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Symptom Patterns (symptom + pattern)

Distribution by Scientific Domains

Medical Sciences	84%

Selected Abstracts

The Dimensionality of DSM-IV Alcohol Use Disorders Among Adolescent and Adult Drinkers and Symptom Patterns by Age, Gender, and Race/Ethnicity

ALCOHOLISM, Issue 5 2009
Thomas C. Harford
Background:, There is limited information on the validity of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) alcohol use disorders (AUD) symptom criteria among adolescents in the general population. The purpose of this study is to assess the DSM-IV AUD symptom criteria as reported by adolescent and adult drinkers in a single representative sample of the U.S. population aged 12 years and older. This design avoids potential confounding due to differences in survey methodology when comparing adolescents and adults from different surveys. Methods:, A total of 133,231 current drinkers (had at least 1 drink in the past year) aged 12 years and older were drawn from respondents to the 2002 to 2005 National Surveys on Drug Use and Health. DSM-IV AUD criteria were assessed by questions related to specific symptoms occurring during the past 12 months. Factor analytic and item response theory models were applied to the 11 AUD symptom criteria to assess the probabilities of symptom item endorsements across different values of the underlying trait. Results:, A 1-factor model provided an adequate and parsimonious interpretation for the 11 AUD criteria for the total sample and for each of the gender,age groups. The MIMIC model exhibited significant indication for item bias among some criteria by gender, age, and race/ethnicity. Symptom criteria for "tolerance,""time spent," and "hazardous use" had lower item thresholds (i.e., lower severity) and low item discrimination, and they were well separated from the other symptoms, especially in the 2 younger age groups (12 to 17 and 18 to 25). "Larger amounts,""cut down,""withdrawal," and "legal problems" had higher item thresholds but generally lower item discrimination, and they tend to exhibit greater dispersion at higher AUD severity, particularly in the youngest age group (12 to 17). Conclusions:, Findings from the present study do not provide support for the 2 separate DSM-IV diagnoses of alcohol abuse and dependence among either adolescents or adults. Variations in criteria severity for both abuse and dependence offer support for a dimensional approach to diagnosis which should be considered in the ongoing development of DSM-V. [source]

Depressive symptom patterns in patients with Parkinson's disease and other older adults

JOURNAL OF CLINICAL PSYCHOLOGY, Issue 12 2001
Kristi J. Erdal
Research on depression in Parkinson's disease (PD) has suggested that PD patients experience a qualitatively different depression from that of other older adults, endorsing fewer cognitive symptoms of depression (e.g., guilt, failure) and greater somatic (e.g., poor sleep) and mood symptoms (e.g., sadness, hopelessness); however, this has never been tested directly. In the present study, two PD groups, one with cognitive impairment (PD + CI; n = 26) and one without cognitive impairment (PD; n = 45), and three control groups of older adults were compared on measures of depressive symptomatology. The control groups included a physically disabled group (n = 46), a cognitively impaired group (CI; n = 21), and a healthy group (n = 50). Confirmatory factor analysis verified a four-factor model of depressive symptoms (Cognitive, Mood, Somatic, and Fatigue symptoms). Comparisons revealed that the PD group had a depressive-symptom pattern that was not significantly different from the disabled and healthy groups. The PD + CI group had a symptom pattern that was more similar to the CI group than to the PD group. Implications for the conceptualization of depression in older adults are discussed. © 2001 John Wiley & Sons, Inc. J Clin Psychol 57: 1559,1569, 2001. [source]

Chemosensitivity of the human gastrointestinal tract in health and in disease

NEUROGASTROENTEROLOGY & MOTILITY, Issue 4 2007
J. Tack
Abstract, Although visceral sensitivity in man comprises chemosensitivity, thermosensitivity and mechanosensitivity, only the latter has been intensively studied. Studies in health have aimed at characterising the type of mechanoreceptors involved in visceral mechanosensitivity,. Several authors have studied the prevalence and relevance to the symptom pattern of hypersensitivity to visceral balloon distention in patients with functional gastrointestinal disorders. Chemosensitivity of the gastrointestinal tract in man has received much less attention. In this issue of Neurogastroenterology and Motility, intraluminal application of capsaicin is described as a tool to study chemosensitivity of the proximal gastrointestinal tract. The authors report how activation of chemosensitive pathways induces symptoms that differ from those induced by activation of mechanosensitive pathways, and propose to use capsaicin as a tool to study the prevalence and role of hypersensitivity to visceral chemosensitivity in patients with functional gastrointestinal disorders. Our current knowledge of visceral chemosensitivity of the human gastrointestinal tract in health and in disease is reviewed, with a specific focus on the interaction between mechano- and chemosensitive pathways. [source]

Intragastric distribution of a standardized meal in health and functional dyspepsia: correlation with specific symptoms

NEUROGASTROENTEROLOGY & MOTILITY, Issue 5 2003
H Piessevaux
Abstract, In functional dyspepsia, abnormal intragastric distribution of a test meal has been identified but has never been correlated to any symptom pattern. The aim of this study was to compare the intragastric distribution of a meal between functional dyspepsia patients and controls, and to correlate distribution with symptom patterns, using scintigraphic gastric emptying studies. In forty patients with functional dyspepsia and 29 healthy volunteers, scintigraphic planar images were obtained immediately after ingestion of a mixed radiolabelled test meal and every 20 min for 2 h. The images of the stomach were divided into proximal and distal compartments. The mean intragastric distribution was similar in patients and controls. Over the whole test, 18 (45%) and 20 (50%) patients had a distal redistribution of the solid and liquid phase of the meal, respectively, while proximal retention of these phases was found in 13 (33%) and 9 (23%) patients. Early satiety was associated with early distal redistribution of the liquid phase and fullness was associated with late proximal retention. This study shows similar intragastric distribution of a test meal in health and functional dyspepsia. Within the patient group, an association between abnormal intragastric distribution patterns and symptom profiles was found, which might be related to different pathophysiological mechanisms. [source]

Somatic awareness, uncertainty, and delay in care-seeking in acute heart failure

RESEARCH IN NURSING & HEALTH, Issue 2 2006
Corrine Y. Jurgens
Abstract Symptom monitoring is difficult for heart failure (HF) patients. Difficulties physically sensing and determining symptom meaning may lead to uncertainty and delay treatment. Somatic awareness may provide insight into symptom monitoring ability. A model combining physical and cognitive aspects of the symptom experience was developed to examine factors affecting care-seeking among HF patients. Adults hospitalized with acute HF were interviewed and completed questionnaires measuring somatic awareness and uncertainty. HF symptom duration prior to admission measured delay. HF specific somatic awareness and symptom pattern predicted delay. Uncertainty correlated with somatic awareness, but did not predict delay. Few responded to early HF symptoms delaying until acutely ill. Development of interventions to improve symptom monitoring is needed. © 2006 Wiley Periodicals, Inc. Res Nurs Health 29:74,86, 2006 [source]

Is bipolar II depression phenotypically distinctive?

ACTA PSYCHIATRICA SCANDINAVICA, Issue 6 2009
G. B. Parker
Objective:, We examine the depressive symptom profile of bipolar II disorder patients compared with a comparator (composite) group of those with unipolar depression, with stratification by melancholic and non-melancholic subtypes. Method:, Out-patients (n = 394) attending a specialist depression clinic comprised the sample. Data on severity and prototypic status of depressive symptoms were analysed. Results:, Age-matched analyses revealed minimal differentiation between bipolar II and composite unipolar groups. Stratified analyses suggested that ,bipolar II depression' more closely approximated melancholic depression in terms of psychomotor and cognitive slowing. Severity-based analyses and prototypic symptom patterns yielded differing results, suggesting that definition of bipolar II depression is influenced by rating strategies, and age. Conclusion:, We found limited differentiation of bipolar II depression from unipolar, melancholic and non-melancholic depression. Differences suggested previously may reflect age, gender and severity differences, highlighting the need for appropriately matched groups in defining bipolar II depression. [source]

Depressive symptom patterns in patients with Parkinson's disease and other older adults

Advances in the management of irritable bowel syndrome

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 4 2002
John E Kellow
Abstract Recent advances in different aspects of irritable bowel syndrome have led to a need to reassess the overall management of this common, complex disorder. Important areas include: first, the heterogeneity of symptom patterns and the role of specific diagnostic symptom criteria for use in both clinical practice and in clinical research; second, the growing interest in the potential interaction between ,peripheral' and ,central' pathophysiological mechanisms; and third, the development of novel and effective drugs designed to target specific receptor systems in the enteric nervous system. This review covers each of these aspects and emphasizes an approach to management of patients based on pathophysiological considerations. © 2002 Blackwell Publishing Asia Pty Ltd [source]

Sensory processing disorder: Any of a nurse practitioner's business?

JOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 6 2009
DrNPc, Elise D. Fish Professor of Clinical Health Care for the Underserved, FAAN Stone Foundation, Mary W. Byrne PhD
Abstract Purpose: Children who exhibit the confusing symptom patterns associated with sensory processing deficits are often seen first by primary care providers, including family and pediatric nurse practitioners (NPs). The purpose of this article is to alert NPs to the state of the science for these disorders and to the roles NPs could play in filling the knowledge gaps in assessment, treatment, education, and research. Data sources: Literature searches using PubMed and MedLine databases and clinical practice observations. Conclusions: Sensory integration disorders have only begun to be defined during the past 35 years. They are not currently included in the DSM IV standard terminology, and are not yet substantively incorporated into most health disciplines' curricula or practice, including those of the NP. Implications for practice: NPs are in a unique position to test hypothesized terminology for Sensory Processing Disorder (SPD) by contributing precise clinical descriptions of children who match as well as deviate from the criteria for three proposed diagnostic groups: Sensory Modulation Disorder (SMD), Sensory Discrimination Disorder (SDD), and Sensory-Based Motor Disorder (SBMD). Beyond the SPD diagnostic debate, for children with sensory deficit patterns the NP role can incorporate participating in interdisciplinary treatment plans, refining differential diagnoses, providing frontline referral and support for affected children and their families, and making both secondary prevention and critical causal research possible through validation of consistently accepted diagnostic criteria. [source]

Irritable bowel syndrome in the United States: prevalence, symptom patterns and impact

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 11 2005
A. P. S. Hungin
Summary Background :,The impact of irritable bowel syndrome, a gastrointestinal motility disorder, is underestimated and poorly quantified, as clinicians may see only a minority of sufferers. Aim :,To determine the prevalence, symptom patterns and impact of irritable bowel syndrome in the US. Methods :,This two-phase community survey used quota sampling and random-digit telephone dialling (screening interview) to identify individuals with medically diagnosed irritable bowel syndrome or individuals not formally diagnosed, but fulfilling irritable bowel syndrome diagnostic criteria (Manning, Rome I or II). Information on irritable bowel syndrome symptoms, general health status, lifestyle and impact of symptoms on individuals' lives was collected using in-depth follow-up interviews. Data were also collected for healthy controls identified in the screening interviews. Results :,The total prevalence of irritable bowel syndrome in 5009 screening interviews was 14.1% (medically diagnosed: 3.3%; undiagnosed, but meeting irritable bowel syndrome criteria: 10.8%). Abdominal pain/discomfort was the most common symptom prompting consultation. Most sufferers (74% medically diagnosed; 63% undiagnosed) reported alternating constipation and diarrhoea. Previously diagnosed gastrointestinal disorders occurred more often in sufferers than non-sufferers. Irritable bowel syndrome sufferers had more days off work (6.4 vs. 3.0) and days in bed, and reduced activities to a greater extent than non-sufferers. Conclusions :,Most (76.6%) irritable bowel syndrome sufferers in the US are undiagnosed. Irritable bowel syndrome has a substantial impact on sufferers' well-being and health, with considerable socioeconomic consequences. [source]

Intragastric distribution of a standardized meal in health and functional dyspepsia: correlation with specific symptoms

Ovarian steroids and premenstrual symptoms: A comparison of group differences and intra-individual patterns

RESEARCH IN NURSING & HEALTH, Issue 3 2007
Martha J. Lentz
Abstract To examine the relationship of gonadal hormone and symptom patterns across the menstrual cycle, women screened for 2,3 cycles completed an intensive study cycle; 26 had a low-severity symptoms (LS), 20, a premenstrual syndrome (PMS), and 26, a premenstrual magnification pattern (PMM). All completed daily symptom diaries and collected late afternoon urine samples which were assayed for pregnanediol and estradiol for that cycle. The PMS and PMM groups had significantly more positive cross-correlations of pregnanediol and symptoms than the LS group. Women in all groups had similar levels of estradiol and pregnanediol. Women with PMS and PMM patterns responded to progesterone differently than women with LS patterns: thus the former groups may not benefit from hormone therapies. © 2007 Wiley Periodicals, Inc. Res Nurs Health 30: 238,249, 2007 [source]

The search for meaning,Symptoms and transvaginal sonography screening for ovarian cancer,

CANCER, Issue 16 2009
Predicting malignancy
Abstract BACKGROUND: The mortality rate of ovarian cancer is greater than that of all other major gynecologic malignancies. Detecting ovarian cancer at an early and curable stage long has been an objective of oncologists. Recently, it was reported that certain symptom patterns are informative for the presence of ovarian malignancy. In this article, the authors report on how symptoms and ultrasound predict ovarian malignancy. METHODS: Two hundred seventy-two women who were participating in annual transvaginal sonography (TVS) screening were selected from among 31,748 women who were enrolled. Symptom results were correlated with ultrasound and surgical pathology findings. RESULTS: TVS performed better than symptoms analysis for detecting malignancies (sensitivity, 73.3% vs 20%), and symptoms analysis performed better for distinguishing benign tumors (specificity, 91.3% vs 74.4%). The use of TVS and symptoms analysis in series resulted in poorer identification of malignancy (sensitivity, 16.7%) but improved the ability to distinguish benign tumors (specificity, 97.9%). Decisions using either symptoms or TVS combined in parallel had small increases in sensitivity (+3.3%) and had coordinated, small decreases in specificity (,5.8%). CONCLUSIONS: Symptoms did identify ovarian malignancies, but not as well as TVS. The current findings indicated that: 1) tumors that are negative by both ultrasound and a symptoms index are likely to be benign (specificity, >97%), and 2) adding symptoms information that has weight equal to the weight of ultrasound only slightly improves the discrimination of malignancy (sensitivity increase, +3.3%). Thus, a major benefit in discriminating malignancy was achieved through ultrasound, whereas the absence of symptoms in conjunction with an abnormal ultrasound (characterized by a low morphology index) indicated that the mass was benign and that surgery may not be required. Finally, informative symptoms can be expected to be absent in 80% of patients with ovarian malignancies. Cancer 2009. © 2009 American Cancer Society. [source]