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1.
Front Psychiatry ; 14: 1129794, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36846237

RESUMO

Background: Symptoms of mental stress are a hallmark of the COVID-19 pandemic. We hypothesized that just testing for COVID-19 could act as an effective stressor for persisting symptoms of mental distress including posttraumatic stress disorder. Our study aimed to determine whether personal beliefs on individual control and competence (locus of control, LoC) correlate with symptoms of mental distress and positive screening for post-traumatic stress disorder during a 9-month observational period. Methods: Between March and December 2021, we applied online versions of the Questionnaire on Competence and Control Expectations (FKK), the Depression, Anxiety, and Stress Score (DASS), the Short Screening Scale for DSM-IV Posttraumatic Stress Disorder (PTSD), and a medical history questionnaire for COVID-19 symptoms (visit 1). 48 hours after negative COVID-19 testing, DASS was repeated to address relief effects on mental distress (visit 2). Following 90 days (visit 3), development of mental distress was addressed by a combination of DASS and PTSD, while the possible long-term manifestation of PTSD was evaluated 9 months later (visit 4). Results: At visit 1, 7.4 percent of the total sample (n = 867) demonstrated a positive screening for PTSD, while after nine months (at visit 4), 8.9 percent of the remaining sample (n = 204) had positive screening results. The mean age was 36.2 years; 60.8% were women, 39.2% men. In contrast to individuals with negative PTSD screening, these participants demonstrated a significantly different LoC personality profile. This was confirmed by the results of both DASS and the COVID-19 medical history questionnaire. Conclusion: Following testing for COVID-19, individuals with positive long-term PTSD screening present with significantly different personality traits than those w/o suggesting that self-confidence and effective control over one's own actions serve as a protective function against mental distress.

2.
BMC Infect Dis ; 21(1): 915, 2021 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-34488680

RESUMO

BACKGROUND: The aims of this study are to determine (i) SARS-CoV-2 antibody positive employees in Austrian trauma hospitals and rehabilitation facilities, (ii) number of active virus carriers (symptomatic and asymptomatic) during the study, (iii) antibody decline in seropositive subjects over a period of around 6 months, (iv) the usefulness of rapid antibody tests for outpatient screening. METHOD: A total of 3301 employees in 11 Austrian trauma hospitals and rehabilitation facilities of the Austrian Social Insurance for Occupational Risks (AUVA) participated in this open uncontrolled prospective cohort study. Rapid lateral flow tests, detecting a combination of IgM and IgM against SARS-CoV-2), two different types of CLIA (Diasorin, Roche), RT-PCR tests and serum neutralization tests (SNTs) were performed. The tests were conducted twice, with an interval of 42.4 ± 7.7 (Min = 30, Max = 64) days. Positive participants were re-tested with CLIA/SNT at a third time point after 188.0 ± 12.8 days. RESULTS: Only 27 out of 3301 participants (0.82%) had a positive antibody test at any time point during the study confirmed via neutralization test. Among positively tested participants in either test, 50.4% did not report any symptoms consistent with common manifestations of COVID-19 during the study period or within the preceding 6 weeks. In the group who tested positive during or prior to study inclusion the most common symptoms of an acute viral illness were rhinitis (21.9%), and loss of taste and olfactory sense (21.9%). Based on the neutralization test as the true condition, the rapid antibody test performed better on serum than whole blood as 84.6% instead of 65.4% could be detected correctly. Concerning both CLIA tests overall the Roche test detected 24 (sensitivity = 88.9%) and the Diasorin test 22 positive participants (sensitivity = 81.5%). In participants with a positive SNT result, a significant drop in neutralizing antibody titre from 31.8 ± 22.9 (Md = 32.0) at T1 to 26.1 ± 17.6 (Md = 21.3) at T2 to 21.4 ± 13.4 (Md = 16.0) at T3 (χ2 = 23.848, df = 2, p < 0.001) was observed (χ2 = 23.848, df = 2, p < 0.001)-with an average time of 42.4 ± 7.7 days between T1 and T2 and 146.9 ± 13.8 days between T2 and T3. CONCLUSIONS: During the study period (May 11th-August 3rd) only 0.82% were tested positive for antibodies in our study cohort. The antibody concentration decreases significantly over time with 14.8% (4 out of 27) losing detectable antibodies.


Assuntos
COVID-19 , SARS-CoV-2 , Anticorpos Antivirais , Infecções Assintomáticas , Áustria/epidemiologia , Humanos , Recursos Humanos em Hospital , Estudos Prospectivos , Estudos Soroepidemiológicos
3.
Psychophysiology ; 58(5): e13799, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33655551

RESUMO

In an aging society, late-life depression has become an increasing problem. There is evidence that physical activity ameliorates depressive symptoms and increases the quality of life (QoL). However, the underlying mechanisms are still poorly understood. Myokines are molecules secreted in response to muscle contraction. Some of them can cross the blood-brain barrier, making them promising candidates for mediating the beneficial effects of physical activity on mood. The present study aims to compare circulating myokine levels to depression/QoL in older athletes and controls. 55 athletes, 57 controls >59 years were enrolled. The assessment included ergometry, magnetic resonance imaging, blood withdrawal, and neuropsychological testing. Serum interleukin-6 (IL-6), irisin, brain-derived neurotrophic factor (BDNF), kynurenine, and cathepsin B were analyzed and compared to surrogates of depression and quality of life. Athletes presented with higher levels of Cathepsin B. Among controls, all myokines but irisin were associated with age. Also, among controls, kynurenine and IL-6 correlated inversely with specific dimensions of quality of life questionnaires, and IL-6 further with depressive symptoms and decreased physical performance. No such associations could be found among athletes. Irisin levels were inversely associated with mild depression and low-grade white matter-lesions in the brain and predicted impaired QoL. The circulating levels of several myokines/muscle activity-related factors appear to be associated with depressive symptoms and impaired QoL among older adults. However, in athletes, some of these connections seem ameliorated, suggesting additional stressors (as f.e. age) or a different pathomechanism among athletes.


Assuntos
Atletas , Fator Neurotrófico Derivado do Encéfalo/metabolismo , Catepsina B/metabolismo , Depressão/metabolismo , Fibronectinas/metabolismo , Interleucina-6/metabolismo , Cinurenina/metabolismo , Qualidade de Vida , Fatores Etários , Idoso , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Corrida de Maratona , Pessoa de Meia-Idade , Desempenho Físico Funcional , Estudos Retrospectivos
4.
Sci Rep ; 8(1): 9151, 2018 06 14.
Artigo em Inglês | MEDLINE | ID: mdl-29904183

RESUMO

Burnout and work-related stress symptoms of anxiety disorder and depression cause prolonged work absenteeism and early retirement. Hence, reliable identification of patients under risk and monitoring of treatment success is highly warranted. We aimed to evaluate stress-specific biomarkers in a population-based, "real-world" cohort (burnouts: n = 40, healthy controls: n = 26), recruited at a preventive care ward, at baseline and after a four-month follow up, during which patients received medical and psychological treatment. At baseline, significantly higher levels of salivary cortisol were observed in the burnout group compared to the control group. This was even more pronounced in midday- (p < 0.001) and nadir samples (p < 0.001) than for total morning cortisol secretion (p < 0.01). The treatment program resulted in a significant reduction of stress, anxiety, and depression scores (all p < 0.001), with 60% of patients showing a clinically relevant improvement. This was accompanied by a ~30% drop in midday cortisol levels (p < 0.001), as well as a ~25% decrease in cortisol nadir (p < 0.05), although not directly correlating with score declines. Our data emphasize the potential usefulness of midday and nadir salivary cortisol as markers in the assessment and biomonitoring of burnout.


Assuntos
Esgotamento Psicológico/metabolismo , Ritmo Circadiano , Hidrocortisona/metabolismo , Saliva/metabolismo , Vigília , Adulto , Biomarcadores/metabolismo , Esgotamento Psicológico/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
5.
PLoS One ; 12(5): e0177174, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28475643

RESUMO

Endurance sports are enjoying greater popularity, particularly among new target groups such as the elderly. Predictors of future physical capacities providing a basis for training adaptations are in high demand. We therefore aimed to estimate the future physical performance of elderly marathoners (runners/bicyclists) using a set of easily accessible standard laboratory parameters. To this end, 47 elderly marathon athletes underwent physical examinations including bicycle ergometry and a blood draw at baseline and after a three-year follow-up period. In order to compile a statistical model containing baseline laboratory results allowing prediction of follow-up ergometry performance, the cohort was subgrouped into a model training (n = 25) and a test sample (n = 22). The model containing significant predictors in univariate analysis (alanine aminotransferase, urea, folic acid, myeloperoxidase and total cholesterol) presented with high statistical significance and excellent goodness of fit (R2 = 0.789, ROC-AUC = 0.951±0.050) in the model training sample and was validated in the test sample (ROC-AUC = 0.786±0.098). Our results suggest that standard laboratory parameters could be particularly useful for predicting future physical capacity in elderly marathoners. It hence merits further research whether these conclusions can be translated to other disciplines or age groups.


Assuntos
Alanina Transaminase/sangue , Atletas , Colesterol/sangue , Ácido Fólico/sangue , Peroxidase/sangue , Aptidão Física/fisiologia , Ureia/sangue , Idoso , Ciclismo/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resistência Física/fisiologia , Estudos Prospectivos , Corrida/fisiologia
6.
PLoS One ; 11(6): e0157695, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27304888

RESUMO

BACKGROUND AND AIM: Recent studies revealed a link between hypovitaminosis D3 and the risk for hyperglycemia. Further mechanistic and interventional investigations suggested a common reason for both conditions rather than a causal relationship. Exposure to sunlight is the most relevant source of vitamin D3 (25(OH)D), whereas adipose tissue is able to store relevant amounts of the lipophilic vitamin. Since running/bicycling leads to increased out-door time and alters physiological response mechanisms, it can be hypothesized that the correlation between hypovitaminosis D3 and hyperglycemia might be disturbed in outdoor athletes. METHODS: 47 elderly marathoners/bicyclists and 47 age/sex matched controls were studied in a longitudinal setting at baseline and after three years. HbA1c as a surrogate for (pre-)diabetic states was quantified via HPLC, 25(OH)D levels were measured by means of chemiluminescent assays. Physical performance was assessed by ergometry. RESULTS: When adjusted for seasonal variations, 25(OH)D was significantly higher in athletes than in controls. 25(OH)D levels inversely correlated with triglycerides in both groups, whereas only in controls an association between high BMI or low physical performance with hypovitaminosis D3 had been found. Likewise, the presence of hypovitaminosis D3 at baseline successfully predicted hyperglycemia at the follow up examinations within the control group (AUC = 0.85, 95% CI [0.74, 0.96], p < .001, statistically independent from BMI), but not in athletes. CONCLUSION: Our data suggest that mechanisms of HbA1c elevation might differ between athletes and controls. Thus, intense physical activity must be taken into account as a potential pre-analytic confounder when it is aimed to predict metabolic risk by vitamin D3 levels.


Assuntos
Atletas , Colecalciferol/metabolismo , Hiperglicemia/metabolismo , Deficiência de Vitamina D/metabolismo , Idoso , Ciclismo/fisiologia , Índice de Massa Corporal , Ergometria , Exercício Físico/fisiologia , Feminino , Seguimentos , Hemoglobinas Glicadas/metabolismo , Humanos , Hiperglicemia/diagnóstico , Hiperglicemia/fisiopatologia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Curva ROC , Corrida/fisiologia , Estações do Ano , Fatores de Tempo , Deficiência de Vitamina D/fisiopatologia
7.
Neuropsychobiology ; 71(3): 168-75, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25998702

RESUMO

BACKGROUND/AIMS: Depression is a highly prevalent disorder in elderly individuals. A genetic variant (rs6265) of the brain-derived neurotrophic factor (BDNF) impacting on emotion processing is known to increase the risk for depression. We aim to investigate whether intensive endurance sports might attenuate this genetic susceptibility in a cohort of elderly marathon athletes. METHODS: Fifty-five athletes and 58 controls were included. rs6265 of the BDNF gene was genotyped by the TaqMan method. Depressive symptoms were assessed by standardized self-rating tests (BDI = Beck Depression Inventory, GDS = Geriatric Depression Scale). RESULTS: In multivariable analysis of BDI and GDS scores, the interaction between group (athletes vs. controls) and genotypes ([C];[C] vs. [C];[T] + [T];[T]) was found to be statistically significant (BDI: p = 0.027, GDS: p = 0.013). Among [C];[C] carriers, merely controls had an increased relative risk of 3.537 (95% CI = 1.276-9.802) of achieving a subclinical depression score ≥10 on the BDI. There was no such effect in carriers of the [T] allele. In a multivariable binary logistic regression, genetic information, group (athletes/controls), but no information on rs6265 allele carrier status presented as a significant predictor of BDI scores ≥10. CONCLUSION: Physical exercise positively affects BDNF effects on mood. Since 66Met BDNF secretion is impaired, this effect seems to be much stronger in [C];[C] homozygous individuals expressing the 66Val variant. This confirms that genetic susceptibility to depressive symptoms can indeed be influenced by endurance sports in elderly people.


Assuntos
Fator Neurotrófico Derivado do Encéfalo/genética , Depressão/genética , Depressão/prevenção & controle , Exercício Físico , Predisposição Genética para Doença/genética , Predisposição Genética para Doença/prevenção & controle , Idoso , Atletas , Fator Neurotrófico Derivado do Encéfalo/sangue , Estudos de Casos e Controles , Estudos de Coortes , Depressão/sangue , Depressão/psicologia , Feminino , Predisposição Genética para Doença/psicologia , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Testes Psicológicos , Estatísticas não Paramétricas , Inquéritos e Questionários
8.
Gynecol Oncol ; 136(3): 415-23, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25462202

RESUMO

OBJECTIVE: To evaluate health-related quality of life (HR-QoL) and patient reported symptoms (PRS) before, during and early after treatment with external-beam radiotherapy (EBRT), chemotherapy and image-guided adaptive brachytherapy (IGABT) for locally advanced cervical cancer. METHODS: In fifty consecutive patients, HR-QoL and PRS were prospectively assessed with the EORTC-QLQ-C30+CX24 questionnaire prior to and during treatment, one week after IGABT and three months thereafter. HR-QoL was compared to an age-matched, female normative reference population. Prevalence rates of individual PRS are presented and defined as "substantial", if reported as "quite a bit" or "very much". RESULTS: Global health status and physical and role functioning show a highly significant decline during treatment (p≤0.001), before returning to near the baseline levels three months after end of treatment. Compared to the reference population, the global health status and emotional and role functioning remain impaired. The most frequently reported substantial PRS during active treatment are: fatigue (78%), diarrhea (68%), urinary frequency (60%) and nausea (54%); these recover to some degree three months after end of treatment. However, fatigue remains increased (50%) and an onset of hot flashes (44%), sexual worries (38%) and limb edema (22%) is observed. CONCLUSIONS: Several impairments in HR-QoL and PRS were found during definitive radio(chemo)therapy with IGABT, with different patterns of progress over time and signs of recovery three months thereafter, although some aspects of functional HR-QoL remain impaired. These findings support a comprehensive patients' counseling on what to expect and how to organize professional, social and family life and plan additional support during this period.


Assuntos
Antineoplásicos/efeitos adversos , Braquiterapia/efeitos adversos , Quimiorradioterapia/efeitos adversos , Cisplatino/efeitos adversos , Qualidade de Vida , Radioterapia Guiada por Imagem/efeitos adversos , Neoplasias do Colo do Útero/terapia , Adulto , Idoso , Antineoplásicos/uso terapêutico , Braquiterapia/métodos , Quimiorradioterapia/métodos , Cisplatino/uso terapêutico , Feminino , Nível de Saúde , Indicadores Básicos de Saúde , Humanos , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estudos Prospectivos , Radioterapia Guiada por Imagem/métodos , Recuperação de Função Fisiológica , Inquéritos e Questionários , Resultado do Tratamento , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/psicologia
9.
J Sport Exerc Psychol ; 37(6): 637-45, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26866771

RESUMO

A single nucleotide variant within the promoter of the 5-hydroxytryptamine1A (5HT1A) receptor, rs6295, is part of a binding site for the transcription factor. We aimed to ascertain whether the rs6295 mediates the effect of exercise on depressive mood in elderly endurance athletes. We prospectively enrolled 55 elderly athletes (marathon runners/bicyclists) and 58 controls. In a controlled, univariate model, an interaction between the [C]-allele and physical activity indicated that only among athletes, the variant resulting in an imperfect NUDR binding site was associated with a lower depression score. Hence, athletes presented with a significantly lower relative risk of achieving a suspicious depression score among carriers of at least one [C]-allele. Our results suggest that the positive effect of physical exercise on depressive mood might be mediated by the 5HT1A receptor and the extent of this protective effect seems to be enhanced by the [C]-allele of the rs6295 variant.


Assuntos
Atletas/psicologia , Depressão/genética , Resistência Física/genética , Polimorfismo de Nucleotídeo Único/genética , Receptor 5-HT1A de Serotonina/genética , Idoso , Alelos , Proteínas de Ligação a DNA , Feminino , Humanos , Masculino , Proteínas Nucleares/metabolismo , Escalas de Graduação Psiquiátrica , Receptor 5-HT1A de Serotonina/metabolismo , Corrida/psicologia , Fatores de Transcrição
11.
Int J Clin Exp Hypn ; 62(3): 260-91, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24837060

RESUMO

This study compared the effectiveness of hypnobehavioral therapy (HypBe) and HypBe enhanced by elements of energetic psychotherapy (hypnoenergetic therapy, HypEn) for obese women. Sixty clients were randomized to either HypBe or HypEn. Body weight, BMI, eating behavior, and body concept were assessed at baseline, posttreatment, and at a follow-up. Mixed ANOVA models and effect sizes were used for statistics. Both treatments improved weight, BMI, eating behavior, and some aspects of body concept. Improvements in eating behavior and body concept were higher for those who also lost weight (responders). Weight and BMI reductions were not significantly different for the HypEn versus HypBe groups at follow-up.


Assuntos
Terapia Comportamental/métodos , Hipnose/métodos , Obesidade/terapia , Psicoterapia/métodos , Acupressão , Adulto , Idoso , Imagem Corporal , Terapia Combinada , Comportamento Alimentar , Feminino , Humanos , Pessoa de Meia-Idade , Obesidade/psicologia , Inquéritos e Questionários , Redução de Peso
12.
Int J Radiat Oncol Biol Phys ; 89(2): 260-7, 2014 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-24721589

RESUMO

PURPOSE: To investigate the psychological consequences of high-dose-rate brachytherapy with 2 fractions in 1 application under spinal/epidural anesthesia in the treatment of locally advanced cervical cancer. METHODS AND MATERIALS: In 50 patients with locally advanced cervical cancer, validated questionnaires were used for prospective assessment of acute and posttraumatic stress disorder (ASD/PTSD) (Impact of Event Scale-Revision), anxiety/depression (Hospital Anxiety and Depression Scale), quality of life (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30/Cervical Cancer 24), physical functioning (World Health Organization performance status), and pain (visual analogue scale), before and during treatment and 1 week and 3 months after treatment. Qualitative interviews were recorded in open format for content analysis. RESULTS: Symptoms of ASD occurred in 30% of patients 1 week after treatment; and of PTSD in 41% 3 months after treatment in association with this specific brachytherapy procedure. Pretreatment predictive variables explain 82% of the variance of PTSD symptoms. Helpful experiences were the support of the treatment team, psychological support, and a positive attitude. Stressful factors were pain, organizational problems during treatment, and immobility between brachytherapy fractions. CONCLUSIONS: The specific brachytherapy procedure, as performed in the investigated mono-institutional setting with 2 fractions in 1 application under spinal/epidural anesthesia, bears a considerable risk of traumatization. The source of stress seems to be not the brachytherapy application itself but the maintenance of the applicator under epidural anesthesia in the time between fractions. Patients at risk may be identified before treatment, to offer targeted psycho-social support. The patients' open reports regarding helpful experiences are an encouraging feedback for the treatment team; the reported stressful factors serve as a basis for improvement of patient management, especially regarding pain control.


Assuntos
Braquiterapia/efeitos adversos , Transtornos de Estresse Pós-Traumáticos/etiologia , Estresse Psicológico/etiologia , Neoplasias do Colo do Útero/radioterapia , Doença Aguda , Adulto , Idoso , Anestesia Epidural , Raquianestesia , Ansiedade/diagnóstico , Braquiterapia/instrumentação , Braquiterapia/métodos , Depressão/diagnóstico , Fracionamento da Dose de Radiação , Feminino , Humanos , Incidência , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Dor/psicologia , Medição da Dor , Posicionamento do Paciente/psicologia , Projetos Piloto , Estudos Prospectivos , Pesquisa Qualitativa , Fatores de Risco , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/psicologia , Estresse Psicológico/diagnóstico , Estresse Psicológico/psicologia , Inquéritos e Questionários , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/psicologia
13.
Brain Behav Immun ; 37: 23-9, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24513877

RESUMO

A number of studies have shown that mental challenge under controlled experimental conditions is associated with elevations in inflammatory markers such as interleukin-6 (IL-6) and C-reactive protein (CRP). However, relatively little work has been done on the effects of 'naturalistic' stressors on acute changes in inflammatory markers. The present study examined whether perceived arousal, valence and dominance in musicians are associated with pro-inflammatory and oxidative responses to a concert situation. Blood and salivary samples obtained from 48 members of a symphony orchestra on the day of rehearsal (i.e., control situation) and on the following day of premiere concert (i.e., test situation) were used to determine changes in salivary cortisol, pro-inflammatory markers (plasma myeloperoxidase, serum CRP, plasma IL-6), oxidative stress markers (paraoxonase1 activity and malondialdehyde), and homocysteine, a risk factor for vascular disease. Results of regression analyses showed a significant trend to increased myeloperoxidase (MPO) response in individuals with low valence score. Both affective states, valence and arousal, were identified as significant predictors of cortisol response during concert. In addition, control levels of plasma malondialdehyde were positively correlated with differences in IL-6 levels between premiere and rehearsal (r=.38, p=.012), pointing to higher oxidative stress in individuals with pronounced IL-6 response. Our results indicate that stress of public performance leads to increased concentrations of plasma MPO (20%), IL-6 (27%) and salivary cortisol (44%) in musicians. The decreasing effect of pleasantness on the MPO response was highly pronounced in non-smokers (r=-.60, p<.001), suggesting a significant role of emotional valence in stress-induced secretion of MPO. Additional studies are needed to assess the generalizability of these findings to other 'naturalistic' stress situations.


Assuntos
Afeto/fisiologia , Estresse Psicológico/metabolismo , Adulto , Proteína C-Reativa/análise , Feminino , Humanos , Hidrocortisona/análise , Inflamação/metabolismo , Interleucina-6/sangue , Masculino , Pessoa de Meia-Idade , Música , Estresse Oxidativo/fisiologia , Peroxidase/sangue , Adulto Jovem
14.
Am J Gastroenterol ; 108(4): 602-9, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23419384

RESUMO

OBJECTIVES: Gut-directed hypnotherapy (GHT) in individual sessions is highly effective in the treatment of irritable bowel syndrome (IBS). This study aimed to assess the long-term effect of GHT in group sessions for refractory IBS. METHODS: A total of 164 patients with IBS (Rome-III-criteria) were screened, and 100 refractory to usual treatment were randomized 1:1 either to supportive talks with medical treatment (SMT) or to SMT with GHT (10 weekly sessions within 12 weeks). The primary end point was a clinically important improvement on several dimensions of daily life (assessed by IBS impact scale) after treatment and 12-month follow-up. The secondary end point was improvement in general quality of life (QOL; Medical Outcome Study Short-Form-36), psychological status (Hospital Anxiety Depression Scale) and reduction of single IBS symptoms. Analysis was by intention to treat. RESULTS: A total of 90 patients received allocated intervention. After treatment, 28 (60.8%) out of 46 GHT patients and 18 (40.9%) out of 44 SMTs improved (absolute difference 20.0%; 95% confidence interval (CI): 0-40.2%; P=0.046); over 15 months, 54.3% of GHT patients and 25.0% of controls improved (absolute difference 29.4%; 95% CI 10.1-48.6%; P=0.004). GHT with SMT improved physical and psychological well being significantly more than SMT alone (P<0.001). Gender, age, disease duration and IBS type did not have an influence on the long-term success of GHT. CONCLUSIONS: GHT improves IBS-related QOL, is superior to SMT alone, and shows a long-term effect even in refractory IBS.


Assuntos
Hipnose/métodos , Síndrome do Intestino Irritável/terapia , Qualidade de Vida , Índice de Gravidade de Doença , Adulto , Ansiedade , Áustria , Depressão , Feminino , Seguimentos , Humanos , Síndrome do Intestino Irritável/psicologia , Masculino , Pessoa de Meia-Idade , Medição da Dor , Psicoterapia de Grupo , Resultado do Tratamento
15.
J Clin Psychol Med Settings ; 18(4): 400-9, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21969226

RESUMO

Using the example of a voiding cystourethrogram (VCUG), a painful radiological procedure, this study investigated whether parental soothing behavior (reassuring comments like "it's almost over" or "You're O.K." and soothing by "sh, sh") in one phase of the procedure influenced the child's distress in the following phase. The sample was comprised of 68 2-8 year-old children and the accompanying parent(s). Child and parental behavior during the VCUG was coded using a standardized rating scale (CAMPIS-R). Parental reassurance during the anticipatory phase significantly increased the child's distress of the following phase, while parental "sh, sh" significantly reduced it. Both parental behaviors showed no significant effect on the child's distress of the following phase when applied during the procedure itself. Results underline the importance of differentiating between anticipatory and procedural phases of the VCUG. Counselling methods for parents on more appropriate strategies to assist their children during procedural phases of the VCUG are necessary.


Assuntos
Adaptação Psicológica , Poder Familiar/psicologia , Estresse Psicológico/psicologia , Urografia/psicologia , Criança , Comportamento Infantil/psicologia , Pré-Escolar , Feminino , Humanos , Masculino , Pais/psicologia , Estresse Psicológico/etiologia , Urografia/efeitos adversos
16.
Bioelectromagnetics ; 31(3): 173-9, 2010 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19753600

RESUMO

There is extensive literature on possible effects of extremely low-frequency magnetic fields (ELF-MFs) on human cognitive functions. However, due to methodological deficits (e.g., low statistical power, small sample sizes) findings have been inconsistent. In the current study we try to overcome these problems by carrying out a meta-analysis. Literature research revealed 17 studies. Nine of these were included in the meta-analysis because they fulfilled minimum requirements (e.g., at least single-blind experimental study design and documentation of means and standard deviation of the dependent variables). All of the studies used a 50 Hz magnetic field exposure. Small but significant effect sizes could be detected in two cognitive dimensions: in the hard level of visual duration discrimination, task-exposed subjects performed better than controls; at the intermediate level however, exposed subjects performed worse. Additionally, a significant improvement of correct responses was observed in the dimension of "flexibility" under exposure. However, due to the small number of studies per performance dimensions and the resulting instability of estimates, these findings have to be treated with extreme caution. Taken together, the results of the meta-analysis provide little evidence that ELF-MFs have any effects on cognitive functions.


Assuntos
Cognição , Campos Eletromagnéticos , Adolescente , Adulto , Idoso , Transtornos Cognitivos/etiologia , Discriminação Psicológica , Campos Eletromagnéticos/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Percepção Visual , Adulto Jovem
17.
Psychother Psychosom Med Psychol ; 60(3-4): 118-25, 2010.
Artigo em Alemão | MEDLINE | ID: mdl-19399699

RESUMO

OBJECTIVES: Little is known about the attitude of medical students towards psychotherapy and the influence of lectures on psychotherapy during the medical curriculum on these attitudes. METHODS: 2 years in a row, medical students of the Medical University of Vienna in their fourth academic year were asked regarding their attitudes, connotations and associations towards psychotherapy before and after a 5-week psychotherapeutic course. RESULTS: The attitudes of the medical students were predominantly positive, while some prejudices could be found. The students' sex and prior experience with psychotherapy influenced their attitudes. The attitudes turned out to be relatively resistant to change through teaching. CONCLUSIONS: Reasons for the small influence of the training program on the students' attitudes and possible improvements of the course (small lecture groups) are discussed.


Assuntos
Atitude do Pessoal de Saúde , Psicoterapia/educação , Estudantes de Medicina , Adulto , Currículo , Coleta de Dados , Feminino , Humanos , Masculino , Fatores Sexuais , Inquéritos e Questionários , Adulto Jovem
18.
Pflege ; 22(6): 401-9, 2009 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-19943225

RESUMO

Patient orientation and patient participation are important aspects of modern health care and should be taken into consideration in the context of nursing care decision-making. The concept of evidence-based nursing also includes patient preferences in participation on decision-making, an area, however, which has not been adequately investigated so far. The aim of the present study was the development and testing of an instrument in German language for collecting data on patients' preferences and the experience of patients regarding their participation in nursing care decision-making in acute hospitals. The generation of items was based on available literature and in collaboration with specialists, using the theoretical model of Charles, Gafni and Whelan (1999). For testing the instrument, data was collected on 967 adult patients in surgical and medical wards of five hospitals in Vienna from October 2007 to March 2008. Test theoretical analyses included checking internal consistency, construct validity and criterion validity. The reliability of the scale preference and experience were confirmed by Cronbach's alpha (> or = 0.84) and the results of item analysis. The construct validity was supported by representing the decision model in the data. The criterion validity (concordant and discriminant validity) was tested with the two external criterions of subjective satisfaction with the information provided and decision making, and was supported by the results both at the level of total scores and at the level of item scores. In summary, the developed instrument represents an adequately reliable and valid test-theoretic, and also model-theoretic instrument for research in the field of evidence-based nursing. Therefore it is capable of gathering new knowledge on patients' preferences on participation in nursing care decision making.


Assuntos
Coleta de Dados/estatística & dados numéricos , Participação do Paciente/psicologia , Satisfação do Paciente , Assistência Centrada no Paciente/estatística & dados numéricos , Inquéritos e Questionários , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Áustria , Pesquisa em Enfermagem Clínica/estatística & dados numéricos , Estudos Transversais , Enfermagem Baseada em Evidências/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Paternalismo , Educação de Pacientes como Assunto/estatística & dados numéricos , Psicometria/estatística & dados numéricos , Garantia da Qualidade dos Cuidados de Saúde/estatística & dados numéricos , Reprodutibilidade dos Testes , Adulto Jovem
19.
Pflege ; 22(6): 411-9, 2009 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-19943226

RESUMO

Patients' preferences regarding their participation in nursing care decisions represent a key aspect of the concept of evidence-based nursing; nonetheless, very little quantitative research has been carried out in this area. The aim of the present study was to describe the patients' preferences and experience concerning their participation in nursing care decision-making processes in acute hospitals. A total of 967 patients in five hospitals in Vienna participated in this study by completing questionnaires. The results revealed that 38.5 % of patients preferred the paternalistic style of decision-making, 42.1 % wanted to make decisions together with the nursing staff and 5.7 % expressed a wish to make their own decisions. During their hospital stay, however, patients experienced paternalistic decision-making to a higher degree than they wished for. Age, sex, form of treatment and subjectively experienced health condition represented person-related characteristics that influenced preferences regarding the form of decision-making. The results of this study underline the importance of collecting data on patients' preferences in decision-making processes in order to meet the social, legal, and professional demands of patient-oriented nursing care based on the most recent scientific knowledge.


Assuntos
Coleta de Dados/estatística & dados numéricos , Participação do Paciente/psicologia , Satisfação do Paciente , Assistência Centrada no Paciente/estatística & dados numéricos , Inquéritos e Questionários , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Áustria , Pesquisa em Enfermagem Clínica/estatística & dados numéricos , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria/estatística & dados numéricos , Reprodutibilidade dos Testes , Fatores Sexuais , Adulto Jovem
20.
Neuropsychiatr ; 23(2): 91-100, 2009.
Artigo em Alemão | MEDLINE | ID: mdl-19573502

RESUMO

OBJECTIVES: Considering the specific situation of psychotherapy in Austria with its wide range of different therapeutic methods which are accredited by law, we investigated their respective level of familiarity and the connotative associations of future therapists and of a sample group of the lay public regarding the different schools. METHODS: 175 persons (students of economics, students at the university clinic for psychoanalysis, and prospective psychotherapists) were interviewed concerning terms of familiarity and popularity of the therapeutic methods. Using the semantic differential we tried to operationalize the resonant connotative associations. RESULTS: There is insufficient information with regards to the existence of the various different schools on the side of the lay public. The connotations of the different groups are similar: independent of the level of familiarity, 4 different types of therapy can cluster-analytically be identified in relation to the 3 factors of the polarity profile (activity-potency-valence). CONCLUSIONS: More extensive information of the public concerning the different therapeutic possibilities is needed. Further the importance of considering subjective connotations in situations of referral and indication is discussed. Specific attention has been given to the situation of prospective psychotherapists.


Assuntos
Psicoterapia/educação , Opinião Pública , Adolescente , Adulto , Terapia Comportamental/educação , Terapia Comportamental/métodos , Coleta de Dados , Feminino , Educação em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Terapia Psicanalítica/educação , Terapia Psicanalítica/métodos , Psicoterapia/métodos , Psicoterapia de Grupo/educação , Psicoterapia de Grupo/métodos , Encaminhamento e Consulta , Estereotipagem , Adulto Jovem
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