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Biomedical subjects

R Mayou

Publications and source records attributed to R Mayou.

At least 19 recordsLinked to original sources
PubMed1992

The psychological treatment of patients with functional somatic symptoms: a practical guide.

Functional somatic symptoms (FSS) are bodily sensations which do not result from physical disease, but which the patient responds to as if they did. Such symptoms are common and usually transient. In some patients they become persistent and associated with distress and disability. In such cases specific treatment is indicated. A cognitive-behavioural model of the aetiology of FSS and a psychological treatment approach based on the model, are outlined. The practical details of treatment are described.

Cognitive Behavioral Therapy↗
PubMed1992

Psychological factors in patients with non-specific abdominal pain acutely admitted to a general surgical ward.

Non-specific abdominal pain is the commonest reason for acute admission to a general surgical ward. The present study assessed the importance of specific symptom patterns, psychological and behavioural factors in a group of acute admissions and compared patients with appendicitis with those with no specific diagnosis. Psychiatric symptoms were no more prominent than in subjects with appendicitis as measured by psychological rating scales. Patients with non-specific abdominal pain had a poor symptomatic prognosis with continuing use of medical services. NSAP is best seen as a behavioural syndrome with repeated consultation over a long period before and after the index admission for both abdominal and other non specific symptoms.

Abdomen, Acute↗
PubMed1992

The outcome of unexplained dyspepsia. A questionnaire follow-up study of patients after endoscopy.

Ninety-three consecutive patients referred to a gastroenterology unit with unexplained dyspeptic symptoms were sent a postal questionnaire 6-12 months after endoscopy. It inquired into their current physical symptoms and subjective improvement since investigation, satisfaction with treatment, past history and current psychological well-being. A comparison group of 47 patients with peptic disease were similarly surveyed. Those with unexplained dyspepsia reported more current physical symptoms, more dissatisfaction with their treatment and less subjective improvement than those with peptic disease. The two groups were similar in terms of psychological distress but previous consultation for abdominal and other somatic complaints were more common in those with unexplained dyspepsia. The implications for management of dyspeptic patients are discussed.

Adult↗
PubMed1991

Use of psychiatric services by patients in a general hospital.

OBJECTIVE: To identify physical disorders associated with increased rate of use of psychiatric services. DESIGN: Retrospective analysis of routine abstracts of general hospital inpatient records linked with those of psychiatric care, for inpatients with physical disorders with possible psychiatric associations and for controls. SETTING: Oxfordshire health district. SUBJECTS: Inpatients aged 15-64 years discharged from general hospitals during 1975-85 with a diagnosis among 14 selected diagnostic groups (including potentially life threatening conditions, chronic disabling diseases, and non-specific symptomatic conditions) and control inpatients with acute conditions. MAIN OUTCOME MEASURES: Observed and expected numbers of patients receiving psychiatric care. RESULTS: Observed use of psychiatric services before and after index admission was close to that expected for controls. For most other diagnoses the observed use was significantly increased in the year preceding and that subsequent to the admission. For four diagnostic groups it was significantly greater in the year after admission than in that before (acute myocardial infarction (ratio before to after 2.17, 95% confidence interval 1.5 to 3.3), cancer (2.05, 1.7 to 2.5), diabetes mellitus (1.89, 1.4 to 2.9), and chest pain (1.78, 1.3 to 2.4)). During four years after the admission the use of psychiatric services was significantly higher than in the general population for nonspecific symptomatic conditions (observed/expected: abdominal pain 1.7, chest pain 2.0, and headache 4.2), cirrhosis of the liver (10.4), and fractures in road accidents and other fractures (1.3, 1.6). CONCLUSIONS: More patients with certain physical conditions used psychiatric services. Alternative methods of service delivery may be needed, especially for disabling chronic physical illness, alcohol related disorders, and non-specific symptomatic conditions.

Adolescent↗
PubMed1991

The effects of road traffic accidents on driving behaviour.

Questionnaires about the effects of accidents on subsequent driving behaviour were sent to 869 people admitted consecutively to a general hospital as a result of involvement in road traffic accidents 4-6 years previously. There were 418 (48 per cent) replies, 67 per cent of delivered questionnaires. One-fifth of the motorcyclists had stopped using a motorcycle. Nearly one-half the motorcyclists and vehicle drivers reported that they now drove more slowly and that they were more cautious. A considerable proportion of replies described emotional distress, avoidance and limitation of activities. Lack of confidence in driving was common immediately after the accident. After 4-6 years, one-third of respondents reported that they still suffered specific anxiety about the place of the accident and about situations similar to the accident. Many people were anxious about being passengers. The findings have implications for road safety, for the recognition and management of a common, and often disabling, clinical problem, and for the assessment of disabilities in medical reports for compensation proceedings.

Accidents, Traffic↗
PubMed1991

Cardiac failure: symptoms and functional status.

The associations between exercise capacity, symptoms and specific aspects of quality of life were examined in subjects participating in a trial of the treatment of heart failure. Patients were assessed on entry and after three months treatment. The principle symptoms were fatigue, breathlessness and chest pain. These limited the extent and speed of physical activities, restricted social, leisure and family life and were associated with emotional distress. There were associations between baseline exercise capacity and measures of quality of life. Change in exercise capacity during three months treatment was correlated with changes in measures of symptoms, limitation of activity and quality of life. The findings confirm the value of change in exercise capacity as a measure of functional status and suggest that it should be supported by a limited number of specific measures of quality of life.

Activities of Daily Living↗
PubMed1991

Psychosocial factors and admission for poor glycaemic control: a study of psychological and social factors in poorly controlled insulin dependent diabetic patients.

Psychological and social factors were investigated in 89 poorly controlled insulin-dependent diabetic admissions matched with out-patient controls. Those admitted were found to suffer greater current and past psychiatric morbidity, to report more social problems and chronic difficulties and to experience more life events in the six months before interview. The occurrence of significantly more independent events and chronic difficulties among admissions suggests that social stress can lead to poor control. These results emphasize the importance of global assessment of diabetic admissions to include psychological and social aspects as well as medical status.

Adolescent↗
PubMed1991

What should British consultation-liaison psychiatry be doing?

Despite increasing clinical interest and research consultation-liaison (C-L) services in the United Kingdom are mainly haphazard and unsatisfactory. Although the clinical problems are similar to those in other Western countries, the answers must reflect the British health care system. The national C-L organization must formulate and promote detailed policies for 1) clinical priorities; 2) staffing and other resources; 3) integration with other specialist psychiatric services for local populations and primary care; and 4) persuading other medical organizations to place greater emphasis on psychological skills, training requirements, and practice. Some of our conclusions are parochial, some are generally applicable; others are applicable only to countries with comprehensive health care.

Clinical Protocols↗
PubMed1991

Consultation-liaison psychiatry in western Europe. The European Consultation-Liaison Workgroup.

Consultation-liaison psychiatry (C-L) services have developed throughout Europe, largely as a result of individual local initiative. Reviews by contributors from 14 countries reveal similarities in national approaches and in the problems caused by inadequate resources, lack of recognition from psychiatric colleagues, and difficulties in integrating C-L with comprehensive systems of psychiatric care, which are mainly oriented toward community care. National C-L organizations and a recently established European Workgroup have focused attention on the clinical importance of C-L and the need to define national and local policies for its clinical role, staffing, and other resources. There is considerable and increasing interest in European C-L research.

Cross-Cultural Comparison↗
PubMed1991

Psychiatric morbidity in young adults with insulin-dependent diabetes mellitus.

Psychiatric disorder and sub-threshold psychological distress were more common in 113 young men and women with insulin-dependent diabetes living in a defined area than in comparable general population samples. Twelve per cent of men and 19% of women were classified by the PSE as psychiatric 'cases'. Forty per cent of women and 47% of men reported at least one major social problem; effects of diabetes on everyday activities were common. There were associations between medical and social variables. The clinical implications are discussed.

Adolescent↗
PubMed1991

Psychiatric problems among medical admissions.

The prevalence, nature, associations and outcome of psychiatric morbidity among four hundred and fifty severe general medical admissions are described. Affective disorder was diagnosed in 13 percent of men and 17 percent of women. It was associated with a history of previous psychiatric disorder and current social problems. Persistent affective disorder after discharge was associated with continuing medical and social problems. Alcohol problems were common in men, especially in those with social problems, and often went unrecognized by medical staff. Cognitive impairment was confined to the elderly and was associated with longer hospital stay and high mortality. Patients with emotional and cognitive disorder make considerable demands on medical, social and psychiatric services during and following admission. The implications for improved recognition and management of psychiatric morbidity in general medical patients are discussed.

Adolescent↗
PubMed1990

Quality of life in non-insulin-dependent diabetes and a comparison with insulin-dependent diabetes.

The reported effects of diabetes on quality of life have been assessed in two groups of attenders at out-patient clinics: 1. One hundred and twenty-one non-insulin-dependent diabetic patients randomly allocated to diet, tablet or ultralente insulin therapy; 2. Fifty-seven patients with insulin-dependent diabetes consecutively attending an out-patient clinic. The overall picture for those with non-insulin-dependent diabetes was of relatively little disruption to most areas of life, but 27% reported considerable loss of enjoyment and reduction in social life. High fasting plasma glucose was significantly associated with fatigue and leisure difficulties. The type of therapy, tablet, diet or insulin, made little difference to psychological, social or attitude variables. Those with insulin dependent diabetes showed similar psychological morbidity, but described a rather different pattern of social consequences with more effects on work and less on leisure.

Activities of Daily Living↗