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Symptom Clusters (symptom + cluster)

Distribution by Scientific Domains

Medical Sciences	69%
Psychology	30%

Selected Abstracts

Symptom cluster and physical activity in relapsing-remitting multiple sclerosis

RESEARCH IN NURSING & HEALTH, Issue 5 2010
Robert W. Motl
Abstract We compared the explanatory power of two symptom clusters that consisted of either three or five symptoms as correlates of physical activity in individuals with relapsing-remitting multiple sclerosis (RRMS; N,=,218). The data were primarily analyzed using covariance modeling in Mplus 3.0. A symptom cluster of fatigue, depression, and pain had a moderate, negative relationship with physical activity, and this relationship was comparable in magnitude with a symptom cluster of fatigue, depression, pain, perceived cognitive dysfunction, and poor sleep quality. The relationships were attenuated after controlling for exercise history and neurological impairment. Such findings further support the consideration of a narrowly defined cluster of three symptoms as an independent correlate of physical activity in persons with RRMS. © 2010 Wiley Periodicals, Inc. Res Nurs Health 33:398,412, 2010 [source]

Hazardous alcohol use and treatment outcome in male combat veterans with posttraumatic stress disorder

JOURNAL OF TRAUMATIC STRESS, Issue 1 2003
Stanley R. Steindl
Abstract The relationship between alcohol problems and posttraumatic stress disorder (PTSD) remains unclear. Six hundred and eight combat veterans diagnosed with PTSD were assessed for PTSD symptoms and alcohol problems prior to group cognitive,behavioral treatment. They were reassessed 3 and 9 months after treatment. Participants were classified into low-risk and hazardous drinkers at each time point. Drinking status at intake did not predict PTSD symptoms at intake or follow-up. However, drinking status was associated with PTSD symptoms when both were assessed at follow-up. PTSD arousal symptoms were the only symptom cluster to differentiate drinking groups. [source]

Work-attributed symptom clusters (darkroom disease) among radiographers versus physiotherapists: Associations between self-reported exposures and psychosocial stressors

AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 6 2004
FRCPC, Susan M. Tarlo MB
Abstract Background "Darkroom disease" (DRD) has been used to describe unexplained multiple symptoms attributed by radiographers to their work environment. This study determines the prevalence of symptom clusters similar to other unexplained syndromes among (medical radiation technologists (MRTs) as compared with physiotherapists (PTs), and identifies associated work-related (WR) factors. Methods A mail survey was undertaken of members of the professional associations of MRTs and PTs in Ontario, Canada. Questions were included to determine the prevalence and frequency of symptom clusters including abnormal tiredness as well as WR headaches, and symptoms suggestive of eye, nasal, and throat irritation. For the purpose of this study, these are considered to be DRD symptom clusters. Individuals with doctor-diagnosed asthma were excluded from our analyses. Results Overall, 63.9% of MRTs and 63.1% of PTs participated. Criteria for DRD were met by 7.8% of 1,483 MRTs and 1.8% of 1,545 PTs [odds ratio, OR 4.8 (confidence interval, CI 3.1,7.5); (P,<,0.0001)]. Both occupations showed significant associations between responses reflecting psychosocial stressors and DRD. Those with this symptom cluster were more likely to report additional symptoms than those without, and MRTs with DRD symptoms reported significantly more workplace chemical exposures. Conclusions Findings suggest excess symptoms consistent with DRD among MRTs versus PTs, and there were associations among those meeting our definition of DRD with self-reported irritant exposures and psychosocial stressors. Am. J. Ind. Med. 45:513,521, 2004. © 2004 Wiley-Liss, Inc. [source]

Symptom cluster and physical activity in relapsing-remitting multiple sclerosis

Prevalence and implications of psychopathological non-cognitive symptoms in dementia

ACTA PSYCHIATRICA SCANDINAVICA, Issue 2 2009
P. Saz
Objective:, Clinical experience and recent population studies suggest that psychopathological, non-cognitive symptoms are both frequent and relevant in dementia. Method:, A representative community sample (n = 4,803 individuals, 55 + years) was interviewed in a two-phase design. The Geriatric Mental Sate (GMS) was used for assessment and cases were diagnosed according to DSM-IV-TR criteria. Results:, The prevalence of non-cognitive symptoms (1 + symptoms) in cases of dementia (n = 223) was 90.1%, and negative-type symptoms were most frequently found. A GMS ,apathy-related symptom cluster' (anergia, restriction of activities and anhedonia) was significantly more frequent in the demented (55.6%) than in non-cases (0.7%; specificity = 99.2%). In both dementia of Alzheimer's type and vascular dementia, number of symptoms tended to be inversely related to severity of dementia, but psychopathological profiles differed. Conclusion:, Non-cognitive, negative-type symptoms are very frequent in cases of dementia living in the community. They have powerful specificity in the distinction with non-cases, and might change current concepts of dementia. [source]

Surveillance of Infectious Disease Occurrences in the Community: An Analysis of Symptom Presentation in the Emergency Department

ACADEMIC EMERGENCY MEDICINE, Issue 7 2003
Joe Suyama MD
Objectives: To determine the effectiveness of a simulated emergency department (ED)-based surveillance system to detect infectious disease (ID) occurrences in the community. Methods: Medical records of patients presenting to an urban ED between January 1, 1999, and December 31, 2000, were retrospectively reviewed for ICD-9 codes related to ID symptomatology. ICD-9 codes, categorized into viral, gastrointestinal, skin, fever, central nervous system (CNS), or pulmonary symptom clusters, were correlated with reportable infectious diseases identified by the local health department (HD). These reportable infectious diseases are designated class A diseases (CADs) by the Ohio Department of Health. Cross-correlation functions (CCFs) tested the temporal relationship between ED symptom presentation and HD identification of CADs. The 95% confidence interval for lack of trend correlation was 0.0 ± 0.074; thus CCFs > 0.074 were considered significant for trend correlation. Further cross-correlation analysis was performed after chronic and non-community-acquirable infectious diseases were removed from the HD database as a model for bioterrorism surveillance. Results: Fifteen thousand five hundred sixty-nine ED patients and 6,489 HD patients were identified. Six thousand two hundred eight occurrences of true CADs were identified. Only 87 (1.33%) HD cases were processed on weekends. During the study period, increased ED symptom presentation preceded increased HD identification of respective CADs by 24 hours for all symptom clusters combined (CCF = 0.112), gastrointestinal symptoms (CCF = 0.084), pulmonary symptoms (CCF = 0.110), and CNS symptoms (CCF = 0.125). The bioterrorism surveillance model revealed increased ED symptom presentation continued to precede increased HD identification of the respective CADs by 24 hours for all symptom clusters combined (CCF = 0.080), pulmonary symptoms (CCF = 0.100), and CNS symptoms (CCF = 0.120). Conclusions: Surveillance of ED symptom presentation has the potential to identify clinically important ID occurrences in the community 24 hours prior to HD identification. Lack of weekend HD data collection suggests that the ED is a more appropriate setting for real-time ID surveillance. [source]

Psychological trauma exposure and trauma symptoms among individuals with high and low levels of dental anxiety

EUROPEAN JOURNAL OF ORAL SCIENCES, Issue 4 2006
Ad De Jongh
This questionnaire-based study investigated the traumatic background and trauma-related symptomatology among 141 treatment-seeking individuals with high levels of dental anxiety and among a low-anxious reference group consisting of 99 regular dental patients. The highly anxious individuals reported a significantly higher number of traumatic events, both within and outside the dental or medical setting, than those in the reference group (73% vs. 21%). Horrific experiences in the dental setting were the most common traumatic events reported. Of the highly anxious individuals, 46.1% indicated suffering from one or more of the post-traumatic stress disorder (PTSD) symptom clusters (re-experiencing, avoidance, loss of interest, and insomnia), while in the reference group this percentage was 6%. Severity of dental anxiety was significantly associated with number of screening criteria for specific phobia and the extent to which the anxious subjects displayed symptoms of post-traumatic stress. Two variables were uniquely predictive for positive diagnostic screens for dental phobia and PTSD: having experienced a horrific dental treatment and having been a victim of a violent crime. In conclusion, post-traumatic symptoms are common accompaniments of severe forms of dental anxiety and are experienced even when dental treatment is not imminent. [source]

Alexithymia and posttraumatic stress: subscales and symptom clusters,

JOURNAL OF CLINICAL PSYCHOLOGY, Issue 10 2010
Frédéric Declercq
Abstract This study examined the relationship between the emotion-regulating factor alexithymia and the occurrence of posttraumatic stress disorder (PTSD) after critical incidents in a nonclinical sample of 136 nurses and ambulance personnel working in military facilities. The results showed that alexythima accounts for variance in PTSD symptoms. Breaking PTSD into its 4 symptom clusters, alexithymia was found to predict numbing and hyperarousal symptoms but not avoidance or reexperiencing symptoms. Finally, the rarely investigated, but clinically relevant, distinctive subdimensions of alexithymia were examined in relation to the 4 PTSD clusters. The difficulty identifying feelings subscale contributed most to the numbing and hyperarousal PTSD subscales. Clinical implications and future research directions are discussed. © 2010 Wiley Periodicals, Inc. J Clin Psychol 66: 1,14, 2010. [source]

Violence exposure in home and community: Influence on posttraumatic stress symptoms in Army recruits,

JOURNAL OF COMMUNITY PSYCHOLOGY, Issue 5 2004
Mark G. Chapin
This study assessed the levels and types of violence exposure, levels of posttraumatic stress symptoms, and the relationship among exposure to violence, posttraumatic stress symptoms, and early discharge in U.S. Army recruits at Basic Combat Training (BCT). The study applied a modified ABCX model of family stress adaptation developed by McCubbin, Thompson, and McCubbin (1996). A sample of 779 BCT recruits were surveyed before training began. At the end of training, data was collected on those recruits who had been discharged before completion of training. Statistical measures of association were used to assess the relationship between the variables. Results supported all three of the hypotheses tested. Significant positive relationships were found between violence exposure and trauma symptoms, as well as levels of trauma symptoms and odds of early discharge. Patterns of association were found between types of exposure to community versus home violence and specific symptom clusters of traumatic stress. © 2004 Wiley Periodicals, Inc. J Comm Psychol 32: 527,541, 2004. [source]

Does prior psychological health influence recall of military experiences? a prospective study

JOURNAL OF TRAUMATIC STRESS, Issue 4 2008
Jennifer Wilson
In a prospective study, we evaluated pre- and postdeployment psychological health on recall of risk factors to assess recall bias. Measures of the General Health Questionnaire (GHQ), PTSD Checklist (PCL), and symptom clusters from the PCL were obtained from 681 UK military personnel along with information on traumatic and protective risk factors. Postdeployment psychological health was more important in explaining recall of traumatic experiences than predeployment psychological health. Predeployment intrusive cluster scores were highly associated with traumatic exposures. Postdeployment, but not predeployment GHQ showed small effects for most risk factors. With the exception of intrusive thoughts, there is insufficient evidence to suggest predeployment psychological status would be useful in correcting for recall bias in subsequent cross-sectional studies. [source]

Posttraumatic stress after a motor vehicle accident: A six-month follow-up study utilizing latent growth modeling

JOURNAL OF TRAUMATIC STRESS, Issue 6 2006
Kitty K. Wu
Features of posttraumatic stress disorder (PTSD) for 596 survivors of motor vehicle accidents were examined by self-report measures at 1 week, 1 month, 3 months, and 6 months after the motor vehicle accident (MVA). Latent growth modeling was utilized to study the trend and predictors of the level of distress. Results indicated that 5,20% of the participants reported to have a significant level of posttraumatic stress in one, two, or three of the PTSD symptom clusters within the period studied. Survivors with significant acute stress 1 week after the MVA had a higher risk for developing chronic posttraumatic stress. Although the severity of intrusive and hyperarousal symptoms decreased over time, the severity of avoidance symptoms remained unchanged. Factors predicting the course of PTSD after an MVA are identified. [source]

Work-attributed symptom clusters (darkroom disease) among radiographers versus physiotherapists: Associations between self-reported exposures and psychosocial stressors

Classifying subgroups of patients with symptoms of acute coronary syndromes: A cluster analysis

RESEARCH IN NURSING & HEALTH, Issue 5 2010
Holli A. DeVon
Abstract The purpose of the study was to identify subgroups of patients presenting with acute coronary syndromes based on symptom clusters. Two hundred fifty-six patients completed a symptom assessment in their hospital rooms. Latent class cluster analysis and analysis of variance were used to classify subgroups of patients according to selected clinical characteristics. Four subgroups were identified and labeled as Heavy Symptom Burden, Chest Pain Only, Sweating and Weak, and Short of Breath and Weak (model fit ,2 [130,891, n,=,256],=,867.5, p,=,1.00). The largest group of patients experienced classic symptoms of chest pain and shortness of breath but not sweating. Younger patients were more likely to cluster in the Heavy Symptom Burden group (F,=,5.08, p,=,.002). Interpretation of the clinical significance of these groupings requires further study. © 2010 Wiley Periodicals, Inc. Res Nurs Health 33:386,397, 2010 [source]

Symptom cluster and physical activity in relapsing-remitting multiple sclerosis

Urological symptom clusters and health-related quality-of-life: results from the Boston Area Community Health Survey

BJU INTERNATIONAL, Issue 11 2009
Susan A. Hall
OBJECTIVE To determine whether urological symptom clusters, as identified in previous studies, were associated with health-related quality-of-life (HRQoL) and use of healthcare. SUBJECTS AND METHODS The Boston Area Community Health Survey is a population-based epidemiological study of 2301 male and 3201 female residents of Boston, MA, USA, aged 30,79 years. Baseline data collected from 2002 to 2005 were used in this analysis. Data on 14 urological symptoms were used for the cluster analysis, and five derived symptom clusters among men and four among women were used in multivariate linear regression models (adjusted for age group, race/ethnicity, and comorbidity) to determine their association with physical (PCS-12) and mental health component scores (MCS-12) calculated from the Medical Outcomes Study 12-item Short Form Survey. RESULTS For both men and women, being in the most symptomatic cluster was associated with decrements in the PCS-12 score (men, cluster 5, ,10.42; women, cluster 4, ,9.80; both P < 0.001) and the MCS-12 score (men, cluster 5, ,9.35; women, cluster 4, ,6.24; both P < 0.001) compared with the asymptomatic groups. Both men and women in these most symptomatic clusters appeared to have adequate access to healthcare. CONCLUSION For men and women, those with the most urological symptoms reported poorer HRQoL in two domains after adjusting for age and comorbidity, and despite adequate access to care. [source]

A randomized clinical trial of energy conservation for patients with cancer-related fatigue

CANCER, Issue 6 2004
Andrea M. Barsevick D.N.Sc.
Abstract BACKGROUND The efficacy of energy conservation and activity management (ECAM) for fatigue reduction and maintenance of functional performance has never been evaluated in adults with cancer who are undergoing treatment. METHODS A randomized clinical trial compared an ECAM intervention with a control intervention focused on nutrition. Individuals initiating chemotherapy, radiotherapy, or concurrent therapy for cancer were randomized to receive either the semistructured ECAM intervention (n = 200) or the control intervention (n = 196). Participants in each group participated in 3 telephone sessions with an oncology nurse during the first 5 weeks of treatment. Data on fatigue and limitation of functioning were obtained before cancer treatment and at two follow-up points that coincided with times of high fatigue for each type of treatment. The outcomes of interest included perception of fatigue and functional performance. RESULTS A repeated-measures analysis of covariance using the type of cancer treatment as a covariate revealed a significant study group,by-time interaction indicating that the ECAM group experienced a greater decrease in fatigue over time compared with the control group (F2,544 = 4.5; P = 0.01). The intervention was not associated with changes in overall functional performance. CONCLUSIONS Individuals who received the ECAM intervention derived a modest but significant benefit from it. To achieve a more robust clinical benefit from the intervention, it may be necessary to manage other key symptoms in addition to fatigue. Research is needed to examine symptom clusters or combinations associated with negative outcomes as well as combination strategies for symptom management. Cancer 2004. © 2004 American Cancer Society. [source]

The validity and internal structure of the Bipolar Depression Rating Scale: data from a clinical trial of N-acetylcysteine as adjunctive therapy in bipolar disorder

ACTA NEUROPSYCHIATRICA, Issue 5 2010
Michael Berk
Berk M, Dodd S, Dean OM, Kohlmann K, Berk L, Malhi GS. The validity and internal structure of the Bipolar Depression Rating Scale: data from a clinical trial of N-acetylcysteine as adjunctive therapy in bipolar disorder. Background: The phenomenology of unipolar and bipolar disorders differ in a number of ways, such as the presence of mixed states and atypical features. Conventional depression rating instruments are designed to capture the characteristics of unipolar depression and have limitations in capturing the breadth of bipolar disorder. Method: The Bipolar Depression Rating Scale (BDRS) was administered together with the Montgomery Asberg Rating Scale (MADRS) and Young Mania Rating Scale (YMRS) in a double-blind randomised placebo-controlled clinical trial of N-acetyl cysteine for bipolar disorder (N = 75). Results: A factor analysis showed a two-factor solution: depression and mixed symptom clusters. The BDRS has strong internal consistency (Cronbach's alpha = 0.917), the depression cluster showed robust correlation with the MADRS (r = 0.865) and the mixed subscale correlated with the YMRS (r = 0.750). Conclusion: The BDRS has good internal validity and inter-rater reliability and is sensitive to change in the context of a clinical trial. [source]

Phenomenology and psychological assessment of complex posttraumatic states

JOURNAL OF TRAUMATIC STRESS, Issue 5 2005
John Briere
The authors offer a framework for the assessment of psychological responses associated with exposure to early onset, multiple, or extended traumatic stressors. Six prominent and overlapping symptoms clusters are described: altered self-capacities, cognitive symptoms, mood disturbance, overdeveloped avoidance responses, somatoform distress, and posttraumatic stress. A strategy for the structured, psychometrically valid assessment of these outcomes is introduced, and specific recommendations for use of various generic and trauma-specific child and adult measures are provided. Implications of trauma assessment for treatment planning are discussed. [source]