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A de Jongh

Publications and source records attributed to A de Jongh.

At least 19 recordsLinked to original sources

Localization of fast MEG waves in patients with brain tumors and epilepsy.

It was investigated if single dipole analysis of spontaneous fast waves (>8 Hz) can be used to determine the location of the epileptic focus. Automatic dipole analysis was applied to MEG data of 25 patients with intracranial tumors and epilepsy. The frequency range of 8-50 Hz was divided into standard EEG bands. MEG results were overlaid on the MRI scans of the patients. Dipoles describing fast wave fields were located in the parietal/occipital cortex, and not at tumor border zones. In the cases that the dipoles were lateralized there was no clear preference to be located ipsi or contralateral to the tumor. However the generators of epileptic activity in these patients are thought to be located in the border areas of the tumors. Therefore it seems unlikely that the dipole locations describing fast waves are related to the epileptic zones in patients with brain tumors and epilepsy. A remarkable finding is that lateralized dipoles tend to be located in the right hemisphere and not in the left hemisphere. This appears to reflect an asymmetry of possibly normal background activity.

Adult↗

Trauma-related phenomena in anxious dental patients.

OBJECTIVES: The main purpose of this descriptive study was to investigate whether dental anxiety is associated with the occurrence of trauma-related symptoms (i.e. recurrent memories and a tendency to avoid these memories) associated with earlier traumatic dental experiences. METHODS: A sample of 37 consecutive anxious patients attending a dental fear clinic was assessed prior to dental treatment. The results were compared with those of a sample of 32 consecutive patients of a general dental practice, who served as a reference group. RESULTS: The proportion of patients who indicated they had had a horrific dental experience at least once in their life did not significantly differ between the anxious group and the reference group. Conversely, significantly more patients (76%) in the anxious group reported suffering from memories of these events. They also showed a higher level of trauma-related symptomatology as indexed by the Impact of Event Scale (IES). About half of the anxious patients suffered from symptoms typically reported by patients with posttraumatic stress disorder (PTSD). Severity of dental anxiety showed a high correlation with both frequency of intrusions (r = 0.64, P < 0.001) and avoidance of the memories (r = 0.62, P < 0.001). CONCLUSIONS: The results suggest that in anticipation of treatment dentally anxious individuals suffer from a high level of intrusive recollections of earlier dental experiences.

Adolescent↗

Referrals to a secondary care dental clinic for anxious adult patients: implications for treatment.

OBJECTIVES: This study aimed to determine the methods suggested by general dental practitioners for management of patients with dental anxiety whom they refer to a dental hospital setting, the treatment modalities eventually used with such patients and the relationship between patients previous sedation experience and the current referral. METHODS: Consecutive referral letters (n = 125) for management of patients with dental anxiety over a 16 month period were analysed for content, including reason for referral and suggested treatment modalities. Patient records were also examined for previous sedation experience. RESULTS: From 115 referrals eligible for analysis, the dentists requested management of anxiety using pharmacological methods in 113 referrals with only two referrals mentioning psychologically-based treatments. In secondary care, 29% of the adult referrals opted for dental treatment using psychological techniques alone. CONCLUSIONS: In spite of the efficacy of psychological treatments for dental anxiety, primary and secondary care dentists appear not to be suggesting or promoting their use for patients with dental anxiety. Further research into the availablility of, and barriers to accessing the full range of services for those with dental anxiety, including patient perspectives, needs to be undertaken.

Adolescent↗

The localization of spontaneous brain activity: first results in patients with cerebral tumors.

OBJECTIVE: From EEG studies, it is known that structural brain lesions are accompanied by abnormal rhythmic electric activity. With the better spatial resolution of MEG, MEG dipole analysis can extend the knowledge based on EEG power spectra. This study presents the first results of a completely automatic analysis method applied to spontaneous MEG. METHODS: Spontaneous MEG data of 5 patients with cerebral brain tumors and 4 controls were collected using a whole-head MEG system. Signals were bandpass-filtered with cut-off frequencies according to standard EEG bands. A moving dipole model was fitted to samples with at least twice the average sample power. Dipoles explaining 90% or more of the magnetic variance were projected onto a matched MR scan. RESULTS: In controls, dipole distributions are symmetrical with respect to the mid-sagittal plane whereas distributions in patients often are asymmetrical to it. Dipoles describing gamma activity were located contralateral, and dipoles describing delta and theta activity were located ipsilateral to lesions. CONCLUSIONS: The automatic method gives plausible 3-dimensional information about generator foci of abnormal slow waves and other rhythms with respect to lesion foci and thereby adds physiological knowledge to that derived from EEG power spectra.

Adult↗

[Dental--mental].

Explore the source record for details and available documents.

Dental Anxiety↗

[Evaluation of patient's level of functioning in the dental practice].

In order to improve the reliability of diagnostic judgements of complex or persisting dental complaints it is important to be aware of the role of emotional problems regarding the origin and the maintenance of dental complaints. In this paper the focus is on the collection of information about patients' history through an anamnesis, and the observation of patients behaviour and mood.

Child↗

[Patients with mental problems].

Epidemiological studies show that one out of four Dutch individuals suffers from a mental disorder. Consequently, dentists are confronted with noticeable deviant or problematic behaviour. In this paper an overview is presented of several of psychological problems and their relevance to dental treatment. This is illustrated by a case description. For a proper diagnosis and adequate treatment planning it is important that dentists have some general knowledge of psychological functioning of patients, and the possible psychological determinants of illness and well-being. This would prevent unnecessary damage of dental tissues and needless suffering but also frustration, both for the patient and the dentist.

Adult↗

[Dental complaints are found always between the ears. Somatization in the dental practice].

The aim of the present study was to investigate the occurrence of somatization-specific behaviour in the dental setting and its relationship with patients' report of both dental and psychological complaints. Somatization-specific behaviour was operationalized as an unexplained dental complaint, high dental attendance, a high treatment consumption or an unreasonable demand with regard to treatment. Of the 309 patients 8.7% fulfilled the criteria for somatization-specific behaviour, which was mainly expressed as a high frequency of attendance (6.8%). Women showed significantly more often (73%) somatization-specific behaviour than men (27%). Further, a relation between depression and somatization-specific behaviour was found. Particularly patients with a relatively high level of long-lasting dental complaints demonstrated somatization-specific behaviour.

Adolescent↗

[Crying for attention: patients who mimic manifestations of disease].

This article focuses on the different forms of factitious diseases. Patients may mimic or produce the manifestations of a disease in order to attract attention of doctors. Sometimes patients inflict such serious injuries on their own bodies that they need to undergo long-term treatment in a hospital such as in the case of Munchausen syndrome. Recognition of alarm signals associated with this type of condition may help to avoid a long lasting process of illness, screening and unnecessary treatments.

Adult↗

[Extremely anxious patients: does treatment achieve the desired effect?].

The aim of the present study was to determine the outcome of treatment of several treatment modalities utilized at the Centre for Special Dental Care in Amsterdam, the Netherlands. Outcome was assessed in 341 patients in terms of dental anxiety after treatment (response 65%) and dental attendance one year later (response 74%). After treatment, patients treated with a behavioral management approach had lower dental anxiety scores than patients treated with intravenous sedation. Furthermore, one year after treatment 66.7% of the treated patients indicated to visit a general dental practitioner regularly. It is concluded that treatment was effective. However, it was felt that dental attendance level could be increased by a change in the referral procedure to general dental practitioners. It is recommended that a psychologist is involved in diagnosis and treatment planning in dental fear clinics.

Adolescent↗

Dental anxiety reduction and dental attendance after treatment in a dental fear clinic: a follow-up study.

OBJECTIVES: The aim of the present study was to assess treatment outcome in terms of dental anxiety reduction at a post-treatment assessment and dental anxiety reduction and dental attendance one year later. Furthermore, it was determined to what extent psychopathological characteristics were related to treatment outcome. METHODS: Questionnaires were sent to 280 patients treated with one of three treatment modes (i.e., behavioral management (BM), nitrous oxide sedation (NOS), and intravenous sedation (IVS)) at a dental fear clinic in The Netherlands. Dental anxiety before (T1) and after (T2) treatment was assessed using the Dental Anxiety Scale (DAS) and the Short version of the Dental Anxiety Inventory (S-DAI); the Symptom Checklist 90 (SCL-90) was used to assess general psychopathology. Dental anxiety was assessed again a year later and patients were questioned about their dental attendance pattern (T3). RESULTS: ANOVA showed that the DAS and S-DAI scores at T2 and T3 were statistically significant lower than the initial scores. In addition, IVS patients showed less anxiety reduction than BM patients at both T2 and T3. Of the 145 patients whose last visit to the clinic was at least one year ago, 62% had visited a GDP at T3. A regression analysis revealed that, beside treatment mode, somatization, number of visits to clinic for dental treatment, and number of months between first and last visit to the clinic predicted dental anxiety at follow-up. CONCLUSIONS: It is concluded that, although a reduction in dental anxiety level was present, a relatively large proportion of patients did not improve, in terms of both dental anxiety and dental attendance.

Adolescent↗

[Choking phobia: symptomatology, diagnosis and treatment].

Clinically significant forms of choking fear (i.e., choking phobia) are characterized by fear and avoidance of objects and situations that may lead to choking such as ingestion of food or pills. During dental treatment patients may also be confronted with situations that give rise to extreme fear of suffocating or being choked (mouth full of water, the making of dental radiographs and dental impressions). Choking phobia often develops following an episode of choking on food. The paper shortly reviews relevant literature, medical and psychiatric differential diagnosis, as well as possible treatment approaches to individuals suffering from choking fear.

Airway Obstruction↗

Treatment modalities in a dental fear clinic and the relation with general psychopathology and oral health variables.

OBJECTIVE: To assess differences among highly anxious dental patients assigned to different treatment modes (i.e. behavioural management (BM), nitrous oxide sedation (NOS), intravenous sedation (IVS). Patients were compared with regard to psychological and dental variables before treatment (e.g. number of decayed teeth), and dental variables after treatment (e.g. number of fillings made). DESIGN: Dentists experienced in the treatment of highly anxious patients allocated patients to a treatment mode based upon their clinical judgement. SETTING: Centre for Special Dental Care, Amsterdam, The Netherlands. SUBJECTS: 211 patients from this dental fear clinic. MEASURES: General psychopathology, as measured by the Symptom Checklist 90 (SCL-90), and dental anxiety (DAS, S-DAI, 10-point scale) were measured prior to treatment. From the panoramic radiograph the following pre-treatment dental variables were assessed: number of teeth, number of decayed teeth, number of retained roots, and number of root-filled teeth. After treatment, number of fillings, extractions, endodontically treated elements, number of visits, and treatment duration, were determined from the patients' records. RESULTS: Of the 144 patients who received dental treatment at the clinic, 46.5% was treated using a BM approach, 27.8% with NOS, 22.9% with IVS, and 2.8% under GA. No differences among the treatment groups were found with regard to SCL-90 and dental anxiety. The results showed that patients in the IVS group had statistically significant more decayed teeth than patients in the BM group. Furthermore, more fillings were made in the IVS group than in the BM group. CONCLUSION: Since it appeared possible to treat a large proportion of patients by BM alone, training dentists in the application of psychological methods for the treatment of anxious patients should be stimulated. In addition, future research should seek for variables that, besides oral health, are better able to discriminate between groups of highly anxious patients than measures of dental anxiety and psychopathology.

Adolescent↗

Psychological characteristics of patients applying for treatment in a dental fear clinic.

The aim of the present study was to assess psychological characteristics of highly anxious dental patients. Subjects were 321 patients (203 women) applying for treatment at a dental fear clinic in The Netherlands. Patients filled out several questionnaires to assess the amount of psychological complaints (Dutch version of the Symptom Checklist 90-Revised; SCL-90) and dental anxiety (Dental Anxiety Scale, Short version of the Dental Anxiety Inventory) approximately 4 months prior to their first appointment. The total mean score on the SCL-90 for the highly anxious patients was 142.7 (SD=47.2) for men and 166.5 (SD=64.3) for women. The SCL-90 total score and the mean scores of all subscales were significantly higher, and above the 80th percentile for most of the subscales, than the mean scores of the Dutch general population. The results indicate that patients who apply for treatment at a dental fear clinic are not just dentally anxious; they show complaints on a wide range of other psychological dimensions.

Adolescent↗

[Beware of pitfalls. Problems in the somatization patient].

Somatization is a process that makes that psychological and social problems are experienced physically and presented as a physical complaint. This phenomenon should be considered as a potentially dangerous pitfall for the dentist. Not recognizing the underlying problems may lead of unnecessary and inadequate treatments. The purpose of this article is to provide the dentist with practical guidelines for proper assessment, treatment and referral of this patient category.

Dental Care↗

[Mental problems in the dental practice: a compulsive disorder].

The aim of the present paper is to inform the reader about individuals who are suffering from severe mental disorders, such as obsessive-compulsive disorder (OCD). A case story enlightens the fact that anxiety disorders like OCD can have profound implications for the dental treatment plan.

Dental Anxiety↗