Psychometric properties of an English short version of the Trier Inventory for chronic Stress.

BACKGROUND: Although a variety of instruments are available that capture stress experience, the assessment of chronic stress has been hindered by the lack of economical screening instruments. Recently, an English-language version of the Trier Inventory for Chronic Stress (TICS-EN) consisting of 57 items according to a systemic-requirement-resource model of health in nine subdomains of the chronic stress experience has been introduced. METHODS: We constructed a new 9-item short version of the TICS covering all nine subdomains and evaluated it in two samples (total N = 685). We then used confirmatory factor analysis to check factorial validity. RESULTS: This version showed a highly satisfactory model fit, was invariant across participant gender, demonstrated a very high correlation with the original TICS (r = .94), and showed a moderate correlation (r = .58) with a measure of perceived stress in the past month. CONCLUSIONS: Therefore, this theoretically driven instrument can be recommended as a short version of the TICS in English language.

[Traumatization and posttraumatic stress disorder. Effect of type and number of traumatic experiences]. / Traumatisierung und posttraumatische Belastungsstörungen. Auswirkung von Art und Anzahl traumatischer Erfahrung.

OBJECTIVE: The number and type of traumatic experiences show differential associations with posttraumatic stress disorder (PTSD). OBJECTIVE: The associations of number and type of traumatic experiences with PTSD were investigated in a representative population sample in Germany. MATERIAL AND METHODS: Traumatic experiences and PTSD were assessed with a self-rating questionnaire in a sample of 2510 participants from the general German population. RESULTS: The risk of (partial) PTSD increased with an increasing number of traumatic experiences. In contrast interpersonal and accidental traumatization showed no substantial differences with respect to the risk of PTSD. CONCLUSION: To quantify the relevance of the number and type of traumatic experiences for onset and persistence of PTSD, a multidimensional and complex assessment of those experiences is necessary. This is a great challenge in epidemiological research on this topic.

Erectile dysfunction after radical prostatectomy: the impact of nerve-sparing status and surgical approach.

The core question of the study was whether the nerve-sparing status and surgical approach affected the patients' sexual life in the first year after surgery. In addition, determinants of erectile function (EF) and the extent of sexual activity were investigated. We conducted a multicentric, longitudinal study in seven German hospitals before, 3, 6 and 12 months after radical prostatectomy (RP). A total of 329 patients were asked to self-assess the symptoms associated with erectile dysfunction (ED). These symptoms were assessed using the International Index of Erectile Function and EORTC QLQ-PR25 questionnaires. A multiple regression model was used to test the influence of clinical, socio-demographic and quality-of-life-associated variables on the patients' EF 1 year after RP. Before surgery, 39% of patients had a severe ED (complete impotence). At 3, 6 and 12 months after surgery, it was 80, 79 and 71%, respectively. Although the surgical approach had no significant effect on EF, patients who had undergone nerve-sparing surgery had significantly lower ED rates. Nevertheless, 1 year after RP, 66% of these patients had severe ED. Age, nerve-sparing status and the burden of urinary symptoms had the greatest impact on the patients' EF. Regardless of nerve-sparing status and surgical approach, postsurgical improvement of EF does not mean a full convalescence of presurgical EF. Instead, it may rather reduce the degree of postsurgical ED in time. Consequently, urologists should disclose to the patient that ED is a likely side effect of RP.

Age- and gender-specific prevalence and risk factors for depressive symptoms in the elderly: a population-based study.

OBJECTIVES: Information on the prevalence and risk factors for depressive disorders in old age is of considerable interest for the assessment of future needs of the health care system. The aim of the study is to determine age- and gender-specific prevalence of major depression (MD), minor depression (MiD), and depressive symptoms, and to analyze risk factors associated with depressive symptoms. METHODS: A representative sample of the German population of 1,659 individuals aged 60 to 85 years were visited at home and answered self-rating questionnaires. Depressive symptoms and syndromes (MD, MiD) were assessed using the Patient Health Questionnaire (PHQ-9). Factors associated with depressive symptoms were determined with linear regression models for the total sample and for men and women separately. RESULTS: Depressive symptoms were found in 28.7% of the participants, while 6.6% were affected by MD or MiD. The highest prevalence of MD and depressive symptoms was found in the oldest age groups. MiD showed an unsteady course across age groups in both sexes. In the total sample as well as in the male subsample, depressive symptoms were significantly associated with increasing age, lower household income, an increasing number of medical conditions, and lower social support. In women only, the number of medical conditions and lacking social support were significantly associated with depressive symptoms. CONCLUSIONS: Depressive symptoms are common in old age and occur on a spectrum ranging from very mild forms to MD. The potential modifiability of a number of risk factors for depressive symptoms opens possibilities of secondary prevention such as treatment of chronic diseases as well as support in requirements of daily living.

Somatization symptoms and hypochondriacal features in the general population.

OBJECTIVE: The principal goal of this study is to examine the base rates of somatoform symptoms and of hypochondriacal features in the general population. METHODS: A representative sample of 2050 persons in Germany was examined by use of screening for somatoform symptoms and the Whiteley Index. RESULTS: The most frequent somatoform symptoms were back pain, joint pain, pain in extremities, and headache, as well as abdominal symptoms (bloating or intolerance of several foods) and cardiovascular symptoms (palpitation). People reported a mean of two somatization symptoms of DSM-IV somatization disorder (SD) during the prior 2 years. Strong age and medium gender effects were found for most somatoform symptoms, as well as for composite indices. However, the sex ratio suggested in DSM-IV for SD seems to be an overestimation. Hypochondriacal features showed only small sex differences but, again, pronounced age effects. In contrast to low rates for SD, the base rates for somatization and hypochondriacal features were high and represented the health care relevance of subthreshold syndromes. CONCLUSION: We present base rates of hypochondriacal and somatization features that may be important facets in the development of classification criteria and in the interpretation of health care expenditure.