ABSTRACT
BACKGROUND: While psychosomatic factors may be involved in eliciting as well as coping with chronic itch, psychiatric comorbidity often goes unrecognized in dermatological patients. AIM: To record psychiatric illness, psychiatric and psychotherapeutic pretreatment, and psychotherapy indication in dermatology inpatients with pruritus. METHODS: A consecutive sample of 109 dermatology inpatients with the symptom of pruritus were examined by interviews with consecutive ratings by experts (using psychiatric ICD-10 diagnoses, the Global Assessment of Functioning Scale and the Impairment Score) and self-assessment using the the Eppendorf Itch Questionnaire. RESULTS: In > 70% of the pruritus patients, 1-6 psychiatric diagnoses could be demonstrated. In > 60%, psychotherapeutic or psychiatric treatment was recommended. In contrast, almost 90% of the patients had had no previous psychotherapeutic experience. CONCLUSION: As psychiatric comorbidity in dermatology inpatients suffering from chronic itch is high, dermatology departments should aim for an improvement of their psychosomatic consultation and liaison services.
Subject(s)
Mental Disorders/diagnosis , Pruritus/psychology , Psychophysiologic Disorders/diagnosis , Adult , Aged , Aged, 80 and over , Chronic Disease , Female , Humans , Male , Mental Disorders/therapy , Middle Aged , Pruritus/etiology , Pruritus/therapy , Psychiatric Status Rating Scales , Psychophysiologic Disorders/therapy , Psychotherapy , Psychotropic Drugs/administration & dosage , Severity of Illness IndexABSTRACT
METHOD: The ELDERMEN Study, which was funded by the German Research Association, comprises baseline assessment during 1994-1997 and a second assessment during 2000-2002. A total of 261 in-patients participated in an extensive examination at baseline assessment and were contacted again five years later. RESULTS: Five years after baseline assessment, 135 former participants had deceased, 29 newly fulfilled exclusion criteria. Of the 97 individuals who matched the study's inclusion criteria at the second assessment, 74 participated in the second evaluation. Baseline assessment revealed no significant differences between participants at second assessment and those persons who refused the second participation. However, participants in the extensive examination and longitudinal design were a positive selection when compared to the whole baseline sample. DISCUSSION: Because of increasing morbidity and mortality, longitudinal gerontological studies have to deal with the problem of selective diminishment of the sample, which can endanger the validity and generalizability of results. The problem has to be dealt with by careful documentation and evaluation of selectivity effects. We focus on the problems of longitudinal studies in gerontologic research and examine the longitudinal development of a sample of geriatric in-patients aged > or = 60 years.
Subject(s)
Clinical Trials as Topic/methods , Data Interpretation, Statistical , Epidemiologic Research Design , Geriatric Assessment/methods , Pain/epidemiology , Pain/psychology , Psychophysiologic Disorders/epidemiology , Psychophysiologic Disorders/psychology , Aged , Aged, 80 and over , Bias , Depression/psychology , Female , Germany/epidemiology , Humans , Longitudinal Studies , Middle Aged , Reproducibility of Results , Sample Size , Sensitivity and Specificity , Somatoform Disorders/epidemiology , Somatoform Disorders/psychologyABSTRACT
A new depressive entity called the "Sisi syndrome," named in reference to the former empress of Austria, was introduced by a drug company in 1998. Their advertising campaign presents information about nosology, symptoms, and recommended therapy. We review the relevant literature about this syndrome and are not able to confirm the statements about it. The lack of scientific proof of it as an independent entity of depression stands in contrast to the widespread media coverage in Germany, which was organized by a public relations company. Therefore, we discuss new kinds of marketing strategies ("disease mongering") by drug companies and conclude with some preventive recommendations.
Subject(s)
Advertising , Antidepressive Agents, Second-Generation/therapeutic use , Depressive Disorder/diagnosis , Drug Industry , Marketing , Paroxetine/therapeutic use , Depressive Disorder/classification , Depressive Disorder/drug therapy , Germany , Humans , SyndromeABSTRACT
This paper presents the most important arguments in medical allocation based on an analysis of the relevant literature. The main arguments of rationing scarce medical resources are scrutinized. Especially the use of age limit considerations are critically reviewed. The discussion takes place against a backdrop of aggravating pressure on old people as cost factors. As a basis for further discussion, the authors give a brief history of theories of justice in philosophy. Finally minimum requirements for a constructive and responsible discussion are stated.
