Reha-Psychologie – Aktuell - Klinische Psychologie in der medizinischen Rehabilitation

Kernaussagen

1. Auch gesunde Personen grübeln und machen sich Sorgen; sie können diese wiederkehrenden Gedanken jedoch wieder ohne anhaltende, tief greifende Stimmungseinbußen beenden. Bei Depression und Generalisierter Angststörung tritt häufig lang anhaltendes Gedankenkreisen, Grübeln und sich Sorgen auf, das sich verheerend auf Stimmung und Konzentration auswirkt und verhindert, dass die einfachsten Aufgaben in Angriff genommen werden können.
2. In mehreren großen, gut kontrollierten Längsschnittstudien wurde gefunden, dass depressives Grübeln einen Prädiktor für eine depressive Episode darstellt. Aus diesem Grund ist es unerlässlich, z. B. im Rahmen von Anpassungsstörungen oder anderen psychiatrischen Störungen darauf zu achten, in welchem Umfang der Patient grübelt, welche positiven Erwartungen er dem Grübeln zuschreibt und welche Copingstrategien er anwendet. In der psychotherapeutischen Behandlung kann depressives Grübeln den Behandlungserfolg deutlich schmälern und verzögern, nicht zuletzt deshalb gilt es, bereits zu Beginn der Psychotherapie auf die Veränderung von Grübelgedanken hinzuwirken. Auch bei gebesserten Patientinnen und Patienten sollte im Verlauf auf „riskantes” oder heimliches Grübeln geachtet werden. (weiterlesen…)

Cyberbullying has been described as a type of electronic bullying and has recently been subjected to intense media scrutiny largely due to a number of high profile and tragic cases of teen suicide. Despite the media attention relatively little is known about the nature of cyberbullying. (weiterlesen…)

Although employers commonly review administrative database indicators to assess depression treatment quality, they do not know whether these indicators predict relevant outcomes like absenteeism. In 230 employed patients in five health plans, we tested how administrative database-derived indicators for antidepressant medication and psychotherapy provided during the first 6 months of a new depression treatment episode predicted patient-reported absenteeism change over 12 months. The medication indicator was not significantly associated with absenteeism change over 12 months (p= .64); however, the psychotherapy indicator was significantly associated with an average 26.1% improvement in absenteeism over 12 months (p< .05). If subsequent studies confirm the results we report, quality monitoring initiatives interested in employer-relevant indicators of depression treatment quality should examine administrative database indicators of psychotherapy.

Quelle: SpringerLink – Zeitschriftenbeitrag

Objective: To examine the role of self-efficacy and depression as potential pathways from physical activity to fatigue in two study samples: breast cancer survivors (BCS) (n = 192) and individuals with multiple sclerosis (MS) (n = 292).

Methods: We hypothesized that physical activity would be associated indirectly with fatigue through its influence on self-efficacy and depressive symptomatology. A cross-sectional path analysis (BCS) and a longitudinal panel model (MS) were conducted within a covariance modeling framework.
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Objective: To identify moderators that influence the relationship of anxiety and long-term prognosis in patients with coronary heart disease (CHD). It has been an ongoing source of controversy what the long-term effects of anxiety are on mortality in patients with CHD, suggesting heterogeneity in prognostic parameters.

Methods: The prognostic role of anxiety was examined in a large sample of patients (n = 4864), who completed the Hospital Anxiety and Depression Scale (HADS) before routine exercise testing. At 5-year follow-up, survival data were obtained and mortality was assessed by means of Cox proportional hazard models.

Results: In the whole sample, higher anxiety scores were associated with reduced mortality (weiterlesen…)

Objective: To examine the cross-sectional associations between generalized anxiety disorder (GAD) and major depressive disorder (MDD), their comorbidity, and hypertension.

Methods: Participants (n = 4180) were drawn from a cohort of men who were members of the U.S. army during the Vietnam war era. Occupational, sociodemographic, and health data were collected from military service files, telephone interviews, and medical examinations. Hypertension status was defined by the presence of (weiterlesen…)

Objective: To evaluate the association between secondhand smoke (SHS) exposure and depression. Tobacco smoking and depression are strongly associated, but the possible effects of SHS have not been evaluated.

Methods: The 2005 to 2006 National Health and Nutrition Examination Survey (NHANES) is a cross-sectional sample of the noninstitutionalized civilian U.S. population. SHS exposure was measured in adults aged ≥20 years by serum cotinine and depressive symptoms by the Patient Health Questionnaire. Zero-inflated Poisson regression analyses were completed with adjustment for survey design and potential confounders.

Results: Serum cotinine-documented SHS exposure was positively associated with depressive symptoms in never-smokers, (weiterlesen…)

Objective: To examine the effect of depression treatment on medical and social outcomes for individuals with chronic pain and depression. People with chronic pain and depression have worse health outcomes than those with chronic pain alone. Little is known about the effectiveness of depression treatment for this population.

Methods: Propensity score-weighted analyses, using both waves (1997–1998 and 2000–2001) of the National Survey of Alcohol, Drug, and Mental Health Problems, were used to examine the effect of a) any depression treatment and b) minimally adequate depression treatment on persistence of depression symptoms, depression severity, pain severity, overall health, mental health status, physical health status, social functioning, employment status, and number of workdays missed. (weiterlesen…)