Showing papers in "International Journal of Psychiatry in Medicine in 2010"
TL;DR: Symptom burden associated with cancer survivorship was consistent among the four most common types of cancer (breast, gynecological, prostate, and rectal/colon), despite various types of treatment exposure.
Abstract: Background:The number of cancer survivors is steadily increasing. Following completion of primary cancer treatment and many years thereafter, specific symptoms continue to negatively affect cancer survivors. The purpose of this article is to review the evidence of symptom burden following primary treatment for cancer in survivors of the most common types of cancer (breast, gynecological, prostate, and colorectal).Methods:A systematic review of literature published between the years 2000–2008 that reported late-effects and/or long-term psychosocial symptoms associated with cancer survivorship post-completion of primary cancer treatment was conducted. The symptoms include physical limitations, cognitive limitations, depression/anxiety, sleep problems, fatigue, pain, and sexual dysfunctions.Results:Symptom burden associated with cancer survivorship was consistent among the four most common types of cancer (breast, gynecological, prostate, and rectal/colon), despite various types of treatment exposure. Genera...
560 citations
TL;DR: Despite acknowledging its importance to patients, the majority of deans are uncertain about including spirituality and do not think more content is needed, although most U.S. medical schools have curricular content on S&H, although this varies greatly in scope.
Abstract: Objective:No systematic information exists on what U.S. medical schools are teaching on spirituality and health or on the attitudes of faculty toward inclusion of this subject in the medical curriculum. We systematically surveyed U.S. medical school deans and assessed both attitudes about and the extent to which spirituality is addressed in medical school curricula.Methods:The responses to a questionnaire were solicited from deans representing 122 U.S. medical schools accredited by the Liaison Committee for Medical Education. Completed surveys were received from 85% (n = 104), with 94% (n = 115) responding to the primary question. Outcomes were proportion of medical schools with curricular content on spirituality and attitudes of deans toward such material.Results:Ninety percent (range 84%–90%) of medical schools have courses or content on spirituality and health (S&H), 73% with content in required courses addressing other topics and 7% with a required course dedicated to S&H. Although over 90% indicate t...
106 citations
TL;DR: It is shown that, compared with old people with more education, those with less education had higher risk for depression, and less education is associated with increase risk of late life depression.
Abstract: Objective:Less education is commonly viewed as an important risk factor for late life depression. However, this has still not been confirmed. The goal of this study was to determine the relationship between education and risk for depression among the old.Method:MEDLINE, EMBASE, and The Cochrane Library database were used to identify potential studies. The studies were divided into cross-sectional and longitudinal subsets. The qualitative meta-analysis of cross-sectional studies and that of longitudinal studies were preformed, respectively. For prevalence and incidence rates of depression, odds risk (OR) and relative risk (RR) were calculated, respectively.Results:Twenty-four cross-sectional and 12 prospective longitudinal studies were included in this review. In this meta-analysis, in the more and less education groups, there were 22,964 and 28,024 subjects and 3032 and 6462 cases of depression, respectively. The qualitative meta-analysis showed that, compared with old people with more education, those wi...
95 citations
TL;DR: It is suggested that anxiety, especially depressive symptoms, are significantly associated with SAH and had a significant effect on hypertensive patients' worse quality of life.
Abstract: Objective:Despite all progress made in understanding and treating systemic arterial hypertension (SAH), the study of the impact of psychological disorders in SAH is still controversial and is not well understood. Our aim was to test the hypothesis that SAH can be associated with anxiety and depressive symptoms and to verify its effect on the quality of life.Method:A controlled cross-sectional study included 302 patients (152 hypertensive and 150 normotensive) outpatients at Hospital Sao Lucas of PUC-RS. Measurements were made in individual interviews and included data collection and application of general scales such as State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI), and Medical Outcome Study Short Form, General Health Survey (SF-36).Results:Anxiety was significantly associated with SAH only after adjusted for relevant risk factors (odds ratio (OR) = 2.83, 95% confidence interval (CI) = 1.55 to 5.18). Depressive symptoms were significantly associated with SAH (OR) = 4.34 (95% CI: 2....
49 citations
TL;DR: Screening substantially increased the number of children and youth who would be identified as possibly having a mental health problem and may have the most potential to increase the identification of problems among patients who have moderate mental health symptoms and those who are African American or Latino.
Abstract: Objective:Few pediatric primary care providers routinely use mental health screening tools, in part because they may have concerns about whether screening is useful and how it will affect their pra...
39 citations
TL;DR: The results suggest that the BDI-II and its cognitive subscale are effective tools for screening for MDD in post-MI patients.
Abstract: Objective:To assess the operating characteristics of the Beck-Depression Inventory-II (BDI-II) and the BDI-II cognitive subscale (BDI-II-cog) in screening for major depression (MDD) in post-myocardial infarction (MI) patients.Methods:Between October 2003 and July 2005, 131 post-MI patients admitted to an urban academic medical center completed the BDI-II and a semi-structured interview for depression within 72 hours of symptom onset. Sensitivity, specificity, positive and negative predictive values, overall correct classification, and likelihood ratios for various cutoff values on both scales were evaluated by comparing scores to interview diagnosis of MDD. Receiver-operator curves (ROC) were also calculated and area under the curve (AUC) measured.Results:The optimal cutoff value for the BDI-II was > 16, with a sensitivity of 88.2% and a specificity of 92.1%. Cutoff values of > 3 or > 4 were both acceptable for the BDI-II-cog (sensitivity = 88.2% and 82.4%, respectively; specificity = 81.6% and 88.6%, res...
33 citations
TL;DR: In this paper, ethnic differences in accessing treatment for depression and substance use disorders (SUDs) among men and women in a large integrated health plan and explored factors potentially contributing to health care disparities.
Abstract: Objective:This study examined ethnic differences in accessing treatment for depression and substance use disorders (SUDs) among men and women in a large integrated health plan and explored factors potentially contributing to health care disparities.Methods:Participants were 22,543 members ages 20 to 65 who responded to health surveys in 2002 and 2005. Survey questions were linked to provider-assigned diagnoses, electronic medication, psychiatry, and chemical dependency program records.Results:Among women diagnosed with depression, Latinas (p < .01) and Asian-Americans (p < .001) were less likely than Whites to fill an antidepressant prescription. Among men diagnosed with depression, African Americans (p < .01) were less likely than Whites to do so. Among women diagnosed with an SUD, African Americans (p < .05) were less likely than Whites to have one or more chemical dependency program visits.Conclusions:Results demonstrated ethnic differences in accessing depression and SUD treatment among patients diagn...
30 citations
TL;DR: TCAs might, among other mechanisms, act as antidepressants by suppressing the production of pro-inflammatory cytokines, whereas no significant effect of venlafaxine and O-desmethylvenlafAXine on IFN-γ secretion could be demonstrated.
Abstract: Objective:A growing body of data indicates that an activation of proinflammatory cytokines such as interferon-gamma (IFN-γ) is involved in the pathophysiology of depression and that the suppression...
30 citations
TL;DR: A novel geographic analysis of Attention-Deficit/Hyperactivity Disorder (ADHD) diagnosis in Midwest United States to determine if geographic distribution of ADHD diagnosis can be partially explained by differential efficiency of referral for diagnosis by school districts, by race/ethnicity, and/or built environment.
Abstract: Objective:To perform a novel geographic analysis of Attention-Deficit/Hyperactivity Disorder (ADHD) diagnosis in Midwest United States.Method:Primary care children age 5–17 with ADHD diagnosis (N =...
24 citations
TL;DR: The amount of disease as measured by laboratory abnormalities such as viral load, liver function tests, liver biopsy, and INR do not provide much useful information about a patient's depressive symptoms, and these depressive symptoms are more influenced by psychological and social factors.
Abstract: Objective:Given that the hepatitis C virus (HCV) crosses the blood-brain barrier, biological factors are commonly blamed for the high rates of mood disturbance in HCV-infected patients. However, no study assessing the potential contribution of psychosocial factors to depression in HCV has yet been conducted.Methods:A cross-sectional survey of 65 patients was undertaken to identify biological, psychological, and sociological contributions to depression. Biological, psychological, and sociological variables were tested for their association with depressive symptomatology as measured by the BDI-II. Separate analyses were conducted on health-related quality of life (HRQOL), as measured by the SF-36, in order to confirm findings in previous work.Results:Psychosocial variables assessed in the study, such as less social functioning, less religious faith, less ability to work, less salary, personal suicide attempt, worse reaction to diagnosis, and feeling “stressed out” were all associated with higher depression ...
24 citations
TL;DR: Results suggest that life stress is related to atherosclerosis once paths of unhealthy coping behaviors are considered, and significant indirect pathways between chronic life stress and CAC through smoking, excessive alcohol use, high caloric intake, sedentary lifestyle, and obesity were found.
Abstract: Objective:To examine the relationship between a general measure of chronic life stress and atherosclerosis among middle aged adults without clinical cardiovascular disease via pathways through unhealthy lifestyle characteristics.Methods:We conducted an analysis of The Multi-Ethnic Study of Atherosclerosis (MESA). The MESA collected in 2000 includes 5,773 participants, aged 45–84. We computed standard regression techniques to examine the relationship between life stress and atherosclerosis as well as path analysis with hypothesized paths from stress to atherosclerosis through unhealthy lifestyle. Our outcome was sub-clinical atherosclerosis measured as presence of coronary artery calcification (CAC).Results:A logistic regression adjusted for potential confounding variables along with the unhealthy lifestyle characteristics of smoking, excessive alcohol use, high caloric intake, sedentary lifestyle, and obesity yielded no significant relationship between chronic life stress (OR 0.93, 95% CI 0.80–1.08) and C...
TL;DR: Non-smoking patients had fewer hospital readmissions than smoking patients, and this finding could be a reason to promote cessation of smoking which might provide positive influences on prognosis of schizophrenia.
Abstract: Objectives:To consider smoke-free policies for the patients with schizophrenia, the present study examined how smoking behavior is related to hospital readmission among patients with schizophrenia.Methods:A retrospective study was conducted in 2007 on 460 discharged patients with schizophrenia who voluntarily admitted in the participating psychiatric hospitals at first time. We reviewed smoking status, readmissions, and other variables including socio-demographic characteristics, process of care, and social functioning at discharge using the Global Assessment of Functioning scale (GAF).Results:The rate of cigarette smoking in this study was 42.2%. The rate of smoking was significantly higher in males (56.1%) than in females (26.2%). Mean GAF score at discharge was slightly higher in smoking patients than non-smoking patients (g = 0.18). Cox proportional hazard model revealed that hospital readmission rate was significantly higher in smoking patients than non-smoking patients after controlling for all othe...
TL;DR: In this article, the significance of sense of humor for survival over 7 years in an adult county population in Norway was explored, and it was found that humor appeared to increase the probability of survival into retirement, and this effect appeared independent of subjective health.
Abstract: Objective To prospectively explore the significance of sense of humor for survival over 7 years in an adult county population. Methods Residents in the county of Nord-Trondelag, Norway, aged 20 and older, were invited to take part in a public health survey during 1995-97 (HUNT-2), and 66,140 (71.2 %) participated. Sense of humor was estimated by responses to a cognitive (N = 53,546), social (N = 52,198), and affective (N = 53,132) item, respectively, taken from the Sense of Humor Questionnaire (SHQ). Sum scores were tested by Cox survival regression analyses applied to gender, age, and subjective health. Results Hazard ratios were reduced with sense of humor (continuous scale: HR = 0.73; high versus low by median split: HR = 0.50) as contrasted with increase of HR with a number of classical risk factors (e.g., cardiovascular disease: HR = 6.28; diabetes: HR = 4.86; cancer: HR = 4.18; poor subjective health: HR = 2.89). Gender proved to be of trivial importance to the effect of sense of humor in survival. Subjective health correlated positively with sense of humor and therefore might have presented a spurious relation of survival with humor, but sense of humor proved to reduce HR both in individuals with poor and good subjective health. However, above age 65 the effect of sense of humor on survival became less evident. Conclusion Sense of humor appeared to increase the probability of survival into retirement, and this effect appeared independent of subjective health. Age under 65 mediated this effect, whereas it disappeared beyond this age.
TL;DR: Patients who are not known to psychiatric services prior to assessment in the emergency department may need a more proactive outreach if compliance with psychiatric follow-up appointments is to be improved.
Abstract: Background:Several factors may predict adherence with psychiatric follow-up appointment for patients seen in the emergency department (ED) by liaison psychiatric teams. Awareness of these factors w...
TL;DR: Increased use of formal screening tools, increased curricular time for mental health in primary care residencies, support for physicians in the field in the form of referral options and remote consultation and support, may all serve to improve quality of care for individual patients, and may also serve to regularize treatment across socioeconomic and sociodemographic lines, hence reducing disparities.
Abstract: The regional study by Baumgardner and colleagues converges with existing literature to clearly show that the distribution of ADHD diagnosis falls along socioeconomic lines, according to the relative wealth of neighborhoods. This adds additional evidence that trends in the diagnosis and treatment for ADHD in children move in the exact opposite direction from those who are at highest risk for meeting criteria, for experiencing impairment, for and downstream socioeconomic sequelae. Contributing factors, such as marginal diagnoses (such as when parent and teacher symptom reports diverge), inadequate insurance coverage, limited time, and lack of familiarity and comfort with diagnostic and prescribing guidelines, may leave the door open to misdiagnosis and treatment. In some cases, this may take the form of over-diagnosis and over-treatment, in the form of false-positive diagnoses with ADHD, and treatments for it, or may alternatively take the form of false-negative diagnoses. If the social and epidemiological data are any indication, it is furthermore likely that such false-positive or false-negative outcomes may break along socioeconomic lines. Increased use of formal screening tools, increased curricular time for mental health in primary care residencies, support for physicians in the field in the form of referral options and remote consultation and support, may all serve to improve quality of care for individual patients, and may also serve to regularize treatment across socioeconomic and sociodemographic lines, hence reducing disparities. Further research is needed to study the root causes and dynamics that create such disparities, but the steps outlined above may help in the near term.
TL;DR: Wang et al. as discussed by the authors assessed the frequency of anxiety disorders and their correlates in Chinese PD patients and found that generalized anxiety disorder, agoraphobia, and social phobia were the commonest subtypes of ANDI in PD patients.
Abstract: Objective:Anxiety disorders (ANDI) commonly occur in patients with Parkinson's disease (PD) but their socio-demographic and clinical correlates have not yet been unequivocally determined. This study aimed to assess the frequency of ANDI and their correlates in Chinese PD patients.Methods:A cohort of 133 patients of PD were recruited from three neurology outpatient clinics. Participants' neurological, cognitive, and psychiatric status was assessed using standardized rating instruments. ANDI were diagnosed by qualified psychiatrists using the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders–4th Edition (SCID-DSM IV).Results:Thirty-six patients (27.1%) were diagnosed with some types of ANDI; Generalized Anxiety Disorder, Agoraphobia, and Social Phobia were the commonest subtypes of ANDI in PD (n = 11, 8.3%, in each of the three subtypes). Nine patients had more than one subtype of ANDI. In multivariate logistic regression, younger age of onset of PD [odds ratio (OR)...
TL;DR: Findings revealed significant relationships between molecular mediators of the inflammatory and immune systems and variables measuring the relational context patients with T2DM, which suggest a next step in understanding and exploring the complex but important biopsychosocial pathways in Type 2 DM.
Abstract: Objective:The aim of this study was to investigate the association between psychosocial variables, biomarker hemoglobin A1C (HbA1C), and immune modulatory cytokine mediators among diabetic patients in marital or committed long-term relationships.Method:This is a cross-sectional study of adult patients with Type 2 diabetes mellitus (T2DM) presenting at a university-based ambulatory medical clinic. Social/interpersonal constructs were assessed using measures of dyadic adjustment, interpersonal sensitivity and social functioning, and expressed emotion. HbA1c and cytokines were measured from blood samples using standard laboratory tests. Associations of relational systems constructs with biomarkers were assessed using bivariate tests.Results:Dyadic adjustment was significantly associated with cytokine IL-8. Interpersonal relationship functioning was significantly associated with biomarker HbA1c, and cytokines TNF-α, and IL-1ra. Social functioning was significantly correlated with cytokines IL-17, IL-1ra, IL-2...
TL;DR: Individuals who reported road rage appear to be less disciplined drivers and are subject to more types of driving citations, although they do not report greater rates of vehicular crashes or driving while intoxicated.
Abstract: OBJECTIVE: The objectives of this study were to determine: (1) the prevalence of self-reported road rage in a primary care sample; (2) the relationship, if any, between road rage and borderline personality disorder (BPD); and (3) whether those with road rage have a greater prevalence of different types of driving citations compared to those without road rage. METHOD: Using a consecutive, cross-sectional sample of primary care outpatients, we surveyed 419 individuals. RESULTS: The prevalence of self-reported road rage in this sample was 35.3%. BPD was significantly more prevalent among participants with road rage (24.8% vs. 9.8%). Compared to those without road rage, those with road rage reported statistically significantly higher numbers of different types of driving citations, including moving and non-moving violations, as well as having had a driver's license suspended. There were no differences between the groups with regard to vehicular crashes or driving while intoxicated. CONCLUSIONS: About one-third of individuals reported road rage. The prevalence of BPD was significantly higher among those with road rage compared to those without road rage, and is likely to be one of the contributory variables to reckless driving. Individuals who reported road rage appear to be less disciplined drivers and are subject to more types of driving citations, although they do not report greater rates of vehicular crashes or driving while intoxicated. Language: en
TL;DR: Antidepressive treatment can improve the conditions of psychology and the ANS reactivity to stress in patients with IBS and Gastrointestinal symptoms of IBS were relieved significantly.
Abstract: Background and Aim:Irritable bowel syndrome (IBS) patients usually manifest autonomic nerve dysfunctions and abnormal psychological behaviors. This study was to assess autonomic nervous system (ANS) response to different stressor as well as evaluate effects of antidepressive treatment of Saint John's Wort Extract in women with IBS.Method:Thirty women with IBS and 20 healthy women underwent serial ANS function tests. Five-minute-short-time heart rate variability (HRV) spectral analysis were assessed at a stress or resting recording period. Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) were used to measure their anxiety and depression conditions. After 8–weeks' antidepressant treatment, groups of IBS repeated the tests above. Subjects also completed a GI symptom diary once daily during the 2 weeks before therapy and for 2 weeks in the last scheduled therapy session.Results:IBS-group showed a higher score in HAMA and HAMD (p < 0.01) and showed a significant increase in the low frequency ...
TL;DR: It appears that elderly women are at greatest risk, repeated stress is generally required, and recovery is achieved quickly after ECT, and Elevated levels of catecholamines and of vasopressin may be implicated.
Abstract: A 90-year-old woman who had received more than 100 electroconvulsive treatments (ECT) over many years requested another course for depression. After the third ECT, an electrocardiogram showed new T-wave inversion (V2-V6) and ST elevation (V2). Catheterization revealed severe left ventricular dysfunction but no coronary obstruction, leading to a diagnosis of Takotsubo cardiomyopathy (stress-related). The patient's recovery was uneventful. Recent literature cites three other cases post-ECT. It appears that elderly women are at greatest risk, repeated stress is generally required, and recovery is achieved quickly. Elevated levels of catecholamines and of vasopressin may be implicated.
TL;DR: Asthmatic patients can be distinguished by a specific pattern of temperament (low NS) and character (high ST) dimensions and compared with both psoriatic patients and healthy controls.
Abstract: Objective Psychosocial factors have been implicated as being important in the onset and/or exacerbation of asthma. This study was performed to evaluate the personality profiles of asthma patients. Method Ninety-five asthmatic, 98 psoriatic patients, and 96 healthy controls completed the Temperament and Character Inventory (TCI), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI). The relationships between asthma illness duration, asthma severity score, depression, anxiety, and temperament and character personality variables were evaluated. Results Asthmatic patients had significantly higher mean scores on the BAI, Harm Avoidance, Persistence, and Self-transcendence dimensions and lower scores on the BDI, Novelty Seeking, and Reward Dependence dimensions of the TCI than the psoriatic patients. Significant group effect was found for the BDI and BAI scores in between groups. Significant differences in TCI scores were found across groups except for Persistence and Self-transcendence. Post hoc tests revealed significantly lower Novelty Seeking, higher Harm Avoidance, lower Reward Dependence, and higher Self-transcendence scores in patients with asthma. Regression analysis revealed a significant effect between duration of illness and Persistence and Self-transcendence. Illness severity had a significant effect on the Harm Avoidance. Anxiety scores had significant effect on the Harm Avoidance, Self-directedness, and Self-transcendence. Depression scores had no significant effect on any of the TCI dimensions. Conclusions Asthmatic patients can be distinguished by a specific pattern of temperament (low NS) and character (high ST) dimensions and compared with both psoriatic patients and healthy controls. Illness duration is associated with ST scores, and illness severity is associated with HA.
TL;DR: In this study, hopelessness prevalence was high and it was also associated with the current state of health, perceived health, disability, and some socio-demographic variables.
Abstract: Background:Hopelessness has become an important issue in the fields of health and social care.Objective:This study aims to determine the prevalence of hopelessness and its association with the curr...
TL;DR: Findings indicate that diabetes care address spiritual well-being, both its religious and existential components, in Black women with T2DM.
Abstract: Objective:Examine coping as a mediator in the relationships of spiritual well-being to mental health in Black women with type 2 diabetes (T2DM).Methods:Using a cross-sectional design, data were collected from a convenience sample of 45 Black women with T2DM. Measures of coping strategies, spiritual well-being (religious and existential well-being), and mental health, as measured by diabetes-specific distress (DSED), were collected. Bivariate findings informed mediational, trivariate model development.Results:Religious well-being was significantly related to cognitive reframing (CR) coping strategies (p = 0.026) but not DSED (p = 0.751). Existential well-being was significantly related to CR (β = 0.575, p < 0.001), direct assistance (DA) coping (β = 0.368, p = 0.006) and DSED (β = −0.338, p = 0.023). Although CR (β = −0.305, p = 0.021) and DA (β = −0.262, p = 0.041) had significant bivariate associations with DSED, the relationships were not significant when existential well-being was controlled. However, ...
TL;DR: Various aspects of alcohol use disorders in the geriatric population are reviewed, such as range ofcohol use, epidemiology, medical/psychiatric impact, detection, comprehensive treatment planning, modalities of psychotherapy, medication management, and resources for clinicians/patients.
Abstract: Alcohol use disorders cause significant morbidity and mortality in the geriatric population This review article begins with a hypothetical case for illustration, asking what the primary care physician could do for a geriatric patient with alcohol abuse over a course of four office visits Various aspects of alcohol use disorders in the geriatric population are reviewed, such as range of alcohol use, epidemiology, medical/psychiatric impact, detection, comprehensive treatment planning, modalities of psychotherapy, medication management, and resources for clinicians/patients
TL;DR: Among Californians with Type 2 diabetes, SPD was associated with fewer physician foot checks but not with fewer eye examinations or hemoglobin AlC checks, highlighting a specific area—foot complication evaluation and prevention—for improving the quality of diabetes care.
Abstract: Objective:To evaluate three aspects of diabetes care (foot checks, eye examinations, and hemoglobin AlC checks by a physician) among California adults with Type 2 diabetes and serious psychological distress (SPD).Method:Data were from the population-based 2005 California Health Interview Survey. Estimates were that in 2005, 1,516,171 Californians (5.75% of all adults) had a physician-given diabetes diagnosis, and of those, 108,621 (7.16%) had co-morbid SPD.Results:Among Californians with Type 2 diabetes, SPD was associated with fewer physician foot checks (odds ratio = 0.56, 95% Confidence Interval = 0.32 to 0.97) but not with fewer eye examinations or hemoglobin AlC checks.Conclusions:The findings highlight a specific area—foot complication evaluation and prevention—for improving the quality of diabetes care among adult Californians with Type 2 diabetes and SPD.
TL;DR: Co-morbidity of depression and chronic physical illnesses is common in Hong Kong as in Western countries and speaks to the need for evidence-based practice that encompasses models of integrated care in Hong Hong Kong.
Abstract: Objective:To examine the co-morbidity of depression and chronic physical illnesses in a representative sample of Hong Kong ChineseMethods:Five thousand and four participants aged 18–65 years completed a structured telephone interview on major depressive episode (MDE) and eight chronic physical illnessesResults:215% (N = 1078) of respondents had any physical illness in the previous 1 year Twelve-month MDE was found in 15% (N = 162) of these physically ill respondents and was significantly associated with physical illnesses (OR: 256, 95% CI: 207–316, p < 0001) Number of co-morbid physical illnesses had an incremental association with the risk of MDEConclusion:Co-morbidity of depression and chronic physical illnesses is common in Hong Kong as in Western countries This speaks to the need for evidence-based practice that encompasses models of integrated care in Hong Kong
TL;DR: Effective management of severe behavioural and psychiatric symptoms in dementia is challenging even in a NHS continuing care dementia unit due to the absence of clear benefit from pharmacological interventions and lack of resources for optimum non-pharmacological interventions.
Abstract: Objectives:With the increasing concerns over the safety of some pharmacological interventions or lack of sufficient evidence of effectiveness in managing neuropsychiatric symptoms in dementia, there is a constant need to review how such patients are managed This study looks at the prevalence and management of behavioural and psychiatric symptoms amongst patients with dementia in a National Health Service (NHS) continuing care unitMethod:In this study, a survey of all 50 patients admitted to a longstay NHS-funded dementia care unit was carried out The socio-demographic details along with severity of dementia, neuropsychiatric symptoms, and medication were obtained on all the patientsFindings:All 50 patients were prescribed some form of medication for either physical and/or mental health reasons Only five (10%) patients were not prescribed any form of psychotropic medication A lack of non-pharmacological treatment options for the treatment of neuropsychiatric symptoms was evident in the unit with only
TL;DR: The practice of meditation may have therapeutic value in the management of psychological distress, and could be offered as a non-pharmacological treatment alternative in patients with anxiety and depression.
Abstract: Objective:This study aimed to ascertain whether there is an association between meditation and psychological distress.Method:Within a cohort of meditating Monks and Nuns who have accomplished varying levels of skill in the art of meditation, we studied whether there are varying degrees of psychological distress, and if so, whether this correlates to how advanced the meditators are. In this cross-sectional study, Monks and Nuns were recruited from monasteries, nunneries, and volunteer centres throughout Dharamshala, Northern India. A total of 331 Monks and Nuns participated. Psychological distress was measured using the GHQ-12, and the expertise on meditation was assessed through the number of years practising meditation and the maximum length of time held in concentration in one sitting.Results:A dose response association was found with more years meditating associated with increasingly lower GHQ scores. There was 0.21 points drop in GHQ scores for every year meditating (p = 0.001).Conclusion:This study s...
TL;DR: There was a statistically significant relationship between positive scores of borderline personality symptomatology on both measures, and prevented wounds from healing.
Abstract: Patients with borderline personality disorder are characterized by ongoing engagement in self-destructive behavior, which may, according to previous studies of samples of convenience, include preventing wounds from healing. In this study, we examined in a consecutive sample of internal medicine outpatients the relationship between borderline personality symptomatology (using two self-report measures for borderline personality) and the phenomenon of prevented-wounds-from-healing. According to two different statistical approaches, there was a statistically significant relationship between positive scores of borderline personality symptomatology on both measures, and prevented wounds from healing.
TL;DR: N400 detections are helpful to the early diagnostic of PSD, and provide objective electrophysiology indexes for follow-up visits, and blood platelet 5-HT concentration may influence ERPs N400 in PSD patients.
Abstract: Objective: To evaluate event-related potentials (ERPs), N400, and the related factors in patients with poststroke depression (PSD). Methods: Eighty-five stroke patients with depression, conforming to the diagnoses standard of Chinese Classification of Mental Diseases (3rd edition) (CCMD-3), were treated with fluoxetine hydrochloride for 3 months and another 85 stroke patients without depression were selected as the control group. The traits about N400 and blood platelet 5-HT concentrations of all patients were measured. Results: There were significant differences between the incubation periods and average amplitudes of N400 in patients with PSD and those in patients without PSD (p < 0.01), while the blood platelet 5-HT concentrations of PSD patients were much lower than those of the patients without PSD (p < 0.01). For PSD patients, the N400 incubation periods were significantly shortened, averaged amplitudes were significantly increased (p < 0.01), and the blood platelet 5-HT concentrations were significantly raised after 3 months' treatment. Conclusions: For ERPs N400 in PSD patients, the incubation period is significantly prolonged and the average amplitude is reduced. Blood platelet 5-HT concentration may influence ERPs N400 in PSD patients. Significance: N400 detections are helpful to the early diagnostic of PSD, and provide objective electrophysiology indexes for follow-up visits.