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

We examined the relationship between social discomfort and depression in a sample of 89 adults with leg amputations at two outpatient clinics. It was hypothesized that individuals who reported being uncomfortable with social contacts involving acknowledgement of their amputation or prosthesis were more prone to depression than other patients. A set of questions addressing different aspects of social discomfort demonstrated internal consistency and were used as a scale. Social discomfort was significantly correlated with scores on the Center for Epidemiologic Studies-Depression Scale depression scale (r = .41). Multiple regression analysis showed that social discomfort was a significant independent predictor of depression, after holding constant the effects of age, gender, social support, time since amputation, reason for amputation, and perceived health. These data indicate that health care professionals should view the expression of social discomfort by amputee patients as a possible "marker" for depression. Further studies are planned to develop and validate an expanded social discomfort scale.
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PMID:Social discomfort and depression in a sample of adults with leg amputations. 146 82

Internal noise related mainly to the activities and overcrowding of schools is the main source of teachers' discomfort. It causes negative feelings and generates various hindrances at work in 80.2% of women and 67% of men. for a substantial part of the teachers' milieu (42.1% of women and 32.3% of men), noise is the dominant element among the whole complex of adverse professional factors. In schools with a higher noise level, the number of teachers assessing negatively the acoustic climate of schools increases, and the intensity of discomfort is enhanced. This is associated with awareness of excessive vocal effort, as well as with intensification of discomfort symptoms and of negative emotions. The group of teachers working under more adverse acoustic conditions is characterized by higher incidence of irritation states, deconcentration of attention, sleepiness, tiredness, depression and headaches. Moreover, there are symptoms on the part of the cardio-vascular, upper respiratory and digestive system, as well as signs of neurosis. Some of these health problems are intensified in smokers.
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PMID:[Evaluation of school noise by teachers and assessment of its effect on health and general feeling]. 147 Aug 67

Within the framework of family typology, the therapist can organize and orient his own observations, by confronting the characteristics of a particular family system, with the models of a "shared reality". Structural and organizational analysis of the family system, according to a general typology, can also be useful when the therapist has to deal with a defined and a not specific symptom or disease, and when a differential diagnosis is necessary for its pragmatic effects. This is often the case of hysteria, which according to many authors can show today various, confused shapes, as depression, general existential discomfort, anorexia and bulimia, and forms of exhibited addition. The authors present a clinical case, trying to point out how a "typology-oriented" observation of the family system, allowed the therapists to clarify an individual condition, otherwise difficult to understand.
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PMID:Hysterical personality and family: a clinical case. 147 62

Administering intravenous sedation in conjunction with intraoperative monitoring to cataract surgery patients is a widely accepted technique. Numerous articles report local sedation techniques for cataract surgery that are, in essence, abbreviated general anesthetic techniques for insertion of the retrobulbar block (RBB). Because of variations in levels of consciousness, a number of complications have been encountered with this specific patient population, ie, movement upon insertion of the RBB, intraoperative patient movement, confusion, hypotension, respiratory depression, and respiratory arrest. In an attempt to meet the specific needs of this patient population, a study comparing propofol-fentanyl with midazolam-fentanyl was initiated. Seventy-five (ASA 1 to 3) patients were randomly assigned to two groups: propofol-fentanyl (P/F) or midazolam-fentanyl (M/F). The mean age of patients in the P/F group was 71.1 +/- 13 SD, and the mean age in the M/F group was 74.4 +/- 8.8 SD. All patients entered the operating room unpremedicated. Before the RBB, patients in both groups were given a single intravenous dose of 50 micrograms fentanyl. Propofol (mean dose, 24.7 mg) or midazolam (mean dose, 1.58 mg) was then titrated to slurred speech or nystagmus. Patients' responses to the RBB were evaluated and recorded by an objective observer. The amnestic properties of both agents were evaluated by patient questioning at 10 minutes and 24 hours. Levels of discomfort were evaluated on a scale of 1 to 5, with 1 being extremely uncomfortable and 5 being noticeable without pain. Respiratory depressant effects of both techniques was assessed via continuous pulse oximetry. Results were analyzed using the chi 2 test, rank t test, and SD.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Propofol-fentanyl versus midazolam-fentanyl: a comparative study of local sedation techniques for cataract surgery. 147 88

Persons undergoing colostomy surgery face body mutilation and some loss of body function, which in turn causes their concept of self to change. Although nurses use physical and behavioral indicators as bases for assessment, planning, and evaluation of nursing intervention, only minimal empiric data is available on the physical and behavioral indicators of self-concept changes (e.g., lack of participation in self-care, depression, anxiety, fear of social rejection) among these patients. This study is a beginning in the description of the self-concept changes with time of the patient with a colostomy. The purpose of this study was twofold: (1) to begin the description of the postoperative behavioral indicators of cancer patients with colostomies according to Erikson's stages of trust and autonomy at 4 and 12 weeks after operation; and (2) to measure several indexes of psychosocial discomfort anticipated by patients before colostomy operations and them measurements with measurements of psychosocial discomfort at 4 and 12 weeks after operation. The study design incorporated three serial assessments. Each consenting subject was interviewed once before the operation and twice after (at 4 and 12 weeks). The study sample consisted of 12 subjects who had colostomy operations for cancer. Ages ranged from 41 to 74 years, with a mean age of 59.4 years. Results show an increase in trust, from a mean of 203.6 at 4 weeks to a mean of 221.7 at 12 weeks. Autonomy scores decreased, from 146.2 at 4 weeks to 143.9 at 12 weeks. Psychosocial discomfort decreased from 25.7 before to 22.1 4 weeks after and 8.0 12 weeks for operation.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Self-image changes with time in the cancer patient with a colostomy after operation. 148 14

Hormones are partial determinants of certain sexually dimorphic behaviors and interact with psychosocial, environmental, and other physiologic factors. The part played by sex hormones in the direct control of overt human behavior is, compared with that found in lower animals, slight and less readily definable. In humans, these hormones, although necessary for maintenance of libido and sexual behavior, seem to control the intensity of such behavior rather than its direction. In most women of reproductive age, the different phases of the menstrual cycle are not associated with major physical or psychologic discomfort. Some women actually report positive changes during the premenstrual period. Only 5-10% of women in this age group have changes in mood, sleep, eating habits, level of energy, and physical symptoms that appear to be linked temporally to the late-luteal phase of the cycle. It is plausible to assume that women with LLPDD are vulnerable to the menstrual cycle as a Zeitgeber. In these women, a cascade of events triggered originally along the HPG axis brings about the shift from an existing vulnerability to the actual manifestations of LLPDD and other forms of female-specific mood disorders. The degree of vulnerability becomes apparent at puberty when girls are exposed to increasing estrogenic influences. Particularly vulnerable times are the periods that mark shifts in the reproductive stages (menarche, the premenstruum, puerperium, and menopause), periods associated with major hormonal turmoil and psychosocial stresses. A conditioning-sensitization model has been described to explain the longitudinal course of affective disorders, and it also has been proposed for PMS. According to this model, even low levels of psychosocial stress are capable of triggering episodes of dysphoria in vulnerable previously sensitized subjects. LLPDD is associated strongly with a lifetime diagnosis of major depression, and the concurrent comorbidity in these women is also high. Future epidemiologic studies on depression should consider the effects of female-specific Zeitgeber on mood disorders in the populations studied.
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PMID:Female-specific mood disorders. 152 88

104 women, between the ages of 18 and 45 years, were surveyed to investigate the relationship between premenstrual symptomatology, as measured by the Modified Menstrual Distress Questionnaire, and irrational thinking, as measured by the General Attitude and Belief Scale. The women who reported greater premenstrual symptomatology also reported significantly higher scores in the "need for comfort" irrationality subscale. This indicated that these women had particular difficulty dealing with hassles and the resulting feelings of tension and irritability in the premenstruum. It was suggested that the absence of significant effects for other rationality-irrationality subscales could be associated with testing at different times during the menstrual cycle. Irrationality, like other conditions (such as anxiety and depression) prevalent in the premenstruum, could change in intensity across phases of the menstrual cycle.
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PMID:Premenstrual symptoms: the role of irrational thinking. 152 64

This study examined psychologic distress and immune function in patients with chronic-progressive multiple sclerosis participating in a placebo-control trial of cyclosporine. Immune measures included percentages and absolute numbers of CD2+, CD4+, CD8+, Leu-11-b+, HLA-DR (IA+), and transferrin-receptor-positive cells, which were evaluated by immunofluorescence using monoclonal antibodies. Distress was measured with self-report scales. The Expanded Disability Status Scale assessed neurologic disability. Subjects were followed up for 2 years, and their high-depressed and low-depressed times were compared. Times of greater depression were associated with lower CD8+ cell numbers and CD8+%, and a higher CD4/CD8 ratio. CD4+ cell numbers and percent were also higher when subjects were depressed, but only in the placebo group. There were no differences in Expanded Disability Status Scale when subjects were more depressed. Evaluation of a single subject revealed that Ia+ and transferrin-receptor-positive lymphocytes increased 3 months before distress increased. It was concluded that distress is associated with immune dysregulation in multiple sclerosis, although the mechanisms of this association have yet to be delineated.
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PMID:A prospective study of depression and immune dysregulation in multiple sclerosis. 153 25

The HRSD, HRSA, SCL-90 scales were psychometrically investigated in a cross-national sample of patients with varieties of non-psychotic symptoms of anxiety and depression. Across the cultural backgrounds the scores obtained from the original versions of these scales are not sufficient statistics. However, latent structure analysis has identified homogeneous subscales for depression (the HRSD) and for discomfort (an SCL subscale). High concurrent validity was found between the subscales of depression, anxiety and discomfort. In international research, inhomogeneity among scale items can be confounded with group differences which are usually ascribed to drug differences.
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PMID:The Hamilton scales and the Hopkins Symptom Checklist (SCL-90). A cross-national validity study in patients with panic disorders. 152 Nov 18

This study investigated the relationship between several aspects of memory self-report, objective memory, attitude toward intellectual aging, self-rated health, and self-rated depression in young and older adults. Participants completed a self-report depression scale, and then rated their discomfort with eight categories of everyday forgetting and their attitudes toward intellectual aging. One week later, they rated how frequently they experience the same categories of forgetting, and then completed a battery of objective memory tests analogous to those categories. Ten days later, they rated their willingness to participate in both memory improvement classes and nonmemory classes. Older adults reported significantly more frequent failures but less discomfort with the failures than the young adults. Frequency, discomfort, and self-reported depression were all positively correlated in the older group, but not the young group. Young and old adults were equally positive about participating in memory classes, which both age groups preferred to nonmemory classes; the correlation between willingness to participate in memory classes and objective memory approached significance in the young, but not in the old. Attitude toward intellectual aging was correlated with frequency of and discomfort with forgetting in the older group.
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PMID:Dimensions of self-report about everyday memory in young and older adults. 160 18


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