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Query: UMLS:C0028754 (obesity)
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16 patients of the Medical ambulatory at the University of Basel born between 1940 and 1945 were explored with the State-Trait Anxiety Inventory (STAI) of Spielberger for the presence of anxiety. With this self-rating inventory state anxiety as well as general trait anxiety can be recognized. The examined group was not selected on specific diagnoses. Two patients with a heavy organic disease (Aids, Friedreich's ataxia) showed an increased state anxiety and an increased general trait anxiety. Six patients with hypertension showed decreased, average as well as increased values of state anxiety and general trait anxiety. In one patient with epilepsia decreased general trait anxiety and average state anxiety were manifest. A patient with a depressive neurosis and functional abdominal pain showed increased general trait anxiety and average state anxiety. Finally, in six patients with different diseases, such as patients with different diseases, such as bronchitis, diabetes, coronary and congestive heart disease, obesity and myalgias, no deviation of their state and general trait anxiety values was evident when compared with standard values. The results are discussed.
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PMID:[The assessment of anxiety in somatic patients--a pilot study]. 291 53

Men who do not drink are frequently used as a baseline against which the effects of alcohol consumption are measured. The characteristics of such men have been examined in a large-scale prospective study of cardiovascular disease involving 7735 middle-aged men drawn from general practices in 24 British towns. Non-drinkers include lifelong teetotallers and ex-drinkers, both long-term and recent. Long-term ex-drinkers have many characteristics likely to increase their morbidity and mortality; recent ex-drinkers have similar characteristics but to a less marked degree. Ex-drinkers are older than the other groups and include an increased proportion of unmarried men and men in manual occupations. They have the same high percentage of current cigarette smokers as moderate/heavy drinkers and a prevalence of hypertension and obesity similar to moderate/heavy drinkers and higher than lifelong teetotallers or occasional/light drinkers. Ex-drinkers have the highest percentage of men with multiple doctor-diagnosed disorders. In particular, they have the highest prevalence rates of angina and possible myocardial infarction on standardized questionnaire, of myocardial infarction on electrocardiogram and of recall of a doctor-diagnosis of ischaemic heart disease. They also have high prevalence rates of recall of high blood pressure, peptic ulcer, diabetes, gall bladder disease and bronchitis. They have the highest rates for regular medical treatment and the highest proportion of men who consider their health to be poor. It is abundantly clear that the general category of non-drinkers, which includes a large proportion of ex-drinkers, should not be used as a baseline against which to measure the effects of alcohol consumption. Overall, it would appear that the occasional/light drinking category (less than 15 drinks/week) provides a large and satisfactory baseline group for comparative purposes in the study of cardiovascular and other organic disorders.
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PMID:Men who do not drink: a report from the British Regional Heart Study. 340 25

Not only does the psychological pressure of suffering from a chronic and in most cases incurable disease have a major impact on the patient's mind; it has also to be assumed that it is rather the mental predisposition which contributes to the manifestation of an organic disease and its becoming chronic. Studies of insulin-depending diabetics have shown that with two thirds of the patients there had been a mental conflict which they were unable to cope with prior to the manifestation proper of this metabolic disorder. With type-II diabetics it is an unsurmounted feeling of anxiety and guilt which makes patients break off their interhuman relations and leads, in most cases, to obesity and, eventually, to the manifestation of the disease. Adolescent diabetics who accept the disease as part of their lives once they have overcome their initial feelings of inferiority and recovered a certain mental equilibrium, develop an optimistic and predominantly life-affirming character and tend to restore the self-confidence they had lost. The situation is different with type-II diabetics who, even if the disease has been completely integrated into their lives, will show a basically depressive mood with a distinct lack of open-mindedness and self-criticism. Patients who suffer from a chronic hepatic disease can be characterised by a pronounced hypochondriac and anxious mood which is apparent even before the outbreak of an acute hepatocellular disorder or, at least, before this disease becomes chronic. From the psychological point of view, these persons reveal a marked depressive personality with a neurotic element in it which shows in the course of the disease and even after it has been cured or stopped. As a result, these patients often retire prematurely from their jobs. On the other hand, diabetics will not give up their professional activities unless they are forced to do so because of organic complications or delayed diabetic effects.
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PMID:[Comparative studies of the personality structure of the diabetic patient and the patient with chronic liver disease]. 346 34

The aim of this study is to explore the effectiveness of a short-term psychodynamic oriented group therapy with a selected sample of obese patients. We selected, from the patients referred to the Eating Disorders Consultation Service, 7 obese patients. Selection criteria were as follows: 1) aged between 20 and 40; 2) absence of severe organic disorders, as determining factors for the onset of obesity; 3) absence of severe psychiatric symptomatology. In addiction the selected subjects had to be sufficiently motivated to take up a psychological treatment. Subject underwent a clinical semi-structured interview and two questionnaires (SCL90 and TFEQ) were administered. Patients were re-evaluated at the end of the treatment and a two-years follow-up has been carried out. The group was conducted by a psychiatric and a psychologist, supervised by a group therapist. The group therapy lasted 6 months with 75' minutes weekly sessions. When the therapy was over all subjects showed an improved clinical picture: two of them had a remarkable weight reduction and one subject reached his ideal weight. The weight loss and maintenance at follow-up compared favorably with the results reported for other psychological treatments for obesity. The group setting, for its homogeneity, allowed great cohesiveness and let the members achieve, an increased emotional awareness of their self-image. This experience seem to confirm the effectiveness of a short-term group therapy in an institutional setting.
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PMID:[Psychodynamic group psychotherapy with obese patients]. 880 97

The global epidemic of childhood and adolescent obesity in developing and developed countries has become a major public health concern. Given the relation between obesity and hypertension as documented in several landmark studies, it is no surprise that as the prevalence of obesity has increased in the pediatric population, the rates of hypertension have also increased substantially. Hypertension is one of the most important risk factors for cardiovascular diseases and stroke; therefore, evaluation and initiation of appropriate treatment are extremely important in the pediatric population. Evaluation for secondary causes of hypertension, including renovascular, renoparenchymal, and endocrine disease is the approach most commonly used in healthcare settings, with the goal to detect abnormalities that already have or might, if left unrecognized, affect the physical health of the child in the future. Children and adolescents are commonly evaluated for organic disease even in situations in which secondary hypertension is unlikely and overweight or obesity is most likely the primary factor contributing to hypertension. Psychological and psychosocial factors, which may play an important role in the etiology of obesity and related blood pressure elevation, are often addressed inadequately or completely ignored, potentially reducing long-term therapy success and increasing the incidence of avoidable complications. It is proposed that a comprehensive evaluation by a behavioral health provider will improve outcomes and potentially reduce long-term morbidity and hypertension-related end organ disease. A framework for mental health evaluation is provided.
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PMID:Obesity, hypertension, and mental health evaluation in adolescents: a comprehensive approach. 1854 Feb 79

Obesity has become a serious health problem worldwide because it is closely related to the leading causes of morbidity and mortality, including diabetes mellitus, hypertension, atherosclerosis, and dyslipidemia. It is therefore imperative for the scientific community to understand the main environmental and social-cultural factors, as well as organic disorders arising from breakdown of the physiological mechanisms that control energy balance in our body, all of which are ultimately responsible for development of obesity. Adequate understanding of the mechanisms involved in regulation of energy balance is therefore essential to understand the pathogenesis and pathophysiology of the growing pandemic of obesity. This study was intended to review the main factors involved in development of obesity and advances in understanding of the mechanisms that regulate body weight and appetite and their pathophysiology.
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PMID:Obesity: etiologic and pathophysiological analysis. 2262 57

The authors seek to find new connections between recent results of biology and older theories. This paper aims to assemble the jigsaw puzzle. The theoretical background of the hypothesis was described in the previous issue of the journal (Sikter et al. 2017a). Human stress response often coexists with persistent hypocapnia or hypercapnia - developing via psychosomatic pathomechanism - which can lead to mental and psychosomatic illnesses. Chronic hypocapnia mainly generates hyperarousal disorders which may be reversible for an extended time, however, vicious cycles may start when hypoxia and/or severe somatic diseases are simultaneously present (commonly in the elderly), which conditions often end with death without medical help. Chronic hypercapnia devastates the organism initially without symptoms, partly due to neurohumoral contraregulation, consequential dysregulation and metabolic remodeling. Psychosomatic disorders (e.g., diseases of civilization that evolve in people with disadvantaged psychosocial situations) develop over years and decades, causing irreversible changes. Hypercapnia usually occurs in clinical pictures of chronic obstructive pulmonary disease, obesity hypoventilation syndrome, obstructive sleep apnea, and its unobstructed version (sleep-related hypoventilation), generating various organic disorders (hypertension, type 2 diabetes, cardiovascular disorders, immunological diseases, depression, etc.). Because of the above, chronic hypocapnia and hypercapnia cannot be regarded as harmless accompanying phenomena. That is why we have to strive for restoring eucapnia and normalizing the induced ionic changes, which does not appear to be a hopeless task.
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PMID:New aspects in the pathomechanism of diseases of civilization, particularly psychosomatic disorders. Part 2. Chronic hypocapnia and hypercapnia in the medical practice. 2930 7

Over the past years, there has been a growing interest in the association between lifestyle psychosocial interventions, severe mental illness, and suicide risk. Patients with severe mental disorders have higher mortality rates, poor health states, and higher suicide risk compared to the general population. Lifestyle behaviors are amenable to change through the adoption of specific psychosocial interventions, and several approaches have been promoted. The current article provides a comprehensive review of the literature on lifestyle interventions, mental health, and suicide risk in the general population and in patients with psychiatric disorders. For this purpose, we investigated lifestyle behaviors and lifestyle interventions in three different age groups: adolescents, young adults, and the elderly. Several lifestyle behaviors including cigarette smoking, alcohol use, and sedentary lifestyle are associated with suicide risk in all age groups. In adolescents, growing attention has emerged on the association between suicide risk and internet addiction, cyberbullying and scholastic and family difficulties. In adults, psychiatric symptoms, substance and alcohol abuse, weight, and occupational difficulties seems to have a significant role in suicide risk. Finally, in the elderly, the presence of an organic disease and poor social support are associated with an increased risk of suicide attempt. Several factors may explain the association between lifestyle behaviors and suicide. First, many studies have reported that some lifestyle behaviors and its consequences (sedentary lifestyle, cigarette smoking underweight, obesity) are associated with cardiometabolic risk factors and with poor mental health. Second, several lifestyle behaviors may encourage social isolation, limiting the development of social networks, and remove individuals from social interactions; increasing their risk of mental health problems and suicide.
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PMID:Lifestyle Interventions and Prevention of Suicide. 3045 60

Testosterone is the main male sex hormone and is essential for the maintenance of male secondary sexual characteristics and fertility. Androgen deficiency in young men owing to organic disease of the hypothalamus, pituitary gland or testes has been treated with testosterone replacement for decades without reports of increased cardiovascular events. In the past decade, the number of testosterone prescriptions issued for middle-aged or older men with either age-related or obesity-related decline in serum testosterone levels has increased exponentially even though these conditions are not approved indications for testosterone therapy. Some retrospective studies and randomized trials have suggested that testosterone replacement therapy increases the risk of cardiovascular disease, which has led the FDA to release a warning statement about the potential cardiovascular risks of testosterone replacement therapy. However, no trials of testosterone replacement therapy published to date were designed or adequately powered to assess cardiovascular events; therefore, the cardiovascular safety of this therapy remains unclear. In this Review, we provide an overview of epidemiological data on the association between serum levels of endogenous testosterone and cardiovascular disease, prescription database studies on the risk of cardiovascular disease in men receiving testosterone therapy, randomized trials and meta-analyses evaluating testosterone replacement therapy and its association with cardiovascular events and mechanistic studies on the effects of testosterone on the cardiovascular system. Our aim is to help clinicians to make informed decisions when considering testosterone replacement therapy in their patients.
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PMID:Testosterone replacement therapy and cardiovascular risk. 3112 40