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Symptom Domains (symptom + domain)
Terms modified by Symptom Domains Selected AbstractsThe phenomenology of bipolar disorder: what drives the high rate of medical burden and determines long-term prognosis?DEPRESSION AND ANXIETY, Issue 1 2009Isabella Soreca M.D. Abstract Bipolar disorder (BD) has been classically described as one of episodic mood disturbances. New evidence suggests that a chronic course and multisystem involvement is the rule, rather than the exception, and that together with disturbances of circadian rhythms, mood instability, cognitive impairment, a high rate of medical burden is often observed. The current diagnostic approach for BD neither describes the multisystem involvement that the recent literature has highlighted nor points toward potential predictors of long- term outcome. In light of the new evidence that the long-term course of BD is associated with a high prevalence of psychiatric comorbidity and an increased mortality from medical disease, we propose a multidimensional approach that includes several symptom domains, namely affective instability, circadian rhythm dysregulation, and cognitive and executive dysfunction, presenting in various combinations that give shape to each individual presentation, and offers potential indicators of overall long-term prognosis. Depression and Anxiety, 2009. © 2008 Wiley-Liss, Inc. [source] Behavioural and psychological syndromes in Alzheimer's diseaseINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 11 2004A. Mirakhur Abstract Objectives The origins of behavioural and psychological symptoms of dementia are still poorly understood. By focusing on piecemeal behaviours as opposed to more robust syndrome change valid biological correlates may be overlooked. Our understanding of BPSD via the identification of neuropsychiatric syndromes. Methods We recruited 435 subjects from old age psychiatry and elderly care memory outpatient clinics fulfilling the criteria for diagnosis of probable Alzheimer's disease. Behavioural and psychological symptoms were assessed using the Neuropsychiatric Inventory. Principal components factor analysis was carried out on the composite scores of the 12 symptom domains to identify behavioural syndromes (factors). Results were confirmed by performing three different rotations: Varimax, Equamax and Quartimax. Results Four factors were identified (which accounted for 57% of the variance): ,affect' factor,depression/dysphoria, anxiety, irritability/lability and agitation/aggression; ,physical behaviour' factor,apathy, aberrant motor behaviour, sleep disturbance and appetite/eating disturbance; ,psychosis' factor,delusions and hallucinations; ,hypomania' factor,disinhibition and elation/euphoria. These groups were unchanged when different methods of rotation were used. Conclusions We report novel observations that agitation/aggression/irritability cluster within a depressive symptom factor and apathy is found within a physical behaviour factor. Copyright © 2004 John Wiley & Sons, Ltd. [source] Expressed Emotion about children: reliability and validity of a Camberwell Family Interview for Childhood (CFI-C)INTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 1 2000Adolescent Psychiatry, Stephen Scott Senior Lecturer in Child Abstract A Camberwell Family Interview for Childhood (CFI-C) was developed by adding questions about the family impact of the child's problems to a semi-structured interview on child psychiatric symptoms. The whole CFI-C took under an hour to administer; the questions about family impact added 15,20 minutes. The inter-rater reliability was good (kappa 0.64,1.0). Mothers of 25 boys aged four to nine years referred with disruptive behaviour, and 25 matched controls were interviewed twice in five months. Test-retest stability was fair to good (kappa 0.36,1.0). Discriminant validity between referred and control samples was strong for critical comments, positive comments and warmth, but not significant for emotional overinvolvement or hostility. The same three scales showed strong discriminant validity between child symptom domains, being strongly correlated with conduct symptoms (kappa = 0.49,0.71) but not emotional symptoms (kappa = 0.10,0.17). Sensitivity to change with treatment was shown by a reduction in the mean number of critical comments from 4.7 to 2.9, an increase in positive comments from 2.3 to 3.9, and an increased score on the warmth scale from 2.1 to 2.6. The CFI-C is a useful instrument for the study of the relationship between parenting style and child psychiatric symptoms. Copyright © 2000 Whurr Publishers Ltd. [source] The reliability and validity of general psychotic rating scales with people with mild and moderate intellectual disabilities: an empirical investigationJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 7 2005C. Hatton Abstract Background Whilst assessment tools have been developed to diagnose schizophrenia in people with mild intellectual disabilities (IDs), little attention has been paid to developing reliable and valid dimensional measures of psychotic experiences with this population. This study investigates the reliability and validity of two such measures developed for the general adult psychiatric population, the Positive and Negative Syndrome Scale (PANSS) and the Psychotic Symptom Rating Scales (PSYRATS), with a population of adults with mild IDs. Method Sixty-two adults with mild IDs were interviewed using the PANSS and PSYRATS, and independently interviewed using the Psychiatric Assessment Schedule , Adults with Developmental Disability (PAS-ADD) to obtain psychiatric diagnoses to the criteria of the International Classification of Diseases , Tenth Revision (ICD-10). On the basis of ICD-10 diagnosis, participants were divided into three groups: psychosis (n = 11); other mental health problem (n = 14); no mental health problem (n = 37). PANSS and PSYRATS subscale scores were compared across these three groups and were correlated with PAS-ADD symptom scores across a number of PAS-ADD symptom domains. Results All PANSS and PSYRATS subscales showed adequate internal reliability, largely good test-retest reliability, and logical inter-correlations between subscales. The PANSS positive symptoms and the PSYRATS auditory hallucinations subscales differentiated between the psychosis group and the other groups; the PANSS general symptoms subscale differentiated between the psychosis and no mental health problem groups; and the PANSS negative symptoms and the PSYRATS delusions subscales did not differentiate between the three groups. Conclusions The PANSS and PSYRATS are promising measures for use with people with mild IDs and psychotic experiences, although further investigation of items relating to negative symptoms and delusions is warranted. [source] Social contextual links to emotion regulation in an adolescent psychiatric inpatient population: do gender and symptomatology matter?THE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 11 2009Molly Adrian Background:, The regulation of emotion is essential for adaptive functioning. However, delineating the pathways of emotion regulation (ER) processes that lead to psychological adaptation remains under-studied, with mixed evidence for the specificity vs. generality of ER deficits in relation to specific forms of psychopathology. To examine this issue, this study investigated links among ER, social-contextual factors (family, peer), and psychological adjustment (internalizing, externalizing). Method:, Participants were 140 adolescents (71% female, 83.3% Caucasian, M age = 16.03 years) who were consecutive psychiatric admissions over a one-year period. Adolescents completed measures on family environment and peer relationship experiences. Both adolescents and parents reported on adolescents' characteristic patterns of ER and psychopathology. Results:, Discriminant analyses revealed that two functions, ER skills and impulsivity/lability, differentiated among adolescents who were elevated in internalizing symptoms only, in externalizing symptoms only, in both domains, or in neither domain. Regarding social contextual variables, family cohesion was associated with adaptive ER behaviors for girls along the internalizing dimension and all adolescents reporting externalizing behaviors. Relational victimization predicted difficulties with ER in both symptom domains for all adolescents. Within the internalizing domain, friendship support was related to adaptive ER. Conclusion:, Facets of ER do differentiate between global indices of internalizing and externalizing behaviors and suggest that both general and specific factors contribute to adolescents' unique learning history with emotions and characteristic patterns for managing emotions. [source] Do delay aversion and executive function deficits make distinct contributions to the functional impact of ADHD symptoms?THE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 11 2007A study of early academic skill deficits Background:, The present study examined the distinct properties of executive functioning in relation to ADHD symptoms, as well as functional outcomes associated with ADHD. In line with the dual-pathway model of ADHD, executive functioning and delay aversion were expected to show independent effects on ADHD symptoms. Furthermore, relations to early academic skills were examined, and it was hypothesized that the two processes of the dual-pathway model can be differentiated in terms of their effect on academic skill deficits, such that EF deficits, but not delay aversion, mediate the link between ADHD and academic functioning. Results:, As hypothesized, both EF deficits and delay aversion were independently related to ADHD symptoms. However, when conducting separate analyses for the two ADHD symptom domains, only the effect of EF deficits was independently related to symptoms of inattention, whereas only the effect of delay aversion was independently related to symptoms of hyperactivity/impulsivity. The mediation analysis showed that EF deficits, but not delay aversion, act as a mediator in the relation between symptoms of inattention and both mathematics and language skills. In addition, there was also a significant direct effect of inattention on early academic skills. Conclusions:, The findings of the present study are of importance for current models of heterogeneity in ADHD as they 1) provide further support for the notion that EF deficits and delay aversion are two possible pathways to ADHD, 2) add new interesting knowledge by showing that EF deficits and delay aversion can be differentiated in terms of their relations to the two ADHD symptom domains, and 3) indicate that the two processes of the dual-pathway model can also be differentiated in terms of their effect on functional impairments associated with ADHD. [source] Influence of Polyps on Outcomes After Endoscopic Sinus SurgeryTHE LARYNGOSCOPE, Issue 10 2007Neil Bhattacharyya MD Abstract Objective: To determine clinical and comparative outcomes for endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS) with polyposis. Methods: Two cohorts of adult patients with refractory CRS with and without nasal polyps were prospectively studied before and after ESS (minimum follow-up, 12 months) with the Rhinosinusitis Symptom Inventory (RSI). For the non-polyp and polyp cohorts, RSI symptom domains and medical resource utilization were compared in the preoperative and postoperative states. Corresponding effect sizes were computed and compared between cohorts to determine the effect of polyps on prognosis after ESS. Results: A total of 165 non-polyp and 86 polyp patients were enrolled. Polyps were more common in female patients (2:1, P = .025); age (mean, 42.9 years) and follow-up (18.5 months) were similar between groups. Lund scores were significantly higher for polyp patients (13.7, SD 4.8) vs. non-polyp patients (8.1, SD 5.3, P < .001). At baseline, polyp patients reported lower symptom scores for facial, oropharyngeal, and systemic RSI symptom domains (all P < .012); nasal and total symptom domains were similar between groups. Both non-polyp and polyp groups obtained significant symptomatic benefit from ESS with effect sizes for RSI symptom domain improvements ranging from 0.89 to 1.38 and 0.43 to 1.19, respectively (all P < .001). There were no significant differences between groups in symptomatic improvement, excepting oropharyngeal symptoms (better improvement in non-polyp group, P = .024). Non-polyp patients decreased medical resource consumption more significantly than did polyp patients. Conclusions: Both non-polyp and polyp patients derive similar clinically significant symptomatic improvement after ESS. These similarities suggest that polyp patients do not necessarily have a poorer symptomatic outcome after ESS. [source] Clinical Symptomatology and Paranasal Sinus Involvement With Nasal Septal PerforationTHE LARYNGOSCOPE, Issue 4 2007FACS, Neil Bhattacharyya MD Abstract Objective: Determine the symptom manifestations, clinical impact, and incidence of chronic rhinosinusitis (CRS) in patients with newly diagnosed nasal septal perforation. Methods: A consecutive series of adult patients with nasal septal perforation were prospectively studied at the time of endoscopic diagnosis with the rhinosinusitis symptom inventory (RSI) and sinus computed tomography (CT). Patients' symptoms in the RSI symptom domains were computed. From the CT scan, septal perforation size and Lund scores were obtained. A separate (control) cohort of patients with CRS without septal perforation was matched to these patients for age, sex, and Lund score. RSI symptom domain comparisons were conducted between groups to determine the additional symptom burden conferred by septal perforation. Results: Thirty-three patients with septal perforation were enrolled (mean age, 48.2 yr; 69.7% female). Mean perforation size was 1.9 (SD, 2.1) cm2. The mean Lund score was 5.8 (SD, 5.3); 16 (57.1%) patients met radiographic criteria for a concurrent diagnoses of CRS. Patients with septal perforation reported significant nasal and facial symptom domain scores (56.8 and 47.0, respectively [range, 0,100]). Oropharyngeal and systemic symptoms were less severe (29.7 and 34.7, respectively). However, after comparison with the matched control patients, no statistically significant differences were identified in sinonasal symptoms between patients with and without septal perforation (all P > .131). Conclusions: Concurrent CRS may frequently accompany nasal septal perforation and may require appropriate treatment along with the perforation itself. The presence of septal perforation does not appear to significantly augment symptom severity in CRS. [source] Chronic Recurrent Rhinosinusitis: Disease Severity and Clinical CharacterizationTHE LARYNGOSCOPE, Issue 2 2005Neil Bhattacharyya MD Objectives/Hypothesis: The objective was to clinically characterize and determine disease severity parameters for chronic recurrent rhinosinusitis (CRRS). Study Design: Prospective. Methods: A consecutive series of adult patients undergoing evaluation for CRRS was prospectively evaluated. Patients with four or more acute rhinosinusitis episodes in the previous calendar year with an absence of symptoms between episodes were considered as manifesting CRRS. Symptom severity and disease data from the Rhinosinusitis Symptom Inventory was obtained, as well as Lund staging information from the paranasal sinus CT scan. The Lund staging scores for patients with CRRS were compared with a control group of patients without CRRS. Symptom domain scores and disease severity parameters were compared between the CRRS group and a third group of patients with chronic persistent rhinosinusitis. Results: In all, 30 patients met inclusion criteria for the diagnosis of CRRS. Mean age was 40.9 years with a 3:1 female preponderance. The mean Lund score for patients with CRRS was 3.79. Patients with CRRS failed to demonstrate a statistically different Lund score from control patients (mean Lund score, 4.26 [P = .538]). Symptom severity scores according to Rhinosinusitis Symptom Inventory domains were largely similar for the nasal, facial, and total symptom domains between patients with CRRS versus chronic persistent rhinosinusitis. However, patients with CRRS demonstrated statistically significant increases in oropharyngeal and systemic symptom domain scores. Patients with CRRS also had significant increases in number of antibiotic courses (4.8 vs. 2.9 [P < .001]) and number of missed workdays (8.8 vs. 4.6 d [P = .046]) attributable to rhinosinusitis. Conclusion: Chronic recurrent rhinosinusitis is a distinct form of chronic rhinosinusitis differing somewhat from chronic persistent rhinosinusitis. However, patients with CRRS still experience significant symptoms associated with this diagnosis, which results in significant medication usage and workplace impact. [source] Do tests of malingering concur?BEHAVIORAL SCIENCES & THE LAW, Issue 5 2006Concordance among malingering measures Malingering test accuracy is increasingly a major issue in psychology and law. Integrating results across measures might offset limitations of a single test, but the practical benefits of using several tests depend on the extent to which they misclassify the same individuals. Data from 66 evaluatees were used to assess the degree of overlap and consistency of classification among several commonly used malingering instruments. Although correlative data indicated that measures were highly redundant even across symptom domains, classification accuracy analyses revealed that findings based on conjunctions of these scales may not overlap to the degree that the correlations might suggest. Copyright © 2006 John Wiley & Sons, Ltd. [source] | |||||||||||||