Franz Bleichner

Alterations of Autonomic Cardiac Control in Anorexia Nervosa

BACKGROUND The authors investigated autonomic cardiac function in anorexia nervosa. METHODS Forty-eight patients, who in the present or past met the DSM-III-R criteria for anorexia nervosa, and 16 normal control subjects participated in a standardized analysis of heart rate variability during supine and standing postures. RESULTS Several heart rate variability parameters showed an inverse correlation to the present weight of the anorexic subjects. The values of the spectral power analyses were significantly (p < .01) lower in patients (n = 18) weighing less than 75% of ideal weight when compared to the results found in the control group; however, the heart rate variability parameters of anorexic subjects with restored weight (n = 12) did not differ from those of the control subjects. CONCLUSIONS The obtained results provide evidence for autonomic cardiac dysfunction in acutely ill anorexic patients. Further research is required to elucidate possible clinical consequences of these findings.

Vocational training integrated into inpatient psychosomatic rehabilitation--short and long-term results from a controlled study.

Purpose. The aim of this study was to determine the impact of a vocational training programme on short- and long-term results after psychosomatic rehabilitation. Method. 1,590 inpatients were screened for vocational integration. A high-risk group of 266 patients was randomly assigned to the vocational training programme plus psychosomatic treatment; treatment- as- usual served as a control condition. An occupational training was conducted at local companies, closely integrated into psychosomatic treatment. Vocational attitudes and adjustment were studied at intake, discharge, three, 12 and 24 month follow-ups. Results. More than half of the study participants were unemployment and/or long-term work-disabled harbouring strong negative attitudes toward return to work. Forty-six percent of the intervention group declined from participation, but complied with follow-up investigation. At discharge, participants of the vocational training programme had become more optimistic regarding resuming work. One year following discharge, participants of the training programme reported less absence from work. After 24 months, vocational adjustment had improved considerably among programme participants, and declined among controls and refusers. Conclusion. An intensive vocational training programme is effective in promoting positive attitudes to work, reducing work disability and promoting return-to-work. However, a randomized design may be not optimal; evaluation necessitates long-term follow-up.

Does a cognitive-training programme improve the performance of middle-aged employees undergoing in-patient psychosomatic treatment?

Purpose. With the ever-increasing average life expectancy and rising age of retirement, cognitive and work capacities in advanced age take on great importance. Cognitive impairments, however, increase with age. The effect of cognitive-training programmes on people with mild cognitive impairment has not been verified in any systematic investigations. Method. This study presents a cognitive-training programme designed for middle-aged employees that was implemented and evaluated at the Psychosomatic Clinic Bad Neustadt/Saale in an AB study design (A: no intervention; B: intervention). Results. Memory performance of the intervention group (n = 33) improved significantly between intake and discharge, compared with that of the control group (n = 40), as did self-ratings of memory and work-related attitudes. Conclusions. A cognitive-training programme is useful and effective in patients with mild cognitive impairment. Future studies should investigate how older or more severely impaired patients benefit from such a programme.

[Cognitive training in rehabilitation: a program to treat mild cognitive impairment].

ZusammenfassungIm Rahmen eines Forschungsprojekts wurde ein verhaltenstherapeutisch orientiertes Trainingsprogramm zur Verbesserung der kognitiven Leistungsfähigkeit älterer Arbeitnehmer entwickelt und evaluiert. Ziel des Trainings war es, die kognitiven, affektiven und verhaltensbezogenen Bedingungen kognitiver Leistungseinbußen im Beruf zu analysieren. Das Training fokussierte auf zwei Themenschwerpunkte: erstens Erschließen neuer Arbeitsaufgaben, zweitens Zeitmangel und Termindruck. Insgesamt 316 Patienten der Psychosomatischen Klinik Bad Neustadt im Alter zwischen 50 und 59 Jahren nahmen an der Studie teil. Diejenigen mit objektivierbaren kognitiven Beeinträchtigungen wurden in der Interventionsphase dem Training, in der Kontrollphase der Kontrollgruppe zugewiesen. Die kognitiv auffälligen Patienten wurden vor der Entlassung erneut neuropsychologisch untersucht. Die Ergebnisse zeigten, dass sich die objektive und subjektive Gedächtnisleistung der Trainingsteilnehmer im Vergleich zur Kontrollgruppe signifikant verbesserte. Zum Zeitpunkt der Katamnese gaben 84% der Teilnehmer an, die im Training erworbenen Strategien in ihrem beruflichen Alltag einsetzen zu können.AbstractAs part of a research project, a behavior therapy-oriented cognitive training program, designed to improve the cognitive ability of middle-aged employees (50 to 59 years), was implemented and evaluated. The goal of the training program was to analyze the cognitive, affective and behavior-related conditions of memory deficits in the workplace. The training focused on two topics: (1) development of new job tasks, (2) lack of time and deadline constraints. A total of 316 patients in the psychosomatic clinic of Bad Neustadt participated in the study. Those who showed cognitive impairments took part in the cognitive training program during the intervention phase. During the control phase, patients with cognitive impairments received no additional intervention. The neuropsychological screening was repeated with patients with cognitive impairments at discharge. The findings show that the objective and subjective memory performance of the participants improved significantly compared to that of the control group. At the 1-year follow-up, 84% of the participants reported that they could use the training strategies in their job.As part of a research project, a behavior therapy-oriented cognitive training program, designed to improve the cognitive ability of middle-aged employees (50 to 59 years), was implemented and evaluated. The goal of the training program was to analyze the cognitive, affective and behavior-related conditions of memory deficits in the workplace. The training focused on two topics: (1) development of new job tasks, (2) lack of time and deadline constraints. A total of 316 patients in the psychosomatic clinic of Bad Neustadt participated in the study. Those who showed cognitive impairments took part in the cognitive training program during the intervention phase. During the control phase, patients with cognitive impairments received no additional intervention. The neuropsychological screening was repeated with patients with cognitive impairments at discharge. The findings show that the objective and subjective memory performance of the participants improved significantly compared to that of the control group. At the 1-year follow-up, 84% of the participants reported that they could use the training strategies in their job.

Gedächtnismanagementtraining in der Rehabilitation (KTR)@@@Cognitive training in rehabilitation: Programm zur Behandlung leichter kognitiver Beeinträchtigungen@@@A program to treat mild cognitive impairment

ZusammenfassungIm Rahmen eines Forschungsprojekts wurde ein verhaltenstherapeutisch orientiertes Trainingsprogramm zur Verbesserung der kognitiven Leistungsfähigkeit älterer Arbeitnehmer entwickelt und evaluiert. Ziel des Trainings war es, die kognitiven, affektiven und verhaltensbezogenen Bedingungen kognitiver Leistungseinbußen im Beruf zu analysieren. Das Training fokussierte auf zwei Themenschwerpunkte: erstens Erschließen neuer Arbeitsaufgaben, zweitens Zeitmangel und Termindruck. Insgesamt 316 Patienten der Psychosomatischen Klinik Bad Neustadt im Alter zwischen 50 und 59 Jahren nahmen an der Studie teil. Diejenigen mit objektivierbaren kognitiven Beeinträchtigungen wurden in der Interventionsphase dem Training, in der Kontrollphase der Kontrollgruppe zugewiesen. Die kognitiv auffälligen Patienten wurden vor der Entlassung erneut neuropsychologisch untersucht. Die Ergebnisse zeigten, dass sich die objektive und subjektive Gedächtnisleistung der Trainingsteilnehmer im Vergleich zur Kontrollgruppe signifikant verbesserte. Zum Zeitpunkt der Katamnese gaben 84% der Teilnehmer an, die im Training erworbenen Strategien in ihrem beruflichen Alltag einsetzen zu können.AbstractAs part of a research project, a behavior therapy-oriented cognitive training program, designed to improve the cognitive ability of middle-aged employees (50 to 59 years), was implemented and evaluated. The goal of the training program was to analyze the cognitive, affective and behavior-related conditions of memory deficits in the workplace. The training focused on two topics: (1) development of new job tasks, (2) lack of time and deadline constraints. A total of 316 patients in the psychosomatic clinic of Bad Neustadt participated in the study. Those who showed cognitive impairments took part in the cognitive training program during the intervention phase. During the control phase, patients with cognitive impairments received no additional intervention. The neuropsychological screening was repeated with patients with cognitive impairments at discharge. The findings show that the objective and subjective memory performance of the participants improved significantly compared to that of the control group. At the 1-year follow-up, 84% of the participants reported that they could use the training strategies in their job.As part of a research project, a behavior therapy-oriented cognitive training program, designed to improve the cognitive ability of middle-aged employees (50 to 59 years), was implemented and evaluated. The goal of the training program was to analyze the cognitive, affective and behavior-related conditions of memory deficits in the workplace. The training focused on two topics: (1) development of new job tasks, (2) lack of time and deadline constraints. A total of 316 patients in the psychosomatic clinic of Bad Neustadt participated in the study. Those who showed cognitive impairments took part in the cognitive training program during the intervention phase. During the control phase, patients with cognitive impairments received no additional intervention. The neuropsychological screening was repeated with patients with cognitive impairments at discharge. The findings show that the objective and subjective memory performance of the participants improved significantly compared to that of the control group. At the 1-year follow-up, 84% of the participants reported that they could use the training strategies in their job.

Gedächtnismanagementtraining in der Rehabilitation (KTR)

ZusammenfassungIm Rahmen eines Forschungsprojekts wurde ein verhaltenstherapeutisch orientiertes Trainingsprogramm zur Verbesserung der kognitiven Leistungsfähigkeit älterer Arbeitnehmer entwickelt und evaluiert. Ziel des Trainings war es, die kognitiven, affektiven und verhaltensbezogenen Bedingungen kognitiver Leistungseinbußen im Beruf zu analysieren. Das Training fokussierte auf zwei Themenschwerpunkte: erstens Erschließen neuer Arbeitsaufgaben, zweitens Zeitmangel und Termindruck. Insgesamt 316 Patienten der Psychosomatischen Klinik Bad Neustadt im Alter zwischen 50 und 59 Jahren nahmen an der Studie teil. Diejenigen mit objektivierbaren kognitiven Beeinträchtigungen wurden in der Interventionsphase dem Training, in der Kontrollphase der Kontrollgruppe zugewiesen. Die kognitiv auffälligen Patienten wurden vor der Entlassung erneut neuropsychologisch untersucht. Die Ergebnisse zeigten, dass sich die objektive und subjektive Gedächtnisleistung der Trainingsteilnehmer im Vergleich zur Kontrollgruppe signifikant verbesserte. Zum Zeitpunkt der Katamnese gaben 84% der Teilnehmer an, die im Training erworbenen Strategien in ihrem beruflichen Alltag einsetzen zu können.AbstractAs part of a research project, a behavior therapy-oriented cognitive training program, designed to improve the cognitive ability of middle-aged employees (50 to 59 years), was implemented and evaluated. The goal of the training program was to analyze the cognitive, affective and behavior-related conditions of memory deficits in the workplace. The training focused on two topics: (1) development of new job tasks, (2) lack of time and deadline constraints. A total of 316 patients in the psychosomatic clinic of Bad Neustadt participated in the study. Those who showed cognitive impairments took part in the cognitive training program during the intervention phase. During the control phase, patients with cognitive impairments received no additional intervention. The neuropsychological screening was repeated with patients with cognitive impairments at discharge. The findings show that the objective and subjective memory performance of the participants improved significantly compared to that of the control group. At the 1-year follow-up, 84% of the participants reported that they could use the training strategies in their job.As part of a research project, a behavior therapy-oriented cognitive training program, designed to improve the cognitive ability of middle-aged employees (50 to 59 years), was implemented and evaluated. The goal of the training program was to analyze the cognitive, affective and behavior-related conditions of memory deficits in the workplace. The training focused on two topics: (1) development of new job tasks, (2) lack of time and deadline constraints. A total of 316 patients in the psychosomatic clinic of Bad Neustadt participated in the study. Those who showed cognitive impairments took part in the cognitive training program during the intervention phase. During the control phase, patients with cognitive impairments received no additional intervention. The neuropsychological screening was repeated with patients with cognitive impairments at discharge. The findings show that the objective and subjective memory performance of the participants improved significantly compared to that of the control group. At the 1-year follow-up, 84% of the participants reported that they could use the training strategies in their job.

Beruflicher Wandel und Psychotherapie älterer Arbeitnehmer

Umgangssprachlich finden sich viele Begriffe fur berufliche Uberforderungs- und Konfliktkonstellationen, wie Tabelle 1 zeigt.