T. Loew

Functional Relaxation and Guided Imagery as Complementary Therapy in Asthma: A Randomized Controlled Clinical Trial

Background: Asthma is a frequently disabling and almost invariably distressing disease that has a high overall prevalence. Although relaxation techniques and hypnotherapeutic interventions have proven their effectiveness in numerous trials, relaxation therapies are still not recommended in treatment guidelines due to a lack of methodological quality in many of the trials. Therefore, this study aims to investigate the efficacy of the brief relaxation technique of functional relaxation (FR) and guided imagery (GI) in adult asthmatics in a randomized controlled trial. Methods: 64 patients with extrinsic bronchial asthma were treated over a 4-week period and assessed at baseline, after treatment and after 4 months, for follow-up. 16 patients completed FR, 14 GI, 15 both FR and GI (FR/GI) and 13 received a placebo relaxation technique as the control intervention (CI). The forced expiratory volume in the first second (FEV1) as well as the specific airway resistance (sRaw) were employed as primary outcome measures. Results: Participation in FR, GI and FR/GI led to increases in FEV1 (% predicted) of 7.6 ± 13.2, 3.3 ± 9.8, and 8.3 ± 21.0, respectively, as compared to –1.8 ± 11.1 in the CI group at the end of the therapy. After follow-up, the increases in FEV1 were 6.9 ± 10.3 in the FR group, 4.4 ± 7.3 in the GI and 4.5 ± 8.1 in the FR/GI, compared to –2.8 ± 9.2 in the CI. Improvements in sRaw (% predicted) were in keeping with the changes in FEV1 in all groups. Conclusions: Our study confirms a positive effect of FR on respiratory parameters and suggests a clinically relevant long-term benefit from FR as a nonpharmacological and complementary therapy treatment option.

Cabergoline treatment in men with psychogenic erectile dysfunction: a randomized, double-blind, placebo-controlled study

The effectiveness of cabergoline in 50 men with psychogenic erectile dysfunction was investigated in a 4-month, randomized, placebo-controlled, double-blind study with validated psychological tests, and prolactin, follicle-stimulating hormone, luteinizing hormone and testosterone serum levels. Cabergoline treatment was well-tolerated and resulted in normalization of hormone levels in most cases. In the cabergoline-treated group, significant interactions between prolactin and testosterone serum concentrations were observed. Erectile function improved significantly. Sexual desire, orgasmic function, and the patients and his partners sexual satisfaction were also enhanced. Cabergoline may be an effective and safe alternative agent for men with psychogenic ED.

[Self-help and consultation via Internet. Self-responsible users redefine the physician-patient relationship].

Zusammenfassung.Die verstärkte Nutzung von Internet-Gesundheitsportalen zur Informationssuche über die eigene Krankheit und zum Erfahrungsaustausch mit anderen Betroffenen kann zu einem besser informierten, mündigen Patienten führen und eine neue Art der Arzt-Patienten-Beziehung begünstigen. Vor allem bei eingreifenden und chronischen Erkrankungen wie Krebs, HIV-Infektion, Essstörungen und Depression sind Patienten für begleitende Unterstützung durch Informationsseiten und Kommunikation in Foren, Mailinglisten und Chats dankbar. Internetbenutzer mit Essstörungen gaben in einem Onlinefragebogen an, sie fühlten sich von ihren Peers verstanden und würden durch die Nutzung des Onlinemediums nachhaltig zur Therapie ermutigt.Statt um ihren Wissensvorsprung zu bangen, können Ärzte durch aktive Mitgestaltung geeigneter Onlinemedien die Chancen des Internets für eine patientenzentrierte, professionell begleitete Therapie, Verbesserung der Compliance, erleichterte Nachsorge und örtlich flexible Versorgung ihrer Patienten nutzen. Die Evaluation solcher internetgestützter Behandlungsangebote ist aber in jedem Fall erforderlich.Abstract.Using e-health portals to the internet seeking information about one’s illness and to exchange experience with other sick persons can result in more self-responsible patients and in a more partnership-based physician-patient relationship. Especially with serious and chronic diseases like cancer, HIV infection, eating disorders, and depression, concerned patients may find support by accessing web pages and by using internet communication like message boards, mailing lists, and chat rooms. In an online questionnaire, internet users with eating disorders stated that they felt understood by their internet peers and, therefore, were encouraged to start therapy.Physicians may fear their advance in knowledge to decrease, resulting in an overprotective attitude to the informed patient. Nevertheless, they will recognize, by active participation, that the medical internet may promote an earlier start of expert-guided therapy, improved compliance, aftercare, and basic care independent of place and time. However, further evaluation of internet-supported treatment is required.

Anger, interpersonal relationships, and health-related quality of life in bullying boys who are treated with outpatient family therapy: a randomized, prospective, controlled trial with 1 year of follow-up

Objective. Ten to 30% of students engage in bullying behavior. Bullies stand out on account of increased anger, poor interpersonal relationships, and poor quality of life. Our aim was to determine the effectiveness of outpatient family psychotherapy as a monotherapy for anger reduction and improvement of behavior and interpersonal relationships and of health-related quality of life in male youths with bullying behavior. Methods. Twenty-two boys with bullying behavior took part in a family therapy program for 6 months. The control group was also composed of 22 youths and took part in a placebo intervention program. Every 2 weeks, results were checked with the Adolescents Risky-Behavior Scale (ARBS), the State-Trait Anger Expression Inventory (STAXI), the Inventory of Interpersonal Problems (IIP-D), and the SF-36 Health Survey (SF-36). Follow-up testing took place 12 months after treatment. Results. In comparison with the control group (according to the intention-to-treat principle), bullying behavior was reduced. Significant changes on all ARBS scales and on the STAXI scales State-Anger, Trait-Anger, Anger-Out, and Anger-Control were observed after 6 months. In the IIP-D, significant differences were found on the scales for overly autocratic, overly competitive, overly introverted, overly expressive, and exploitable/compliant. In the SF-36, significant differences were observed in general health perceptions, vitality, social functioning, role-emotional, and mental health. The reduction in expression of anger correlated with a reduction in several scales of the ARBS, IIP-D, and SF-36. Follow-up after 1 year showed relatively stable, lasting treatment effects. Conclusion. The results of this study show that outpatient family therapy seems to be an effective method of reducing anger and improving interpersonal relationships and health-related quality of life in male youths with bullying behavior. Language: en