The author reviews briefly the recent history of psychiatric hospitals, with particular reference to changes which have taken place in the Scandinavian countries. He also reviews the new expectations society has of psychiatric hospitals and of their role. He concludes that the psychiatric hospital has still an important role to play but that its organization and aims will have to change. He gives a number of guidelines for the changes and describes his own experience as director of two psychiatric hospitals in Norway which under his guidance underwent the transition from the old to their new function. The hospital here described in detail is called 'Gaustad', situated in Oslo. He outlines the planning procedure and the way the plans were implemented. Finally he asked each professional group working in the hospital as well as the patients to evaluate the changes. By and large, all groups seemed to welcome the new way of working. Finally staff and patients give opinions as to what functions should be expected of the hospital in the future and the author gives his own ideas. He feels the psychiatric hospitals will have to change, but they have to continue to play an important and, in some ways, unique role.
With regard to experiences described in the literature, and the particular psychotherapeutic and paedagogic effects on mother and child in the inpatient treatment setup presented in this paper, we give an account of the preliminary deliberations and preconditions arising from this particular setup. Prognostically unfavourable aspects of joint admission and treatment are also presented. Finally, previous experiences are discussed, and suggestions for improvement of care for mentally ill mothers and their infants or toddlers are made, taking into consideration the facilities existing in England and Denmark.
We assumed that persons with a Russian/Soviet cultural background have a more skeptical attitude towards psychotherapy than persons with a German background because of the poor distribution of psychotherapy and the knowledge about this kind of treatment in Russia.
We compared the views of Russian probands (n=40), Russian migrants living in Germany (n=65) and German probands (n=70) with the "Questionnaire on Attitudes towards Psychotherapeutic Treatment" (QAPT). For the study of the Russian probands we translated the questionnaire into the Russian language.
The psychometric examination predominantly suggests the quality of the Russian version of the QAPT. Russian probands showed a more skeptical attitude towards psychotherapy compared to the German probands. The migrants had a tendentially more negative attitude than the Germans and a more positive attitude than the Russians. However, we could not determine any differences concerning the anticipated social acceptance regarding participation in psychotherapy.
The results suggest the relevance of culture-specific factors in psychotherapy and an increased need for information of persons with a Russian/Soviet cultural background about psychotherapy.
[Quality of life of patients with metastatic breast or intestinal cancer, treated with anthroposophic medicine or with mainstream medicine, the latter with or without psycho-oncologic or supplementary anthroposophic therapy]
This project dealt with two subjects. On the one hand, the measurement of the quality of life of cancer patients which needed to be further refined in order to assess the usefulness and efficacy of a treatment by complementary medicine. On the other hand, it was important to know whether severely ill cancer patients treated in an anthroposophical clinic would differ from equally ill patients in a university hospital in terms of attitude towards their illness and in terms of clinical diagnosis. Finally, an attempt was made to demonstrate an improvement of quality of life in conventionally treated patients of the university hospital, who were offered an additional treatment either with a supportive-expressive group therapy or with an anthroposophical therapy. More than 500 patients participated in the study. There were marked sociodemographic and medical differences between the patients of the anthroposophical clinic and those of the university hospital. In addition, it seems that spiritually oriented and active, problem-oriented coping contribute a lot to the quality of life. It was not possible to truly compare the value of the two additional therapies offered to the patients at the university hospital because patient accrual was much slower than anticipated and many patients left the study too early for health reasons or death.
BACKGROUND: Citizens of Novosibirsk were questioned regarding their ideas about schizophrenia and depressive disorders, with one of the main concerns being a comparison with the ideas and attitudes of the German population. METHOD: In 2002, a representative survey (N = 745) was conducted among the adult population of Novosibirsk, using a fully structured interview that has been used in previous surveys in Germany. RESULTS: Symptoms of schizophrenia were more frequently identified as an indication of mental disorder than were depressive symptoms. Psychosocial stress and biological influences were similarly frequently seen as the cause of schizophrenia, with the former prevailing among the respondents in the case of depressive symptoms. Psychotherapy was most frequently recommended as a treatment measure, also for schizophrenia. Supposing that no treatment measures will be taken, respondents assessed the prognosis for both mental disorders negatively. Conversely, interviewees gave a positive treatment prognosis. DISCUSSION: Respondents from Germany and Novosibirsk showed similar beliefs, especially as regards the importance of biological influences and psychosocial stress and the assessment of psychotherapy as compared to psychopharmacology. However, German and Russian respondents also held differing views: a comparatively strong tendency of the Russian population to consider mental disorders as self-inflicted - an important finding that could shape future anti-stigma programs.