Bernd Röhrle

Individual prognosis for changes in sperm quality on the basis of perceived stress.

Background: In this study we examined whether stress has a negative influence on sperm quality. To investigate this issue we developed a scale assessing perceived stress resulting from infertility. Methods and Results: The Infertility Distress Scale was constructed based on the data of 158 infertility patients contacting an andrological clinic for the first time. The Infertility Distress Scale consists of items assessing self-reported stress, different appraisals of infertility and cognitive involvement in infertility. The scale was shown to have good psychometric properties. Changes in sperm quality were predicted by this scale for 69 patients. Changes in sperm concentration and sperm motility were predicted correctly 75.4 and 65.6% of the time, respectively. While these prediction accuracies were significantly better than chance prediction, the Infertility Distress Scale had no predictive value for changes in morphology. Conclusion: Results indicate that distress caused by infertility is a risk factor for a decrease in sperm quality.

Why do infertile males use psychological couple counselling

The purpose of the present study was to identify characteristics of male patients that could be relevant for the uptake of psychological couple counselling for infertility. Therefore, 94 male patients who participated in psychological couple counselling were compared to 134 unselected infertility patients who attended an andrological clinic. Counselling users showed higher scores for depression and anxiety as well as a higher number of impaired sperm parameters. Multivariate analysis revealed that beyond the level of depression the number of impaired sperm parameters delivered additional information about the probability of a patient using counselling. For interpretation of these results the former research was broadly reviewed. It is suggested that an increased level of distress, the feeling of being responsible for infertility and few marital difficulties are relevant for the usage of couple counselling by male infertility patients. Practical consequences are discussed.

Children of mentally ill parents—a pilot study of a group intervention program

Objective: The transgenerational transmission of mental disorders is one of the most prominent risk factors for the development of psychological disorders. Children of mentally ill parents are a vulnerable high risk group with overall impaired development and high rates of psychological disorders. To date there are only a few evidence based intervention programs for this group overall and hardly any in Germany. We translated the evidence based Family Talk Intervention by Beardslee (2009) and adapted it for groups. First results of this pilot study are presented. Method: This investigation evaluates a preventive group intervention for children of mentally ill parents. In a quasi-experimental design three groups are compared: an intervention group (Family Talk Intervention group: n = 28), a Wait Control group (n = 9), and a control group of healthy children (n = 40). Mean age of children was 10.41 years and parental disorders were mostly depressive/affective disorders (n = 30), but a small number also presented with Attention-Deficit/Hyperactivity Disorder (n = 7). Results: Children of mentally ill parents showed higher rates of internalizing/externalizing disorders before and after the intervention compared to children of parents with no disorders. Post intervention childrens knowledge on mental disorders was significantly enhanced in the Family Talk Intervention group compared to the Wait Control group and the healthy control group. Parental ratings of externalizing symptoms in the children were reduced to normal levels after the intervention in the Family Talk Intervention group, but not in the Wait Control group. Discussion: This pilot study of a group intervention for children of mentally ill parents highlights the importance of psycho-education on parental mental disorders for children. Long-term effects of childrens enhanced knowledge about parental psychopathology need to be explored in future studies.

Early Detection of Postpartum Depressive Symptoms in Mothers and Fathers and Its Relation to Midwives’ Evaluation and Service Provision: A Community-Based Study

Background Postpartum parental mental health problems pose a serious risk for child development and often remain undetected in postpartum primary care. Within the framework of the German Midwifes Prevention Study, the aim of this study was to investigate the presence of postpartum emotional distress in mothers and fathers, and the detection of distressed parents by midwives in a primary care setting. We also examined whether a temporal extension of the postpartum midwife care period is associated with greater use of midwife contacts and higher rates of referral to further professional support if needed. Methods Mothers, fathers, and midwives filled out questionnaires at 2 weeks (t1) and 6 months (t2) postpartum. Compared to standard care in the control group (CG), midwives in an intervention group (IG) offered extended postpartum care of 6 months postpartum. Parental psychological distress was assessed using the Edinburgh postnatal depression scale (EPDS). Midwives reported on parental psychological distress as well as the number of postpartum contacts and referrals to additional social- and health-care providers. Results Based on their ratings, midwives identified half of mothers and around one-quarter of fathers with elevated depressive symptoms according to the EPDS at t1 and t2. IG mothers used significantly more midwife contacts than CG mothers. IG mothers with high-postnatal psychological distress at t2 used significantly more contacts than mothers with lower levels of distress. IG mothers with high-psychological distress at t2 were referred to additional support services more often than mothers with lower levels of distress.

A validation study on the negative association between an active coping style and sperm concentration

In the present study hypotheses derived from a psychobiological model of male fertility were tested. The basic assumption of the model proposes that, mediated by specified endocrine mechanisms, an active coping style and sperm concentration are negatively correlated. Data from 55 infertile patients without organic causes for impaired spermatogenesis were included to test this assumption. Patients completed questionnaires to assess coping efforts in relation to infertility and distress due to infertility. For each patient a mean value for sperm concentration based on several semen analyses was computed. As hypothesized, there was a significant negative correlation between sperm concentration and an active coping style, but no significant correlation between sperm concentration and a passive coping style. These associations were significantly different. Previous research suggests that the confirmed association cannot be supposed to be simply a reaction to former semen analyses. The results indicate that further validation of the psychobiological model under study could lead to a better understanding of male infertility.

Psychische Erkrankungen eines Elternteils

Das Zusammenleben mit psychisch erkrankten Eltern stellt ein quantitativ und qualitativ beachtliches Risikopotenzial fur einen ungunstigen Entwicklungsverlauf dar und fur die Wahrscheinlichkeit der Kinder, selbst psychisch zu erkranken (Lenz, 2007; 2008; Zobel, 2006). Die Folgen dieser Belastung sind sehr unterschiedlich und entsprechend facettenreich sind die bestehenden Interventionen, die entwickelt wurden, um diesem Risikopotenzial zu begegnen (Sharpe & Rossiter, 2002).

Psychische Gesundheit — Essstörungen, internalisierende, externalisierende Verhaltens- und Lernstörungen

In Deutschland gehorte die Pravention psychischer Storungen bis in die 1990er Jahre zu den vernachlassigten Forschungsgebieten. In den letzten Jahren hat dieses Gebiet hier zwar an Bedeutung gewonnen, in anderen europaischen und ausereuropaischen Landern wie den USA und Australien gibt es jedoch langer schon zahlreiche Institutionen, spezielle Task Pannels und internationale Organisationen, die sich der Pravention widmen (z. B. Greenberg et al., 2001).

Prävention chronischer körperlicher Erkrankungen im Kindes und Jugendalter

Das vorliegende Kapitel gibt einen Uberblick zu verschiedenen Ansatzen der Pravention chronischer Erkrankungen bei Kindern und Jugendlichen. Es werden sowohl primarpraventive Programme, d. h. Programme fur noch vollig gesunde Kinder und Jugendliche vorgestellt, die einen universellen Zugang haben, als auch Programme, die sich an Risikopersonen richten, die sich im Ubergang zu einer chronischen Erkrankung befinden (sekundarpraventive oder auch indizierte Programme). Ubergreifend wird deutlich werden, dass bei diesen Programmen ein Uberhang an individuenzentrierten Programmen vorliegt und umweltorientierte oder auch sog. verhaltnisorientierte Programme recht selten sind.

Swimming against the Tide

Accessible online at: http://BioMedNet.com/karger The independent and uncoventional attitude of this journal is now well known to our readers. The publication of the 1997 impact factors of journals listed in the Science Citation Index by the Institute for Scientific Information seems to support our quest. Our impact factor of 1.80 places Psychotherapy and Psychosomatics in the top 10 psychological journals and at the 24th position in the psychiatry ranking. The progress of the journal is depicted by figure 1, which also shows how psychosomatic medicine is alive and well at the turn of the century by including the other 4 leading psychosomatic journals. Such psychosomatic prominence is also supported by other psychosomatic journals which are included in the Science Citation Index (International Journal of Psychiatry in Medicine, Stress Medicine, Journal of Psychosomatic Obstetrics and Gynecology, Zeitschrift für Psychosomatische Medizin und Psychoanalyse). The journal’s progress has been the result of the joint effort of several factors. One factor has certainly been the expert advice of our reviewers (such as the ones listed below who supplemented the Editorial Board during 1998). In 1998 we introduced a new policy in our review process. All reviewers are asked to disclose

Psychische Störungen des Kindes- und Jugendalters

Weltweit liegt die Lebenszeitpravalenz psychischer Storungen im Kindes- und Jugendalter zwischen 11,5 % und 12,8 % (WHO, 2001). In deutschen Studien werden sogar Pravalenzraten von bis zu 41,9 % erreicht (Essau et al., 1998). Dem Bundesgesundheitssurvey zufolge weisen 20 % der Jugendlichen psychische Storungen auf (Hurrelmann et al., 2003). Hinsichtlich der Lebenszeitpravalenz treten psychische Storungen bei der Halfte aller Falle bereits vor dem 14. Lebensjahr auf und bei zwei Dritteln vor dem 25. Lebensjahr. Bei einem spateren Auftreten psychischer Storungen handelt es sich vornehmlich um komorbide Storungen und nicht um Erstmanifestationen psychischer Storungen (Kessler et al., 2005). Insofern konnen psychische Erkrankungen insgesamt als Storungen des Kindes- und Jugendalters verstanden werden, fur die es in der Regel keine ausreichenden praventiven und fruhzeitigen therapeutischen Interventionen gibt. Noch immer werden viele Betroffene gar nicht oder zu spat behandelt, obwohl vor allem fruhe Storungen besonders resistent sind und spatere Beeintrachtigungen vorhersagen.