Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0848237 (acute stress)
 4,619 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Nightmares can be defined as very disturbing dreams, the events or emotions of which cause the dreamer to wake up. In contrast, unpleasant dreams can be defined in terms of a negative emotional rating of a dream, irrespective of whether or not the emotions or events of the dream woke the dreamer. This study addresses whether frequency of unpleasant dreams is a better index of low well-being than is frequency of nightmares. A total of 147 participants reported their nightmare frequency retrospectively and then kept a log of all dreams, including nightmares, for 2 weeks, and rated each dream for pleasantness/unpleasantness. Anxiety, depression, neuroticism, and acute stress were found to be associated with nightmare distress (ND) (the trait-like general level of distress in waking-life caused by having nightmares) and prospective frequency of unpleasant dreams, and less so with the mean emotional tone of all dreams, or retrospective or prospective nightmare frequency. Correlations between low well-being and retrospective nightmare frequency became insignificant when trait ND was controlled for, but correlations with prospective unpleasant dream frequency were maintained. The reporting of nightmares may thus be confounded and modulated by trait ND: such confounding does not occur for the reporting of unpleasant dreams in general. Thus there may be attributional components to deciding that one has been awoken by a dream, which can affect estimated nightmare frequency and its relationship with well-being. Underestimation of nightmare frequency by the retrospective questionnaire compared with logs was found to be a function of mean dream unpleasantness and ND.
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PMID:The relationship of nightmare frequency and nightmare distress to well-being. 1517 92

Perpetual noise, pain, disturbed day-night-cycle, the inability to talk and the difficulty, especially during weaning, to differentiate alertness from sleep and dream from reality are some of the burdens ICU patients are suffering from. Additional sedation and potential sedation gaps plus the medical treatment itself put strain on critically ill humans. Those external stimuli partly cannot be handled well by the patients. Some of these factors or a combination of them, combined with a predisposition and/or insufficient coping mechanisms can result in a wide range of psychiatric disorders. Often psychiatric symptoms appear unspecific and difficult to categorize. Firstly some psychopathological cardinal symptoms are described and potential differential diagnoses are mentioned. After that the following article focuses on sleep, adjustment, depressive and the spectrum of anxiety disorders (especially generalized anxiety disorders, panic disorders, acute stress disorder (ASD) and posttraumatic stress disorder (PTSD)). The article provides prevalences, etiology and risk factors as well as symptomatology, diagnostics and therapeutic options. Those disorders can be diagnosed in ICU but also after transferring to general ward. In our own experience the transfer period is a vulnerable phase for psychopathologic symptoms. As apart from the individual suffering the course of the somatic disease as well as the rehabilitation process are impaired and the disorders have a tendency to have a chronic course, close and early collaboration of ICU physicians and psychiatrists is mandatory.
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PMID:[Psychiatric disorders in intensive care--part three: psychic reactions, affective and anxiety disorders]. 1736 37

The human dimensions of medical care were highlighted by such pioneering figures as Cicely Saunders, Elizabeth Kubler-Ross, and Jimmie Holland and their tireless advocacy helped to build an evidence base for psychosocial and palliative interventions. In that spirit, we studied physical and psychological distress in advanced cancer and modeled pathways to distress in this population. We considered acute stress disorder as the prototype for psychological disturbances following the acute onset of life-threatening disorders, showing that it occurred in one-third of patients after the diagnosis of acute leukemia. To treat and prevent these symptoms, we developed Emotion and Symptom-focused Engagement (EASE), an integrated psychotherapeutic and early palliative intervention. We showed that EASE reduced both traumatic stress and physical suffering in these patients and a large multi-center trial is now underway. We also identified symptoms of depression and hopelessness n one quarter of patients with metastatic and advanced cancer, with worsening toward the end of life. To alleviate this distress, we developed a brief supportive-expressive therapy, referred to as Managing Cancer and Living Meaningfully (CALM). We showed in a large RCT that CALM improves depression, distress related to dying and death, and preparation for the end of life. We have now launched a global initiative involving 20 sites to date across North and South America, Europe, Australia, and Asia to have CALM implemented routinely in cancer care. Such initiatives are needed to move psychosocial care in cancer from evidence to implementation and to fulfill the dream of Jimmie Holland that cancer care be as humanistic as it is effective.
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PMID:From evidence to implementation: The global challenge for psychosocial oncology. 2998 Jan 65