Although supported housing works well for some individuals, a continued need exists for an array of housing with varying levels of structure. The results suggest that clients and families identify the same problems as priorities.

Reliable, language-independent, short screening instruments to test for cognitive function in patients with multiple sclerosis (MS) remain rare, despite the high number of patients affected by cognitive decline. We developed a new, short screening instrument, the Faces Symbol Test (FST), and compared its diagnostic test characteristics with a composite of the Digit Symbol Substitution Test (DSST) and the Paced Auditory Serial Addition Test (PASAT), in 108 MS patients and 33 healthy controls. An Informant-Report Questionnaire, a Self-Report Questionnaire, and a neurologist's estimation of the Every Day Life Cognitive Status were also applied to the MS patients. The statistical analyses comprised of a receiver operating characteristic analysis for test accuracy and for confounding variables. The PASAT and DSST composite score estimated that 36.5% of the MS patients had cognitive impairment. The FST estimated that 40.7% of the MS patients were cognitively impaired (sensitivity 84%; specificity 85%). The FST, DSST and PASAT results were significantly correlated with the patients' physical impairment, as measured by the Expanded Disability Status Scale (EDSS). The results suggest that the FST might be a culture-free, sensitive, and practical short screening instrument for the detection of cognitive decline in patients with MS, including those in the early stages.

In the epidemiological area of Southern Lower Saxony 92 patients with clinically definite or probable diagnosis of multiple sclerosis (MS) were interviewed and examined. This group contained a remarkably high percentage of benign cases (52%) in comparison with a sample of hospitalized patients. Neurological examination revealed spasticity and pareses to be the most important disturbances followed by ataxia and bladder/bowel problems. After a mean duration of 18.4 years, 52% received a pension and about 30% were still working full time. The pension was granted too early to 11 patients and vocational rehabilitation services would be required for 13 men. Although only half of the patients had an acceptable income, the socioeconomic situation of the families was adequate in 71%; 80% lived with their own families and could stay there in case more ambulant services were offered. Psychotherapeutic measures are required among these to relieve the stress within the families (present in 42%)and to improve the coping behavior (unsatisfactory in 60%).

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Die Parkinson'sche Erkrankung (PD) stellt im Zusammenhang mit der demographischen Entwicklung eine zunehmende Belastung für Patienten und die Gesellschaft dar. Die Entwicklung von Behandlungsleitlinien ist eine Maßnahme zur Optimierung der Versorgung von Parkinsonpatienten, deren Umsetzung allerdings mit Investitionen in Fortbildung einhergeht. Ziel dieser Studie war es, die Versorgungskosten in neurologischen Schwerpunktpraxen zu untersuchen, die sich zur Umsetzung bestehender PD-Behandlungsleitlinien verpflichtet haben.

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