ABSTRACT
BACKGROUND: Wisdom is a capacity, which is needed in coping with difficult problems in life. It can be understood as a special type of problem solving skill. It is getting growing recognition in psychology in general, and in psychotherapy and clinical practice in particular. Goal of the present study is to assess wisdom competencies and their correlates in psychosomatic patients, using for the first time the 12-WD-scale. METHOD: The 12-WD-Scale covers 12 wisdom dimensions. As part of their routine intake assessment, 202 unselected inpatients of a department of psychosomatic medicine filled in the 12-WD-scale together with the differential life burden scale, the global belief in a just world scale and the posttraumatic embitterment scale. Additional patient and clinical data could be taken from the routine data. RESULTS: Wisdom scores showed a normal distribution. The mean was in the positive range (4.50, SD=0.71). A factor analysis showed three factors (sobriety, serenity, modesty), explaining 53.7% of the total variance. There were positive correlations of the wisdom score with life satisfaction and age, negative correlations with beliefs in justice and embitterment, but not with formal education. DISCUSSION: The results of the 12-WD-Scale show that psychosomatic patients appreciate wisdom attitudes and that this is associated with better coping in life. Wisdom competencies are an interesting field in psychotherapy when patients are burdened by difficult situations in life. The 12-WD-scale can provide helpful information in this regard.
Subject(s)
Adaptation, Psychological , Problem Solving , Psychophysiologic Disorders/psychology , Adult , Aged , Culture , Female , Germany , Humans , Life Change Events , Male , Middle Aged , Psychophysiologic Disorders/rehabilitation , Rehabilitation Centers , Social Adjustment , Surveys and QuestionnairesABSTRACT
OBJECTIVE: To determine whether a psychiatric-psychosomatic consultation can identify unmet treatment needs and improve treatment of patients with mental disorders in general practice. METHODS: In 40 primary care practices, 307 consecutive primary patients who met criteria for chronic mental disorders were assessed by a psychiatric-psychosomatic consultant. After random assignment, general practitioners (GPs) were informed for half of the patients about the results of the assessment and received recommendations on how to improve treatment. Changes in treatment and patient status were reevaluated after 6 months. RESULTS: Patients were mostly having depression, adjustment, or anxiety disorders, with 28.8% on sick leave. Contact with their respective GPs was longer than a year in 77.2% of cases. Patients had already received pharmacotherapy (60.9%), psychotherapeutic counseling by GPs themselves (27.7%), psychotherapy by specialists (73.9%), psychiatric outpatient care (57%), inpatient psychiatric treatment (12.1%), inpatient psychosomatic rehabilitation (ie, specialized behavioral medicine facilities for patients with work problems; 41.4%), and a broad spectrum of other diagnostic and therapeutic measures. Newly recommended interventions included leisure activities (42%), a new specialist psychotherapy (37.5%), or inpatient psychosomatic treatment (15.3%). Most recommendations were agreed upon by the GP. Nevertheless, there was only a limited increase in therapeutic actions 6 months later, and no statistically significant improvement in the status of patients. CONCLUSION: General practitioners undertake a broad spectrum of therapeutic interventions in patients with chronic mental disorders. According to our results, additional psychiatric-psychosomatic consultations can intensify treatment but does not significantly change the general course of chronic mental disorders.
ABSTRACT
OBJECTIVE: ADHD (attention deficit hyperactivity disorders) and MCD (minimal cerebral dysfunctions) can impair participation. They pose difficult diagnostic problems. Aim of the present study has been to describe the frequency and the spectrum of ADHD and MCD in psychosomatic inpatients. METHODS: 1453 psychosomatic inpatients filled in the ADHS-SB and the MCD-TLS-FB screening for self-reported ADHD and minimal cerebral dysfunctions. Prevalence rates were calculated depending on different intensities of symptoms. RESULTS: According to the ADHS-SB 49.5% of the patients met the criteria of an adult ADHD when taking all intensities of symptoms into account. The prevalence rate decreases to 14,6% if moderate to severe symptoms and to 1% if only severe symptoms ratings were recognized. Additional to core symptoms of attentions deficit and hyperactivity patients with ADHD reported about problems with orientation, memory, cognition, emotion regulation, vegetative stability and movement. DISCUSSION: ADHD-related symptoms and minimal cerebral dysfunctions are frequently seen in psychosomatic inpatients. In clinical practice the full spectrum of TLS must be taken into account as they all can impair participation depending on context requirements.
