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 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

While twin studies of psychiatric disorders have been conducted for over 65 years, surprisingly little is known about the comparability of psychiatric symptoms in adult twins and singletons. To address this question, we compared the means and variances of four-factor scores on the self-report Symptom Check List in twins and their relatives from the Virginia 30,000 twin-family study. The four factors were depression, panic-phobia, somatization, and insomnia. Twins had significantly higher scores on the panic-phobia factor than their relatives, by about one eighteenth of a standard deviation, and this was replicated in both subsamples. However, no consistent and significant mean differences between twins and their relatives were detected for the other three symptom factors. While some differences in variance were found between twins and their relatives, in no case were the differences replicated in both subsamples. With the possible exception of modestly elevated scores for panic-phobia, these results suggest that both the level and variability of common psychiatric symptoms reported by twins are similar to those found in the nontwin population.
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PMID:Self-report psychiatric symptoms in twins and their nontwin relatives: are twins different? 882 3

This study reports on the use of the Brief Symptom Inventory, a shortened version of the Symptom Check List-90-Revised, to measure psychopathological symptoms that predict male domestic violence. A sample of 152 men and their partners reported on the severity of violent behavior present in their relationship. Discriminant analysis indicated variation in men's violent status as a function of psychopathological symptoms. Violent men evidenced higher scores on 7 of the 9 subscales of the Brief Symptom Inventory, namely, Depression, Anxiety, Hostility, Phobia, Paranoid Ideation, Interpersonal Sensitivity, and Psychoticism.
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PMID:Utilization of the Brief Symptom inventory to discriminate between violent and nonviolent male relationship partners. 896 15

Recently the development of several promising new compounds for anxiety and depression was discontinued because of difficulty demonstrating therapeutic effects. This article explores alternatives to "increasing placebo response rate" as explanations. We reanalyzed a study of 81 panic patients treated with placebo, alprazolam 2 mg or 6 mg, or imipramine 225 mg daily to investigate the effect of baseline pathology and selective effects of treatment on biological and cognitive components of panic disorder. The regression of endpoint on baseline number of spontaneous panic attacks differed among treatment groups, with lower slopes for the more active compounds. Only patients with many panic attacks at baseline benefited from the active compounds. Also, treatment effects declined progressively on the more cognitive aspects of the disorder (situational panic attacks and phobia ratings) for alprazolam and were entirely absent for imipramine. Implications for the etiology of panic disorder, its treatment, and therapeutic research are discussed.
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PMID:Growing placebo response rate: the problem in recent therapeutic trials? 913 49

In recent years the study of subjective well-being has attracted much research interest. A 1993 operational definition is the Depression-Happiness Scale of McGreal and Joseph. The aim of the present research was to investigate the convergent validity of the Depression-Happiness Scale with the Crown-Crisp Experiential Index. Among 40 undergraduate university students, higher scores on the Depression-Happiness Scale were significantly associated with lower scores on Free floating anxiety (-.63), Somatic anxiety (-.56), Depression (-.78), and Hysteria (-.36) scales but not the Phobic anxiety (-.27) or Obsessionality (-.25) scales of the Crown-Crisp Experiential Index. These data provide further evidence for the convergent validity of the Depression-Happiness Scale.
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PMID:Convergent validity of the depression-happiness scale with the Crown-Crisp experimental index. 914 7

This study examined the extent to which the presence of comorbid anxiety disorder affected the course of depression. 650 depressed outpatients visiting general medical clinicians and mental health specialists were followed for 1 or 2 years. All types of anxiety increased the probability of a new depressive episode among patients with subthreshold depression. Co-occurring panic and phobia decreased the likelihood of remission. The initial number of depressive symptoms was greatest among depressed patients with comorbid anxiety and this relatively higher level persisted over two years. The findings emphasize the poor clinical prognosis associated with comorbid anxiety disorder.
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PMID:Course of depression in patients with comorbid anxiety disorders. 918 95

This paper reviews research on the psychological characteristics of patients suffering from anorexia nervosa and that examining the therapeutic relationship. The former research suggests that anorexic patients possess a psychological profile characterized by: a phobia of weight gain and fear of loss of control; alexithymia and lack of introceptive awareness; mistrust of self and others; cognitive dysfunction; low self-esteem; and often the presence of starvation-induced depression. The latter strongly suggests that in order for a relationship to be therapeutic it needs to be characterized by: empathy; positive regard and acceptance; warmth; commitment; trust; genuineness; and be non-judgemental. The implications of these research findings regarding the nurse's role in forming a therapeutic relationship with anorexic patients is then discussed. It is seen that it is vital that nurses receive adequate education before working with such patients, and that their knowledge is regularly updated. Nurses should receive regular clinical supervision and support, in order to ensure that they are able to provide therapeutic care for such patients.
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PMID:The psychological characteristics of patients suffering from anorexia nervosa and the nurse's role in creating a therapeutic relationship. 937 93

Motor vehicle accidents (MVAs), even those of a nonserious nature, appear to increase the risk of severe psychiatric morbidity in survivors. The present review examines the evidence indicating the levels of psychiatric morbidity in MVA survivors. Although no consistent profile has emerged, the most commonly reported symptoms are depression, anxiety, irritability, driving phobia, anger, sleep disturbances, and headache, with rates of posttraumatic stress disorder (PTSD) across studies of 0% to 100%. Variability in the type and severity of psychiatric outcomes may be due, in part, to methodological inadequacies in many studies, particularly the use of biased population samples, inclusion of subjects exposed to varied types of accidents, an absence of a clear definition of PTSD, a reliance on clinical judgment rather than the use of objective psychometric measures, the failure to include ratings of injury severity, and the absence of assessments for past exposure to traumatic events or preexisting posttraumatic reactions. The most important concern relates to the use of nonrepresentative samples, usually patients referred for medicolegal assessment in whom issues of compensation are of central importance. Gender and age differences distinguish the compensation group from the general population of MVA survivors, who therefore may also differ in the vulnerability to posttraumatic morbidity. It is argued that more systematic research on unselected subject samples is critical to establish epidemiological data on the true nature and extent of psychiatric morbidity following MVAs.
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PMID:Psychiatric morbidity following motor vehicle accidents: a review of methodological issues. 960 76

The definition of case is a core issue in psychiatric epidemiology. Psychiatric symptom screening scales have been extensively used in population studies for many decades. Structured diagnostic interviews have become available during recent years to give exact diagnoses through carefully undertaken procedures. The aim of this article was to assess how well the Hopkins Symptom Checklist-25 (HSCL-25) predicted cases by the Composite International Diagnostic Interview (CIDI), and find the optimal cut-offs on the HSCL-25 for each diagnosis and gender. Characteristics of concordant and discordant cases were explored. In a Norwegian two-stage survey mental health problems were measured by the HSCL-25 and the CIDI. Only 46% of the present CIDI diagnoses were predicted by the HSCL-25. Comorbidity between CIDI diagnoses was found more than four times as often in the concordant cases (case agreed upon by both instruments) than in the discordant CIDI cases. Concordant cases had more depression and panic/generalized anxiety disorders. Neither the anxiety nor the depression subscales improved the prediction of anxiety or depression. The receiver operating characteristic (ROC) curves confirmed that the HSCL-25 gave best information about depression. Except for phobia it predicted best for men. Optimal HSCL-25 cut-off was 1.67 for men and 1.75 for women. Of the discordant HSCL-25 cases, one-third reported no symptoms in the CIDI, one-third reported symptoms in the CIDI anxiety module, and the rest had symptoms spread across the modules. With the exception of depression, the HSCL-25 was insufficient to select individuals for further investigation of diagnosis. The two instruments to a large extent identified different cases. Either the HSCL-25 is a very imperfect indicator of the chosen CIDI diagnoses, or the dimensions of mental illness measured by each of the instruments are different and clearly only partly overlapping.
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PMID:Concordance between symptom screening and diagnostic procedure: the Hopkins Symptom Checklist-25 and the Composite International Diagnostic Interview I. 968 97

To determine whether psychopathology is associated with disability as a result of underlying physical illness or whether such psychopathology antedates disability and is an independent determinant of disability, the authors conducted a nested case-control study within the Epidemiologic Catchment Area Follow-up Study in Baltimore, Maryland. From a 1981 random sample of 3,481 persons from Baltimore interviewed for psychopathology, disability, and other comorbidity, 1,920 who were alive in 1993 were traced and were reinterviewed with a similar instrument. Within the study population, 168 new cases of disability were identified as occurring between 1981 and 1993, as measured by the inability to perform activities of daily living. These cases were compared with 1,715 controls who reported no disability. The sociodemographic factors that were significantly related to incident disability in this analysis were age, female gender, and less than a high school education. These comparisons revealed associations of incident disability in activities of daily living with almost all antecedent chronic physical illnesses. Significant age- and gender-adjusted associations were observed between incident disability in activities of daily living and antecedent (in 1981) alcohol abuse and dependence (odds ratio (OR)=2.5, 95% confidence interval (CI) 1.5-4.2), major depressive disorder (OR=4.2, 95% CI 2.2-8.3), and phobia (OR=1.9, 95% CI 1.3-2.8). The adjusted odds ratio for the joint effect of antecedent depression and chronic physical illness on incident disability in activities of daily living was 17.0 (95% CI 6.9-41.7). There was a significant independent effect of antecedent major depression on activities of daily living disability. The effect of psychopathology on incident disability is nonspecific as to type of baseline chronic physical illness. Such a finding has important implications for defining strategies to prevent disability.
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PMID:Psychopathology as a predictor of disability: a population-based follow-up study in Baltimore, Maryland. 969 Mar 64

In a recent study, the authors reported that 25% (108/441) of consecutive emergency department (ED) chest pain patients had panic disorder (PD). As part of this study, the authors sought to answer the question: How do ED patients with PD compare with patients with PD who seek treatment in a psychiatric setting? PD patients from an ED (n = 108) and psychiatric clinic (n = 137) were compared with respect to comorbid Axis I diagnoses, self-report scores, and recent suicidal ideation. The group of psychiatric patients was younger (36.5 vs. 52.3 years) (P < 0.0001) and consisted of proportionally more women (63% vs. 39%) (P = 0.0001) than the ED patients. The psychiatric patients had significantly higher rates of comorbid agoraphobia (100% vs. 15%) (P < 0.0001), social phobia (23% vs. 3%) (P = 0.0001), specific phobia (12.3% vs. 4.6%) (P = 0.03), and posttraumatic stress disorder (16.9% vs. 5.6%) (P = 0.006), compared with the ED patients, and displayed significantly higher scores on all of the self-report panic measures. However, the patients in both groups had similar rates of comorbid generalized anxiety disorder (41.2% vs. 33.3%) (P = 0.17), major depression (8.8% vs. 11.1%) (P = 0.54), and obsessive-compulsive disorder (1.5% vs. 2.8%) (P = 0.7). Both groups also did not differ on the Beck Depression Inventory and in their rate of report of recent suicidal ideation (32% vs. 25%) (P = 0.23). Both psychiatric and ED patients with PD appear to be highly distressed patients who require treatment. Early intervention for ED patients may prevent both chronic patient distress and development of the significant phobic avoidance observed in psychiatric patients.
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PMID:Comparing emergency department and psychiatric setting patients with panic disorder. 981 51


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