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

It is well described that quality of life (QoL) improved after liver transplantation. The aim of the present study was to investigate how psychosocial parameters develop after liver transplantation (LTX) and whether post-operative complaints are the result of osteoporosis or patient somatization. The prospective study looks into biomedical and psychosocial parameters of 82 LTX patients before, 1 and 3 yrs after transplantation. Osteoporosis was measured by bone mineral density (BMD) and psychosocial parameters were assessed with validated questionnaires measuring complaints, mood and overall QoL. Overall QoL and mood improved after liver transplantation, while back and limb pain increased continuously. Back and limb pain were highly correlated with reduced bone density and high values for tiredness and depressive anxiety. Back and limb pain of patients following liver transplantation may indicate the development of a post-operative depression in some cases. The treatment offered by an essentially biologically based medicine may promote the manifestation of this depression as a somatization disorder.
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PMID:Psychosomatic interrelations following liver transplantation. 1209 88

Patients with sensitivities to multiple chemicals report symptoms of cognitive dysfunction, respiratory distress, and mood disturbance. Lifetime and current psychiatric disorders, personality traits associated with symptom reporting, and tests of cognitive function were compared between 30 subjects with Multiple Chemical Sensitivities (MCS), 19 asthmatics, and 31 healthy controls. Relative to asthmatics and controls, more MCS subjects met criteria for current depression and somatization disorder. MCS subjects and asthmatics scored significantly higher than controls on scales of chemical odor intolerance and anxiety sensitivity, both of which were significant predictors of physical symptoms. Few differences on objective neuropsychological tests were noted. However, MCS subjects with comorbid depression performed significantly worse on a verbal memory test relative to asthmatics but not to controls. Anxiety and depression are significant contributors to the physical and cognitive symptoms of MCS subjects.
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PMID:Anxiety sensitivity and depression in multiple chemical sensitivities and asthma. 1239 67

Despite increased awareness of the prevalence and morbidity of psychiatric illnesses, relatively few studies have been undertaken in primary care settings in the African context. The authors determined the prevalence of trauma exposure and posttraumatic stress disorder (PTSD) in a South African township primary health care clinic and assessed associated demographic factors, comorbidity, service use, service satisfaction, and quality of life. Subjects were directly interviewed using translated, standardized instruments to assess variables described. Retrospective chart analysis assessed clinician case identification and psychotropic drug-prescribing habits. Of the 201 participants, 94% reported exposure to traumatic events (mean, 3.8). Trauma was associated with single status (p =.01), and PTSD was associated with poverty and single status (p =.04). Both sexes were equally likely to develop PTSD. PTSD (current; 19.9%), depression (37%), and somatization disorder (18.4%) were the most common diagnoses. Comorbidity with PTSD was high and included depression (75%, p <.01), somatization (35%, p <.01), and panic disorder (25%, p <.01). Levels of functional impairment were higher for subjects with PTSD, depression, and somatization than for those without (p <.05). PTSD comorbid with depression compounded impairment (p =.04). Levels of trauma, PTSD, and depression did not increase service use or dissatisfaction with services. Clinicians did not identify trauma (0%) or psychopathology (0%), and psychotropic medication was prescribed for only 1% of participants. In this population, trauma and PTSD were highly prevalent and associated with significant unidentified morbidity and comorbidity. Patients remain untreated for years in the current system of primary care consultations.
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PMID:Trauma and posttraumatic stress disorder in an urban Xhosa primary care population: prevalence, comorbidity, and service use patterns. 1269 33

Recurrent abdominal pain (RAP) is one of the most common pain syndromes in childhood, with prevalence rates ranging from 10 to 20% in all school-age children. In nearly 50% the complaints persist over many years of their life-span to adolescence or adulthood. Although the empirical findings have increased in the last decade, our knowledge about the etiology, pathogenesis, and pathophysiology is still very limited. Current approaches suggest that we understand recurrent pain syndromes as a complex and multidimensional disturbance (biopsychosocial paradigm). In this respect there is strong evidence for the major importance of psychosocial causes (daily hassles, specific life events), psychopathological factors (anxiety, depression, somatization disorder), and social environmental influences (mother's psychopathology, social modelling, reinforcement) in the pathogenesis of functional abdominal pain. The noticeable correlation with other pain syndromes and functional disturbances indicates that recurrent pain may possibly be a manifestation of a basic somatization disorder. The unfavourable long-term prognosis supports the need for early and specific interventions. Psychological treatment requires a medical examination to exclude organic origins. Some of these invasive diagnostic procedures can be very difficult, expensive and distressing for the child. Behavioural medicine is based upon having an extensive family history and symptom analysis. The psychological interventions applied in clinical practice include prophylaxis, reduction of pain symptoms and environmental modification. In recent years there has been an increasing trend to create more complex and multidimensional behavioural treatment programs for children. Although preliminary data on the use of these behavioural medicine programs have shown some promise, further investigations are needed to examine the applicability and effectiveness of specific interventions in the treatment of abdominal pain symptoms.
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PMID:[Idiopathic abdominal pain in children: results, deficits and perspectives of empirical research]. 1279 16

The aim of this study was to identify symptoms of depression, anxiety and somatization disorder in gynecological and obstetrical inpatients by screening questionnaires and to compare this findings with utilisation of a psychosomatic consultation service. 517 patients were screened with HADS (anxiety and depression) and GBB-24 (somatic complaints). 28.7% had pathological and, in addition, 19.8% borderline scores in at least one scale. More than 40% had pathological or borderline scores even in a 4-week follow-up and emphasised that they would have preferred having psychosomatic support in hospital. In only 2.9% psychosomatic consultation service was requested. Physicians in the gynecology department rated anxiety depression and the patients' acceptance of psychological factors of their illness significantly lower than the patients themselves. Our results demonstrate that anxiety and depression in gynecological and obstetric patients are not only a momentary phenomenon. Physicians underestimate the need of psychosomatic consultation.
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PMID:[Psychosomatic complaints and utilisation of psychosomatic consultation services in gynecology and obstetrics]. 1466 Nov 52

Eighty treatment-seeking adults age 60 or over with panic disorder, generalized anxiety disorder, and mixed anxiety states (generalized anxiety with panic attacks, panic disorder with secondary generalized anxiety) completed a clinical assessment and battery of self report measures. Several hypotheses were tested from the domains of distinguishing symptoms, associated features, and rates of comorbidity with other disorders. Greater between- than within-group variance was found on a subset of measures suggesting that the distinction between GAD and PD is generally valid in the older adult population. Higher scores on measures of sympathetic arousal, agoraphobic avoidance, and rates of comorbid somatization disorder and alcohol dependence distinguished those with PD from those with GAD. Higher scores on measures of depression and hostility, but not trait anxiety or worry, distinguished the GAD group. Results indicate that distinguishing features of GAD and PD in older treatment-seeking adults may be fewer and slightly different from those of younger adults.
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PMID:Distinguishing generalized anxiety disorder, panic disorder, and mixed anxiety states in older treatment-seeking adults. 1512 77

There is no doubt that chronic pain is recognized as a biopsychosocial phenomenon in which biological, psychological, and social factors dynamically interact with each other. Thus, the role of psychological factors and understanding chronic, persistent disabling pain has been well recognized, but poorly understood. Approximately 1/2 to 2/3 of all patients diagnosed with chronic pain manifest to various levels of psychological distress. Chronic pain and psychological disorders are the two most common elements in the United States. Statistics show that, approximately 22% of Americans suffer from a diagnosable mental disorder in a given year. In addition, 28% of the American population suffers with chronic pain. Depression in chronic pain is the most common condition, followed by generalized anxiety disorder, somatization disorder, and drug dependence. However, psychogenic pain appears to be the least prevalent of all psychopathological issues. Chronic pain disability is a complex psychosocial economic phenomenon. There is no data in the literature with regards to treatment of personality disorders, anxiety disorders, and somatization disorders in managing chronic pain. In contrast, treatment of depression and the influence of treatment on outcomes have been studied to some extent. In conclusion, patients with chronic pain frequently have psychopathology - most often common depressive disorders, anxiety disorders, somatization disorders, drug dependence and occasionally personality disorders. This review discusses various issues involved with psychopathology in chronic pain including epidemiology; relationship of psychopathology to pain; influence of depression, generalized anxiety disorder, somatization, and personality disorders on chronic pain, along with diagnosis and management in interventional pain management.
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PMID:Understanding psychological aspects of chronic pain in interventional pain management. 1689 59

Recent reports of provocative discography not only instill confusion, but also create numerous questions about its value in evaluating low back pain. It was reported that provocative discography produced pain in patients who were not suffering with low back pain but suffering with somatization disorder and depression. This study was designed to evaluate 50 randomly assigned patients, with 25 patients in Group I without somatization disorder and 25 patients in Group II with diagnosis of somatization disorder. In addition, depression, generalized anxiety disorder and combinations thereof were also evaluated. All patients underwent discography, investigating two to three discs in each patient. All studies included a control level with a disc that did not produce the patient's pain upon injection of contrast medium. Provocation with exact pain reproduction concordant with the symptom complex upon injection of contrast into the disc was considered positive. Any other response, with or without pain, was considered negative. Results showed positive provocative discography in 46% of the patients in the somatization group compared to 54% in the non-somatization group; in 46% of patients with depression compared to 54% of patients without depression; in 15 of 30 patients with generalized anxiety disorder; in 11 of 20 patients without generalized anxiety disorder; and in 42% of patients with combined somatization and depression, with negative discography in 58% of the patients. It is concluded that provocative discography provides similar results in patients with or without somatization, with or without depression, with somatization but with or without depression or with other combinations of the psychological triad of somatization disorder, depression, and generalized anxiety disorder.
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PMID:Provocative discography in low back pain patients with or without somatization disorder: a randomized prospective evaluation. 1690 Feb 51

This study was designed to evaluate psychological status of 150 individuals; 50 without chronic pain and without psychotherapeutic drug therapy, Group I or control group; 50 patients with chronic pain, Group II, chronic pain group with involvement of one region; and 50 chronic pain patients with involvement of two or more regions, Group III. All the participants were tested utilizing Millon Clinical Multiaxial Inventory -III (MCMI-III). Results were analyzed and compared for various clinical personality patterns including personality traits and personality disorders; severe personality pathology for schizotypal, borderline and paranoid personality pathology; and multiple clinical syndromes including generalized anxiety disorder, somatization disorder, major depression, bipolar manic disorder and dysthymic disorder, etc. There were no significant differences noted in clinical personality patterns or severe personality pathology. In the analysis of clinical syndromes, generalized anxiety disorder, somatization disorder, and depressive disorders were seen in a progressively greater proportion of patients in Groups I to III. In conclusion, this evaluation showed that abnormal clinical personality patterns are present in both groups of patients. Psychological abnormalities with generalized anxiety disorder, somatization disorder, and depression are commonly seen in chronic pain patients.
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PMID:Do number of pain conditions influence emotional status? 1690 60

This study was designed to determine the prevalence of lumbar facet joint pain in patients suffering with or without somatization disorder. The study was performed using comparative local anesthetic blocks. One hundred consecutive patients with chronic low back pain, with or without somatization, were evaluated. The results showed that, among patients suffering with chronic low back pain, 44% of the patients without somatization and 38% of the patients with somatization were positive for facet joint pain. The diagnosis of facet joint pain was not influenced by the presence or absence of somatization disorder. The evaluation also was extended to depression, generalized anxiety disorder and combinations with or without somatization thereof which showed no significant differences in the prevalence of facet joint pain. The results of this study demonstrated that the facet joint was a source of pain in chronic low back pain patients in 44% of the patients without somatization and 38% of the patients with somatization. This study also showed that there was no correlation between the presence or absence of facet joint pain and the presence or absence of somatization disorder or any other psychological condition or combination thereof.
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PMID:Influence of psychological factors on the ability to diagnose chronic low back pain of facet joint origin. 1690 81


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