Elisabeth Jandl-Jager

Influence of psychotherapist density and antidepressant sales on suicide rates.

Objective:  Antidepressant sales and suicide rates have been shown to be correlated in industrialized countries. The aim was to study the possible effects of psychotherapy utilization on suicide rates.

Experiences of Domestic and School Violence Among Child and Adolescent Psychiatric Outpatients.

The experience of cumulative childhood adversities, such as exposure to domestic violence or abuse by caregivers, has been described as risk factor for poor mental health outcomes in adolescence and adulthood. We performed an investigation of experience of violence in all patients aged 6 to 20 years who had consulted the Department of Child and Adolescent Psychiatry, Medical University of Vienna, as outpatients during the period of one year. We were using the Childhood Trauma Interview (CTI) in order to obtain information on the kind of violence. Seventy-five percent of all patients had reported experiences of violence. These youth were significantly more often involved in acts of school violence, thus a significant correlation between experience of domestic violence and violence at school could be revealed. The results of our study emphasize the need for interventions preventing violence both in domestic and in school environments.

Awareness and knowledge of child abuse amongst physicians – a descriptive study by a sample of rural Austria

ZusammenfassungDiese Studie mit eigens ausgewählten Ärzten hat zum Ziel, das Wissen über und die Wahrnehmung von Kindesmisshandlung im medizinischen System Österreichs zu erheben. Zwei Drittel aller Teilnehmer bestätigten Kontakt mit misshandelten Kindern im Laufe ihres Berufslebens, wohingegen 87.3 % keine vorhergehende Ausbildung diesbezüglich angeben. Kinderärzte nahmen misshandelte Kinder signifikant häufiger wahr (p = 0,021) und besaßen signifikant mehr themenrelevante Ausbildung (p = 0,012). Die vorliegenden Ergebnisse lassen darauf schließen, dass Ärzte in ländlichen Regionen Österreichs zwar ein Grundwissen über das Erkennen und die Behandlung von Kindesmisshandlung haben, jedoch weitere Ausbildung und Spezialisierung benötigen um Diagnoseprozesse zu erleichtern, Meldungsraten zu erhöhen, Zusammenarbeit mit anderen Spezialisten zu verbessern und Ängste im Umgang mit misshandelten Kindern zu verringern. Österreich ist ein reiches Land mit einem ausgezeichneten Gesundheitssystem und konkurrenzfähigen Forschungsstrukturen, in der Forschung zu Kindesmisshandlung müssen jedoch noch Rückstände zu gegenwärtigen internationalen Entwicklungen aufgeholt werden.SummaryThis study with a selected sample of physicians was conducted to assess their awareness and knowledge of child abuse. Two thirds (66.7%) of all participants confirmed contact with obviously abused children in the course of their professional life, whereas 87.3% did not report any prior education or training in that field. In relation to general practitioners, pediatricians had significantly more contacts with abused children (p = 0.021) and more prior education (p = 0.012). Results indicate that physicians in rural regions of Austria possess basic knowledge. Better training and further specialization is needed to facilitate diagnosing, enhance reporting, strengthen cooperation with experts and reduce fears when handling abuse victims. Austria is a rich country with excellent health care and competitive research structures. However, child abuse research in Austria still has to fill gaps in order to keep up with international developments.

[Predictive power on therapy engagement in personality disorders: SWAP- 200 versus SCID-II].

The study compares the predictive power of the Shedler-Westen-Assessment Procedure-200 with the Structured Clinical Interview for DSM-IV on engagement in (psychoanalytic) psychotherapy within 297 patients with personality disorders in a 4-year-follow-up. Multinomial logistic regression showed small differences between the prediction rates in the cross-validated data. Both instruments showed clinically useful prediction rates for treatment rejecters: SWAP scales led to correct predictions with dysphoric traits as semi-stable predictors for rejecters, while SCID scales led to correct predictions with Negativistic, Depressive and Schizotypal PD as stable predictors. Results are discussed under the aspect of advantages and disadvantages of the SWAP-200 diagnostic procedure, which includes the assessment of affect-experience, defence-organisation, and object-relation-style.