Showing papers by "Winfried Häuser published in 2005"

Biopsychosocial predictors of fatigue in quiescent and mild ulcerative colitis - an explorative study.

Abstract: In 37 patients with ulcerative colitis (UC) and ileal pouch-anal anastomosis (IPAA) and 40 patients without IPAA fatigue was measured using the Short Form Giesen Subjective Complaints List GBB 24. Age, sex, disease activity (measured by the Colitis Activity Index CAI or the Pouch Disease Activity Index PDAI) and depressiveness (measured by the Hospital Anxiety and Depression Scale or the Center for Epidemiological Studies Depression Scale), active medical comorbidities and therapy by corticosteroids were tested for their predictive capacity regarding fatigue. One third of the patients indicated fatigue scores above the 95th percentile of the score of the general German population. The amount of fatigue in patients without IPAA was best predicted by the degree of depressiveness (corrected R2=0.30, β=0.57, p<0.001). The amount of fatigue in patients with IPAA was best predicted by the PDAI-score (corrected R2=0.20, β=1.35, p=0.03).

[Fibromyalgia in the legal procedures of the german sozialgericht -- psychosocial risk factors and predictors of health care utilization].

Abstract: Retrospectively all consecutive medical expertise within the appraisal of early retirement/occupational disability or of the status of a severely disabled person in 88 people (85 % female) diagnosed with fibromyalgia who were investigated by a structured pain therapist's and psychotherapeutic assessment were analysed. 44 % had a history of psychiatric disorder, 85 % met the criteria of a current psychiatric disorder according ICD-10. 8 % indicated sexual abuse, 16 % severe physical abuse in childhood or adulthood and 13 % emotional deprivation in the childhood. A preponderance of belonging to lower class compared to the general German population was noted. Former and current psychiatric disorders, biographic adverse experiences, duration of generalized pain, age, sex and social class had no substantial predictive value on the extensive health care utilization (number of doctors, pain-related hospital and rehabilitation stays and pain-related operations).

Mental Disorder and Psychologic Distress in Patients With Ulcerative Colitis After Ileal Pouch-Anal Anastomosis

Abstract: The aim of this study was to determine if ileal pouch-anal anastomosis in patients with ulcerative colitis is a psychologic burden for patients, the frequency of mental disorders, the amount of psychologic distress, and their possible disease-related determinants. These factors were studied in patients with ulcerative colitis after ileal pouch anal anastomosis and were compared with ulcerative colitis patients without ileal pouch-anal anastomosis and the general German population. A total of 37 patients with ulcerative colitis after ileal pouch-anal anastomosis (age 46.8 ± 11.8 years; 35 percent female) and 62 patients with ulcerative colitis without ileal pouch-anal anastomosis (age 44.4 ± 13.9 years; 37 percent female) completed the following questionnaires: medical and sociodemographic questionnaire of the German Competence Network “Inflammatory Bowel Diseases” and the German version of the Hospital Anxiety and Depression Scale. Disease activity was measured in patients with ileal pouch-anal anastomosis by the Pouch Disease Activity Index and in patients without ileal pouch-anal anastomosis by the German Inflammatory Bowel Disease Activity Index. Psychologic distress was assessed by the subscale scores of the Hospital Anxiety and Depression Scale. A probable mental disorder was identified if a patient scored 11 or higher in at least one subscale of the Hospital Anxiety and Depression Scale. The frequency of a probable psychiatric disorder in patients with ileal pouch-anal anastomosis (16 percent) and without ileal pouch-anal anastomosis (23 percent) did not differ from that in the general German population (17 percent). Ulcerative colitis patients with or without ileal pouch-anal anastomosis did not differ in the amount of psychologic distress. Ileal pouch-anal anastomosis patients had higher levels of anxiety than the general population (P < 0.01). Regression models of disease-related factors predicting mental disorder and psychologic distress showed no significant results. Ileal pouch-anal anastomosis neither increases nor decreases the frequency of mental disorders or the amount of psychologic distress in ulcerative colitis patients.

[Comorbidity of internal inpatients in the german diagnosis related groups-system].

Abstract: The representation of comorbid mental disorders within the German Diagnosis Related Groups-System was investigated. First the complication and complexity level CCL of diagnoses of mental disorders (ICD-10 category F) within the G-DRG-calculation handbooks 2004 and 2005 were checked. Second the revenue based on a fictitious base rate of 3000 with the G-DRG versions 2004/2005 respectively was calculated with and without inclusion of diagnosed comorbid mental disorders of 6610 cases of both medical departments of a hospital of tertiary care level (year 2004). Only F0-diagnoses could lead to a CCL of 3. In 28.2 % of the patients at least one comorbid diagnosis of the category F of the International Classification of Diseases (mental and substance induced disorders) had been coded. Renunciation of the diagnosed mental disorders would have been resulted in a fictitious reduction in revenues based on the G-DRG version 2004 of 93 600 and on the G-DRG version 2005 of 69 000 . The Patient Clinical Complexity Level PCCL was increased 0.15 by the comorbid mental disorders in each year. To achieve an adequate representation of comorbid mental disorders in the G-DRG-system and to ensure a financial survival of psychosomatic/psychiatric CL-services coordinated efforts of psychosomatic scientific societies and hospitals taking part in the G-DRG-calculation sample are necessary.

Biopsychosocial predictors of fatigue in quiescent and mild ulcerative colitis: an explorative study Biopsychosoziale Prädiktoren von Müdigkeit (Fatigue) bei Patienten mit Colitis ulcerosa in Remission und leichter Krankheitsaktivität: eine explorative Studie

Abstract: In 37 patients with ulcerative colitis (UC) and ileal pouch-anal anastomosis (IPAA) and 40 patients without IPAA fatigue was measured using