[Communicate instead of stigmatizing - does social contact with a depressed person change attitudes of medical students towards psychiatric disorders? A study of attitudes of medical students to psychiatric patients]. / Kommunizieren statt Stigmatisieren - Verändert der soziale Kontakt mit einer an Depression erkrankten Person die Einstellungen von MedizinstudentInnen zu psychisch Kranken? Eine Studie zu Einstellungen von MedizinstudentInnen zu psychisch erkrankten Menschen.

OBJECTIVE: The aim of the present study was to investigate how attitudes to psychiatric patients of medical students change, when given an opportunity to have social contact with a depressed individual, during their usual psychiatric practical. METHODS: In the course of their compulsory practical at the University Clinic for General and Social Psychiatry, 127 students additionally participated in an information session in which a person suffering from depression reported on his/her life, illness and experiences with the illness. The control group comprised 98 students who did only the psychiatry practical. Both at the beginning and end of the practical, students filled in a questionnaire, among others, on cognitive and affective dimensions and social distance. The questionnaire was preceded by 4 different case vignettes describing a fictional person (a man/woman suffering from paranoid schizophrenia and a man/woman suffering from unipolar depression). RESULTS: The results of our study show that before students took their practical, female students felt more pro-social and socially closer, but at the same time more fearful, in relation to mentally ill persons than male students. Females also considered psychiatric illnesses as better treatable than males. Basically, students felt socially closer towards depressed persons than towards schizophrenic patients who were also perceived to be more severely ill, more dangerous and more unpredictable. Students with personal contact with a female depressed patient during their practical demonstrated significant reduction of social distance and fear in relation to depressed persons, and in the sense of a generalization effect, there was also a significant reduction in their assessment of the danger and unpredictability of schizophrenic patients. As against this, students who did only their compulsory practical developed an even stronger stereotype of schizophrenic patients as being dangerous and unpredictable. Additionally, contact with a depressed person during practical resulted in a better assessment of the treatability of this illness. Students who participated in the compulsory practical alone reduced their fear towards depressed persons and increased prosocial feelings towards schizophrenic patients. CONCLUSIONS: Compared to students who did only the psychiatry practical, additional contact with a depressed person resulted in major changes in attitude, in particular, in relation to the stereotype of schizophrenic patients being "dangerous". Thus, enabling direct contact with patients during psychiatry practical represents a meaningful and effective anti-stigma intervention.

[Computer assisted cognitive training advances mood and psychological wellbeing - a comparison to paper pencil training relating to neuropsychological parameters, mood and cognitions]. / Computergestütztes Kognitives Training verbessert Stimmung und psychische Befindlichkeit: Der Vergleich einer computergestützten Variante mit einer Papier-Bleistift-Version in Bezug auf neuropsychologische und kognitionspsychologische Parameter.

AIM: In this study a computer-assisted cognitive training programme (CAT) was compared to a paper-pencil-cognitive training and evaluated in psychiatric patients for its effects on neuropsychological parameters, mood and dysfunctional cognitions. METHODS: A total of 29 subjects were randomized either to the computer group or the paper-pencil group. Both groups underwent 20 sessions cognitive training. At the beginning and at the end of the training, both groups were given neuropsychological tests (memory, attention, concentration and information processing speed) and also questionnaires to assess depressive mood, thoughts, negative self communication and locus of control. RESULTS: At the start of the study, both the groups were comparable in demographic, diagnostic, neuropsychological and almost cognitive parameters. Compared to the baseline values, only the computer group improves significantly in mood and increases its positive self-verbalisation. In both groups no remarkable changes were found in the neuropsychological parameters. CONCLUSION: According to these results a computer-assisted cognitive training programme might primarily have a positive influence on mood than in parameters of performance and thus could be a very interesting therapeutic tool in the treatment of psychiatric patients.

[Health-related quality of life, anxiety and depression before and after coronary artery bypass grafting]. / Gesundheitsbezogene Lebensqualität, Angst und Depression vor und nach einer aortokoronaren Bypass-Operation.

Aim of the study was to assess health-related quality of life as well as anxiety and depression in patients undergoing coronary artery bypass graft (CABG). A total of 54 patients answered questionnaires assessing quality of life (SF-36, MacNew), anxiety and depression (STAI, HADS-D) before surgery as well as 4 weeks and 3 months afterwards. Significant improvements in health-related quality of life (MacNew) were identified 3 months after surgery. Whereas preoperative anxiety significantly correlated with health-related quality of life (MacNew) three months after surgery, correlations between preoperative depression and postoperative quality of life were only found for singular scales. Regarding clinical practice providing information about the probable course of quality of life and explaining surgery as a kind of input for the benefit of long-term enhancement seems necessary. Furthermore the assessment of preoperative well-being should be integrated in routine care in order to identify and support patients with higher levels of anxiety and/or depression.

[The psychometric value of the Verbal Short-Term Memory Scale by Arnold & Kohlmann in psychiatry]. / Der verbale Kurzzeitgedächtnistest von Arnold & Kohlmann - ein zu Unrecht in Vergessenheit geratenes Diagnostikum in der Psychiatrie?

OBJECTIVE: Of various tests used to determine verbal short-term-memory deficits in mentally ill persons the Verbal Short-Term Memory Scale by Arnold and Kohlmann meets the important criteria of being fast, user-friendly and every day life-like, despite its old norms and questionable validity. The aim of this study was to assess the psychological value of this instrument by correlating it with those two subtests of the standardized Wechsler Memory Scale (WMS), which assess verbal shortterm memory. METHODS: 478 random patients at a university psychiatric hospital, who were referred for psychological testing, were examined with the Verbal Short-Term Memory Scale by Arnold & Kohlmann and the subtests "Logical Memory" and "Verbal Paired Associates" of the Wechsler Memory Scale. RESULTS: Performance by the total sample on both memory tests was in the lowest or just below the range of dispersion for normal values. All scales of both tests showed significant positive correlation. CONCLUSIONS: Despite its age the Verbal Short-Term Memory Scale by Arnold & Kohlmann is especially recommended for quick differential diagnosis of a patient's memory in an acute psychiatric examination.

[Does education focusing on depression change the attitudes towards schizophrenia? A target-group oriented anti-stigma-intervention]. / Verändert der Unterricht über Depression die Einstellungen gegenüber Schizophrenie? Eine zielgruppenorientierte Anti-Stigma-Intervention.

OBJECTIVE: It should be evaluated, whether two units of education about depression in a secondary school alter the student;s attitude towards patients suffering from depression and whether this intervention could also change the attitude towards patients with schizophrenia. METHODS: A patient with depression - at the moment without symptoms - was involved in the educational program. At three specific times (T0 = some days before the intervention; T1 = some days after the intervention; T2 = 3-4 month follow-up), students have been presented with the same case vignette, one with the description of a fictitious depressive classmate as well as with one fictitious classmate with schizophrenia. The affective, the behavior-related and the cognitive dimensions of attitudes towards the described person were assessed by questionnaires. RESULTS: At T0, the attitudes towards the case vignette "depression" have been significantly more positive than the attitudes to the case vignette "schizophrenia" in all dimensions of attitude. At T1, in the case vignette "depression" the factor "fear" showed a decrease, as well as the opinion this person could be dangerous. At T2, these factors reached the level of T0 again. The opinion, that these fictitious depressive classmates suffer from a treatable illness, was approved significantly more often at T1 and T2 compared to T0. The change of attitude towards the case vignette "schizophrenia" was even more distinctive. Compared to T0 feelings of fear, social distance and stereotypes, that such a person would be dangerous and unpredictable, decreased significantly at T1 as well as T2. CONCLUSIONS: Target group oriented interventions including the contact with patients, may improve the attitude towards patients with mental illnesses. Seeing that some improvements decreased again after three month one may wonder whether a single shortterm educational program would be sufficient in order to provoke a sustainable change in attitudes. Although the intervention focused on a less stigmatized illness (like depression), the attitudes towards a more stigmatized illness (like schizophrenia) could markedly be improved.

[Effects of fitness training and yoga on well-being stress, social competence and body image]. / Fitnesstraining und Yoga - Auswirkungen auf Befindlichkeit, Stressempfinden, Unsicherheit im Sozialkontakt und Körperbild.

OBJECTIVES: Aims of our study were to describe and compare influences from a physical activity program and a yoga program on well-being, mood, stresscoping, body-image and social competence in healthy people. METHODS: 18 persons attending a gym and 21 taking part in a yoga program answered following questionnaires before entering the program and after taking part for 20 units: Body-Image-Questionnaire (25), Symptom-Checklist- 90R (8), Complaint- List (31), Adjective Mood-Scale (32) and a Visual Analogue Scale for assessing stress-level (10). RESULTS: Statistical analyses show significant improvement in social competence in both training groups; the gym-group report reduced sexual discomfort, whereas people taking part in yoga-group show a reduction in somatization and body-related anxiety as well as an improvement in physical and emotional well-being. CONCLUSION: Our findings support the evidence that physical activity in general improves psychological well-being, however, gym and yoga seem to have different psychological impacts. Future research should focus on comparing the psychological effects of different physical activity interventions in prevention programmes as well as exercise prescriptions in patients with mental illness.

Aerobic exercise with relaxation: influence on pain and psychological well-being in female migraine patients.

OBJECTIVE: The objective of this pilot study was to address the influence of an aerobic exercise program combined with relaxation on pain and psychological variables in migraine patients. DESIGN: Controlled, randomised design with half of the group receiving an intervention (aerobic exercise group) in addition to standard medical care received by all patients. SETTING/PATIENTS/OUTCOME MEASUREMENT: Thirty female migraine outpatients completed a range of psychological questionnaires measuring sensational and affective dimensions of pain, body image, depression, and quality of life. INTERVENTION: The aerobic exercise group (n = 15) participated in a 6-week, twice-weekly, indoor exercise program (45 minutes of gymnastics with music and 15 minutes of progressive muscle relaxation). RESULTS/CONCLUSION: The program led to a significant reduction of self-rated migraine pain intensity. Although there was an improvement in depression-related symptoms within the aerobic exercise group, no significant differences in psychological variables between groups were found.

["StigMa" - Evaluation of a Psychological Therapy Program for Stigma-Management]. / "StigMa" ­ Evaluation eines psychologischen Therapieprogramms zu Stigma-Management.

OBJECTIVE: The project "Stigma Management - StigMa" aims on the evaluation of an adaptive therapy program for patients with psychiatric illness to help them in managing internalized stigma and self-stigmatization. METHODS: The patients for this pilot-study were recruited in day-hospitals of pro mente tirol. 26 patients participated in 11 group sessions, following 6 modules: "Education", "Activation of Resources", "Social Network", "Self-Esteem", "Social competence in public places" and "My personal stigma management". The control group consisted of 20 patients who did not participate in StigMa. Pre-post-evaluation was done by the Internalized Stigma of Mental Illness-Scale 1. RESULTS: No significant interaction effects could be observed, although in the treatment group, the burden of perceived discrimination was significantly less pronounced after training than before it. The program, however, was evaluated as being extremely positive by the participants. CONCLUSIONS: The program StigMa will be adapted in accordance with the suggestions of the participants and reevaluated taking into consideration methodological optimization.

[The effects of a computer assisted cognitive training on neuropsychological parameters, mood and dysfunctional cognitions in depressive patients]. / Der Einfluss eines computergestützten kognitiven Trainings auf neuropsychologische und kognitionspsychologische Funktionen depressiver Patienten.

AIM: In this pilot study a computer-assisted cognitive training programme (CAT) was tested and evaluated in patients with depressive syndromes for its effects on neuropsychological parameters, modd and dysfunctional cognitions. METHODS: A total of 48 patients were randomized either to the treatment or the control group. The former underwent 20 sessions, 30-45 minutes each, of computer-assisted cognitive training, twice a week. At the beginning and at the end of the training (ten weeks later), both groups were given neuropsychological tests (memory, attention, concentration and information processing speed) and also questionnaires to assess depressive mood, thoughts, negative self communication and locus of control. RESULTS: At the start of the study, both the groups information processing speed. All these were absent in the control group. Also the depressive mood, as well as negative self-communication markedly improved in the training group. As expected, these results were not observed in the control group. CONCLUSION: According to these results in depressed patients a computer-assisted cognitive training programme might have a positive influence not only on their neuropsychological functions but also on their dysfunctional beliefs. Thus CAT should be part of the treatment of depressive patients.

Erythropoietin-Mediated Neuroprotection in Insects Suggests a Prevertebrate Evolution of Erythropoietin-Like Signaling.

The cytokine erythropoietin (Epo) mediates protective and regenerative functions in mammalian nervous systems via activation of poorly characterized receptors that differ from the "classical" homodimeric Epo receptor expressed on erythroid progenitor cells. Epo genes have been identified in vertebrate species ranging from human to fish, suggesting that Epo signaling evolved earlier than the vertebrate lineage. Studies on insects (Locusta migratoria, Chorthippus biguttulus, Tribolium castaneum) revealed Epo-mediated neuroprotection and neuroregeneration. Recombinant human Epo (rhEpo) prevents apoptosis by binding to a janus kinase-associated receptor, stimulation of STAT transcription factors, and generation of factors that prevent the activation of proapoptotic caspases. Insect neurons were also protected by a neuroprotective but nonerythropoietic Epo splice variant, suggesting similarity with mammalian neuroprotective but not with homodimeric "classical" Epo receptors. Additionally, rhEpo promotes the regeneration of neurites in primary cultured insect brain neurons and after nerve crush in an in vivo preparation. In contrast to neuroprotective and regenerative effects shared with mammalian species, no evidence for a role of Epo signaling in the regulation of neuro- or gliogenesis was found in insects. Similar structural and functional characteristics of the Epo binding receptors, partly shared transduction pathways that prevent apoptosis and the functional implication in neuroprotective and neuroregenerative processes in both mammalian and insect species, suggest that Epo-like signaling was already established in their last common ancestor. Originally functioning as a tissue-protective response to unfavorable physiological situations, cell injury, and pathogen invasion, Epo was later adapted as a humoral regulator of erythropoiesis in the vertebrate lineage.

[StigMa--The Development of the Therapy Program Stigma Management]. / StigMa--Die Entwicklung des Therapieprogramms Stigma-Management.

OBJECTIVE: While lots of projects focus on "stigmatization by others" in people with mental diseases, the problem of "self-stigmatization" is rarely considered in their treatment.Thus, the program "Stigma Management" aims on the conception of a therapeutic manual concerning self-stigmatization. As experts on their own, in phase 1 the patients' experiences and needs are assessed by themselves. METHODS: 17 patients with schizophrenia discussed the topic of self-stigmatization in the setting of focus groups. The discussions were analyzed by the documentary method of Bohnsack 1. RESULTS: Ten topics could be identified, such as prejudice, self-help groups, openness and public relations. CONCLUSION: Concerning these 10 topics the program "Stigma Management" was designed (phase 2) and will be evaluated shortly (phase 3).

Life satisfaction and active coping style are important predictors of recovery from surgery.

OBJECTIVE: The objectives of this study were to investigate the influence of psychological factors on the recovery of surgical patients and to explore whether there are any psychological variables other than anxiety that have a significant influence on recovery from surgery. METHODS: The participants were 112 adult patients undergoing a variety of surgical procedures. On the day prior to surgery, the Freiburg Personality Questionnaire, the State-Trait Anxiety Inventory, a coping schedule and the Questionnaire of Social Support were used to measure psychological parameters including personality, anxiety, coping and social support. The quality of the surgical outcome was rated by two independent and blinded surgeons by the length of hospital stay and analgesia and sedation requirements. The ratings controlled for the diagnosis, type of operation, intraoperative complications, postoperative medical problems and health limitations independent of the surgical procedure. RESULTS: Patients who had a complicated recovery were found to have reduced life satisfaction and lower situation-specific self-control expectations. Structural equation modeling revealed direct relationships between recovery from surgery and personality dimensions with the strongest correlations to life satisfaction, extraversion and attainment orientation. CONCLUSION: The data from this study suggests that valid predictions of the course of postoperative recovery need to take into account personality and coping behaviour orientated data as well as clinical variables. No direct influence on recovery could be predicted from preoperative state anxiety, but it seems likely that state anxiety may influence coping behaviour and that it is this that appears to have a significant impact to surgical recovery.

[Social network and social support in patients with chronic inflammatory bowel disease]. / Soziales Netzwerk und soziale Unterstützung bei Patienten mit chronisch entzündlicher Darmerkrankung.

OBJECTIVES: The aim of the present study was to make a precise analysis of social network and social support to patients with chronic inflammatory bowel diseases (CEDE) in comparison with healthy controls. METHODS: 35 patients with colitis ulcerosa and 47 patients with Morbus Crohn were interviewed using the questionnaire for investigating social network and social support (SONET). Medical data on disease activity were also assessed. CEDE patients were compared with healthy controls, and patients with active disease were compared with those whose disease was in remission. RESULTS: In comparison to healthy controls, the patients demonstrated a significantly smaller network, comprising fewer extra-familial persons but more relationships to the closest core family members. CEDE patients also reported a significantly smaller number of persons from whom they received social support. Patients with active disease were generally more unsatisfied with the support received than those whose disease was in remission. CONCLUSIONS: Our study shows that the closest family members are usually responsible for the patient's social support. Further investigation is necessary to assess the needs of the core family in this stressful situation.

[Therapy of fear of flying]. / Therapie der Flugangst.

Fear of flying is a widespread phenomenon and therefore, there is no clear-cut borderline between "normal" and "pathological" fear. People who seek help are those whose lives are severely affected by their avoidance behaviour. Fear of flying can be treated, and in particular, procedures for coping with fear, as developed in behavioural therapy are employed in the course of treatment. 'Systematic desensitization' is particularly suitable for dealing with specific flying phobia. 'Exposure according to the reaction management model' is indicated in the case of patients in whom fear of flying is an expression of panic attacks. A variety of pharmacological therapy measures are available which aim at influencing the vegetative reaction to phobic situations (benzodiazepine, antidepressants, beta-blockers). However, the effectiveness of such medications is subject to controversy.