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PubMed1993

Patterns of psychiatric comorbidity, cognition, and psychosocial functioning in adults with attention deficit hyperactivity disorder.

OBJECTIVE: Although attention deficit hyperactivity disorder is a common disorder of childhood, its status as a disorder in adults is not clear. The authors reasoned that if the adult diagnosis of the disorder is a valid clinical entity, it should be similar to the childhood disorder with regard to patterns of psychiatric and cognitive findings. METHODS: Eighty-four adults with a clinical diagnosis of childhood-onset attention deficit hyperactivity disorder confirmed by structured interview who were referred for treatment were studied. Findings were compared with those from a preexisting study group of referred children with attention deficit hyperactivity disorder, nonreferred adult relatives of those children who also had attention deficit hyperactivity disorder, and adults without the disorder who were relatives of normal children. Subjects were evaluated with a comprehensive battery of psychiatric, cognitive, and psychosocial assessments. RESULTS: The referred and nonreferred adults with attention deficit hyperactivity disorder were similar to one another but more disturbed and impaired than the comparison subjects without the disorder. The pattern of psychopathology, cognition, and functioning among the adults with attention deficit hyperactivity disorder approximated the findings for children with the disorder. CONCLUSIONS: These results show that referred and nonreferred adults with attention deficit hyperactivity disorder have a pattern of demographic, psychosocial, psychiatric, and cognitive features that mirrors well-documented findings among children with the disorder. These findings further support the validity of the diagnosis for adults.

Adult↗
PubMed1995

Neurobehavioral and psychosocial functioning of children with opsoclonus-myoclonus syndrome.

Childhood opsoclonus-myoclonus syndrome (OMS) is a movement disorder which typically strikes children in the early preschool years, seriously affecting intellectual, social-emotional and general adaptive development. This series of 13 cases with well-documented neurological histories, aged 1.7 to 16.3 years, provides an initial systematic evaluation of these children's neuropsychological, psychosocial and adaptive status. As expected, children with OMS had significantly reduced intelligence and severe speech and motor output problems; however, most of them also demonstrated a range of preserved neurocognitive abilities and impressive goal-directedness and communicative effort. Psychosocial problems included mild behavioral impairment on the Achenbach Child Behavior Checklist, and severe adaptive limitations on the Vineland Adaptive Behavior Scales despite relatively strong social skills. Developmental factors and likelihood of subcortical localization are discussed, and practical guidelines are provided for behavioral and educational management of these children.

Adolescent↗
PubMedDate not supplied

Frequent hemodialysis and psychosocial function.

Studies suggest that more frequent hemodialysis (HD; short daily and long nocturnal dialysis) may be associated with a variety of clinical benefits, including improvement in blood pressure, anemia, and hyperphosphatemia, regression of left ventricular hypertrophy, and reduced rates of hospitalization. Whether these clinical benefits are paralleled by improvements in health-related quality of life (HRQOL) has been unclear. In addition, the psychosocial burden of more intensive HD schedules has not been critically evaluated. Recent reports have suggested beneficial effects of frequent HD on global HRQOL, dialysis-related and uremic symptoms, patient satisfaction, and psychosocial burden. However, the interpretation of many of these studies is restricted by limitations in study design, follow-up, and generalizability. This article reviews the current literature focusing on psychosocial and HRQOL effects of frequent HD and suggests future directions for research in this important area.

Humans↗
PubMed1990

Mental health and psychosocial functioning in children with recent onset of rheumatic disease.

Mental health was evaluated early in the course of juvenile rheumatic disease; 106 parents of children (aged 1-17 yrs) were interviewed and 98 of the children were assessed when the child was hospitalized. Instruments included the Child Assessment Schedule (CAS), the Children's Global Assessment Scale (CGAS) and the Child Behavior Checklist (CBCL). Half the patients received a psychiatric diagnosis; psychosocial dysfunction of at least mild severity was found in 64% of the patients. In the polyarthritic group there was a negative correlation between CGAS and severity of disease. CBCL behaviour scores did not differentiate between patients and siblings when corrected for somatic components.

Adaptation, Psychological↗
PubMed2001

Effects of housing relocation on immunocompetence and psychosocial functioning in older adults.

BACKGROUND: The psychological and physical response to moderate life stressors among older adults has not been well characterized. This research examines effects of voluntary housing relocation on distress and immune function in healthy older adults as a model for studying the effects of moderate life stress. METHODS: Thirty older adults moving to congregate living facilities were assessed 1 month premove, 2 weeks postmove, and 3 months postmove. Twenty-eight nonmoving control subjects were assessed at similar time points. Subjects completed psychosocial questionnaires and had early morning blood draws in their homes. Blood samples were assayed for natural killer cell cytotoxicity (NKCC), interleukin-6 (IL-6), and IgG antibody titers to the Epstein Barr virus (EBV) viral capsid antigen. RESULTS: Movers demonstrated decreased vigor and elevated thought intrusion 1 month premove and 2 weeks postmove. By the 3-month follow-up, vigor increased, and intrusion decreased to levels commensurate with the controls. Averaged across all time points, movers showed lower NKCC than controls; however, post-hoc analyses indicate that by the 3-month follow-up time point, these differences were no longer significant. There were no differences between groups in IL-6 or in EBV antibody titers. Independent of the effects of group, higher levels of vigor were associated with greater NKCC at all assessments and with lower EBV titers at 2 weeks postmove. CONCLUSIONS: Findings suggest that in general, healthy older adults recover well psychologically from moderate. temporary life stressors such as moving. Whereas movers showed generally lower NKCC than controls, IL-6 and EBV antibody titers appeared not to be strongly affected by the stress of moving.

Adaptation, Psychological↗
PubMed1993

Comparison of postpartum and nonpostpartum depression: clinical presentation, psychiatric history, and psychosocial functioning.

This study compared a sample of postpartum women diagnosed with depression with a nonpostpartum depressed group and 2 nondepressed control groups. Women's depressive episodes were compared to determine whether differences existed in symptomatology, previous history, or course. Results indicate that postpartum depression tends to be relatively mild. Both depressed groups had high rates of positive psychiatric history and were equally likely to have recovered at a 6-month follow-up. Groups were also compared on psychosocial variables known to covary with depression: interpersonal relations, stress, and coping. A series of multivariate analyses of covariance showed few differences between the depressed groups that were not attributable to symptom severity, although postpartum depressed women did report better marital relations than did the nonpostpartum depressed women. These findings suggest that there is little to distinguish postpartum from nonpostpartum depression beyond differences in symptom severity.

Adaptation, Psychological↗
PubMedDate not supplied

[Psychosocial functioning of children and adolescents dependent on inhalation of toxic substances].

Fifty persons of the age of 13 to 18 who had been stuffing themselves with steams of solvents, were medically examined. There were used medical (psychiatrical, neurological, internal) and psychological examinations--with the D. Weschler's scale of intelligence and questionnaire interviews obtaining from those who underwent the examinations and their parents. It was stated that the beginning of the intoxication was mostly preceded by the difficulties in social adjustment. Number of inter-related negative elements of biological and psychosocial nature were at the base of those difficulties from among which the substantial part was taken by disturbed family conditions and irregularly formed (for various reasons) personality of those peoples. The dependency was followed with more and more intensified social difficulties.

Adjustment Disorders↗
PubMed1994

Psychosocial function following temporal lobectomy: influence of seizure control and learned helplessness.

Learned helplessness is the perception that one's behaviour cannot produce a desired outcome. Individuals with intractable epilepsy who have learned that the occurrence of a seizure is beyond their control can develop such a helpless attitude with cognitive, affective and behavioral components which may generalize to many aspects of life. Post-operative testing was done on 42 patients, aged 17-60 years with I.Q. > 80 who had temporal lobectomies (25 R, 17 L) with follow-up 1-14 years (mean 5 years). In addition to seizure outcome, psychosocial adjustment was measured using the Washington Psychosocial Inventory (WPSI) and a structured interview. Three variables of learned helplessness were also assessed: internal or external locus of control, resourcefulness, and depression. Seizure outcome was: completely seizure free, 36%; > 90% improvement, 38% < 90% improvement, 26%. Overall post-operative psychosocial adjustment was good, marked improvement in lifestyle was noted by 85%, personality change for the better by 65% and improved mood by 47%. A transient mood disorder was noted by 38% in the first six months following surgery. Psychosocial adjustment was better in patients who were seizure free or had > 90% reduction in seizures compared to those with < 90% improvement. Two measures of learned helplessness, depression and lack of resourcefulness correlated with poor postoperative psychosocial adjustment. Other variables beside seizure control must be considered in determining the ultimate outcome of epilepsy surgery.

Adaptation, Psychological↗
PubMed1983

Measuring physical and psychosocial function in patients with low-back pain.

Techniques for assessing daily function in Patients with back pain are generally crude and limited in scope. We therefore examined a "health status" questionnaire, the Sickness Impact Profile (SIP) to assess its measurement characteristics in such patients. Eighty patients with mechanical low-back pain completed the SIP and a physical examination at a walk-in visit and again three weeks later. Test-retest reliability of the SIP was substantial. Biologic validity was confirmed by significant correlations with age, pain duration, spine flexion, straight leg raising, and pain severity. Validity of psychosocial subscales was confirmed by significant associations with patient anxiety and psychiatric problems. Scores changed in the expected directions when patients were evaluated three weeks later. The SIP is thus valid, reliable, sensitive to clinical changes, and comprehensively assesses a wide range of dysfunctions.

Activities of Daily Living↗
PubMed1983

Psychosocial functioning, life change, and clinical status in adolescents with cystic fibrosis.

Twenty-six adolescents with cystic fibrosis (CF) were administered the Tennessee Self Concept Scale. The mean overall scores placed the CF patients at the 30th percentile of a normative adolescent population. Eighty-five percent were at appropriate school grade level, 69% participated in physical education classes, and 81% had future plans for college and/or a career. Total Life Event scores of CF adolescents were not significantly different from the normal adolescent population. However, in 22 CF adolescents evaluated with a modified National Institute of Health Scoring System, negative Life Event scores were higher in 10 adolescents with moderate to severely impaired health status than in 12 with lesser impairment. This relationship was not modified by other psychosocial variables.

Activities of Daily Living↗
PubMed2003

Psychosocial functioning before and after laparoscopic adjustable gastric banding: a cross-sectional study.

BACKGROUND: The aim of this cross-sectional study was to examine short and long-term physical, mental and, particularly, social quality of life (QoL) of patients with severe obesity after laparoscopic adjustable gastric banding (LAGB). METHODS: 250 patients (221 female, 29 male, mean age 39.6 years, age range 22-61) filled out questionnaires to evaluate several aspects of QoL: 93 patients before LAGB, 48 with a follow-up duration of 8 through 24 months, and 109 patients 25 through 68 months after LAGB. RESULTS: Compared with patients before surgery, patients after surgery, in both follow-up groups, had lower weight and co-morbidity, felt and functioned better on physical and psychological dimensions of QoL, and on most aspects of social QoL. No significant differences emerged between the two postoperative groups. On average, the postoperative QoL was still lower than the age norm group. Mutual correlations between QoL and weight outcome were very low up to 2 years after surgery, but more strongly associated >2 years after surgery. CONCLUSION: LAGB could be a long-term solution to morbid obesity with regard to both weight and QoL outcome. The findings of our study emphasize the importance of including social QoL variables in outcome research. They further suggest that when the follow-up duration increases, especially in patients who are single, intervention and consultation should be simultaneously directed at weight and psychosocial variables.

Adult↗
PubMed2000

Psychosocial Functioning of People with Substance Abuse and Bipolar Disorders.

This study assessed whether a secondary diagnosis of a substance use disorder in hospitalized people with bipolar disorder was associated with poorer outcomes on self-reported measures of mood (Profile of Mood States), subjective distress (Behavior and Symptom Identification Scale), and coping resources (Coping Resources Inventory), and with specific patient characteristics. Sixty-two patients with bipolar disorder and a secondary diagnosis of a substance use disorder and 60 patients with only a bipolar disorder diagnosis participated. Patients with bipolar disorder and a secondary diagnosis of a substance use disorder perceived significantly more impairment on all three measures than did patients without the secondary diagnosis. Moreover, the background characteristics of a history of violence, past or current involvement with the criminal justice system, and not having an antipsychotic medication prescribed during hospitalization had the strongest association with having a secondary diagnosis of a substance use disorder among the characteristics examined. These findings suggest the existence of a subgroup of patients with substance abuse and bipolar disorders who have substantial psychosocial impairment and probably require more intense treatment.

Journal Article↗
PubMed1996

Physical and psychosocial functioning of 117 survivors of bone marrow transplantation.

All surviving patients receiving a BMT at our center since 1976 were surveyed. Among 163 eligible patients, 145 were contacted and 117 (81%) responded. Their median follow-up was 55 months (range 6-154). The research instruments consisted of a demographic questionnaire, a current medical status form, a quality of life questionnaire (Nottingham Health Profile), and a screening instrument for psychiatric morbidity (the 28-item version of the General Health Questionnaire). Current functioning varied considerably across patients. They reported a high use of medical services (37%) and varied ongoing medical problems within the last 6 months. Most of them (93%) received Karnofsky ratings of 80 or above. Eight percent had current chronic GVHD. Comparing our patients' quality of life with a British reference population, most important differences were found for physical mobility, work, and sex life. Psychiatric morbidity in BMT survivors was higher than in a Spanish general population. Multivariate analyses revealed that a higher systemic symptomatology score, a lower educational level, an older age at BMT, a shorter time post-BMT, a female gender, and impotence were significant predictors of an impaired overall quality of life. Similarly, a higher systemic symptomatology score, a shorter time post-BMT, a higher number of major infections, and a lower educational level were predictive factors of a higher psychosocial distress. No differences in quality of life or psychosocial status between allogeneic and autologous transplants were found. Quality of life and psychosocial distress improved with the passage of time, specially within the first 3 years.

Adolescent↗
PubMed1994

Alcoholic subtypes: psychosocial functioning in Vietnam era men.

Data from the Vietnam Experience Study (Centers for Disease Control [CDC], 1988a) were used to investigate differences in sociodemographic characteristics, psychological functioning, and social support among five groups: (a) controls; (b) alcohol use disorder only; (c) alcohol use disorder and major depression; (d) alcohol use disorder and generalized anxiety, and (e) alcohol use disorder and antisocial personality (ASP). Consistent with prior findings, alcoholics with co-occurring disorders were more pervasively dysfunctional across the domains measured than the controls, and in some instances, than the alcohol use disorder only group. Differences among alcohol-comorbid groups also were found. The alcohol-depression group had the highest number of elevated MMPI scores, the highest levels of negative affect, and along with the alcohol-ASP group, the lowest levels of perceived social support. The alcohol-ASP group had the highest school dropout rate and, along with the alcohol-depression group, the earliest onset of problem drinking. Results were discussed regarding the importance of identifying distinctive psychosocial variables associated with alcoholic subtypes that may enhance perspectives on etiology, prevention, and treatment.

Adult↗
PubMed1993

The psychosocial functioning and family environment of depressed adolescents.

OBJECTIVE: This study examined measures of functional impairment and family relations in a sample of 62 adolescents with major depressive disorder (MDD) and 38 normal controls with no history of psychiatric illness. METHOD: Ratings of the following domains were obtained: mother-child relations, father-child relations, spousal relations, sibling relations, peer relations, and school performance. Ratings of each domain for the 3-month period preceding the assessment were derived from information obtained using a semistructured interview administered independently to the adolescents and one of their parents. RESULTS: Adolescents with MDD were found to have severe difficulties in all areas. Ninety percent of the depressed adolescents had scores greater than 2 SD above the mean of the normal controls on one or more of the domain ratings. In addition, adolescents with difficulties in parent-child relations were more likely than those adolescents without problems in family relations to have difficulties in peer relations and school performance. CONCLUSIONS: The authors discuss the importance of systematically examining psychosocial variables in future studies of the etiology, course, and treatment of MDD in adolescents.

Adolescent↗
PubMed1998

Well-being of haemophilia patients: a model for direct and indirect effects of medical parameters on the physical and psychosocial functioning.

This study outlines the development and evaluation of a structural equation model for establishing the consequences of haemophilia. The hereditary disorder is characterized by a high tendency to haemorrhages, with recurrent bleeding into the joints causing irreversible joint damage. The model is, in general, an attempt to answer the following questions: what is the effect of haemophilia on the well-being (i.e. satisfaction, health, somatic complaints and self-esteem) of patients and what is the additional or mediating role of other individual characteristics in this pathway? Disease severity, joint impairment and disability are defined as antecedents of well-being and the mediating roles of appraisal (i.e. the personal evaluation of the disease), health beliefs (i.e. locus of control), psychological characteristics (i.e. anxiety, anger, depression and optimism) and social support are investigated. Psychological variables turned out to be the strongest determinants of well-being and partly mediated the detrimental effect of disability on well-being. The role of appraisal remained somewhat unclear, as no significant relationship was established between this personal evaluation of haemophilia and well-being. Nevertheless, appraisal very well reflected the level of disability. An internal locus of control and favourable psychological characteristics appeared to reduce the perceived seriousness of haemophilia. No evidence was found for social support to act as a mediator between disability and well-being. The perception of support did show moderately strong associations with psychological characteristics (i.e. anxiety and depression) and satisfaction ratings. The study merits further research on quantifying the relationships between clinical parameters and psychosocial outcomes in patients with a chronic disease.

Adult↗
PubMed1996

Cognitive and psychosocial functioning of patients with congenital nephrogenic diabetes insipidus.

Mental retardation (MR) is generally considered one of the main complications of congenital nephrogenic diabetes insipidus (NDI). However, psychometric studies of NDI patients are scarce and outdated. In the present study, 17 male NDI patients underwent psychological evaluation. Total intelligence quotient of 14 patients was within (n = 13) or above (n = 1) the normal range, 1 patient had an intelligence score between -1 and -2 standard deviations (S.D.) and 2 young patients had a general cognitive index more than 2 S.D. below the norm. Attention deficit hyperactivity disorder criteria were met by 8 out of 17 patients and scores on short-term memory were low in 7 out of 10. No relation between test performances and age at diagnosis or hypernatremia could be found, with the exception of a negative correlation between age at start of therapy and verbal IQ in one age group. Although several explanations for an association between MR and NDI can be postulated, it seems that the current prevalence of MR among patients with this disease is considerably lower than suggested in literature.

Child↗