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 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To understand the content of ambulatory family practice and find effective ways to improve clinical service, education and research in the Department of Family Medicine of Kaohsiung Medical College Hospital, we surveyed 14,064 patients from Jan. 1984 to Feb. 1991 and analysed (a) their basic demographic data including sex, age, insurance type, source and residential district and (b) clinical health problems covering 25,679 diagnoses and 148,994 diagnostic visits. Clinical health problems were recorded by the ICHPPC-2 code system. Results of basic demographic survey were as follow: 49.1% of patients was male and 50.9% female; 58.9% fell in the age group of 16-40 years and 22.4%, 12.0% and 6.7% of patients fell into the age groups of 41-65, under 16 and over 65 years respectively; 62.8% was insured usually by labor insurance and 26.9% had no insurance; the commonest referrals were other patients, colleagues, company personnel, doctors, media ... etc.; 58.8% lived in Kaohsiung City and 19.6% in Kaohsiung county. As for clinical health problems, the data showed that the commonest thirty diagnoses encountered at our clinic accounted for 69.3% of 25,679 diagnoses and the commonest ten diagnoses in descending order were medical health examination, acute URI, abdominal pain, uncomplicated hypertension, prophylactic immunization, hepatitis B carrier, back pain, anxiety disorder, viral hepatitis and irritable bowel syndrome. By calculating the average value of each diagnosis in a sample of 148,994 diagnostic visits to evaluate the habits of practice, we found that the commonest ten diagnostic visits at clinic in descending order were diabetes mellitus, hypertension involving target organ, uncomplicated hypertension, gout, hyperthyroidism, duodenal ulcer, tuberculosis, lipid metabolism disorder, other peptic ulcer and depressive disorders; all were chronic diseases. We concluded it was very important and helpful for the development of family medicine program and primary care unit to understand the content of their own ambulatory practice.
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PMID:[The content of ambulatory family practice in Kaohsiung Medical College Hospital]. 156 Apr 75

This study measured the prevalence of chronic medical conditions in 4,549 middle aged persons attending three large general practices in Dublin over the course of a calender year. The prevalence of the following conditions were measured: coronary heart disease, hypertension, stroke, diabetes, asthma, chronic bronchitis, rheumatic disorders, dyspepsia, depression, anxiety disorders, psychoses, and cancer. In order to obtain a valid denominator for the study a second community based study was carried out in the same areas to determine what proportion of persons visit their general practitioner over the course of a year. Overall 40.5% of males and 44% of females suffered from a least one of the twelve conditions, with rheumatic disorders having the highest prevalence (14.5%) and psychotic disorders the lowest (0.75%).
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PMID:General practice estimates of the prevalence of common chronic conditions. 147 57

In order to examine the validity of the distinction between generalized anxiety disorder (GAD) and panic disorder (PD) we compared 41 subjects with GAD and 71 subjects with PD. The GAD subjects had never had panic attacks. In contrast to the symptom profile in PD subjects suggestive of autonomic hyperactivity, GAD subjects had a symptom pattern indicative of central nervous system hyperarousal. Also, subjects with GAD had an earlier, more gradual onset of illness. In terms of coexisting syndromes, GAD subjects more often had simple phobias, whereas PD subjects more commonly reported depersonalization and agoraphobia. GAD subjects more frequently had first-degree relatives with GAD, whereas PD subjects more frequently had relatives with PD. A variety of measures indicated that our GAD subjects had a milder illness than those with PD. Also, fewer GAD subjects gave histories of major depression than did PD subjects. Among GAD subjects, coexisting major depression was associated with simple phobia and thyroid disorders and among PD subjects, comorbid depression was associated with social phobia and hypertension. Our findings indicate that the separation of GAD from PD is a valid one. They also indicate that, within disorders, unique patterns of comorbidity may exist that are important both clinically and theoretically.
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PMID:Generalized anxiety disorder vs. panic disorder. Distinguishing characteristics and patterns of comorbidity. 143 31

American former prisoners of war (POWs) are an aging group who seek health care with increasing frequency. To examine the prevalence of long-term physical and emotional consequences of captivity in this population, the authors analyzed medical and psychiatric examination data for 426 former POWs. Detailed psychiatric diagnostic criteria were used to assess the POWs' mental health. Compared with general population groups, POWs had moderately elevated lifetime prevalence rates of depressive disorders and greatly elevated rates of posttraumatic stress disorder (PTSD), although their rates of hypertension, diabetes, myocardial infarction, bipolar disorder, schizophrenia, and alcoholism were not elevated. POWs who lost more than 35 percent of their body weight during captivity had higher rates of anxiety disorder, depressive disorders, PTSD, and schizophrenia, compared with other POWs.
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PMID:Prevalence of somatic and psychiatric disorders among former prisoners of war. 189 54

Sympatho-adrenal activation induced by stress contributes to the development of pathological states such as hypertension and anxiety disorders. The Stroop Color Word Test (CWT) is evaluated as a test for the study of stress-induced sympathetic effects, on the basis of psychological, physiological and biochemical responses. The CWT induced increases in plasma and urinary adrenaline, heart rate, respiration rate, electrodermal activity, electromyography, feelings of anxiety, and decreased finger pulse amplitude.
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PMID:Characterization of stress reactions to the Stroop Color Word Test. 273 55

A case of placental abruption is described in a nonmedicated pregnant woman with panic disorder who experienced panic symptoms and resultant hypertension. The authors suggest that sympathetic arousal associated with panic symptoms may have an adverse effect on the fetoplacental unit. The potential impact of untreated anxiety symptoms on fetal well-being must be considered when deciding whether pharmacotherapeutic intervention is appropriate for certain patients with anxiety disorders.
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PMID:Panic attack-associated placental abruption: a case report. 273 32

The authors estimated the sex- and age-adjusted prevalence of affective, substance use, and anxiety disorders in persons in a general population sample who identified themselves as having arthritis, diabetes, heart disease, high blood pressure, chronic lung disease, or no chronic medical conditions. Persons who reported ever having arthritis, heart disease, chronic lung disease, or high blood pressure had a significantly increased adjusted prevalence of each of the three groups of lifetime psychiatric disorders, relative to a no-chronic conditions comparison group (each p less than 0.05). Persons who ever had diabetes had an increased adjusted prevalence of lifetime affective and anxiety but not substance use disorder. Persons with current (i.e., active) arthritis, heart disease, or high blood pressure had a significantly increased adjusted prevalence of recent (6-month) anxiety disorder, whereas those with current chronic lung disease had an increased adjusted prevalence of recent affective and substance use but not anxiety disorder.
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PMID:Affective, substance use, and anxiety disorders in persons with arthritis, diabetes, heart disease, high blood pressure, or chronic lung conditions. 279 44

The authors studied data on psychiatric disorders and eight chronic medical conditions in a community sample of 2,554 persons. The sex- and age-adjusted prevalence of any psychiatric disorder in the preceding 6 months was 24.7% and of lifetime psychiatric disorder was 42.2% among persons with one or more medical conditions, compared to 17.5% and 33.0%, respectively, for persons with no medical condition. Persons with chronic medical conditions were more likely to have lifetime substance use disorders and recent affective and anxiety disorders. Arthritis, cancer, lung disease, neurological disorder, heart disease, and physical handicap were strongly associated with psychiatric disorders, but hypertension and diabetes were not.
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PMID:Psychiatric disorder in a sample of the general population with and without chronic medical conditions. 296 99

Anxious patients have a higher incidence than the general population for cardiovascular disorders and sudden death. Several studies have emphasized abnormal pulse rate, abnormal heart response conditioning, high incidence of arrhythmia, and abnormal blood pressure. Essential hypertension has been studied in relation to stress, and chronic hypotension ('low blood pressure syndrome') has been clinically recognized for decades, but rarely systematically studied. We investigated these abnormal blood pressures in anxious patients, during controlled trials with 80 patients having generalized anxiety disorder as defined in DSM III, for at least 6 months duration, and of moderate to severe intensity. They were randomly assigned to placebo, or bromazepam, 18 mg/day. Blood pressure, pulse, and several other measurements were taken on a weekly basis for 2 months (washout phase--1 week, treatment phase--4 weeks, and withdrawal phase--3 weeks). One third of these patients had an abnormal blood pressure (hypertension or hypotension) while untreated, and this is statistically significant when compared to a matched control group of nonanxious patients. Bromazepam improved several patients having either hypertension or chronic hypotension. These findings are relevant for long-term treatment of anxious patients, since cardiovascular psychosomatic complications are a major health problem.
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PMID:Psychophysiological disorders in anxious patients: hypertension and hypotension. 714 63

The authors studied data on psychiatric disorders in 34 insulin-dependent and 27 non-insulin dependent diabetic patients by comparison with 25 patients suffering from hypertension. Analysis was performed following clinical diagnosis (according to DSM III-R criteria), Hamilton Anxiety Inventory, Hopkins Symptom Check List 58 and Beck Anxiety Inventory. In all groups the two major psychiatric clinical diagnoses were anxiety disorders (respectively, 53, 59 and 60%, NS) and depressive disorders (respectively 21, 22 and 20%, NS). These disorders were more common in women. The influence of degenerative complications was studied. Insulin-dependent diabetics with objective nephropathy had significantly higher anxiety scores. In non-insulin-dependent diabetic patients, microangiopathy, diabetic foot and poor control (HbA1c > or = 10%) were also associated with depressive disorders. We conclude that diabetics present with high prevalences of anxiety and depressive disorders and we suggest specific therapeutic approaches.
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PMID:[Prevalence of anxiety and depressive symptoms in patients with type 1 and 2 diabetes]. 837 11


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