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Objective: Spouses of patients with depression have an elevated risk to develop an affective disorder themselves. We evaluate whether a group intervention program for spouses of patients with depression does improve participants' depressive and anxiety symptoms., Methods: 66 spouses participated in a six months intervention with 12 group sessions. 50 nonparticipants were included as a control group. We measured depressive and anxiety symptoms with the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI) at the beginning and the end as well as 3 and 9 months after the intervention., Results: The intervention did not cause any improvement with regard to BDI and BAI scores. Scores in the BDI and BAI were normal in most participants before the intervention. Regardless, satisfaction with the program among participants was very high., Conclusion: The influence of the intervention concept on the wanting participation of more severely affected spouses is discussed and adaptations of the program are proposed.

A new group intervention program has been assessed, rating its ability to increase the quality of life in partners of patients suffering under depression. Over a period of six months 66 subjects participated in an intervention group for a total of twelve sessions. The control group consisted of 50 persons, and quality of life was assessed with the WHOQOL-BREF. The five WHOLQOL domains were used as independent variables in random-effects regression models measuring the time effect. Although the quality of life of the subjects was below that of the general population at the beginning of the intervention, the study resulted in no significant improvement in quality of life. In contrast, satisfaction of participants with the intervention was high.

Objective: To determine the conditional factors underlying a premature termination of vocational rehabilitation programs., Methods: 123 rehabilitation participants were assessed prospectively regarding sociodemographic and psychopathological variables, level of functioning, subjective health, intellectual and work capacity., Results: 23 persons terminated rehabilitation prematurely. Drop-outs differed regarding sociodemographic and illness-related variables, in subjective physical health, level of functioning, intelligence and work capacity. Three types of "drop-outs" could be identified: Termination due to exacerbation (of a functional psychosis), due to reluctance to show-up (mainly men with antisocial personality disorders) and a non-specific group., Conclusion: Vocational rehabilitation of subjects with severe mental illness should take account of each rehabilitant's individual capacities and abilities as well as individual concepts of the disorder. Moreover, integrated concepts of medical treatment and vocational rehabilitation are needed to ensure rehabilitation success.

Objective: Persons with severe mental illnesses often need additional vocational rehabilitation in order to gain or regain an adequate capability to work. The objective of this paper is the assessment of work capability and its development throughout the rehabilitation process, as well as clarification of its correlating variables, and predictors., Method: We present data obtained at two different points in time (at rehabilitation program intake and at the six month mark of being in the program) from a sample of 117 rehabilitants. Capability to work was assessed by using the adapted German version of the Work Personality Profile (WPP), called the Arbeitsfähigkeitenprofil (AFP). Additionally, sociodemographic, intellectual, psychopathological, and subjective quality of life measures were examined., Results: The AFP sum score revealed a significant change after six months' participation in the rehabilitation program. More precisely, for the subscales "capability to learn" and "communication skills", a significant increase was obtained, whereas "social adaptation" showed a non-significant improvement., Conclusion: Our results show that the rehabilitants' "capability to work" had improved at the six month mark of the rehabilitation program. It appears that baseline variables of the AFP subscales at program intake were largely related to psychopathology and subjective quality of life measures. Sociodemographic parameters, educational level, and attention measures were associated with work capability improvement after six months.

Objective: To assess subjective quality of life (QOL) of subjects with unipolar depressive and bipolar affective disorders., Methods: 153 consecutive psychiatric in-patients were assessed with standardized interviews. Prior to discharge QOL was assessed with WHOQOL-bref. With the help of multivariate statistics, the effect of illness and biographical factors on four domains of QOL (physical health, psychological, social relationships and environment) was analyzed., Results: 103 patients suffered from unipolar depression, 51 from bipolar affective disorder (30 fulfilled criteria for a mixed or pure manic episode). With the exception of the domain environment for (mixed) manic patients, all patients reported lower QOL in all domains than was reported for the general population according to the German test manual. Multivariate analyses revealed that the chosen variables explained between 11.1 % (social relationships) and 33.6 % (psychological) of the variance of the QOL domains. The domains "psychological" and "environment" were first of all explained by the presence of a (mixed) manic episode, while the best variable to predict "physical health" was presence of comorbid neurotic disorder. The depression score had little additional effects on QOL., Conclusions: We found little support that the QOL domains of the WHOQOL-bref in affective disorder are only hidden depression scores, as has been argued before. Therefore, QOL could be an interesting construct to better understand differences between subjective evaluation and (supposedly) objective psychopathology in bipolar affective disorders.

Objective: Little is known concerning the frequency of disability payments due to depressive and bipolar affective disorders in Germany., Method: 177 consecutive psychiatric in-patients were assessed with standardized interviews concerning diagnosis (SCID-I, DSM-IV) and illness history. To compare unipolar depressive and bipolar affective patients, a survival analysis was calculated., Results: 116 patients suffered from unipolar depression, 61 from bipolar affective disorder. Highly significantly, patients with bipolar affective disorders were granted disability payments more frequently and at an earlier age. Half of the bipolar affective patients received disability payments by the age of 46 years, half of the unipolar depressive patients by the age of 58 years., Conclusions: In this sample, bipolar affective patients received disability payments frequently and at an early age, which stresses that the prognosis of bipolar affective disorders is not as good as has been assumed for a long time. Early disability payments may lead to poverty and may obstruct access to social rehabilitation.