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Previous research has found over-the-counter (OTC) medication use not easily predicted from physical symptom experience. The purpose of this study was to examine the relationship between older adults' use of OTC medications and mood, social, health and demographic variables. Interviews were conducted with 186 adults aged 65 to 99 years. The mood variables of anxiety and depression were measured by the Profile of Mood States. The quality and degree of intimacy in a social relationship was measured by the Emotional Bondedness Scale. OTC medication use was measured by assessing frequency of OTC medication use, the total number of categories of OTC medication used, and the use of OTC medications in response to symptoms. Subjective health appraisal, number of chronic illnesses, number of prescriptive medications, the number of symptoms experienced in the previous month, and physician-office visit frequency were recorded. OTC medication use was predicted by the total number of symptoms experienced, emotional bondedness, age, anxiety, income, cohabitation status, and the frequency of physician-office visits. The total number of symptoms experienced accounted for more variance in OTC medication use than any other variable.
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PMID:Older adults: factors that predict the use of over-the-counter medication. 175 85

100 women consecutively referred to a gynaecological clinic with premenstrual problems were prospectively assessed by daily completion of a set of visual analogue scales (VAS). The relationship of their symptoms to menstrual cycle phase was quantified by calculating the percentage change in symptom intensity between the premenstrual week and the postmenstrual week and also during menstruation itself. The results indicated that the physical symptoms of breast discomfort and swelling were more closely related to menstrual cycle phase than were the psychological symptoms of tension, irritability or lethargy and depression. Only 32 of the women showed reduction of the premenstrual psychological symptoms by 75% or more during the postmenstrual week, while the corresponding degree of physical symptom relief was recorded by 62 women. For almost half the women, adverse mental symptoms reached their peak after the onset of menstrual bleeding. Significantly fewer of the women with almost total (75% or more) relief of their psychological symptoms postmenstrually had a history of psychiatric treatment, marital breakdown, or more than three children, compared with those whose symptoms were less completely relieved. The results suggest that a large proportion of women who experience premenstrual symptoms suffer a premenstrual and/or menstrual exacerbation of problems which are present throughout the cycle and are therefore unlikely to respond to hormonal manipulation.
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PMID:The characteristics of 100 women presenting to a gynecological clinic with premenstrual complaints. 263 46

Primary fibromyalgia syndrome (PFS) is a form of connective tissue rheumatism, characterized by diffuse chronic pain in periarticular tissue, for which no organic cause can be identified. The present study examined the personal and family history, clinical and psychodynamic features of 40 PFS patients, and compared them to a matched control group of patients suffering from rheumatoid arthritis. Depression, either in the past or at present, was seen significantly more often among PFS patients that among controls. Dependence and passivity, idealization of family relationships, obsessive-compulsive personality, maladaptive response to loss, and prepain ergomania were the psychodynamic features characteristic of PFS patients. It is suggested that PFS is a well-defined disorder, in which specific premorbid, familial, and psychodynamic characteristics result in a depressive disorder which takes the form of a physical symptom: pain.
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PMID:Primary fibromyalgia syndrome--a variant of depressive disorder? 263 21

The purpose of this study was to identify factors related to daily activities of post myocardial infarction patients. Data were collected from Aug. 1 to Aug. 31, 1988 through an interview schedule lasting for about 30-60 minutes by the investigators. Tools for this study were a daily activities scale and a subjective physical symptom scale developed by the researchers, and Zung's self rating depression scale. The subjects were 45 men 18 women post myocardial infarction patients who were receiving follow up care at SNU Hospital. The data were analyzed by percentage, mean, t-test, ANOVA, the Pearson moment Correlation Coefficient test, and Cronbach's a reliability test. The results were as follows. 1. Reliability of the daily activities scale was 0.91 by Cronbach's a. In the daily activities scale, items about transfer, exercise, and job related activities were most highly rated as meaningful to the post myocardial infarction patients. 2. The average daily activities score of these patients was 3.30 (maximum point:4) all scores were high except for exercise and job related activities. 3. There was a significant difference in daily activities according to sex; men had a higher daily activities score than women (T=2.32, P less than 0.05). 4. There was a significant difference in daily activities according to job status. Subjects having a job had a higher daily activities score. 5. The lower the depression score, the higher the daily activities score (gamma=-0.5748, P less than 0.05). 6. The lower the subjective physical symptoms score, the higher the daily activities score (gamma=-0.6015, P less than 0.05).
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PMID:[A study on factors related to daily activities of post myocardial infarction patients]. 273 31

Perhaps because negative emotions are frequently expressed in physiological reactions, psychosomatic theories have often identified Neuroticism and its component traits (including anxiety, anger, and depression) as causal influences on the development of disease. These views are apparently supported by correlations between physical symptom reports and measures of Neuroticism in males. Data from 347 adult women in the Baltimore Longitudinal Study of Aging replicate this finding for total physical complaints and for most body systems. However, analyses of mortality in the literature and in the present article show no influence of Neuroticism, suggesting that symptom reporting may be biased by Neuroticism-related styles of perceiving and reporting physiological experiences. Researchers in this area are urged to employ objective measures of medical status, and to be alert to possible biases of self-selection and selective perception in interpreting associations between Neuroticism and disease.
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PMID:Neuroticism, somatic complaints, and disease: is the bark worse than the bite? 361 72

In Part I, the authors described the relationship between somatization and depression and the extent and rate of misdiagnosis of the problem of depression in primary care. A conceptual model was developed to explain the patient's selective perception and focus on the somatic manifestation of depression and the resulting misdiagnosis. In the first section, the sociocultural and childhood experience were reviewed as two major factors influencing the ability of the patient to perceive affective changes. In this second part, the authors review the influence of the developmental stage of the patient's cognitive mechanisms and the effect of the environmental systems in which the patient dwells, i.e., medical care, family and social network, work/disability and the sociopolitical institutions, on the recognition of affective, cognitive and somatic symptoms.
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PMID:Depression and somatization: a review. Part II. 646 Apr 43

It has been suggested that psychosocial (PS) factors may influence morbidity and mortality in chronically ill patients. However, investigators have not examined how PS factors affect specific medical problems in chronic peritoneal dialysis (CPD) patients. Sixty-eight patients maintained on CPD therapy were studied. PS testing included a self-rating form of patient-assessed quality of life (PaQOL), depression [Beck's Depression Inventory (BDI)], anxiety [Patient Rated Anxiety Scale (PRAS)], and assessment of physical symptoms (KDS-II). Peritonitis rates six months prior to PS assessment and six months after assessment were tabulated. The data show that during the study period patients with more than one episode of peritonitis compared to those with no episodes of peritonitis had: (1) significantly higher anxiety and physical symptom scores; (2) significantly lower PaQOL; and (3) higher depression scores, which did not reach statistical significance (p < 0.06). Whether higher peritonitis rates result in worse PS symptoms, or whether poor PS symptoms cause higher peritonitis rates needs to be determined with further investigations.
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PMID:Psychosocial factors and incidence of peritonitis. 886 1

The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) guidelines, originally developed in the United States, were translated and used to classify TMD patients on physical diagnosis (Axis I) and pain-related disability and psychologic status (Axis II) in a TMD specialty clinic in Sweden. The objectives of the study were to determine if such a translation process resulted in a clinically useful diagnostic research measure and to report initial findings when the RDC/TMD was used in cross-cultural comparisons. Findings gathered using the Swedish version of the RDC/TMD were compared with findings from a major US TMD specialty clinic that provided much of the clinical data used to formulate the original RDC/TMD. One hundred consecutive patients were enrolled in the study. Five patients with rheumatoid arthritis and 13 children or adolescents were excluded. The remaining 82 patients participating in the study comprised 64 women and 18 men. Group I (muscle) disorder was found in 76% of the patients; Group II (disc displacement) disorder was found in 32% and 39% of the patients in the right and left joints, respectively; Group III (arthralgia, arthritis, arthrosis) disorder was found in 25% and 32% of the patients in the right and left joints, respectively. Axis II assessment of psychologic status showed that 18% of patients yielded severe depression scores and 28% yielded high nonspecific physical symptom scores. Psychosocial dysfunction was observed in 13% of patients based on graded chronic pain scores. These initial results suggest that the RDC guidelines are valuable in helping to classify TMD patients and allowing multicenter and cross-cultural comparison of clinical findings.
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PMID:Comparing TMD diagnoses and clinical findings at Swedish and US TMD centers using research diagnostic criteria for temporomandibular disorders. 916 Dec 29

The nature and scope of depression and its relationship to physical symptom distress and functional status were examined in 79 women 3 to 7 months after breast cancer diagnosis. Psychiatric diagnostic criteria for depressive disorders and a depression rating scale were used to measure depression. Nine percent of the sample had depressive disorder, and 24% had elevated depressive symptoms. Women with elevated depressive symptoms had more physical symptom distress (p < .0001) and more impaired functioning (p < .0001) than subjects with depressive disorders and without depression. Multiple regression was used to examine the contribution of key variables to functional status. Two variables accounted for 35% of the variance in functional status: symptom distress (28%) and depressive symptoms (7%).
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PMID:Depressive phenomena, physical symptom distress, and functional status among women with breast cancer. 953 89

Although preliminary reports indicate that fatigue is a common symptom of human immunodeficiency virus (HIV) disease, little empirical research has focused on its prevalence or characteristics among patients with acquired immunodeficiency syndrome (AIDS). We assessed the frequency of fatigue and its medical and psychological correlates, in a cross-sectional survey of ambulatory AIDS patients. Ambulatory patients with AIDS who participated in a study of quality life (N = 427) were classified into fatigue/no fatigue groups based on their responses to fatigue items on the Memorial Symptom Assessment Scale (MSAS) and the AIDS physical symptom checklist. Self-report inventories were also administered to assess psychological distress, depressive symptoms, and overall quality of life. Medical information was elicited through clinical interview and review of medical chart. Fifty-four percent of the patients endorsed both of the fatigue items from the MSAS and the AIDS physical symptom checklists, and were classified as having fatigue. Women were significantly more likely to report fatigue than men (chi square = 5.28, df = 1, P < 0.03), and patients reporting homosexual contact as their transmission risk factor were significantly less likely to report fatigue than were patients reporting injection drug use or heterosexual contact (chi square = 5.13, df = 2, P < 0.03). The presence of fatigue was significantly associated with the number of current AIDS-related physical symptoms [t(425) = 8.00, P < 0.0001], current treatment for HIV-related medical disorders (chi square = 12.51, df = 1, P < 0.0001), anemia [t(174) = -2.35, P < 0.02], and pain (chi square = 36.36, df = 1 P < 0.0001). Patients with fatigue also had significantly poorer physical functioning ability [Karnofsky: t(422) = -6.27, P < 0.0001], as well as greater degree of overall psychological distress and lower quality of life [F(5,418) = 23.79, P < 0.0001], as measured by the Brief Symptom Inventory, Beck Depression Inventory, Beck Hopelessness Scale, Functional Living Inventory for Cancer (modified for AIDS), and the MSAS Psychological Distress Subscale. Fatigue is a common symptom in ambulatory AIDS patients and is associated with significant physical and psychological morbidity.
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PMID:Fatigue in ambulatory AIDS patients. 956 17


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