[Resilience and psychological impairment in adulthood: the impact of age and social inequality]. / Resilienz und psychische Belastung im Erwachsenenalter: Zum Einfluss von Alter und sozialer Ungleichheit.

In a cross-sectional study the influence of social inequality on resilience and psychological distress was investigated in a sample of N=4 142 adults. A social stratum was created, including education, financial income and job-status, as well as age (≥ 25 years). Multivariate analysis of variance (MANOVA) showed influences of gender, social status and age on resilience (RS-11) and psychological distress: depression (PHQ-2), anxiety (GAD-7), life satisfaction (FLZ(M)). In contrast to the most continuous influence of the social background in women across any age-group, older males (≥ 65 years) were not affected by their social background. In both sexes members of the social underclass had the lowest resilience. The results indicate the need for specific intervention as to prevention.

[Life satisfaction and subjective importance of life domains in schizophrenia patients: the role of partnership and parenthood]. / Lebenszufriedenheit und subjektive Relevanz von Lebensbereichen bei schizophren Erkrankten.

OBJECTIVE: The aim is to analyze determinants of subjective quality of life in schizophrenia patients. METHODS: Life satisfaction and subjective importance of life domains were assessed in 107 patients (FLZ (M)) and compared with the general population (n = 2974). RESULTS: Schizophrenia patients experience lower levels of life satisfaction as well as less meaningfulness in all life domains. According to the range-of-affect hypothesis, patients with low importance ratings judged their life satisfaction more homogenously. While the presence of a partnership increases life satisfaction, parenthood has only indirect influences on satisfaction. CONCLUSION: Psychiatrists should not only explore life satisfaction, but also the importance of different life domains and the patient's family relations. Supporting beneficial family relations can increase the quality of life in schizophrenia patients.

Comparison of social support and psychosocial stress after heart and liver transplantation.

We studied social support, psychological symptoms, and subjective appraisal of quality of life among 233 patients at 1 to 3 years after heart (HTX) or orthotopic liver transplantation (OLT): 78 HTX in 62.8% men and 155 OLT in 51% men. Patients after OLT versus HTX were more often single or divorced (14.4% and 12.3% vs 3.9% and 7.7%), had better school education (68.4% vs 37.8%), and were more often employed (25.5% vs 11.8%). Among the HTX patients, 40.3% had more than 3 inpatient treatments due to complications after transplantation vs only 9.3% of OLT patients. HTX patients had more rejection reactions (55.4% vs 21%). Asked for their appraisal of quality of life, HTX and OLT patients gave comparably good "school grades" (2.6 vs 2.7), describing similar scores of social support in the F-SozU (4.4 vs 4.2). OLT patients, women in particular, reported a significantly higher grade of global psychological stress than HTX patients (67.4 vs 55.1; P < .001). Our results indicated that social support, employment status, and degree of somatic complications cannot sufficiently explain the degree of emotional distress after transplantation. Subjective factors such as making sense of the transplantation in terms of regarding it as a worthwhile operation within the life course are important mediators of psychological stress and perceived quality of life.

Changes in quality of life after renal transplantation.

Quality of life is becoming an increasingly important concept in the evaluation of different therapeutic interventions. In this cross-sectional study, quality of life analyzed in 76 renal transplant patients was compared with 65 patients with end-stage renal disease (ESRD) awaiting transplantation. Both groups were asked to estimate their subjective quality of life by responding to a multidimensional questionnaire that sought information in the following areas: (1) sociodemographic data, (2) a personality test (Giessen-Test), (3) information about employment, (4) assessment of anxiety and depression (GHQ-28), (5) the SF-36 as an important measurement for quality of life, and (6) the ESRD symptom checklist-transplantation module. The sociodemographic profiles of both groups were similar. The SF-36 revealed significantly higher values for transplant recipients in terms of physical functioning (P < or = .001), general health perceptions (P < or = .01), social functioning (P < or = .01), and physical summary value (P < or = .001). The other tests (Giessen-Test and GHQ-28) and employment data showed no significant differences between the two samples. Collectively, the data demonstrate a considerable improvement in quality of life in renal transplant patients. Despite good physical recovery and higher quality of life after transplantation, the rate of vocational rehabilitation remained low, partially explained by the currently high levels of unemployment.

[Not Available]. / Diagnostik und Behandlung in der Psychosomatischen Grundbehandlung.

It may be possible to identify elements of psychosomatic/psychotherapeutic pri-mary care in the Federal Republic of Germany and the former German Democratic Republic by comparing the current state of basic psychosomatic care (BPSC) in the eastern and western part of Berlin. 278 Berlin patients with psychosocial problems were recruited 1995 for a basic documentation system of the BPSC in connection with a project supported by the Federal Ministry for Health at the Berlin Center. Their data were compared with re-gard to diagnostic and therapeutic measures applied in the eastern and western part of Berlin. Furthermore, 617 questionnaires on basic psychosomatic care were filled out by physicians in private practice in both parts of the city in 1994. Despite the identical or lower assessment of their patients* biopsychosocial stress, East Berlin physicians take considerably more therapeutic measures than their collea-gues in West Berlin. There are only minor differences between physicians from the eastern and western part of the city despite variances in the training and advanced training systems for BPSC. The possible causes are discussed.

[Publication practices of academics in medical psychology and in psychosomatics and psychotherapy]. / Veröffentlichungspraxis der Lehrstuhlinhaber in der Medizinischen Psychologie und in der Psychosomatik/Psychotherapie.

When qualifying for higher academic positions junior academics face increasing demands for submitting papers for publication. The criteria for assessing these publications are presently under discussion. Contributions to international English language journals are more highly regarded, and it has become indispensable to have papers published in journals listed in SCI and SSCI. The question remains whether these criteria are valid to judge academic qualifications. Whereas one criterion for validity may be the publication practice of the present academic representatives, it appears that to some extent the chairs themselves would not fulfill the requirements for academic qualification today. Results regarding this are presented and discussed.

["Ledderhose" disease. Plantar fibromatosis--clinical aspects]. / Morbus Ledderhose. Die plantare Fibromatose--klinische Aspekte.

The Ledderhose's diseases is a relatively rare and not well known clinical picture. Even there are tight pathomorphological and clinical relations to the Dupuytren's contracture, the genesis is also here quite unknown. Because of inefficiency of conventional therapy the surgical treatment is the only alternative. On the sample of 12 operations in 7 patients from 1979 to 1989 surgical procedure and long-term results are discussed.