To what extent could acute general psychiatric day care reduce inpatient admissions?

The multi-site research project (Acronym: EDEN-study) “Psychiatric day hospital treatment: An alternative to inpatient treatment, being cost-effective and minimizing post-treatment needs for care? An evaluative study in European countries with different care systems” was funded by the European Commission (Quality of Life and Management of Living, contract no. QLG4-CT-2000-01700). Additional national grants supporting the project were provided by Roland-Ernst-Stiftung für Gesundheitswesen and the Faculty of Medicine at the Dresden University of Technology, the National Health Service Executive Organization and Management Programme, the Polish National Committee of Scientific Affairs, and the Slovak Ministry of Education. Pfizer Pharmaceutical Company supported travel and accommodation for EDEN project meetings

Negative and positive childhood experiences across developmental periods in psychiatric patients with different diagnoses – an explorative study

BACKGROUND: A high frequency of childhood abuse has often been reported in adult psychiatric patients. The present survey explores the relationship between psychiatric diagnoses and positive and negative life events during childhood and adulthood in psychiatric samples. METHODS: A total of 192 patients with diagnoses of alcohol-related disorders (n = 45), schizophrenic disorders (n = 52), affective disorders (n = 54), and personality disorders (n = 41) completed a 42-item self-rating scale (Traumatic Antecedents Questionnaire, TAQ). The TAQ assesses personal positive experiences (competence and safety) and negative experiences (neglect, separation, secrets, emotional, physical and sexual abuse, trauma witnessing, other traumas, and alcohol and drugs abuse) during four developmental periods, beginning from early childhood to adulthood. Patients were recruited from four Psychiatric hospitals in Germany, Switzerland, and Romania; 63 subjects without any history of mental illness served as controls. RESULTS: The amount of positive experiences did not differ significantly among groups, except for safety scores that were lower in patients with personality disorders as compared to the other groups. On the other side, negative experiences appeared more frequently in patients than in controls. Emotional neglect and abuse were reported in patients more frequently than physical and sexual abuse, with negative experiences encountered more often in late childhood and adolescence than in early childhood. The patients with alcohol-related and personality disorders reported more negative events than the ones with schizophrenic and affective disorders. CONCLUSIONS: The present findings add evidence to the relationship between retrospectively reported childhood experiences and psychiatric diagnoses, and emphasize the fact that a) emotional neglect and abuse are the most prominent negative experiences, b) adolescence is a more 'sensitive' period for negative experiences as compared to early childhood, and c) a high amount of reported emotional and physical abuse occurs in patients with alcohol-related and personality disorders respectively

Trauma, cognition and chronic PTSD: A study of former East German political prisoners

The investigation aimed to identify cognitive correlates of chronic Posttraumatic Stress Disorder (PTSD) in former East German political prisoners (PP). The pilot study developed a manual for rating cognitive processing during and after imprisonment. In the main study, blind raters rated semi-structured interviews with 26 PP without PTSD and 26 with chronic PTSD. The groups did not differ in conditions of imprisonment, or sociodemographic variables. The majority of participants with chronic PTSD reported mental defeat during imprisonment whereas those without PTSD retained an autonomous frame of mind and did not give up. Participants with PTSD described to a larger extent than those without PTSD an overall feeling of alienation from other people and a feeling of permanent change for the worse in their personality and life. Participants without PTSD reported a greater oppositional political motivation prior to imprisonment. Mental defeat and alienation classified 90 % of the participants correctly