Our findings suggest that the effect of stigmatization on skin-related QoL is driven by symptom severity and stigmatization combined, whereas its effect on mental health is driven mostly by stigmatization alone. Further, although women and men experience the social impact of psoriasis differently, the effect of stigmatization on QoL is similar for both genders.

Rosacea is associated with mental distress and depression, yet no studies have looked at the mediating effect of stigmatization and other factors on psychological sequelae. Using a survey of affected individuals, the objective of this study was to explore relationships between self-reported symptom severity, discomfort, stress reactivity, quality of life, and symptoms of depression and anxiety. Participants were recruited from the mailing list of a German rosacea organization. The survey instrument included the Dermatology Life Quality Index (DLQI), the rejection scale of the Questionnaire on Experience with Skin Complaints (QES), and the German version of the Hospital Anxiety and Depression Scale (HADS-D). A total of 168 persons with rosacea were participated. The sample returned a HADS anxiety score of 7.2 ± 4.60, a HADS depression score of 5.1 ± 4.09, a DLQI of 4.05 ± 4.67, and a QES rejection score of 2.,61 ± 3.,37. Path analysis suggested that symptoms of anxiety and depression are linked with somatic symptoms indirectly, mediated through quality of life and stigmatization. Men are more negatively affected. Physicians treating rosacea patients should consider recommending psychological co-treatment for patients who have experienced stigmatization or who report low life quality.

Chronic stress is an additional factor predicting cumulative sickness absence among severely affected OHE patients. Other relevant factors for this study sample included the 'cognitive weariness' subscale of the Shirom Melamed Burnout Measure and the physical component summary score of the SF-36, a measure of health-related life quality. Prevention and rehabilitation should take job stress into consideration in multidisciplinary treatment strategies for severely affected OHE patients.

The delivery of consensually recommended mental health support for ventricular assist device patients involves the performance of multiple, complex tasks that vary across treatment phases. Mental health professionals should have specialized skills and should interact frequently with other caregivers in care teams.

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Zusammenfassung Fragestellung Ziel dieser Studie ist es, die Bedeutsamkeit des Geschlechts im Verlauf und Erfolg psychosomatischer Rehabilitation genauer zu bestimmen. Methoden Die Stichprobe besteht aus 401 Rehabilitanden einer stationären psychosomatischen Rehabilitation, 72% Frauen, 28% Männer, Durchschnittsalter 49 Jahre. Sie wurden zu Rehabilitationsbeginn, -ende sowie 12 Monate danach befragt. Die Rücklaufquote zum Follow-up beträgt 74%. Ergebnisse Die Ergebnisse zum Verlauf zeigen bei fast allen untersuchten Variablen signifikante Verbesserungen, am deutlichsten bei den ressourcenbezogenen bzw. klinischen Merkmalen (Selbstregulationsfähigkeit, Resilienz, Symptombelastung) und dem objektiven, für den Rehabilitationserfolg wichtigsten Indikator Return-to-Work. Allerdings zeigten die Untersuchungen der anderen arbeitsbezogenen Variablen geschlechtsunabhängig nur sehr geringe Verbesserungen (subjektive Prognose der Erwerbstätigkeit) oder eine Verringerung (Arbeitsmotivation). Die Effektstärken zu den Verbesserungen der ressourcenbezogenen und klinischen Merkmale liegen bei den Frauen (d=0,67 bis 1,35) etwas höher als bei den Männern (d=0,55 bis 0,93), obgleich die Return-to-Work-Rate bei Männern etwas höher ist (78 vs. 71%). Subgruppenanalysen kommen zu dem Ergebnis, dass für beide Geschlechter eine unterdurchschnittliche Symptombelastung und eine hohe Resilienz vorteilhaft für die Rückkehr in den Beruf sind. Schlussfolgerung Arbeitsplatzbezogenen Merkmalen sollte sowohl bei Frauen als auch bei Männern in der psychosomatischen Rehabilitation eine größere Bedeutung eingeräumt werden.

Zusammenfassung. Antriebslosigkeit und Motivationsdefizite im Beruf sind für viele Personen wichtige Aspekte bei depressiven Störungen. In der kognitiven Verhaltenstherapie (KVT) der Depression nach Beck ist die Förderung der berufsbezogenen Motivation bislang ein untergeordnetes Ziel. Dieser Beitrag stellt Aussagen und Wirkungen der kognitiven Verhaltenstherapie zum Thema Arbeitsmotivation dar und fragt nach ihren motivationalen Folgen. Es wird ein erwartungs-wert-bezogener Ansatz für Emotionen und Motivation nahegelegt. Um zu einer systematischeren Förderung der beruflichen Motivation in der KVT zu kommen, empfehlen wir, die Begriffe intrinsische Arbeitsmotivation und Interesse in Zukunft zu fokussieren und Förderstrategien aus der pädagogischen Psychologie zu übernehmen oder zu adaptieren.

A psychosomatic consultation for regional health care in the workplace – evaluation and recommendations Goal: The study’s goal was the qualitative evaluation of a new variant of the mental health intervention “psychosomatic consultation in the workplace” from the perspective of participating firms and individuals. Methods: The study data encompassed group discussions with workplace actors based on open-ended interview questions about their experiences with the intervention and narrative interviews with individual participants. This material was augmented by problem-oriented expert interviews with psychotherapists and company medical officers and by descriptive statistics of the individuals participating in the consultation. Results: All the firms implemented the consultation in response to perceived high rates of sick leave caused by mental health problems and due to a lack of confidence in how to deal with the employees concerned. The advantages of the consultation are seen to lie in its easily accessible and timely provision of professional assistance (psychoeducation, short interventions, coaching in difficult life situations and referral to other parts of the medical system) and in its flexibility in implementation. The consultation is adaptable to firms’ varying expectations and needs and increases the confidence of workplace actors (especially top management, personnel management, company medical officers and employee representatives) in dealing with mental health problems. Conclusions: The consultation proved to be a flexible, practicable and beneficial part of primary, secondary and tertiary prevention measures in the workplace. It can have positive effects on the preventive behaviour of individual participants. It is recommended that such programmes should be coupled with additional health-promotion services inside and outside the company in the future. Employees should be able to choose between using the consultation either anonymously or non-anonymously in consultation with a trusted colleague or company medical officer. Some form of (anonymous) feedback to company management on the findings of the consultation in relation to systemic sources of psychological distress is also recommended for the purpose of introducing suitable preventive measures. Keywords: psychosomatic consultation in the workplace (PSIB) – mental health – intervention – occupational medicine