bluuebunny/crossref_metadata_2025 huggingface dataset:
The prevalence of sexual dysfunctions in infertile women
Authors: Tayebi N.
Published: May 2011

Objective

Sexuality is an important and integral part of every woman's life. The aim of this study was to assess the degree of sexual dysfunction among infertile women and its correlation with age, duration of marriage and etiology of infertility in women.

Materials and methods

300 infertile women who were referred to IVF center for management of their infertility problem involved in this study after informed consent. They were asked to fill a questionnaire that contained three parts of demographic, infertility and sexual function items. Distribution of sexual dysfunction and its relationship to infertility and marriage duration were analyzed through SPSS software.

Results

The most common sexual dysfunction was orgasm disorder (83.76%) and the rate of sexual desire disorder, dyspareunia and vaginismus were 80.7%, 67.7% and 76.7% respectively. More than 50% of cases mentioned decreased frequency of coitus after diagnosis of infertility. Vaginismus and dyspareunia were more common in 20–24 years age group.

Conclusion

According to the high rate of sexual dysfunction in this study and almost the same rate in other studies, gynecologists should pay more attention to this important issue and encourage the patients to have an evaluation by a psychiatrist or psychologist.
Relaibility and validity of the Chinese translation of insomnia severity index (C-ISI) in Chinese patients with insomnia
Authors: Badiee Aval Baghyahi S. , Torabi S. , Gao Y. , Cao K.G. , Badiee Aval Baghsyahi H.R.
Published: May 2011

Introduction

The Insomnia Severity Index (ISI) is a Questionnaire to screen insomnia in clinics;so,it has been translated into many languages.

Objectives

To determine the relaibility and validity of the Chinese Translation of Insomnia Severity Index(C-ISI) in patients with Insomnia and compare it with Chinese version of Pittsburgh Sleep Quality Index(C-PSQI).

Aims

To prove the relaibility and validity of C-ISI for using it in chinese speakers.

Method

English version ISI was translated into Chinese base on standard guidelines then Chinese version was filled in 83 patients with insomnia as a clinical group and 45 persons without sleep complain as the control group by themselves in Neuropsychiatery Department of DongzhiMen hospital. For finding Test-Retest reliability they refilled ISI questionnaire 2 weeks later.

Results

Cronbach-α coefficient of C-ISI for the clinical group, control group and both of them was 0.72, 0.75 and 0.91 respectively. The C-ISI component and total scores in test were significantly correlated with their related components and total scores in re-test (P < 0.05). Mean Ranks for All C-ISI components, total score were significantly higher in clinical group than control group that presents low sleep quality in clinical group. There are Significant correlations between C-ISI component and total scores and C-PSQI components and Total scores in related Items.

Conclusions

C-ISI has acceptable reliability and good sensitivity for assessing insomnia patients; besides, C-ISI can evaluate the insomnia patients similar to the PSQI-C so it can be used as a good scale to measure sleep quality in Chinese speakers.
Effect of acupuncture as a complementary medicine in treating insomnia
Authors: Badieeavalbaghyahi S. , Zhang X. , Torabi S. , Badieeavalbaghsyahi H.
Published: May 2011

Introduction

Acupuncture, as complementary medicine, has been used since many years ago in china and many researches have proved its effect separately or combined with other treatment methods.

Objectives

To compare therapeutic effects of Acupuncture plus estazolam and Cognitive - Behavioral Therapy plus estazolam on insomnia.

Aims

To determine the efficacy of acupuncture as complementary medicine in treating insomnia.

Method

64 insomnia patients were randomly divided into an acupuncture group and a behavioral group, 30 cases in acupuncture group and 18 cases in behavioral group completed research. The acupuncture group was treated by administration oral estazolam before sleeping each day and needling, three times a week, the behavioral group received Stimulus control as a Cognitive - Behavioral Therapy plus oral estazolam before sleeping each day. Treatment course was 3 weeks. The insomnia severity index (ISI) scores before and after treatment were observed in the both groups.

Results

The total effective rate was 86.7% in the acupuncture group and 50% in the behavioral group with statistically significant difference (P < 0.05). The cured rate of 30% in the acupuncture group was significantly higher than 16.7% in the behavioral group (both P < 0.05).

Conclusions

The therapeutic effect of Acupuncture as a complementary medicine on insomnia is better than stimulus therapy as a Cognitive - Behavioral Therapy.
Is disturbed sleep predictive for later “burnout” - a 20 year perspective
Authors: Hetta J. , Mallon L. , Broman J.-E.
Published: May 2011

The aim was to examine if sleeping difficulties in year 1983 predicted “burnout” in year 2003.

Methods

In 1983: 1.687 subjects, aged 30–44 years, answered a sleep questionnaire (USI).

In 2003: In a follow-up, 1.192 subjects, aged 50–64 years, answered the same sleep questionnaire. Subjects were asked about difficulties initiating sleep (DIS) and difficulties maintaining sleep (DMS), and not being rested by sleep (NRS). The questions were answered on a five-point scale

(1 = no problems,

2 = minor problems,

3 = moderate problems,

4 = severe problems,

5 = very severe problems).

At least severe problems (scores 4 and 5) were considered to be a complaint. Insomnia was defined as having at least one complaint. In year 2003 questions about health included a statement about being “burnout”.

Results

In year 2003 “burnout” was reported by 7,3% of women, and in 3,9% in men.

In a logistic regression we examined the risk for “burnout” in relation to DIS, DMS and NRS at baseline. For women DMS (OR 2,8 CI 1,1-8,0) and NRS (OR 3,3 CI 1,2-9.3) were significant. DIS which was the only significant association for men (OR 7,3 CI 2,0-25,3).

Conclusion

Sleep complaints are predictive for a “burnout”-condition later in life.
An evaluation study of the Epworth sleepiness scale adapted for children and adolescents: a tool for case finding of pediatric excessive daytime sleepiness (EDS)
Authors: Lecendreux M. , Gamble H. , Sanchez-Garrido L. , Giordanella J.-P. , Konofal E.
Published: May 2011

Child and adolescent sleepiness is an important public health issue with potentially serious consequences on attention, learning, behaviour, and quality of life. For some individuals, sleepiness may be due to a sleep disorder which requires clinical investigation and subsequent treatment. A reliable measure of child and adolescent sleepiness is needed and a version of the Epworth Sleepiness Scale has been adapted for use in child and adolescent populations.

The adapted Epworth Scale is a questionnaire which aims to identify the chance of falling asleep in 10 different situtations. This questionnaire is normally used in a clinical context as a diagnostic tool. The objective of this study was to investigate whether the adapted Epworth Scale could be used to screen for sleep disorders in a similar manner to the adult scale. This presentation describes a validation study of the adapted Epworth Scale in a population of college students. 9,005 Parisian college students (50.4% female) completed an on-line questionnaire. The mean age was 12.7 years (sd = 1.35). The response rate was greater than 95% for each item of the adapted Epworth score. The mean score was 8.6 / 30 (sd = 4.62).

We suggest that the adapted Epworth Scale could be used as a tool for case finding of excessive daytime sleepiness in schools. If the adapted scale is to be used for this purpose, subjects with high scores should be offered investigation to exclude underlying sleep disorders such as narcolepsy, primary hypersomnia or ADHD.
One night sleep restriction impairs the cortical oxygenation responses
Authors: Miyata S. , Noda A. , Ito M. , Iwamoto K. , Ozaki N.
Published: May 2011

Introduction

Sleep restriction has adverse effects on performance and neurobehavioral function. However, the mechanism of impaired performance and neurobehavioral function has not been studied yet.

Objectives

We examined the effect of insufficient sleep on cerebral blood flow and cognitive function in 8 healthy adults (mean age 22.4 years).

Methods

All participants were in bed for 8 h (sufficient sleep), and for < 4 h (insufficient sleep). The oxyhemoglobin (oxyHb) level by a word fluency task was measured with a near-infrared spectroscopy recorder on the morning following sufficient and insufficient sleep periods. Wisconsin card sorting test (WCST), continuous performance test (CPT) and N-back test were evaluated on the same days.

Results

The peak oxyHb level was significantly lower in the left and right frontal lobes after insufficient sleep than after sufficient sleep (left: 0.25 ± 0.10 vs. 0.70 ± 0.29 mmol, P < 0.05; right: 0.23 ± 0.13 vs. 0.73 ± 0.22 mmol, P < 0.05). There was no significant difference in the number of words generated during the word fluency task between sufficient and insufficient sleep states. The percentage of correct responses on CPT after insufficient sleep was significantly lower than that after sufficient sleep (86.6 ± 10.2 vs. 96.0 ± 4.9%, P < 0.05). The reaction time of WCST was significantly longer after insufficient sleep than after sufficient sleep (76.6 ± 13.4 vs. 70.6 ± 16.2 sec, P < 0.05).

Conclusions

One night sleep restriction decreased the concentration changes of oxyHb in brain tissue, leading to impaired cognitive function.
Effect of melatonin on insomnia in patients with hyperthymic temperament: An open clinical trial
Authors: Nastase S. , Ivanovici D. , Nastase L.
Published: May 2011

Introduction

The link among melatonin levels, pineal function, insomnia and affective spectrum is strengthened by epidemiologic and chronobiological evidence. From the affective spectrum, we selected the hyperthymic temperament, which is characterized by exuberant, upbeat, overenergetic, and overconfident lifelong traits.

Objectives

We examined whether insomnia in persons with hyperthymic temperament responds particularly to the treatment with melatonin, in comparison with the euthymics patients with insomnia.

Method

We ran an open label study on 20 subjects. None suffered from depression, mania or hypomania.

The study population comprised two groups: one group with patients with insomnia whose temperament presented hyperthymic traits (10 subjects) and the other group with euthymic adults, (10 subjects).

The Athens Insomnia Scale 5-item version (AIS-5) was administered to the two groups before and after the treatment with melatonin. The AIS is a self-assessment psychometric instrument designed for quantifying sleep difficulty based on the ICD-10 criteria.The patients took a single daily dose of 5 mg of melatonin with 30 minutes before bedtime. Using the AIS-5, we have assessed sleep at baseline and after 4 weeks of treatment. SPSS version 11 was used for statistical analysis.

Results

After 4 weeks of melatonin therapy (5 mg/day), the comparison of the two groups showed that melatonin is more effective in the insomniacs with hyperthymic temperament comparative with the euthymic patients.

Conclusion

Melatonin has shown promising results in the treatment of insomnia in patients with hypertimic temperament. Further studies are necessary to better investigate the role of melatonin on insomnia in bipolar spectrum.
High rate of prevalence of clock 3′UTR polymorphism rs1801260 and a novel variation: Association with diurnal preference
Authors: Paul B. , McAlonan G.M. , Banerjee M.
Published: May 2011

There are a number of reports which show CLOCK 3111 T/C SNP rs1801260 is associated with ‘eveningness’ circadian type, but the results are not consistent across different populations. The present study tried to address the effect of CLOCK polymorphisms on Diurnal preference in the South Indian population. 108 subjects were genotyped for rs1801260 polymorphism by direct sequencing. Demographic data was collected from genotypically stratified groups of subjects using a modified sleep wake cycle questionnaire. Data from the questionnaire recorded the subjects sleep wake pattern and their peak performance time of the day. The sequencing data was aligned and analyzed using Mutation Survey software for new mutations. We found a new variation in the 3′UTR region of the CLOCK gene (BankIt1368312 Seq1 HM626403, BankIt1368312 Seq2 HM626404) which may be a possible miRNA binding site. Our study found that CLOCK 3111 T/C polymorphism is negatively associated with Eveningness with a significance of 0.038. We found that the prevalence rate of rs1801260 is high and the ancestral genotype is associated with eveningness. Though the sample size was small this was a homogenous group from south India selected for the study. It is the first study in south Indian population to document the effect of CLOCK polymorphisms on Circadian rhythm.
Sleep quality and its correlation to general health status in health care students
Authors: Sahraian A. , Javadpour A. , Mani A.
Published: May 2011

Introduction

Sleep-wake cycle is one of human biological rhythm highly correlated to well being and general health status.Poor sleep quality, sleep disruption and changes in regular Sleep-wake pattern may cause physical and psychological burden such as impairment in job performance, decreased work efficiency and learning disability.

Objective

Health care students trained in medical, nursing and midwifery fields is a population who are at great risk to develop sleep disruption and its subsequent physical and mental morbidity.

Aim

The aim of this study was to describe how sleep quality correlated to general health status among 280 health care students.

Methods

280 health care students studying in health related fields participated in this cross section study. Pittsburg sleep quality index (PSQI), sleep- wake questionnaire and the general health questionnaire (GHQ) administered to gather data describing sleep quality, sleep wake disruption and the general health status.

Results

Preliminary results showed that 61.4% of subjects defined as poor sleeper. In further co relational analysis there was a significant correlation between sleep quality and general health status (r = .6, p = . 000, n = 280). Regression analysis showed that number of nights with sleep disruption due to shift work or academic needs was a strong predictor for both poor sleep quality and general health status.

Conclusion

In conclusion, Sleep disruption due to shift work or other academic demands is a predictor for poor sleep and its subsequent mental health morbidity, which should be considered as a part of mental health policy for health related college students.
The contribution of individual and combined common non-communicable diseases to poor sleep quality: The japanese civil servants study
Authors: Sekine M. , Tatsuse T.
Published: May 2011

Introduction

Some of common non-communicable diseases deteriorate sleep quality, which worsens the disease itself. This study aims to evaluate

(1)

whether common non-communicable diseases are associated with poor sleep quality and

(2)

whether the combination of such diseases increase the possibility of poor sleep quality.

Methods

The subjects were civil servants in local government in Japan. A questionnaire survey was conducted in January 2003. Altogether 4272 subjects responded (response rate: 79.2%). Subjects were asked about whether they were diagnosed as having common non-communicable diseases (i.e. heart disease, cerebrovascular disease, hypertension, hyperlipidemia, diabetes, bronchial asthma, gastroduodenal ulcer, mental disorders, and low back pain). Overweight was evaluated by using BMI. Poor sleep quality was evaluated using Pittsburgh Sleep Quality Index (PSQI).

Results

The age- and sex-adjusted odds ratio (OR) for poor sleep quality was higher among patients with heart disease, cerebrovascular disease, hypertension, hyperlipidemia, diabetes, bronchial asthma, gastroduodenal ulcer, mental disorders, low back pain, and obesity but the associations were not necessarily significant. However, the combination of such common non-communicable diseases significantly increased the possibility of poor sleep quality, with a dose-response relationship.

Conclusion

Although individual common non-communicable diseases may not necessarily cause poor sleep quality, the combination of these may increase the prevalence of poor sleep quality. Clinician should think that patients may have poor sleep quality if they have several non-communicable diseases.
Long-term efficacy and safety of zolpidem extended-release 12.5 mg, in old patients with chronic primary insomnia: a randomized, double-blind, placebo-controlled, parallel-group, multicenter study
Authors: Zarra J. , Schmidt L.
Published: May 2011

Objective

To evaluate long-term efficacy and safety of zolpidem extended-release, in old patients for chronic primary insomnia.

Design

Multicenter, randomized, double-blind, placebo-controlled, parallel-group.

Method

Population: Outpatient with aged more of 65 years. Diagnosis: DSM-IV criteria for chronic primary insomnia; Treatment: Single-dose zolpidem extended-release 12.5 mg (n = 128) or placebo (n = 127), self-administered every night.

Results

Patient's Global Impression (PGI) and Clinical Global Impression-Improvement (CGI-I) were assessed every 4 weeks up to six month. Patient Morning Questionnaire (PMQ), recorded daily, assessed subjective sleep measures-sleep onset latency (SOL), total sleep time (TST), number of awakenings (NAW), wake time after sleep onset (WASO), and quality of sleep (QOS)-and next-day functioning. Zolpidem extended-release also was statistically significantly superior to placebo at every time point for PGI (Items 1–4) and CGI-I (P < 0.0001, rank score), TST, WASO, QOS (P < 0.0001), and SOL (P < or = 0.0014); NAW (Months 2–6; P < 0.0001). Sustained improvement (P < 0.0001, all time points) was observed in morning sleepiness and ability to concentrate (P = 0.0014, month 6) with zolpidem extended-release compared with placebo. Most frequent adverse events for zolpidem extended-release were headache, anxiety and somnolence to the morning. No rebound effect was observed during the first 3 nights of discontinuation.

Conclusions

These findings establish the efficacy of dosing of zolpidem extended-release 12.5 mg for up to 6 months. Treatment provided sustained and significant improvements in sleep onset and maintenance and also improved next-day concentration and morning sleepiness.
Cognitive-behavioral psychotherapy of somatoform disorders
Authors: Mykhaylov B. , Fedak B. , Kudinova O.
Published: May 2011

Last 10 years there is tendency to increased deseaseness and prevalence's of somatoform disorders in Ukraine.

The most significant role belongs to the patients self-evaluation of the influence of the disease on their social status, that is an essential past of the self picture of the disease and the important point of therapeutic rehabilitation intervention.

On the basis of the examined 300 patients on somatoform disorders and 200 patients on psychosomatic diseases we have elaborated a formal test that allows to evaluate quantitatively the influents of the disease on various spheres of patients’ social status. It was absolutely unexpectable the common for psychosomatic and somatoform disorders patients rise of significance of personal individual, every day life factors in cases of aggravation of the main disease course. We created the cognitive-behavioral psychotherapy system with suggestive and autosuggestive implementations.

Elucidation of peculiarity of personal perception of the disease served as basis of elaboration of purposeful system of psychotherapy, consulting, psychological support for patients with high-effectiveness 1,5 - 3 years catamnesis in 85% patients.

Our experience showed the necessity of the use the target-oriented integrativе models of psychotherapy, parted on stages. On the first stage - sedative-adapting the receptions of cognitive and suggestive psychotherapy are used. There is group therapy on second-main-stage. On the third stage-supportive- elements of the autogenic training mastered.
Somatization disorder treated with electro convulsive therapy
Authors: Gahr M. , Schoenfeldt-Lecuona C. , Connemann B.
Published: May 2011

Electroconvulsive therapy (ECT) is predominantly being recommended for treatment of severe mood disorders and of catatonia. We report improvement with ECT in a patient suffering from somatization disorder.

The patient, a 55-year-old man, suffered from intractable somatization disorder for more than thirty years. Numerous diagnostic and several futile surgical procedures had been performed in the past. On admission there had been no psychopharmacological therapy for one month. Subsequently treatment trials with duloxetine, mirtazapine, and venlafaxine were performed, but remained ineffective. Pregabalin lead to only slight amelioration of anxiety and no improvement of pain symptoms. After 3 months of unsuccessful clinical treatment, including pharmacotherapy, cognitive behavioral therapy, and regularly scheduled interdisciplinary medical consultations, ECT was first considered. A trial of right unilateral ECT was initiated. After five sessions the course had to be terminated due to severe ECT-related hypertension. During and following the ECT course, the patient reported rapid and significant improvement of somatic symptoms. In order to evaluate the effects of ECT the patient passed an assessment before and after the ECT (Hamilton Depression Rating Scale, Whiteley-Index, Quantification Inventory for Somatoform Syndroms, and an observer-rated version of the Screening for Somatoform Disorders). Assessment scores were in line with our clinical impression. Follow-up examination four months later showed no further change.

Though somatic anxiety and hypochondriasis have been described to be negative predictors of successful remission with ECT, in our patient ECT has been particularly effective with regard to somatic symptoms of somatization disorder.
Somatoform disorders psychotherapy correction
Authors: Kudinova O.I.
Published: May 2011

At the present time in Ukraine the special priority has the problem of somatoform disorders. A prevalence of clinical somatization neurotic disturbances and necessity of differential diagnostics with somatic diseases were the precondition for studying this area. At the same time, in Ukraine the diagnosis “Vegetative-vascular dystonia” which is ciphered G 90.8, according to ICD-10 instead of “Somatoform disoders” F40.0-F48 is used. It leads unreasonable treatment significant contingents of neurotic patients in neurological departments. On the basis of complex study 300 patients with somatoform disorders and 200 patients with chronic psychosomatic disease are conducted determination of structure and dynamic of somatoform disorders in general practice in Kharkiv-city. Clinic-epidemiological and clinic-statistical research allowed to define the structure of somatoform disorders in ambulatory-policlinic practice. Somatoform dysfunction of cardiovascular system has 60%, of gastrointestinal system 25%, urinal system 8,0%, other - 7%. On that ground has been developed complex differential system of medical- psychological and psychotherapy correction of somatoform disorders with the - 80% high efficasy. Our experience showed the necessity of the integrative models of psychotherapy provided, parted on stage. On the first stage - sedative-adapting the receptions of cognitive and suggestive psychotherapy are used. There is groupe therapy on second-main-stage. On the third stage-supportive-elements of the autogenic training mastered.
Psychological qualities person with functional pathology of spine
Authors: Onishchenko V. , Panchenko O. , Panchenko L. , Garazha M. , Petrakova T.
Published: May 2011

Introduction

The wide circulation vertebral pathologies is one of the most significant modern medical and social problems.

Aims

Establishment of psychological qualities of the person with a functional pathology of spine.

Methods

«Valuable orientations» by M. Rokich; «Firmness definitions to stresses and social adaptation» by Holmes and Rage; «Versatile scale perfectionisme by Huite and Flate; «Revealing dependence on work»; «Degree of expressiveness of neurotic bents of the person» by M.A. Kuznetsov. 100 patients with following functional infringements of spine have been surveyed. In control group have entered 30 students of medical school.

Results

Such features of the person with a functional pathology of a backbone are established: dependence on work - 100%; socially caused perfectionism - 26% which is interpreted as the non-realised overestimated requirements of associates; primacy of individualist values; requirements for the power over associates, using own intelligence and will - 13 %, in love and favor of other people - 37%, in independence and self-sufficiency - 22 %; danger of occurrence of psychosomatic frustration - 54% (p < 0,05). Statistically significant differences between group of patients with functional pathology of spine control group are established on indicators «dependence on work» (p < 0,02), «stability to stress» (p < 0,046).

Conclusions

The timely psychological analysis of the person of the patient and correctly developed program of psychotherapeutic intervention promote achievement of comprehension and understanding of investigatory communication between features of its person and disease, is the concrete help to patients in overcome diseases and its negative corporal or mental displays.
Estimation of emotionally-strong-willed sphere at patients with assencial hypertension
Authors: Onishchenko V. , Panchenko O. , Pugach E.
Published: May 2011

Aims

An establishment of psychological characteristics of patients hypertensive illness (HI) with presence of psychological semiology, the past a course group psychocorrection therapies.

Methods

MMPI, Color test by Lusher, Technique of diagnostics of interpersonal relations by Leary, statistical methods. Patients received complex therapy. The psychotherapy was applied individual, group and associative. 90 patients with assencial hypertension have been surveyed. The age of examinees at the moment of research has made 32–48 years.

Results

73 persons (81,1%) the internal conflict caused ancompatible of type interpersonal relations “Authoritarianism-submission”, constant struggle against accruing is hostile-aggressive feeling has been revealed, at the same time there are difficulties of self-affirmation. In 48 cases (53,3%) prevalence I octant in personal pattern positively correlates with characteristics of sthenic type of reaction according to MMPI (type 469 profiles,-/0) and color test (preference of bright color standards on the first positions, the importance of positions of 4, 2 and 3 colors). 90 persons (100%) from a surveyed contingent high points on VIII octant (11–16) have been revealed, that speaks about hyperresponsibility presence (р ≤ 0,05).

Conclusions

During group psychocorrection patients have seized methods of removal of an emotional pressure, intrapersonal conflicts have been resolved, at them the relation to success and failure situations has changed. Carrying out of group trainings at patients essential hypertension with use of methods of the therapy focused on the decision of problems and psychorelaxation therapy, is an effective complex of methods in correction and preventive maintenance of infringements in emotionally-strong-willed sphere.
Medically unexplained physical symptoms - a multidisciplinary approach
Authors: Pais V. , Correia D. , Ramalho e Silva F.
Published: May 2011

Background

Medically unexplained physical symptoms (MUPS) can be defined as physical symptoms that have no currently known physical pathological cause. MUPS account for one in five new consultations in primary care and for one third of new patients when neurology consultations are considered.Patients with MUPS present significant distress and impaired function and their diagnosis is sometimes hard to establish. The classification of somatoform disorders has been found to be insufficiently useful for therapeutic and scientific purposes. Some authors suggest that new classifications should attend to clinical utility, defined as (1) the extent to which a diagnosis can help clinicians understand or conceptualize a disorder in their daily work; (2) the extent to which a diagnosis can help the clinician communicate useful information to others, including practitioners, family members, patients, and administrators; (3) the extent to which the presence of a disorder helps the clinician choose effective interventions, and (4) the extent to which a disorder can predict future clinical management needs.

Aim

This review aims to discuss the management of MUPS in mental health services, attending to the importance of a multidisciplinary approach.

Methods

Pubmed Medline search on MUPS and review of recent literature.

Discussion

The management of MUPS implies a multidisciplinary approach that can offer different solutions for different degrees of disorder severity and takes into account the perception of the patient about his own illness. New classifications of somatoform disorders that include comprehensible explanations about these symptoms could be helpful for patients and health professionals.
Prevalence of ADHD in chronic fatigue syndrome
Authors: Sáez Francàs N. , Alegre J. , Calvo Piñero N. , Ramos Quiroga J.A. , Ruiz E. , Olivares B. , García Gíménez E. , Casas M.
Published: May 2011

Introduction

Chronic Fatigue Syndrome (CFS) is characterized by severe fatigue associated with pain, sleep disturbance, attentional impairment and headaches. Evidence points towards a prominent role for Central Nervous System in its pathogenesis, and alterations in serotoninergic and dopaminergic neurotransmission have been described.

Attention-deficit Hyperactivity Disorder (ADHD) courses with inattention, impulsivity, and hyperactivity. It affects children and persists into adulthood in 50% of patients. Dopamine transporter abnormalities lead to impaired neurotransmission of catecholaminergic frontal-subcortical-cerebellar circuits.

Objectives

To describe the prevalence of ADHD in a sample of CFS patients, and the clinical implications of the association.

Aims

To study the relationship between CFS and ADHD.

Methods

The initial sample consisted of 142 patients, of whom 9 were excluded because of severe psychopathology or incomplete evaluation. All the patients (age 49 ± 87; 94,7 women) received CFS diagnoses according to Fukuda criteria. ADHD was assessed with a diagnostic interview (CAADID), ADHD Rating Scale and the scale WURS, for childhood diagnose. The scales FIS-40, HAD, STAI and Pluthik Risk of Suicide (RS) were administrated.

Results

38 patients (28,8%) were diagnosed of childhood ADHD (4 combined, 22 hyperactive-impulsive, 12 inattentive) and persisted into adulthood in 28 (21,1%; 5 combined, 4 hyperactive-impulsive, 19 inattentive). There were no differences in Fukuda criteria profile and FIS-40 between groups. ADHD patients scored higher in HAD-Anxiety (9,88 ± 4,82 vs. 12,57 ± 3,49; p = 0,007), HAD-Depression (9,69 ± 4,84 vs. 12,04 ± 4,53; p = 0,023), STAI-E (30,55 ± 14,53 vs. 38,41 ± 11,35; p = 0,012), and RS (6,13 ± 3,48 vs. 8,49 ± 3,07; p = 0,002).

Conclusions

ADHD is frequent in CFS patients and it is associated with more severe clinical profile.
Incidence of axis I and axis II dual diagnosis in hospitalised patients with somatization disorder
Authors: Vasile D. , Vasiliu O. , Grigorescu G. , Mangalagiu A.G. , Ojog D.G. , Bogdan V.
Published: May 2011

Introduction

Somatization disorder is frequently associated in epidemiologic trials with depressive, anxiety, other somatoform or substance related disorders, as well as with personality disorders. An examination of psychiatric comorbidity in patients diagnosed with somatization disorder is strongly advised due to the impact of these associated conditions over the prognosis and treatment.

Objective

To establish the incidence of psychiatric dual diagnosis in hospitalized patients with somatization disorder.

Methods

A group of 37 patients, 22 female and 15 male, mean age 45.9, were evaluated using Structured Clinical Interview for DSM Axis I (SCID-I) and Axis II (SCID-II) disorders at the admission in our department for a diagnosis of somatization disorder. All patients included in this trial were known with somatization disorder for at least one year prior to this admission.

Results

Patients diagnosed with somatization disorder presented mostly depressive disorders (46%, n = 17), anxiety disorders (37.8%, n = 14), substance related disorders (16.2%, n = 6) and personality disorders (67.5%, n = 25). A more detailed analysis on axis I established major depressive disorder as the most frequent diagnosis (37.8%, n = 14), followed by panic disorder (27%, n = 10) and alcohol dependence (13.5%, n = 5), while on axis II the histrionic (21.6%, n = 8) and obsessive-compulsive (19%, n = 7) personality disorders were the most frequently associated conditions. A number of 21 patients presented at least three axis I and/or II simultaneous diagnosis (64.8%).

Conclusion

The most frequently comorbidities in somatization disorder are major depressive disorder and panic disorder on axis I, as well as histrionic and obsessive-compulsive personality disorder on axis II.
Repeated prenatal stress sessions produce changes in exploration and despair detectable at weanling in wistar rats
Authors: Bernal-Morales B. , Contreras C.M. , Cueto-Escobedo J. , Guillén-Ruiz G.
Published: May 2011

Introduction

During gestation and maternal behavior, some physiological events can protect the dam and offspring, but explanations for such phenomena are partially unknown. The effects of stress during prenatal development and infancy can be studied in controlled laboratory conditions.

Objective

To determine the pre- and postnatal effects of stress on coping strategies in weanling rats subjected to the open field and forced swim tests after their dams are subjected to stress during gestation.

Method

Rats aged 21 postnatal days (PND) were assigned to either a Control group (n = 36; offspring from intact dams during gestation) or a Prenatal stress group (n = 36; offspring from dams forced to swim during 5 min sessions on gestational days 1, 7, 14, and 19). Both groups were tested in the open field to evaluate locomotor activity and rearing. In another experiment, PND21 intact rats assigned to a Control group (n = 26) or Postnatal stress group (n = 35) were subjected to restraint stress for 6 min prior to the tests and were later evaluated in the forced swim test.

Results

Locomotor activity (p < 0.026) and rearing (p < 0.001) were lower in the Prenatal stress group compared with the Control group. The latency to first immobility was shorter (p < 0.008), and the total immobility time was longer (p < 0.005) in the Postnatal stress group than Control group.

Conclusion

Stress exposure during gestation produces detectable changes during weanling, consisting of reduced exploratory activity and susceptibility to despair.
The prevalence of stress factors among medicine students in Iran
Authors: Biglu M.H. , Asgharzadeh A.
Published: May 2011

Stress is the body's reaction to any kind of changes that requires a physical, mental or emotional adjustment. The objective of this study is to visualize and analyze the most common stress factors among medicine students in Iran.

A cross-sectional study was conducted among 3,337 medicine students in Iran. A questionnaire was used to gather the data.

Findings indicated that there was a significant relationship among instructor/student interaction (p = 0.05), intern/externship (p = 0.000), self-efficacy factor (p = 0.05) and classmate pressure (p = 0.007) with respect to the year of admittance. The study further revealed that there was no significant correlation between academic theories, staff/management and admittance year factor. The most common stress factors among extern/intern group were the lack of educational disciplines in hospitals and related wards.
Work stress, social support, and burnout in junior doctors: A cross-sectional study
Authors: Bowers A. , Sochos A.
Published: May 2011

Background

Burnout is known to be higher in doctors than in the general population and is associated with adverse patient outcomes. By identifying factors that can lead to burnout, interventions can be implemented to support the health of the workforce and improve patient care.

Aim

The aim of this study is to (1) look at whether psychiatric trainees differ from medical trainees in the work−related stress they experience and the social support they perceive, within and outside the workplace. It also aims to (2) look at whether social support can mediate the stressor-burnout relationship in trainees.

Method

The sample consisted of 184 London based trainees. Participants were administered the Maslach Burnout Inventory (strain), the Specialist Doctors’ Stress Inventory (stressors) and the House and Wells social support scale. To explore the pathways and potential mediating effect of social support within the stressor-burnout relationship structural equation modeling was applied to the data.

Results

42% of all doctors exhibited high levels of emotional exhaustion and depersonalization. Medical trainees were significantly more burnt out than psychiatric trainees (p < .01). Occupational stressors were significantly correlated with the core burnout dimensions. Family, consultant and top management support demonstrated significant correlations with burnout dimensions whereas co-worker support failed to reach significance. Direct, indirect and mediational pathways between study variables were found.

Conclusion

Psychological distress is still prevalent amongst our junior workforce. Medical trainees appear to exhibit more severe levels of burnout and suggestions to improve psychological wellbeing are discussed.
The mental health consequences of protracted asylum seeking in Australia
Authors: D'Souza R.F. ,   Prof Suresh Sundram Refugee Resource Centre
Published: May 2011

The mandatory detention of asylum seekers in Australia and the administrative, legal and ministtreal appeal processes have lead to protracted process of refugee determination.

Further compounding of trauma/ torture, diminished sense of self future and purpose leading to high levels distress including anxiety depressive and somatoform disorders. High levels of distress appear to persisit after refgugees are settled.

Study/methods

•Harvard Trauma Questionnaire-R (HTQ-R) •Hopkins Symptoms Checklist (HSCL-25) •Post-Migration Living Difficulties Checklist (PMLDC) •Psychiatric Epidemiology Research Interview - Demoralisation Scale (PERI-D)f •

Results

N = 124. 84% Male; 93% conversant in English •Age: 20–62 years (μ = 35 yrs, SD = 10.8) •Residency Status: PR n = 32 (25%) Asylum Seeker n = 92 (75%) •Visa status: BVE (30%) BVA (23%) Student Visa (10%) •Time since application: 0 – 178 months (14.8 yrs) (μ = 31.2, SD = 48.4) •Not economic refugees. > 99% arrived by plane. • 34% without Medicare & 23% no work rights.

Conclusion

Multiple fold higher than the general population. -Highly traumatised population -Marginal reduction when granted protection •Inter-correlation between clinical measures à indicates pan-distress. •Clinical measures with number of rejections & time since app •Comparable number of pre-migration traumas yet difference in ‘refugee’ trauma & PTSD for AS vs. PR may reflect that current state of trauma is due to RDP ∨ perpetuating psychosocial factors •It has characteristics of many disorders but its own identity lication à weak association. -Ceiling effect of distress? -current state of trauma is due to RDP &/or perpetuating psychosocial factors •It has characteristics of many disorders but its own identity.
Disruptive situation disorders: evidence fromcrisis and disaster psychiatry
Authors: D'Souza R.F. ,   Disaster Psychiatry Section World Psychiatric Association
Published: May 2011

Every disaster natural or human made places extreme demands on health care and mental health care in particular. Disasters affect large and diverse populations. How the psychological response to a disaster is managed may be the defining factor in the ability of a community to recover. (Holloway et al 1997) Interventions require rapid effective and sustained mobilization of resources (Ursano & Freedman) Facilitating recovery depends on the leadership's understanding of the distress, disorders responses to the event. The World Psychiatric Association section on disdaster psychiatry has been studing recent disasters and with this evidence have considered disasters as disruptive situation and have described these disorders. It concerns the pathogenic quality of a factual event imploding into the psyche. The radical distortion of the human environment implode into the human psyche, confronting us with a new nosological entity. we call- Anxiety by Disruption. •Are we in the presence of a new sustainable nosological entity? Given the peculiarities of the alarm situation, are such responses organized in a distinctive manner? Some basic features • Feelings of neglect. • Loss of hope. • Helplessness. • Mistrust. • Suspicion. • Present and future uncertainties. • Frustration. • Uneasiness and guilt. • Selfishness, indifference, and hostility. • Freezing. • Feeling trapped. • Solitude. • Fear and discomfort. • Incapacity to make decisions. Symptoms include • Uneasiness. • Generalized and constant state of alarm. • Feelings of insecurity, neglect and loneliness. • Anhedonia. • Sleeping Disorders. • Constant pondering on the uncertainty issue. • The need to share feelings and fears with others. • Different somatic symptoms. • Tendency to overact fear. • Avoid daily pleasure activities. Irritability, agressive attitude.
Stress in first-year Egyptian and Saudi female medical students: a cross cultural comparison
Authors: Amr M. , El-Gilany A.-H. , El-Wasify M.
Published: May 2011

Introduction

College students, especially freshmen, are particularly prone to stress due to the transitional nature of college life. However most of studies in this context were conducted in Western Europe and North America with only few recent studies conducted in the Arab world. This study sought to determine whether there was a difference in perceived stress levels of female medical students at Mansoura University, Egypt, and King Faisal University, Saudi Arabia.

Methods

The sample consisted of first year female medical students. The self-reported questionnaire covered four categories, including 13 items, of sources of stress (stressors).Perceived stress scale and Hospital Anxiety and Depression Scale were used to measure stress, anxiety and depression.

Results

There is no significant difference between the two groups regarding number of stressors. However, Saudi students were more likely to cite emotional problems, excessive workload and fear of future. The most common items in Egyptian students were financial and environmental problems. Prevalence of stress and clinical anxiety was higher in the Saudi sample. Logistic regression analyses of independent predictors of high level of stress among both groups combined were Saudi nationality, larger family size, clinical depression and clinical anxiety.

Conclusions

Perceived stress and anxiety are frequent among Saudi students. This information could be useful in designing preventive mental health programs that should be an integral part of the routine clinical facilities caring for medical students to help them to cope with the increasing demands of medical education.
Anger arousal and well being as markers of social functioning and quality of life in the aftermath of exposure to life threatening trauma
Authors: Faruqui R. , Bashir A. , Taj R. , Khan A. , Yousaf F. , Bibi A. , Ayub Z. , Waheed A.
Published: May 2011

Introduction

Severe stress or exposure to life threatening trauma is known to affect social functioning and quality of life.

Objectives

To study well-being and anger arousal as markers of social functioning and quality of life in a group of University students exposed to a suicide bomb attack on a University in Pakistan.

Aims

To examine indicators of social functioning in order to higlight them as targets for therapeutic interventions.

Methods

Subjects were assessed after one year of exposure to a life threatening incident on University campus. Subjects completed an assessment schedule incorporating World Health Organization's Well-Being Index and Novarco Anger Inventory (25 items).

Results

54 students completed the assessment. The mean age of the group was 24 years. All subjects had completed 14–16 years of education and were in full time education at the time of assessment. The Well Being Index Score range was 1–24 with 26 sujects scoring 13 or lower scores indicating poor quality of life. 29 subjects scored higer levels of anger arousal on 10 or more items of Novarco Anger Inventory indicating difficulties in social functioning. The overall group showed a statistically significant negative correlation between the Well-Being Index Scores and the number of Novarco Anger Inventory items scored in the two highest categories of anger arousal.

Conclusions

The results of the study highlight anger arousal and well-being as important markers of functioning in the aftermath of a stressful life event. The study confirms their usefulness as legitimate therapeutic targets for pharmacotherapy, psychotherapeutic, and social interventions.
Personality dimensions and learning modes as the predictors of stress in university students
Authors: Homayouni A.
Published: May 2011

Introduction & objectives

No matter what age you are, if you are under stress it will affect your ability to learn, think and perform at your best. Severe stress releases chemicals in our brains and bodies that can hamper our performance and learning. So for better understanding of stress especially in the learning process, the study aimed to investigate personality characteristics, learning modes, and stress in university students.

Method

131 students were randomly selected from three universities. Hogan-Champagne's Personal Style Inventory (PSI) based on Jungian personality types, Kolb’s Learning Style Inventory (LSI) based on Kolb’s experiential learning theory and Coudron's Stress Inventory (CSI) were used. The data were analyzed with Pearson correlation coefficient and T independent tests.

Results

Analysis showed that in learning modes, there is positive correlation between concrete experience and stress. In personality characters, positive correlation between introversion and stress, negative correlation between extroversion and stress. More analysis showed that across learning modes, males use the concrete experience mode more than females, and females use the abstract conceptualization mode more than males.

Conclusion

In regard to introverted individuals, such individuals are quiet, diligent at working alone, and socially reserved, they make decisions somewhat independently of constraints and prodding by situations, culture, people, or things around them, and so facing stress factors interrupts their own world and reduces their function. In learning modes, people with concrete experience like new experience, rely on feeling and sensing, and generally find theoretical approaches to be unhelpful and prefer to treat each situation as a unique case. These factors cause variability in situations and circumstances and how stress comes about.