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

This article examines the effect of a series of physical and sociopsychological variables on the response shown by Parkinson patients to levodopa therapy. Of the ten major variables examined, six measure relatively enduring personality adaptations: suggestibility, passivity, self-expectations, stigma, attitudes toward illness, and the perception of the expectations of others. Four are illness-related characteristics: diagnosis (primary or secondary parkinsonism); the existence of health problems in addition to Parkinson's disease; whether or not the patient was hospitalized at the beginning of treatment; and symptom improvement as rated by the patient's physician. Age, sex, severity and duration of disease, and use of anti-Parkinson drugs in addition to levodopa were controlled in all of the analyses. The effect of levodopa therapy was assessed in four major areas: activity, social participation, depression, and enjoyment of life. Findings can be summarized as follows: Five of the six personality variables do, in fact, modify the amount of social or psychological change shown by Parkinson patients treated with levodopa. The only one which fails to have such an effect is passivity; this may reflect a measurement problem. However, only two of the four illness-related characteristics which were examined made a difference in treatment outcome: diagnosis and symptomatic improvement, as rated by the patient's physician.
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PMID:Sociopsychological factors influencing response to levodopa therapy for Parkinson's disease. 93 17

Inadequate treatment of mood (affective) disorders is related to the mind/body dualism, desinformation about methods of treatment, the stigma of psychiatry, low funding of psychiatric research, low educational priority, and slow acquisition of new knowledge of psychiatry. The "respectable minority rule" has often been accepted without regard to the international expertise, and the consequences of undertreatment have not been weighed against the benefits of optimal treatment. The risk of chronicity increases with delayed treatment, and inadequately treated affective disorders are a leading cause of suicide. During the past 20 years the increase in suicide mortality in Norway has been the second largest in the world. Severe mood disorders are often misclassified as schizophrenia or other non-affective psychoses. Atypical mood disorders, notably rapid cycling and bipolar mixed states, are often diagnosed as personality, adjustment, conduct, attention deficit, or anxiety disorders, and even mental retardation. Neuroleptic drugs may suppress the most disturbing features of mood disorders, a fact often misinterpreted as supporting the diagnosis of a schizophrenia-like disorder. Treatment with neuroleptics is not sufficient, however, and serious side effects may often occur. The consequences are too often social break-down and post-depression syndrome.
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PMID:[Inadequate treatment of affective disorders]. 141 90

Compared widowed spouses who joined (n = 40) bereavement support groups (BSGs) during the first 13 months of bereavement with those who declined to join (n = 96). Controlling for gender, age, and socioeconomic status, no differences were found for perceived levels of social support, but joiners, compared with nonjoiners, reported experiencing more stressful events and scored significantly higher on measures of depression, anger, anxiety, and subjective stress. Nonjoiners and, to a lesser extent, joiners viewed those attending groups as less self-sufficient (e.g., need help, lonely), suggesting a mildly stigmatizing image of BSGs. A dialectical model is proposed in which BSG utilization rates are seen as the product of an avoidance-avoidance conflict involving the choice between suffering emotional distress on one's own or the perceived stigma of joining a BSG. Implications for future research on participation in self-help and mutual support groups are discussed.
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PMID:Bereavement support groups: who joins; who does not; and why. 148 15

Of 63 sexual assault victims who were a mean 7.9 years postevent, almost two thirds (60%, n = 38) demonstrated some degree of depression. Over half (56%, n = 35) the sample also reported a history of childhood sexual abuse. Three factors had a significant positive association with higher levels of depression: nondisclosure of the assault to significant others due to concerns about stigma; the presence of children living with the victim; and a civil lawsuit pending. One factor, currently being sexually active, had a significant negative association with depression. Results are discussed from the perspective of depression, a common pathway by which unresolved sexual trauma is expressed.
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PMID:Factors associated with long-term depressive symptoms of sexual assault victims. 156 43

Recent work demonstrates that hearing impairment is much more common than previously suspected. The disability may be unrecognized or denied by the sufferer and may attract social stigma rather than sympathy from others. The effect on mental health is surprisingly neglected. Early studies of psychiatric patients suggested hearing impairment is an important cause of paranoid illness, but more recent studies of wider populations have failed to confirm this association. Hearing impairment is unrelated to intellect when controlled for age, but is an important differential diagnosis of dementia in the elderly. Evidence accumulates to suggest that the hearing impaired are vulnerable to depression, social stress and isolation, but reliable controlled studies of psychiatric sequelae are needed.
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PMID:Mental health and acquired hearing impairment: a review. 218 May 15

Primary care physicians in the tri-state area of Nebraska, Iowa and South Dakota were surveyed concerning their baseline practices in requesting psychiatric consultations, and their recommendations for improvement in psychiatric consultation. A two-page questionnaire was used to collect data. The information obtained was analyzed by tetrachoric correlations. Our results indicate that most primary care physicians refer patients to psychiatrists and prescribe psychotropic medications. It was generally noted that the respondents do not do psychotherapy themselves. In contrast to studies from other areas, our research showed that the symptoms which prompted psychiatric referral the most are psychosis and depression. Suggestions for improvement in psychiatric consultations included that psychiatrists need to be more available to the primary care practitioner. It was also indicated that financial constraints, social stigma and psychiatric shortage were problems in referral of patients to psychiatrists.
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PMID:Use of adult psychiatric services by primary care physicians in midwestern cities. 231 13

Despite the nearly universally shared agreement among group therapists about the importance of group norms, empirical studies have rarely demonstrated a positive relationship between specific norms in psychotherapy groups and patient benefit. The study explored this relationship by examining the linkages between norms, a specific therapeutic process, and patient outcome. Examined were seventy-two spousal bereavement groups. Subjects' responses to a thirty-one item behavioral inventory were used to define norms; outcomes were based upon Time 1/Time 2 differences on a series of eleven measures indexing depression, anxiety, somatic symptoms, abuse of psychotropic medication, coping mastery, well-being, self-esteem, target problem rating, several measures of role stress and strain, and stigma. The findings suggest that normative characteristics were linked to a process, reciprocal social exchange, that influences positive outcomes. The results are preliminary, since they only serve to demonstrate such a relationship can exist.
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PMID:Group properties and outcomes: a study of group norms in self-help groups for widows and widowers. 270 32

The psychosocial issues of homosexual men with AIDS and their significant others pose a profound nursing care challenge. The nurse's knowledge and sensitivity to these issues is necessary to meet the challenge of this patient group. Unique aspects of AIDS such as youth, stigma, contagiousness and sexual transmission, combined with neurologic complications, resultant anxiety and depression, and drug and alcohol use present a complicated array of needs to be addressed by the nurse. Crisis and existential theory frameworks are useful to apply to the nursing process when caring for patients facing a life-threatening illness. Goals such as maintenance of psychological well-being and the promotion of psychological growth can occur as the nurse assists the patient and his significant others to confront existential concerns. These concerns include death, meaning, freedom, and isolation. Providing nursing care for this patient population also has an impact on the nurse as he or she confronts mortality and sexuality. This calls for the nurse to examine his/her values and attitudes in order to provide optimal nursing care. In caring for homosexual men with AIDS and their significant others, the nurse is likely to experience personal growth. As the nurse assists the patient and his loved ones to live as they confront potential death, the nurse often gains an added appreciation of life.
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PMID:Psychosocial issues of AIDS in the nursing care of homosexual men and their significant others. 305 63

Starting from a prior study, in which cognitive and coping variables proved to be related to well-being, the use of medical resources and the absence from work in asthmatic patients, the authors constructed a cognitive-educational (a combination of health education and rational emotive behaviour modification) intervention programme aiming at altering coping behaviour in asthmatic patients in order to influence emotional distress and use of medical resources. The effects of the programme were assessed by means of a pre-test-post-test control group design. The programme was offered to ten patients and their partners. Both before and after the intervention cognitive attitudes (optimism, locus of control, and shame or stigma), coping behaviour in attack situations (minimizing the seriousness of the attack, rational action and reacting emotionally), coping in daily life (maintaining a restrictive life-style, focussing on asthma and hiding asthma), emotional distress (anxiety, anger, and depression), and the use of medication were measured in the experimental and control group. It was found that patients who received the programme became less preoccupied with their asthma and reported significantly less emotional distress (anxiety and anger) in daily life. In addition, they used less maintenance medication (corticosteroids). The authors wish to stress the importance of using medical variables such as the number of attacks as covariates in this type of research.
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PMID:Changing health behaviour outcomes in asthmatic patients: a pilot intervention study. 334 56

In China, the diagnosis of depression is made much less frequently than in the West, likely because there is a somewhat lower prevalence rate and because of other factors related to culture and to the development of Chinese psychiatry. Some of the relevant factors are: 1) depressed patients often avoid seeking help because of the stigma of mental disorder; 2) many patients seek help from practitioners of Traditional Chinese Medicine; 3) depression is often diagnosed as schizophrenia because of diagnostic criteria that are broader for schizophrenia and narrower for affective disorder than in the West; and 4) somatization is more frequent in China and many depressives receive the label "neurasthenia".
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PMID:Some issues in the diagnosis of depression in China. 365 79


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