Cardiac late events in German breast cancer patients: a validation study on the agreement between patient self-reports and information from physicians.

Background: Self-administered health-status questionnaires are important tools in epidemiology. The objective of the presented validation study is to measure the agreement between breast cancer patients' self-reports and their physicians' information on late cardiac events, and to investigate determinants of agreement. To estimate possible misclassification is an important requirement for observational studies on cardiovascular endpoints.

Loneliness in the elderly is associated with the use of psychotropic drugs.

Objective: The aim of this study was to evaluate the association between loneliness in elderly people with the use of psychotropic drugs.

Methods: A subsample of 3111 participants (ages 55-85) of the large population-based German ESTHER study was included in the study. Loneliness was measured by using a three-item questionnaire.

Significance and costs of complex biopsychosocial health care needs in elderly people: results of a population-based study.

Objective: To improve health care for the elderly, a consideration of biopsychosocial health care needs may be of particular importance-especially because of the prevalence of multiple conditions, mental disorders, and social challenges facing elderly people. The aim of the study was to investigate significance and costs of biopsychosocial health care needs in elderly people.

Methods: Data were derived from the 8-year follow-up of the ESTHER study-a German epidemiological study in the elderly population.

Assessing generalized anxiety disorder in elderly people using the GAD-7 and GAD-2 scales: results of a validation study.

Objective: The aim of this study was to evaluate the validity of the seven-item Generalized Anxiety Disorder scale (GAD-7) and its two core items (GAD-2) for detecting GAD in elderly people.

Methods: A criterion-standard study was performed between May and December of 2010 on a general elderly population living at home. A subsample of 438 elderly persons (ages 58-82) of the large population-based German ESTHER study was included in the study.

Gender specific temporal and cross-sectional associations between BMI-class and symptoms of depression in the elderly.

Objective: The aim of the study was the gender specific analysis of cross-sectional and longitudinal associations between body mass index class (BMI-class) and symptoms of depression in a representative sample of elderly German people.

Methods: At the baseline of the ESTHER study (2000-2002), 9953 participants completed a comprehensive questionnaire including items regarding weight, height, and depression history. After five years, 7808 participants again completed the questionnaire and the 15-item geriatric depression scale (GDS-15).

[Patients' perspectives on behavioral and cognitive changes after hospitalization: a 3-month follow-up cohort study using qualitative and quantitative research methods].

Objectives: To describe patients' subjective perspectives on hospitalization at time of admission, to prospectively investigate patients' views on changes actually achieved after discharge, and to identify predictors of subjective changes 3 months after hospitalization.

Methods: We conducted a 3-month follow-up cohort study using qualitative and quantitative research methods. Consecutive adult inpatients of an internal medicine ward and a ward integrating internal and psychosomatic medicine were included.

Psychiatric comorbidity in cardiovascular inpatients: costs, net gain, and length of hospitalization.

Objective: Although psychiatric comorbidity often goes undetected and untreated in cardiovascular patients, it is not clear whether the costs for a special treatment of psychiatric comorbidity are appropriately reflected in the reimbursement system. To investigate the economic impact of psychiatric comorbidity, we compared costs, returns, net gain, and duration of hospitalization in cardiovascular inpatients with and without psychiatric comorbidity.

Methods: For a period of 2 years, we analyzed costs, net gain, and other outcome variables according to the diagnosis-related group (DRG) system for cardiovascular inpatients of a German university department (n = 940).

Development of a group therapy to enhance treatment motivation and decision making in severely obese patients with a comorbid mental disorder.

Background: The prevalence rate of mental disorders in severely obese patients appears to be high. In the Department of Psychosomatic Medicine, Heidelberg, we established a short outpatient group intervention for severely obese patients with an affective, anxiety, and/or eating disorder who either are not able to make a clear decision for an intensive weight loss program or who have already decided to undergo bariatric surgery but are advised to attend a support group before surgery. The aim of the group intervention was to reduce depressive symptoms and, in indecisive patients, to enhance the motivation of the patients for engagement in further intensive treatment programs, including bariatric surgery.

[Outcome of simultaneous psychosomatic/internal-medicine inpatient care--a naturalistic follow-up study].

Objectives: The effectiveness of simultaneous psychosomatic and internal-medicine inpatient care has not yet been satisfyingly investigated. What outcome is found in patients treated in a psychosomatic/internal medicine setting? Can we predict a reduction in depression and symptom severity?

Methods: The study design is prospective and naturalistic. Patients from a psychosomatic/internal-medicine setting and a solely internal-medicine ward filled in self-report questionnaires on the day of admission, five days thereafter, and three months after discharge.

Risk factors of symptom underestimation by physicians.

Objective: The aims of this study were to characterize patient-physician agreement on various psychological and somatic symptoms in internal medicine inpatients and to identify predictors of symptom severity underestimation by physicians.

Methods: Consecutive adult inpatients of two internal medicine wards of a university hospital completed visual analogue scales (VASs) for severity of disability, anxiety, depression, somatic symptoms, and pain at the time of admission (n=639, participation rate=70%) and 5 days thereafter (n=401, participation rate=82%). In addition, the Patient Health Questionnaire 9 (PHQ-9) depression scale and the Clinical Global Impression Scale--Revised were used.

Effectiveness of a 1-year resident training program in clinical research: a controlled before-and-after study.

Background: To increase the number of clinician scientists and to improve research skills, a number of clinical research training programs have been recently established. However, controlled studies assessing their effectiveness are lacking.

Objective: To investigate the effectiveness of a 1-year resident training program in clinical research.

[Crash course "clinical research in psychosocial medicine": changes in research knowledge and subjective research competence].

In the field of psychosocial medicine, there is a lack of structured training programs in clinical research methodology for young investigators. This study investigates changes in research knowledge and subjective research competence during a one-day crash course in clinical research. In addition, the participants evaluated the quality of the course.

[Elevated costs of treatment in medical inpatients with psychiatric comorbidity are not reflected in the German DRG-system].

Objective: So far, it remains unclear whether treatment of psychiatric comorbidity in medical inpatients is appropriately reflected in the German Diagnosis-Related Groups (DRG) system. Therefore, we investigated the relationship of psychiatric disorders and costs, returns, net gain, and duration of hospitalization in internal medicine inpatients.

Methods: For a period of 1 year, we analyzed costs, net gain and other outcome variables according to the DRG system for all inpatients of a university department of internal and psychosomatic medicine (n = 697).