Showing papers in "International Journal of Psychiatry in Medicine in 2008"
TL;DR: It is suggested that specific therapies, such as CBT, exposure therapy and cognitive therapy are equally effective, and more effective than supportive techniques in the treatment of PTSD.
Abstract: Objective:Cognitive behavioral therapy (CBT) is the most common psychotherapy approach for the treatment of PTSD. Nevertheless, previous reviews on the efficacy of several types of psychotherapy we...
124 citations
TL;DR: Poorer health related QOL in Nigerian subjects with HIV was associated with depression, lower educational and socioeconomic levels, and poor social support.
Abstract: Objective:Despite the fact that two-thirds of all the people with HIV live in sub-Saharan Africa, little is known about the emotional state and quality of life (QOL) of subjects with HIV in this re...
100 citations
TL;DR: Findings indicate that parental death may be a specific risk factor for depressive and anxiety disorders and highlights the overriding influence of risk factors that commonly co-occur with this form of parental loss.
Abstract: The purpose of this study was to determine whether childhood parental death and childhood parental separation are linked to lifetime depressive and anxiety disorders after controlling for related risk factors. Participants were 105 individuals from the community, including a group with separation/desertion from a parent, a group with childhood parental death, and a matched control group whose parents remained married and living together. Participants completed interviews and questionnaires assessing symptoms of anxiety and depression, family psychiatric history, childhood maltreatment, and childhood parental relationships. Participants with separation/desertion and those with parental death were significantly more likely than the control subjects to report the subsequent onset of symptoms of a depressive or anxiety disorder. These effects were not fully explained by parental relationships or childhood maltreatment. However, in the group with parental separation only, family history of depressive and anxiety disorders accounted for the apparent effect of parental separation. These findings indicate that parental death may be a specific risk factor for depressive and anxiety disorders. For parental separation/desertion, our results highlight the overriding influence of risk factors that commonly co-occur with this form of parental loss.
67 citations
TL;DR: This paper explored perceived barriers to mental health care-seeking for depressed, low-income African Americans who are already engaged in psychotherapy, during a trial to improve psychotherapy for low income African Americans.
Abstract: Objective:We explored perceived barriers to mental health care-seeking for depressed, low-income African Americans who are already engaged in psychotherapy.Methods:During a trial to improve psychot...
63 citations
TL;DR: Pediatricians and family medicine physicians who prescribe the majority of psychotropic medications for children report disconcerting degrees of discomfort with the diagnosis and treatment of children's psychiatric disorders.
Abstract: Context:Twelve to twenty-one percent of children and adolescents have psychiatric disorders with at least mild functional impairment. Pediatricians and family medicine physicians prescribe 85% of psychotropic medications taken by children. However, little is known about the comfort level of these physicians with the diagnosis and treatment of psychiatric disorders in children.Objective:To determine the comfort level of physicians in diagnosing and treating psychiatric disorders in children.Method:An anonymous survey was sent to pediatricians and family medicine physicians in upstate New York. Of 483 surveys, 200 surveys were returned.Outcome Measures:To compare differences between pediatricians and family medicine physicians in comfort in diagnosing and prescribing medications for psychiatric disorders.Results:After controlling for age, race, and years since residency, pediatricians were more comfortable in diagnosing (O.R. = 3.05, C.I. = 1.40–6.63) and prescribing stimulants for (O.R. = 4.16, C.I. = 1.96...
60 citations
TL;DR: Those with borderline personality symptomatology were more likely to have an earlier onset of sexual intercourse as well as to report date rape, but not other aspects of sexual impulsivity such a greater number of sexual partners, more frequent treatment for sexually transmitted diseases, etc.
Abstract: Objective: According to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, borderline personality disorder (BPD) is an Axis II phenomenon that is characterized by impulsivity, including sexual impulsivity. However, little empirical research has been undertaken to confirm and/or define the nature of sexual impulsivity in patients with BPD, which is the focus of the present study. Method: Using a cross-sectional approach and sample of convenience, we surveyed 76 women who were being seen as outpatients in an internal medicine clinic regarding: a) borderline personality symptoms using two measures (i.e., the borderline personality scale of the Personality Diagnostic Questionnaire-4, McLean Screening Inventory for Borderline Personality Disorder); and b) their sexual histories. Results: We found two statistically significant differences—those with borderline personality symptomatology were more likely to have an earlier onset of sexual intercourse as well as to report date rape. Conclusions: Individuals with borderline personality symptomatology report earlier sexual exposure as well
55 citations
TL;DR: The incidence of PTSD following MI was low, but 16% of MI patients developed subsyndromal PTSD, and black and younger patients were in increased risk of developing PTSD symptoms post-MI.
Abstract: Objectives:The objectives of this pilot study were to determine the incidence of Posttraumatic Stress Disorder (PTSD) one to two months after Myocardial Infarction (MI), and to evaluate potential p...
46 citations
TL;DR: The prevalence of MetS in Turkish patients with schizophrenia is similar to that of the general population, but lower than in other reports regarding the schizophrenia population.
Abstract: Objective:Cardiovascular disease is one of the most prevalent factors responsible for excess mortality in schizophrenia. Metabolic syndrome (MetS) is associated with the development of coronary heart disease and diabetes mellitus. The aim in this cross-sectional study was to assess the prevalence of MetS in schizophrenic Turkish inpatients.Method:The study was conducted from January 2006 to June 2006, and included 231 patients with schizophrenia. All participants were enrolled from inpatients attending the Samsun Mental Health Hospital psychiatry clinic. All subjects were aged between 18 and 65 and met the DSM IV criteria for schizophrenia. MetS was taken as central obesity (defined as waist circumference: men ≥ 94 cm, women ≥ 80 cm) and meeting ≥ 2 of the following abnormalities described by the International Diabetes Federation (IDF): a serum triglyceride level > 150 mg/dL, high-density lipoprotein (HDL) cholesterol < 40 mg/dL in men and < 50 mg/dL in women, blood pressure ≥ 130/85 mm Hg, and a fasting ...
46 citations
TL;DR: Cancer patients with long-term courses had just a moderate reliance on external divine powers, and depressive behavioral symptoms were connected with internal adaptive coping styles such as Conscious Living/Positive Attitudes rather than intrinsic religiosity in response to disease.
Abstract: Objective:Because an increasing number of studies indicate that a religious attitude is associated with lower depression, we intended to investigate the interrelationship between intrinsic religios...
45 citations
TL;DR: Intrinsic religious orientation, in particular, appears to be a useful construct in measuring religiosity in the association with the consequences of trauma, and there are preliminary indications that the association between intrinsic religiosity and the consequence of trauma may change depending on the time after the event.
Abstract: Objective:An increasing body of literature examines the association of religious factors with posttraumatic stress as well as posttraumatic growth. This review of selected empirical studies describes religious and spiritual factors that have been examined in their association with the consequences of trauma. A comprehensive model is proposed to explain the complex interrelationship.Method:We performed a qualitative review of empirical research in August 2006, updated in February 2008, using Medline (1950-present), PsychInfo (1806-present), Web of Science (1900-present), and PILOTS (1960-present). We searched the terms posttraumatic, post-traumatic stress, posttraumatic growth, and religion, religious, spirituality, spiritual, meditation, and forgiveness. Based on supporting data from reviewed literature, we then developed a model for key religious factors derived from this review predictive of the response to trauma over time.Results:Twenty-three studies were identified that describe religious pre-trauma ...
41 citations
TL;DR: Whether mass murders are preventable acts, the extent to which they are contributed to by biological and psychological factors, the notion that they are inextricably linked to mental illness, the role of the media, and what lessons can be learned by mental health professionals are uncovered.
Abstract: In this article, we attempt to uncover whether mass murders (the killing of multiple victims in single events) are preventable acts, the extent to which they are contributed to by biological and psychological factors, the notion that they are inextricably linked to mental illness, the role of the media, and what lessons can be learned by mental health professionals.
TL;DR: The hypothesis that alexithymia is associated with perceived parental bonding and attachment style is supported by the results of this study.
Abstract: Background:This study examines the relationship between parental bonding, adult attachment, and alexithymia in patients with Somatoform Disorders (SFD). There are few empirical studies to support the clinical hypothesis that alexithymia may be due to disturbances in the early parent-child relationship.Sampling and Methods:In a cross-sectional study, data from 76 patients with SFD were obtained, consisting of questionnaire measures of alexithymia (TAS scale), attachment style (BFKE), and also the German version of the MOPS (Measure of Parental Style), the FDEB scale for measuring perceived parental attitude.Results:A higher than average prevalence of insecure attachment (n = 67, 88.2%) was found in our sample with SFD and a T-value of 54.3 (9.5) in the TAS total score, 22% reaching clinically significant alexithymia. Regression analyses demonstrated the relationship between the “ambivalent clinging” and “ambivalent withdrawing” attachment style and more marked alexithymia features. Furthermore, alexithymia...
TL;DR: The associations of private spiritual practices, existential well-being, and abstinence self-efficacy with one year of continuous abstinence following treatment discharge suggest the importance of addressing issues related to these variables during alcoholism treatment.
Abstract: Objective:The primary aim of this prospective study was to examine the role of several aspects of spirituality in maintaining abstinence from alcohol for one year in persons treated for alcohol dep...
TL;DR: The results of this study suggest that depressive disorders may be under-recognized and under-treated amongst individuals with diabetes in the primary care setting.
Abstract: Objectives:To determine the prevalence of self-reported depression symptoms among diabetic individuals enrolled in Gold Choice, a Medicaid managed care organization specifically for people with mental health and/or substance abuse diagnoses; and to assess the sensitivity and specificity of individuals' self-report with encounter data.Methods:The 9-item depression scale of the Patient Health Questionnaire (PHQ-9) was mailed to 454 Gold Choice members in Western New York diagnosed with diabetes; and 249 completed PHQ-9 forms were returned (55% response rate). The PHQ-9 forms were compared to primary care encounter data to determine whether the respondents had been diagnosed with depression. Descriptive and inferential statistical analysis was undertaken.Results:The majority (56%) of individuals in the sample screened positive for depression (PHQ-9 ≥ 10), and half (49%) did not have evidence of a diagnosis in their encounter data. The percentage of those diagnosed with depression rose with increasing PHQ-9 s...
TL;DR: Depression is associated with many chronic diseases in the community in Aleppo, a finding consistent with reports from other cultures and inform public mental health planning and support the delivery of depression treatment in primary care settings.
Abstract: Objective:To assess the comorbidity and correlates of depression in chronic diseases in the community in Aleppo, Syria. This has never been previously investigated in an Arab country.Method:We conducted a cross-sectional, population-based study in Aleppo on adults aged 18–65 (N = 2038). We collected data utilizing a structured interview questionnaire. Socio-demographics, general health information, and self-report of physician-diagnosed depression and chronic diseases active in the past year were obtained. We used logistic regression to estimate the odds of depression in chronic diseases and socio-demographic correlates of depression comorbid with chronic diseases.Results:Mean age (SD) was 35.3 (12.1) years, 55% were female. In women, predictors of depression were heart disease (OR = 3.95, 95% CI: 1.50–10.40), hypertension (OR = 2.92, 95% CI: 1.53–5.55), and kidney disease (OR = 2.96, 95% CI: 1.64–5.32). Depression comorbidity with any chronic disease decreased in higher socio-economic status (middle vs. ...
TL;DR: NRT improved cessation both among the depressed and non-depressed participants, and when adjusted for marital status and education, the treatment effect remained significant (p < .001), whereas the depression effect became non-significant.
Abstract: Objective:The aim was to investigate the role of nicotine gum and pre-treatment depressive symptoms in long-term smoking cessation.Methods:12-month follow-up of 608 participants within a randomized, controlled trial was conducted. Participants received brief counseling plus nicotine or placebo treatment. Based on the Center for Epidemiological Studies Depression Scale pre-treatment score (≥ 16), 32% of the participants were classified as depressed at baseline.Results:At the 12-month follow-up the non-depressed participants with nicotine replacement therapy (NRT) were most successful (20.1%), while the depressed ones with placebo were least successful (5.7%) (p = .004). However, the depressed participants with NRT (15.1%) were not significantly less successful than the non-depressed ones with NRT (20.1%, p = .23). Survival analysis showed significant depression (p = .01) and treatment effects (p = < .001) on the abstinence. Further, when adjusted for marital status and education, the treatment effect remai...
TL;DR: MS patients experience elevated symptoms of psychological distress, especially depressive symptoms, which are most closely associated with disease parameters, but the crucial role of various personality traits such as ego defenses and hostility features in the psychiatric symptom formation also appear to contribute to the development of depressive symptoms.
Abstract: Objective:The aim of the present study was to identify disease parameters, defensive styles and ego strength measurements associated with various forms of psychiatric complications in patients with...
TL;DR: Current and anticipated federal funding, policy changes, and large scale research projects provide promise for increasing knowledge about Autism Spectrum Disorders.
Abstract: Objective:This review article provides an overview of the most recent developments in the literature regarding autism spectrum disorders including epidemiology, etiology, assessment, and management...
TL;DR: The increase of adrenal volume and VAT and the correlation of BDI with VAT in the upper abdomen support the hypothesis of long-term production of stress hormones in depression.
Abstract: Objective:Depression is often accompanied by increased visceral adipose tissue (VAT), stress, enlarged adrenal glands, and an increased risk of cardiovascular disease VAT turn-over is regulated by adrenal stress hormones such as cortisol Aim of this study was to investigate the relationship between the adrenal volume as a marker for long-term stress and the volume fractions of several body fat compartments in healthy and depressive womenMethods:Ten depressive and 12 healthy women were investigated Fat compartments (VAT, VAT in the upper abdomen, subcutaneous adipose tissue (SCAT), and adrenal volume) were measured by MRIResults:Depressive women revealed more VAT in the upper abdomen than the healthy There was a significant correlation of age and Body Mass Index (BMI) with the visceral adipose tissue volume and adrenal gland size In a partial correlation, Beck Depression Inventory (BDI) was correlated with VAT in the upper abdomen (r = 045, p < 005)Conclusions:The increase of adrenal volume and V
TL;DR: In 81% of children, spells disappeared completely and in 9% frequency was reduced to less than one per month and of much lesser intensity, suggesting piracetam is an effective prophylactic treatment for severe BHS.
Abstract: Background:Breath holding spells (BHS) are apparently frightening events occurring in otherwise healthy children. Generally, no medical treatment is recommended and parental reassurance is believed to be enough, however, severe BHS can be very stressful for the parents and a pharmacological agent may be desired in some of these children.Objective:In this prospective study aim was to determine the usefulness of piracetam as prophylactic treatment for severe BHS.Methods:Children were recruited from Neurology Clinic in Children's Hospital, Islamabad between January 2002 to December 2004. Diagnosis of BHS was based on characteristic history and normal physical examination. Piracetam was prescribed to those children who were diagnosed as severe BHS in a dose ranging from 50–100 mg/kg/day. Iron supplements were added if hemoglobin was less than 10 gm%. Patients were seen at 2–4 weeks interval and follow-up was continued until 3 months after the cessation of drug therapy.Results:Fifty-two children were enrolled ...
TL;DR: Depressive symptoms are common in women attending primary health care centers in the Emirate of Sharjah and stressful life events, in particular, are related to the level of depressive symptoms experienced by these women.
Abstract: Background:Depression is one of most common mental illnesses in the world, with a high prevalence in primary health care settings. Some research has been conducted in the Arab region, but this rese...
TL;DR: The results showed a higher rate of depression in HTLV-1 infected individuals, and it was not possible to determine whether depression was related to knowledge of chronic retroviral infection or related to a biological effect of the retroViral infection.
Abstract: Objective:Viral infections have been previously associated with psychiatric disorders. This work aimed to study the relationship between the human T-cell lymphotropic virus type 1 (HTLV-1) and depr...
TL;DR: Non-cardiac chest pain patients with PD should be identified and offered treatment for significantly impaired HRQoL, similar to PD patients seeking treatment in psychiatric care.
Abstract: Objective: Little is known about health-related quality of life (HRQoL) in non-cardiac chest pain patients with (PD) or without panic disorder (NoPD). The aims of the study were: 1) to compare the HRQoL scores in chest pain patients with and without PD and compare their scores with those from the general population; 2) to compare the 36-item Short Form Health Survey (SF-36) scores of PD patients with those of PD patients in other studies; and 3) to identify predictors of HRQoL. Method: We assessed HRQoL in 167 patients consecutively referred for outpatient investigation of chest pain but who proved to have no cardiac condition (non-cardiac chest pain). HRQoL was assessed with the SF-36 and compared with Norwegian population norms. Factors affecting HRQoL were examined using multiple linear regression models. Results: SF-36 scores were lower in PD patients compared to NoPD patients for all domains. Both groups were significantly more impaired than the normal population. Gender, age, being married, years of education, the sum of chronic illnesses, neuroticism, and the presence of panic disorder and depression symptoms accounted for 17-67% of the variance in three selected SF-36 scales. Conclusions: Non-cardiac chest pain patients reported significantly impaired HRQoL. Chest pain patients with PD exhibited significant impairment, similar to PD patients seeking treatment in psychiatric care. Non-cardiac chest pain patients with PD should therefore be identified and offered treatment.
TL;DR: This retrospective review and subsequent case reports confirm the rare, but serious, potential of serotonin syndrome associated with the combination of linezolid and serotonergic antidepressants.
Abstract: Objective:To report the results from a retrospective chart review looking at the combination of linezolid and serotonergic antidepressants and to report two cases of serotonin syndrome which were i...
TL;DR: Antidepressant medication use was somewhat higher in persons with medical co-morbidities, although these differences were small and inconsistent.
Abstract: Objective:Since co-morbid depression can complicate medical conditions such as cardiovascular disease and cancer, physicians may treat depression more aggressively in patients with these conditions...
TL;DR: Faith factors appear to have independent but complex effects on end-of-life decision making in middle-aged and older cardiac patients.
Abstract: Settling one's end-of-life affairs in the face of coronary artery bypass graft surgery (CABG) can be both distressing and beneficial for individuals who are facing imminent threat of death. Religious thoughts, common in this context, may offer some comfort and support for facing this process. However, few empirical studies have addressed the role of religious or spiritual involvement in the settling of one's end-of-life affairs in cardiac patients. This prospective study investigated the effect of religious and spiritual factors on whether decisions regarding end-of-life had been made in a sample of middle-aged and older patients undergoing CABG. In particular, we expected faith factors of an intrinsic nature would promote this decision. Two weeks pre-operatively, patients (mean age = 65 years) were recruited for interviews. One hundred seventy-seven CABG patients completed the pre-operative and post-operative follow-up one month after surgery, while 96 offered information regarding their engagement in settling end-of-life affairs. Cardiac indicators were obtained from the computerized Society of Thoracic Surgeons' Adult Cardiac Database (STS). Multiple regression analyses revealed that private religiousness increased the likelihood of having engaged in end-of-life decision planning by nearly half again (OR = .1.47, 95% CI = 1.10, 1.96, p < .05) and that experiencing reverence in secular contexts nearly doubled the likelihood (OR = .1.99, 95% CI = 1.16, 3.44, p < .05). The reduced likelihood of having made plans was observed among those who scored higher on experiencing reverence in religious contexts (OR = .44, 95% CI = .23, .87, p < .05) and among patients using petitionary prayer (OR = .21, 95% CI = .04, .98,p < .05). These effects manifested after controlling for age, impacted functioning, and number of diseased arteries. Therefore, faith factors appear to have independent but complex effects on end-of-life decision making in middle-aged and older cardiac patients.
TL;DR: Reliability and validity of the DAS-A and its relevant sub-scales were investigated in a sample of 308 Chinese adults in Hong Kong and it was hoped that with this type of cross-cultural information, the universality of the construct validity could be reliably demonstrated.
Abstract: Objective:This study investigated the reliability and validity of the DAS-A in a sample of 308 Chinese adults in Hong Kong.Method:The reliability of the DAS-A and its relevant sub-scales was measured using internal consistency (Cronbach's alpha) and Guttman split-half reliability. Principal components analysis was performed to assess construct validity. Discriminant validity of the DAS-A was performed by examining whether the DAS-A could discriminate between the depressed and the non-depressed subjects in this study.Results:The split-half reliability of the DAS-A was found to be r = 0.87; Cronbach's alpha was 0.945; and item-total correlations ranged between 0.36 and 0.75. Factor analysis revealed three factors that were similar to those that were found in other studies: Performance Evaluation, Need for Approval, and Anaclitic Self-Esteem. Discriminant validity suggested that the DAS-A discriminated successfully between the non-depressed and the depressed groups. Nevertheless, some differences were notice...
TL;DR: The data demonstrate the reliability and validity of the 6-item BENEFIT scale that captures a unique aspect of SpR that can be used in epidemiological studies and clinical trials for those who wish to assess both the external and internal dimensions of Spr.
Abstract: Objective:We intended to develop a brief and compact scale which measures the beneficial effects of spirituality/religiosity (SpR) on several dimensions of patients' life concerns, to be used in he...
TL;DR: A 3-year cooperation project coordinated by the Freiburg University Clinic for the development and promotion of psychosomatic medicine in China, Vietnam, and Laos to improve doctor-patient communication and to acquire Psychosomatic knowledge, skills, and attitudes.
Abstract: Objective:The European Union is supporting a 3-year cooperation project coordinated by the Freiburg University Clinic for the development and promotion of psychosomatic medicine in China, Vietnam, and Laos. The main objective is the development and performance of post-graduate training for medical doctors to improve doctor-patient communication and to acquire psychosomatic knowledge, skills, and attitudes.Method:The project is based on contacts which have existed for several years with the Tongji University and the affiliated Tongji Hospital in Shanghai. Medical doctors in all disciplines are to learn to promptly recognize emotional disorders which frequently present in the primary care setting, to offer limited treatment themselves, and to cooperate with mental health specialists.Results:In the first year of the project, 50 medical doctors from different medical fields were trained as future teachers. In the second year, we are starting a pilot curriculum which will include 60 hours of theory and psychos...
TL;DR: Among individuals who are addicted to opioids and seeking treatment with buprenorphine, the prevalence of BPD, as mutually confirmed by three self-report measures, is quite high.
Abstract: Objective:In this study, we examined the prevalence of borderline personality disorder (BPD) in a sample of patients seeking outpatient treatment with buprenorphine for opioid addiction.Method:To assess for BPD, we used three self-report surveys in a consecutive study sample.Results:Of the 111 participants who completed all three measures of BPD, 49 (44.1%) exceeded the cut-off score indicative of BPD.Conclusions:Among individuals who are addicted to opioids and seeking treatment with buprenorphine, the prevalence of BPD, as mutually confirmed by three self-report measures, is quite high.