We are very interested in clinical pictures that are considered "difficult" to treat, especially so-called functional disorders. We have been able to gain a new perspective on these clinical pictures, which has resulted in other forms of therapy. We are constantly developing these - mainly non-drug - therapy methods.
On these pages you will find some results of our accompanying research.
Dissertation in cooperation with Heidelberg University
We are currently conducting a study on the importance of breathing for functional disorders.
This involves measuring the respiratory gases before and after therapy in each case, and asking a series of questions by means of a questionnaire.
Dizziness online survey
We work intensively on differentforms of vertigo. This concerns especially those, where no organic cause can be identified. If you suffer from vertigo, you can help us in our work byanswering a questionnaire. Like all our surveys, this one is completely anonymous. No personal data, email or IP address is collected.
We have been completely surprised by the response to our request. It already appears to be one of the most comprehensive data collection efforts we are aware of on the topic.
Results can be found in the film below, if you have not yet participated in the survey, we would be happy if you took a few minutes to do so.
Vulvodynia online survey
Unfortunately, little research has been done on vulvodynia syndrome. Therefore, we are currently conducting a survey in collaboration with a Swiss self-help group(www.vulvodynie.ch) in order to better understand correlations and to gain new insights into therapy.
This survey is anonymous. We do not collect any name, email, IP address or other personal information.
If you feel that you suffer from vulvodynia, we would be very grateful if you could take a few minutes to complete this questionnaire. The investigation will continue even after the first results are available. However, please fill out the questionnaire only once.
Muscle fasciculation online survey
Thesymptoms can seem extremely threatening: Suddenly, the muscles twitch in various parts of the body. At the same time, nothing moves and it does not hurt. Only under the skin do parts of the muscles seem to develop a life of their own. What are these strange complaints? Are they really threatening?we try to understand the clinical picture better. If you take 2-3 minutes of your time and fill out theonline questionnaire, you will help us. Thank you very much!
Phagophobia - fear of swallowing - online survey
Phagophobia or swallowing anxiety is the fear of swallowing. This is usually accompanied by a fear of choking (choking phobia) and should not be confused with globus hystericus or anorexia nervosa. In addition to the fear of choking on food, there may also be a fear of swallowing saliva.
We have been able to gain new insights into fear of swallowing that will lead to better treatment outcomes. Since there is little research in this area, we ask you tofill out anonline questionnaire( if you suffer from swallowing anxiety. You will then find the results on youtube or on our pages.
CFS online survey
In recent years, we have been able to establish that many exhausted patients show changes in their breathing. These correlations are still very little researched but allow the development of new therapeutic strategies.
We would therefore be very grateful if you would fill outthe following questionnaire. You also have the possibility to send an email at the end (cfs@weiss.de) if you want to be informed about the first results and you will find out where they will be published.
Derealization online survey
Respiratory therapy online survey
After therapy with us, we are currently using other novel methods of respiratory therapy. We are exploring these with aquestionnaire.
Diploma Thesis Psychological Institute University of Heidelberg
Self-help research
In several years of work, a model project was carried out in Baden-Württemberg, which is probably (possibly worldwide) unique in this form.
Fundamental points: Self-help is a recognized important element in the treatment of fibromyalgia. The exchange with affected persons means not to be alone anymore and to put one's own fate into perspective. At the same time, confrontation with the abundance of suffering can also be a burden. Especially when fellow sufferers are much worse off.
In this situation, a 3-month program was developed in cooperation with the Rheumatism League and with Prof. Fyndrich, University of Heidelberg, and Dr. Weiss, which is intended to provide practical help beyond conversation.
Content elements of the self-help
- Stretching exercises
- Gymnastic exercises
- muscle building
- Nutritional build-up, weight normalization
- Relaxation techniques, self-observation
- Group discussions: taking care of the body, consideration for oneself, forming a partnership, dealing with pain, relapse prevention, etc.
- Partners are included in one evening.
The model project is scientifically supervised by the Psychological Institute of the University of Heidelberg. Currently, the working group includes several diploma and doctoral students under the supervision of Prof. Dr. Fydrich. The research instrument consists mainly of a 10-page questionnaire.
Diploma theses
Some years ago we developed a self-help program for fibromyalgia groups, which was scientifically supervised by the University of Heidelberg (Psychological Institute).
Some diploma theses have been published about it, which you can find here.
Evaluation of a structured behavioral self-help program for fibromyalgia: results of the 12-month catemnesis on changes in psychological well-being
In this paper, the long-term efficacy of a behavioral medical treatment program for FMS sufferers, the Twelve-Week Program by Weiss, MD (2000), in the area of psychological well-being was examined against the background of mul- tidimensional pain models. The program was conducted under non-professional guidance in fibromyalgia self-help groups, which was a novelty in the field of FMS treatment. The goal of this intervention was not to eliminate pain, but rather to improve coping with the disease in terms of tertiary prevention. As in the study of effectiveness immediately after completion of the program, "depressiveness", "subjective impairment due to physical and psychological symptoms", "cause attributions" and "control beliefs" were again taken as significant dependent variables within the catamnesis study. In the self-help organization of the Rheuma-Liga Baden-Württemberg e.V., 36 (of originally 76) participants in self-help groups who went through the twelve-week program were compared with 61 (of originally 131) participants in self-help groups who continued their traditional program over a study period of one year. A standardized questionnaire with elements of the pain questionnaire of the Documentation Working Group of the German Society for the Study of Pain (DGSS; Dillmann et al., 1998; now German Pain Society DSG), the General Depression Scale (ADS; Hautzinger, & Bailer, 1993/22012), the Brief Symptom Inventory (BSI; Franke, 2000), and the Rheumatism Control Scale (RKS; Leibing, Hoyer et al. 1999).
Whereas in a group comparison directly after the intervention, the expe- rimental group showed stronger positive effects regarding the variables "depressiveness" (ADS) and "physical and mental impairment" (BSI), these rather small effects did not occur one year later, nor did positive changes regarding the BSI scales "somatization," "anxiety," and "depressiveness." Control beliefs alone were still higher in the EG than in the TG after one year. One year after the intervention, all participants continue to attribute their complaints more frequently to factors that are easy to influence, something that may motivate them to remain active and not to accept their illness as an inevitable fate.
The results now available from all completed studies show that the multimodal self-help program showed therapeutic success in all areas studied, albeit less than expected and primarily immediately after the intervention at t2. However, the program was well accepted by the participants (Schmidt, E., 2003) and was still considered effective by 80% of the participants one year later (Beyer, 2005). This and the important improvement in the physical condition of the patients, which also has a positive effect on their health, have been very positive.
This and the improvement in physical well-being, which is important for the patients and was still evident after one year (Kadura, 2003), make a continuation of the twelve-week program appear desirable. However, based on the results of the study, a few changes would be desirable to increase the longer-term effectiveness. One possibility would be to involve a professional helper as a contact person, another would be to dovetail the program better with the specialist care of the participants, and finally, to repeat individual program modules at regular intervals so that the contents become present again and can be better integrated into everyday life in the long term. Then there is a lot to be said for a self-help program as a possible supplement to specialist care, which takes the patients seriously and in the course of which the participants can actively tackle their illness and thus experience self-efficacy.
To the entire work
Evaluation of a structured behavioral self-help program for fibromyalgia: changes in psychological well-being
Against the background of multidimensional pain models, the effectiveness of Weiss' 12-week self-help program in the area of psychological well-being was examined for individuals with the chronic pain disorder fibromyalgia. It is novel in the field of chronic pain evaluation research that such a self-help program was self-administered under nonprofessional direction by FMS sufferers. Significant dependent variables were depressiveness, subjective impairment due to physical and psychological symptoms, and locus of control. Within the self-help organization of the Rheuma-Liga Baden-Württemberg e.V., 68 persons of the experimental group, who underwent the 12-week program, were compared with 118 persons of the traditional group, both times predominantly women with an average age of 54 years, before and after the intervention. The data collection instruments used were a standardized questionnaire with items from the pain questionnaire of the Documentation Working Group of the German Society for the Study of Pain (DGSS; Dillmann, Nilges, Saile & Gerbershagen, 1998), the General Depression Scale (ADS; Hautzinger & Bailer, 1993), the Brief Symptom Inventory (BSI; Franke, 2000), and the Rheumatism Control Scale (RKS; Leibing, Hoyer et al. 1999).
In a group comparison, the experimental group showed stronger positive effects regarding the variables depressiveness (ADS) and physical and mental impairment (BSI) after the intervention than the traditional group. Regarding the BSI scalesSomatization, Anxiousness, and Depressiveness, positive changes were shown - as expected. Overall, however, the effect sizes were small to medium. Very weak effects were found with regard to the variable conviction of control. From the results it is concluded that the multimodal self-help program under non-professional implementation shows therapeutic successes, which are, however, smaller than expected. It is worth considering the addition of a professional management for the implementation of the 12-week program with the aim of achieving a higher effectiveness of the approach or the further development of the program in the sense of a temporal extension, as this can further consolidate the individual building blocks of the program.
To the complete work
Catamnesis study of a structured behavioral self-help program for fibromyalgia patients: Change in physical well-being
In the present study the effectiveness of the 12-week program of Weiss (2000) was examined with regard to the physical well-being of FMS patients. The program is a structured behavioral self-help program that was developed based on the latest findings of research in the field of chronic pain disorders, as well as many years of practical experience with sufferers. It meets the requirements of current biopsychosocial models. In the context of this and two previous studies it proved to be successful.
To the complete work
Fibromyalgia and neurasthenia
The results could show that in relation to mental disorders such as major depression, anxiety disorders and somatoform disorders, the subjects had a higher prevalence rate compared to the general population. When comparing these mental disorders with respect to chronic somatic diseases, only the prevalence of major depression of the FM patients was comparably high. The prevalence of anxiety disorders was higher in FM patients compared to persons with chronic somatic diseases. In the case of somatoform disorders, no comparison could be made with regard to persons with chronic somatic illnesses, since too few results are available in this research area. However, the prevalence of somatoform disorders of over 75% in the sample of the present study, indicates insufficient discriminant validity between the FMS and somatization disorder and pain disorder.
FM patients were found to have a higher prevalence of neurasthenia andCFS compared with the general population and compared with the medical care network. Neurasthenia, in particular, was highly prevalent at over 50%. Thus, the differential diagnostic delineation of CFS, neurasthenia, and FMS is questionable and there is a need for more recent definitions and criteria of the three disorders.
Results between pain parameters and ADS could show that pain has an influence on depressive symptomatology as well as depressive symptomatology has an influence on pain parameters. The correlations between the pain parameters and the BSI as well as the correlations between the BSI and the ADS did not show any informative results, although this is probably due to the low availability of data.
The results show a high comorbidity in FM patients regarding major depression, anxiety disorders, and somatoform disorders. Due to this high prevalence, it is imperative to treat these as well, in addition to the FMS disorder, to benefit disease progression.
To the complete work
Myopain
At a meeting of the International Myopain Society in Washington, we presented, among other things, research on the (positive) influence of education on complaints.
The influence of diagnosis on the course of fibromyalgia syndrome.
Objective: The diagnostic process of a fibromyalgia syndrome is considered in its
Meaning divergently considered. The relief of uncertainty and shame is opposed to the
possible stigmatization through a labeling process that may worsen the prognosis.
worsen the prognosis.
The question of what influence the diagnosis/first consultation has on the short- and
medium-term course.
Method: 406 fibromyalgia patients (39 men and 367 women) were evaluated within 194
months in one center with the help of physical examination, tender points,
Laboratory examination and various questionnaires diagnosed (T1).
Group 1 (G2: 123 patients) participated in a multimodal therapy program consisting of physical therapy, educational procedures, brief psychotherapy, dietary changes, self-help, and small amounts of amitriptyline, among others.
In group (G2: 277 patients), self-help education and counseling took place. No other specific therapy was provided.
After an average of 3 months (T2) and again 1 year later (T3), a second
and a third survey phase took place. For T2, 278 largely complete data sets were
data sets were obtained for T2 and 134 for T3.
Results: G1 (with treatment) showed an improvement (p<.05) from T1to T2in27 of31 variables examined (especially pain, depressiveness, vegetative complaints). G2 (diagnosis/education) showed an improvement in18variables from T1 to T2 (p< .05).
At T3, G1 still showed a significant improvement in21 of these27 variables compared to T1.
At T3, 21ofthese 27 variables showed a significant improvement compared to T1, while at G2 only7 of the18 variables improved at T1 showed a significant improvement.
The Influence of the diagnosis on the disease process in fibromyalgia
Category:
Fibromyalgia
Author:
Weiss TJ, Praxisklinik Dr. Weiss, Mannheim, Germany.
Title:
The Influence of the diagnosis on the disease process in fibromyalgia
Objectives:
It was examined which influence has the diagnosis in addition with information about self-help and no further treatment on the short and medium-term process of fibromyalgia in comparison to a multimodul treatement program.
Methods:
406 patients (39 men and 367 women) were diagnosed within 194 months in a single center by physical and tender points investigation, laboratory test and different questionnaires (T1). Group 1 (123 patients) participated in a multimodal therapy program, consisting of physiotherapy, physical therapy, educational program, short time psychotherapy, change of nutrition, self-help and low-dose amitriptyline. Group 2 (277 patients) received no further specific therapy exept information about self-help. After 3 months (T2) and 1 year later (T3) a second and a third investigation took place (questionnaires). At T2 it succeeded to receive 278 to a large extent complete data records and at T3 134.
Results:
Group 1 (treated) showed an improvement (p<.05) from T1 to T2 in 27 of 31 examined variables. Group 2 (diagnosis and information) showed significant improvement from T1 to T2 in 18 of 27 variables. After one year (T3) significant improvement compared to T1 was still found in 21 of 27 variables in Group 1, while in Group 2 still 7 of 18 variables showed significant improvement in comparison to T1.
Conclusions:
Diagnosis and information about self-help alone improves the short- and middle-term prognosis in fibromyalgia. This effect is less marked than the outcome of a multimodule therapy program.
Poster download
Fibromyalgia comparative study
Study fibromyalgia
Comparative study fibromyalgia
In another study, we compared 150 patients who were treated with us with 47 patients who were only with us for diagnosis and education. We examined at first contact, after 3 and 12 months.
We found, among other things, that the treated group had significantly (p<0.05) better outcomes in the following areas:
- Pain, current and last week
- Depressiveness
- Dejection
- Fatigue
- Nervousness
- somatization, i.e. vegetative complaints
- general mental stress
- Number of days of feeling well
- Number of days with inability to work
- Work impairment
However, even in the group with only diagnostics and education, well-being improved, although not in the long term.
Download results comparative study
Fibromyalgia online survey
In a survey of more than 2000 Internet users of my pages, the following revealing answers were given on the subject of fibromyalgia.
Since the diagnosis and the sincerity of the answers can of course not be verified on the Internet, such a survey does not meet the strict criteria of scientificity. Nevertheless, I have little doubt that the answers are representative.
In addition, the high number of responses is also interesting, as there are few studies with large numbers of participants.
Gender ratio
In contrast to the literature: With 15%, men are somewhat more represented than would be expected. Possibly the medium Internet plays a role here, which is more likely to be preferred by men and younger people.
Age distribution
The age distribution is very typical for fibromyalgia syndrome. With a peak between 41-50 years (622 affected). What I find remarkable is the relatively large symmetry of the distribution. While younger sufferers are more common, they are not as much more common as one would expect on the internet.
Diagnosis
Most of the people affected have been diagnosed a relatively short time ago and use the Internet as a way to get information and look for solutions.
However, there is also a not inconsiderable number of people who were diagnosed a long time ago.
A distinction must be made here: The diagnosis is not the beginning of the complaint. This is usually years (about 7 years) before.
Reliability of diagnosis
What surprised me personally was the large number of sufferers who visited the pages with a clear diagnosis, especially in view of the fact that the diagnosis "fibromyalgia" is rather reserved.
The other group is made up of many responses: suspect I have F., not sure, etc.
Pain intensity
The average pain intensity is strong or very strong for those affected. The strength was indicated from 0 (no pain) to 10 (unbearable, strongest pain). The peak is at "8". On the vertical scale: the number of affected persons.
Thus, the majority of those affected are severe pain sufferers.
Hair loss
Many sufferers state hair loss as a symptom. What surprises me most about this survey is how common this is. Since 85% of the participants are women, it is easy to imagine how stressful this complaint is!
Classic massages
Classic kneading massages are among the most frequently prescribed measures. The result, according to the survey, is staggering: the further to the left the answer, the more ineffective.
For me personally, this is also depressing, as resources are wasted here in the wrong place, which would be urgently needed in other places.
Gentle massages
Gentler forms of massage (stroking massages) perform much better than classic massages, according to the opinion of those affected. Although the method is often ineffective, it is not judged as decidedly negative as kneading massages.
Manual lymphatic drainage
No clear picture emerges for lymphatic drainage: while a large number of patients are unable to verify its effectiveness, praise and blame are otherwise equally distributed.
Fitness studio
General rehab
Rehab is the subject of the greatest hopes on the part of those affected. As a rule, it only takes place when all outpatient measures have failed and a high degree of despair prevails.
In many cases, fibromyalgia patients come to clinics that are not sufficiently specialized for the clinical picture. Unfortunately, from the point of view of those affected, the result is anything but satisfactory. Only an almost vanishing minority of patients are satisfied with the outcome.
Psychosomatic rehab
There is hardly any measure where the assumptions of the patients and parts of the medical system diverge as much as in the case of psychosomatic cures. While the majority of patients do not have the impression that their complaints are predominantly psychological, some doctors do.
For those affected, the inpatient measures based predominantly on psychotherapeutic procedures are quite predominantly not very successful.
Reha with Fibromyalgie program
Specialized hospitals with a special Fibromyalgie program are better estimated than unspecific cures. Nevertheless it may not be overlooked that also these hospitals have a - compared with the expenditure - rather modest success from the view of the concerning.
While 289 patients indicate the successes as rather unfavorable (0-5), only 165 affected persons speak of successes between 6-10.