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BACKGROUND: Depression predicts adverse prognosis in patients with coronary artery disease (CAD), but previous treatment trials yielded mixed results. We tested the hypothesis that stepwise psychotherapy improves depressive symptoms more than simple information. METHODS: In a multicenter trial, we randomized 570 CAD patients scoring higher than 7 on the Hospital Anxiety and Depression Scale-depression subscale to usual care plus either one information session (UC-IS) or stepwise psychotherapy (UC-PT). UC-PT patients received three individual psychotherapy sessions. Those still depressed were offered group psychotherapy (25 sessions). The primary outcome was changed in the Hospital Anxiety and Depression Scale-depression scores from baseline to 18 months. Preplanned subgroup analyses examined whether treatment responses differed by patients' sex and personality factors (Type D). RESULTS: The mean (standard deviation) depression scores declined from 10.4 (2.5) to 8.7 (4.1) at 18 months in UC-PT and from 10.4 (2.5) to 8.9 (3.9) in UC-IS (both p < .001). There was no significant group difference in change of depressive symptoms (group-by-time effect, p = .90). Preplanned subgroup analyses revealed no differences in treatment effects between men versus women (ptreatment-by-sex interaction = .799) but a significant treatment-by-Type D interaction on change in depressive symptoms (p = .026) with a trend for stronger improvement with UC-PT than UC-IS in Type D patients (n = 341, p = .057) and no such difference in improvement in patients without Type D (n = 227, p = .54). CONCLUSIONS: Stepwise psychotherapy failed to improve depressive symptoms in CAD patients more than UC-IS. The intervention might be beneficial for depressed CAD patients with Type D personality. However, this finding requires further study. TRIAL REGISTRATION: www.clinicaltrials.gov NCT00705965; www.isrctn.com ISRCTN76240576.

OBJECTIVE: The relationship between attachment orientations and the recovery from depressive symptoms in patients diagnosed with coronary artery disease (CAD) with and without a psychotherapeutic intervention was examined in this study. METHODS: In a multicenter trial of 570 depressed CAD patients (SPIRR-CAD), assigned to usual care plus either a stepwise psychotherapy intervention or one information session, 522 patients provided attachment data at baseline. Attachment was measured with the Relationship Scales Questionnaire (RSQ), yielding four attachment orientations. The primary outcome was change in Hospital Anxiety and Depression Scale depression (HADS-D) scores from baseline to follow-up at 18 months. Secondary outcomes were HADS-D scores at 1, 6, 12, and 24 months. RESULTS: Independent of treatment assignment, attachment was related to change in depression at 18 months (p

Die Lüge gehört zur Psychologie des Alltagsverhaltens. Sie ist in jedem sozialen Kontext einsetzbar und mit jeder denkbaren Motivstruktur zu verbinden. Definitorisch ist davon auszugehen, dass nur dann von einer Lüge gesprochen werden kann, wenn eine bewusste Entscheidung des Akteurs vorliegt (nicht vollständig aufrichtig zu sein) und das Opfer keine Zustimmung zu dieser Verhaltensvariante gegeben hat. So wie man nicht nicht kommunizieren kann (Watzlawick), so kann man demnach nicht leben ohne zu lügen und dennoch unterscheiden sich Menschen beträchtlich hinsichtlich der Häufigkeit sowie der eingesetzten Technik des Lügens und vor allem bezüglich der implizierten Destruktivität. Es werden bedeutende Motivstränge des Lügens sowie die gängigen Techniken und deren Vor- und Nachteile erläutert. Die beiden großen Forschungszweige der Psychologie zur Aufdeckung von Lügen werden skizziert (der Lügendetektor und die Analyse der Körpersprache). Le mensonge est un comportement psychologique de la vie quotidienne qui peut donc apparaître dans tout contexte social et avoir un lien avec toutes les motivations possibles. La la présente analyse se fonde sur la définition suivante : le mensonge relève d’une décision consciente de son auteur (n’être pas tout à fait sincère), en l’absence de consentement de la victime. De même que l’on ne peut pas ne pas communiquer (Watzlawick), on ne peut pas vivre sans mentir. Toutefois, les humains sont très différents les uns des autres en ce qui concerne la fréquence de leurs mensonges, les techniques qu’ils utilisent et avant tout la destructivité impliquée. Sont abordées ici les motivations les plus importantes de l’acte de mentir et les techniques utilisées le plus couramment, dans leurs aspects positifs et négatifs. Sont ensuite évoqués rapidement deux grands domaines de recherche en psychologie sur le mensonge (détecteur de mensonge et analyse du langage corporel). Lying is part of our everyday behaviour: it appears in every social context and is linked with all existing motivations. For our understanding of this kind of behaviour it is necessary to claim that lying is always a clear decision of the acting person (not to state the truth) and that the victim did not declare his agreement. As one cannot help communicating (Watzlawick), one cannot live without lying. Nevertheless people greatly differ as to the occurrence, the techniques and the destructiveness of their lies. This article discusses the most important motivations and techniques as well as their advantages and disadvantages. It also outlines the most important areas of scientific research (for example, lie detector, polygraph and body language).

Live kidney donation is increasing rapidly. Increases of blood pressure and proteinuria but no accelerated loss of renal function in kidney donors have been described. The credibility of this research is hampered by retrieval rates of only 50-70% of donors. We studied renal function, blood pressure, proteinuria, parathyroid hormone, 1,25(OH)2 cholecalciferol and calcium and phosphate excretion in a live kidney donor cohort with a 93% retrieval rate. A comprehensive physical and laboratory examination including 24-h urine collection was conducted. None of the 152 donors had renal failure. Mean time after uninephrectomy was 11 +/- 7 (range: 1-28) years. GFR had declined by 25%. Blood pressure had increased from 125 +/- 15/79 +/- 11 to 134 +/- 19/81 +/- 9 mmHg (p0.01) but remained significantly below normal. Fifty six percent of donors developed proteinuria (150 mg/day), but only 10% had albuminuria. Nineteen percent had increased PTH, 30% had a decreased tubular reabsorption rate of phosphate. Regarding risk factors for a higher loss of GFR, greater increases in blood pressure or proteinuria no consistent picture emerged. Because of the high incidence of proteinuria and possible changes in bone metabolism inclusion of kidney donors in registries appears worthwhile.

OBJECTIVES: This multi-methodical single case study examines how relationship, resistance and insight, the important therapeutic factors, are conveyed in a therapeutic process. METHODS: For depicting interaction the textual parameters - direct speech, acknowledgement tokens, activity of speech and personal pronouns - of Formal Psycholinguistic Text Analysis (Overbeck et al., 1996) are applied. The activity of the unconscious theme is measured by the Interferenzindex (Argelander, 1984). The link of emotional experiences with words is depicted by the Computerized Referential Activity method (Mergenthaler and Bucci, 1999). The attainment of emotional insight in the Model of the Therapeutic Cycle is perceived via the Emotion-/Abstraction-Patterns (Mergenthaler, 1997). RESULTS: Three phases are discriminated accordingly: Resistance, characterised by defensive intellectualization, symbolic representation on the basis of the secure relationship and emotional insight and detachment. CONCLUSIONS: The validity of the results in this single case study is guaranteed by the multi-methodical strategy.

The aim of the study was a comprehensive psychological evaluation of living kidney donors. Existing studies indicate a high donor satisfaction with the decision to donate and good donor quality of life in short-term, as well as in long-term follow-up periods. In many studies, questionnaires with only a few items have been used to assess psychological health or well-being; however, most studies exclusively measured quality of life. Therefore, our retrospective single center study applied a broad assessment of psychological variables. We evaluated whether standardized, differentiated and specific psychological research instruments confirmed the positive, long-term condition of kidney donors as reported in the scientific literature, albeit based on a limited set of variables.From 1973 to 2001, 152 nephrectomies were performed in Frankfurt. In the context of a detailed medical follow-up examination, a psychological study was implemented using a semi-structured interview and a set of four standardized, well-established questionnaires. Overall, data from 145 donors was included in the medical follow-up and 112 donors participated in the psychological investigation.The mean age of donors was 55.9 (+/- 10.7) yrs at follow-up, and the time-since-donation was 11.2 (+/- 7.5) yrs. Donors scored better on a wide range of the psychological scales such as psychological symptoms, health behavior and health consciousness that was to be expected in comparison with data from representative German population samples. Nearly all donors (97%) would choose to donate again, and 91% remain entirely satisfied with their decision.The study demonstrates that existing results, reporting positive long-term psychological donor well-being, could be confirmed by a set of comprehensive, standardized and multi-methodological psychological instruments.