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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The purposes of this study were: (1) to test the usefulness of intensive design in detecting the effects of an established antianxiety agent in a single patient studied for a period as brief as 8 weeks and (2) to explore the usefulness of combining intensive and extensive designs by jointly analyzing the results from several similarly treated patients. Fifteen primarily anxious, psychoneurotic patients aged 21-50 and scoring 17 or more on the Taylor Manifest Anxiety Scale were admitted to the study; and 11 completed the full treatment program. Medications were diazepam 5 mg t.i.d. and a matching placebo, administered under double-blind conditions. Patients were treated for 8 weeks, divided into 42-week blocks. In each block, the patient received diazepam 1 week and placebo the other, with the order in each block determined at random. The patient came weekly for evaluation, including, self-ratings on the Hopkins Symptom Checklist (SCL), global status, global change; reports of occupational and social function; resting pulse; reaction time; psychiatrist's ratings on the Hamilton Anxiety Scale, global status and global change. The patient also reported daily his mood on the Profile of Mood States (POMS). Mean deviations from the general trend for post-diazepam and postplacebo scores on each criterion were compared within patients. Diazepam-placebo differences on each criterion were analyzed between patients. Criteria that clearly recorded the anti-anxiety effect of diazepam as compared to placebo included the Hamilton Anxiety Scale, the psychiatrist's global status and global change ratings, the SCL Anxiety and Somatization Scales, and the POMS Anxiety Scale. Other criteria that showed a reliable diazepam effect included SCL Depression (decrease), POMS Vigor (increase), POMS Fatigue (decrease), SCL Anger (increase), and reaction time (increase). The most sensitive criteria distinguished diazepam from placebo even when results were considered only from the first 6 patients during their first 4 weeks of treatment- a total of 24 patient weeks of treatment. The factors contributing to the sensitivity of this design were investigated and discussed.
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PMID:Intensive design in evaluating anxiolytic agents. 1 97

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 study assessed the psychometric properties of a set of nine commonly used lists in an English-speaking Hispanic sample taken from a primary care setting. Those were the General Health Questionnaire-12, the Anxiety, Depression, and Somatization scales from the SCL-90, the Medical Outcomes Study Short Form-36, the Holmes and Rahe Family Life Changes, abbreviated versions of the Daily Hassles and Uplifts, the Herth Hope Index, Duke Social Support and Stress scales, Alcohol Use Disorders Identification Test, and Marlowe-Crowne Brief Social Desirability Scale. 68 adult patients completed the measures via structured interview. Internal consistency was measured using Cronbach alpha and the Kuder-Richardson-20. Construct validity was assessed using Pearson correlations among sets of scores. Internal consistencies were good-to-excellent for all measures except for the Duke Social Support and Stress scales (Stress scale), and the Brief Social Desirability Scale. Construct validity was suggested for all except the Mental Health and Energy/Fatigue scales of the Short Form-36. Further study is needed to verify these results in other Hispanic populations and to address other forms of reliability and validity.
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PMID:Psychometric assessment of measures of psychological symptoms, functional status, life events, and context for low income Hispanic patients in a primary care setting. 1258 23

OBJECTIVES: Assess the moderating role of somatization on depression in the perception of fatigue for a healthy adult population. DESIGN: Correlational survey. METHODS: Several fatigue questionnaires, a mental health inventory, somatic complaints and demographic data were collected from a targeted, randomly selected adult sample (N = 278). RESULTS: Depression levels were positively and significantly related to all aspects of fatigue except fatigue that responds to rest and sleep (i.e. tiredness). When high levels of depression were coupled with somatization, fatigue complaints were more severe. CONCLUSIONS: Even within a non-patient population, somatization and depression had interactive effects on fatigue. Somatization increased fatigue level for the relatively dysphoric individuals.
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PMID:Multidimensional fatigue, somatic symptoms and depression. 1459 18

The 17-item Hamilton Rating Scale for Depression (HAMD-17) Anxiety/Somatization factor includes six items: Anxiety (psychic), Anxiety (somatic), Somatic Symptoms (gastrointestinal), Somatic Symptoms (general), Hypochondriasis and Insight. This study examines the relationship between early changes (defined as those observed between baseline and week 1) in these HAMD-17 Anxiety/Somatization Factor items and treatment outcome among major depressive disorder (MDD) patients who participated in a study comparing the antidepressant efficacy of a standardized extract of hypericum with both placebo and fluoxetine. Following a 1-week, single-blind washout, patients with MDD diagnosed by the Structured Clinical Interview for DSM-IV (SCID) were randomized to 12 weeks of double-blind treatment with hypericum extract (900 mg/day), fluoxetine (20 mg/day) or placebo. The relationship between early changes in HAMD-17 anxiety/somatization factor items and treatment outcome was assessed separately for patients who received study treatment (hypericum or fluoxetine) versus placebo with a logistic regression method. One hundred and thirty-five patients (female 57%, mean age=37.3+/-11.0 years; mean baseline HAMD-17=19.7+/-3.2 years) were randomized to double-blind treatment and were included in the intent-to-treat (ITT) analyses. After adjusting for baseline HAMD-17 scores and for multiple comparisons with the Bonferroni correction, patients who remitted (HAMD-17 score <8) after study treatment had significantly greater early improvement in Somatic Symptoms (General) scores than non-remitters. No other significant differences in early changes were noted for the remaining items between remitters versus non-remitters who received active treatment. For patients treated with placebo, early change was not predictive of remission for any of the items after Bonferroni correction. In conclusion, the presence of early improvement on the HAMD-17 item concerning fatigue and general somatic symptoms is significantly predictive of achieving remission at endpoint with active study treatment but not with placebo.
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PMID:The relationship between early changes in the HAMD-17 anxiety/somatization factor items and treatment outcome among depressed outpatients. 1572 83