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Parahippocampal atrophy underlies the observed cognitive deficits in aging-associated cognitive decline. These findings support the hypothesis that aging-associated cognitive decline represents a preclinical stage of Alzheimer's disease.

Background: The knowledge that patients with affective disorders have about their illness is attributed increasing importance. For a number of psychiatric disorders, the imparting of information about the illness is now standard treatment. However, the relevance of knowledge about a patient’s disorder has to date not been sufficiently studied. One reason for that is that only few psychometrically validated instruments for the assessment of illness knowledge exist. The aim of this study was the development and psychometric evaluation of a questionnaire to assess knowledge about affective disorders. Methods: The Knowledge about Depression and Mania Inventory (KDMI) was evaluated with a sample of 337 patients with major depression, relatives of patients with depression and schizophrenia, and controls. Results: With the 44-item KDMI, the 3 dimensions knowledge of symptoms, knowledge of treatment and knowledge of coping strategies were differentiated. From these 44 items two 22-item parallel tests were developed for follow-up assessment. The scales showed good internal consistency. There were numerous indicators of the validity and sensitivity to change of the scales. It was shown that older patients and patients with lower levels of education are less knowledgeable about affective disorders. There were significant differences in the scales of the KDMI before and after a psychoeducative group for relatives. Conclusions: The study showed that knowledge about affective disorders can be reliably and validly measured by a questionnaire. Because of its brevity the KDMI is suitable for everyday use in clinical practice, and it forms the basis for further investigation of the significance of illness knowledge, as well as for evaluation of the effects of psychotherapy in this area.

Background: Increasing importance is attributed to the knowledge that patients have concerning their illness. For psychiatric disorders, imparting information about the illness has become a standard part of treatment. Despite the great clinical relevance of knowledge about depression, only few empirical studies on this subject have been carried out. This study aimed to identify psychosocial factors associated with greater or lesser knowledge about affective disorders. Methods: Sixty-one in-patients with depression were recruited and tested with the Knowledge about Depression and Mania Inventory. Results: Almost all patients sought specific information about their disorder prior to admission to hospital. There were large differences in patients’ knowledge about the disorder and their choice of information source. Older and less educated patients had less knowledge about affective disorders. Patients with less illness knowledge also have a less favourable illness concept, poorer interpersonal relationships and more passive coping strategies. Conclusions: The results show that knowledge about affective disorders is a central illness characteristic that has numerous implications for the ability to cope with the disorder, as well as for psychotherapeutic management. The results contribute to a clarification of the relationship between psychoeducation and psychotherapy.

The relevance of family interactions in the course of affective disorders has been well described. In contrast to the situation regarding schizophrenic disorders, there are few systematic concepts for involvement of the relatives of patients with affective disorders in treatment. The goal of this study was the development and evaluation of a standardised psychoeducational treatment programme. We determined the number and characteristics of relatives accepting the offer of such a group. Relatives of almost half of 55 patients with major depression and a bipolar disorder participated in the group. Relatives of male patients were more likely to take part than relatives of female patients. Relatives of patients with a bipolar disorder were more likely to take part than relatives of patients with unipolar depression. The patients whose relatives attended the group showed a more favourable understanding of the illness and more knowledge about affective disorders, but on the other hand, felt themselves to be more strongly criticised by their relatives and had less social support than the other patients. These results emphasise the importance of differential family-focused treatment modalities in affective disorders.