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 10,606 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In summary, the physician should view abnormal behavior in the cancer patient as an early and important diagnostic sign that an underlying medical problem (such as hypercalcemia) may be present. Depression and insomnia yield to intervention with antidepressants and hypnotics in cancer patients as readily as in noncancer patients. Finally, attentive listening is in and of itself anxiety-relieving and can go a long way toward reducing the emotional distress of people with cancer.
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PMID:Psychiatric treatment of the patient during cancer therapy. 313 Sep 61

Lung cancer is the number one cause of cancer-related death for women in the United States, yet studies describing the experience of women living with lung cancer are nonexistent. A sample of 69 women with lung cancer described their symptom distress using the Symptom Distress Scale (SDS). The majority of the women (86%) had been diagnosed with primary or recurrent lung cancer within the 2 years previous, 78% had non-small-cell lung cancer, and 43% were currently receiving treatment. The most prevalent and most distressing symptoms included fatigue, frequent pain, and insomnia. Poor outlook, dyspnea, and appetite disruptions were other common distressing problems. Sixty-one percent of the subjects had two or more serious symptoms. Forty-one percent of those subjects with fatigue concurrently experienced frequent pain, and 31% had insomnia. Those with recurrent disease had significantly greater levels of distress (P = 0.03). Concurrent respiratory disease, previous chemotherapy, recurrent lung cancer, no surgical treatment, and low income were associated with a high level of symptom distress (P < 0.05). Treatment was not a significant factor relating to distress. Distress was strongly correlated to quality of life (r = 0.72, P < 0.001) and functional status (r = 0.71, P < 0.001). Poverty-level income was a weak predictor of distress among demographic and disease/treatment variables, accounting for 17% of the variance. Combined with recurrence, the model accounted for 26% of the variance.
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PMID:Correlates of symptom distress in women with lung cancer. 832 26

Although the initial phase of illness is recognized as important in the overall process of adjustment after a diagnosis of breast cancer, little is known about pretreatment patterns of symptom distress. Seventy-four women ages 25 to 79 years and newly diagnosed with breast cancer were studied to determine physical, cognitive, and affective distress in the pretreatment period. Severity of distress was assessed about 11 days before primary surgery using the Symptom Distress Scale (SDS), Attentional Function Index (AFI), and Profile of Mood States (POMS). Higher levels of distress (SDS) were related to a triad of symptoms, insomnia, fatigue, and loss of concentration. Also, lowered effectiveness in cognitive function (AFI) and significant disturbances in mood state (POMS) were observed. Overall, a greater number of symptoms was associated with lowered cognitive function (r = -0.47; p < 0.01) and greater mood disturbance (r = 0.65; p < 0.01). Younger women younger than 55 years of age (n = 25) reported significantly (p = 0.02) greater overall symptom distress (SDS) than older women (n = 49). Interestingly, severity of distress did not differ in groups anticipating breast-conserving surgery (n = 35) instead of mastectomy (n = 39). The findings showed a discernible pattern of symptom distress before any treatment in women newly diagnosed with breast cancer, indicating a need for early intervention to promote the initial process of adjustment.
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PMID:Pretreatment symptom distress in women newly diagnosed with breast cancer. 1037 79

Insomnia is a condition which affects millions of individuals, giving rise to emotional distress, daytime fatigue, and loss of productivity. Despite its prevalence, it has received scant clinical attention. An adequate evaluation of persistent insomnia requires detailed historical information as well as medical, psychological and psychiatric assessment. Use of a classification system for sleep disorders and familiarity with major diagnostic groups will facilitate the clinician's evaluation and treatment. Thorough assessment also requires attention to the unique aspects of presentation and specific set of etiologies which are associated with particular age groups.
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PMID:Evaluation of chronic insomnia. An American Academy of Sleep Medicine review. 1073 42

Tinnitus has been much researched within adult populations with consideration of prevalence as well as the impact of tinnitus on individual's lives. Although the literature highlights the prevalence of tinnitus in children, there is little information on its effects from a psychological perspective. This small-scale preliminary study looked at 24 children (50% with normal hearing and 50% with a hearing loss) who presented to the Psychology Department with troublesome tinnitus. In line with adult studies, preliminary results suggested that tinnitus can have as marked an effect on children's lives as it is reported to have on adults. Insomnia, emotional distress, listening and attention difficulties are the main psychological factors associated with tinnitus in children. These, in turn, may have an effect upon their school performance. Differences were found between children with normal hearing and those with some degree of hearing loss. Overall, children with normal hearing found tinnitus more troublesome and presented with higher levels of anxiety than those with some level of hearing impairment. The present study suggests that children who complain of tinnitus should be taken seriously. In terms of management, individual intervention packages were found to be useful in alleviating anxiety and other associated factors. Recommendations are made on areas for future research.
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PMID:Children's experience of tinnitus: a preliminary survey of children presenting to a psychology department. 1120 20

The aim in this study was to assess the frequency and type of self-reported side-effects among hypertensives in a general population, and to estimate the relationship between drug use and side-effects and health utility using the Rating Scale (RS) method. The study is based on a postal questionnaire that was sent to a random sample of 8000 inhabitants aged 20-84 years (response rate 68%) in Uppsala County, Sweden, in 1995. The results showed that nearly 20% of the users of antihypertensive drugs reported side-effects. Men and women reported side-effects to nearly the same extent. In the linear regression analyses, those with hypertension, with or without medication, rated lower health utilities (-6.0 and -7.1 respectively) than did normotensives after controlling for age and sex. The lowest value, -8.7, was found among drug users who experienced side-effects. Side-effects causing impotence and emotional distress, i.e. insomnia, tiredness and depression had the strongest negative impact on health utility. To conclude, the study showed that side-effects among hypertensives are common. Both the disease and the drug treatment adversely affect the patient's well-being. However, drug treatment was of less importance than that found in prior studies. The findings here stress that side-effects should be taken into greater consideration when evaluating drug treatment.
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PMID:Self-reported side-effects of antihypertensive drugs: an epidemiological study on prevalence and impact on health-state utility. 1121 61

Hormone replacement therapy (HRT) for perimenopausal women has been suggested to minimize the physical symptoms of menopause and improve mood and psychological functioning; however, the therapy remains controversial. In this study the effects of such therapy (comprising tablets, patches, and implants) on mood states was investigated within a sample of 70 perimenopausal women who were attending a family planning clinic within the Brisbane metropolitan area. On a battery of standardized questionnaires, including the General Health Questionnaire, the Profile of Mood States, the Eysenck Personality Questionnaire, and the Menstrual Distress Questionnaire, those 35 women who were using hormone replacement therapy prescribed by the clinic physician reported significantly lower scores on anxiety, insomnia, and somatic symptoms than did a comparable group of 35 untreated perimenopausal women. These findings provide some tentative support for the beneficial effects of the therapy on physical symptoms and psychological mood states related to the onset of menopause. Given increased life expectancy, there is a growing need for research into issues of aging.
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PMID:A preliminary study of hormone replacement therapy and psychological mood states in perimenopausal women. 1129 22

Insomnia is one of the most prevalent psychological disorders, causing sufferers severe distress as well as social, interpersonal, and occupational impairment. Drawing on well-validated cognitive models of the anxiety disorders as well as on theoretical and empirical work highlighting the contribution of cognitive processes to insomnia, this paper presents a new cognitive model of the maintenance of insomnia. It is suggested that individuals who suffer from insomnia tend to be overly worried about their sleep and about the daytime consequences of not getting enough sleep. This excessive negatively toned cognitive activity triggers both autonomic arousal and emotional distress. It is proposed that this anxious state triggers selective attention towards and monitoring of internal and external sleep-related threat cues. Together, the anxious state and the attentional processes triggered by it tricks the individual into overestimating the extent of the perceived deficit in sleep and daytime performance. It is suggested that the excessive negatively toned cognitive activity will be fuelled if a sleep-related threat is detected or a deficit perceived. Counterproductive safety behaviours (including thought control, imagery control, emotional inhibition, and difficulty problem solving) and erroneous beliefs about sleep and the benefits of worry are highlighted as exacerbating factors. The unfortunate consequence of this sequence of events is that the excessive and escalating anxiety may culminate in a real deficit in sleep and daytime functioning. The literature providing preliminary support for the model is reviewed and the clinical implications and limitations discussed.
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PMID:A cognitive model of insomnia. 1218 52

Fatigue is a highly prevalent and distressing symptom in cancer patients. The purpose of this study was to assess the validity of three fatigue measures [the Brief Fatigue Inventory (BFI), the Functional Assessment of Cancer Therapy Fatigue Subscale (FACT-F), and the lack of energy item from the Memorial Symptom Assessment Scale Short Form (MSAS-SF)] and compare these measures in relation to broader quality-of-life (QOL) constructs and clinical factors in veteran cancer patients. One-hundred-eighty cancer patients completed the BFI, FACT-F, FACT-G, MSAS-SF, and the Zung depression scale with concurrent Karnofsky performance status (KPS), laboratory tests, and demographic data. The Cronbach alpha coefficient was from 0.93 to 0.94 for BFI fatigue scales and 0.94 for FACT-F. There were significant correlations between BFI subscales, FACT-F, and lack of energy from MSAS-SF (p < 0.0001). All three fatigue measures showed significant correlation with MSAS-SF symptom subscales (p < 0.0001), FACT-G subscales (p < 0.0001), depression (p < 0.0001), KPS (p < 0.0001), inpatient status (P < 0.0001), insomnia (p < 0.05), hemoglobin (p < 0.05), and albumin levels (p < 0.01). Distress from lack of energy discriminated among levels from the BFI, FACT-F, and FACT-G subscales and MSAS-SF subsclea by one-way of variance analysis. Patient responses to BFI, FACT-F, and the lack of energy item yielded similar information about broader QOL constructs and clinical factors. Single questions about lack of energy, or fatigue severity, may provide a simple and acceptable way to assess fatigue.
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PMID:A comparison of three fatigue measures in veterans with cancer. 1290 Dec 82

The purposes of this study were to explore symptom distress, catastrophic thinking (catastrophizing) and hope, and factors predicting hope in Taiwanese nasopharyngeal carcinoma (NPC) patients within 3 years of receiving radiation therapy (RT). Instruments used were the modified Symptom Distress Scale, disease catastrophizing scale (modified from Coping Strategies Questionnaire), and Herth's Hope Index. Adult NPC patients (N = 115; 33 undergoing RT, 44 who completed RT within 1 year, and 38 who completed RT more than 1 year but less than 3 years) were recruited from an outpatient RT center in Northern Taiwan. Although participants' overall symptom distress was mild to moderate, they scored moderate level for several distressful symptoms: dry mouth, fatigue, hearing difficulty, loss of appetite, insomnia, and pain. Patients undergoing RT had greater symptom distress than subjects in the other 2 groups. Regression analysis revealed that catastrophizing was the only predictor of hope. Patients who engaged in catastrophizing reported much lower levels of hope. Particular care and attention are recommended to help NPC patients deal with the top distressful symptoms listed. Nursing interventions to reduce catastrophic thinking and enhance hope are discussed.
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PMID:Symptom distress, catastrophic thinking, and hope in nasopharyngeal carcinoma patients. 1502 80


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