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

Subtle problems of perplexity, distractibility, and fatigue accompany all kinds of brain injury for they appear to result from disruption of accustomed neural pathways and loss or change of mental function. Emotional disturbances may mask these subtle problems, but they can also result from them. Clinical experience indicates that these problems are more apt to become stressful when the patient misinterprets or copes ineffectively with them. That these common problems of brain injured adults may be overlooked in the usual clinical examination was shown in a comparison of clinical records of 50 patients referred for neuropsychological consultation with records of 46 patient-participants in a longitudinal neuropsychological study. Significantly more reports of these problems appeared in the latter group of records. However, consultation records did reflect emotional distress. Irritability, depression, or anxiety affected all but six consultation patients and appeared with equal frequency among working patients as among those unable to work or needing full-time care. This suggests that some of their emotional distress resulted from less obvious problems than those impairing mobility, strength, or competency. Counseling can reduce the patient's vulnerability to the psychologically crippling effects of perplexity, distractibility, and fatigue. Specific recommendations for patient and family counseling are offered.
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PMID:Subtle sequelae of brain damage. Perplexity, distractibility, and fatigue. 2 22

An epidemiologic investigation of the mental needs and services of 1645 respondents, aged 17 to 92 years and living in a representative southeastern county in Florida, revealed that 7.8% of the sample lived in crowded conditions. The crowded respondents scored significantly higher than did the uncrowded on both a depression scale and on the Health Opinion Survey. Associations between crowding and high scores on both scales were strongest among: respondents in the childrearing and middle years of life, blacks at all income levels, whites in the intermediate annual family income range of $6000 to $9999, and especially, females rather than males. Consistently, the crowded black population, and particularly, crowded white women, had much higher scores than did the uncrowded women. A multiple regression analysis showed that three variables--being a female, having a lower income, and crowding--accounted for 16.5% of the variance. The discussion emphasizes that the relationship between crowding and higher scores on indices of emotional distress is quite complicated. In crowded situations, depression may be a costly, semi-adaptive reaction to excessive interpersonal stimulation. Women living in crowded situations appear to be at high risk for depressive illness; their plight brings to mind the classic animal experiments which showed that the maternal behavior of females deteriorated in crowded situations.
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PMID:Crowding and mental health. 26 18

The influence of progesterone on gestagen upon stress reactions and the metabolism of the biogenic amines, noradrenaline (NA) and serotonin (5-HT), were evaluated. For the 1st experiments, the 54 subjects ranged in age from 18 to 30 years. Of these, 19 (35%) had reported premenstrual tension, depression, or somatic complaints. After a preliminary interview the Moss Menstrual Distress Questionnarie and the Eysenck Personality Inventory were completed. Each subject was subsequently seen at Day 8 before predicted menstruation and 1 day before menstruation. At each session, blood samples were taken for progesterone assay. The patients sat in a darkened room and were asked to memorize words heard from a tape recording while being given a mild electric shock. The morning after the session, subjects completed the Scale of Well-Being. Psychic difficulty shortly before menstruation was higher in 49 subjects; in 16.3% of these it was severe. Only 10.2% had a negative effect. There was a correlation between the different tests. Only in the medroxyprogesterone-treated group was there a significantly higher reaction to stress on Day 1 before menstruation than a week earlier. There were large individual variations. For studies of the effects of progesterone on NA metabolism, Sprague-Dawley rats which had been ovariectomized 3 weeks earlier, were given progesterone 20 mg/kg sc on 2 consecutive days. These animals were injected with tritiated NA intracisternally and underwent a stress procedure. 3 hours after the intracisternal injection, rats were killed and tritiated-NA and its metabolites estimated. Progesterone injections did not influence NA turnover or percentage distribution of tritiated-NA and its metabolites in unstressed rats but did increase 5-HT turnover. In stress-altered 5-HT metabolism an effect of progesterone was shown. Footshock also raised endogenous progesterone levels.
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PMID:Influence of progesterone on serotonin metabolism: a possible causal factor for mood changes. 56 84

Gynecologists and other primary care physicians have long recognized the occurrence of psychogenic factors in some patients with urinary incontinence, usually of the urgency or detrusor dyssynergia types. However, to the best of our knowledge this is the first report of psychiatric study of these patients. Eighteen patients were referred following complete gynecologic urology work-up including electronic urethrocystometry and chain cystography. Most of these patients were 40 to 60 years of age, were multiparous, and had had hysterectomies. Major psychiatric findings were a) severe situational problems in all 18 patients, b) chronic depression in 17, and c) hysterical personality traits in 10. Patients whose psychiatric treatment provided some relief of their situational and emotional distress also, concomitantly, had relief of urinary incontinence.
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PMID:Psychogenic aspects of urinary incontinence in women. 69 14

An account is given of attachment theory as a way of conceptualizing the propensity of human beings to make strong affectional bonds to particular others and of explaining the many forms of emotional distress and personality disturbance, including anxiety, anger, depression and emotional detachment, to which unwilling separation and loss give rise. Though it incorporates much psychoanalytic thinking, many of its principles derive from ethology, cognitive psychology and control theory. It conforms to the ordinary criteria of a scientific discipline. Certain common patterns of personality development, both healthy and pathological, are described in these terms, and also some of the common patterns of parenting that contribute to them.
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PMID:The making and breaking of affectional bonds. I. Aetiology and psychopathology in the light of attachment theory. An expanded version of the Fiftieth Maudsley Lecture, delivered before the Royal College of Psychiatrists, 19 November 1976. 84 68

A group of 17 Israeli soldier psychiatric casualties of the Yom Kippur war were readministered the MMPI and intensively interviewed a year after they had been discharged from a psychiatric ward. A comparison between the hospitalization and post-hospitalization MMPI profiles yielded no significant difference on any of the scales. Thus, the degree of emotional distress experienced by these veterans continues to be extraordinarily high and is characterized by extreme depression, anxiety and extensive physical complaints. The interview reports are completely consistent with the MMPI data. These data emphasize the prolonged effect of combat stress and highlight the special problems that these men face in re-entering their social community.
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PMID:Some personality characteristics of soldiers exposed to extreme war stress: a follow-up study of post-hospital adjustment. 85

The prominence of postmastectomy depression and loss of self esteem, together with its reputed relation to symbolism or sexual significance of the breasts, has been investigated. Neither could be confirmed. Forty newly diagnosed breast cancer patients were compared with 50 women with other types of cancer. Only 20 per cent of breast patients and 18 per cent of others reported the syndrome of depression, lowered self esteem, increased health concerns, and loss of energy. Peak emotional distress did occur in breast patients about two to three months after mastectomy, a finding which may be influenced by the treatment, as well as by return to regular responsibilities. Few women ascribed psychosocial problems primarily to losing their breast. While the postmastectomy syndrome is not common, the frequency of breast cancer itself means that a substantial number of women may still be affected. But other variables are better predictors or concomitants of emotional distress than are problems about damaged body image.
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PMID:The fallacy in postmastectomy depression. 86 Jul 32

The Depression Adjective Check List, State-Trait Anxiety Inventory, and a battery of factor analytically derived cognitive tests sensitive to anxiety or depression were administered to 50 women between the ages of 30 and 45 during the 4 days prior to the onset of menstruation and again 2 weeks later. Testing sessions were scheduled on the basis of a previously completed Menstrual Distress Questionnaire. There were significant increases in anxiety and depression during the premenstruum. However, no statistically significant differences were found in cognitive test performance, and correlation data failed to support any consistent relationship between premenstrual mood and cognitive function. Moreover, no significant correlations were found between premenstrual complaints on the Menstrual Distress Questionnaire and either cognitive test performance or mood scores obtained during the premenstrual testing sessions. It was concluded that the magnitude of the premenstrual mood change was not great enough to affect intellectual function. Alternative explanations of the absence of decrements in performance are discussed.
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PMID:The effect of premenstrual anxiety and depression on cognitive function. 98 38

The newly diagnosed CA patient faces psychosocial as well as physical problems. To assess the impact of diagnosis, and to find significant clues for later emotional distress, 163 new patients with CA of the breast, colon, lung, Hodgkin's disease, and malignant melanoma were evaluated by interviews, psychological testing, and personality inventories, then followed regularly for six months. Vulnerability was but one parameter that measured emotional distress and faltering capacity to cope with concurrent problems. It was found that the more vulnerable patients had more symptoms when first diagnosed, and that systemic symptoms were more significant than the type of CA or the staging. High vulnerability patients were generally pessimistic, anticipating little recovery and practically no support from significant others. They had more marital problems, tended to suppress feelings, but often had a history of depression. Denial in itself did not mean vulnerability. Indecision about treatment and regrets about the past were more indicative of future emotional problems than was delay. Most patients showed little denial throughout the period of observation, but more vulnerable patients tended to vacillate between denial and acceptance. By learning to listen and ask tactful questions, this information can be elicited by the physician who can then intervene effectively.
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PMID:Early diagnosis of vulnerability in cancer patients. 126 89

In this paper, we examine the performance of a pencil-and-paper screening questionnaire on depressive symptoms (the Center for Epidemiologic Studies Depression Scale, or CES-D) in a sample of 120 adult American Indians belonging to a single Northwest Coast tribe. Results of factor analyses suggest that somatic complaints and emotional distress are not well differentiated from each other in this population. CES-D scores (which have shown good sensitivity and specificity for depressive disorders in this sample) also show weak and apparently nonsignificant trends to be elevated in the presence of other psychiatric diagnoses (including alcoholism) or general impairment. However, because of the use of a convenience sample (rather than a probability sample), analyses of associations between study factors--including comorbidity--are liable to produce spurious results due to selection bias (including Berkson bias). On this basis, we suggest that the use of probability samples should assume a high priority in cross-cultural studies. The study of the entire population of interest is another solution to the sampling problem, particularly in small communities.
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PMID:Use of the CES-D in an American Indian village. 130 29


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