Innerhalb der letzten Jahre nahm der Anteil aktiver Internetnutzer über 50 Jahre rapide zu. Auch die damit verbundene Präsenz derer in sozialen Online-Medien erfuhr einen Zuwachs. Die Risiken und Potenziale der Aktivitäten auf diesen Plattformen wurden bisher nahezu ausschließlich altersunabhängig oder nur in Bezug auf eine recht junge Altersgruppe untersucht. Um auf den daraus ergehenden Forschungsbedarf zu reagieren, wurde auf Basis umfassender Literaturrecherche ein entsprechendes Messinstrument in Form eines Online-Fragebogens entwickelt. Hauptelemente sind dabei die Art und Weise der Social-Media-Nutzung, die durch den Grad der Depression repräsentierte psychische Gesundheit, sowie diese beeinflussende Faktoren. Zu Erfassung der depressiven Ausprägung wurde das verkürzte Beck-Depressions-Inventar implementiert und für einen Korrekturversuch des vermuteten Gender Bias angepasst. Der Feldzugang wurde durch das Respondent Driven Sampling in Kombination mit der Vorgehensweise des viralen Marketings geschaffen. Der Fragebogen sowie dessen geplante Verbreitung wurde mit Hilfe eines Pretest auf seine Güte und etwaige Probleme geprüft. Um die ermittelten Effekte der Zielgruppe (N=25) verlässlich zuschreiben zu können, wurde in gleichem Maß eine Refrenzgruppe (N=26) befragt. Die ermittelten Ergebnisse konnten einen Optimierungsbedarf am Erhebungsinstrument und der Umsetzung der gewählten Verbreitungsmethode aufzeigen. Zudem wurden erste Erfolge für den Ausgleichsversuch des Gender Bias verzeichnet. Die Zusammenhänge von Art und Weise der Social-Media-Nutzung und dem Grad der Depressionen wurden in Anlehnung an bestehende theoretische Ansätze untersucht. Neben der persönlichen Relevanz einzelner Grundfunktionen konnten bei den Silver Surfern vor allem die Motive sozialer Interaktion innerhalb sozialer Online-Medien die Ausprägung von Depressionen erklären.

Ce mémoire constitue la poursuite des travaux de validation de Vézina et Bourque de deux échelles d'auto-évaluation de la dépression, soient l'Inventaire de Dépression de Beck et l'Échelle de Dépression Gériatrique et ce, auprès de personnes âgées francophones. Trois volets d'analyse psychométrique ont composé ce projet de recherche dont l'objectif général était d'estimer les performances diagnostiques de ces deux échelles lorsque confrontées à un critère diagnostic de dépression majeure établi selon les critères du Diagnostic and Statistical Disorders(DSM-III-R). Le premier volet avait comme objectif principal de comparer et de déterminer lequel de ces deux instruments offrait la meilleure performance diagnostique auprès d'une population âgée francophone vivant à domicile. Il poursuivait comme autre objectif d'évaluer des indices de stabilité temporelle, de validité concomitante et discriminante ainsi que les taux de sensibilité et de spécificité pour l'ensemble des seuils d'utilisation. Le deuxième volet cherchait à mesurer lequel de ces deux instruments présentait la meilleure performance diagnostique mais cette fois-ci, auprès d'une population âgée francophone vivant en hébergement. Des taux de sensibilité et de spécificité pour tous les seuils d'utilisation, des indices de stabilité temporelle ainsi que de validité concomitante ont également été recueillis auprès de cette deuxième population. Le troisième volet adoptait une perspective d'étude différente en évaluant l'influence du milieu de vie d'hébergement et domiciliaire sur les performances diagnostiques respectives de ces deux échelles. Finalement, l'un des attraits majeur de ces analyses résidait dans l'apport novateur des courbes caractéristiques(Receiver Operating Characteristics (ROC) Curves) au domaine de la psychométrie.

Abstract The aim of this study was to evaluate the results of lumbar spine surgery and determine which factors modify outcome. A follow-up questionnaire, the Beck Depression Inventory (BDI, the Short Form 36 Health Survey (SF-36) and the Oswestry Low Back Disability Questionnaire (ODI) were sent to working-aged patients who had undergone lumbar spine surgery in the Oulu University Hospital between June, 2005 and May, 2008. Those with a BDI ≥ 10 were further classified into either non-melancholic (NmDS) or melancholic depression (MDS) groups. Potential spinal cord stimulation (SCS) candidates were interviewed via telephone. The postal survey was sent to 814 patients, of which 537 (66%) replied. Of these, 361 had undergone disc surgery, 85 stabilizing surgery and 91 decompression. Pain intensity was milder, the frequency of pain more rare, functional disability minimal and quality of life better after disc surgery compared to stabilizing surgery and decompression, which are technically more demanding operations and the patients’ condition are often more serious. Altogether, 213 patients presented with depressive symptoms (DS) defined as having a BDI ≥ 10, and these were further classified into NmDS (n = 153) and MDS (n = 60) subtypes. ODI differed between DS subtypes: those without DS had minimal, NmDS moderate and MDS severe functional disability. Pain was more frequent and more intense among DS patients. In particular, MDS patients suffered from pain, used more pain medication, but received less benefit from it. Disc surgery patients were divided according to body mass index (BMI): normal, pre-obese and obese. Pre-obese and obese patients gained weight during the follow-up. Obese patients had more DS and a worse functional outcome than normal-weighted or pre-obese patients. Of the entire cohort (n = 814), 21 patients received SCS. Eleven respondents underwent SCS treatment after they had replied. Features predicting SCS treatment were daily or continuous pain, higher pain intensity with predominant radicular pain, more severe pain-related functional disability, more DS and reduced benefit from pain medication. The time between lumbar surgery and implantation of a SCS device was extensive. Based on data from phone interviews, it appears that SCS was not offered to all potential candidates. In conclusion, the outcome of lumbar spine surgery was good after disc surgery but less favourable after more demanding stabilizing surgery or decompression. DS, especially of the MDS subtype, and obesity were more often seen in patients with a poorer surgical outcome. SCS treatment was used late and only for patients with very severe pain. / Tiivistelmä Tutkimuksen tarkoitus oli arvioida tuloksia lannerangan kirurgiassa ja kartoittaa tekijöitä, jotka vaikuttavat leikkaustulokseen. Seurantakysely, Beckin depressio¬kysely (BDI), SF-36 elämänlaatukysely ja Oswestryn toiminta¬kyky¬kysely (ODI), lähetettiin työikäisille Oulun yliopistollisessa sairaalassa kesäkuu 2005 - maaliskuu 2008 alaselkäleikatuille potilaille. Beckin depressioasteikko > 10 luokiteltiin ei-melankolisesti masentuneisiin (NmDS) ja melankolisesti masen¬tuneisiin (MDS). Mahdolliset takajuostestimulaatio (TJS) -ehdokkaat haastateltiin puhelimitse. Postikysely lähetettiin 814 potilaalle, joista 537 (66%) vastasi. Näistä 361:lle tehtiin välilevytyräleikkaus, 85:lle stabiloiva leikkaus ja 91:lle juurikanavan avarrusleikkaus. Välilevytyräleikatuilla kipu oli lievempää, harvemmin esiintyvää, toiminnallinen haitta vähäisempää ja elämänlaatu parempaa verrattuna potilaisiin, joille tehtiin vaativampi stabiloiva tai juurikanavan avarrusleikkaus. Kaikkiaan 213 potilaalla oli depressio-oireita (DS, BDI ≥ 10) ja nämä luokiteltiin edelleen NmDS (n = 153) ja MDS (n = 60) alaryhmiin. ODI erottui eri DS alatyyppien välillä: ei-DS-potilailla oli minimaalinen, NmDS-potilailla kohtuullinen ja MDS-potilailla vaikea toiminnallinen haitta. Kipua oli useammin ja voimakkaampana DS-potilailla. Erityisesti MDS-potilaat kärsivät kivuista, käyttivät enemmän kipulääkkeitä ja hyötyivät niistä vähemmän. Välilevytyräleikatut luokiteltiin painoindeksin (BMI) pohjalta normaaleihin, ylipainoisiin ja lihaviin. Ylipainoiset ja lihavat lihoivat seuranta-aikana. Lihavilla potilailla oli enemmän masennusta ja huonompi toiminnallinen tulos verrattuna normaaleihin ja ylipainoisiin. Koko tutkimusryhmässä (n = 814) 21 potilasta oli saanut TJS:n. Yksitoista vastaajaa sai TJS:n kyselytutkimuksen jälkeen. TJS:n saaneilla oli päivittäistä tai jatkuvaa, kovempaa ja pääasiassa jalkaan säteilevää kipua. Kipu aiheutti enemmän toiminnallista haittaa, enemmän masennusta ja nämä saivat vähemmän apua kipulääkityksestä. Aika leikkauksen ja TJS:n asennuksen välillä oli pitkä. Puhelinhaastattelun avulla saatu tieto osoittaa, ettei TJS-hoitoa tarjota kaikille potentiaalisille hyötyjille. Yhteenvetona voidaan todeta, että välilevytyräleikkauksen jälkeen tulos oli hyvä ja vaativampien stabiloivan ja juurikanavan avarrusleikkauksen jälkeen heikompi. DS, etenkin MDS ja lihavuus korostuivat huonommin toipuneissa. TJS-hoitoa käytettiin vain vaikeimmille tapauksille ja odotusajat olivat pitkät.

Psychologist and bariatric tretment of obesity PhDr.Jitka Herlesová Tutor: PhDr.Tamara Hrachovinová, CSc. Abstract The aim of the dissertation thesis is to map psychosocial characteristics associated with obesity and their changes after bariatric surgery. The Empirical part follows the points settled in the Theoretical part. Obesity is a disease, whose prevalence rises. Bariatric and metabolic surgery is one of the most effective treatment of obesity and its comorbidities. The mental diseases are associated with high levels of obesity. The standard part of pre-bariatric examination is the psychological assessment. Several changes accompany the weight loss after bariatric surgery, such as normalization of psychosocial functioning, the decrease of mental disorders but in some cases the changes might be also negative. The Empirical part focuses on the psychosocial characteristics of bariatric surgery candidates assessed during the psychological evaluation and the changes after operation. The data from semi-structured psychological interview, Three factor eating questionnaire, Beck Depression Inventory-II, Obesity Weight Loss Quality of Life and Weight Related Symptom Measure were evaluated. The changes after surgery were assessed after 6, 12 and 24 months. Statistically significant differences were ascertained...

Magister Psychologiae - MPsych / The aim of the present study was to determine whether it was possible to identify changes in levels of postpartum depression and maternal adjustment and attitude in primiparae before and after birth. It aimed, furthermore, at assessing certain risk factors that could provide an understanding of the etiological factors (causes, determinants) influencing postpartum levels of depression and maternal adjustment and attitude. The study focused on risk factors among married and unmarried primiparae (first time mothers), with a view to establishing vulnerability profiles of the respective groups. The specific risk factors that formed part of the investigation were social support, personality (neuroticism) and life events. All the subjects investigated were recruited from the Mitchells Plain Maternity and Obstetrics Unit. A sample of 70 subjects, in the third trimester of pregnancy, voluntarily participated in the first part of this study. Of these, 26 belonged to the married group and 44 belonged to the unmarried group. As a result of the attrition factor, 57 subjects constituted the final sample for analysis. The final sample comprised 20 married and 37 unmarried subjects. Subjects were followed up four to eight weeks postpartum. Results revealed that there were no significant changes in levels of depression between the married and unmarried groups, either before or after delivery. Of significance was that with the event of birth, the depression scores amongst women rated high in neuroticism decreased significantly. Married women with high social support satisfaction scores were found to have low depression scores. Similarly, married women who experienced fewer negative life events had lower levels of depression than did the unmarried women who experienced fewer negative life events. The maternal adjustment and attitude scores did not change before or after birth, except in the married group. The married group showed a significant increase in scores on the maternal adjustment and attitude scores after the birth of the child. Regarding personality (neuroticism), the high neuroticism scorers had significantly lower maternal adjustment and attitude than did the low neuroticism scorers. As was the case with social support and depression, married women with high social support had a higher maternal adjustment and attitude. A significant effect of negative life events on maternal adjustment and attitude was only found for the married women (after delivery) who experienced a low number of life events. A stepwise multiple regression analysis was performed, in order to yield a model in which the depression and maternal adjustment and attitude scores would be predicted by risk factors. The finding of this analysis for both depression and maternal attitude and adjustment was not significant. Social Identity theory was suggested as a possible interpretation of these results. Future research which views social identity as a factor in understanding postpartum depression and maternal adjustment and attitude has been proposed .