Los nuevos requisitos para la formación en Psiquiatría y Psicoterapia. Una nueva perspectiva para la Psiquiatría alemana.

Sin resumen

Los nuevos requisitos para la formación en Psiquiatría y Psicoterapia. Una nueva perspectiva para la Psiquiatría alemana.

Sin resumen

Onset and maintenance of psychiatric disorders after serious accidents

The purpose of this study was to prospectively investigate the onset, course, and remission of psychiatric disorders in the first 6months after a serious accident for consecutive patients in a hospital emergency department. Participants were 58 patients aged 18-65 who were assessed shortly after attending a hospital emergency department and were followed up 6months afterwards. Patients were interviewed with regard to past and current psychiatric history using different instruments (e.g. SCID for DSM-IV). Prior to their accidents, 35% of all subjects had experienced one or more psychiatric disorders (lifetime prevalence). Shortly after the accident, the incidence of Acute Stress Disorder (7%), subsyndromal Acute Stress Disorder (12%), and adjustment disorder (1.5%) was increased as a reaction to the accident. At this time, 29% of all patients suffered from an acute psychiatric disorder. Six-months after the accident, 10% of the subjects met criteria for Major Depression, 6% for PTSD, 4% for subsyndromal PTSD, and 1.5% for Specific Phobia as newly developed disorders. The course of the psychiatric disorders shows that those patients who met criteria for any psychiatric diagnosis shortly after the accident ran a much higher risk for developing new or comorbid psychiatric disorders in the futur

Health economic evaluation of a web-based intervention for depression: the EVIDENT-trial, a randomized controlled study.

Gräfe V, Berger T, Hautzinger M, et al. Health economic evaluation of a web-based intervention for depression: the EVIDENT-trial, a randomized controlled study. Health economics review. 2019;9(1): 16.BACKGROUND: Depression often remains undiagnosed or treated inadequately. Web-based interventions for depression may improve accessibility of treatment and reduce disease-related costs. This study aimed to examine the potential of the web-based cognitive behavioral intervention "deprexis" in reducing disease-related costs.; METHODS: Participants with mild to moderate depressive symptoms were recruited and randomized to either a 12-week web-based intervention (deprexis) in addition to care as usual (intervention group) or care as usual (control group). Outcome measures were health-related resource use, use of medication and incapacity to work as well as relating direct health care costs. Outcomes were assessed on patients' self-report at baseline, three months and six months.; RESULTS: A total of 1013 participants were randomized. In both groups total direct health care costs decreased during the study period, but changes from baseline did not significantly differ between study groups. Numeric differences between study groups existed in outpatient treatment costs. They could be attributed to differences in changes of costs for psychotherapeutic treatment from baseline. Whereas costs for psychotherapeutic treatment decreased in the intervention group, costs increased in the control group (-16.8% (80) vs. +14.7% (60)) (tdf=685=2.57; p=0.008).; CONCLUSION: The study indicates the health economic potential of innovative e-mental-health programs. There is evidence to suggest that the use of deprexis over a period of 12weeks leads to a decrease in outpatient treatment cost, especially in those related to different types of psychotherapeutic treatment

現代語の終助詞「さ」の機能に関する考察

本稿では,長崎(1998)の追調査として,昭和初期から現代に至る終助詞「さ」の機能的変遷を観察した。長崎(1998)では,江戸語における終助詞「さ」の機能を調査し,その主たる機能は断定の働きであったこと,またこの働きが,明治から大正にかけて,現在のように情意表現を主体とした終助詞の機能に移行していく経過を報告した。本調査では,終助詞「さ」を,昭和前期(第二次大戦前),昭和後期(第二次大戦後),平成期に分けて,その機能的変遷を観察した。昭和前期には,終助詞「さ」の用法として,江戸語に見られた丁寧な会話にも使用される用例が見られた。特に江戸語の名残のある女性の言葉遣いの中心その用法が見られた。戦後は,終助詞「さ」の女性の用例は減少し,用言に接続する用例加増加し,「さ」は主に男性が使用する終助詞として定着した。平成に入ると,「さ」は終助詞としての使用より,間投助詞としての使用が目立つようになる。特に若い世代では終助詞「さ」は,男性にもあまり使用されなくなっている。この結果から,今後「さ」の終助詞としての機能は,衰退していくことが予想される

The EVIDENT-trial: protocol and rationale of a multicenter randomized controlled trial testing the effectiveness of an online-based psychological intervention

Klein JP, Berger T, Schroeder J, et al. The EVIDENT-trial: protocol and rationale of a multicenter randomized controlled trial testing the effectiveness of an online-based psychological intervention. BMC Psychiatry. 2013;13(1): 239.Background: Depressive disorders are among the leading causes of worldwide disability with mild to moderate forms of depression being particularly common. Low-intensity treatments such as online psychological treatments may be an effective way to treat mild to moderate depressive symptoms and prevent the emergence or relapse of major depression. Methods/Design: This study is a currently recruiting multicentre parallel-groups pragmatic randomized-controlled single-blind trial. A total of 1000 participants with mild to moderate symptoms of depression from various settings including in-and outpatient services will be randomized to an online psychological treatment or care as usual (CAU). We hypothesize that the intervention will be superior to CAU in reducing depressive symptoms assessed with the Personal Health Questionnaire (PHQ-9, primary outcome measure) following the intervention (12 wks) and at follow-up (24 and 48 wks). Further outcome parameters include quality of life, use of health care resources and attitude towards online psychological treatments. Discussion: The study will yield meaningful answers to the question of whether online psychological treatment can contribute to the effective and efficient prevention and treatment of mild to moderate depression on a population level with a low barrier to entry