The aftercare intervention was efficacious in enhancing treatment outcome after discharge from inpatient treatment.

The development of a text messaging (SMS) based intervention for the aftercare treatment of bulimia nervosa is reported. The programme is offered to bulimic patients for 6 months following discharge from inpatient psychotherapy in a German hospital for psychosomatic medicine. The intervention consists of weekly messages from the patients on their bulimic symptomatology and a corresponding weekly feedback that is a mixture of pre-programmed parts and individually tailored information. An ongoing pilot study is described, designed to investigate the acceptance, the practicability, and the effectiveness of the intervention. Preliminary results indicate that the programme is well-accepted and gives support to bulimic patients after finishing inpatient treatment. Advantages and limitations of the use of the SMS intervention programme in the treatment of bulimia nervosa are discussed.

a b s t r a c tObjective: Depression and burnout are two psychopathological labels that have been subject to an extensive discussion over the last decades. The crucial question is whether they can be seen as conceptually equal or as two distinct syndromes. One argument for the distinction is that depression impacts on the whole life of a suffering person whereas burnout is restricted to the job context. Depression has been shown to be affected by life stress. The more stressful life events a person experiences, the more he or she is susceptible for developing a depression. As there is the widespread but controversial opinion that burnout is a prodromal syndrome of depression, the present study examined whether the number of stressful life events is also associated with an increased risk for burnout. Methods: N = 755 healthy participants and N = 397 depressed patients completed the Maslach Burnout Inventory (MBI), the Beck Depression Inventory (BDI II) and reported the extent of experienced life stress. Results: A significantly closer relation between depression and life stress than between burnout and life stress was found in the healthy (z = 3.01, p = .003) as well as in the depressed sample (z = 3.41, p = .001). This finding was supported in both samples by means of a path analytic approach where the associations between life stress, burnout, and depression were controlled for possible mediator and moderator effects, also considering the influence of age. Conclusion: By considering the influence of life stress it could be demonstrated that depression and burnout are not identical although they share substantial phenotypic variance (r = .46-.61). Most important, the trivariate associations are the same in a representative employee sample and in an inpatient clinical sample suggesting the same underlying mechanisms covering the whole range from normal behavior to psychopathology. However, only longitudinal data can show if burnout necessarily turns into depression with the consequence that the burnout -life stress association approaches the depressionlife stress association over time.

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Recent research supports the current idea that the incidence of anorexia nervosa and related eating disorders is increasing in Western societies. This phenomenon raises questions regarding the possibilities of prevention. It seems difficult, if not impossible, to change sociocultural influences such as the fashion of slenderness, and upper/middle-class family characteristics. It is more fruitful to search for different risk factors and ‘suspicious’ signs instead of deducting preventive measures from any linear theory of causation. Specific attention should be paid to early recognition of (pre) anorexics, but this secondary prevention is seriously hampered both by patient delay and doctor delay.

Three different methods were used to study perceptual disorders of body image in 36 anorexia nervosa patients and 35 age‐matched ballet/gymnastics pupils: (1) a video distortion of width of head and whole body of the subject; (2) a modification of the Image Marking Procedure first described by Askevold (1975); and (3) the Body Image Screening Scale, a paper‐pencil version (not in a scale of 1:1, but diminished) of (2) (Fichter & Meermann, 1981). Concerning the video task (1), both groups under investigation show underestimation of their own body dimensions (head, whole body “en face,” whole body “en profile”) and of a female dummy. Underestimation seems to be due to the method used. For the other techniques (2,3), we found the known overestimation of body dimensions in anorexia nervosa patients. But the ballet/gymnastics pupils show overestimation as well. Anorexia nervosa patients show significantly higher overestimation in both techniques only for the thighs, calves, and hips. In neither task 1 nor task 3 were there significant differences found between patients and pupils in estimating the size of a female dummy, confirming that our methods deliver information about body image disturbances and not about a more general perceptual disorder including external objects. The diagnostic and therapeutic implications of body image disturbances in anorexia nervosa are discussed.

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Stress-related affective disorders have been identified as a core health problem of the twenty-first century. In the endeavor to identify vulnerability factors, personality has been discussed as a major factor explaining and predicting disorders like depression or burnout. An unsolved question is whether there are specific personality factors allowing differentiation of burnout from depression. The present study tested the relation between one of the most prominent, biological personality theories, Cloninger’s Temperament and Character Inventory, and common measures of burnout (Maslach Burnout Inventory General) and depression (Beck Depression Inventory 2) in a sample of German employees (N = 944) and a sample of inpatients (N = 425). Although the same personality traits (harm avoidance and self-directedness) were predominantly associated with burnout and depression, there was a much stronger association to depression than to burnout in both samples. Besides, we observed specific associations between personality traits and subcomponents of burnout. Our results underline differences in the association of burnout vs. depression to personality, which may mirror differences in scope. While symptoms of depression affect all aspects of life, burnout is supposed to be specifically related to the workplace and its requirements. The much stronger association of personality to depression can be important to select appropriate therapy methods and to develop a more specified treatment for burnout in comparison to depression.