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Query: UMLS:C0848237 (acute stress)
 4,619 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Over a 5-yr period, 19 adults presented to our sleep disorders center with histories of involuntary, nocturnal, sleep-related eating that usually occurred with other problematic nocturnal behaviors. Mean age (+/- SD) at presentation was 37.4 (+/- 9.1) yr (range 18-54); 73.7% of the patients (n = 14) were female. Mean age of sleep-related eating onset was 24.7 (+/- 12.9) yr (range 5-44). Eating occurred from sleep nightly in 57.9% (n = 11) of patients. Chief complaints included excessive weight gain, concerns about choking while eating or about starting fires from cooking and sleep disruption. Extensive polysomnographic studies, clinical evaluations and treatment outcome data identified three etiologic categories for the sleep-related eating: (a) sleepwalking (SW), 84.2% (n = 16); (b) periodic movements of sleep (PMS), 10.5% (n = 2) and (c) triazolam abuse (0.75 mg hs), 5.3% (n = 1). DSM-III Axis 1 psychiatric disorders (affective, anxiety) were present in 47.4% (n = 9) of the patients, and only two patients had a daytime eating disorder (anorexia nervosa), each in remission for 3-7 yr. Nearly half of all patients fulfilled established criteria for being overweight, based on the body mass index. Onset of sleep-related eating was linked directly to the onset of SW, PMS, triazolam abuse, nicotine abstinence, chronic autoimmune hepatitis, narcolepsy, encephalitis or acute stress. In the SW group, 72.7% (8/11) of patients had nocturnal eating and other SW behavior suppressed by clonazepam (n = 7) and/or bromocriptine (n = 2) treatment. Both patients with PMS likewise responded to treatment with combinations of carbidopa/L-dopa, codeine and clonazepam. Thus, sleep-related eating disorders can generally be controlled with treatment of the underlying sleep disorder.
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PMID:Sleep-related eating disorders: polysomnographic correlates of a heterogeneous syndrome distinct from daytime eating disorders. 175 95

The dexamethasone suppression test (DST) was performed in 21 drug-free schizophrenic patients. The patients satisfied DSM-III and Research Diagnostic Criteria for schizophrenia and were in an acute phase of the disease. In 15 of the patients the DST was repeated after about 5 weeks of treatment with neuroleptics. DST compliance was checked by analysis of dexamethasone concentrations in plasma. In the acute phase 71% (at 04 p.m.) of the patients were nonsuppressors. After neuroleptic treatment the frequency of abnormal responders had decreased to 20%. The decrease in nonsuppressors was not due to alteration of the dexamethasone concentration between the two test occasions. Prolactin levels were markedly increased at the second test occasion compared with the first. There were no significant relationships between cortisol levels, cortisol suppression and prolactin levels. The high frequency of nonsuppressors among schizophrenic patients in the acute phase of the disease indicates that acute stress may be a confounding factor in the outcome of DST.
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PMID:Dexamethasone suppression test in schizophrenic patients before and during neuroleptic treatment. 287 44

Although it is not yet clear that striking gains can be made toward the goal of preventing the development of post-traumatic stress disorder (PTSD) through early treatment, an initial step has been made by identification of a new category of disorder in DSM-IV, the acute stress disorder. Evidence exists that, at the least, it is possible to have a significant effect on the symptomatology generated by acute stress through the use of culturally endorsed rituals, psychological methods such as support and formal crisis intervention, focused psychotherapy, and psychopharmacology. Whether success on this front will ultimately affect the incidence and development of PTSD remains to be seen.
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PMID:The treatment of acute trauma. Post-traumatic stress disorder prevention. 793 65

The stress-buffering effect of perceived support is explored in a large panel survey of adult female twins. The analysis begins by documenting a significant interaction between perceived support and acute stress in predicting DSM-III-R major depression. Various hypotheses are investigated to explain this interaction. These include the possibilities that the interaction is due to a stress-buffering effect of perceived support which is mediated by received support, that perceived support promotes either the increased use or the increased effectiveness of certain coping strategies, or that there is some underlying genetic factor that affects both the perception of support and adjustment to stress. No evidence was found for any of these hypotheses. The paper closes with a discussion of directions for future research aimed at explaining the interaction between perceived support and acute stress.
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PMID:Perceived support and adjustment to stress in a general population sample of female twins. 808 28

Stress induces an imbalance of neuroimmunomodulation, a phenomenon involving the immune, central nervous and endocrine systems. Receptors to substances involved in stress reactions and anxiety, like adrenaline, acetylcholine, histamine, endomorphines, ACTH and several neuropeptides, are present on lymphocytes and lymphocytes can secrete various hormones and neuropeptides. Peripheral and central, cortical and subcortical nervous structures influence immune response. Steroids play a dose dependent inhibitory role perhaps via GIF (Glucocorticoid Increasing Factor) and cytokines (IL 1). In rats, stress induces an increase of corticosterone levels and a lymphopenia depending on the presence of adrenals and pituitary, whereas functional responses to mitogens appear decreased in animals even after surgical removal of adrenals and/or pituitary. Immune response vary according to the degree of control over stressors, to the type of stressor and the animal species. Chronic or repeated stress tends to stimulate immune reaction, contrary to acute stress. In man grief reactions, terminal illness of a spouse, divorce, examinations, caregiving to Alzheimer patients have been used as models of stress, with immune consequences. Pathological anxiety has been less studied, with only few anomalies reported in DSM III-R panic disorder. The immune system participation in the adaptive response to stress is reviewed.
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PMID:[Stress and panic. Immunologic aspects]. 828 94

The stress associated with experiencing or witnessing physical trauma can cause abrupt and marked alterations in mental state, including anxiety and transient dissociative symptoms. Intense manifestations of this pattern of response to trauma are described in a new diagnostic category proposed for DSM-IV: acute stress disorder. Severe dissociative symptoms may predict subsequent posttraumatic stress disorder. Persons who experience a series of traumatic events may be especially vulnerable to a variety of dissociative states, including amnesia, fugue, depersonalization, and multiple personality disorder. Treatment for these symptoms emphasizes strengthening supportive interpersonal relationships and developing insight that reduces psychological pain by integrating the trauma into a meaningful, less self-blaming perspective.
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PMID:Trauma and dissociation. 850 55

The ICD-10 and DSM-IV classifications have both given low priority to "reactivity" to acute stress as a classificatory principle for functional psychoses. In Scandinavia, reactivity is still considered an important factor in the development of such psychoses. Reactivity is a complex concept, and its various components are historically examined. The Reactivity of Psychosis Rating Form (RPRF) was developed in order to operationalize reactivity. Seven of the 10 elements of RPRF can be rated reliably. Factor analysis of the RPRF yields three factors: stressor, onset and change, that also show high interrater reliability. Our results indicate that RPRF has both construct and discriminant validity. Further studies with the RPRF may elucidate the true status of reactivity in functional psychoses.
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PMID:The Reactivity of Psychosis Rating Form (RPRF): background, development and psychometrics. 868 80

Psychological stress is extremely high in patients with oncological diseases. About 50% of all cancer patients show psychological signs and symptoms which are related to the multiple stress factors of their oncological illness. Although many psychological problems connected with cancer are well known, additional acute stress could result from new therapeutic strategies which require settings similar to intensive care, e.g. bone marrow transplantation. For 2 years the Department of Psychiatry in Innsbruck has provided a "liaison service" at the Department of Bone Marrow Transplantation. Within this observation period, 40 patients have received psychooncological care. The diagnostic distribution according to DSM III-R and specific psychooncological interventions are presented.
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PMID:[Psychiatric problems in bone marrow transplantation patients during isolation]. 899 80

From August to November 1992, five typhoons struck the U.S. Pacific island territory of Guam. Three hundred and twenty subjects exposed to all five typhoons participated in a population survey measuring their acute stress symptoms and subsequent diagnoses of posttraumatic stress disorder (PTSD) and depression. A 23-item scale approximating the new DSM-IV diagnosis of acute stress disorder (ASD) was used to classify subjects into three groups based on their symptoms one week after the first typhoon: (1) probable ASD, (2) an early traumatic stress response (ETSR) of fear, intrusion, avoidance, and arousal, without dissociation, and (3) no acute diagnosis. A multi-dimensional measure of PTSD and the Zung Self-Rating Depression Scale were used to assess PTSD and depression 8 months after the first storm. The point prevalence of ASD at one week was 7.2%. An additional 15% of subjects had ETSR. Subjects with probable ASD at one week had significantly increased rates of PTSD and somewhat higher rates of depression at 8 months than those without ASD. In contrast, subjects with ETSR at one week did not have a poorer outcome than those with no acute diagnosis. These findings suggest that ASD is prognostically important, but also indicate that all acute stress symptoms do not have the same discriminative value. In this study, the acute dissociative symptoms of emotional numbing and derealization differentiated highly symptomatic subjects at risk for subsequent psychopathology (ASD) from others who were highly symptomatic at one week, but then had a more benign, posttraumatic course (ETSR).
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PMID:Acute stress disorder, subsequent posttraumatic stress disorder and depression after a series of typhoons. 916 Jun 26

Basal cortisol levels were compared in prisoners convicted of violent crimes, in men previously convicted of violent crimes but currently not in prison, in non-violent alcoholics, and in randomly selected control males. Most of the violent men were diagnosed with antisocial personality disorder (DSM-III-R 301.70). Morning, afternoon, and evening levels of plasma cortisol were assessed after a minimum alcohol abstinence of 24 h. The imprisoned violent men had significantly lower cortisol levels than the unimprisoned, which may reflect their prolonged alcohol abstinence and/or habituation to chronic stress. The unimprisoned violent men were heavy drinkers and their elevated sober-state cortisol may reflect temporary alcohol withdrawal or acute stress. We suggest that variations in basal cortisol are influenced more by environmental factors than by violent predisposition or antisocial personality disorder.
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PMID:Sober-state cortisol as a predictor of drunken violence. 937 5


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