Pub Date : 2001-12-01DOI: 10.2190/8HJA-LPRY-P16X-BH8U
F. Pfeffer, M. Grube
Objective: An extraordinary case of an organic psychosis during the treatment of a patient with a bipolar affective disorder. Methods: Clinical observation and further investigations including monitoring of serum levels (case report). Results: A significant interaction between venlafaxine and propafenone causes markedly increased serum levels of venlafaxine correlating with unexpected psychopathological changes. Conclusions: There is a potentially dangerous interaction between venlafaxine and propafenone. Serum levels of venlafaxine should be monitored if propafenone is added.
{"title":"An Organic Psychosis Due to a Venlafaxine-Propafenone Interaction","authors":"F. Pfeffer, M. Grube","doi":"10.2190/8HJA-LPRY-P16X-BH8U","DOIUrl":"https://doi.org/10.2190/8HJA-LPRY-P16X-BH8U","url":null,"abstract":"Objective: An extraordinary case of an organic psychosis during the treatment of a patient with a bipolar affective disorder. Methods: Clinical observation and further investigations including monitoring of serum levels (case report). Results: A significant interaction between venlafaxine and propafenone causes markedly increased serum levels of venlafaxine correlating with unexpected psychopathological changes. Conclusions: There is a potentially dangerous interaction between venlafaxine and propafenone. Serum levels of venlafaxine should be monitored if propafenone is added.","PeriodicalId":22510,"journal":{"name":"The International Journal of Psychiatry in Medicine","volume":"7 1","pages":"427 - 432"},"PeriodicalIF":0.0,"publicationDate":"2001-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88494993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-09-01DOI: 10.2190/Q8BW-RAA7-F2H3-19BF
H. Nazemi, Adelpha Abrahamson Larkin, M. Sullivan, W. Katon
Objective: To compare two strategies of patient recruitment, waiting room (WR) screening and screening after physician referral (PR), for participation in a treatment-outcome study of minor depression and dysthymia in primary care. The influence of demographic factors on patients' refusal to participate in WR screening was also examined. Method: Of a convenience sample of 3,344 first stage patients, a total of 609 patients were evaluated in a semi-structured manner using a two-stage screening procedure from the mood module of the Primary Care Evaluation of Mental Disorders (PRIME-MD). Results: Male and older patients were more likely to refuse participation in screening than female and younger patients. Waiting room screens yielded a higher number of qualified patients compared to PR screens, but PR screens yielded a higher percentage of patients who qualified for further participation. Conclusions: The recruitment of male and older primary care patients is complicated by their tendency to refuse participation in WR screening for a treatment-outcome study of milder depression. Although each recruitment strategy offers advantages and disadvantages, the simultaneous use of both is recommended to recruit the most patients in the least amount of time.
{"title":"Methodological Issues in the Recruitment of Primary Care Patients with Depression","authors":"H. Nazemi, Adelpha Abrahamson Larkin, M. Sullivan, W. Katon","doi":"10.2190/Q8BW-RAA7-F2H3-19BF","DOIUrl":"https://doi.org/10.2190/Q8BW-RAA7-F2H3-19BF","url":null,"abstract":"Objective: To compare two strategies of patient recruitment, waiting room (WR) screening and screening after physician referral (PR), for participation in a treatment-outcome study of minor depression and dysthymia in primary care. The influence of demographic factors on patients' refusal to participate in WR screening was also examined. Method: Of a convenience sample of 3,344 first stage patients, a total of 609 patients were evaluated in a semi-structured manner using a two-stage screening procedure from the mood module of the Primary Care Evaluation of Mental Disorders (PRIME-MD). Results: Male and older patients were more likely to refuse participation in screening than female and younger patients. Waiting room screens yielded a higher number of qualified patients compared to PR screens, but PR screens yielded a higher percentage of patients who qualified for further participation. Conclusions: The recruitment of male and older primary care patients is complicated by their tendency to refuse participation in WR screening for a treatment-outcome study of milder depression. Although each recruitment strategy offers advantages and disadvantages, the simultaneous use of both is recommended to recruit the most patients in the least amount of time.","PeriodicalId":22510,"journal":{"name":"The International Journal of Psychiatry in Medicine","volume":"6 1","pages":"277 - 288"},"PeriodicalIF":0.0,"publicationDate":"2001-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88326971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-09-01DOI: 10.2190/3987-2N5A-FJDG-M89F
Z. Dreznik, T. Vishne, D. Kristt, D. Alper, E. Ramadan
Objective: Rectal prolapse is a complication of AN that may be more common than previously recorded experience would suggest. Method: In this report we document, for the first time, the association of anoxia nervosa (AN) and rectal prolapse in a series of three patients seen in the past three years. An extensive review of the literature using Medline over the period from 1966 to Jan 2000 failed to reveal any previous example of this association. Results and Conclusion: The finding could have significant health care implications if confirmed. It would suggest that patients with either the psychiatric or surgical problem may not be receiving the appropriate complementary referrals: psychiatrist to surgeon and vice versa. The importance of recognition of this association in anorectic patients is the availability of effective surgical therapy.
{"title":"Rectal Prolapse: A Possibly Underrecognized Complication of Anorexia Nervosa Amenable to Surgical Correction","authors":"Z. Dreznik, T. Vishne, D. Kristt, D. Alper, E. Ramadan","doi":"10.2190/3987-2N5A-FJDG-M89F","DOIUrl":"https://doi.org/10.2190/3987-2N5A-FJDG-M89F","url":null,"abstract":"Objective: Rectal prolapse is a complication of AN that may be more common than previously recorded experience would suggest. Method: In this report we document, for the first time, the association of anoxia nervosa (AN) and rectal prolapse in a series of three patients seen in the past three years. An extensive review of the literature using Medline over the period from 1966 to Jan 2000 failed to reveal any previous example of this association. Results and Conclusion: The finding could have significant health care implications if confirmed. It would suggest that patients with either the psychiatric or surgical problem may not be receiving the appropriate complementary referrals: psychiatrist to surgeon and vice versa. The importance of recognition of this association in anorectic patients is the availability of effective surgical therapy.","PeriodicalId":22510,"journal":{"name":"The International Journal of Psychiatry in Medicine","volume":"19 1","pages":"347 - 352"},"PeriodicalIF":0.0,"publicationDate":"2001-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89638249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-09-01DOI: 10.2190/0JJ0-4BHW-FM8K-D5RH
J. Lyness, J. Moynihan, D. Williford, C. Cox, E. Caine
Objective: A model has been proposed in which atherosclerosis contributes to depression in later life by the effects of cytokines on central monoamine systems. We collected pilot data to test the hypothesis that interleukin-1 (IL-1) is associated with depression in a cardiac patient group. Method: Thirty-seven subjects completed research evaluations that included depression diagnosis (Structured Clinical Interview for DSM-III-R), depressive symptom severity (Hamilton Rating Scale for Depression), medical illness burden (Cumulative Illness Rating Scale), and serum IL-1 level measured by enzyme linked immunosorbent assay. Results: Serum IL-1 level was not significantly associated with depressive symptom severity or depression diagnosis, whether or not controlled for medical illness burden, age, and gender. IL-1 level was significantly correlated with medical illness burden. Conclusions: We did not confirm our study hypothesis. The correlation of IL-1 level with medical illness burden likely reflects its release as part of the “sickness response” in a wide variety of disease states. Further research using a larger sample size and a non-cardiac comparison group is warranted.
{"title":"Depression, Medical Illness, and Interleukin-1β in Older Cardiac Patients","authors":"J. Lyness, J. Moynihan, D. Williford, C. Cox, E. Caine","doi":"10.2190/0JJ0-4BHW-FM8K-D5RH","DOIUrl":"https://doi.org/10.2190/0JJ0-4BHW-FM8K-D5RH","url":null,"abstract":"Objective: A model has been proposed in which atherosclerosis contributes to depression in later life by the effects of cytokines on central monoamine systems. We collected pilot data to test the hypothesis that interleukin-1 (IL-1) is associated with depression in a cardiac patient group. Method: Thirty-seven subjects completed research evaluations that included depression diagnosis (Structured Clinical Interview for DSM-III-R), depressive symptom severity (Hamilton Rating Scale for Depression), medical illness burden (Cumulative Illness Rating Scale), and serum IL-1 level measured by enzyme linked immunosorbent assay. Results: Serum IL-1 level was not significantly associated with depressive symptom severity or depression diagnosis, whether or not controlled for medical illness burden, age, and gender. IL-1 level was significantly correlated with medical illness burden. Conclusions: We did not confirm our study hypothesis. The correlation of IL-1 level with medical illness burden likely reflects its release as part of the “sickness response” in a wide variety of disease states. Further research using a larger sample size and a non-cardiac comparison group is warranted.","PeriodicalId":22510,"journal":{"name":"The International Journal of Psychiatry in Medicine","volume":"21 1","pages":"305 - 310"},"PeriodicalIF":0.0,"publicationDate":"2001-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81732176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-09-01DOI: 10.2190/F0BA-BN4F-61KA-UD99
W. Dinn, C. Harris, K. McGonigal, R. C. Raynard
Objective: A postinfectious, autoimmune response may be associated with the development of pediatric obsessive-compulsive disorder (OCD). According to this model, antistreptococcal antibodies cross-react with basal ganglia neurons following streptococcus infection. This autoimmune reaction disrupts a basal ganglia-thalamocortical circuit and generates obsessive-compulsive symptoms. One implication of this model is that prolonged immunologic stress may be a risk factor for OCD. That is, immunologic stress may compromise the blood-brain barrier and permit the influx of antistriatal antibodies into the central nervous system. This article explores one part of this putative relationship by investigating whether adult OCD patients, compared to members of other psychiatric groups, demonstrate a higher incidence of recurrent infections and other conditions suggestive of compromised immune function. Method: To test this hypothesis, we conducted a medical records review of 100 consecutive patients evaluated at a private psychiatric clinic specializing in the treatment of anxiety disorders. Sixty-five patients met diagnostic criteria for an Axis-I syndrome. Primary diagnoses included OCD, posttraumatic stress disorder, social anxiety disorder, generalized anxiety disorder, panic disorder with agoraphobia, and dysthymic disorder. Each medical record was reviewed for the presence of target syndromes or presenting symptoms suggestive of compromised immune function. Results: Chart review revealed an increased rate of immune-related symptoms and syndromes among OCD patients in comparison to other anxiety and mood disorder groups. Groups did not differ significantly in the incidence of non-immune symptoms and syndromes. Conclusion: Adult OCD patients appear to have an increased rate of immune-related diseases above and beyond that seen in other psychiatric disorders.
{"title":"Obsessive-Compulsive Disorder and Immunocompetence","authors":"W. Dinn, C. Harris, K. McGonigal, R. C. Raynard","doi":"10.2190/F0BA-BN4F-61KA-UD99","DOIUrl":"https://doi.org/10.2190/F0BA-BN4F-61KA-UD99","url":null,"abstract":"Objective: A postinfectious, autoimmune response may be associated with the development of pediatric obsessive-compulsive disorder (OCD). According to this model, antistreptococcal antibodies cross-react with basal ganglia neurons following streptococcus infection. This autoimmune reaction disrupts a basal ganglia-thalamocortical circuit and generates obsessive-compulsive symptoms. One implication of this model is that prolonged immunologic stress may be a risk factor for OCD. That is, immunologic stress may compromise the blood-brain barrier and permit the influx of antistriatal antibodies into the central nervous system. This article explores one part of this putative relationship by investigating whether adult OCD patients, compared to members of other psychiatric groups, demonstrate a higher incidence of recurrent infections and other conditions suggestive of compromised immune function. Method: To test this hypothesis, we conducted a medical records review of 100 consecutive patients evaluated at a private psychiatric clinic specializing in the treatment of anxiety disorders. Sixty-five patients met diagnostic criteria for an Axis-I syndrome. Primary diagnoses included OCD, posttraumatic stress disorder, social anxiety disorder, generalized anxiety disorder, panic disorder with agoraphobia, and dysthymic disorder. Each medical record was reviewed for the presence of target syndromes or presenting symptoms suggestive of compromised immune function. Results: Chart review revealed an increased rate of immune-related symptoms and syndromes among OCD patients in comparison to other anxiety and mood disorder groups. Groups did not differ significantly in the incidence of non-immune symptoms and syndromes. Conclusion: Adult OCD patients appear to have an increased rate of immune-related diseases above and beyond that seen in other psychiatric disorders.","PeriodicalId":22510,"journal":{"name":"The International Journal of Psychiatry in Medicine","volume":"353 1","pages":"311 - 320"},"PeriodicalIF":0.0,"publicationDate":"2001-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81346890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-09-01DOI: 10.2190/Q3VY-T8V9-30MA-VC5C
J. Harman, B. Mulsant, K. Kelleher, H. Schulberg, D. Kupfer, C. F. Reynolds
Objective: Although effective treatments for depression exist, under or non-treatment of depression is common. Efforts were made in the early 1990s to improve recognition and treatment of depression, with many of those efforts targeted at groups most vulnerable to under-treatment. The purpose of this study is to assess treatment rates in 1993–1994 and 1996–1997. Method: Using nationally representative surveys of office-based practice covering the years 1993, 1994, 1996, and 1997, we obtained estimates of visits by adults in which depression was diagnosed and a prescription for antidepressant medication and/or psychotherapy was provided or ordered. Results: The proportion of physician office visits in which a depression diagnosis was recorded did not change from 1993–1994 (3.48 percent) to 1996–1997 (3.40 percent). However, the rate of antidepressant prescription or psychotherapy rose from 74.2 percent of visits with a depression diagnosis in 1993–1994 to 82.3 percent of these visits in 1996–1997. Significantly lower rates of treatment for depression during office visits made by African American patients, elderly patients, and patients on Medicaid occurred in 1993–1994, but were not evident in 1996–1997, reflecting improved rates of depression treatment in these populations. Conclusions: Although rates of diagnosis of depression during office visits have not increased, treatment rates for depression are improving among those who are diagnosed, including groups of people who historically were less likely to be offered treatment. Additional efforts to improve recognition and diagnosis of depression in ambulatory medical practice and to improve dissemination of treatment are needed.
{"title":"Narrowing the Gap in Treatment of Depression","authors":"J. Harman, B. Mulsant, K. Kelleher, H. Schulberg, D. Kupfer, C. F. Reynolds","doi":"10.2190/Q3VY-T8V9-30MA-VC5C","DOIUrl":"https://doi.org/10.2190/Q3VY-T8V9-30MA-VC5C","url":null,"abstract":"Objective: Although effective treatments for depression exist, under or non-treatment of depression is common. Efforts were made in the early 1990s to improve recognition and treatment of depression, with many of those efforts targeted at groups most vulnerable to under-treatment. The purpose of this study is to assess treatment rates in 1993–1994 and 1996–1997. Method: Using nationally representative surveys of office-based practice covering the years 1993, 1994, 1996, and 1997, we obtained estimates of visits by adults in which depression was diagnosed and a prescription for antidepressant medication and/or psychotherapy was provided or ordered. Results: The proportion of physician office visits in which a depression diagnosis was recorded did not change from 1993–1994 (3.48 percent) to 1996–1997 (3.40 percent). However, the rate of antidepressant prescription or psychotherapy rose from 74.2 percent of visits with a depression diagnosis in 1993–1994 to 82.3 percent of these visits in 1996–1997. Significantly lower rates of treatment for depression during office visits made by African American patients, elderly patients, and patients on Medicaid occurred in 1993–1994, but were not evident in 1996–1997, reflecting improved rates of depression treatment in these populations. Conclusions: Although rates of diagnosis of depression during office visits have not increased, treatment rates for depression are improving among those who are diagnosed, including groups of people who historically were less likely to be offered treatment. Additional efforts to improve recognition and diagnosis of depression in ambulatory medical practice and to improve dissemination of treatment are needed.","PeriodicalId":22510,"journal":{"name":"The International Journal of Psychiatry in Medicine","volume":"107 1","pages":"239 - 253"},"PeriodicalIF":0.0,"publicationDate":"2001-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80800062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-09-01DOI: 10.2190/BBNG-265Y-298T-UJEF
C. Marchesi, Elisabetta Brusamonti, A. Giannini, R. Di Ruvo, Francesco Mineo, C. Maggini
Objective: The present study examined patients during the year after the index hospitalization in an Emergency Ward (ED) to determine whether patients with depressive or anxiety disorders have a higher rate of readmission than patients without these conditions. Method: For this purpose, 165 subjects (85 diagnosed with DSM-IV depressive or anxiety disorders and 80 controls) were evaluated with the Hospital Anxiety and Depression Scale (HADS) and with the Duke Severity of Illness Scale both during the index hospitalization and one year later. Hospitalizations during the follow-up period were determined using the hospital database. Results: During the follow-up period, depressed and anxious patients were more frequently rehospitalized in ED wards than controls (p = 0.006), after controlling for the effect of medical illnesses severity, marital status, living arrangement, and employment status. No difference was found regarding the admissions to wards different from ED. Conclusions: Patients with depressive or anxiety disorders use the ED ward more frequently than controls for the diagnosis and treatment of somatic symptoms.
目的:本研究对急诊病房(ED)指数住院后一年内的患者进行调查，以确定患有抑郁症或焦虑症的患者是否比没有这些疾病的患者有更高的再入院率。方法:采用医院焦虑抑郁量表(HADS)和杜克疾病严重程度量表(Duke Severity of disease Scale)对165名被诊断为DSM-IV抑郁或焦虑障碍的患者(85名)和对照组(80名)在住院期间和一年后进行评估。使用医院数据库确定随访期间的住院情况。结果:随访期间，在控制疾病严重程度、婚姻状况、生活安排、就业状况等因素的影响后，抑郁、焦虑患者在急诊科病房的再住院率高于对照组(p = 0.006)。结论:抑郁症或焦虑症患者比对照组更频繁地使用急诊科病房诊断和治疗躯体症状。
{"title":"The Use of an Emergency Ward by Patients with Depressive or Anxiety Disorders: A One Year Follow-up Study","authors":"C. Marchesi, Elisabetta Brusamonti, A. Giannini, R. Di Ruvo, Francesco Mineo, C. Maggini","doi":"10.2190/BBNG-265Y-298T-UJEF","DOIUrl":"https://doi.org/10.2190/BBNG-265Y-298T-UJEF","url":null,"abstract":"Objective: The present study examined patients during the year after the index hospitalization in an Emergency Ward (ED) to determine whether patients with depressive or anxiety disorders have a higher rate of readmission than patients without these conditions. Method: For this purpose, 165 subjects (85 diagnosed with DSM-IV depressive or anxiety disorders and 80 controls) were evaluated with the Hospital Anxiety and Depression Scale (HADS) and with the Duke Severity of Illness Scale both during the index hospitalization and one year later. Hospitalizations during the follow-up period were determined using the hospital database. Results: During the follow-up period, depressed and anxious patients were more frequently rehospitalized in ED wards than controls (p = 0.006), after controlling for the effect of medical illnesses severity, marital status, living arrangement, and employment status. No difference was found regarding the admissions to wards different from ED. Conclusions: Patients with depressive or anxiety disorders use the ED ward more frequently than controls for the diagnosis and treatment of somatic symptoms.","PeriodicalId":22510,"journal":{"name":"The International Journal of Psychiatry in Medicine","volume":"35 1","pages":"265 - 275"},"PeriodicalIF":0.0,"publicationDate":"2001-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89712525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-09-01DOI: 10.2190/EJBR-DWLH-EV3P-TWHX
J. Strik, A. Honig, R. Lousberg, J. van Os, Eduard J. M. Van Den Berg, H. M. van Praag
Objective: Post-MI depression increases mortality, especially in the first 18 months after MI. Identifying patients at risk for post-MI depression is therefore important. In the present study we investigated possible correlates for post-MI depression on an a priori basis. Method: Based on the literature, four clinically easily attainable variables were selected as possible correlates for post-MI depression. These were prescription of benzodiazepines during acute hospitalization, cardiac complications during acute hospitalization, history of depression, and not being able to stop smoking within six months after MI. A consecutive cohort of 173 first-MI patients was screened with the SCL-90 depression scale and DSM-III-R citeria for major depression. Of this cohort 35 depressed patients were compared with 35 non-depressed post-MI patients, matched for gender, age, and severity of MI. Results: In univariate analyses, complications during hospitalisation (OR = 2.14; CI = 0.89–5.14), prescription of benzodiazepines (OR = 3.67; CI = 1.11–12.1), history of depression (OR = 3.0; CI = 0.87–10.4), and not being able to stop smoking (OR = 4.5; CI = 1.11–18.2) were clinical correlates for post-MI depression. Multivariate analyses showed that none of these variables were independent of the others in predicting depression. Conclusions: A number of easily measurable patient characteristics identify those MI-patients at risk of post-MI depression. Further investigations should focus on the predictive value of these factors in relation to post-MI depression.
{"title":"Clinical Correlates of Depression following Myocardial Infarction","authors":"J. Strik, A. Honig, R. Lousberg, J. van Os, Eduard J. M. Van Den Berg, H. M. van Praag","doi":"10.2190/EJBR-DWLH-EV3P-TWHX","DOIUrl":"https://doi.org/10.2190/EJBR-DWLH-EV3P-TWHX","url":null,"abstract":"Objective: Post-MI depression increases mortality, especially in the first 18 months after MI. Identifying patients at risk for post-MI depression is therefore important. In the present study we investigated possible correlates for post-MI depression on an a priori basis. Method: Based on the literature, four clinically easily attainable variables were selected as possible correlates for post-MI depression. These were prescription of benzodiazepines during acute hospitalization, cardiac complications during acute hospitalization, history of depression, and not being able to stop smoking within six months after MI. A consecutive cohort of 173 first-MI patients was screened with the SCL-90 depression scale and DSM-III-R citeria for major depression. Of this cohort 35 depressed patients were compared with 35 non-depressed post-MI patients, matched for gender, age, and severity of MI. Results: In univariate analyses, complications during hospitalisation (OR = 2.14; CI = 0.89–5.14), prescription of benzodiazepines (OR = 3.67; CI = 1.11–12.1), history of depression (OR = 3.0; CI = 0.87–10.4), and not being able to stop smoking (OR = 4.5; CI = 1.11–18.2) were clinical correlates for post-MI depression. Multivariate analyses showed that none of these variables were independent of the others in predicting depression. Conclusions: A number of easily measurable patient characteristics identify those MI-patients at risk of post-MI depression. Further investigations should focus on the predictive value of these factors in relation to post-MI depression.","PeriodicalId":22510,"journal":{"name":"The International Journal of Psychiatry in Medicine","volume":"12 1","pages":"255 - 264"},"PeriodicalIF":0.0,"publicationDate":"2001-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91085060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-09-01DOI: 10.2190/AFM3-01XY-CYGA-PHMD
V. Bozikas, Nikos Vlaikidis, P. Petrikis, Anastasios Kourtis, A. Karavatos
In this article a case of schizophrenic-like symptoms in a patient with thrombo-angiitis obliterans (TAO) is presented. His CT and MRI findings indicated a diffuse ischemia in the white matter, suggestive of TAO, not of focal lesions. The patient, except for age, did not have other risk factors for other cerebrovascular diseases. Psychotic symptoms may be the result of cerebral TAO, via deep and periventricular white matter lesions.
{"title":"Schizophrenic-Like Symptoms in a Patient with Thrombo-Angiitis Obliterans (Winiwarter-Buerger's Disease)","authors":"V. Bozikas, Nikos Vlaikidis, P. Petrikis, Anastasios Kourtis, A. Karavatos","doi":"10.2190/AFM3-01XY-CYGA-PHMD","DOIUrl":"https://doi.org/10.2190/AFM3-01XY-CYGA-PHMD","url":null,"abstract":"In this article a case of schizophrenic-like symptoms in a patient with thrombo-angiitis obliterans (TAO) is presented. His CT and MRI findings indicated a diffuse ischemia in the white matter, suggestive of TAO, not of focal lesions. The patient, except for age, did not have other risk factors for other cerebrovascular diseases. Psychotic symptoms may be the result of cerebral TAO, via deep and periventricular white matter lesions.","PeriodicalId":22510,"journal":{"name":"The International Journal of Psychiatry in Medicine","volume":"73 1","pages":"341 - 346"},"PeriodicalIF":0.0,"publicationDate":"2001-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82195570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-09-01DOI: 10.2190/U0P3-5VPV-YXKF-GRG1
L. Edgar, Z. Rosberger, J. Collet
Objective: Nucare, a short-term psychoeducational coping skills training intervention was evaluated in a randomized controlled clinical trial (RCT) of 225 newly diagnosed breast and colon cancer patients. Method: Measures of psychosocial distress, well being and optimism were evaluated every four months during a one-year period. Patients were randomized to one of four arms: Nucare presented in an individual basis; Nucare presented in a group format; a non-directive supportive group; and a no-intervention control. The interventions were provided in five sessions of ninety minutes each. Results: Patients with breast cancer who received Nucare presented in an individual format showed more significant improvements in well-being over time compared to those in the control and group arms. Conclusions: We were unable to develop functioning groups within the RCT. Partial explanations for the latter finding include the structural limitations of the RCT: the groups were small, difficult to schedule and patients indicated that they would have preferred to choose whether or not to participate in a group. The positive changes in women with breast cancer who received Nucare persisted at 12 months.
{"title":"Lessons Learned: Outcomes and Methodology of a Coping Skills Intervention Trial Comparing Individual and Group Formats for Patients with Cancer","authors":"L. Edgar, Z. Rosberger, J. Collet","doi":"10.2190/U0P3-5VPV-YXKF-GRG1","DOIUrl":"https://doi.org/10.2190/U0P3-5VPV-YXKF-GRG1","url":null,"abstract":"Objective: Nucare, a short-term psychoeducational coping skills training intervention was evaluated in a randomized controlled clinical trial (RCT) of 225 newly diagnosed breast and colon cancer patients. Method: Measures of psychosocial distress, well being and optimism were evaluated every four months during a one-year period. Patients were randomized to one of four arms: Nucare presented in an individual basis; Nucare presented in a group format; a non-directive supportive group; and a no-intervention control. The interventions were provided in five sessions of ninety minutes each. Results: Patients with breast cancer who received Nucare presented in an individual format showed more significant improvements in well-being over time compared to those in the control and group arms. Conclusions: We were unable to develop functioning groups within the RCT. Partial explanations for the latter finding include the structural limitations of the RCT: the groups were small, difficult to schedule and patients indicated that they would have preferred to choose whether or not to participate in a group. The positive changes in women with breast cancer who received Nucare persisted at 12 months.","PeriodicalId":22510,"journal":{"name":"The International Journal of Psychiatry in Medicine","volume":"81 1","pages":"289 - 304"},"PeriodicalIF":0.0,"publicationDate":"2001-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78144834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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