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Psychological Comorbidity (psychological + comorbidity)
Selected AbstractsPsychogastroenterology: a call for psychological input in Australian gastroenterology clinicsINTERNAL MEDICINE JOURNAL, Issue 2 2009A. Mikocka-Walus Abstract Gastroenterologists should be able to refer patients directly to psychologists with full Medicare reimbursement. Psychological comorbidities are frequently seen in patients with gastrointestinal conditions. However, time pressure and lack of expertise in non-medical therapies of psychological problems prevent gastroenterologists from initiating psychological treatment although such treatment may improve patients' outcomes and reduce health-care utilization. Psychologists are needed as part of the multidisciplinary team in gastroenterology clinics in Australia to take the leading role in the psychological management of those patients by contributing to screening, faster diagnosis and treatment of depression and anxiety disorders in particular. [source] Gender Differences in Treatment-Seeking Chronic Headache SufferersHEADACHE, Issue 7 2001Dawn A. Marcus MD Objective.,To identify gender differences within a group of patients seeking treatment for chronic headache. Previous studies of the general population have reported differences in headache symptoms, frequency, disability, and psychological distress, with women affected with more severe and disabling symptoms than men. This study evaluated these features in a population seeking treatment. Methods.,Two hundred fifty-eight consecutive patients with headache attending a university headache clinic were evaluated with questionnaires about headache symptoms and psychological distress. Comparisons between men and women were made for headache symptoms, severity, frequency, trigger factors, comorbid depression and anxiety, and response to treatment. Results.,There were no gender differences in headache symptoms, frequency, severity, and duration. Headache triggers were gender-specific, with men more likely to endorse exercise and women more likely to endorse stress and exposure to odors. Psychological comorbidity was similar among men and women seeking treatment, with a mean Beck Depression Inventory score of 10 and a mean Spielberger trait anxiety score of 39 for both men and women. Disability was greater in men, with 46% reporting restrictions in activities more than 3 days per week because of headache compared with 29% of women. In addition, men were more likely to contribute headache control to external figures than women. Conclusions.,Patients seeking treatment for chronic headache do not have the same gender-specific differences that have been reported in general population surveys. Men who seek treatment for headache are more likely to have significant disability, and are equally likely to have symptoms of depression and anxiety as women who seek treatment. Clinical and research investigations of headache triggers need to be gender-specific. [source] Psychological comorbidity and complexity of gastrointestinal symptoms in clinically diagnosed irritable bowel syndrome patientsJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 7pt1 2008Antonina Mikocka-Walus Abstract Background and Aim:, The prevalence of psychological disorders is high in patients with irritable bowel syndrome (IBS) but their role in symptom reporting is uncertain. It is thus interesting whether the number of functional gastrointestinal disorders (FGID) determines the load of psychological comorbidity. The Rome III criteria have not been used to evaluate such a relationship as yet. Moreover, not many studies have examined the sensitivity of the Rome III criteria in detecting IBS. Our aims were therefore: (i) to determine whether those IBS participants with more FGID had a tendency to greater psychological comorbidity than those with fewer FGID; and (ii) to assess the performance of the Rome III criteria in detecting IBS versus the diagnosis of the gastroenterologist. Methods:, A cross-sectional survey of 32 consecutive outpatients with clinically diagnosed IBS was performed. The Hospital Anxiety and Depression Scale (HADS), the Short Form 12 Health Survey (SF-12), and the Rome III criteria questionnaire (BDQ-6) were administered. Multiple linear regression was conducted to detect associations among FGID, anxiety, depression and quality of life. Results:, Overall, 50% of participants were anxious and 12% were depressed. Forty-four percent of participants had >two FGID; however, the number of FGID did not correlate with scores for anxiety, depression or quality of life. Amazingly, only 50% (CI: 33,67) of participants clinically diagnosed with IBS met Rome III criteria for IBS. Conclusion:, Contrary to our expectations, a greater load of FGID did not correlate with a greater load of psychological comorbidity. Surprisingly, the Rome III criteria detected only 50% of clinical cases of IBS. [source] Review article: gastro-oesophageal reflux disease and psychological comorbidityALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 4 2009I. MIZYED Summary Background, A growing number of studies have shown the impact of psychological comorbidities on gastro-oesophageal reflux disease (GERD) patients' symptom reports and healthcare-seeking behaviour. Aim, To review the reported relationship between GERD and psychological comorbidity. Methods, Review of the literature on GERD and psychological comorbidity. Results, Psychological comorbidity is common among GERD patients and appears to afflict all GERD phenotypes. Sexual and physical abuse is also common in GERD patients. Stress enhances perception of oesophageal acid exposure. Treatment for GERD, especially in those who are not responsive to antireflux treatment, may require further evaluation for psychological comorbidity. Conclusions, Psychological comorbidity is very common in GERD patients and is likely to play an important role in response, or failure of response, to proton pump inhibitor treatment. [source] Un-promoted issues in inflammatory bowel disease: opportunities to optimize careINTERNAL MEDICINE JOURNAL, Issue 3 2010J. M. Andrews Abstract Inflammatory bowel diseases (IBD), comprising Crohn's disease (CD) and ulcerative colitis (UC), are chronic inflammatory disorders of the gut, which lead to significant morbidity and impaired quality of life (QoL) in sufferers, without generally affecting mortality. Despite CD and UC being chronic, life-long illnesses, most medical management is directed at acute flares of disease. Moreover, with more intensive medical therapy and the development of biological therapy, there is a risk that management will become even more narrowly focused on acute care, and be directed only at those with more severe disease, rather than encompassing all sufferers and addressing important non-acute issues. This imbalance of concentration of medical attention on ,high-end' care is in part driven by the need to perform and publish randomized clinical trials of newer therapies to obtain registration and licensing for these agents, which thus occupy a large proportion of the recent IBD treatment literature. This leads to less attention on relatively ,low-technology' issues including: (i) the psychosocial burden of chronic disease, QoL and specific psychological comorbidities; (ii) comorbidity with functional gastrointestinal disorders (FGIDs); (iii) maintenance therapy, monitoring and compliance; (iv) smoking (with regard to CD); (v) sexuality, fertility, family planning and pregnancy; and (vi) iron deficiency and anaemia. We propose these to be the ,Un-promoted Issues' in IBD and review the importance and treatment of each of these in the current management of IBD. [source] Identifying and screening for psychological and comorbid medical and psychological disorders in medical settings,JOURNAL OF CLINICAL PSYCHOLOGY, Issue 3 2009Rodger Kessler Abstract There is increased attention to the medical and economic consequences of psychological problems comorbid with medical issues. There is also a clear awareness that most psychological problems are assessed and responded to in nonpsychiatric medical settings. This has furthered interest and attention in implementing screening procedures to better identify psychological, behavioral, and substance abuse problems in medical settings. Such interest is taking the form of recommendations from federal government task forces, and the funding of large projects to include screening in medical settings. At the same time there has been further attention to brief, valid, and reliable measures with which to capture psychological comorbidities. However, there have been multiple concerns raised about a variety of issues concerning the utility and effectiveness of such screening procedures and the identification of multiple issues to be considered in screening design. The author outlines and reviews the rationale and concerns about screening, identifies the issues that need to be considered in screening program development, and describes the efforts to develop a screening capacity in a rural family practice. © 2009 Wiley Periodicals, Inc. J Clin Psychol: In Session 65:1,15, 2009. [source] Psychological comorbidity and complexity of gastrointestinal symptoms in clinically diagnosed irritable bowel syndrome patientsJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 7pt1 2008Antonina Mikocka-Walus Abstract Background and Aim:, The prevalence of psychological disorders is high in patients with irritable bowel syndrome (IBS) but their role in symptom reporting is uncertain. It is thus interesting whether the number of functional gastrointestinal disorders (FGID) determines the load of psychological comorbidity. The Rome III criteria have not been used to evaluate such a relationship as yet. Moreover, not many studies have examined the sensitivity of the Rome III criteria in detecting IBS. Our aims were therefore: (i) to determine whether those IBS participants with more FGID had a tendency to greater psychological comorbidity than those with fewer FGID; and (ii) to assess the performance of the Rome III criteria in detecting IBS versus the diagnosis of the gastroenterologist. Methods:, A cross-sectional survey of 32 consecutive outpatients with clinically diagnosed IBS was performed. The Hospital Anxiety and Depression Scale (HADS), the Short Form 12 Health Survey (SF-12), and the Rome III criteria questionnaire (BDQ-6) were administered. Multiple linear regression was conducted to detect associations among FGID, anxiety, depression and quality of life. Results:, Overall, 50% of participants were anxious and 12% were depressed. Forty-four percent of participants had >two FGID; however, the number of FGID did not correlate with scores for anxiety, depression or quality of life. Amazingly, only 50% (CI: 33,67) of participants clinically diagnosed with IBS met Rome III criteria for IBS. Conclusion:, Contrary to our expectations, a greater load of FGID did not correlate with a greater load of psychological comorbidity. Surprisingly, the Rome III criteria detected only 50% of clinical cases of IBS. [source] Review article: gastro-oesophageal reflux disease and psychological comorbidityALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 4 2009I. MIZYED Summary Background, A growing number of studies have shown the impact of psychological comorbidities on gastro-oesophageal reflux disease (GERD) patients' symptom reports and healthcare-seeking behaviour. Aim, To review the reported relationship between GERD and psychological comorbidity. Methods, Review of the literature on GERD and psychological comorbidity. Results, Psychological comorbidity is common among GERD patients and appears to afflict all GERD phenotypes. Sexual and physical abuse is also common in GERD patients. Stress enhances perception of oesophageal acid exposure. Treatment for GERD, especially in those who are not responsive to antireflux treatment, may require further evaluation for psychological comorbidity. Conclusions, Psychological comorbidity is very common in GERD patients and is likely to play an important role in response, or failure of response, to proton pump inhibitor treatment. [source] Significant psychological morbidity occurs in irritable bowel syndrome: a case-control study using a pharmacy reimbursement databaseALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 4 2009J. B. CANAVAN Summary Background, Psychological problems are associated with IBS but the strength of this association is unclear. Aim, To assess co-prescribing of antispasmodic and CNS-acting drugs through a nested case-control study. Methods, A national dispensing database identified patients who were first dispensed antispasmodic medicines for a continuous 3-month period or more during 2006, using 2005 as a run-in period. Each patient was matched with four control patients and excluded if they received drugs indicated for IBD. Results, Four hundred and seven patients commenced antispasmodic drugs during 2006. These patients were matched with 1628 controls. In 2005, patients subsequently prescribed antispasmodics were 2,3 times more likely to receive CNS-acting drugs than controls. In the year following commencement of IBS therapy, patients were 2,4 times more likely than controls to be prescribed CNS-acting drugs including antidepressants (35.4% vs. 9.3%), anxiolytics (27.8% vs. 8.8%), antipsychotics (9.8% vs. 3.3%) and hypno-sedatives (32.7% vs. 11.3%; P < 0.0001). The adjusted OR (95% CI) for antidepressant, anxiolytic, hypnosedative and antipsychotic prescribing in IBS patients were 3.81 (2.79,5.20), 2.84 (2.12,3.81), 2.62 (1.91,3.60) and 2.58 (1.80,3.66), respectively. Conclusions, Patients prescribed ongoing therapy for presumed IBS are 2,4 times more likely to be prescribed CNS-acting drugs than controls, providing evidence of psychological comorbidity in IBS. [source] | ||||||||||