Anxiety Disorders: Schützwohl M

Gavrilovic JJ, Schützwohl M, Fazel M, Priebe S. · Unit for Social and Community Psychiatry, Barts and the London School of Medicine, Queen Mary, University of London, United Kingdom. · J Trauma Stress. · Pubmed #16382432 No free full text.

Abstract: This review aimed to identify factors associated with seeking treatment from mental health services after a traumatic event. Databases of literature were searched in a systematic manner and 24 relevant articles were found. Although many of the findings are inconsistent, the most important factors associated with treatment seeking appear to be a higher level of psychopathology, the type and level of the traumatic event, and sociodemographic characteristics, in particular female gender. Even though the evidence is insufficient to guide service development, suggestions for future research are made. The methodological quality of research should be improved to establish whether the inconsistency of findings reflects methodological artefacts or true differences between different samples and contexts.

Schützwohl M. · Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum C. G. Carus, TU Dresden. · Fortschr Neurol Psychiatr. · Pubmed #11037640 No free full text.

Abstract: A powerful motivation for clinicians working in the field of trauma is the wish to prevent or minimize chronic posttraumatic reactions by early interventions. This paper illustrates the process and the elements of important programs that have been introduced into the psychological or psychiatric literature. Studies that have been done to evaluate these programs are discussed. With regard to early interventions given to traumatized victims regardless of whether they suffer from posttraumatic stress or not, it is clearly shown that the evidence that these programs have a substantial positive benefit is disappointingly scarce. However, with regard to the treatment of acute stress disorder, a brief cognitive-behavioral program appears to effectively prevent the development of chronic posttraumatic stress disorders. In summary, it has to be noted that much more research on this issue is needed.

Rymaszewska J, Jarosz-Nowak J, Kiejna A, Kallert T, Schützwohl M, Priebe S, Wright D, Nawka P, Raboch J. · Department of Psychiatry, Wroclaw Medical University, Wyb. L. Pasteura 10, 50-367 Wroclaw, Poland. · Eur Psychiatry. · Pubmed #17227704 No free full text.

Abstract: OBJECTIVE: To assess the social disability of people with different psychiatric disorders. METHODS: Cross-site survey in five psychiatric hospitals (Dresden, Wrocław, London, Michalovce and Prague). Working-aged patients diagnosed (ICD-10) with schizophrenia and related disorders (F2), affective disorders (F3), anxiety disorders (F4), eating disorders (F5) and personality disorders (F6), were assessed at admission (n=969) and 3 months after discharge (n=753) using the Brief Psychiatric Rating Scale and the Groningen Social Disability Schedule. The main outcome measure was Interviewer-rated social disability. RESULTS: During acute episodes patients with personality, eating and schizophrenic disorders functioned less effectively than those with affective or anxiety disorders. After controlling for age and severity of psychopathology, there was no significant effect of the diagnosis (during remission), sex, education and history of disorder on disability. Site, employment and partnership were significant factors for the level of social disability in both measure points. CONCLUSION: Severity of psychopathological symptoms, not the diagnosis of a mental disorder, was the most significant factor in determining the level of social functioning, particularly during the remission period. Site, employment and partnership appeared as significant factors influencing the level of social disability.

Schützwohl M, Koch R, Kallert TW. · Klinik und Poliklinik für Psychiatrie und Psychotherapie am Universitätsklinikum Carl Gustav Carus der TU Dresden. · Psychiatr Prax. · Pubmed #16802261 No free full text.

Abstract: OBJECTIVE: To search for predictors of the discharge status in day-hospital patients and inpatients, within a randomized controlled trial on the effectiveness of acute psychiatric day hospital treatment as compared to inpatient treatment. METHOD: The study was conducted at the Department of Psychiatry and Psychotherapy, Dresden University of Technology. Regression analyses assessing the relationship between theoretically chosen predictor variables and the discharge status as measured using the Brief Psychiatric Rating Scale (BPRS 4.0) were conducted on a sample of 69 day-hospital patients and a sample of 76 inpatients. RESULTS: In both settings, admission status was the strongest predictor of discharge status. As concerns day-hospital patients, those suffering from a personality disorder as well as those showing a higher degree of social disability were discharged with a higher level of psychopathological symptoms. Among inpatients, those suffering from an anxiety, obsessive-compulsive, or adjustment disorder as well as those being retired or unemployed benefited less from treatment. CONCLUSIONS: Given the explorative character of the present study, further prospective studies are needed in order to cross-validate findings on the potential criteria for allocating acute mentally ill either to day-hospital or inpatient treatment.

Maercker A, Beauducel A, Schützwohl M. · Department of Psychology, Dresden University of Technology, Germany. · J Trauma Stress. · Pubmed #11109237 No free full text.

Abstract: This study explores the relationships among trauma severity, initial trauma reactions, posttraumatic stress disorder (PTSD) symptoms, and dissociation in a group of 98 former East-German political prisoners. Trauma severity and initial reactions were assessed using a persecution checklist and a coping process questionnaire. PTSD symptoms were assessed through a structured clinical interview. Chronic dissociation was evaluated using the Dissociative Experiences Scale. The two assumptions of the study were confirmed by structural equation modeling: (1) Lifetime PTSD symptoms were predominantly predicted by initial reactions to trauma and (2) chronic dissociation was predominantly predicted by trauma severity. The first finding is discussed in relation to the participants' initial trauma processing. The second finding is discussed especially in the context of trauma duration and dissociation-prone coping attempts. Limitations concerning the long-term interval between traumatization and data collection are discussed.

Schützwohl M, Maercker A. · Department of Psychiatry, Dresden University of Technology, Germany. · J Nerv Ment Dis. · Pubmed #10972566 No free full text.

Abstract: Anger is a salient symptom of traumatized victims and a major sign for posttraumatic stress disorder (PTSD). However, the causes for the increased level of anger remain almost unknown. The present study investigates the interrelationship of anger, posttraumatic stress reactions, and social support in a group of former East German political prisoners (N = 91). Assessments included the German version of the Anxiety Disorders Schedule (DIPS) as well as measures of anger (STAXI), posttraumatic stress reactions (IES-R), and social support (SSQ). As expected, participants reported a high level of anger. Most measures of anger, posttraumatic stress reactions, and social support were significantly correlated. Within structural equation modeling, trait-anger was shown to be directly activated by the experience of chronic posttraumatic intrusions. Social support appeared to lessen the level of anger. The results confirm findings from studies on other traumatic events and provide additional information on the relationship between posttraumatic anger and social support. The findings indicate that treatments for PTSD might be effectively supplemented by addressing anger and social support.

Schützwohl M, Maercker A. · Dresden University of Technology, Germany. · J Trauma Stress. · Pubmed #10027149 No free full text.

Abstract: The purpose of the present study was to investigate the appropriateness of different diagnostic criteria sets for posttraumatic stress disorder (PTSD). This was done by varying diagnostic criteria on the diagnosis of PTSD in a study group of N = 146 former political prisoners, and comparing the resulting diagnostic groups with a study group of N = 75 nontraumatized controls with regard to mean scores on measures of subjective distress (i.e., IES-R, BDI, BAI, SCL-90-R). The findings did not support the diagnostic boundaries as defined by the DSM-IV or the lowering of the avoidance criterion from three to two symptoms. The concept of partial PTSD appeared to be the most appropriate way to provide diagnostic coverage for those who did not meet full DSM IV criteria.