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Somatic Illness (somatic + illness)
Selected AbstractsAnxiety and depression among abstainers and low-level alcohol consumers.ADDICTION, Issue 9 2009The Nord-Trøndelag Health Study ABSTRACT Aims The aim of this study was to examine the levels of anxiety and depression among individuals consuming low levels of alcohol. Design Prospective and cross-sectional population-based study. Setting and participants This study employed data from the Nord-Trøndelag Health Survey (HUNT-2, n = 38 930). Measurements Alcohol consumption was measured by self-report of usual alcohol consumption during a 2-week period. Low-level alcohol consumption was defined as self-reported abstainers and non-abstainers currently consuming no alcohol. Anxiety and depression were measured using the Hospital Anxiety and Depression Rating Scale. Potential explanatory variables included somatic illness and symptoms, health-related behaviour, socio-economic status and social activity. In a subsample (n = 20 337), we also looked at the impact of previous heavy drinking among abstainers ('sick-quitting'). Findings A U-shaped association between alcohol consumption and the risk of anxiety and depression was found. Abstention was related to increased odds for both case-level anxiety [1.34, 95% confidence interval (CI) 1.19,1.52] and depression (1.52, 95% CI 1.30,1.77). This association was accounted for partly by adjustments for socio-economic status, social network, somatic illness, age (depression only), gender (anxiety only) and ,sick-quitting'. We also identified significant differences between participants who label themselves as abstainers compared to those who report no usual alcohol consumption, but who do not label themselves as abstainers. Conclusions The risk of case-level anxiety and depression is elevated in individuals with low alcohol consumption compared to those with moderate consumption. Individuals who label themselves as abstainers are at particularly increased risk. This increased risk cannot fully be explained by somatic illness, social activity or ,sick-quitting'. [source] Mental health in infants with esophageal atresia,INFANT MENTAL HEALTH JOURNAL, Issue 1 2009Anne Faugli Chronic somatic illness in infancy may challenge the development of mental health and impinge the infant's capability to form close interpersonal relationships. Esophageal atresia (EA) is a congenital anomaly requiring neonatal surgery, medical aftertreatment, and extended hospitalization. The aim of the study was to assess mental health and to find prognostic factors for mental health among infants with EA. Thirty-nine infants treated consecutively during 2000 to 2003 and their mothers were included. Infant mental health was assessed by Diagnostic Classification: 0,3 (Zero to Three, 1994). Medical and environmental data were collected from medical records and semistructured interview with the mothers. Child development was assessed with the Bayley scales, second edition (N. Bayley, 1993). Maternal psychological distress, anxiety, and child temperament were assessed by self-report questionnaires: the General Health Questionnaire, 30-item version (D. Goldberg & P. Williams, 1988); the State Trait Anxiety Inventory (C.D. Spielberger, R. Gorsuch, & R. Lushene, 1970); and the Infant Behaviour Questionnaire (M.K. Rothbart, 1981). Thirty-one percent of the infants with EA showed mental health disorders by 1 year of age. Prognostic factors predicting mental health were posttraumatic symptoms reported by mother, more than one operation, mechanical ventilation beyond 1 day, and moderate/severe chronic family strain. Relational trauma, vulnerable attachment, and impaired self-development are highlighted as possible pathways for psychopathology. Children with EA are vulnerable to mental health disorders, and this study may help clinicians to identify children at risk. [source] Efficacy of integrated interventions combining psychiatric care and nursing home care for nursing home residents: a review of the literatureINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 1 2010Janine Collet Abstract Background Nursing home residents needing both psychiatric care and nursing home care for either somatic illness or dementia combined with psychiatric disorders or severe behavioural problems are referred to as Double Care Demanding patients, or DCD patients. Integrated models of care seem to be necessary in order to improve the well-being of these residents. Objectives Two research questions were addressed. First, which integrated interventions combining both psychiatric care and nursing home care in DCD nursing home residents are described in the research literature? And second, which outcomes of integrated interventions combining both psychiatric care and nursing home care in DCD nursing home residents are reported in the literature? Method A critical review of studies was done that involved integrated interventions combining both psychiatric care and nursing home care on psychiatric disorders and severe behavioural problems in nursing home patients. A systematic literature search was performed in a number of international databases. Results Eight intervention trials, including four RCTs (2b level of evidence), were identified as relevant studies for the purpose of this review. Seven studies, three of which were RCTs, showed beneficial effects of a comprehensive, integrated multidisciplinary approach combining medical, psychiatric and nursing interventions on severe behavioural problems in DCD nursing home patients. Conclusions Important elements of a successful treatment strategy for DCD nursing home patients include a thorough assessment of psychiatric, medical and environmental causes as well as programmes for teaching behavioural management skills to nurses. DCD nursing home patients were found to benefit from short-term mental hospital admission. This review underlines the need for more rigorously designed studies to assess the effects of a comprehensive, integrated multidisciplinary approach towards DCD nursing home residents. Copyright © 2009 John Wiley & Sons, Ltd. [source] Identifying target groups for the prevention of anxiety disorders in the general populationACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2010N. M. Batelaan Batelaan NM, Smit F, de Graaf R, van Balkom AJLM, Vollebergh WAM, Beekman ATF. Identifying target groups for the prevention of anxiety disorders in the general population. Objective:, To avert the public health consequences of anxiety disorders, prevention of their onset and recurrence is necessary. Recent studies have shown that prevention is effective. To maximize the health gain and minimize the effort, preventive strategies should focus on high-risk groups. Method:, Using data from a large prospective national survey, high-risk groups were selected for i) the prevention of first ever (n = 4437) and ii) either first-ever or recurrent incident anxiety disorders (n = 4886). Indices used were: exposure rate, odds ratio, population attributable fraction and number needed to be treated. Risk indicators included sociodemographic, psychological and illness-related factors. Results:, Recognition of a few patient characteristics enables efficient identification of high-risk groups: (subthreshold) panic attacks; an affective disorder; a history of depressed mood; a prior anxiety disorder; chronic somatic illnesses and low mastery. Conclusion:, Preventive efforts should be undertaken in the selected high-risk groups. [source] Metabolic drug interactions with new psychotropic agentsFUNDAMENTAL & CLINICAL PHARMACOLOGY, Issue 5 2003Edoardo Spina Abstract New psychotropic drugs introduced in clinical practice in recent years include new antidepressants, such as selective serotonin reuptake inhibitors (SSRI) and ,third generation' antidepressants, and atypical antipsychotics, i.e. clozapine, risperidone, olanzapine, quetiapine, ziprasidone and amisulpride. These agents are extensively metabolized in the liver by cytochrome P450 (CYP) enzymes and are therefore susceptible to metabolically based drug interactions with other psychotropic medications or with compounds used for the treatment of concomitant somatic illnesses. New antidepressants differ in their potential for metabolic drug interactions. Fluoxetine and paroxetine are potent inhibitors of CYP2D6, fluvoxamine markedly inhibits CYP1A2 and CYP2C19, while nefazodone is a potent inhibitor of CYP3A4. These antidepressants may be involved in clinically significant interactions when coadministered with substrates of these isoforms, especially those with a narrow therapeutic index. Other new antidepressants including sertraline, citalopram, venlafaxine, mirtazapine and reboxetine are weak in vitro inhibitors of the different CYP isoforms and appear to have less propensity for important metabolic interactions. The new atypical antipsychotics do not affect significantly the activity of CYP isoenzymes and are not expected to impair the elimination of other medications. Conversely, coadministration of inhibitors or inducers of the CYP isoenzymes involved in metabolism of the various antipsychotic compounds may alter their plasma concentrations, possibly leading to clinically significant effects. The potential for metabolically based drug interactions of any new psychotropic agent may be anticipated on the basis of knowledge about the CYP enzymes responsible for its metabolism and about its effect on the activity of these enzymes. This information is essential for rational prescribing and may guide selection of an appropriate compound which is less likely to interact with already taken medication(s). [source] Effects of a group-based exercise program on the mood state of frail older women after discharge from hospitalINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 12 2002L. Timonen Abstract Background Older people with somatic illnesses are at increased risk of depression. It is not known whether exercise alleviates depressive symptoms in frail, very old people recuperating from an acute illness. Objective To determine the effects of a group-based exercise training program on mood. Methods Sixty-eight women (mean age 83.0, SD 3.9 years) who were hospitalized due to an acute illness, and were mobility impaired at admission, were randomized into group-based 10-week strength training intervention (N=34) and home exercise control (N=34) groups. Twenty-four women in the training and 28 in the control group completed the follow-up. Measures of mood state with the Zung Self-Rating Depression Scale (ZSDS) were performed before and after the training intervention, and follow-up data was collected 3 and 9 months after the end of the intervention. Results After the intervention, there was a significant improvement in mood in the intervention group compared to the home exercise control group: ,3.1 (SD 9.0) points vs +1.3 (SD 7.6) points (p=0.048) and the positive effect was still apparent three months after the intervention ceased: ,2.6 (SD 7.7) points vs +3.5 (SD 9.7) points (p=0.015). Improvement of mood state at the first follow-up measurement was associated with the improvement in lower limb isometric muscle strength. Conclusions Group-based exercise program organized in the context of a Finnish health care organization improved mood in frail older women recuperating from an acute illness. Copyright © 2002 John Wiley & Sons, Ltd. [source] | ||||||||||