or secondary SUD diagnosis. In comparison to patients with other mental disorders, patients with SUD had a higher prevalence of infectious and digestive diseases but a lower prevalence of endocrine, nutritional and metabolic disorders. Patterns of physical comorbidities differed according to type of substance used (alcohol use – cardiovascular; tobacco use – respiratory, neoplasms; cannabinoid use – injuries; opioid use – infectious, digestive; benzodiazepine use – endocrine, nutritional, metabolic; stimulants – urogenital). Conclusions: SUD are related to specific somatic health risks while some of our findings point to potentially protective effects. The widespread prescription of benzodiazepines requires research on physical health effects. Early detection of SUD and their integration into programmes targeting physical comorbidity should be a priority in organizing mental health care.

Background: Patients with a psychiatric illness have a higher prevalence of physical diseases and thus a higher morbidity and mortality. Aim: The main aim was to investigate where patients with co-occurring physical diseases and mental disorders (psychotic spectrum or mood) in the health and social service system are identified most frequently before admission into psychiatry. The second aim was to compare the differences in the treatment routes taken by the patients before entry into psychiatric services in all the participating countries (Denmark, Germany, Japan, Nigeria and Switzerland). Methodology: On admission to a psychiatric service, patients diagnosed with schizophrenia, schizotypal or delusional disorders (International Classification of Diseases-10 (ICD-10) group F2) or mood (affective) disorders (ICD-10 group F3) and a co-morbid physical condition (cardiovascular disease, diabetes mellitus and overweight) were asked with which institutions or persons they had been in contact with in the previous 6 months. Results: Patients from Denmark, Germany and Switzerland with mental disorders had almost the same contact pattern. Their primary contact was to public or private psychiatry, with a contact percentage of 46%–91%; in addition, general practice was a common contact, with a margin of 41%–93%. Similar tendencies are seen in Japan despite the small sample size. With regard to general practice, this is also the case with Nigerian patients. However, religious guidance or healing was rarely sought by patients in Europe and Japan, while in Nigeria about 80% of patients with mental disorders had contacted this type of service. Conclusion: Promoting prophylactic work between psychiatry and the general practice sector may be beneficial in diminishing physical conditions such as cardiovascular disease, diabetes mellitus and overweight in patients with mental disorders in European countries and Japan. In Nigeria (a low-to-middle-income country), religious guides or healers, along with general practitioners, are the most frequently contacted, and they therefore seem to be the most obvious partner to collaborate with.