PubMed · 12877032
The source did not provide an abstract. Follow the original record for more information.
Explore connections, maps & timelines
Masatoshi Kawase, Masanori Kunizawa, Tomoyuki Asano, Yuzuru Ikegami, Makoto Tsuda. 2003. [Adjustment disorder].. https://pubmed.ncbi.nlm.nih.gov/12877032/
Cite the original work for its findings. Save a collection to share your selection of sources.
KEEP EXPLORING
It is reported that the common psychiatric disorders among cancer patients are adjustment disorder, major depression, and delirium. Pharmacotherapy is often provided for management of these distressing symptoms. Antianxiety drugs, especially benzodiazepines, are often used for ameliorating adjustment disorder. Among them, shorter-acting benzodiazepines are usually preferred. Several randomized clinical trials indicate the efficacy of antidepressants for management of major depression experienced by cancer patients. Because there are no significant differences of effectiveness among available antidepressants, it is recommended that selection of antidepressant should depend on its adverse event profiles. Although the principal management strategies of delirium are detection and treatment of underlying causes of delirium, concurrent pharmacotherapy as symptomatic treatment is often needed. Neuroleptics, especially haloperidol, are most widely used for management of delirium.
BACKGROUND: Adjustment disorders have been found to be the most frequent psychiatric diagnosis in the medically ill. Problems have been raised, however, as to their clinical value. The aim of the study was to characterize the psychosomatic features of adjustment disorders. METHODS: One hundred patients with medical illness and a diagnosis of adjustment disorder according to DSM-IV criteria were interviewed according to the Diagnostic Criteria for Psychosomatic Research (DCPR) system, consisting of 12 clusters. RESULTS: A considerable overlap was shown between adjustment disorders and DCPR clusters related to abnormal illness behavior (health anxiety, tanatophobia, nosophobia and illness denial) (54%), somatization (functional somatic symptoms secondary to a psychiatric disorder, persistent somatization, conversion symptoms and anniversary reaction) (37%) and demoralization (33%). Only 13 of the patients with adjustment disorders did not present any DCPR syndromes. LIMITATIONS: The study is cross-sectional and does not allow to determine the prognostic features of DCPR categorization. CONCLUSION: The clinical information which derives from the concomitant application of the DCPR might improve and make more specific the treatment of patients with adjustment disorders.
Most heart transplant candidates are equipped with left ventricular assist devices (LVADs). LVAD therapy is associated with characteristic psychiatric and psychosocial problems. To investigate the mental states of heart transplant candidates, psychiatric diagnosis, psychological or behavioral problems, and the need for treatment were evaluated around the time of registration to the waiting list and during follow-up. Saitama Medical University Hospital has been designated a hospital for heart transplantation since October 2002. The subjects were 14 heart transplant candidates (9 male candidates and 5 female candidates, mean age 29 years) at the hospital from September 1997 to October 2005. These 14 candidates were equipped with LVADs. The waiting periods on LVAD support were from 119 days to 1028 days, and the average waiting period was 313 days. Six candidates among the 14 had more than one DSM-IV diagnosis. Seven candidates were diagnosed with adjustment disorder, which was the most frequent diagnosis. Three candidates had depressive disorder, one had psychotic disorder, and one had dissociative disorder. Three candidates had acute cognitive dysfunction (delirium) due to their general medical condition. All three had other disorders with mainly psychological elements. Nine candidates (64%) were diagnosed with disorders with mainly psychological elements. Antipsychotics were used for the candidates in psychotic states and with delirium, and there was a need for crisis intervention. Antidepressants and antianxiety drugs were used for the candidates with depressive disorder; they needed intensive observation. Four candidates (28%) needed some attention and some antianxiety drugs or hypnotics. Psychiatric interventions were not necessary in five candidates (36%).