Home About us Contact
|
Home About us Contact | ||
|
|
||
Somatic Complaints (somatic + complaints)
Selected AbstractsPersonality and psychopathology in an impulsive aggressive college sampleAGGRESSIVE BEHAVIOR, Issue 1 2006Laura E. Helfritz Abstract Certain personality traits have been associated with impulsive aggression in both college and community samples, primarily irritability, anger/hostility, and impulsivity. The literature regarding the psychopathology associated with impulsive aggression is relatively sparse and strongly emphasizes DSM-IV-TR [APA, 2000] Axis II personality disorders, although some comorbidity with Axis I clinical disorders has been reported. The current study compares impulsive aggressive (IA) college students with their non-aggressive peers on several self-report measures of personality and psychopathology. Personality results were as predicted, with IAs scoring higher than controls on measures of impulsivity and aggression. Additionally, the Psychopathic Personality Inventory (PPI), which was given for exploratory purposes, revealed a unique pattern of psychopathic traits in impulsive aggression that contained key differences from the callous-unemotional profile seen in premeditated aggression. Contrary to our hypothesis that a specific pattern of psychopathology (personality disorders, bipolar disorder, and adult attention deficit hyperactivity disorder) would emerge for impulsive aggression, IAs scored significantly higher than controls on nearly every clinical scale of the Personality Assessment Inventory (PAI; Somatic Complaints, Anxiety, Anxiety-Related Disorders, Depression, Mania, Schizophrenia, Borderline Features, Antisocial Features, Alcohol Problems, and Drug Problems), indicating a global elevation of psychopathology. In conclusion, while the personality traits and behaviors that characterize impulsive aggression are relatively consistent across individuals, its associated psychopathology is unexpectedly variable. Aggr. Behav. 00:1,10, 2005. © 2005 Wiley-Liss, Inc. [source] Evidence of a complex association between dose, pattern and timing of prenatal alcohol exposure and child behaviour problemsADDICTION, Issue 1 2010Colleen M. O'Leary ABSTRACT Background There is a lack of evidence regarding the effect of dose, pattern and timing of prenatal alcohol exposure and behaviour problems in children aged 2 years and older. Methods A 10% random sample of women delivering a live infant in Western Australia (1995,96) were invited to participate in an 8-year longitudinal survey (78% response rate n = 2224); 85% were followed-up at 2 years, 73% at 5 years and 61% at 8 years. Alcohol consumption was classified by combining the overall dose, dose per occasion and frequency to reflect realistic drinking patterns. Longitudinal analysis was conducted using generalized estimating equations (GEE) to investigate the association between child behaviour as measured by the Child Behaviour Checklist at 2, 5 and 8 years of age and prenatal alcohol exposure collected 3 months postpartum for each trimester separately, adjusting for a wide range of confounding factors. Results Low levels of prenatal alcohol were not associated with child behaviour problems. There were increased odds of internalizing behaviour problems following heavy alcohol exposure in the first trimester; anxiety/depression [adjusted odds ratio (aOR) 2.82; 95% confidence interval (CI) 1.07,7.43] and somatic complaints (aOR 2.74; 95% CI 1.47,5.12) and moderate levels of alcohol exposure increased the odds of anxiety/depression (aOR 2.24; 95% CI 1.16,4.34). Conclusions Prenatal alcohol exposure at moderate and higher levels increased the odds of child behaviour problems with the dose, pattern and timing of exposure affecting the type of behaviour problems expressed. Larger studies with more power are needed to confirm these findings. [source] Emotions and self-esteem as indicators of somatic complaints in childrenINFANT AND CHILD DEVELOPMENT, Issue 6 2006Mark Meerum Terwogt Abstract The literature on somatic complaints in children without a clear physical medical cause often demonstrates connections with various psychological factors, such as negative emotions and problems handling them, poor self-image, and coping potential. We entered these elements into a structural model to elucidate the relationships among them and tested it on 330 children (mean age 10 years and 9 months). The results showed that mood balance contributed most to the prediction of self-reported somatic complaints. Moreover, mood (in combination with anxiety and depression problems) had an indirect impact on children's somatic complaints by influencing self-esteem. The influence and position of coping was less clear. The results are discussed in terms of the ,symptom perception theory'. Copyright © 2006 John Wiley & Sons, Ltd. [source] Patients presenting with somatic complaints: epidemiology, psychiatric co-morbidity and managementINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 1 2003Kurt Kroenke MD Abstract Somatic symptoms are the leading cause of outpatient medical visits and also the predominant reason why patients with common mental disorders such as depression and anxiety initially present in primary care. At least 33% of somatic symptoms are medically unexplained, and these symptoms are chronic or recurrent in 20% to 25% of patients. Unexplained or multiple somatic symptoms are strongly associated with coexisting depressive and anxiety disorders. Other predictors of psychiatric co-morbidity include recent stress, lower self-rated health and higher somatic symptom severity, as well as high healthcare utilization, difficult patient encounters as perceived by the physician, and chronic medical disorders. Antidepressants and cognitive-behavioural therapy are both effective for treatment of somatic symptoms, as well as for functional somatic syndromes such as irritable bowel syndrome, fibromyalgia, pain disorders, and chronic headache. A stepped care approach is described, which consists of three phases that may be useful in the care of patients with somatic symptoms. Copyright © 2003 Whurr Publishers Ltd. [source] Association between perceived social support and strain, and positive and negative outcome for adults with mild intellectual disabilityJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 2 2001Y. Lunsky Abstract Social strain has been identified as a trigger for both depression and physical health problems, but has not been well researched in people with intellectual disability (ID). The present study contrasted the effects of social support with social strain on depressive symptoms, somatic complaints and quality of life over time in adults with mild ID. The level of social support explained a significant proportion of variance in quality of life 6 months later, but not depressive symptoms or somatic complaints. In contrast, the level of social strain accounted for a significant proportion of variance in depressive symptoms and somatic complaints 6 months later, but not quality of life. The results suggest that interpersonal relationships can be both positively and negatively associated with physical and mental health for people with ID. [source] Civilian-based posttraumatic stress disorder and physical complaints: Evaluation of depression as a mediatorJOURNAL OF TRAUMATIC STRESS, Issue 4 2002Robert Miranda Jr. Abstract This study examined the role of comorbid depression in the somatic complaints of 32 individuals with civilian-based posttraumatic stress disorder (PTSD) while restricting the influence of detectable pathophysiology and additional psychiatric conditions. It was hypothesized that depressive symptomatology would mediate the relationship between PTSD and somatic symptom reporting. Participants were administered structured clinical interviews, a physical examination, and an electrocardiogram. Results of this study supported the hypothesis that depressive symptoms mediate the relationship between PTSD and physical complaints. These results add to a growing body of literature that suggests psychological factors play an influential role in the physical symptom reports of individuals with PTSD. [source] Chronic Pain and Violent Ideation: Testing a Model of Patient ViolencePAIN MEDICINE, Issue 3 2007Daniel Bruns PsyD ABSTRACT Objective., Physicians are at risk of patient-perpetrated violence. The objective of this study was to test a clinical model of patient violence, which had been developed previously by Fishbain and colleagues. The developers of this model believed that it would be associated with increased risk of violence in pain patients. Design., Hypotheses generated by the model were tested using manova and chi-square procedures. Setting., A total of 527 subjects for this study were patients obtained from 90 medical facilities in 30 U.S. states. Patients., All subjects were patients being treated for injury and nonmalignant pain. All of the subjects were adults, ranging in age from 18 to 65 years, and were able to read at the sixth-grade level. The demographics of the sample approximated U.S. Census data for race, education, age, and gender. Results., The results included findings that violent ideation was associated with higher levels of physical difficulties, including pain (P = 0.01), problems with functioning (P = 0.0003), and somatic complaints (P = 0.0001). Significant psychosocial variables included hostility (P < 0.0001), dependency (P < 0.0001), substance abuse (P < 0.0001), litigation (P < 0.001), and a lack of trust in the physician (P < 0.001). Conclusions., Using the Battery for Health Improvement 2 as a measure, the findings of this study consistently supported the Fishbain Model of violence risk, and also reinforced the need for psychological assessment and management when working with chronic pain patients. Suggestions for intervention were also offered, but further research will be necessary to see whether these interventions are effective in decreasing patient violence. [source] Long-term psychological consequences of pregnancy termination for fetal abnormality: a cross-sectional studyPRENATAL DIAGNOSIS, Issue 3 2005M. J. Korenromp Abstract Objective We examined women's long-term psychological well-being after termination of pregnancy (TOP) for fetal anomaly in order to identify risk factors for psychological morbidity. Methods A cross-sectional study was performed in 254 women, 2 to 7 years after TOP for fetal anomaly before 24 weeks of gestation. We used standardised questionnaires to investigate grief, posttraumatic symptoms, and psychological and somatic complaints. Results Women generally adapted well to grief. However, a substantial number of the participants (17.3%) showed pathological scores for posttraumatic stress. Low-educated women and women who had experienced little support from their partners had the most unfavourable psychological outcome. Advanced gestational age at TOP was associated with higher levels of grief, and posttraumatic stress symptoms and long-term psychological morbidity was rare in TOP before 14 completed weeks of gestation. Higher levels of grief and doubt were found if the fetal anomaly was presumably compatible with life. Conclusion Termination of pregnancy for fetal anomaly is associated with long-lasting consequences for a substantial number of women. Clinically relevant determinants are gestational age, perceived partner support, and educational level. Copyright © 2005 John Wiley & Sons, Ltd. [source] Behavioural functioning of retinoblastoma survivorsPSYCHO-ONCOLOGY, Issue 1 2009J. van Dijk Abstract Objective: To assess behavioural problems in retinoblastoma (RB) survivors. Methods: This population-based cross-sectional study included 148 RB survivors (8,35 years), registered in the Dutch national RB register. Survivors and parents were asked to fill in behavioural questionnaires. Prevalence rates were computed, based on both self-reports and proxy reports. One-sample T -tests were applied to analyse differences compared with healthy reference samples. Multiple regression analyses were performed to identify predictors for behavioural problems within the RB sample. Results: Between-group differences varied across informants and across age groups. Parents reported significantly elevated total problem behaviour in 30% of their offspring (aged 8,17 years); this against 9% in adolescents (12,17 years) and 12% in adults (18,35 years) based on self-report. Parental reports showed significantly elevated rates of (1) internalising problems in boys and (2) somatic complaints in both girls and boys. Self-reports indicate significantly lowered levels of (1) externalising problems in adolescent and adult women and (2) thought problems in female adolescents and in adult men. Especially survivors who suffered hereditary RB, who had undergone more intensive treatment, and who came from a single-parent family were identified to be at most behavioural risk. Conclusion: Perception of severity and the nature of behavioural problems seem to differ between beholder, and to vary between age groups, if not between life stages. Health professionals should be aware that especially those who are confronted with hereditary RB and who subsequently undergo intensive treatment, and who grow up in broken families, run the risk of developing behavioural difficulties. Copyright © 2008 John Wiley & Sons, Ltd. [source] Longitudinal course of depression, fatigue, and quality of life in patients with high risk melanoma receiving adjuvant interferonPSYCHO-ONCOLOGY, Issue 8 2004Peter C. Trask Purpose: Treatment of malignant melanoma with interferon- , has been associated with a variety of side effects ranging from fatigue to depression, and a concomitant impact on quality of life (QOL), in a variety of case reports and cross-sectional clinical trials. Few, if any, studies have been conducted with the express purpose of assessing the longitudinal course of depression, fatigue, and QOL before and during interferon therapy. Description of study: The current study reports on 16 patients who were assessed at 6 points in time: baseline, post high dose, and 1, 2, 3, and 6 months post high dose treatment with interferon- , with the Brief Symptom Inventory, Beck Depression Inventory, Revised Piper Fatigue Scale, and Functional Assessment of Cancer Therapy-Biological Response Modifiers. Results: Results revealed consistent changes from baseline through 6 month assessment. Specifically, increased somatic complaints, depression, and fatigue were observed on the BSI, BDI, and RPFS, respectively. Additional reductions in QOL on the FACT-BRM were also identified. Clinical implications: The findings suggest that IFN has a significant effect on QOL, but that it may be the somatic symptoms of fatigue that contribute to changes on measures of mood. Limiting the amount of fatigue and depression would appear to be significant if individuals are to successfully complete IFN therapy. Copyright © 2003 John Wiley & Sons, Ltd. [source] Behaviour problems in children with language impairmentTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 11 2007John Van Daal Background:, Language impairment is often associated with behaviour problems. However, detailed relations between different types of language impairment and specific behaviour problems in children have yet to be demonstrated. The present study attempted to do just this with an eye to the implications to identify foci for early intervention. Methods:, The language abilities of 71 five-year-old children with language impairment were assessed via the administration of an extensive battery of language tests. The children's behaviour profile was assessed via administration of the Child Behaviour Checklist. Results:, Factor analyses confirmed the presence of four language factors: speech, syntax, semantics and phonology. Forty percent of the children displayed serious significant behaviour problems. The most frequently occurring behaviour problems were: withdrawn behaviour, somatic complaints, thought problems and aggressive behaviour. Behaviour problems were associated with three of the four language factors but not strongly associated with speech problems. Conclusions:, Differential relations between specific types of language impairment and specific behaviour problems already exist at a young age. Phonological problems showed broad relations to problem behaviour; semantic language problems were especially related to internalizing behaviour problems. This finding suggests the need for specific therapies for both different types of language problems and different types of behaviour problems. [source] Posttraumatic Symptoms, Functional Impairment, and Coping among Adolescents on Both Sides of the Israeli,Palestinian Conflict: A Cross-Cultural ApproachAPPLIED PSYCHOLOGY, Issue 4 2009Ruth Pat-Horenczyk This study assessed the effects of the ongoing violence on the mental health of Palestinian and Israeli youths. Parallel instruments were developed and adapted, as part of a collaborative project, in order to assess, in each society: (1) differential rates of exposure to the conflict, (2) the association between exposure and the severity of posttraumatic symptoms (PTS), and (3) the inter-relationships among PTS, functional impairment, somatic complaints, and coping strategies. Participants were 1,016 Israeli and 1,235 Palestinian adolescents. A self-report questionnaire assessed exposure. PTS was measured using the UCLA PTSD Reaction Index, functional impairment and somatic complaints were measured with the DISC, and coping strategies were assessed with Brief Cope. In both societies, greater exposure to conflict-related violence was associated with more PTS and more somatic complaints, with girls reporting more distress than boys. A total of 6.8 per cent of the Israeli students and 37.2 per cent of the Palestinian students met criteria for Post Traumatic Stress Disorder (PTSD). In both societies, but more pronounced in the Palestinian Authority, adolescents reported significant levels of functional impairment, mainly in the area of school functioning. Students with PTSD reported more somatic complaints as well as greater functional impairment. The results show the serious psychological impact of the ongoing violent conflict on Israeli and Palestinian students and point to the need to develop appropriate school-based interventions to address their mental health needs. Cette étude évalue les effets de la violence continuelle sur la santé mentale des jeunes palestiniens et israéliens. Des instruments analogues ont été développés et adaptés, dans le cadre d'un projet de collaboration, afin d'évaluer dans chaque société: (1) les différences de taux d'exposition au conflit, (2) l'association entre l'exposition et la sévérité des symptômes post-traumatiques (PTS) et (3) les interrelations entre les PTS, les troubles fonctionnels, les plaintes somatiques et les stratégies de faire-face. 1016 adolescents israéliens et 1235 adolescents palestiniens ont participéà cette étude. Un questionnaire auto-administré mesure l'exposition au conflit. Les PTS sont mesurés par l'utilisation de l'UCLA PTSD Reaction Index, les troubles fonctionnels et les plaintes somatiques sont approchés par le DISC, et les stratégies de faire-face par le Brief Cope. Dans les deux sociétés, une plus grande exposition au conflit et à ses violences est associée à des PTS plus importants et à plus de plaintes somatiques, les filles manifestant plus de détresse que les garçons. Un total de 6.8% des étudiants israéliens et 37.2% des étudiants palestiniens répondent à des critères du Post Traumatic Stress Disorder (PTSD). Dans les deux sociétés, mais de façon plus prononcée dans l'Autorité palestinienne, les adolescents rapportent des niveaux significatifs de troubles fonctionnels, principalement dans le domaine du fonctionnement scolaire. Les étudiants avec PTSD manifestent plus de plaintes somatiques, il en va de même pour les troubles fonctionnels. Les résultats montrent le sérieux impact psychologique d'un conflit violent et continuel sur les étudiants israéliens et palestiniens et signale le besoin de développer des interventions scolaires appropriées à leurs besoins en matière de santé mentale. [source] Gabapentin withdrawal syndrome in the presence of a taperBIPOLAR DISORDERS, Issue 3 2005Kien T Tran Objective:, To report a case report of a geriatric patient with a 5-year history of gabapentin use for enhanced bipolar control, who was tapered off of gabapentin over 1 week. The patient displayed unique withdrawal symptoms after the taper of gabapentin. Methods:, The patient is an 81-year-old white female with a life-long history of schizoaffective disorder with bipolar type I tendencies who had been prescribed gabapentin for 5 years. Results:, The patient displayed moderate upper respiratory tract infection symptoms and somatic complaints 1 day after termination of gabapentin. These symptoms gradually worsened until 10 days after, at which time she acutely developed severe mental status changes, severe somatic chest pain, and hypertension. Physical examination, electrolytes, electrocardiogram, computerized tomography, magnetic resonance imaging, and magnetic resonance angiography were all normal. Upon reintroduction of gabapentin, the patient returned to baseline within 1,2 days. Conclusions:, Gabapentin is widely utilized currently for the chronic treatment of recalcitrant migraines, bipolar illness, pain, and epilepsy. It has a wide therapeutic index with few side effects and drug interactions, is not hepatically metabolized, and is excreted by the kidneys. Past reports have suggested that some withdrawal symptoms can present after 1,2 days upon abrupt discontinuation of gabapentin after chronic use within young to middle-aged patients. These symptoms mimic that of alcohol and benzodiazepine withdrawal purportedly due to a similar mechanism of action. Unique to this case is that this geriatric patient developed debilitating withdrawal symptoms after a gradual, week-long taper of gabapentin along with flu-like symptoms. It is proposed herein that a gabapentin taper should follow a course similar to that of a benzodiazepine taper , slowly and over a period of weeks to months. [source] Tiagabine in treatment refractory bipolar disorder: a clinical case seriesBIPOLAR DISORDERS, Issue 5 2002Trisha Suppes Objectives:, Anticonvulsants have provided major treatment advances for patients with bipolar disorder. Many of these drugs, including several with proven efficacy in bipolar mania or depression, enhance the activity of the ,-amino butyric acid (GABA) neurotransmitter system. A new anticonvulsant, tiagabine, has selective GABAergic activity and is approved for patients with partial epilepsy. Few reports of its potential effectiveness in bipolar disorder, however, have been published. We sought to evaluate the effectiveness of tiagabine added to ongoing medication regimens in patients with bipolar disorder inadequately responsive to or intolerant of usual treatments. Methods:, Seventeen treatment-refractory patients participating in the Stanley Foundation Bipolar Network (SFBN) long-term follow-up study were offered open treatment with add-on tiagabine after discussion of the risks, benefits, other treatment options and giving informed consent. Patients' clinical symptoms and somatic complaints were closely monitored with SFBN longitudinal and cross-sectional ratings. Four patients discontinued low-dose tiagabine prior to the second visit and were excluded from data analysis. Results:, Thirteen patients received a mean of 38 days of treatment at a mean dose of 8.7 mg/day of tiagabine. On the Clinical Global Impression Scale for Bipolar Disorder Overall category, three (23%) patients showed much or very much improvement and 10 (77%) patients showed no change or worsening. Three significant adverse events were noted, including two presumptive seizures. Conclusions:, Open add-on tiagabine for treatment-refractory patients with bipolar disorder demonstrated limited efficacy with the majority of patients showing no change or worsening of clinical symptoms. In addition, patients experienced serious side-effects attributed as likely due to the medication, which resolved without lasting consequence when tiagabine was discontinued. [source] The burden and determinants of dysmenorrhoea: a population-based survey of 2262 women in Goa, IndiaBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 4 2006V Patel Objective, To describe the prevalence and determinants of dysmenorrhoea, the most common menstrual complaint, in a community in India. Design, Cross-sectional survey. Setting, Catchment area of primary health centre in Goa, India. Population, Three thousand women aged 18,45 years randomly selected. A total of 2494 women consented to participate (83.1%). Methods, Eligible participants were asked standardised questions regarding menstrual complaints over the past 12 months, and socio-demographic, psychosocial and reproductive risk factors. Vaginal or urine specimens were collected for the diagnosis of reproductive tract infections. Main outcome measures, Dysmenorrhoea of moderate to severe intensity. Results, A total of 2262 women were eligible. More than half reported dysmenorrhoea; moderate to severe dysmenorrhoea was reported by 755 participants (33.4%, 95% CI 31.4,35.4). There was a linear association between severity of pain and impact (medication and taking rest) and the onset of pain (premenstrual onset associated with more severe pain). On multivariate analyses, the risk of moderate,severe dysmenorrhoea was associated with the experience of violence (OR 2.23, 95% CI 1.5,34); other somatic complaints (OR 3.67, 95% CI 2.7,4.9 for highest somatoform symptom score category compared with the lowest); gynaecological complaints (non-menstrual lower abdominal pain: OR 1.78, 95% CI 1.3,2.3; dysuria: OR 1.98, 1.4,2.7); menorrhagia (OR 1.92, 95% CI 1.4,2.6); and illiteracy (OR 1.32, 95% CI 1.0,1.7). Having had a pregnancy (OR 0.53, 95% CI 0.4,0.7), older age of menarche (OR 0.70, 95% CI 0.5,0.9, for age >14 compared with <13 years) and older age (OR 0.43, 0.3,0.6 for age 40,50, compared with 18,24 years) were protective. Conclusions, The burden of dysmenorrhoea is greater than any other gynaecological complaint, and is associated with significant impact. Social disadvantage, co-morbidity with other somatic syndromes and reproductive factors are determinants of this complaint. [source] Tsunami, War, and Cumulative Risk in the Lives of Sri Lankan SchoolchildrenCHILD DEVELOPMENT, Issue 4 2010Claudia Catani This study examines the impact of children's exposure to natural disaster against the backdrop of exposure to other traumatic events and psychosocial risks. One thousand three hundred ninety-eight Sri Lankan children aged 9,15 years were interviewed in 4 cross-sectional studies about exposure to traumatic life events related to the war, the tsunami experience, and family violence. Symptoms of posttraumatic stress disorder, somatic complaints, psychosocial functioning, and teacher reports of school grades served as outcome measures. A global outcome variable of "positive adaptation" was created from a combination of these measures. Data showed extensive exposure to adversity and traumatic events among children in Sri Lanka. Findings of regression analyses indicated that all 3 event types,tsunami and disaster, war, and family violence,significantly contributed to poorer child adaptation. [source] | |||||||||||||