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

Pain is both a sensory and an emotional experience. In a multidisciplinary pain management clinic for a geriatric population, pain and mood have been assessed prior to the initiation of management in 49 of 100 referred patients. Patients have been assessed clinically, for psychological disability using the profile of mood states (POMS) and a visual analogue scale for mood, for pain using the McGill pain questionnaire (short form), word descriptor scale and visual analogue scale and for activities of daily living (ADL) using the Disability and Impairment Interview Schedule and the Rapid Disability Rating Scale -2. All testing has followed initial screening to exclude dementia. For the group assessed by psychometric measures, median age was 75 years (range 56 to 91); 41 were female. Major pathologies were degenerative musculoskeletal disease (15), post-herpetic neuralgia (9), and psychiatric conditions (7). Intra-test item correlations were found to be significant for the McGill questionnaire and the POMS. Inter-test correlations were observed for pain measures (McGill present pain intensity with VAS pain, r = 0.67; with word descriptor, 0.64; p less than 0.001), for ADL measures (r = 0.53, p less than 0.001) and for measures of mood (VAS mood with POMS (depression), r = 0.45; p less than 0.001; with POMS (anxiety), r = 0.35; p less than 0.01. There was no significant correlation between measures of mood and pain on the McGill scale. The data to this time support the view that standard psychometric tools can be used reliably to evaluate pain, mood and activity in this population. Furthermore, it appears that mood and pain may be measured separately.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Can psychometric tools be used to analyse pain in a geriatric population? 264 22

During 1986, approximately 2000 women in Australia are likely to relinquish a baby for adoption. A study is presented of 20 relinquishing mothers that demonstrates a very high incidence of pathological grief reactions which have failed to resolve although many years have elapsed since the relinquishment. This group had abnormally high scores for depression and psychosomatic symptoms on the Middlesex Hospital questionnaire. Factors that militate against the resolution of grief after relinquishment are discussed. Guidelines for the medical profession that are aimed at preventing psychological disability in relinquishing mothers are outlined.
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PMID:Psychological disability in women who relinquish a baby for adoption. 394 98

The majority of elderly adults negotiate late life free from significant psychological disability. However, depression is one of the most common and distressing mental health problems they face. A number of factors associated with mental health, illness and depression in older adults is reviewed. In addition, an overview of selected psychological and biological theories related to depression are presented with the focus on genetic studies and the neurobiologic nature of stress to demonstrate the interaction between brain, behavior, cognition, and emotion. Psychiatric mental health nurses are challenged not only to examine the complex interaction between physical, mental, and social factors, but to integrate this knowledge into the discipline of psychiatric-mental health nursing, its practice, research, and education.
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PMID:Mental illness in late life: the neurobiology of depression. 762 69

Asthma is a common but neglected problem in older people, the impact of which is relatively unstudied. The aim of this study was to objectively assess quality of life and depression in older asthmatics. The subjects studied were 50 hospitalized known asthmatics, over 55 yrs of age (mean age 72 yrs). Of these, 40 had objective evidence of asthma, and were compared to 40 age- and sex-matched controls. Using a structured questionnaire, the Geriatric Depression Score, subjective health status (short form (SF)-36), and other comparative disability data were recorded. Spirometric results were also recorded. Depressive symptoms were common in both groups but were not significantly different. Mean SF-36 scores were significantly worse in the asthmatics, especially for components of physical function (p = 0.04), physical role limitation (p = 0.01), energy (p = 0.01), health change (p = 0.01), and general health perception (p = 0.01). However mental, mental role and social scores were similar in both groups. We conclude that quality of life is impaired in hospitalized asthmatics compared to controls. Physical components appear to be most adversely affected. Depressive symptoms are common but no overall difference was found for psychological disability. Older asthmatics appear to adapt well to adverse situations.
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PMID:A hospital-based case-control study of quality of life in older asthmatics. 904 29

Depression is the most common, serious psychological disability presenting to general practitioners. Its prevalence varies from 0.6 to 36% of GP encounters depending on the method of diagnosis. Apart from methodological differences, some of this variability relates to barriers in the diagnostic process. These include 'doctor barriers' both personal and professional, 'consultation barriers', and real or perceived 'patient barriers'. Education and training of GPs to recognise and manage depression in all its guises is only one way of overcoming these barriers. Other ways include raising community awareness through public health campaigns and raising patient and doctor awareness by screening for depression in the course of seemingly unrelated consultations in 'at risk patients'. As 95% of depression is capable of being managed in general practice, GPs will need to be more active in this field to reduce the considerable burden of morbidity and mortality attributed to this condition.
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PMID:Depression in general practice. 919 60

Psychological factors are important in the chronification and aggravation of headaches. We studied 90 patients suffering from migraine, chronic daily headache (CDH) evolved from migraine, and episodic or chronic tension-type headache (TTH). Emotional, cognitive, and behavioral pain coping were assessed using the Kiel Pain Inventory (KPI), Beck's Depression Inventory, the State-Trait-Anxiety Inventory, and Quality of Life Questionnaire. In addition, the clinical course of headache was analyzed using a validated headache diary. The results were as follows. Firstly, the KPI is reliable internally for the assessment of pain-coping strategy employment among headache patients. Secondly, migraine sufferers were characterized by pronounced psychological abnormalities during the headache phase, demonstrating a less adaptive coping behavior. This was in contrast to the TTH patients, who showed more general distress manifesting in elevated anxiety and lower quality of life. The only factor which appeared to be essential for differentiating between migraine and TTH was the intensity of headache. Thirdly, chronic TTH and CDH evolved from migraine demonstrated more pronounced psychological disabilities and more severe clinical courses of headaches than episodic TTH or nontransformed migraine. The predictor variable for transformation of migraine was impairment of well-being/quality of life, and for transformation of TTH, the frequency of headaches and depression. Finally, analgesic misuse seems to be less important for chronification and transformation of headaches than the degree of psychological disability. This study draws attention to the role of psychological factors in the chronification of TTH and transformation of migraine and provides some recommendations for the behavioral treatment of chronic headaches.
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PMID:Coping styles of headache sufferers. 1023 58

The clinical diagnosis of stomatological disease may indicate its cause and prognosis; however, it says little about the resulting level of impairment from the patient's perspective. The primary objective of this study was to test whether patients attending an outpatient oral medicine clinic would have worse oral health related quality of life (OHR-QoL) compared with the general population. In addition, we aimed to assess whether anxiety or depression could be predicted by OHR-QoL and to explore the relationship between clinical diagnoses, OHR-QoL and anxiety/depression. Data were collected from patients (n = 97) through face-to-face interviews using the Oral Health Impact Profile Short form (OHIP-14) to measure OHR-QoL, the Hospital Anxiety and Depression Scale (HADS) for psychiatric morbidity, and a visual analogue scale for self-rated general health. Age- and sex-matched controls (n = 388) were provided from a normative data set collected in a UK national survey in 1998. Participants had significantly lower OHR-QoL scores than the general population on all domains and overall OHR-QoL scores. Of the variance in anxiety, 55% was predicted by general health ratings and OHR-QoL domains of 'psychological discomfort' and 'psychological disability'. Of the variance in depression, 54% was predicted by general health ratings and OHR-QoL domains of 'functional limitation' and 'social disability'. Patient centred, routine assessment of OHR-QoL provides an additional dimension that may help to improve awareness of the impact of disease on the individual's life and enhance the clinical decision-making process.
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PMID:The impact of stomatological disease on oral health-related quality of life. 1288 94

Acne vulgaris is a distressing skin condition which can carry with it significant psychological disability. Patients with acne are more likely to experience anger and are at increased risk of depression, anxiety, suicidal ideation. Certain nutrients which have been implicated as influencing the pathophysiology of acne have also been identified as important mediators of human cognition, behavior and emotions. Zinc, folic acid, selenium, chromium and omega-3 fatty acids are all examples of nutrients which have been shown to influence depression, anger and/or anxiety. These same nutrients, along with systemic oxidative stress and an altered intestinal microflora have been implicated in acne vulgaris. It is our contention that certain nutritional factors, a weakened antioxidant defense system and altered intestinal microflora may interplay to increase the risk of psychological sequelae in acne vulgaris.
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PMID:Acne vulgaris: nutritional factors may be influencing psychological sequelae. 1744 7

Acne vulgaris is a common skin condition, one that is associated with significant psychological disability. The psychological impairments in acne include higher rates of depression, anxiety, anger and suicidal thoughts. Despite a paucity of clinical research, patients with skin conditions and/or mental health disorders are frequent consumers of dietary supplements. An overlap may exist between nutrients that potentially have both anti-acne and mood regulating properties; examples include omega-3 fatty acids from fish oil, chromium, zinc and selenium. Here we report on five cases of acne treated with eicosapentaenoic acid and antioxidant nutrients. Self-administration of these nutrients may have improved inflammatory acne lesions and global aspects of well-being; the observations suggest a need for controlled trials.
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PMID:Acne vulgaris, mental health and omega-3 fatty acids: a report of cases. 1885 33

The Sleep and Pain Diathesis (SAPD) Model predicts that sleep quality is related to Fibromylagia (FM) outcomes such as disability and depression and that these relationships are mediated by both pain and impaired emotional dysregulation. The purpose of this paper is to provide a preliminary test of this model using cross-sectional data. 35 adult women, who had been living with FM for an average of 13 years, completed a battery of questionnaires that included reports of pain, sleep, affect, and disability. Consistent with this model, FM patients who reported more disrupted sleep also reported higher levels of psychological disability (i.e., BDI depression symptoms) and physical disability. Moreover, the trajectory of the relationship between sleep and pain appears to be mediated by cognitive processes such as increased pain helplessness and, thus, the relationship between sleep and disability appears to be mediated via pain. These data are consistent with the SAPD model, and lend support for the need to include sleep related factors as a critical contributor to our understanding of FM.
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PMID:Evaluating Evidence for the Role of Sleep in Fibromyalgia: A Test of the Sleep and Pain Diathesis Model. 2450 33


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