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 9,689 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study assesses the prevalence of psychological disturbance among a consecutive series of 120 neuro-otology outpatients, using a structured interview conducted by a clinical psychologist. 42% of all patients were found to be in need of, and were offered, psychological help (27% of those with hearing loss, 45% of those with tinnitus and 64% of those with dizziness). 86% of those offered psychological help accepted it. Current psychological distress was associated with the number of symptoms complained of and past psychiatric history. Patients completed the General Health Questionnaire which was found to have a sensitivity rate of 82% and a specificity rate of 87% in this setting. Physicians were also asked to rate patients' psychological state; close agreement was found between these ratings and those of a psychologist. The contribution of psychological assessment of neuro-otology patients is discussed.
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PMID:The prevalence of psychological disturbance in neurotology outpatients. 174 91

Somatization implies a tendency to experience and communicate psychological distress in the form of somatic symptoms and to seek medical help for them. So defined, it is neither a disorder nor a diagnostic category but a generic term for a set of experimental, cognitive, and behavioral characteristics of patients who complain of physical symptoms in the absence of relevant medical findings. Such patients are ubiquitous in all medical care settings, pose difficult diagnostic and management problems, and overutilize health care thus contributing to its cost. Somatization may be transient or persistent, and may or may not be associated with a diagnosable medical or psychiatric disorder. The most common concurrence of somatization is with affective and anxiety disorders, and, to a lesser degree, the somatoform disorders. Persistent somatization poses a serious clinical, social, and economic problem and hence early identification of potential chronic somatizers should be attempted to avoid its development. Pain, fatigue, dizziness, and dyspnea are the commonest symptoms. Etiology of somatization is multifactorial and so should be its management.
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PMID:Somatization: the experience and communication of psychological distress as somatic symptoms. 333 84

This paper provides a cross-sectional analysis of the physical and emotional well-being of employed and unemployed workers. The data used consists of a sub-sample (N = 14,313) drawn from the Canada Health Survey's national probability sample (N = 31,688). The analysis indicates substantial health differences between employed and unemployed individuals. The unemployed showed significantly higher levels of distress, greater short-term and long-term disability, reported a large number of health problems, had been patients more often, and used proportionately more health services. Consistent with these measures, derived from self-reported data, physician-diagnosed measures also indicate a greater vulnerability of unemployed individuals to serious physical ailments such as heart trouble, pain in heart and chest, high blood pressure, spells of faint-dizziness, bone-joint problems and hypertension. While these health differences between the employed and unemployed persisted across socio-economic and demographic conditions, further analysis indicated strong interaction effects of SES and demographic variables on the association of employment status with physical and emotional health. Females and older unemployed individuals reported more health problems and physician visits whereas the younger unemployed (under 40) reported more psychological distress. The blue-collar unemployed were found to be considerably more vulnerable to physical illness whereas the unemployed with professional background reported more psychological distress. The low-income unemployed who were also the principal family earners, were the most psychologically distressed. A regional look at the data showed that the low-income unemployed suffered the most in terms of depressed mood in each region of the country. It is apparent that unemployment and its health impact reflect the wider class-based inequalities of advanced industrial societies. The need for social policies that effectively reduce unemployment and the detrimental impact of unemployment is clear.
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PMID:Unemployment and health: an analysis of "Canada Health Survey" data. 387 39

1046 non-hospitalized children and mothers from various regions of Liberia were studied to determine the relationships between their indigenous perceptions of malaria illness with on-going Plasmodium parasitemia and annual incidence of clinical malaria. Eleven pediatric and 14 maternal signs and symptoms of malaria were described, ranked by cultural severity, and evaluated biomedically. Between cultural perceptions of the severity of illness and biomedical evidence of the severity of disease, significant rank order correlations are observed for children (rho = 0.713, P less than 0.01) and mothers (rho = 0.875, P less than 0.001). Clinical, parasitological and cultural concordance were observed for 'anorexia', 'joint pain', 'abdominal tenderness', 'nausea', 'chills', 'severe headache', 'stomach pain', and 'dizziness'. Five other symptoms however either over or underpredicted observed levels of biomedically confirmed malaria: 'fever', 'convulsions', 'vomiting', 'body weakness' and 'psychological distress'. Biomedical studies revealed a parasite rate among children of 68.6%, a mean annual incidence of pediatric clinical malaria of 3.12; and a mean annual incidence of maternal clinical malaria of 2.42. Clinical malaria demonstrated a very early onset among newborns and a shift in acute parasitemia to a chronic status around 2.3 years of age. A significant positive linear correlation (r = 0.75, P less than 0.01) was observed between parasitological and clinical measures of malaria in children. The indigenous perspectives on malaria and the biomedically predictive powers of various biocultural symptoms are discussed and evaluated as an integrative and valuable means of assessing the impact of malaria in an endemic region.
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PMID:Malaria in Liberian children and mothers: biocultural perceptions of illness vs clinical evidence of disease. 389 49

The term Costen's syndrome has been used in the dentomedical literature to describe a constellation of craniofacial symptoms. Since some of the same complaints have been reported in patients with "generalized" psychological distress, symptoms associated with the syndrome may not be useful in differential diagnosis of temporomandibular disorders. The present study investigated whether some somatic complaints, particularly tinnitus and dizziness, were pathognomonic in patients with chronic temporomandibular pain. Illness behavior and personality factors were studied for possible interrelationships with these symptoms. Factor analysis revealed that tinnitus and dizziness loaded on separate factors. Tinnitus loaded with nasal stuffiness, tearing, and itching of the eyelids and nose, while dizziness loaded with complaints of altered taste and smell and blurred vision. Neither was consistently related to measures of pain or to indices of illness behavior or somatic focus.
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PMID:Otalgia and aversive symptoms in temporomandibular disorders. 1052 81

This paper tests the hypothesis of an emerging or increasing female excess in general ill-health and physical symptoms, as well as psychological distress, during early to mid-adolescence. Self-reported data on general health (longstanding illness and health in the last 12 months), recent symptoms (classified as 'physical' and 'malaise') and depressive mood were obtained from a large, Scottish, school-based cohort at ages 11, 13 and 15. Generally high levels of health problems at age 11 tended to increase with age, these increases being greater for females than males, not only in respect of depression and 'malaise' symptoms, but also limiting illness, 'poor' self-rated health, headaches, stomach problems and dizziness. The consequence, by age 15, is the emergence of a female excess in general ill-health and depressive mood, and a substantial strengthening of the small excess in both 'physical' and 'malaise' symptoms already apparent at 11 years. These findings are discussed in relation to explanations for the adult female excess in poorer health, and the emergence of a female excess of depression during adolescence.
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PMID:Sex differences in health at ages 11, 13 and 15. 1243 49

The purpose of this study was to explore the effect of Chan-Chuang qigong on symptoms distress and psychological distress of breast cancer patients who underwent chemotherapy. A quasi-experimental design was adopted. Subjects were recruited from breast cancer outpatients receiving chemotherapy at an 1800-bed medical center in Taipei, Taiwan. Of these subjects, 35 were assigned to the control group and 32 to the experimental group in which Chan-Chuang qigong was administered. Assignment was not random. The instruments included a 21-item symptom distress scale and psychological distress with the symptom checklist-90-revised. Data of the symptoms and psychological distress were collected on the day before chemotherapy as baseline values, and also collected on days 8, 15 and 22 of chemotherapy. The results showed that the overall severity of symptom distress in the experimental group was significantly lower than the control group on day 22 (p < 0.05). The symptoms with significant improvement included pain, numbness, heartburn and dizziness (p < 0.05). With regard to psychological distress, the difference of overall severity between the two groups was not statistically significant (p > 0.05). However, the items of "unwillingness to live" (p < 0.05) and "hopelessness about the future" (p < 0.05) were significantly improved in the experimental group. In conclusion, Chan-Chuang qigong had the effect of attenuating the symptom distress and probably some part of the psychological distress of chemotherapy patients.
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PMID:Effects of chan-chuang qigong on improving symptom and psychological distress in chemotherapy patients. 1643 37

A prospective, open-label clinical trial was conducted for two aims: first, to evaluate the role of fluvoxamine, one of selective serotonin reuptake inhibitors, in the treatment of dizziness for the first time and to investigate its effective mechanisms. Second, to test the hypothesis that dizziness in patients without abnormal neuro-otologic findings would be induced by psychiatric disorders rather than by unnoticed neuro-otologic diseases. Nineteen patients with neuro-otologic diseases (Group I) and 22 patients in whom standard vestibular tests revealed no abnormal findings (Group II) were treated by fluvoxamine (200 mg/day) for eight weeks. Subjective handicaps due to dizziness using a questionnaire, anxiety and depressive symptoms measured with the Hospital Anxiety and Depression Scale (HADS), and stress hormones (vasopressin and cortisol) were examined before and 8 weeks after treatment. Overall, fluvoxamine decreased subjective handicaps of both Groups I and II. Fluvoxamine decreased HADS of only patients whose subjective handicaps were reduced (=responders) in both groups, suggesting that fluvoxamine was effective for dizziness via psychiatric action rather than a recovery of vestibular function through serotonergic activation. In non-responders of Group II, pre-treatment HADS was higher than in Group I non-responders and it was not decreased by the treatment, suggesting that dizziness of Group II non-responders was due to severe psychiatric disorders rather than unnoticed neuro-otologic diseases. Anxiety and depression components of HADS showed a good correlation at both pre- and post-treatment periods. No post-therapeutic decrease was observed in either vasopressin or cortisol even in responders, suggesting that dizziness was not the sole cause of stress in chronic dizziness patients. In conclusion, patients with or without physical neuro-otologic deficits who report chronic dizziness accompanied by anxiety and depression (as measured by HADS) showed improvements across a full range of subjective handicaps and psychological distress, while patients with physical neuro-otologic defects and minimal anxiety or depression did not benefit. The main causes of dizziness in patients without physical neuro-otologic findings were psychiatric disorders.
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PMID:Effects of fluvoxamine on anxiety, depression, and subjective handicaps of chronic dizziness patients with or without neuro-otologic diseases. 1821 99

The term functional somatic syndrome (FSS) refers to several related syndromes characterized chiefly by symptoms, suffering, and disability and the absence of disease-specific, demonstrable structural or functional abnormalities. Dizziness is a common symptom of FSS. Generally, clinical examination in these cases is inconclusive. The complaints of these patients usually persist until a satisfactory treatment is administered. For the treatment of cases with FSS, first, signs of underlying psychological distress should be identified during history taking. It is essential to address the psychosocial aspect in these cases from a medical point of view. Drug therapy with serotonin reuptake inhibitors is therefore prescribed. Next, psychotherapy should be introduced. The final strategy usually is to collaborate with a clinical psychologist or psychiatrist.
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PMID:[Treatment of dizziness as a symptom of functional somatic syndromes]. 1976 18

Restless legs syndrome (RLS) is a sleep-related movement disorder with a high prevalence in the general population. Patients affected by a severe form of the disorder may develop comorbidities, such as psychological distress, cognitive dysfunction and cardiovascular diseases; these patients require pharmacotherapy. Dopamine agonists represent the first line treatment for RLS patients but, if adverse events such as compulsive behaviors and augmentation occur, the pharmacological approach should be modified. Gabapentin is a GABA analogue used in the treatment of seizures and pain syndromes. This drug has an unfavorable pharmacokinetic profile; the prodrug gabapentin enacarbil was developed to overcome this limitation. Unlike oral gabapentin, gabapentin enacarbil shows no evidence of saturation and exposure to gabapentin is dose proportional. The extended release formulation of gabapentin enacarbil has the characteristics of an optimal drug therapy. Doses from 1200 to 1800 mg/day of gabapentin enacarbil appear effective in treating RLS after only a few days of treatment. The most frequently reported adverse events associated with gabapentin enacarbil are dizziness and somnolence, which are transient and of mild intensity. Further studies are required to confirm the long term efficacy and safety of gabapentin enacarbil on the symptoms of RLS.
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PMID:Gabapentin enacarbil in restless legs syndrome. 2020 Jun 91


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