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Biomedical subjects

D Blazer

Publications and source records attributed to D Blazer.

At least 55 records · Page 3Linked to original sources
PubMed1987

Somatization disorder in the community. A study of diagnostic concordance among three diagnostic systems.

Somatization disorder, the presentation of multiple somatic complaints in multiple organ systems, can be diagnosed by three roughly comparable diagnostic systems: the Washington University Feighner criteria, the Research Diagnostic Criteria, and DSM-III criteria. This study evaluates diagnostic concordance for somatization disorder in these three diagnostic systems using data gathered in the National Institute of Mental Health-sponsored Epidemiologic Catchment Area Program at four sites. Data gathered through use of the Diagnostic Interview Schedule at the Duke, Johns Hopkins, Washington, and Yale University sites indicate that each criterion set identifies a somewhat different group of respondents. Feighner criteria identify the fewest number of respondents, followed by DSM-III criteria and the Research Diagnostic Criteria. Demographic, symptomatic, health utilization, and other severity indices indicate that the respondents identified by each group are very similar and that all diagnostic groups are clearly distinguishable from the normal population.

Adolescent↗
PubMed1987

Major depression with melancholia: a comparison of middle-aged and elderly adults.

Patients admitted to an inpatient psychiatric service were screened to identify middle-aged (35 to 50 years of age) and elderly (60 years of age and over) patients suffering from a major depressive episode with melancholia. Thirty-seven subjects (18 middle-aged and 19 elderly) were identified. Criteria symptoms for depression and symptoms specifically associated with melancholic or endogenous depression did not differ across age groups, with few exceptions. Major depression with melancholia in this hospitalized population was symptomatically similar in the middle-aged and elderly. The syndrome is therefore relatively common on this inpatient service and should be easily recognized.

Adult↗
PubMed1987

Stressful life events and the onset of a generalized anxiety syndrome.

In a study of 2,902 subjects from the National Institute of Mental Health Epidemiologic Catchment Area Project in North Carolina, the association between life events and the onset of new cases of generalized anxiety syndrome varied across demographic subgroups and type of life event measure. Men reporting four or more life events had a risk of generalized anxiety syndrome 8.5 times that of men reporting zero to three life events; no association was found for women. Both men and women reporting one or more unexpected, negative, very important life events had a threefold increase in the risk of developing generalized anxiety syndrome.

Adolescent↗
PubMed1986

Developing a screening index for community studies of somatization disorder.

Despite the low prevalence of somatization disorder in the community, the section of the Diagnostic Interview Schedule used to make the diagnosis--as well as previous diagnostic interviews for the related diagnoses of hysteria, and Briquet's syndrome--is quite lengthy. This study evaluates a somatization disorder screening index derived from completed interviews from the NIMH sponsored Epidemiologic Catchment Area program. A screening index comprised of 11 symptoms of somatization was derived at the Duke ECA site and replicated across the Johns Hopkins, Yale, and Washington University sites. Across ECA sites a screening threshold of five of 11 symptoms correctly identified 41 of 42 respondents with DIS/DSM-III somatization disorder (97.6%) while correctly classifying 14,600 of 14,750 (99.0%) without the disorder. The screening index offers promise as a screening device for clinical and community studies of somatization disorder.

Humans↗
PubMed1986

The economic burden of depression.

This article provides estimates of direct treatment costs and indirect costs from lost productivity associated with the morbidity and mortality of depression. Data are based on epidemiologic estimates of the prevalence of major depressive illness and on the number of suicides assumed to be secondary to depression. The number of hospitalizations, hospital days, physician and mental health provider visits, home/nursing home costs, and pharmaceutical costs are estimated. The direct and indirect costs are estimated to be approximately $16.3 billion per year. These economic figures provide a lower-bound estimate of the full economic burden of major depression and further emphasize the need for timely recognition and treatment to potentially minimize the negative impact of the illness on society.

Absenteeism↗
PubMed1986

Somatization disorder in a US southern community: use of a new procedure for analysis of medical classification.

The authors examine somatization disorder in a community population, using grade of membership analysis, a new multivariate analytical technique for the analysis of medical classification. The technique is used to examine whether somatic symptoms will cluster into a clinical syndrome resembling somatization disorder, as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-III), if no a priori assumptions are made about the interrelationship of somatic symptoms or their clustering into clinical syndromes. Grade of membership analysis is applied to all respondents in the US National Institute of Mental Health Epidemiological Catchment Area Project of the Piedmont region of North Carolina reporting three or more somatic symptoms from the somatization disorder section of the Diagnostic Interview Schedule. The analysis indicates that seven 'pure' types, roughly analogous to clusters in cluster analysis, best describe the interrelationship of the symptoms included in the analysis. One 'pure' type in the analysis is nearly identical to DSM-III somatization disorder and is associated with demographic characteristics consistently found among patients with DSM-III somatization disorder. The present results demonstrate that symptoms associated with this disorder do cluster in a highly predictable fashion and represent a strong validation of the natural occurrence of an entity resembling somatization disorder.

Adolescent↗
PubMed1986

Somatization disorder in a community population.

The data recently collected in the Piedmont region of North Carolina as part of the National Institute of Mental Health Epidemiologic Catchment Area Program were used to examine somatization disorder in a community population. The authors found an adjusted prevalence of 0.38% for somatization disorder diagnosed according to the Diagnostic Interview Schedule and DSM-III. Respondents with somatization disorder demonstrated demographic characteristics (female, unmarried, nonwhite, from a rural area, less educated) that are consistent with findings from past clinical and epidemiologic studies of somatization disorder. The adjusted prevalence is higher than that of other Epidemiologic Catchment Area sites, and possible explanations for this findings are discussed.

Adolescent↗
PubMed1986

Psychosocial risk factors and urban/rural differences in the prevalence of major depression.

The Piedmont Health Survey interviewed 3798 adult community residents in a region of North Carolina. Current major depression was nearly three times more common in the urban than in the rural counties; rural residence decreased the risk of major depression for some, but not all, demographic subgroups. The risk of major depression was decreased for young rural residents, compared with their urban age peers; rural residence was more protective for young women than for young men. Rural residence appears to be a buffer against major depression.

Adolescent↗
PubMed1985

Psychiatric disorders. A rural/urban comparison.

We studied rural/urban differences in the prevalence of nine psychiatric disorders from a community survey (part of the Epidemiologic Catchment Area Program) of 3,921 adults living in the Piedmont of North Carolina. Crude comparisons disclosed that major depressive episodes and drug abuse and/or dependence were more common in the urban area, whereas alcohol abuse/dependence was more common in the rural area. When prevalence for these disorders was stratified for age, sex, race, and education (factors that may confound urban/rural comparisons), a number of significant differences were identified, such as higher prevalence of major depression in female and white subjects and higher prevalence of alcohol abuse/dependence in the less educated subjects. A logistic-regression analysis was used to determine if significant urban/rural differences persisted when these potential confounders were controlled. Major depressive disorders were found to be twice as frequent in the urban area in this controlled analysis.

Adolescent↗
PubMed1984

Epidemiology of persecutory ideation in an elderly population in the community.

Of 997 elderly people living in the community, 40 (4%) were found to have generalized persecutory ideation. Sensory deficits and cognitive impairment were significant risk factors for the development of this symptom complex. Generalized persecutory ideation was also associated with impairments in physical health, social and economic resources, and activities of daily living. While more than 50% of the elderly individuals with this symptom complex perceived a need for psychiatric services, a much smaller percentage actually received help.

Activities of Daily Living↗
PubMed1983

Community adjustment of older schizophrenics.

Community adjustment among older schizophrenics is a virtually unresearched area. This study addressed two questions related to this problem: Does the community adjustment of older schizophrenics differ from that of younger schizophrenics?, and Do "older" old schizophrenics differ from "younger" old schizophrenics? Patients from 79 psychiatric wards across the country completed a self-rating adjustment scale within 5 days of admission to the hospital and again 3 months after discharge. Significant others rated these patients for adjustment also. For the first analysis two groups were selected: Those patients diagnosed schizophrenic and at least 55 years of age and those below the age of 55. A second analysis divided patients into "younger" old (between 55 and 60) and "older" old (greater than 60). Results show that older schizophrenics adjust about as well as those younger on self-ratings, but less well when rated by others. Also, "older" old schizophrenics adjust better than the "younger" old in both self- and significant other ratings. These findings are discussed.

Age Factors↗