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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The lifetime prevalence of psychiatric illness was determined in 114 patients with diabetes mellitus (types I and II) who were selected randomly from patients undergoing diabetes evaluations at a large medical center. The relationship of psychiatric illness to diabetic control was studied using glycosylated hemoglobin (HbA1) and self-report measures of metabolic symptoms. Seventy-one percent of the patients had a lifetime history of at least one criteria-defined psychiatric illness; affective and anxiety disorders were the most common diagnoses. A significant difference (p = .02) in mean glycosylated hemoglobin levels was observed comparing patients with a recent psychiatric illness (mean = 10.8%) to those never psychiatrically ill (mean = 9.6%). These psychiatrically ill patients also reported more symptoms of poor metabolic control and more distress associated with these symptoms than did patients never psychiatrically ill (p less than .0001 for both). The overall report of diabetes symptoms was unrelated to HbA1 (p = .25) and was influenced primarily by the recent presence of psychiatric disorder (p less than .0001). We conclude that emotional illness is associated with both poorer metabolic control and the increased report of clinical symptoms of diabetes.
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PMID:Psychiatric illness in diabetes mellitus. Relationship to symptoms and glucose control. 378 41

In routine clinical practice and in research interviews like the Diagnostic Interview Schedule (DIS), symptoms attributed to physical illness are excluded from contributing positively toward psychiatric diagnoses. The maximal rate of underdiagnosis which results from this diagnostic rule was determined in 114 patients with diabetes mellitus. When symptoms attributed to diabetes (total = 296, mean = 2.6 per patient) were discounted, 256 diagnoses were made. Eighteen additional diagnoses (a 6.7% increase) were appreciated when these excluded symptoms were considered as psychiatrically significant; however, only two of these new diagnoses were given to patients previously without a psychiatric diagnosis. The authors concluded that the DIS is sensitive in its detection of psychiatric illness in diabetes and perhaps other physical illnesses as well.
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PMID:Use of the Diagnostic Interview Schedule in patients with diabetes mellitus. 378 42

The aims of this study were to determine the prognosis for women with different symptoms and signs indicating ischaemic heart disease and to relate entry characteristics to events of ischaemic heart disease and stroke, and to overall mortality during a 12-year follow-up period. A prospective cohort study was started as a cross-sectional investigation in 1968-69 (1462 participants aged 38-60, participation rate 90.1%). The same sample was re-studied in 1980-81 (1154 participants, participation rate 78.9% of those studied in 1968-69). In addition, a clinical series comprising all women of similar age in Gothenburg with myocardial infarction during the years 1968-70 (47 women) was followed up for 12 years. The 12-year overall mortality rate for women with initial myocardial infarction in the clinical series was 45%. The 12-year overall mortality rates for women who at the time of the initial study either were considered to have angina pectoris or showed electrocardiographic changes indicating ischaemic heart disease at rest or at work were 10%, 17% and 10% respectively (expected figures 7%, 12% and 10%). Twenty-three women (1.6%) developed myocardial infarction during the follow-up period (8 fatal, 15 non-fatal). New symptoms of angina pectoris were recorded in 56 women (4.0%), new electrocardiographic changes indicating ischaemic heart disease in 73 women (6.0%), and new signs of stroke in 13 women (0.9%). Altogether 75 women (5.1%) died during the follow-up period. These five end-points were taken into consideration. Women with previously untreated arterial hypertension were offered control visits during the follow-up period and were prescribed antihypertensive drugs when clinically indicated. In this group of women, hypertension was not a predictor for any of the end-points. No other systematic intervention was carried out. Increased abdominal adiposity, increased serum triglycerides and low peak expiratory flow were independent predictors of at least three of the end-points studied: myocardial infarction, stroke and death. Increased abdominal adiposity was also an independent predictor of angina pectoris. Initial diabetes was an independent predictor of both myocardial infarction and of death. Low energy intake predicted myocardial infarction and electrocardiographic changes indicating ischaemic heart disease. High serum gastrin levels predicted myocardial infarction. Low education and high degree of mental disorder were independent predictors of angina pectoris. Physical inactivity at leisure and physical inactivity at work were independent predictors of stroke and of death, respectively.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Ischaemic heart disease, stroke and total mortality in women--results from a prospective population study in Gothenburg, Sweden. 387 72

Health economics research has shown pharmaceutical therapy to be a highly cost-effective modality of care in a variety of disease states. Specific examples include vaccines and products aimed at the treatment of infectious disease, mental illness, gastrointestinal disorders, diabetes, and cancer. A review of the characteristics of mitomycin (Mutamycin) for injection therapy and of patients with superficial bladder cancer facilitates examining mitomycin from the standpoint of cost effectiveness. Third-party payment programs, including Medicare and Medicaid, often provide coverage for intravesical chemotherapy for superficial bladder cancer. Methods for obtaining reimbursement for therapy associated with the management and treatment of superficial bladder cancer are suggested. Finally, the total cost of intravesical therapy is examined. Issues such as the cost of surgery and chemotherapy are discussed, as well as the importance of weighing intangible factors, such as lost work time, productivity, and social costs, into the sum of total cost of care.
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PMID:Economic aspects of treatment of superficial bladder cancer. 393 29

School-aged children with newly diagnosed insulin-dependent diabetes mellitus (IDDM) were studied longitudinally in order to document how they adjusted to the medical illness and to assess salient background factors. The extent of life stress and the prevalence of psychiatric disorders that predated the IDDM were within normative ranges, and there was no characteristic preexisting "diabetic personality." The initial strain of living with IDDM elicited two general modes of coping. The prototypical and subdued reaction (seen in 64% of the children) consisted of mild sadness, anxiety, feeling of friendlessness, and social withdrawal. The rest of the children (36%) exhibited reactions that met criteria for a psychiatric disorder; depressive syndromes were the most common presentations. Anamnestic factors and the parents' initial responses to their children's IDDM were unrelated to how the children themselves coped. However, psychiatrically diagnosable reactions were more likely among children whose parents were of low socioeconomic status and had marital distress. Coping with the diagnosis and the early impact of IDDM took no more than 7 to 9 months, no matter how severe the child's response was initially.
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PMID:Initial coping responses and psychosocial characteristics of children with insulin-dependent diabetes mellitus. 399 26

A survey of the health and psychosocial problems of all victims of the 1983 South Australian Ash Wednesday Bushfires was carried out 12 months after the disaster. A total of 1526 victims completed an extensive questionnaire that included the 28-item General Health Questionnaire and a self-reporting check-list of specific health problems. The data received indicated a significant increase in stress-related conditions, including hypertension, gastrointestinal disorders, diabetes, and mental illness, while the prevalence of nonstress-related conditions such as cancer or urological disease were not increased significantly. Health problems increased during the 12 months following the bushfire and diminished toward the end of that period, but a large number of difficulties remained. Certain disaster experiences, particularly the type of loss suffered, were found to be significantly related to health.
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PMID:Some health consequences of a natural disaster. 403 86

The presence of sexual dysfunction was studied comparatively in 80 insulin treated diabetic women, 26-45 years of age, and in an age-matched control group of women without chronic somatic disease or psychiatric illness. We found no significant difference in the incidence of sexual dysfunction between the two groups (27.5% and 25% respectively). In diabetics and controls, the most common symptom of sexual dysfunction was reduced libido (22.5% in both groups) while only 18% complained of orgasmic dysfunction. In diabetics, sexual dysfunction was not correlated to age and diabetes duration. Sexual dysfunction was correlated to peripheral neuropathy but not to retinopathy, nephropathy, reduced beat-to-beat variation, regulation quality, insulin treatment and age at diabetes onset. Nearly half the patients reporting sexual dysfunction were without any late diabetic complications, indicating the influence of psychosocial factors. Somatopsychic reactions (emotional reactions to somatic disease) seem to be of relevance, although diabetic women may have less problems in this area than diabetic men. A better acceptance of the disease might partly explain the difference in sexual complications between diabetic males and females. Diabetic women and their partners should be offered, at least once a year, the possibility to discuss interpersonal relationships and the emotional aspects of living with diabetes. Most sexual problems should be handled in the diabetes clinic and only selected cases referred for sex therapy.
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PMID:Sexual dysfunction in younger insulin-treated diabetic females. A comparative study. 407 8

The total population of 11,865 children of compulsory school age resident on the Isle of Wight was studied to determine the prevalence of epilepsy, cerebral palsy, and other neurological disorders. With the use of reliable methods, children selected from screening of the total population were individually studied by means of parental interviews and questionaries, neurological examination and psychiatric assessment of each child, information from school teachers, and perusal of the records of hospitals and other agencies. The association between organic brain dysfunction and psychiatric disorder was studied by comparing the findings in the children with epilepsy or with lesions above the brain stem (cerebral palsy and similar disorders) with those in (1) a random sample of the general population, (2) children with lesions below the brain stem (for example, muscular dystrophy or paralyses following poliomyelitis), and (3) children with other chronic physical handicaps not involving the nervous system (for example, asthma, heart disease, or diabetes).Psychiatric disorders in children with neuro-epileptic conditions were five times as common as in the general population and three times as common as in children with chronic physical handicaps not involving the brain. It was concluded, on the basis of a study of factors associated with psychiatric disorder, that the high rate of psychiatric disorder in the neuro-epileptic children was due to the presence of organic brain dysfunction rather than just the existence of a physical handicap (though this also played a part). However, organic brain dysfunction was not associated with any specific type of disorder. Within the neuro-epileptic group the neurological features and the type of fit, intellectual/educational factors, and socio-familial factors all interacted in the development of psychiatric disorder.
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PMID:Organic brain dysfunction and child psychiatric disorder. 423 74

Two groups of epileptic children, one newly diagnosed and one with chronic epilepsy, were compared with two comparable groups of diabetic children and with children in the general population in order to investigate the development of psychiatric disorder. The results confirm previous findings that children with chronic epilepsy are significantly more disturbed than children with chronic physical illness not involving the central nervous system, and than children in the general population. Children with newly diagnosed epilepsy were also significantly more disturbed than those with newly diagnosed diabetes, and than children in the general population. The rate of psychiatric disturbance was similar in the two groups of epileptic children. In both groups of epileptic children, those with focal EEG abnormalities and/or complex partial seizures were particularly vulnerable to psychiatric disturbance.
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PMID:The development of psychiatric disorder among schoolchildren with epilepsy. 642 43

This article updates progress and results to date in the Oxford Family Planning Association contraceptive study. This study involves over 17,000 women recruited at clinics in England and Scotland in 1968-74 who have been followed since then. At entry to the study, 56.6% of subjects were oral contraceptive (OC) users, 24.8% were diaphragm users, and 18.6% were IUD users. By the end of 1983, 192,000 woman-years of observation had been collected. Over 4000 women currently have at least 8 years of OC use, providing opportunities for a study of longterm and delayed effects of this contraceptive method. The data suggest changing patterns of contraceptive use over time, with a decline in OC use and a rise in the use of sterilization as subjects have aged. Progestogen-only OCs are moderately popular across the age range, but combined OCs are rarely use past the age of 40 years. Although the study was originally concerned with the risks and benefits of OC use, it has contributed to knowledge about the effects of a wide variety of contraceptive methods. In addition, it has been possible to analyze the influence of factors such as age, parity, social class, and motivation on contraceptive efficacy. 33 individual publications (listed and annotated in the article) have emerged from the study. Work is currently underway on factors affecting fertility, psychiatric illness in users of different methods, patterns of cervical cytology in women with neoplasia of the cervix uteri, the effectiveness of IUDs in women with arthritis, and the realtionship between OC use and chronic inflammatory bowel disease. Future research will focus on the delayed effects of OCs on major chronic diseases such as cancer, coronary heart disease, and diabetes. The study is funded through mid-1989.
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PMID:The Oxford-Family Planning Association contraceptive study. 650 57


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