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Increased Symptoms (increased + symptom)
Selected AbstractsCognitive,behavioral therapy with childhood anxiety disorders: Functioning in adolescenceDEPRESSION AND ANXIETY, Issue 4 2004Katharina Manassis M.D. Abstract We examined anxiety symptoms, anxiety-related impairment, and further treatment in adolescents who received cognitive behavioral therapy (CBT) for childhood anxiety disorders 6,7 years previously. Forty-three adolescents and their parents (14 boys, 29 girls; mean age 16.7 years) participated in structured telephone interviews. Participants (68% of initial sample of 63) did not differ in age, diagnostic profile, socioeconomic status, or initial severity from nonparticipants but more girls than boys participated. Indices based on child- and parent-reported symptoms and impairment were calculated, and within-sample comparisons by age, gender, diagnosis, and initial severity were done using t tests. Predictors of symptoms and impairment were also examined. On average, adolescents reported modest levels of anxiety-related impairment. Further treatment for anxiety had occurred in 30% (13 of 43) of patients. Stepwise regressions found female gender and diagnosis other than generalized anxiety disorder predictive of increased symptoms by parent report, and initial severity predicted adolescent-reported impairment. Adolescents showed limited internalizing symptomatology and impairment but almost one third had required further treatment. Studies comparing treated and untreated samples are needed to clarify whether CBT alters the natural history of childhood anxiety disorders and to replicate our findings regarding predictors of symptomatology and impairment. Depression and Anxiety 00:000,000, 2004. © 2004 Wiley-Liss, Inc. [source] Assessment of progestin-only therapy for endometriosis in macaqueJOURNAL OF MEDICAL PRIMATOLOGY, Issue 2008G. Maginnis Abstract Background, Endometriosis is a condition where endometrium-like tissue forms lesions at ectopic sites outside the uterus. In women, oral contraceptive pills and progestins are often prescribed as therapy for early stage endometriosis. In contrast, in macaques the disease is frequently advanced at the time of diagnosis and ovariectomy is the standard therapy. However, surgery is contraindicated in many patients. A review of 15 endometriosis cases over the past 10 years at the Oregon National Primate Research Center (ONPRC) revealed that 5 failed to show improvement after ovariectomy and were subsequently euthanized. Therefore, our goal was to assess the feasibility of treating endometriosis in macaques with chronic progesterone (P) as an alternative therapy for the disease. Methods, Seven adult rhesus macaques with advanced endometriosis were identified by clinical symptoms and endometriosis was confirmed by abdominal palpation, ultrasound examination, and/or aspiration of menstrual blood from abdominal cysts. The patients were chronically treated with Silastic capsules that released 5,7 ng P /ml in blood for up to 20 months. During treatment the patients were assessed daily and scored numerically for appetite, activity, attitude, abdominal discomfort and menstruation by the Clinical Veterinary staff. The patients were then re-examined by abdominal palpation and ultrasound for the disease at the end of treatment. Results, During the first 2 weeks of treatment, endometriotic symptoms improved significantly in all the patients (P < 0.05). This was associated with a significant increase in body weight and significant reduction in abdominal discomfort and menstrual bleeding. Two of the patients gradually developed increased symptoms of the disease after 5 months of treatment. Post-treatment abdominal examination revealed that 2/5 patients continued to have an abdominal mass even though symptoms were suppressed. Conclusions, We conclude that continuous P treatment of rhesus monkeys provides therapeutic benefit to reduce symptoms of endometriosis and may provide an option for cases where ovariectomy is contraindicated. Supported by RR-00163. [source] The effect of parental mental health on proxy reports of health-related quality of life in children with sickle cell disease,PEDIATRIC BLOOD & CANCER, Issue 4 2010Julie A. Panepinto MD, MSPH Abstract Background The objectives of this study were to evaluate factors that influence agreement between parent-proxy and child self-report of health-related quality of life (HRQL) in sickle cell disease. We hypothesized that the mental health of the parent, parental HRQL and child characteristics would affect agreement. Procedure In a cross-sectional study of children with sickle cell disease, HRQL of the child and the parent's HRQL and mental health were assessed. The effect of parent and child characteristics on agreement between parent-proxy and child self-report of HRQL were determined. Results Rates of agreement between parent-proxy and child self-report of HRQL ranged between 42% and 49%. Parents with increased symptoms of distress had an increased odds of reporting a worse physical (Odds Ratio (OR) 1.12) and psychosocial HRQL (OR 1.10) compared to the child's self-report. Severe sickle cell disease was associated with an increased odds of the parent reporting the child's physical HRQL was worse, (OR 4.68) compared to the child's self-report. Conclusions Greater symptoms of distress in the parent are associated with worse parent-proxy report of the child's HRQL. Severe sickle cell disease is associated with greater disagreement between parent-proxy and child self-report of HRQL. These findings broaden our understanding of factors that influence proxy-reporting of a child's HRQL. Pediatr Blood Cancer. 2010;55:714,721. © 2010 Wiley-Liss, Inc. [source] The Observational Evaluation of Subjective Well-Being in Patients with Rheumatoid ArthritisAPPLIED PSYCHOLOGY: HEALTH AND WELL-BEING, Issue 1 2009Afton L. Hassett An important aspect of general health is subjective well-being (SWB), which is defined as happiness and overall satisfaction with life. Herein we examined the reliability and validity of observation-based ratings of SWB in patients with rheumatoid arthritis (RA). Ten RA patients experiencing a disease flare (period of increased symptoms) completed two semi-structured interviews (baseline and 4 weeks later) that were digitally recorded. Twelve healthcare professionals watched the 20 brief videos in random order and scored them using the Well-Being Coding System (WBCS) for observer-reported SWB. Patient-reported SWB scores and scores from the Medical Outcomes Study: 36-Item Short Form Survey (SF-36) were compared to observer-reported scores for SWB. We found inter-rater reliability to be extremely high and a significant relationship between observer SWB composite scores and patient SWB composite scores. Observer SWB composite scores and other scores associated with SWB from the SF-36 were also related significantly. There was also some evidence supporting the ability of observers to detect change in SWB. Taken together, we found preliminary evidence suggesting that when using information gleaned from brief patient interviews clinicians can make reliable and valid evaluations of patients' SWB. [source] | ||||||||||