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S Consoli

Publications and source records attributed to S Consoli.

26 records · Page 2Linked to original sources

[Specificity of function of a psychiatric unit in a general hospital (author's transl)].

The recent creation of a psychiatric unit in the hospital Broussais gives rise to reflection on what, according to the authors, could constitute the originality of such a treatment unit. It should not be used to satisfy all the requests for psychiatric care within the hospital itself, nor act in parallel with the specialized psychiatric departments established as such in psychiatric or general hospitals. The presence, however, of a group of psychiatrists working as a team in a general hospital, and having several beds for their own autonomous use, should enable the first approach to be made, under the best conditions, to pathological disorders produced by psychological disturbances which are not immediately recognized by the patient: somatic manifestations of anxiety or depression, psychosomatic disorders, behavioural problems such as alcoholism, or even suicide attempts. This clinical function cannot be dissociated from the daily therapeutic approach of the health team or from the conception of medical psychology training based on the true needs of general practitioners. It is also the starting point for a close collaboration with physicians and basic scientists in the field of medical research.

Emergencies↗

Anger expression and cardiovascular reactivity to mental stress: a spectral analysis approach.

The cardiovascular reactivation to a recently described videogame task i.e. a maze test was evaluated in the time and frequency-domain using finger blood pressure (BP) measurement in 25 subjects on no medication, including 6 subjects with mild hypertension. Prior to BP measures subjects completed the items of the State-Trait Anger Expression Inventory questionnaire corresponding to the trait anger and anger expression scales. The BP recording session was divided into resting, test and recovery periods. A detrending procedure was applied to each recording prior to the fast Fourier transform. Systolic BP (SBP) and heart rate (HR) were increased during the test. The mid-frequency (MF, 0.1 Hz) components of SBP and HR variability were also elevated during the stressful period. In resting conditions SBP levels of subjects with low trait anger was lower than in subjects with high trait anger (128 +/- 4 mmHg, n = 14 versus 148 +/- 4 mmHg, n = 11, P < 0.01, Student t test). Nevertheless the average SBP increase due to the stress was of similar magnitude in these two subgroups (14 mmHg). A significant negative relationship was observed between anger-out expression score and the MF SBP variation (r = 0.46, P < 0.05). A significant negative relation was found between anger-in mode of expression and the HR peak during the test (r = 0.43, P < 0.05). In conclusion, our data suggest that individuals who are often in anger-provoking situations (high trait anger) should have heightened BP. Two different patterns of cardiovascular responses (SBP variability and HR levels) were observed for the outward and inward mode of expression of anger. This may reflect a different psychological control of HR levels and BP variability.

Adult↗

[Assessment of antihypertensive compliance using a self-administered questionnaire: development and use in a hypertension clinic].

OBJECTIVE: The most practical method of assessing medication compliance is to ask the patient for a self-report; but the interview question has to be selected and validated. The aim of this work was to select and validate interview questions to be used in a self-administered questionnaire for measurement of medication compliance in hypertensive patients. PATIENTS AND METHODS: In 117 treated hypertensive patients, we compared an interview question to a clinical evaluation of medication compliance. Kappa indices were calculated to test the concordance between interview question and medication compliance. In 184 patients treated for hypertension since at least a year, the validated self-report was compared to a clinical evaluation of medication compliance. RESULTS: Interview questions were not equally sensitive for detection of medication compliance and 6 questions were included in the Compliance Evaluation Test (CET). In 184 patients, we compared the results obtained with CET to clinical evaluation of medication compliance. Values of kappa indices were above 0.5 in "good compliance" when "No" was answered to the 6 items, in "minor noncompliance" when 1 or 2 "Yes" were given, in "noncompliance" when 3 or more "Yes" were given. In this population of hypertensive patients followed in a hypertension clinic, we observed 10% "noncompliance", 24% "minor noncompliance", and 66% "good compliance". CONCLUSION: In clinical practice, interview may be the most useful method of measuring medication compliance. We demonstrated that the compliance evaluation test is validated and may help physicians to face the problem of nonadherence among their hypertensive patients.

Antihypertensive Agents↗