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Biomedical subjects

Thomas N Wise

Publications and source records attributed to Thomas N Wise.

16 recordsLinked to original sources
PubMed2006

A revised Emotional Intelligence Scale: factor re-evaluation and item reduction.

The original Emotional Intelligence Scale of Fukunishi utilized 65 items measuring 3 basic dimensions: intrapersonal, interpersonal, and situational. 170 psychiatric outpatients (84 men and 86 women) completed the inventory. The mean age of the sample was 41.1 yr. (SD= 12.4). Compared with the 65-item scale, factor re-analysis yielded a new 34-item solution with significant correlations for the Intrapsychic (.97) and Interpersonal dimensions (.96) of the larger scale, but not with the Situational dimension (.43). The correlation between the total inventory scores was also significant (.94).

Adult↗
PubMed2005

Interface of Women's Mental and Reproductive Health.

The interface of women's reproductive and mental health is an evolving area of psychiatric practice, necessitating familiarity with psychobiological factors unique to women. The role of estrogen in particular has profound implications for the etiology and treatment of women's psychiatric illness, and has been reviewed along with the role of other hormones. Additionally, the stress of specific life events such as miscarriage, abortion, and menopause affects female mental health from a biological and psychosocial standpoint with the potential for secondary mood and anxiety disorders. Psychiatric issues during pregnancy and the postpartum period present special diagnostic and treatment challenges to the clinician. Biological and psychosocial treatments of these conditions have been reviewed. Management of psychiatric conditions during pregnancy and the postpartum period should include the obstetrician, pediatrician, and involved family members. Treatment decisions should involve careful assessment of the risks and benefits of any intervention including the risk of no treatment.

Abortion, Induced↗
PubMed2004

Attribution of cause by patients with depression, anxiety, and alexithymia.

This study evaluated the relationship between the personality construct of alexithymia and the attribution of depression to biological, psychological, sociocultural, and external stress. When alexithymia was considered as a continuous variable, there was a significant correlation between a higher score on the Toronto Alexithymia Scale and a greater belief in psychological causes for their psychiatric disorder. The other factors also had positive but nonsignificant correlations with alexithymia. When alexithymia was categorically partitioned and controlled for depressed mood, alexithymic subjects more frequently endorsed all four factors to be causal for their psychiatric illness. This appears to contradict earlier assumptions that alexithymic patients tend to be less psychologically minded than those without this psychological trait.

Adult↗
PubMed2004

Managing the neuropsychiatric side effects of interferon-based therapy for hepatitis C.

Neuropsychiatric side effects are common with interferon-based therapy for chronic hepatitis C, and their prompt recognition and management is essential to effective patient care. Depression induced by interferon has been a significant cause of early treatment discontinuation in clinical trials. The need to monitor for and treat interferon-induced depression is well established, but whether to use antidepressants prophylactically remains controversial. Nonetheless, clinicians should maintain a low threshold for antidepressant therapy. Other significant neuropsychiatric side effects include anxiety, hypomania or mania, fatigue, and cognitive dysfunction. These can be additional sources of patient distress during interferon therapy and require appropriate intervention through patient education, psychotropic medications, support, and behavioral techniques.

Antidepressive Agents↗
PubMed2004

Insight and alexithymia in hospitalized psychiatric patients.

The relationship of insight to the personality dimension of alexithymia was investigated in 91 psychiatric inpatients. Insight as a global construct and three subscales: the capacity to recognize that one has a psychiatric disorder, one needs treatment, and to label one's emotional illness as pathological were empirically measured via the Birchwood Scale for Insight. Alexithymia and its three subfactors were assessed by the 26-item Toronto Alexithymia Scale. Two of the alexithymia subfactors did correlate with reduced global insight and less acceptance of the need for therapy. Insight also correlated positively with the magnitude of depressed mood. In a regression model, depressed mood best predicted global insight. Other clinical variables, such as clinical severity upon admission, change in clinical status or diagnosis, did not predict insight levels. In summary, insight is a multidimensional phenomenon that does not simply correlate with alexithymia as a global construct but does correlate with alexithymic subfactor of diminished fantasy life.

Adult↗
PubMed2003

Cardiovascular health and depression.

Research has shown that depression increases the likelihood that otherwise healthy people will develop ischemic heart disease (IHD) and worsens the prognosis of patients who already have IHD. Moreover, concerns about safety (e.g., cardiac side effects, drug-drug interactions) have caused physicians to be hesitant about using antidepressant agents in patients with IHD. This article is based on a recent roundtable of experts who met to discuss risk, diagnosis, and treatment options for depression in patients with IHD. This article reviews clinical and epidemiological studies that have described a link between depression and the subsequent development of IHD and have examined the role of depression as a predictor of cardiac events in patients with existing IHD. The article addresses the issue of whether depression can be safely and efficaciously treated both in patients with stable IHD and in those with acute coronary syndromes. The authors discuss safety issues related to the potential for interactions between antidepressants and cardiovascular medications, the use of nonpharmacologic treatment options such as psychosocial interventions, and the effect of antidepressant therapy on quality of life in patients with IHD. The article concludes with practical clinical guidance concerning the management of depression in patients who have recently experienced myocardial infarction.

Journal Article↗
PubMed2002

Pedophilia.

This article addresses the risk factors associated with the psychiatric disorder pedophilia, its treatment, and treatment outcomes. It addresses physician responsibilities associated with case identification of victims and possible roles in the medical management of pedophilia. The essential feature of pedophilia is that an individual is sexually attracted exclusively or in part to prepubescent children. While pedophilia may be limited to fantasies and impulses, pedophilic behaviors are the primary concern of both the mental health and criminal justice systems. Remote risk factors for development of pedophilia often include the individual having been sexually abused as a child. Proximate risk factors for its behavioral expression are prevalence of comorbid psychiatric disorders and substance abuse disorders. Current treatment goals focus on stopping the behavior and achieving long-term behavioral control in the community. Common treatment methods are cognitive-behavioral, group therapy, and, when appropriate, medications such as androgen-lowering agents that can act as sexual appetite suppressants. Meta-analyses have established that treatment is more effective than nontreatment in preventing recidivism of sexual offenders in general, a finding that has a high probability of application to individuals with pedophilia. Pedophilia is a chronic psychiatric disorder, but it is treatable in terms of developing strategies for preventing behavioral expression. Ultimately, reducing the prevalence of pedophilic behavior requires further collaboration between the criminal justice system and the health care communities.

Adult↗
PubMedDate not supplied

Split gender identity: problem or solution? Proposed parameters for addressing the gender dysphoric patient.

Working with the gender dysphoric patient is complex because of the various clinical issues that arise. One issue that has not been addressed in the psychiatric literature is whether to address the patient with the biologically congruent pronoun or name or with the patient's preferred-gender pronoun or cross-gender name. This article presents clinical examples that allow a template to be developed for pronoun use in working with such patients. Whether the clinician uses biologically congruent names and pronouns may depend upon the patient's progress in adopting the cross gender role as well whether family or friends either know or accept such changes. In certain situations, such as meetings with family members, the therapist may address the patient with gender congruent names; whereas on other occasions use cross-gender pronouns or names.

Adult↗
PubMedDate not supplied

Erectile dysfunction and depression: category or dimension?

Depression, as a risk factor for erectile dysfunction (ED), has received minimal systematic attention. One-hundred twenty men with ED evaluated in a sexual behaviors clinic were studied. The categorical Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) diagnosis of a depressive disorder was found in only 14 subjects (14.7%). Dimensional quantification of depression was measured with the Brief Symptom Inventory (BSI). The BSI data revealed clinically significant elevations of depression and other dysphoric affects. The presence of a comorbid medical diagnosis did not affect the rates of categorical diagnosis of depression or the dimensional levels. The five factors of personality in the NEO-PI were within normal range. The data demonstrates that men with ED are affectively distressed but infrequently meet criteria for categorical DSM-IV depression.

Major Depressive Disorder↗
PubMedDate not supplied

Alexithymia in patients attending a sexual disorders clinic.

We measured alexithymic traits with the Toronto Alexithymia Scale (TAS; Bagby, Taylor, & Parker, 1988) in 170 individuals attending a sexual disorders clinic. We diagnosed 114 of the subjects with a sexual dysfunction and 56 with paraphilic disorders. We determined that 20.2% of the dysfunctional group and 26.8% of the paraphilic were alexithymic when the TAS was measured categorically. When we considered the TAS as a dimensional variable, the subset with paraphilias had significantly higher scores on the TAS only when depressed mood, as measured by the Brief Symptom Inventory (Derogatis, 1993), was covaried. These data suggest that alexithymia in both sexually dysfunctional and paraphilic individuals is related to depressed mood, although the effect is more pronounced in paraphilics.

Adult↗
PubMedDate not supplied

The changing content of Psychosomatics: reflection of the growth of consultation-liaison psychiatry?

Psychosomatics is the official journal of the Academy of Psychosomatic Medicine, the national organization of consultation-liaison psychiatrists. The articles published in Psychosomatics, therefore, represent an important element of the scholarship of consultation-liaison psychiatry, and the evolution of this literature should reflect the development of its knowledge base in the past 40 years. This paper analyzes the content of Psychosomatics over this period and discusses the scientific, academic, and social (including economic and political) factors that have influenced the changes in the content of the journal and, thus, the subspecialty.

Humans↗
PubMedDate not supplied

Increased risk of suicide among patients with breast implants: do the epidemiologic data support psychiatric consultation?

Four epidemiologic studies have examined mortality among women with cosmetic silicone gel-filled breast implants and have found that risk of death from suicide is two- to threefold higher in this group than among women of comparable age in the general population. The authors review the literature on the psychological and psychiatric hypotheses concerning women undergoing plastic surgery, although these hypotheses do not specifically address the association with suicide. Epidemiologic research is urgently needed to evaluate whether this association is an artifact of a higher prevalence of underlying and unreported psychopathology and other risk factors for suicide among women receiving breast implants or whether implants have an actual causal role in the risk of suicide. Until such studies are completed, psychiatric consultation should be considered before breast augmentation, especially for patients perceived to be at high risk by the plastic surgeon.

Breast Implantation↗