Effectiveness of inpatient versus outpatient complex treatment programs in depressive disorders: a quasi-experimental study under naturalistic conditions.

Background: Due to long waiting periods for outpatient psychotherapy and the high resource requirements of inpatient treatment, there is a need for alternative treatment programs for patients with depressive disorders. Thus, we investigated the effectiveness of the "Bielefeld Outpatient Intensive Treatment Program of Depression" (BID) in comparison with a typical inpatient treatment program by using a prospective quasi-experimental observational study. We assumed (i) that both complex programs are effective in pre-post analyses after 6 weeks and (ii) that inpatient treatment is more effective compared with the outpatient program.

[Management of Transition - Problems and Suggestions for Improvement from Psychiatric Outpatient Clinics].

The structure of psychiatric outpatient clinics with multi-professional treatment teams provides a suitable frame for a successful transition from child to adult treatment settings. At present, however, the management of transition, especially for severely mentally ill adolescents, is unsatisfactory. In order to optimize conditions of transition, the following measures are proposed:▪ use of structured transfer sheets▪ round table conferences▪ shared trainings of child and adult psychiatrists▪ development of specific consultation hours for adolescents in transition; financial funding has to be established by health insurances.

Psychiatric lifetime diagnoses are associated with a reduced chance of seizure freedom after temporal lobe surgery.

Objective: To examine whether psychiatric comorbidity is a predictor of long-term seizure outcome following temporal lobe epilepsy surgery.

Methods: A sample of 434 adult patients who received temporal lobe resection to treat epilepsy between 1991 and 2009 and were psychiatrically assessed before surgery were followed for 2 years to assess seizure outcome. Stepwise multivariate logistic regression analyses were used to assess the impact of psychiatric variables on complete seizure freedom (Engel class IA), and freedom from disabling seizures (Engel class I).

Effects of an inpatient rehabilitation program after temporal lobe epilepsy surgery and other factors on employment 2 years after epilepsy surgery.

Objective: To evaluate the effects of a postsurgical rehabilitation program on employment status 2 years after temporal lobe epilepsy surgery in relation to other predictors.

Methods: Employment outcome 2 years after temporal lobe resection in a group of 232 adult patients with the offer of a 3-week inpatient rehabilitation program immediately after surgery ("Reha group") was compared to a group of 119 patients who had surgery before such a rehabilitation program existed. One hundred thirty-nine (59.

Treatment of postsurgical psychiatric complications.

We describe the physical, psychological, and social complications and adaptation demands after epilepsy surgery and the risks of the development of psychiatric disorders when adequate stress processing fails. Practical strategies that can be followed in the prevention and treatment of postsurgical psychiatric complications are reviewed. The postoperative period is divided in three phases: (1) the early postoperative phase of stress processing until discharge from hospital; (2) the coping phase during the first months after discharge; and (3) the reorientation phase.

Long-term outcome and determinants of quality of life after temporal lobe epilepsy surgery in adults.

Aim Of The Study: To find determinants of quality of life (QOL) in long-term follow-up after temporal lobe epilepsy (TLE) surgery in adults.

Methods: The QOLIE-31 questionnaire was sent to 400 of 524 patients who were operated on for refractory TLE between 1991 and 2003 in the Bethel Epilepsy Centre fulfilling the inclusion criteria of this study. Mainly patients with severe cognitive deficits and patients with progressive brain disorders were excluded.

Personality disorders as predictors of severe postsurgical psychiatric complications in epilepsy patients undergoing temporal lobe resections.

Purpose. Psychiatric disorders emerging after temporal lobe resections are a serious problem threatening the surgical success of patients with epilepsy. The present study aims to find psychiatric predictors that would indicate patients' risk to developing severe psychiatric complications after surgery.