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Illness Characteristics (illness + characteristic)
Selected AbstractsNeurocognitive functions in euthymic bipolar patientsACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2009K. Jamrozinski Objective:, Meta-analytic findings support the hypothesis of specific neurocognitive deficits for bipolar patients in the domains of attention, processing speed, memory and executive functions. This study aims to show neurocognitive impairment in euthymic patients with bipolar I disorder compared with healthy controls while detailing the impact of medication side-effects or illness characteristics on neuropsychological test performance. Method:, Forty euthymic patients with bipolar I disorder were compared with 40 healthy controls in a cross-sectional design. Clinical features and neuropsychological measures of IQ, psychomotor speed, verbal fluency, learning and memory, executive functions and attention were assessed. Results:, Patients without antipsychotic drug use did not differ significantly from healthy controls in any neuropsychological measure. Yet patients treated with antipsychotics showed significant underperformance in the domains of semantic fluency, verbal learning and recognition memory as well as executive functions related to planning abilities, even when clinical features were controlled for. Conclusion:, The impact of antipsychotic medication needs to be further clarified for euthymic bipolar patients and should be considered when neuropsychological test performance is interpreted. [source] Sample bias from different recruitment strategies in a randomised controlled trial for alcohol dependenceDRUG AND ALCOHOL REVIEW, Issue 3 2009KIRSTEN C. MORLEY Abstract Introduction and Aims. Participants may be recruited from diverse sources for randomised controlled trials (RCT) of treatments for alcohol dependence. A mixed recruitment strategy might facilitate recruitment and increase generalisability at the expense of introducing systematic selection bias. The current study aims to compare the effects of recruitment method on socio-demographics, baseline illness characteristics, treatment retention and treatment outcome measures. Design and Methods. A secondary analysis from a previous 12 week RCT of naltrexone, acamprosate and placebo for alcohol dependence was conducted. Participants (n = 169) were obtained via four channels of recruitment including in-patient and outpatient referral, live media and print media solicitation. Baseline parameters, retention in treatment and treatment outcomes were compared in these groups. Results. Relative to in-patient subjects, those recruited via live and print media had significantly lower scores on taking steps, less in-patient rehabilitation admissions and less previous abstinence before entering the trial. Subjects recruited via print media had significantly lower scores of alcohol dependence relative to all other modes recruitment. There were no differences between recruitment strategies on treatment retention or compliance. At outcome, no significant effect of recruitment method was detected. Discussion and Conclusions. These results suggest that different recruitment methods may be sourcing subjects with different baseline characteristics of illness. Nonetheless, these differences did not significantly impact on treatment retention or outcome, suggesting that in this population it was appropriate to recruit subjects from mixed sources.[Morley KC, Teesson M, Sannibale C, Haber PS. Sample bias from different recruitment strategies in a randomised controlled trial for alcohol dependence. Drug Alcohol Rev 2009] [source] Correlations between alexithymia and pain severity, depression, and anxiety among patients with chronic and episodic migrainePSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 3 2010Irem Yalug MD Aims:, Some studies have found elevated alexithymia among patients with chronic pain, but the correlations between alexithymia and the severity of pain, depression, and anxiety among migraine patients are unclear. The aims of the present study were to investigate whether individuals suffering from episodic migraine (EM) differ from those with chronic migraine (CM) in regards to depression, anxiety, and alexithymia measures and to investigate the association of alexithymia with the results of depression and anxiety test inventories and illness characteristics. Methods:, A total of 165 subjects with EM and 135 subjects with CM were studied. The Beck Depression Inventory (BDI), State,Trait Anxiety Inventory (STAI), and Toronto Alexithymia Scale (TAS) were administered to all subjects. The correlation between alexithymia and sociodemographic variables, family history of migraine and illness characteristics (pain severity, frequency of episode, duration of illness) were evaluated. Results:, Compared with EM patients, the CM patients had significantly higher scores on measures of depression but not alexithymia and anxiety. There was a positive correlation between TAS scores and age and education in both migraine groups, but there was no correlation between TAS scores and other demographic variables. Depression and anxiety were significantly correlated with alexithymia in both migraine groups. Conclusion:, Our results indicate that CM patients are considerably more depressive than EM patients. In this study, depression and anxiety were significantly correlated with alexithymia in both migraine groups. Our results demonstrate a positive association between depression, anxiety, and alexithymia in migraine patients. [source] Quality of life of husbands of women with breast cancerPSYCHO-ONCOLOGY, Issue 2 2006Christina D. Wagner Abstract The life-threatening nature of breast cancer, along with the side effects of treatment, place great strain on patients and their families. Husbands may be especially vulnerable as the main source of support to patients. The present study compared the quality of life (QOL) of husbands of patients with breast cancer (HBC; n=79) to spouses of healthy wives (n=79). Additionally, associations between QOL and caregiver burden, social support, and coping were examined. HBC scored lower on general health, vitality, role-emotional, and mental health subscales of the Medical Outcomes Study (MOS) SF-36 than comparison group participants. No differences were found between groups on the physical functioning, role-physical, bodily pain, or social functioning subscales. Higher QOL in HBC was associated with less caregiver burden as evidenced by lower burden on the Illness Impact Form, lower use of emotion-focused coping on the Ways of Coping Questionnaire, and higher social support on the Interpersonal Support Evaluation List. Wife illness characteristics such as stage of disease and time since diagnosis were not related to QOL in husbands. These findings illuminate the need to support HBC, whose QOL suffers during the breast cancer experience. Copyright © 2005 John Wiley & Sons, Ltd. [source] Higher prevalence of bipolar I disorder among Asian and Latino compared to Caucasian patients receiving treatmentASIA-PACIFIC PSYCHIATRY, Issue 3 2010Sophia H.J. Hwang MSEd Abstract Introduction: There are limited data regarding relationships between race/ethnicity and bipolar disorder. This study assessed such relationships in patients receiving treatment in a university clinic. Methods: Demographic, illness characteristics, symptom severity, treatment, and care utilization data were collected from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) Affective Disorders Evaluation, Mini-International Neuropsychiatric Interview, and the STEP-BD Clinician Rated Packet. Data were compared among 51 Asian, 35 Latino, and 86 Caucasian patients in treatment at the Stanford University Bipolar Disorders Clinic. ,2 tests and analyses of variance were used to assess between-group differences. Results: Asian and Latino compared to Caucasian patients had significantly higher prevalence of bipolar I disorder (58.8% and 60.0% versus 37.2%, respectively). Asian and Latino patients also had a higher prevalence of history of psychosis, but this was related to the excess of bipolar I disorder, becoming non-significant after controlling for bipolar subtype. The racial/ethnic difference in bipolar subtype prevalence did not appear to be secondary to demographic or socioeconomic differences. Discussion: The higher prevalence of bipolar I disorder and thus lower prevalence of bipolar II disorder and bipolar disorder not otherwise specified in Asian and Latino patients may be related to under-diagnosis, misdiagnosis, or care underutilization of patients with milder forms of bipolar disorders. Additional research and public health efforts are warranted to further understand the effects of race and ethnicity on the management of bipolar disorders and to enhance timely and accurate diagnosis, culturally sensitive treatment, and optimal care utilization. [source] Redefining Affective Disorders: Relevance for Drug DevelopmentCNS: NEUROSCIENCE AND THERAPEUTICS, Issue 1 2008Steven D Targum The evaluation of new drug entities with specific modes of action may be hampered by rigid diagnostic classification systems and patient selection processes that do not focus on the anticipated symptomatic, behavioral, and functional outcomes to be achieved. Patients enrolled in central nervous system (CNS) clinical trials may present with a heterogeneous group of symptoms representing several syndromes or subtypes, subsumed under the same diagnosis in the DSM-IV classification system. As a result, enrolled patients may not have the valid illness characteristics of interest to the particular study. We propose that clinical drug development needs to focus on the primary nosological entity likely to be affected by a new drug entity's mode of action. Ideally, a valid patient will have the acute primary symptoms that the novel drug is supposed to influence. In this article, we propose operational criteria to delineate a more symptom-specific and ecologically valid approach to the identification of the valid patient for clinical trials. [source] | ||||||||||