Untersuchung zu Lebenszufriedenheit und Re-/Migrationswunsch bei Patienten mit Depression und türkischem Migrationshintergrund

Im Rahmen einer retrospektiven Studie wurden die migrationsspezifischen Anamnesedaten von 106 Patienten mit Depression und türkischem Migrationshintergrund aus der Spezialambulanz der Ulmer Universitätsklinik für Psychiatrie und Psychotherapie III unter Verwendung eines halbstrukturierten Fragebogens in Muttersprache analysiert. In dieser Arbeit wurden soziokulturelle Daten von Migranten mit Depression insbesondere zu Lebenszufriedenheit deskriptiv erfasst und Zusammenhänge zwischen Migrationsgrund, Bildungsgrad, Beschäftigungsstatus und Wunsch nach Re-Migration untersucht. Die Auswertung der Daten ergab, dass die Zufriedenheit unter Migranten mit Depression in Ulm mit 45 % relativ hoch lag. Die wesentlichen Faktoren mit Einfluss auf die Zufriedenheit mit den Lebensumständen in Deutschland waren der Beschäftigungsstatus sowie der Migrationsgrund. Patienten, die einer Beschäftigung nachgingen, waren zufriedener als Nichtbeschäftigte. Heiratsmigrantinnen waren deutlich unzufriedener als Patienten, die der zweiten und dritten Generation angehören. Trotz des hohen Anteils von zufriedenen Patientinnen und Patienten war der Wunsch nach Re-Migration mit über 40 % relativ hoch. Dabei zeigte sich, dass Angst vor einer Re-Migration bei mit dem Leben in Deutschland zufriedenen Patienten seltener angegeben wurde als bei Nichtzufriedenen. Von Frauen wurde die Angst vor Re-Migration tendenziell häufiger angegeben als von Männern. Migranten der ersten Generation gaben dagegen seltener Angst vor Re-Migration an als Migranten der zweiten und dritten Generation. Die Daten der vorliegenden Arbeit zeigen, dass die Motivation zu Migration von verschiedenen Faktoren abhängt und eine individuelle differenzierte Anamnese (Migrationsgrund und aktuelle Belastungen) und Behandlung impliziert. Die bisher im sozio-ökonomischen Bereich anerkannten "Push- und Pull-Faktoren" sollten um psychologische Aspekte erweitert werden

The TRACK-MS Test Battery: A Very Brief Tool to Track Multiple Sclerosis-Related Cognitive Impairment

Tracking cognition in patients with multiple sclerosis (MS) is important for detection of disease progression but it is often not performed in routine settings due to time constraints. This exploratory cohort study aims to develop a very brief repeatable tracking tool with comparable test quality criteria to the current gold standard, the Brief International Cognitive Assessment for MS (BICAMS). The study included 88 participants (22 healthy controls, 66 MS patients) who were examined at baseline and at one-year follow-up. As a validity criterion for the six administered cognitive tests, we assessed the difference between MS patients and HC, and the correlation with MS-related disability. Combining the two tests with the highest validity—the Controlled Oral Word Association Test and Symbol Digit Modalities Test—yielded an administration time of 5 min. Comparing this new TRACK-MS test battery with the 15 min BICAMS indicated that TRACK-MS showed larger differences between MS patients and healthy controls, a higher correlation with MS-related disability, smaller practice effects, and a good test–retest reliability. We provide evidence that TRACK-MS, although faster to administer, showed at least comparable quality criteria as the BICAMS. As the study was exploratory, replication of these results is necessary

Facilitating access to emotions: neural signature of EMDR stimulation.

Eye Movement Desensitisation and Reprocessing (EMDR) is a method in psychotherapy effective in treating symptoms of posttraumatic stress disorder. The client attends to alternating bilateral visual, auditory or sensory stimulation while confronted with emotionally disturbing material. It is thought that the bilateral stimulation as a specific element of EMDR facilitates accessing and processing of negative material while presumably creating new associative links. We hypothesized that the putatively facilitated access should be reflected in increased activation of the amygdala upon bilateral EMDR stimulation even in healthy subjects.We investigated 22 healthy female university students (mean 23.5 years) with fMRI. Subjects were scanned while confronted with blocks of disgusting and neutral picture stimuli. One third of the blocks was presented without any additional stimulation, one third with bilateral simultaneous auditory stimulation, and one third with bilateral alternating auditory stimulation as used in EMDR.Contrasting disgusting vs. neutral picture stimuli confirmed the expected robust effect of amygdala activation for all auditory stimulation conditions. The interaction analysis with the type of auditory stimulation revealed a specific increase in activation of the right amygdala for the bilateral alternating auditory stimulation. Activation of the left dorsolateral prefrontal cortex showed the opposite effect with decreased activation.We demonstrate first time evidence for a putative neurobiological basis of the bilateral alternating stimulation as used in the EMDR method. The increase in limbic processing along with decreased frontal activation is in line with theoretical models of how bilateral alternating stimulation could help with therapeutic reintegration of information, and present findings may pave the way for future research on EMDR in the context of posttraumatic stress disorder

Subjective affectedness by emotional pictures.

<p>Relative ratings of how much subjects felt emotionally affected by the pictures depending on the type of auditory stimulation. Subjects were asked for their statements after scanning using a paper and pencil questionnaire showing the same pictures as in the scanner in a randomized order (the order was different from that in the scanner) and without a link to the auditory stimulation used before. Depicted are the mean differences of individual ratings of emotional vs. neutral pictures and standard errors. No significant differences were found.</p

Condition-by-auditory stimulation interaction effects.

<p>Condition-by-auditory stimulation interaction effects.</p

Comparison of Eye Movement Desensitization Reprocessing and Cognitive Behavioral Therapy as Adjunctive Treatments for Recurrent Depression: The European Depression EMDR Network (EDEN) Randomized Controlled Trial

Background: Treatment of recurrent depressive disorders is currently only moderately successful. Increasing evidence suggests a significant relationship between adverse childhood experiences and recurrent depressive disorders, suggesting that trauma-based interventions could be useful for these patients.Objectives: To investigate the efficacy of Eye Movement Desensitization and Reprocessing therapy (EMDR) in addition to antidepressant medication (ADM) in treating recurrent depression.Design: A non-inferiority, single-blind, randomized clinical controlled trial comparing EMDR or CBT as adjunctive treatments to ADM. Randomization was carried out by a central computer system. Allocation was carried out by a study coordinator in each center.Setting: Two psychiatric services, one in Italy and one in Spain.Participants: Eighty-two patients were randomized with a 1:1 ratio to the EMDR group (n = 40) or CBT group (n = 42). Sixty-six patients, 31 in the EMDR group and 35 in the CBT group, were included in the completers analysis. Intervention: 15 ± 3 individual sessions of EMDR or CBT, both in addition to ADM. Participants were followed up at 6-months.Main outcome measure: Rate of depressive symptoms remission in both groups, as measured by a BDI-II score &lt;13.Results: Sixty-six patients were analyzed as completers (31 EMDR vs. 35 CBT). No significant difference between the two groups was found either at the end of the interventions (71% EMDR vs. 48.7% CBT) or at the 6-month follow-up (54.8% EMDR vs. 42.9% CBT). A RM-ANOVA on BDI-II scores showed similar reductions over time in both groups [F(6,59) = 22.501, p &lt; 0.001] and a significant interaction effect between time and group [F(6,59) = 3.357, p = 0.006], with lower BDI-II scores in the EMDR group at T1 [mean difference = –7.309 (95% CI [–12.811, –1.806]), p = 0.010]. The RM-ANOVA on secondary outcome measures showed similar improvement over time in both groups [F(14,51) = 8.202, p &lt; 0.001], with no significant differences between groups [F(614,51) = 0.642, p = 0.817].Conclusion: Although these results can be considered preliminary only, this study suggests that EMDR could be a viable and effective treatment for reducing depressive symptoms and improving the quality of life of patients with recurrent depression. Trial registration: ISRCTN09958202