Patient-centered placement matching of alcohol-dependent patients based on a standardized intake assessment: process evaluation within an exploratory randomized controlled trial.

Background: In the implementation of placement matching guidelines, feasibility has been concerned in previous research. Objectives of this process evaluation were to investigate whether the patient-centered matching guidelines (PCPM) are consistently applied in referral decision-making from an inpatient qualified withdrawal program to a level of care in aftercare, which factors affect whether patients actually receive matched aftercare according to PCPM, and whether its use is feasible and accepted by clinic staff.

Methods: The study was conducted as process evaluation within an exploratory randomized controlled trial in four German psychiatric clinics offering a 7-to-21 day qualified withdrawal program for patients suffering from alcohol dependence, and with measurements taken during detoxification treatment and six months after the initial assessment.

Patient-Centered Placement Matching of Alcohol-Dependent Patients Based on a Standardized Intake Assessment: Primary Outcomes of an Exploratory Randomized Controlled Trial.

Background: Placement matching guidelines are promising means to optimize patient-centered care and to match patients' treatment needs. Despite considerable research regarding placement matching approaches to optimize alcohol abuse treatment, findings are inconclusive.

Objectives: To investigate whether the use of patient-centered placement matching (PCPM) guidelines is more effective in reducing heavy drinking and costs 6 months after discharge from an inpatient alcohol withdrawal treatment compared to usual referral to aftercare.

Placement matching of alcohol-dependent patients based on a standardized intake assessment: rationale and design of a randomized controlled trial.

Background: Despite considerable research on substance-abuse placement matching, evidence is still inconclusive. The aims of this exploratory trial are to evaluate (a) the effects of following matching guidelines on health-care costs and heavy drinking, and (b) factors affecting the implementation of matching guidelines in the treatment of alcohol-dependent patients.

Methods: A total of 286 alcohol-dependent patients entering one of four participating detoxification units and having no arrangements for further treatment will be recruited.

The place of additional individual psychotherapy in the treatment of alcoholism: a randomized controlled study in nonresponders to anticraving medication-results of the PREDICT study.

Background: Goal of the presented study is to evaluate whether alcohol-dependent patients given additional individual psychotherapy after a heavy relapse during pharmacotherapy remain abstinent for longer than those who continue with pharmacotherapy alone.

Methods: In a randomized, multicenter study, 109 alcohol-dependent patients who had suffered a heavy relapse either while receiving anticraving medication or placebo were randomized into 2 groups. One group received medication, medical management, and additional individual, disorder-specific, cognitive-behavioral psychotherapy, while the control group received medication and medical management only.

Results of a double-blind, placebo-controlled pharmacotherapy trial in alcoholism conducted in Germany and comparison with the US COMBINE study.

The results of placebo-controlled trials (RCTs) with acamprosate or naltrexone vary substantially. Those differences have been attributed to differing patient characteristics, recruitment strategies, treatment settings and remuneration systems. We tested these assumptions by comparing a new double-blind, placebo-controlled randomized trial conducted in Germany (called PREDICT Study) with data from the US COMBINE Study.

Efficacy of psychosocial interventions in men and women with sexual dysfunctions--a systematic review of controlled clinical trials: part 1-the efficacy of psychosocial interventions for male sexual dysfunction.

Introduction: As yet, a summary of research evidence concerning the efficacy of psychological treatment in male sexual dysfunction is lacking.

Aim: Our systematic review gives an overview of the efficacy of psychosocial interventions in all male sexual dysfunctions.

Main Outcome Measures: Main outcome measures included, for example, psychometrically validated scales, interviews, and clinical assessment by an independent rater.

Efficacy of psychosocial interventions in men and women with sexual dysfunctions--a systematic review of controlled clinical trials: part 2--the efficacy of psychosocial interventions for female sexual dysfunction.

Introduction: As yet, a summary of the research evidence concerning the efficacy of psychological treatment in female sexual dysfunction is lacking. Previous reviews were often nonsystematic or explored one specific sexual dysfunction.

Aim: Our systematic review provides an overview of the efficacy of psychosocial interventions in all female sexual dysfunction.

Characteristics of predrinking and associated risks: a survey in a sample of German high school students.

Objectives: Finding predictors for predrinking and placing the new phenomenon of predrinking on a greater database. Predrinking is defined as alcohol consumption, alone or with friends, at home or at public places, before going out in the evening to a party or in bars or discotheques.

Methods: Data were collected from a representative sample of 757 ninth- and tenth-grade students from 31 high schools located in a south German rural region and a city.

[Helpful factors in day treatment for alcohol dependent patients--a qualitative narrative interview approach].

Day treatment for alcohol dependent patients is still uncommon in Germany. The presented study aims to answer the question how patients experience this kind of treatment and which factors they perceive as important for their treatment success.7 interviews with alcohol-dependent patients were conducted.

The efficacy of stepped care models involving psychosocial treatment of alcohol use disorders and nicotine dependence: a systematic review of the literature.

Of particular interest in the psychosocial treatment of addictions is determining how much therapy is required to bring about behaviour change. Stepped care approaches, where non-responders to a less intensive therapy receive a more intensive intervention, aim to only provide intensive assistance to those who need it, thereby allocating therapeutic resources more efficiently. This paper provides a systematic review of stepped care models involving different levels of psychosocial intervention for the treatment of alcohol use disorders and smoking cessation.

What works for patients in outpatient treatment for alcohol addiction? An explorative study into clients' evaluation of subjective factors and therapy satisfaction.

This explorative survey investigated clients' evaluation of therapy elements and other supportive factors within a randomized controlled trial. The treatment of patients with alcohol dependence consisted of pharmacotherapy (acamprosate/naltrexone/placebo) and biweekly medical management (MM). Forty-nine study participants were surveyed with a questionnaire to measure both the patients' satisfaction with the therapy and the subjective assessment of treatment elements and supportive factors.

Interrelationship of sildenafil treatment effects on the physiological and psychosocial aspects of erectile dysfunction of mixed or organic etiology.

Introduction: In a previous paper using mediation modeling, the direct and indirect effects of sildenafil on erection maintenance were demonstrated.

Objective: In an extension of this previous work, the historical psychosocial paradigm of ED, which focuses on performance anxiety, is tested by using mediation modeling to define the relationship of the physiological aspects (hardness and maintenance) and the associated psychosocial aspects (confidence, sexual relationship satisfaction, and performance anxiety) of ED.

Methods: Statistical mediation analysis using the following outcomes from a double-blind placebo-controlled trial of fixed-dose sildenafil 100 mg or 50 mg: Erection Hardness Score; the 15-item International Index of Erectile Function (IIEF), including item 4 (frequency of erection maintenance after penetration) and item 5 (difficulty of erection maintenance to intercourse completion); the Self-Esteem And Relationship questionnaire; and the question, "Do you feel anxious about your next attempt at sexual intercourse?"

Main Outcome Measures: Estimated percentages of direct and indirect effects of sildenafil on psychosocial aspects of ED (95% confidence intervals).

Understanding the effects of sildenafil treatment on erection maintenance and erection hardness.

Introduction: Erectile dysfunction (ED) is defined as the inability to attain and/or maintain penile erection sufficient for satisfactory sexual performance. Although intuitively related, the link between erection hardness and erection maintenance has not been formally established and quantified.

Aim: To understand the components of erection maintenance through statistical modeling.

Effect of sexual function on health-related quality of life mediated by depressive symptoms in cardiac rehabilitation. findings of the SPARK project in 493 patients.

Introduction: Empirical evidence suggests associations between cardiovascular diseases, sexual functioning, depressive symptoms, and quality of life. However, to date, the interrelation of these constructs has not been examined simultaneously in a structural analysis.

Aim: To estimate the prevalence of sexual disorders and depressive symptoms and to examine the association between sexual disorders, depressive symptoms, and quality of life in patients in the rehabilitation of cardiovascular disorders.

Is one question enough to detect female sexual dysfunctions? A diagnostic accuracy study in 6,194 women.

Introduction: Literature shows that recognition of sexual dysfunctions in women is insufficient and existing instruments to aid detection are mostly too extensive to be used in routine practice.

Aim: To develop a brief and accurate screening instrument to detect female sexual dysfunctions in routine care.

Methods: The initial item pool for the index test consisted of 15 items.

Drinking before going out--a predictor of negative nightlife experiences in a German inner city area.

Objective: The aim of the presented study is to identify target groups for early interventions to reduce negative effects of nightlife alcohol consumption and negative nightlife experiences (e.g. involvement in fights) as well as to examine the consumption patterns and identify the need for further interventions.

General practitioners and online continuing medical education - which factors influence its use?

Introduction: Although several online continuing medical education (CME) offers exist, the utilization of these by physicians is still low. In this study, we aimed to investigate the attitude towards and use of the Internet and online CME in German general practitioners (GPs) and to identify potential starting points to increase the use of online CME.

Methods: In June 2006, a standardized 6-page questionnaire with 27 questions on the topic "Internet and online continuing education" was sent to all general practitioners in 6 districts (n=1304) of South Baden and South Württemberg in Germany.

Integrated and independent learning of hand-related constituent sequences.

In almost all daily activities fingers of both hands are used in coordinated succession. The present experiments explored whether learning in such tasks pertains not only to the overall sequence spanning both hands but also to the constituent sequences of each hand. In a serial reaction time task, 2 repeating hand-related sequences were intertwined, so that actions of one hand alternated with actions of the other hand.

Action sequences within and across hands: evidence for hand-related sequence learning.

Recent research into the acquisition of action sequences involving both hands suggests that the hand-related (sub)sequences are learned at least partly independently of one another. Here we investigated hand-related sequence learning with a novel approach. Eight stimuli were divided into two sets.

Playing chess unconsciously.

Expertise in a certain stimulus domain enhances perceptual capabilities. In the present article, the authors investigate whether expertise improves perceptual processing to an extent that allows complex visual stimuli to bias behavior unconsciously. Expert chess players judged whether a target chess configuration entailed a checking configuration.

[Alcohol-specific psychotherapy (ASP) in practice--a survey of psychotherapists].

Background: Aim of this investigation was the therapists' subjective assessment of the Alcoholism Specific Psychotherapy (ASP) in practice. By means of a specifically designed questionnaire, we conducted a survey of 21 psychotherapists trained in the method, and performed a descriptive and qualitative analysis.

Results: Of the 21 therapists who participated in the survey, 13 in total used the complete ASP, and 14 parts thereof.

Association of sexual functioning and quality of partnership in patients in cardiovascular rehabilitation--a gender perspective.

Introduction: In the general population, studies indicate a strong association between sexual dysfunction and partnership quality. Despite a high prevalence of sexual problems in patients with cardiovascular diseases, this association has not yet been examined in this sample.

Aim: The central task of this paper is to determine the association between sexual dysfunction and quality of partnership under a gender-specific view.

[Alcohol use and consumption advice of medical students].

Background: An increased incidence of hazardous alcohol consumption in medical practitioners is widely discussed. We conducted a survey of 80 medical students with a standardized questionnaire in order to assess the impact of harmful drinking patterns on the ideas of recommendations about alcohol consumption intended for patients. The statistical analyses were descriptive and inferential.

Meta-analysis: are 3 questions enough to detect unhealthy alcohol use?

Background: Both the 10-item Alcohol Use Disorders Identification Test (AUDIT) and its abbreviated 3-item version (Alcohol Use Disorders Identification Test-Consumption [AUDIT-C]) are considered to detect unhealthy alcohol use accurately.

Purpose: To examine whether the AUDIT-C is as accurate as the full AUDIT for detecting unhealthy alcohol use in adults.

Data Sources: MEDLINE, EMBASE, CINAHL, Web of Science, PsycINFO, and BIOSIS Previews from 1998 to July 2008.