Working conditions and mental health of migrants and refugees in Europe considering cultural origin- a systematic review.

BACKGROUND: Migrants and refugees/asylum seekers, as a large part of the European work force, are often confronted with unfavorable working conditions in the host country. Main aim of this systematic review was to compare the association of these working conditions with mental health between migrants and refugees/asylum seekers due to their diverse migration experiences and cultural origins, and between different European host countries. METHODS: Systematic search for eligible primary studies was conducted in three electronic databases (PubMed/MEDLINE, PsycINFO and CINAHL) using quantitative study designs written in English, German, French, Italian, Polish, Spanish or Turkish and published from January 1, 2016 to October 27, 2022. Primary health outcomes were diagnosed psychiatric and psychological disorders, suicide and suicide attempts, psychiatric and psychological symptoms, and perceived distress. Secondary health outcomes were more general concepts of mental health such as well-being, life satisfaction and quality of life. Two reviewers independently completed screening, data extraction and the methodological quality assessment of primary studies using the Newcastle-Ottawa-Scale. Descriptive summary of primary studies on working conditions and their relationship with mental health were conducted, comparing migrants and refugees/asylum seekers, migrants and refugees/asylum seekers of different cultural backgrounds (collectivistic and individualistic) and migrants and refugees/asylum seekers living in different host countries. RESULTS: Inclusion criteria were met by 19 primary studies. Voluntary migrants are more likely to experience overqualification in the host country than refugees. In all examined host countries, migrants and refugees suffer from unfavorable working conditions, with migrants from collectivistic countries being slightly at risk compared to migrants from individualistic countries. Most unfavorable working conditions are related to poor mental health, regardless of migrant status, cultural origin or host country. CONCLUSIONS: Although the results should be interpreted with caution due to the small number of studies, it is evident that to maintain both the mental health and labor force of migrants and refugees/asylum seekers, their working conditions in host countries should be controlled and improved. Special attention should be paid to specific subgroups such as migrants from collectivistic societies. ETHICS AND DISSEMINATION: This systematic review is excluded from ethical approval because it used previously approved published data from primary studies. TRIAL REGISTRATION NUMBER: CRD42021244840.

Words count in psychotherapy: Differentiating language characteristics of cognitive behavioral therapy and focal psychodynamic therapy for anorexia nervosa.

It is generally assumed that psychodynamic therapy and cognitive behavioral therapy (CBT) differ in terms of applied techniques and processes. To date, however, little is known about whether and how such differences can actually be observed at a basic linguistic level and in what the two treatment approaches differ most strongly (i.e., how psychodynamic and CBT therapists differ in what they actually say word-by-word in therapy sessions). Building on theoretical models and previous research that used observer ratings, we formulated specific hypotheses regarding which word categories psychodynamic and CBT therapists who treat patients with an eating disorder should differ in. To investigate these hypotheses, we used verbatim transcripts from 297 therapy sessions of a randomized controlled trial in which patients with anorexia nervosa (n = 88) received either focal psychodynamic therapy (FPT) or CBT. These transcripts were then examined using computerized quantitative text analysis. In line with our hypotheses, we found that CBT therapists overall spoke more than their FPT counterparts and that they used more words related to eating. Also in line with our hypotheses, FPT therapists used more words related to social processes. Contrary to our expectations, CBT therapists did not show a stronger focus on the future but talked more about emotions than FPT therapists. The latter effect, however, appears to be driven by a stronger focus on positive emotions. These findings suggest that computerized quantitative text analysis can differentiate meaningful language characteristics of CBT and FPT on spoken-word level and that it holds potential as a tool for researchers and therapists. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Smartphone and Instagram use, body dissatisfaction, and eating disorders: investigating the associations using self-report and tracked data.

BACKGROUND: Previous research has linked smartphone and Instagram use to higher body dissatisfaction (BD) as well as eating disorder (ED) symptomatology. However, these studies have typically been limited to using self-report measures for technology use which, as shown by scientific literature, might not be reliable. In the present work, we combine self-reported assessments as well as tracked smartphone and Instagram use. METHODS: The effective sample comprised N = 119 women (34 with ED diagnosis history) who were queried about BD and ED symptomatology, and who provided the data about their smartphone and Instagram use duration for each day of the previous week. RESULTS: The study results show that women with an ED diagnosis history scored higher on both BD as well as ED scales. Although women with an ED diagnosis history had higher smartphone screen time, there were no statistically significant differences in Instagram screen time. Tracked smartphone use duration was positively correlated with both BD and ED symptomatology, but the role of Instagram use needs to be further elucidated. CONCLUSIONS: The results of this study show that while BD and ED symptomatology are correlated with smartphone use, it may be that Instagram use is not the main contributor to that relationship.

The role of general change mechanisms in sudden gains in the treatment of anorexia nervosa.

Previous research has shown a robust association between sudden gains (SGs) and treatment outcome in psychotherapy for various mental disorders including anorexia nervosa (AN). However, little is known about factors contributing to SGs. This study investigated the role of general change mechanisms in body-weight related SGs in AN. Data were drawn from a randomized-controlled trial on cognitive-behavioral therapy (CBT) and focal psychodynamic therapy (FPT) for adult outpatients with AN. Session-level data on the general change mechanisms 'clarification' (insight), 'mastery' (coping), and 'therapeutic relationship' were analyzed. Pre-gain sessions were compared with control (pre-pre-gain) sessions in 99 patients with a SG in body weight. Additionally, propensity score matching was used to compare data from pre-gain sessions from 44 patients with SG and data from the corresponding session from 44 patients without SG. In the pre-gain session, patients experienced higher levels of clarification and mastery but not therapeutic relationship. Compared to patients without a SG, patients with a SG likewise experienced more clarification and mastery but not a better therapeutic relationship in the pre-gain/corresponding session. CBT and FPT did not differ regarding these effects. The findings suggest that general change mechanisms contribute to SGs in CBT and FPT for AN.

Heart rate variability predicts outcome of short-term psychotherapy at the workplace.

The bio-psycho-social model highlights intra-individual and inter-individual interactions, including psychotherapy. The processing of these interactions within a person takes place, among others, in the central autonomic network (CAN). The CAN's autonomic output to the periphery can be indexed by heart rate variability (HRV), representing individual adaptive capacity. Further, the CAN influences the hypothalamus-pituitary-adrenal axis with its product cortisol. The aim consisted in investigating HRV and cortisol as well as their relation to symptom course in response to short-term psychotherapy. A single-arm, uncontrolled, explorative study was conducted at an outpatient psychotherapeutic consultation in the workplace offered to employees with mental or psychosomatic complaints. Questionnaires included symptoms of depression, irritation and functional impairment. Circadian profile of HRV and salivary cortisol concentrations collected pre and post short-term psychotherapeutic intervention (4-12 sessions) were assessed. Multilevel-linear mixed regressions were calculated. Out of 29 participants (mean age 42; 72% female), 24% were on sick leave from work. Cortisol concentrations were neither affected by intervention nor by symptom course. The proportion of individuals showing a vagally mediated HRV in the range of the lowest quartile assessed for age- and sex-matched healthy controls was reduced at follow-up (pre 34%, post 22%; p = .017). Higher vagally mediated HRV at baseline predicted lower symptom burden at follow-up. Thus, the results support the assumption that HRV reflects the capability of an organism to adapt and recover. Patients with reduced HRV might need additional psychotherapeutic sessions to achieve the same symptom improvements than patients with retained HRV.

Occupational physicians dealing with mental health: between employee and company interests: a qualitative study.

BACKGROUND: Occupational health physicians are increasingly confronted with mental health issues at their workplace. Facing them, most of them feel insecure and not sufficiently trained. Employee's mental well-being depends at the same time on individual and significantly on organizational variables. This complicates the physician's position, since they have to serve many interests. The focus of the present study is to investigate what difficulties occupational health physicians face and how organizational culture and management influence their work. METHODS: Interviews were conducted with N = 25 physicians as part of a training for basic mental health care. Interviews were interpreted using qualitative content analysis. RESULTS: Working with mentally ill employees was difficult for the physicians interviewed. Many felt insecure managing and preventing mental health issues. A need for further education was observed. Environmental factors (organizational culture, management) have a strong impact on the work of an occupational health physician and highlight its systemic dimension. Even though many of our participants report a meanwhile more open attitude towards mental disorders at their workplace, on the level of direct contact to the management prevail descriptions of little acceptance and a high priority of economic outcomes. CONCLUSIONS: More education on topics of mental health is needed for occupational health physicians. Future trainings should consider the intertwined nature of their work and enable them in dealing consciously with other actors in the company. For enhancing employee's mental well-being occupational health physicians could be granted a strengthened position in companies or be supported through more exchange with colleagues in other companies.

The association of perceived leadership style and subjective well-being of employees in a tertiary hospital in Germany.

BACKGROUND: Professionals in the healthcare sector are a particularly vulnerable group for occupational strain due to high work-related psychological stress. For the implementation of targeted stress-prevention interventions as an important part of a workplace health management programme for all occupational groups and hierarchy levels, information about the current state of their mental health is mandatory. Hence, this study investigated the association of general well-being and different leadership styles among employees in a German tertiary hospital. METHODS: Via an online survey, 10,101 employees were contacted. The final sample consisted of 1137 employees. Of these, 27.7% described themselves as leaders and 72.3% as followers. Most participants were female (74.8%), more than half were under 41 years old. Besides control variables, general well-being (WHO-5) and leadership style (transactional and transformational, laissez-faire and destructive leadership) were assessed. RESULTS: Leaders reported higher well-being scores than followers. Physicians without leadership responsibilities had the lowest scores for well-being. Practitioners of both transformational and transactional leadership were associated with higher well-being scores, while those practicing laissez-faire and destructive leadership had lower scores for almost every professional group. CONCLUSION: Results highlight the necessity for future multimodal health-preventive leadership interventions feature behavioural and organizational intervention modules specifically tailored to hospital professionals at different hierarchical and functional levels to foster the mental health of employees.

Conceptual Framework of a Psychotherapeutic Consultation in the Workplace: A Qualitative Study.

(1) Background: A new health care offer called 'psychotherapeutic consultation in the workplace' is an early and effective intervention for employees with common mental disorders. Although cost-effective, it lacks a broader roll-out. This might be attributable to undefined context, mechanisms of change, and a lack of communication; therefore, this study explores how the new model works and where problems occur. (2) Methods: Semi-structured interviews on motivation, expectations and experiences with 20 involved experts. Experts were members of the company health promotion team, service users, and cooperating mental health specialists. Analysis was conducted with ATLAS.ti. (3) Results: The conceptual framework comprises three main topics: (a) structured implementation concept; (b) persons involved, shaping the concept's processes; (c) and meaning and function of the offer within the given context. Concerning (c) we found three potential areas of conflict: (1) intra-corporate conflicts, (2) conflicts between company and employee, (3) and conflicts between the company health promotion and the health care system. Category (c) comprises the offer's core characteristics which were described as low-threshold and preventive. Furthermore, the offer was perceived as convenient in handling, confidential, and having immediate impact on a person's well-being. (4) Conclusions: Here we define structures, address the needs of the involved persons, and communicate foreseeable areas of conflict influences whether the implementation of the intervention succeeds.

Evaluation of measurement properties of the German Work Role Functioning Questionnaire.

OBJECTIVE: We assessed the measurement properties of the German Work Role Functioning Questionnaire (WRFQ) after its cross-cultural adaptation of the Dutch version. The WRFQ is a generic role-specific instrument that measures how a particular health status influences the ability to meet work demands. METHODS: We performed an observational study among German employees assessing the following measurement properties: 1) structural, 2) convergent and 3) discriminant validity, 4) floor and ceiling effects, 5) internal consistency, 6) reproducibility and 7) responsiveness. Participants were recruited from an online access panel sample aged 18 to 64 years having worked more than 12 hours in the last 4 weeks prior to study enrollment (n(T0) = 653, n(T1) = 66, n(T2) = 95). RESULTS: Measurement properties proved to be good except for structural validity and responsiveness. An exploratory factor analysis showed limited replicability of three of the four original subscales. CONCLUSION: With the WRFQ German version, the extent can be measured, to which employees with a certain health level experience problems can meet their work demands. This widely used health-related work outcome measurement tool, that helps to identify employees with decreasing work functioning, is now also available in German. This gives researchers and practitioners the opportunity to address work functioning in practice, e.g. in intervention studies in occupational health or rehabilitation. Further research to examine valid subscales is needed.

Group-Treatment for Dealing with the Work-Family Conflict for Healthcare Professionals.

Healthcare professionals' exposure to work-family conflict negatively affects the health and well-being of the whole family and organizational outcomes. Specified workplace interventions are lacking. Therefore, the aim of the study was to evaluate the feasibility of a two-day group-treatment specifically designed for the needs of healthcare professionals with family responsibilities concerning participation, satisfaction with the intervention and family- and individual-related outcome variables. 24 mostly female (85.7%) participants of a community hospital in southern Germany attended the treatment. Data were collected at baseline (T0), directly after the treatment (T1) and two months later (T2). A two-factor analysis of variance with repeated measures showed a statistically significant time x group effect for self-efficacy (F = 5.29, p = 0.011). Contrasts displayed substantial pre-post (T1-T0, T2-T0) increases of self-efficacy in the intervention group as compared with the control group. Non-parametric Mann-Whitney-U tests are in line with these findings. The results indicate that the group-treatment adapted to the needs of healthcare professionals has the potential to boost self-efficacy among healthcare professionals and that participants were predominantly satisfied. Perspectives for future research and practical implications are discussed in the light of the manifest lack of healthcare professionals.

[Providing Rapid Help for Mental Strain at the Workplace: Psychosomatic Consultation in the Workplace]. / Rasche Hilfe bei psychischen Belastungen am Arbeitsplatz: Die Psychosomatische Sprechstunde im Betrieb.

BACKGROUND: Psychosomatic consultation in the workplace (PSIW) is an offer for employees who are under mental and psychosomatic strain. Core elements are early diagnosis and short-term psychotherapy with the aim of improving the care for mentally stressed employees. This article provides a characterization of patients and presents initial data on the effects of short-term psychotherapy. MATERIALS AND METHODS: From 05/2016 to 12/2019, basic data were collected from all employees seeking help. Socio-demographic data, previous treatments, work ability, depression (PHQ-9), anxiety (GAD-7), somatic symptoms (PHQ-15), assessment of psychological state and attitudes towards treatment options were collected by self-report before and (if applicable) after a short-term intervention. RESULTS: A total of 672 employees from 20 companies (49% male) were mostly referred to PSIW by the company physician. Adjustment disorders and depressive disorders each accounted for almost one-third of diagnoses. A quarter of the employees presenting at PSIW were on sick leave at the time of referral. The most frequent recommendations were short-term intervention at PSIW, followed by outpatient psychotherapy. A total of 343 (51%) employees completed the questionnaires, of which 187 (55%) of them received short-term psychotherapy. The symptoms improved significantly across all scales. Satisfaction with PSIW was very high. CONCLUSIONS: PSIW is an innovative care concept in the work context, which is well accepted and effective in various sectors. Close cooperation with company stakeholders such as occupational health physicians is important for a successful outcome.

Early intervention, treatment and rehabilitation of employees with common mental disorders by using psychotherapeutic consultation at work: study protocol of a randomised controlled multicentre trial (friaa project).

BACKGROUND: Common mental disorders are one of the leading causes for sickness absence and early retirement due to reduced health. Furthermore, a treatment gap for common mental disorders has been described worldwide. Within this study, psychotherapeutic consultation at work defined as a tailored, module-based and work-related psychotherapeutic intervention will be applied to improve mental health care. METHODS: This study comprises a randomised controlled multicentre trial with 1:1 allocation to an intervention and control group. In total, 520 employees with common mental disorders shall be recruited from companies being located around five study centres in Germany. Besides care as usual, the intervention group will receive up to 17 sessions of psychotherapy. The first session will include basics diagnostics and medical indication of treatment and the second session will include work-related diagnostics. Then, participants of the intervention group may receive work-related psychotherapeutic consultation for up to ten sessions. Further psychotherapeutic consultation during return to work for up to five sessions will be offered where appropriate. The control group will receive care as usual and the first intervention session of basic diagnostics and medical indication of treatment. After enrolment to the study, participants will be followed up after nine (first follow-up) and fifteen (second follow-up) months. Self-reported days of sickness absence within the last 6 months at the second follow-up will be used as the primary outcome and self-efficacy at the second follow-up as the secondary outcome. Furthermore, a cost-benefit assessment related to costs of common mental disorders for social insurances and companies will be performed. DISCUSSION: Psychotherapeutic consultation at work represents a low threshold care model aiming to overcome treatment gaps for employees with common mental disorders. If successfully implemented and evaluated, it might serve as a role model to the care of employees with common mental disorders and might be adopted in standard care in cooperation with sickness and pension insurances in Germany. TRIAL REGISTRATION: The friaa project was registered at the German Clinical Trial Register (DRKS) at 01.03.2021 (DRKS00023049): https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00023049 .

Mental Health Applications for Primary and Secondary Prevention of Common Mental Disorders: Attitudes of German Employees.

Background: Web-based and mobile mental health applications for the prevention and treatment of common mental disorders (CMDs) are on the rise. Under certain circumstances they have proved to be effective for a range of conditions (e.g., depression). Objective: There is not sufficient evidence regarding the benefits and barriers especially for mobile phone apps and for programs in the field of primary prevention. Studies on the acceptance of potential users of mental health apps yielded mixed outcomes. In a large survey we investigated the attitudes of employees toward mental health apps and various traditional mental health services. Our main research question in this contribution focuses on the acceptance of apps compared to other measures and the moderating influence of individual characteristics. Methods: The standardized survey was completed by members of an online access panel with different job types. A set of 33 self-developed items, including three questions on e-health, captured the perceived relevance of prevention at the (A) occupational, (B) individual, and (C) societal level. On the basis of an exploratory factor analysis, mean scores for mapping seven (sub-)dimensions were constructed and compared using the Wilcoxon test. The influence of potential predictors was analyzed in linear regression models. Results: The data of 610 respondents were analyzed (response rate 75%). Support from mental health applications was rated significantly less important compared to all other dimensions at the levels (A) to (C). Respondents were more likely to use mental health apps if they felt literate with electronic devices, perceived a high relevance of work-related demands as causal factors for CMDs, stated they would be ashamed of having a CMD, and would be willing to begin psychotherapy if recommended. Discussion and Conclusions: The results confirm the critical attitudes of potential mental health app users found in other studies. Since users with a negative attitude toward e-health might have a higher risk for dropout and non-adherence as well as lower intervention effects, well-designed educational strategies should be carried out beforehand.

Cluster-randomised trial evaluating a complex intervention to improve mental health and well-being of employees working in hospital - a protocol for the SEEGEN trial.

BACKGROUND: Health care employees in Germany and worldwide are exposed to a variety of stressors. However, most of the hospitals in Germany lack a systematic workplace health management. Thus, this study aims at the evaluation of the effects of a behavioural as well as organisational (´complex´) intervention on the mental health and well-being of hospital staff. METHODS: Mental health in the hospital workplace (SEElische GEsundheit am Arbeitsplatz KrankeNhaus - SEEGEN) is an unblinded, multi-centred cluster-randomised open trial with two groups (intervention group (IG) and waitlist control group (CG)). Study participants in the intervention clusters will receive the complex intervention; study participants in the waitlist control clusters will receive the complex intervention after the last follow-up measurement. The intervention consists of five behavioural and organisational intervention modules that are specifically tailored to hospital employees at different hierarchical and functional levels. Hospital staff may select one specific module according to their position and specific needs or interests. Towards the end of the intervention roundtable discussions with representatives from all professional groups will be held to facilitate organisational change. Primary outcome is the change in emotional and cognitive strain in the working environment, from baseline (T0) to 6 month-follow up (T1), between IG and CG. In addition, employees who do not participate in the modules are included in the trial by answering shorter questionnaires (cluster participants). Furthermore, using mixed methods, a process evaluation will identify uptake of the intervention, and mediators and moderators of the effect. DISCUSSION: There seems to be growing psychological strain on people working in the health care sector worldwide. This study will examine whether investing directly in the hospital staff and their interpersonal relationship may lead to measurable benefits in subjective well-being at the workplace and improved economic performance indicators of the hospital. In case of a positive outcome, health promotion strategies looking at behavioural as well as organisational components within the hospital may gain additional importance, especially in regard of the growing financial pressure within the health sector. TRIAL REGISTRATION DRKS: The SEEGEN study is registered at the German Clinical Trial Register (DRKS) under the DRKS-ID DRKS00017249. Registered 08 October 2019, URL. https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00017249.

Psychische Erkrankungen im Arbeitskontext ­ eine Verortung im Versorgungssystem.

Work and mental health are closely interrelated. Sick leave rates due to mental illness have constantly been rising for years. Thus, not only companies but also the society as a whole have become more and more aware of the relevance of this topic.At first, various work stress models are outlined in this article. This is followed by an overview of how to classify work-related mental disorders in the ICD and DSM systems. Burnout is explained with regard to terminology, origin and adequate use in clinical practice. Furthermore, the ILO (International Labour Organization) classification of work-related mental disorders is presented. Possible intervention models for the prevention and therapy of work-related mental health problems are discussed. In addition, the most essential components of work-related psychotherapy are pointed out. Finally, corresponding guidelines are put into an international context.

Who Should Play a Key Role in Preventing Common Mental Disorders that Affect Employees in the Workplace? Results of a Survey with Occupational Health Physicians, Primary Care Physicians, Psychotherapists, and Human Resource Managers.

The rising burden of common mental disorders (CMDs) in employees requires strategies for prevention. No systematic data exist about how those involved perceive their roles, responsibilities, and interactions with other professional groups. Therefore, we performed a multi-professional standardized survey with health professionals in Germany. A self-administered questionnaire was completed by 133 occupational health physicians (OHPs), 136 primary care physicians (PCPs), 186 psychotherapists (PTs), and 172 human resource managers (HRMs). Inter alia, they were asked which health professionals working in the company health service and in the outpatient care or in the sector of statutory insurance agents should play a key role in the primary, secondary, and tertiary prevention of CMDs in employees. The McNemar test was used in order to compare the attributed roles among the professionals involved. With regard to CMDs, all the professional groups involved in this study declared OHPs as the most relevant pillar in the field of prevention. In primary prevention, HRMs regarded themselves, OHPs, and health insurance agents as equally relevant in terms of prevention. PTs indicated an important role for employee representatives in this field. In secondary prevention, PCPs were regarded as important as OHPs. HRMs indicated themselves as equally important as OHPs and PCPs. In tertiary prevention, only OHPs identified themselves as main protagonists. The other groups marked a variety of several professions. There is a common acceptance from the parties involved that might help the first steps be taken toward overcoming barriers, e.g., by developing a common framework for quality-assured intersectional cooperation in the field of CMD prevention in employees.

Common mental disorders through the eyes of German employees: attributed relevance of work-related causes and prevention measures assessed by a standardised survey.

PURPOSE: Common mental disorders (CMDs) are becoming increasingly relevant in the working world. Numbers of risk factors have been confirmed by mostly correlative cross-sectional studies. Comprehensive and effective prevention is urgently needed. There is little knowledge about employees' own perceptions on causes of CMDs and prevention measures. Therefore, a survey was conducted in 2016. METHODS: A standardised instrument was developed for an online survey in a commercial access panel, targeted employees in different job types. We assessed two outcomes: perceived relevance of (1) work-related demands to the development of CMDs, and (2) prevention approaches in the workplace and on individual and societal levels. Possible predictive aspects were analysed exploratively by multivariate linear regression analysis. RESULTS: The response rate was 75% (n = 610). Job types were categorised as "blue", "grey" and "white-collar" workers (n = 193, 169, 248). The majority of respondents rated both outcomes consistently as "quite" or "very relevant"; societal prevention strategies were more relevant for non-white-collar workers. Perceived relevance of individual predisposition to develop a CMD was the strongest predictor for both outcomes, indicating the perception that people with higher personal vulnerability might suffer a higher strain from work-related risk factors than others. CONCLUSION: We assume that participants in our survey judged the relevance of work-related causes of CMDs independently of their own workload. The perceived relevance of prevention measures in different areas is consistent with official guidelines. A possible selection bias due to characteristics of access panel collectives and own direct or indirect experiences with CMD should be critically questioned.

[How do users assess the new "Psychosomatic Consultation in the Workplace" model of care? : Results of a controlled observational trial]. / Wie bewerten Nutzer das neue Versorgungsmodell "Die Psychosomatische Sprechstunde im Betrieb"? : Ergebnisse einer kontrollierten Beobachtungsstudie.

BACKGROUND: Within the framework of psychosomatic consultation in the workplace (PSIW), external expert psychotherapists offered consultation sessions for employees at the company premises in order to establish a first contact. In contrast to the first contact usually established in regular care, PSIW explicitly focuses on the workplace and enables in-company actors to get closely involved, if the patient's consent is provided. The new model of care helps to identify mental problems at an early stage and is clinically effective. Reliable data considering the user's point of view is missing. OBJECTIVES: How satisfied are users of the new model of care compared to users of regular care? MATERIAL AND METHODS: A total of 189 people from in-company (n = 91) or regular medical consultations (n = 98) made statements before first contact (t1) and 12 weeks (t2) after the initial contact. They reported satisfaction with the offer (t2), further treatment (t2), and depressiveness (t1, t2) by means of self-assessment tools. On the basis of an OLS (ordinary least squares) regression analysis, we investigated how treatment quality (clinical improvement, further treatment) and the place of treatment influenced user satisfaction (dependent variable), while controlling for selection bias and the different degrees of depression at baseline. RESULTS: Higher clinical improvement predicted more satisfaction with the received treatment in both (b = 1.2, CI 0.802-1.548). The mean value (MV) of satisfaction was 1.6 points higher if further treatment took place (CI 0.236-2.909). PSIW users showed a 1.8 points higher MV of satisfaction than people in regular care (CI 0.322-3.302). CONCLUSIONS: PSIW users consider PSIW as positive in terms of treatment success and service quality.

The importance of body image disturbances for the outcome of outpatient psychotherapy in patients with anorexia nervosa: Results of the ANTOP-study.

This study investigates the role of body image self-appraisal in predicting the outcomes of outpatient psychotherapy in patients with anorexia nervosa (AN). Multiple linear regression analyses and a path-analysis model were applied to test the study hypotheses that body image at baseline predicts treatment outcomes of outpatient psychotherapy in patients with AN at follow-up measurement. The analyses were conducted as secondary analyses in a subgroup (n = 148) of the anorexia nervosa treatment of outpatient-cohort (ANTOP-study) (N = 242) of patients with AN. The results show that Negative Evaluation of the Body at baseline predicts perceived stress during psychotherapy, which in turn predicts depressive symptoms at the end of therapy which in turn predicts the outcomes body mass index and EDI-2 sum score at 12 months follow-up. The results underline the importance of body image disturbance in the course of AN and call for body image as a central target of psychotherapeutic interventions in patients with AN.