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Fremd- und Selbstbeurteilungsverfahren bei der Diagnostik und Therapie psychischer Erkrankungen
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Relationship of periodic leg movements and severity of restless legs syndrome: A study in unmedicated and medicated patients
No full textObjective: To evaluate the relationship of the severity of restless legs syndrome (RLS) as assessed by a subjective, patient-rated scale (International RLS Study Group Rating Scale, IRLS), and of periodic leg movements in sleep (PLMS) as an objective parameter, in two different patient populations. Methods: Data of 200 unmedicated patients with idiopathic RLS were evaluated. Group 1 (n = 100) consisted of selected patients participating in the Pergolide European Australian RLS (PEARLS) study. Group 2 (n = 100) represented an outpatient RLS population investigated in a Sleep Disorders Center. Additionally, Group 1 was also evaluated after a 6 week double-blind treatment period, where 47 patients received pergolide and 53 patients placebo. Results: In unmedicated patients, IRLS scores correlated with the PLMS-arousal index (r = 0.22, p = 0.033) but not with the PLMS index in Group I while no correlation was found in Group 2. The change of the IRLS score under treatment in Group 1 correlated significantly both with the change of the PLMS index (r = 0.42, p < 0.001) and the change of the PLMS-arousal index (r = 0.38,p < 0.001). Conclusions: The IRLS adequately reflects treatment changes of PLMS indices. In unmedicated patients, the IRLS correlates with PLMS indices probably only in selected RLS populations with predefined PSG criteria and high PLM activity. Significance: The IRLS is an appropriate subjective rating scale for measuring treatment effects in RLS. (c) 2007 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved
Pathways between Child Maltreatment, Psychological Symptoms, and Life Satisfaction: A Network Analysis in Adolescent Inpatients
No full textChild maltreatment is a risk factor for mental disorders and decreased life satisfaction during adolescence. We investigated whether child maltreatment would link to life satisfaction both directly and through psychological symptoms, whether these relations would change from admission to discharge after treatment, and which types of maltreatment, symptoms and facets of life satisfaction would be most influential in adolescent inpatients with internalizing mental disorders. N = 896 adolescent receiving inpatient psychotherapeutic treatment completed questionnaires on child maltreatment experiences, current psychopathology and subjective life satisfaction at admission and discharge (n = 765). Main diagnoses were affective (n = 322), eating (n = 447), obsessive-compulsive (n = 70) and anxiety disorders (n = 57). Network models of child maltreatment, psychopathology and life satisfaction nodes were estimated at admission and discharge and compared using network comparison tests. Potential causal shortest pathways were investigated using directed acyclic graphs.Network models were stable with no significant differences between admission and discharge. Strongest nodes of each cluster were "emotional abuse" (child maltreatment), "worthlessness", "thinking about dying" and "feeling lonely" (psychopathology) and "satisfied with life" (life satisfaction) at both admission and discharge. Emotional neglect showed direct connections to life satisfaction, indicating its relevance for therapeutic interventions. At both admission and discharge, "sexual abuse" indirectly predicted lower life satisfaction through psychological symptoms. In conclusion, child maltreatment is directly and indirectly connected to life satisfaction in adolescents with mental disorders. Emotional abuse and neglect were especially important in linking child maltreatment to life satisfaction and psychopathology
Effects of Childhood Emotional Abuse on Treatment Outcome in Adolescent Inpatients With Anorexia Nervosa
No full textObjective: Although childhood maltreatment, especially emotional abuse, is strongly linked to the psychopathology of anorexia nervosa (AN), the impact of such a traumatic experience on treatment outcome is not clear. This study aimed to explore how emotional abuse affects change in psychopathology during treatment. Method: Adolescents with AN (n = 331) completed the Childhood Trauma Questionnaire at admission to inpatient treatment and the Eating Disorder Inventory-2, Patient Health Questionnaire-9, Patient Health Questionnaire-15, and Generalized Anxiety Disorder-7 both at admission and at discharge. Relationships of emotional abuse with body mass index (BMI) and questionnaire scores at admission and at discharge were examined with percentage bend correlation coefficients. Changes in BMI and questionnaire scores from admission to discharge and whether these changes were moderated by emotional abuse were tested with robust mixed models. Results: Higher emotional abuse scores related to higher eating disorder, depressive, anxiety, and somatic symptoms but not to BMI at admission and at discharge. BMI increased and eating disorder, depressive, anxiety, and somatic symptoms decreased from admission to discharge but these changes were not moderated by emotional abuse scores. Discussion: Emotional abuse did not affect treatment response during hospitalization for AN, but it was associated with heightened eating and general psychological symptom severity at both hospital admission and discharge. Clinicians are advised to investigate a history of emotional abuse in adolescents with AN and to consider emotional abuse not as a predictor of treatment resistance, but as a psychological scar that persists regardless of symptom severity
Evidence and perspectives in eating disorders: a paradigm for a multidisciplinary approach
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