[Long-term study of psychological effects in clinical rehabilitation (VESPER-study)].
OBJECTIVE
The course of chronic diseases does not only depend on the patients' physical situation but also on their psychological state of mind. Therefore, inpatient medical rehabilitation has to aim at including psycho-social features present themselves at the beginning and at the end of inpatient rehabilitation - and, even more importantly, six months afterwards.


METHODS
For half a year all patients of an internistic rehabilitation clinic were taking part in a long- term baseline-study. They have been questioned about anxiety, susceptibility to depression, aspects of quality of life and about their body weight, using a standardized questionnaire. The analyzed total spot check (n = 1222) consisted of cardiological (n = 197; mean age 53,5 +/- 10,9 years), pulmonary (n = 709; mean age 47 +/- 11,2 years) and breast cancer patients (n = 277; mean age 54,2 +/- 8,8 years) and n = 39 could not be classified.


RESULTS
At the onset of rehabilitation all patients suffered significantly more from anxiety than from depression. Accordingly, of the cardiological and pulmonary group 12.2 % or 10.9 % respectively showed a clinically strong depression and 27.9 % or 27.1 % respectively revealed remarkable values in anxiety. Moreover, 17.8 % of the cardiological and 14.7 % of the pulmonary patients stated a remarkable restriction of their fitness. Unexpectedly, the statements of the breast cancer patients group showed lower rates in all these categories. Six months after termination of rehabilitation, a significant long-term improvement of anxiety could be observed, especially for those patients who had had the highest values before. This also applies to patients who had stated the highest depression values initially. In addition, there was also a significant improvement in the capability for fitness, pleasure, relaxation and contact - while the BMI benefited, too.


CONCLUSIONS
The data show that the psychological comorbidity of patients in inpatient medical rehabilitation is much higher than that of the general population and that of the general population and the psycho-social situation, especially for psycho-social very stressed patients, improves considerably on a long-term basis.
Kramer
R
R
Klinik Hüttenbühl der BfA, Bad Dürrheim.
Meissner
B
B
Schultze-Berndt
A
A
Franz
I-W
IW
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000209:etiology*; D001835:Body Weight; D001943:Breast Neoplasms / Q000523:psychology / Q000534:rehabilitation; D003863:Depression / Q000209:etiology*; D005260:Female; D006331:Heart Diseases / Q000523:psychology / Q000534:rehabilitation; D006801:Humans; D008137:Longitudinal Studies; D008171:Lung Diseases / Q000523:psychology / Q000534:rehabilitation; D008297:Male; D008875:Middle Aged; D010809:Physical Fitness / Q000523:psychology; D011788:Quality of Life / Q000523:psychology; D012046:Rehabilitation / Q000523:psychology*; D013315:Stress, Psychological / Q000209:etiology / Q000523:psychology; D011795:Surveys and Questionnaires; D013997:Time Factors