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Biomedical subjects

D Gath

Publications and source records attributed to D Gath.

At least 37 records · Page 2Linked to original sources
PubMed1988

Sexual dysfunction among middle aged women in the community.

In a community survey of women aged 35-59 sexual functioning was studied in the 436 women with partners. One third of these women had operationally defined sexual dysfunction: impaired sexual interest was identified in 17% of women (68/406), vaginal dryness in 17% (73/434), infrequency of orgasm in 16% (60/379), and dyspareunia in 8% (30/379). Sexual dysfunctions were statistically significantly associated with increasing age and also with psychiatric disorder, neuroticism, and marital disharmony. One in 10 women regarded themselves as having a sexual problem. These women were no older than women with sexual dysfunction who did not regard themselves as having a sexual problem. Nevertheless, they differed from the rest of the sample in having more psychiatric disorder, neuroticism, marital disharmony, and (in women still menstruating) psychological symptoms of the premenstrual syndrome. In the whole sample 16 women (4%) said that they would like help for a sexual problem. The prevalence of sexual dysfunction in this series of women suggests that general practitioners should increase their alertness to the problem in their patients.

Adult↗
PubMed1987

Psychiatric disorder and gynaecological symptoms in middle aged women: a community survey.

In a community survey 521 women aged 35-59 were selected at random from all patients registered in two groups practices. They were interviewed at home and assessed by means of standardised psychiatric measures and detailed gynaecological inquiry. Levels of psychiatric morbidity were found to be within the expected range for such a sample. Both psychiatric morbidity and the personality dimension of neuroticism were significantly associated with gynaecological symptoms, including dysmenorrhoea and premenstrual tension, some symptoms of excessive menstruation, and flushes and sweats but not disappearance of menstruation for over six months. Current psychiatric state was significantly associated with recent adverse life events and with indices of psychiatric vulnerability (neuroticism and previous psychiatric history), suggesting possible aetiological links with gynaecological symptoms. The findings of this study have implications for the management of gynaecological complaints in general practice.

Adult↗
PubMed1986

The treatment of emotional disorders in general practice: psychological methods versus medication.

This paper describes three recent trials in which psychological methods were evaluated in the treatment of emotional disorders in general practice. In the first trial, brief counselling by the general practitioner was found to be as effective as anxiolytic medication, was welcomed by patients and did not increase demands on doctors' time. In the second trial (still in progress), in which treatment is aimed at emotional disorders of poor prognosis, problem solving treatment by a psychiatrist is being compared with control treatment by the G.P. The third trial evaluated an anxiety management programme provided by clinical psychologists in health centres; substantial reductions in anxiety occurred rapidly and were maintained at follow-up.

Affective Symptoms↗
PubMed1986

Maternity blues reassessed.

Maternity Blues, although seldom a serious problem in clinical practice, is potentially important to research on affective disorders in general. Childbirth is a major life event known to be associated with large changes in maternal hormones. The determinants of the Blues may therefore be psychological and social, or biological, or both. This paper reviews the relevant literature. Reported associations between Maternity Blues and psychiatric disorder are examined. Possible psychological, social and biochemical determinants are reviewed, but no firm inferences on causation can yet be drawn. Conflicting results in the literature may have been due to variations in definition and measurement of the syndrome. The authors have recently used psychometric methods to develop a questionnaire for detecting and measuring Maternity Blues. By cluster analysis of responses to the questionnaire, a 'Primary Blues' cluster was defined, consisting of 7 items: tearful, tired, anxious, over-emotional, up and down in mood, low spirited, muddled in thinking. The item 'depression' appeared in another less frequent cluster.

Affective Disorders, Psychotic↗
PubMed1984

The effects of non-prescribing of anxiolytics in general practice. I. Controlled evaluation of psychiatric and social outcome.

Ninety one patients with new episodes of minor affective disorder were selected by their general practitioners as suitable for anxiolytic medication. Half the patients were allocated randomly to a drug-group (anxiolytic medication), and half to a non-drug group (brief counselling without anxiolytics). Psychiatric and social assessments were made (i) at initial consultation when treatment was started; (ii) one month later; (iii) seven months later. Before treatment the two groups were similar on all main variables. On the General Health Questionnaire, 85 per cent of patients were psychiatric cases before treatment, 40 per cent at one month and 30 per cent at seven months. Similar improvements were found with other measures of psychiatric state (Profile of Mood States; Present State Examination) and social functioning (SAS-M). Improvements were similar and parallel in the two groups. Neither group of patients increased their consumption of alcohol, tobacco or non-prescribed drugs. The non-drug group did not make increased demands on the doctors' time.

Adult↗
PubMed1984

The effects of non-prescribing of anxiolytics in general practice. II. Factors associated with outcome.

Factors associated with psychiatric outcome were examined in a series of 87 patients who had presented in general practice with new episodes of minor affective disorder. Two outcome measures were used: (i) Status on Present State Examination (PSE) seven months after initial consultation; (ii) prescribing of psychotropic medication between one-month and seven-month follow-up assessments. Outcome according to the PSE was significantly associated with: worse measures of psychiatric state (General Health Questionnaire, Profile of Mood states) and of social functioning (SAS-M) at initial consultation and one month later; and with persistent anxious or depressed mood during the follow-up period; but not with life events. During the follow-up period 20 patients received at least one psychotropic prescription; they were significantly associated with worse initial GHQ scores, consumption of tobacco and non-prescribed medication, and initial anxiety. A sub-group of 11 patients received multiple psychotropic prescriptions; they were significantly associated with the same initial measures, and also with poor outcome measures (psychiatric and social).

Adult↗
PubMed1982

Psychological sequelae to elective sterilisation: a prospective study.

A total of 201 women were interviewed four weeks before elective interval tubal sterilisation, of whom 190 (94.5%) were assessed again six months postoperatively and 193 (96.0%) 18 months postoperatively. Before sterilisation the prevalence of psychiatric morbidity as measured by the present state examination was 10.4% (21 patients), no greater than might be expected in a general population sample; six months after the operation the prevalence was significantly reduced to 4.7% (nine patients); and 18 months postoperatively it had returned almost to the preoperative value (9.3%; 18 patients). Postoperative psychosexual disturbance was rare, only 3% of patients reporting reduced enjoyment of sexual intercourse at either follow-up. Considerable regret was reported by only five patients (2.6%) six months after the operation and by eight (4.1%) 18 months after the operation; however, some dissatisfaction was reported by 15 patients (7.9%) at six months and 21 patients (10.9%) at 18 months. Postoperative psychiatric disturbance and dissatisfaction were largely associated with preoperative psychiatric disturbance. Thus there was no evidence that elective interval sterilisation increased the risk of psychiatric disturbance up to 18 months after the operation.

Adult↗
PubMed1982

Hysterectomy and psychiatric disorder: I. Levels of psychiatric morbidity before and after hysterectomy.

One hundred and fifty-six women with menorrhagia of benign origin were interviewed before hysterectomy, and re-interviewed six months post-operatively (n = 147), and again 18 months post-operatively (n = 148). Levels of psychiatric morbidity were significantly higher before the operation than after. On the Present State Examination, 58 per cent of patients were psychiatric cases before surgery, as against 29 per cent at the 18-month follow-up. Similar post-operative improvements were found on measures of mood (POMS), and of psychosexual and social functioning. Most of these improvements had occurred within three to six months after the operation. Both before and after hysterectomy, levels of psychiatric morbidity were high by comparison with women in the general population, but lower than in psychiatric patients. The pre-operative psychiatric morbidity had been mainly of long duration.

Adult↗
PubMed1982

Hysterectomy and psychiatric disorder: II. Demographic psychiatric and physical factors in relation to psychiatric outcome.

One hundred and fifty-six patients with menorrhagia of benign origin were interviewed before hysterectomy, and again six months (n = 147) and 18 months (n = 148) after the operation. Psychiatric outcome, measured in terms of PSE cases detected at 18 months, was strongly associated with pre-operative mental state, neuroticism, previous psychiatric history, and family psychiatric history. No association was found with organic pathology in the uterus, bilateral oophorectomy or demographic variables.

Adult↗
PubMed1982

Evaluation of a modified self-report measure of social adjustment.

A self-report Social Adjustment Scale (SAS-M) for use in British populations was devised by modifying the original North American version, its usefulness was evaluated among 331 women drawn from two local populations. In a group of mothers of one year old babies (n = 130), high levels of agreement were found between the subjects' self-ratings on the SAS-M and (i) a psychiatrist's ratings of their social adjustment made at interview; (ii) ratings of the subjects' social adjustment made by their husbands on the SAS-M; (iii) measures of concurrent mental state. In a group of women undergoing elective sterilization (n = 201), the SAS-M was found to be sensitive to changes in mental state over time. Possible application of the SAS-M in psychiatric research, particularly when an interview is not feasible, are discussed.

Age Factors↗
PubMed1977

Psychiatric illness, maladjustment and juvenile delinquency: an ecological study in a London borough.

Patterns of adult psychiatric referral, of child guidance referral and of juvenile delinquency in a metropolitan borough were examined. The 3 sets of rates showed parallel trends among the 20 electoral wards of the borough, all 3 being similarly related to socio-demographic indices. A cluster analysis technique was used to combine the 450 enumeration districts of the borough into 22 clusters defined by social characteristics rather than by geographical boundaries. Ecological correlates of treated psychiatric disorder and of delinquency, based on these clusters, were found to be similar to those derived from the electoral ward data. The findings suggest that it may be possible to demarcate relatively small urban areas with high concentrations of psychiatric disorder, maladjustment and delinquency.

Adolescent↗