Diagnostik und Bedeutung psychischer Störungen bei körperlich kranken geriatrischen Patienten

Schmeling-Kludas, C; Jäger, K.; Niemann, Bernd

doi:10.1007/s003910050005

Cited by 13 publications

(4 citation statements)

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“…Nevertheless, the agreement of some results (e.g. prevalence of psychogenic disorders) with other studies, which were based on inpatient samples [48, 49]and also on general population samples [50, 51], may allow cautious extrapolations.…”

Section: Discussionmentioning

confidence: 71%

Ageing Styles: Subjective Well-Being and Somatic Complaints in Inpatients Aged ≥60 Years

Schneider

Driesch²,

Kruse³

et al. 2003

Psychother Psychosom

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Background: Recent gerontological research shows a high variability in the elderly population. The aim of the present study is to investigate by means of cluster analysis, as to whether different ‘ageing styles’ can be identified in a sample of cognitively not impaired older persons, and to assess discrepancies between self-rated and expert-rated psychological and physical health. Method: 243 patients aged 60 years and older in a general hospital were investigated using a clinical psychiatric interview, expert ratings, and self-report scales after extensive internal medical diagnostic evaluation. Results: Five clusters, representing significantly different ‘ageing styles’ with regard to subjective well-being and subjective physical complaints, could be identified. Two clusters, which together constituted 57% of the sample, represented quite positive and desirable ageing styles. In two clusters (altogether 23% of the sample), there was a discrepancy between medical findings and subjective physical complaints. Conclusions: These findings support the notion of high variability in the elderly and the existence of subgroups, which show a discrepancy between subjective assessment of well-being and expert assessment of psychological and physical health and impairment. The recording of subjectively perceived physical complaints should, therefore, be part of the evaluation of older peoples’ subjective well-being.

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Section: Discussionmentioning

confidence: 71%

Ageing Styles: Subjective Well-Being and Somatic Complaints in Inpatients Aged ≥60 Years

Schneider

Driesch²,

Kruse³

et al. 2003

Psychother Psychosom

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“…Hinzu kommen etwa 33 % Personen, die sich aufgrund psychischer Belastungen eindeutig von psychisch Gesunden unterscheiden [1]. In geriatrischen Kliniken haben 30-44 % aller Patienten eine psychiatrische Komorbidität [2][3][4][5][6]. Auch neue Ergebnisse bestätigen den Stellenwert psychischer Gesundheit im Alter: 80-85-Jährige leiden mit 34 % fast doppelt so häufig wie 65-69-Jährige an Niedergeschlagenheit oder Antriebslosigkeit, wobei dies abhängig ist von der sozialen Schicht, dem Geschlecht und vom körperlichen Gesundheitszustand [7].…”

Section: Abstract ▼unclassified

Psychotherapie auf der Couch des Patienten

Lindner

Sandner²

2015

Psychother Psych Med

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Despite the high morbidity of mental disorders in old age, psychotherapy take-up, especially by multi-morbid, very old patients, is still negligible, immobility being a significant constraining factor of access. So far, variations of standard psychotherapy adapted to meet these circumstances, such as home visits providing psychotherapy are not widespread and their effectiveness unexplored. An explorative study applying the 'Grounded Theory' method examined medical letters, consultation reports and session protocols of 7 psychotherapies involving 77-89-year-old patients; it also described the setting, nature and content of the therapeutic relationship. Psychotherapy at a patient's home - compared with conventional out-patient therapy - considerably alters the therapeutic relationship in as much as an undifferentiated fullness of experience and information has to be gathered and interpreted by the therapist. Current and previous relationships, as well as the experience of disease and imminent dying are important thematic fields. Within the framework of a supportive, defence-strengthening psychodynamic psychotherapy, clarifications, interpretations, and the accompaniment of existential conflicts and developments are possible. Conflicts of identity, aggression, closeness vs. distance and power can be named. Disease, constraint, dying and death are frequent topics. The therapist is more active, enactments are possible but a reflective attitude towards the patient's inner world can be maintained. Psychodynamic psychotherapy is possible in the patient's domestic environment. Further research on indications, psychotherapeutic attitudes, strategies, techniques and effectiveness of this psychotherapy variation is necessary.

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“…Frauen wiesen höhere Raten auf als Männer und über 75-Jährige höhere Raten als 61-bis 65-Jährige. Die hier gefundenen Häufigkeiten entsprechen auch den Befunden von Schmeling-Kludas et al (16) für Patienten einer medizinisch-geriatrischen Abteilung. Dies lässt in der Stichprobe der vorliegenden Untersuchung ein relativ hohes Ausmaß an Multimorbidität vermuten, das mit depressiven Symptomen verbunden sein dürfte.…”

Section: Diskussionunclassified

“…Angst und depressive Beschwerden treten im Alter relativ häufig auf. Die Prävalenzen liegen insbesondere bei älteren Menschen mit chronischen Erkrankungen deutlich höher als in der älteren Allgemeinbevölkerung insgesamt (9,10,12,16). Die Störungen werden aber in vielen Fällen nicht erkannt (4,12,15).…”

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