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 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The history of psychosomatic medicine in the 20th century is predominantly marked by a concern with studies of major diseases (e.g., angina pectoris, bronchial asthma, diabetes mellitus, essential hypertension, neurodermatitis, rheumatoid arthritis, etc.). Traditional physicians also narrowly focus on disease--a trend that began with Morgagni in the 18th century. But disease (defined by structural alterations) is not the only cause of illness and disability. In fact, most persons seeking health care are ill without having a disease. It is only recently that this distinction has been fully made. The various manifestations of ill-health go by a variety of descriptive names--the functional or irritable bowel and hyperventilation syndromes, fibromyositis, psychophysiological, functional and somatoform or somatization disorders. They lead to loss of productivity, cost the health care system excessively, produce negative reactions in physicians, and are fertile ground for iatrogenic disease. They do not constitute discrete syndromes but overlap, each also being closely associated with anxiety and depression, sleep disturbances or marital disruption. They are the manifestations of sick persons not only of disturbances of bodily systems. They may be precipitated by unemployment, marital discord, bereavement, and job dissatisfaction. Curiously, ill-health has not been the major area of investigative interest of psychosomatic medicine. This presentation will emphasize why it should be, and why proper interventions may radically reduce the cost of medical care, prevent iatrogenic disease, and reduce the use of ill-advised procedures.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Some unexplored regions of psychosomatic medicine. 333 83

We studied the prevalence of sleep disturbances in 184 persons with diabetes, and 99 controls matched for age and sex. Sleep disorders were more common in diabetics (33.7% vs. 8.2% in controls; P < 0.01). Patients with sleep disturbances were younger than those with normal sleep, and had onset of diabetes at a younger age. There was a significant association of sleep disturbances with the presence of cough, dyspnea, nocturnal cramps, paresthesia and burning of soles. Sleep disturbances may be due to physical discomfort, psychosocial factors, fluctuations in metabolic control and perhaps also hypoinsulinemia. Quality of life is affected and coping with the disease is made difficult by sleep disorders. Thus, physicians caring for persons with diabetes must be able to recognize, diagnose and manage sleep disturbances in their patients, when they occur.
Diabetes Res Clin Pract 1994 Apr
PMID:Prevalence of sleep disturbances in diabetes mellitus. 792 79

Depression is a common condition in the geriatric population. A retrospective study of 30 elderly patients suffering from neurotic depression, who were admitted consecutively to a general hospital psychiatric ward, showed a predominance of females (n = 21) over males (n = 9) and young-old (65 to 74 years, n = 22) more than old-old (75 years or over, n = 8). Their ages ranged from 65 to 85 years with a mean of 71.6 years, SD 5.5 years. Co-existing physical disorders were present in every patient, the average being 1.8 per patient, and half (n = 15) had two or more physical disorders. Cardiovascular diseases (e.g. ischaemic heart disease and hypertension) and diabetes mellitus were present in about seven-eighths of the patients. The two commonest symptoms were low mood (n = 18, 60%) and vague somatic complaints inexplicable by any physical pathology (n = 19, 63%). Sleep disturbance bothered 12 patients (40%), while nine (30%) had attempted suicide. Twenty patients (67%) were prescribed antidepressants and 13 (43%) received benzodiazepines in low dosages, mainly as hypnotics. Electroconvulsive therapy was necessary for two patients with high suicidal risk. The mean duration of admission was 15.3 days, SD 12.9 days.
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PMID:Neurotic depression in the elderly. 794 52

Restless legs syndrome is characterized by unpleasant, deep-seated paresthesias in the legs and sometimes the arms. These sensations occur at rest and are relieved by movement. Sleep disturbance is common. Many patients also have periodic movements of sleep. Mild symptoms of restless legs occur in up to 5% of the population. Restless legs syndrome is idiopathic in most patients, but it may be the presenting feature of iron deficiency and is also common in uremia, pregnancy, diabetes mellitus, rheumatoid arthritis, and polyneuropathy. Treatment of the underlying cause, when possible, usually relieves the symptoms. For patients with severe symptoms, levodopa, bromocriptine mesylate, opioids, carbamazepine, clonazepam, and clonidine hydrochloride have proved to be effective.
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PMID:Restless legs syndrome. A review. 891 Dec 49

The objectives of this study were to describe the prevalence of snoring, observed apneas, and daytime sleepiness in older men and women, and to describe the relationships of these sleep disturbances to health status and cardiovascular diseases (CVD). A cross-sectional design was employed to study sleep problems, CVD, general health, psychosocial factors, and medication use. The subjects were participants in the Cardiovascular Health Study, which included 5,201 adults, aged 65 and older, who were recruited from a random sample of Medicare enrollees in four U.S. communities. Study measures employed were sleep questions, echocardiography, carotid ultrasound, resting electrocardiogram, cognitive function, cardiopulmonary symptoms and diseases, depression, independent activities of daily living (IADLs), and benzodiazepine use. Thirty-three percent of the men and 19% of the women reported loud snoring, which was less frequent in those over age 75. Snoring was positively associated with younger age, marital status, and alcohol use in men, and obesity, diabetes, and arthritis in women. Snoring was not associated, however, with cardiovascular risk factors or clinical CVD in men or women. Observed apneas were reported much less frequently (13% of men and 4% women) than snoring, and they were associated with alcohol use, chronic bronchitis, and marital status in men. Observed apneas were associated with depression and diabetes in women. In both men and women, daytime sleepiness was associated with poor health, advanced age, and IADL limitations. The conclusions of the study were that loud snoring, observed apneas, and daytime sleepiness are not associated cross-sectionally with hypertension or prevalent CVD in elderly persons.
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PMID:Prevalence and correlates of snoring and observed apneas in 5,201 older adults. 889 30

The number of patients treated with interferon (IFN) has increased markedly in Japan since 1992, when the Health and Welfare Ministry approved the use of IFN for treating chronic active hepatitis C. It is important to identify and treat depression, which is one of the psychiatric complications of IFN therapy and often leads to discontinuation of the therapy, in patients with chronic hepatitis C. In this study we prospectively investigated the incidence of depression during IFN therapy in patients with chronic active hepatitis C. The psychiatric status of 85 patients (53 men, 32 women; mean age 49.1 years) with chronic active hepatitis C who began receiving IFN at Showa University Hospital was assessed before and 2, 4, 12 and 24 weeks after the start of IFN therapy, using the major depressive episode diagnostic criteria listed in the DSM-III-R and the Hamilton Depression Scale HDS). All of the patients provided informed consent prior to participation in this study. IFN therapy was discontinued in 5 cases (5.9%) because of physical side effects and in 4 cases (4.7%) because of depression. Two, 11, 14, 25 and 16 patients were diagnosed as having major depressive episodes before and 2, 4, 12 and 24 weeks after the start of IFN therapy, respectively. The number of patients who were asymptomatic before the start of IFN therapy but were diagnosed as having a major depressive episode at least once during IFN therapy was 31 (31/83 = 37.3%). The mean HDS scores at 2, 4, 12 and 24 weeks (5.4, 6.0, 8.8 and 6.6) were significantly higher than that before the start of IFN therapy (3.0). The patients whose first diagnosed major depressive episodes occurred more than 4 weeks after the start of IFN therapy tended to be more severely depressed than those in whom it occurred less than 4 weeks after the start of IFN therapy. Compared to the 47 patients who completed 24 weeks of IFN therapy without experiencing depression, the 31 patients who were diagnosed as experiencing major depressive episodes during IFN therapy had significantly higher neuroticism scores determined using the Eysenck Personality Questionnaire, showed a more severely depressed mood and experienced more severe sleep disturbances before the start of IFN therapy. The latter group of patients also tended to have comorbid chronic physical disorders such as hypertension or diabetes mellitus and the histories of mental disorders before the IFN therapy; however these differences were not statistically significant. There were no differences between the two groups in patient age or sex, the severity of hepatitis before the IFN therapy, the type of IFN used in the therapy or the efficacy of IFN in the treatment of the hepatitis C. Our results indicate that the decision as to whether to treat chronic active hepatitis C with IFN should be made carefully and that early intervention and careful monitoring of depression are required during IFN therapy in the treatment of chronic active hepatitis C.
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PMID:[Depression during interferon therapy in chronic hepatitis C patients--a prospective study]. 913 11

Cerebrolysin is a peptide solution with free amino acids and biologically active peptides showing neurotrophic efficiency. In a placebo-controlled longitudinal study we investigated the effect of that drug for treatment of painful diabetic neuropathy in 20 type-II diabetic patients (9 women, 11 men, mean age 63 +/- 9 years, duration of diabetes 14 +/- 7 years). Patients received daily a cerebrolysin-infusion (20 ml in 500 ml Ringer) over a period of 10 days. In an age- and diabetes-duration matched placebo group of 10 type-II diabetic patients (7 women, 3 men, age 66 +/- 9 years, duration of diabetes 12 +/- 5 years) vitamin B infusion was administered (5 ml vitamin B complex in 500 ml Ringer) during 10 days. We compared a five-item symptom score scale (FIS) for pain, dysesthesia, paresthesia, nightly exacerbation, and sleep disturbances (grade 0 to 3) and a graphic visual analogue rating scale (VAS) for recording the magnitude of the pains (scale 0 to 100 mm) at the beginning and the end of the infusion therapy as well as 6 weeks later. Cerebrolysin was associated with a significant decrease in total FIS score from 8.7 +/- 1.9 at the start of therapy to 5.1 +/- 2.2 after 6 weeks (p < 0.001), and to a reduction of the VAS score from 4.2 +/- 0.8 to 2.8 +/- 0.9 (p < 0.001) during the same period of observation. In contrast in the placebo group the total FIS score decreased only from 7.9 +/- 1.2 at the beginning to 6.6 +/- 1.1 (p < 0.05) 6 weeks later and the VAS score from 4.5 +/- 0.6 to 4.0 +/- 0.5 (NS). Thus cerebrolysin led to a significant subjective improvement of painful diabetic neuropathy in type-II diabetic patients at least for a period of 6 weeks.
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PMID:[Cerebrolysin in treatment of painful diabetic neuropathy]. 917 75

Sleep disorders are common and well documented in patients with Parkinson's disease (PD). However, most data on sleep in patients with PD are derived from selected patient populations. This community-based survey evaluated the prevalence of and risk factors for sleep disturbances in an unselected group of 245 patients with PD and two control groups of similar age and sex distribution: 100 patients with another chronic disease (diabetes mellitus) and 100 healthy elderly persons. Nearly two thirds of the patients with PD reported sleep disorders, significantly more than among patients with diabetes (46%) and healthy control subjects (33%). About a third of the patients with PD rated their overall nighttime problem as moderate to severe. The most common sleep disorders reported by the patients with PD were frequent awakening (sleep fragmentation) and early awakening. Sleep initiation showed no significant difference compared with the control groups. Pain and cramps were not more prevalent among the patients with PD, but they were more likely to report sleep disturbed by myoclonic jerks. Use of sedatives was common in all three groups but significantly higher in the PD group than in the healthy elderly. Symptoms of depression and duration of levodopa treatment showed a significant correlation with sleep disorders in the PD group. This community-based study confirms that sleep disorders are common and distressing in patients with PD. The strong correlation between depression and sleep disorders in patients with PD underlines the importance of identifying and treating both conditions in these patients.
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PMID:A community-based study of sleep disorders in patients with Parkinson's disease. 982 12

A representative, prospective population sample of 1,205 7-year-old children in a larger Finnish city was followed for 15 years for headache and other medical disorders and symptoms. The comorbidity associated with headache was found to be higher than expected. Allergy and bronchial asthma, diabetes mellitus and stomachache were more common in boys than in girls, while psychiatric symptoms and sleep disturbances were more typical of girls than boys. The prevalence rate of any headache and migraine increases up to the age of 13 years, but after that age, a decline in the prevalence is found in boys, while girls show an increasing trend both in the presence and in the frequency of any headache and migraine.
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PMID:Headache in teenagers: comorbidity and prognosis. 1120 Jul 81

The circadian rhythm of melatonin secretion was measured in 20 healthy males (20 - 32 yrs.) after intake of placebo or various doses of a special extract of Agnus castus (AC: 120 - 480 mg/die) for 14 days. A significant (p < 0.05) dose-dependent increase of the area under the melatonin secretion curve (AUC) was found. The pattern of circadian rhythm of melatonin secretion was, however, not influenced. It remains to be elucidated whether the AC-stimulated increase of melatonin secretion is suitable for treatment of sleep disturbances.
Exp Clin Endocrinol Diabetes 2003 Feb
PMID:Dose-dependent stimulation of melatonin secretion after administration of Agnus castus. 1260 50


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