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Physical Illness (physical + illness)
Kinds of Physical Illness Selected AbstractsAGITATED BEHAVIOR AS A PRODROMAL SYMPTOM OF PHYSICAL ILLNESS: A CASE OF INFLUENZAJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 12 2006Diana Lynn Woods RN No abstract is available for this article. [source] Physical illness and schizophrenia: a review of the literatureACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2007S. Leucht Objective:, The lifespan of people with schizophrenia is shortened compared to the general population. We reviewed the literature on comorbid physical diseases in schizophrenia to provide a basis for initiatives to fight this unacceptable situation. Method:, We searched MEDLINE (1966 , May 2006) combining the MeSH term of schizophrenia with the 23 MeSH terms of general physical disease categories to identify relevant epidemiological studies. Results:, A total of 44 202 abstracts were screened. People with schizophrenia have higher prevalences of HIV infection and hepatitis, osteoporosis, altered pain sensitivity, sexual dysfunction, obstetric complications, cardiovascular diseases, overweight, diabetes, dental problems, and polydipsia than the general population. Rheumatoid arthritis and cancer may occur less frequently than in the general population. Eighty-six per cent of the studies came from industrialized countries limiting the generalizability of the findings. Conclusion:, The increased frequency of physical diseases in schizophrenia might be on account of factors related to schizophrenia and its treatment, but undoubtedly also results from the unsatisfactory organization of health services, from the attitudes of medical doctors, and the social stigma ascribed to the schizophrenic patients. [source] The functional impact of anxiety sensitivity in the chronically physically illDEPRESSION AND ANXIETY, Issue 4 2005Sonya B. Norman Ph.D. Abstract The symptoms and physical limitations resulting from chronic physical illness often diminish physical functioning. Comorbidity of chronic physical illness and an anxiety disorder is associated with greater impairment in functioning than chronic illness alone. One potential contributor to anxiety in the chronically ill is anxiety sensitivity (AS). The goal of this study was to explore the role of AS on functioning in the chronically ill. Participants were 267 primary care patients. Logistic regression showed that physical AS (but not social or psychological), controlling for age, gender, and negative affect, was associated with hypertension, heart disease, and high cholesterol (P<.01). Higher AS was associated with poorer vitality, mental functioning, and social functioning (P<.05). AS may be a correlate of poorer adjustment to chronic illness. Depression and Anxiety 21:154,160, 2005. © 2005 Wiley-Liss, Inc. [source] Multiple adverse outcomes over 30 years following adolescent substance misuse treatmentACTA PSYCHIATRICA SCANDINAVICA, Issue 6 2009S. Hodgins Objective:, To compare outcomes over 30 years experienced by individuals who as adolescents entered substance misuse treatment and a general population sample. Method:, All 1992 individuals seen at the only clinic for substance misusing adolescents in Stockholm from 1968 to 1971 were compared to 1992 individuals randomly selected from the Swedish population, matched for sex, age and birthplace. Death, hospitalization for physical illness related to substance misuse, hospitalization for mental illness, substance misuse, criminal convictions and poverty were documented from national registers. Results:, Relative risks of death, physical illness, mental illness, substance misuse, criminal convictions and poverty were significantly elevated in the clinic compared to the general population sample. After adjustment for substance misuse in adulthood, the risks of death, physical and mental illness, criminality and poverty remained elevated. Conclusion:, Adolescents who consult for substance misuse problems are at high risk for multiple adverse outcomes over the subsequent 30 years. [source] The fatal outcome of an individual with anorexia nervosa and Sheehan's syndrome as a result of acute enterocolitis: A case reportINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 1 2010Werner Köpp MD Abstract Objectives: To illustrate the close association between a disturbed psychosocial up-bringing, frequent physical illness, and medical interventions. Method: We report a case of a 44-year-old woman with anorexia nervosa (AN) and Sheehan's syndrome who died as a result of a toxic cardiac arrest. Results: The patient presented with a BMI of 13.6 kg/m2. She refused any intensive-care treatment and died from toxic cardiac arrest. Postmortem examination revealed an acute gastroenterocolitis. Discussion: The history of this patient illustrates how psychological deprivation led to eating disturbances, early pregnancy, and the life-threatening delivery of twins. This resulted in a diagnosis of Sheehan's syndrome, hepatitis C, and a ventricular ulcer. A psychosocial event triggered a late exacerbation of her AN. A helpful alliance between patient and staff did not occur as she rejected it. © 2009 by Wiley Periodicals, Inc. Int J Eat Disord 2010. [source] Deliberate self-harm in older adults: a review of the literature from 1995 to 2004INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 8 2007Jenifer Chan Abstract Background The prevention of suicide is a national and international policy priority. Old age is an important predictor of completed suicide. Suicide rates in old age differ markedly from country to country but there is a general trend towards increasing rates with increasing age. In 1996 Draper reviewed critically the evidence on attempted suicide in old age in the 10 years between 1985 and 1994. The review highlighted a need for prospective controlled studies in older people with more representative samples as well as studies examining the interaction of risk factors, precipitants, motivations, psychopathology and response to treatment. The aim of this paper is to update this review and to summarise the advances in our understanding of DSH in later life. Method We have critically reviewed relevant studies published between 1995 and 2004 to summarise the advances in our understanding of factors associated with deliberate self-harm in later life. Results The main advances in understanding have been to clarify the effect of personality and cultural factors, service utilisation pre and post attempt, and the (lesser) impact of socio-economic status and physical illness. Methodological weaknesses continue to include inadequate sample sizes performed on highly selected populations, inconsistent age criteria and lack of informant data on studies relating to role of personality. Conclusions Future studies should include prospective, cross-cultural research with adequate sample sizes and which are population-based. Such approaches might confirm or refute the results generated to date and improve knowledge on factors such as the biological correlates of deliberate self-harm, service utilisation, costs and barriers to health care, and the interaction of these factors. Intervention studies to elucidate the impact of modifying these factors and of specific treatment packages are also needed. Copyright © 2007 John Wiley & Sons, Ltd. [source] A UK survey of psychiatric services for older people in general hospitalsINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 8 2003John Holmes Abstract Background Psychiatric illness is common in older people in general hospitals, but little is known of the service models operating in the UK, or of the views of old age psychiatrists regarding service provision in this area. We set out to determine the range of UK old age psychiatry service models for older people in general hospital wards, and the opinions of clinicians on future service priorities and development. Method A postal questionnaire survey of old age psychiatrists providing psychiatric services to older people in general hospital wards. Results 73% of services were provided through a generic, sector-based, consultation psychiatry model. The remaining 27% employed a range of general hospital-based liaison psychiatry services for older people, involved in proactively seeking referrals and educating general hospital staff. Those providing a generic sector-based model were significantly slower at responding to referrals. 89% of respondents were unhappy with their service to older people in general hospital wards, with only 11% preferring the generic sector-based model. Organisational barriers to change identified included the management of mental health care and physical care by different organisations. Training, both of psychiatric staff in this specialist area, and of general hospital staff in the detection and basic management of common psychiatric conditions in the general hospital setting, was felt to be necessary. Conclusions The management of co-morbid psychiatric and physical illness in older people is an important issue for health services. Old age psychiatrists are unhappy with the prevalent, reactive, consultation-based model, preferring a range of liaison psychiatry models based in the general hospital. The most important barriers to service development in this area were the separate managerial arrangements for psychiatric and physical care services, and a lack of evidence for effective old age psychiatry services in this setting. Copyright © 2003 John Wiley & Sons, Ltd. [source] The effect of somatic symptom attribution on the prevalence rate of depression and anxiety among nursing home patientsINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 3 2005Martin Smalbrugge Abstract The validity of diagnostic psychiatric instruments for depression and anxiety disorders may be compromised among patients with complex physical illness and disability. The objective of this study was to determine the effect on the prevalence rate of depression and anxiety in a nursing home population of attributing somatic symptoms of depression and anxiety to either somatic or psychiatric disorder. Symptoms of major depression (MD), generalized anxiety disorder (GAD) and panic disorder (PD) were measured using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN). Somatic symptoms of MD, GAD and PD were attributed to somatic causes when the interviewer was not sure about a psychiatric cause. To analyse the effect of this attribution on the prevalence rate of MD, GAD and PD, a sensitivity analysis was undertaken in which symptoms that were attributed to somatic causes were recoded as symptoms attributed to psychiatric disorder. Prevalence rates of MD, GAD and PD were calculated before and after recoding. The prevalence of MD after recoding rose from 7.5% to 8.1%. The prevalence of GAD did not change. The prevalence of PD rose from 1.5% to 1.8%. Attribution of somatic symptoms to either somatic or psychiatric disorder when the interviewer was not sure about a psychiatric cause of the somatic symptoms had only a very modest effect on the prevalence rate of major depression, generalized anxiety disorder and panic disorder in a nursing home population. Copyright © 2005 John Wiley & Sons, Ltd. [source] Mental Health and the Churches: the Story of LucreciaINTERNATIONAL REVIEW OF MISSION, Issue 376-377 2006Brenda Consuelo Ruiz In this article, prepared originally as a powerpoint presentation, Brenda Consuelo Ruiz attempts to show, by way of a case study, bow churches can contribute to the mental and physical illness of individuals and families in the church, as well as to their health. She also proposes different ways in which churches can engage in promoting mental health. [source] Ten Dimensions of Health and Their Relationships with Overall Self-Reported Health and Survival in a Predominately Religiously Active Elderly Population: The Cache County Memory StudyJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 2 2006Truls Østbye MD OBJECTIVES: To document the extent of healthy aging along 10 different dimensions in a population known for its longevity. DESIGN: A cohort study with baseline measures of overall self-reported health and health along 10 specific dimensions; analyses investigated the 10 dimensions as predictors of self-reported health and 10-year mortality. SETTING: Cache County, Utah, which is among the areas with the highest conditional life expectancy at age 65 in the United States. PARTICIPANTS: Inhabitants of Cache County aged 65 and older (January 1, 1995). MEASUREMENTS: Self-reported overall health and 10 specific dimensions of healthy aging: independent living, vision, hearing, activities of daily living, instrumental activities of daily living, absence of physical illness, cognition, healthy mood, social support and participation, and religious participation and spirituality. RESULTS: This elderly population was healthy overall. With few exceptions, 80% to 90% of persons aged 65 to 75 were healthy according to each measure used. Prevalence of excellent and good self-reported health decreased with age, to approximately 60% in those aged 85 and older. Even in the oldest old, the majority of respondents were independent in activities of daily living. Although vision, hearing, and mood were significant predictors of overall self-reported health in the final models, age, sex, and cognition were significant only in the final survival models. CONCLUSION: This population has a high prevalence of most factors representing healthy aging. The predictors of overall self-reported health are distinct from the predictors of survival in this age group and, being potentially modifiable, are amenable to clinical and public health efforts. [source] No Old Man Ever Forgot Where He Buried His Treasure: Concepts of Cognitive Impairment in Old Age Circa 1700JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 11 2005Daniel Schäfer PhD Cognitive impairment in old age is one of the most important topics in modern geriatrics. This article discusses the historical dimensions of this phenomenon. To this end, a number of primary sources ranging from antiquity to the modern era are evaluated. Although a physiology and pathology of old age were conceptualized in Greco-Roman times, cognitive impairment in old age remained a marginal issue until the 17th century. Alternatively, after 1500, medicine boasted detailed theories on the physiology and pathology of old age. There are several possible explanations for this unusual situation. Underlying conflict between idealistic and materialistic views of man played a decisive role, for these concepts differed considerably regarding the intellectual and mental functioning of the soul as well as the effects of the passage of time. After Cartesianism and Iatromechanism had pushed these traditional boundaries back, the problem of cognitive impairment in old age was increasingly regarded as a physical illness and began to receive more attention. Just as its philosophical and theological context shaped early modern medicine, contemporary nonmedical disciplines such as genetics, (neuro-)biology, and the information sciences influence modern research. [source] Experiences of loss and chronic sorrow in persons with severe chronic illnessJOURNAL OF CLINICAL NURSING, Issue 3a 2007Gerd Ahlström PhD Aims and objectives., The aims of the present study were to describe losses narrated by persons afflicted with severe chronic physical illness and to identify the concomitant occurrence of chronic sorrow. Background., Reactions connected with repeated losses are referred to in the literature as chronic sorrow, which has recently been described in conjunction with chronic illness. Design., A qualitative study with an abductive approach of analysis, including both inductive and deductive interpretations. Method., The study is based on 30 persons of working age with average disease duration of 18 years. The average age was 51 years. All of the persons had personal assistance for at least three months because of considerable need for help in daily life due to physical disability. Each person was interviewed twice. There was also an independent assessment of the deductive results concerning chronic sorrow. Results., The inductive findings show that all persons had experienced repeated physical, emotional and social losses. Most common were ,Loss of bodily function', ,Loss of relationship', ,Loss of autonomous life' and ,Loss of the life imagined'. ,Loss of identity' included the loss of human worth, dignity and a changed self-image. In addition, the deductive findings suggest that chronic sorrow exists in the study population. Sixteen of 30 participating subjects were assessed by both assessors to be in a state of chronic sorrow and there was an especially high agreement with respect to one criterion of chronic sorrow ,Loss experience, ongoing or single event' (28 of 30 subjects). Conclusions., This study shows that persons with severe chronic illness often experience recurring losses. These experiences are consistent with the phenomenon of chronic sorrow. Relevance to clinical practice., Knowledge of the existence of chronic sorrow in persons with chronic illness will enable nurses to support these persons in a more sensitive and appropriate way. [source] Emotional processing in the treatment of psychosomatic disordersJOURNAL OF CLINICAL PSYCHOLOGY, Issue 5 2006Patricia Coughlin Della Selva Research has supported a hypothesis that was clinically suggested decades ago: that those who have functional disorders exhibit significant deficits in emotional processing. Studies have systematically documented that patients who habitually repress their emotions simultaneously suppress their immune response, rendering them vulnerable to physical illness and early death. Conversely, those who are encouraged to experience and express their feelings demonstrate improvement in immune function, physical condition, and psychological well-being. This article describes a psychotherapy designed to interrupt defensive processes and facilitate the direct experience of previously disavowed feelings in the treatment of patients who have physical ailments. Verbatim transcripts from the treatment of a woman who had a life-threatening illness illustrate the therapeutic techniques designed to facilitate emotional processing and restore health. Data from 14 years of follow-up interviews reveal a sustained remission in her disease. © 2006 Wiley Periodicals, Inc. J Clin Psychol: In Session 62: 539,550, 2006. [source] Ambiguous loss from chronic physical illness: Clinical interventions with individuals, couples, and familiesJOURNAL OF CLINICAL PSYCHOLOGY, Issue 11 2002Pauline Boss The theory of ambiguous loss is applied to chronic illness in individuals, couples, and families. Lack of clarity about prognosis, daily physical condition, and fluctuating capabilities create relationship confusion, preoccupation with the illness, or avoidance of the ill individual. Immobilization, depression, and relationship collapse may occur in response to features of chronic illness over which there is no control. A case study illustrates helpful therapeutic interventions for couples and families with chronically ill members. © 2002 Wiley Periodicals, Inc. J Clin Psychol/In Session 58: 1351,1360, 2002. [source] Coping-related Expectancies and Dispositions as Prospective Predictors of Coping Responses and SymptomsJOURNAL OF PERSONALITY, Issue 4 2000Salvatore J. Catanzaro We used Rotter's (1954, 1982) social learning theory and Kirsch's (1985, 1999) response expectancy extension thereof to clarify distinctions between coping-related expectancies (beliefs about the outcomes of coping efforts) and coping dispositions (tendencies to use particular coping responses), specifically focusing on the role of generalized expectancies for negative mood regulation (NMR) as a predictor of individual differences in coping and well-being. Two studies using structural equation modeling provided support for direct and indirect associations between NMR expectancies and symptoms of depression. In Study 1 NMR expectancies predicted situational avoidance coping responses and symptoms of depression and anxiety, independent of dispositional avoidance coping tendencies. In Study 2, NMR expectancies were associated with depressive symptoms, concurrently and prospectively, independent of dispositional optimism and pessimism. Both studies indicated that NMR expectancies are more strongly associated with depressive symptoms than with symptoms of anxiety and physical illness. Results underscore the importance of distinguishing between expectancies and other personality variables related to coping. [source] Associations between psychological trauma and physical illness in primary careJOURNAL OF TRAUMATIC STRESS, Issue 4 2006Sonya B. Norman Psychological trauma is associated with poor physical health. We examined whether specific trauma types (assaultive, sexual, any) are associated with specific medical illnesses and whether posttraumatic stress disorder (PTSD) mediated these relationships in 680 primary care patients. For men, trauma history was associated with arthritis and diabetes; PTSD mediated the association between trauma and arthritis but not diabetes. Among women, trauma was associated with digestive diseases and cancer; PTSD did not mediate these relationships. Awareness of the presence of the physical illnesses examined here may help with the identification and treatment of primary care patients with trauma histories. [source] Somatization and chronic painACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 9 2001M. Birket-Smith The experience of pain is related not only to tissue damage and physical illness, but also to mental phenomena including depression, anxiety and somatization. Somatization is common among chronic pain patients and presents special problems in management and treatment. Somatoform patients are often given inappropriate diagnoses, treated for non-existent depressive disorders, and exposed to multiple, superfluous investigations. Psychological models of chronic pain and somatization are presented, and treatment issues including psychotherapy and the use of antidepressants are discussed. [source] Factors impacting on psychological distress and recovery after the 2004 Niigata,Chuetsu earthquake, Japan: Community-based studyPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 5 2008Hideki Kuwabara md Aim:, This study was undertaken 5 months after the 2004 Niigata,Chuetsu earthquake in Japan to assess factors that impacted on psychological distress and its recovery. Methods:, Three thousand and twenty-six adult victims who lived in temporary shelter and in seriously damaged areas were evaluated by questionnaire. The questionnaire queried subject profile, degree of house damage, health status, and psychological distress using a 5-point scale before, immediately and 5 months after the earthquake. Results:, Immediately after the earthquake, 59.3% of the subjects had psychological distress. At 5 months after the earthquake, however, this percentage decreased to 21.8%. The psychological distress immediately after the earthquake was significantly serious in victims who: (i) were female; (ii) felt stronger fear of the earthquake and the aftershocks; (iii) lived at home or office after the earthquake; and (iv) were injured due to the earthquake or suffered from sickness after the earthquake. In contrast, the factors impairing psychological recovery 5 months after the earthquake were as follows: (i) being with unfamiliar member(s) during the night after the earthquake; (ii) serious house damage; (iii) living in temporary shelter or at a relative's home after the earthquake; and (iv) physical illness after the earthquake. Conclusion:, Despite differences between disasters, these results were consistent with those in some previous studies and may be useful for long-term mental care support. [source] Efficacy of risperidone in the treatment of delirium in elderly patientsPSYCHOGERIATRICS, Issue 2 2008Koji IKEZAWA Abstract Background:, Despite increasing recognition of delirium as a serious complication of physical illness, little has been reported in this area. Interest has been raised in treatment options other than haloperidol, such as atypical antipsychotic agents. Methods:, A 2-week open-label trial of risperidone for the treatment of delirium was conducted to assess the efficacy and tolerance of this medication in elderly patients. Twenty-two patients with DSM-IV-defined delirium were investigated. All patients had the hyperactive,hyperalert variant of delirium. Patients received a fixed dose of risperidone (mean 1.5 ± 0.7 mg; range 0.5,3 mg). Delirium was assessed using the Delirium Rating Scale (DRS) at baseline and on Days 1, 3, 5, 7, and 14 after the initiation of risperidone treatment. Clinical and demographic data, as well as risperidone therapy related information, were collected. Results:, Delirium resolved in all patients over the course of treatment. The mean period over which delirium resolved was 4.0 ± 2.9 days. The mean DRS score at baseline was 20.7 ± 3.0. The DRS score improved from baseline to Day 1 of treatment and continued to improve until the study end-point. Mild side-effects were present in 27.3% of patients. Stepwise logistic regression identified a decrease of 2 points or higher on the DRS on Day 1 associated with side-effects. There were no significant differences in the response to treatment with the different doses of risperidone used. Conclusion:, Our findings indicate that low-dose risperidone (0.5,3.0 mg/day) is effective and safe for the treatment of delirium in elderly patients, and that an early response on Day 1 of treatment may be associated with side-effects in these patients. [source] Family functioning and juvenile chronic physical illness in Northern RussiaACTA PAEDIATRICA, Issue 2 2009A Zashikhina Abstract Aim: To study family functioning of adolescents with chronic physical illnesses and factors related to it. The following research questions were addressed: (i) if families with adolescents with chronic physical illnesses were at increased risk for problematic functioning compared to the healthy control families; (ii) was disease severity associated with family dysfunction; and (iii) did family functioning level differ in three disease groups (diabetes, asthma and epilepsy). Methods: Self-report family inventory and socio-economic status questions were individually completed by 148 adolescents with physical illnesses aged 13,16 years and their mothers; medical data were obtained from the files at the outpatient clinics. Comparative data were collected from a group of 301 schoolchildren. Results: Overall there were no differences found in functioning of families with physically ill adolescents compared to controls. Family functioning was significantly associated with the number of disease-specific (disease severity and duration) and non-disease (socio-economic status and family type) factors. Conclusion: In our study, families with physically ill adolescents showed considerable resilience and tolerance to the changes in habitual functioning of the family unit. While greater disease severity, longer disease duration, as well as single-parent household were the factors that contributed to the family dysfunction. [source] Psychosomatic tendency for suicide among the elderly in Mie Prefecture, JapanPSYCHOGERIATRICS, Issue 2 2007Ken INOUE Abstract Background:, The aim of the present study is to show the causative factors of suicide among the elderly (over 65) in Mie Prefecture, Japan, and to discuss the prevention of the suicidal influences in elderly patients. Methods:, We investigated all inquest records during the 14-year period 1989,2002 in cooperation with the First Department of Criminal Investigation of Mie Prefectural Police Headquarters. From all cases classified as suicides, we extracted data on age, sex and background, and we focused on suicide in the elderly group. Results:, During the test period, there were 5048 suicides (3276 male and 1772 female suicides) of which 1513 (691 male and 822 female) were in the elderly group. The rate of suicide in the elderly group was approximately 30% of the total in all age groups. The rate of female suicides in the elderly group was approximately 46.3%. The major causative factors of suicide among the elderly were ,suffering from physical illness', and ,psychiatric disorders'. ,Physical diseases' were not negligible backgrounds in middle and elderly groups. Among physical diseases, the number of malignant neoplasm was clearly less than the other diseases. Notably, ,cardiovascular disease' and ,orthopedic disorders' were most frequent causative factors of suicide other than malignant neoplasm. Conclusion:, It is consequently concluded that improvements in the system of home nursing and health care should be involved in the suicidal prevention of the elderly who ,suffer from physical illness'. The patients who ,suffer from physical illness' should be given physical and mental support. In order to prevent suicide, not only psychiatrists but also general practitioners as well as medical staff and general public should be provided with education regarding depression among ,psychiatric disorders'. [source] Trajectories of resilience over 25 years of individuals who as adolescents consulted for substance misuse and a matched comparison groupADDICTION, Issue 7 2010Peter Larm ABSTRACT Aims To examine trajectories of resilience over 25 years among individuals who as adolescents received treatment for substance misuse, the clinical sample (CS) and a matched general population sample (GP). Design Comparison of the CS and GP over 25 years using Swedish national registers of health care and criminality. Setting A substance misuse clinic for adolescents in an urban area in Sweden. Measurements Resilience was defined as the absence of substance misuse, hospitalizations for physical illnesses related to substance misuse, hospitalization for mental illness and law-abiding behaviour from ages 21 to 45 years. Participants The CS included 701 individuals who as adolescents had consulted a clinic for substance misuse. The GP included 731 individuals selected randomly from the Swedish population and matched for age, sex and birthplace. Findings A total of 52.4% of the GP and 24.4% of the CS achieved resilience in all domains through 25 years. Among the CS, another one-third initially displayed moderate levels of resilience that rose to high levels over time, one-quarter displayed decreasing levels of resilience over time, while 9.3% showed little but improving resilience and 8.8% showed no resilience. Levels of resilience were associated with the severity of substance misuse and delinquency in adolescence. Conclusions Individuals who had presented substance misuse problems in adolescence were less likely to achieve resilience over the subsequent 25 years than was a matched general population sample, and among them, four distinct trajectories of resilience were identified. The severity and type of problems presented in adolescence distinguished the four trajectories. [source] Parkinson's disease and suicide: a profile of suicide victims with Parkinson's disease in a population-based study during the years 1988,2002 in Northern FinlandINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 9 2009Arja Mainio Abstract Objective We studied the prevalence of hospital-treated Parkinson's disease (PD) among suicide victims and the profile of these persons, taking into account suicide attempts, timing of depression and comorbid somatic diseases. Methods The database of this study consisted of suicide victims aged 50 years of age or older (n,=,555) during a fourteen-year period in the province of Oulu in Northern Finland. Results Hospital-treated Parkinson's disease occurred in 1.6% of the subjects, indicating a rather low prevalence of suicide in this group of patients. The persons with PD had attempted suicide earlier in 44% of the cases, while the corresponding percentage for other victims in older age was 9.9% (p,=,0.009 Fischer exact test). Conclusions Based on the case characteristics of our study the profile of PD person who completed suicide was as follows: male subject with recently diagnosed disease, living in rural area, having multiple physical illnesses, and having attempted suicide earlier. Psychiatric consultation is thus highly recommended for the PD patients with this disease profile. Copyright © 2009 John Wiley & Sons, Ltd. [source] Holocaust Survivors in Old Age: The Jerusalem Longitudinal StudyJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3 2008Jochanan Stesssman MD OBJECTIVES: To examine the hypothesis that Holocaust exposure during young adulthood negatively affects physical aging, causing greater morbidity, faster deterioration in health parameters, and shorter survival. DESIGN: A longitudinal cohort study of the natural history of an age-homogenous representative sample born in 1920/21 and living in Jerusalem. SETTING: Community-based home assessments. PARTICIPANTS: Four hundred fifty-eight subjects of European origin aged 70 at baseline and 77 at follow-up. MEASUREMENTS: Comprehensive assessment of physical, functional, and psychosocial domains; biographical history of concentration camp internment (Camp), exposure to Nazi occupation during World War II (Exposure), or lack thereof (Controls); and 7-year mortality data from the National Death Registry. RESULTS: Holocaust survivors of the Camp (n=93) and Exposure (n=129) groups were more likely than Controls (n=236) to be male and less educated and have less social support (P=.01), less physical activity (P=.03), greater difficulty in basic activities of daily living (P=.009), poorer self-rated health (P=.04), and greater usage of psychiatric medication (P=.008). No other differences in health parameters or physical illnesses were found. Holocaust survivors had similar rates of deterioration in health and illness parameters over the follow-up period, and 7-year mortality rates were identical. Proportional hazard models showed that being an elderly Holocaust survivor was not predictive of greter 7-year mortality. CONCLUSION: Fifty years after their Holocaust trauma, survivors still displayed significant psychosocial and functional impairment, although no evidence was found to support the hypothesis that the delayed effects of the trauma of the Holocaust negatively influence physical health, health trajectories, or mortality. [source] Associations between psychological trauma and physical illness in primary careJOURNAL OF TRAUMATIC STRESS, Issue 4 2006Sonya B. Norman Psychological trauma is associated with poor physical health. We examined whether specific trauma types (assaultive, sexual, any) are associated with specific medical illnesses and whether posttraumatic stress disorder (PTSD) mediated these relationships in 680 primary care patients. For men, trauma history was associated with arthritis and diabetes; PTSD mediated the association between trauma and arthritis but not diabetes. Among women, trauma was associated with digestive diseases and cancer; PTSD did not mediate these relationships. Awareness of the presence of the physical illnesses examined here may help with the identification and treatment of primary care patients with trauma histories. [source] Geropsychiatric consultation in a general hospital in TaiwanPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 3 2005YEONG-YUH JUANG md Abstract, The aim of this study was to characterize clinically significant issues in a psychiatric consultation service for geriatric inpatients in a general hospital in Taiwan. This was a case-control study. During a 5-month period, 100 geriatric (age ,65 years) inpatients consecutively referred for consultation-liaison psychiatric service from non-psychiatric departments formed the study group. Another 100 medical inpatients, also referred for consultation-liaison to the psychiatric service, but aged 17,50, formed the control (non-geriatric) group. The diagnosis, demography, reason for referral, symptomatology, and other clinical characteristics were determined by consensus between two psychiatrists. Psychiatric diagnosis was made according to criteria in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders. The geropsychiatric consultation rate was 0.9%. Geriatric patients constituted 20.1% of all psychiatric referrals. Common reasons for referral of geriatric inpatients were confusion (32%), depression (17%), disturbing behaviors (14%), and psychosis (14%). The most common psychiatric disorder among geriatric patients was an organic mental disorder (79%), followed by a depressive disorder (13%). More geriatric patients suffered from cancers and cerebrovascular diseases than non-geriatric patients. The geriatric group was more likely to have multiple physical illnesses. Organic mental disorder and depressive disorders are the most common psychiatric diagnoses in the geropsychiatric consultation service of the authors. In the authors' experience, both psychotropic medication treatment and psychosocial intervention are important in geropsychiatric consultation. [source] Coping styles, psychological functioning and quality of life in children with asthmaCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 4 2007M. L. Marsac Abstract Background Previous research suggests that children dealing with the asthma are at a greater risk for experiencing psychological maladjustment than children without asthma. Research also suggests that coping is a factor in psychological adaptation to chronic stressors such as physical illnesses. The question as to how coping relates to psychological functioning and quality of life in the paediatric asthma population has not yet been answered. The objective of the current study was to examine the relationships among coping, psychological functioning and quality of life in children diagnosed with asthma and to investigate the relationship that mothers' quality of life has with these variables. Methods Forty-seven youths (aged 8,15 years) diagnosed with asthma completed measures of coping with asthma and quality of life. Each youth's mother completed measures of her child's coping, psychological functioning and her own quality of life. Results Mothers and children with asthma both reported that children used significantly more approach coping than avoidant coping when dealing with asthma. Three regression analyses indicated that avoidant coping negatively predicted psychological functioning, child's quality of life and mother's quality of life. Bivariate analyses also indicated a positive relationship between child's quality of life and mother's quality of life. Conclusions Results indicate that, in children with asthma, coping style plays an important role in the child's psychological functioning and quality of life and mother's quality of life. Therefore, it is recommended that type of coping be assessed when developing comprehensive treatment plans for children with asthma. Further research is needed to determine the efficacy of focused coping interventions in improving quality of life and psychological functioning in children with asthma. [source] Family functioning and juvenile chronic physical illness in Northern RussiaACTA PAEDIATRICA, Issue 2 2009A Zashikhina Abstract Aim: To study family functioning of adolescents with chronic physical illnesses and factors related to it. The following research questions were addressed: (i) if families with adolescents with chronic physical illnesses were at increased risk for problematic functioning compared to the healthy control families; (ii) was disease severity associated with family dysfunction; and (iii) did family functioning level differ in three disease groups (diabetes, asthma and epilepsy). Methods: Self-report family inventory and socio-economic status questions were individually completed by 148 adolescents with physical illnesses aged 13,16 years and their mothers; medical data were obtained from the files at the outpatient clinics. Comparative data were collected from a group of 301 schoolchildren. Results: Overall there were no differences found in functioning of families with physically ill adolescents compared to controls. Family functioning was significantly associated with the number of disease-specific (disease severity and duration) and non-disease (socio-economic status and family type) factors. Conclusion: In our study, families with physically ill adolescents showed considerable resilience and tolerance to the changes in habitual functioning of the family unit. While greater disease severity, longer disease duration, as well as single-parent household were the factors that contributed to the family dysfunction. [source] | ||||||||||||||||||||||||||||