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Results for “Psychosocial functioning”

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PubMed1994

A psychosocial follow-up of ten adolescents with low anorectal malformation.

Ten adolescents, aged 12-16 (mean 14.5) years, with corrected low anorectal anomalies were assessed with regard to somatic condition, psychopathology and psychosocial functioning by semistructured interviews and questionnaires. Half of the patients still had a persistent dysfunction involving problems with constipation and/or soiling. Six of 10 adolescents met the criteria for a psychiatric diagnosis and had scores indicating mild to severe impairment of psychosocial function. Psychosocial functioning was correlated with chronic family difficulties. The findings are in contrast to previous studies and reveal hidden problems and unmet social needs. To optimize their mental health and psychosocial functioning, children with low anorectal anomalies need both somatic and psychosocial follow-up.

Adaptation, Psychological↗
PubMed1996

Somatic function, mental health, and psychosocial adjustment of adolescents with anorectal anomalies.

Thirty-three adolescents (aged 12 to 20 years; median, 15) with a corrected low (n = 17) or high (n = 16) anorectal anomaly were assessed using anorectal physiological examination, semistructured interviews [Child Assessment Schedule [CAS]), and questionnaires (Child Behavior Checklist [CBCL], Youth Self-Report [YSR]). Seven patients, all of whom had low malformations, were totally continent. Twenty-three (70%) had persistent dysfunction with staining (n = 12) or intermittent/constant soiling (n = 11). Twenty-four (73%) had flatus incontinence. Fecal incontinence correlated negatively with anal canal resting pressure (r = - .58, P = <.001) and squeeze pressure (r = -.54, P < .01). Three adolescents had a permanent colostomy. Nineteen patients (58%) met the criteria for a psychiatric diagnosis, and impairment of psychosocial function was found in 24 (73%). The degree of psychosocial impairment correlated significantly with fecal incontinence (F = -.37, P < .05) and flatus incontinence (r = -.49, P < .01). Continence of flatus correlated significantly with mental health symptom scores (YSR: r = .52, P < .01; CAS:r = .53, P < .01). The findings indicated that, in addition to soiling, staining as well as fear of flatus are associated with psychiatric and psychosocial dysfunction among patients with anorectal malformations. Optimal treatment of patients with low and high anorectal anomalies requires somatic and psychological care and follow-up into adulthood.

Adaptation, Psychological↗
PubMed2002

Brief report: cognitive functioning in children with Tourette's syndrome with and without comorbid ADHD.

OBJECTIVE: To examine whether patients with Tourette's syndrome (TS) with and without comorbid attention deficit and hyperactivity disorder (ADHD) differ in cognitive functioning and whether a higher level of cognitive functioning is associated with severity of TS symptoms and psychosocial functioning. METHODS: Cognitive functioning, symptom severity, and psychosocial functioning were examined in 40 patients (33 boys, 7 girls; age range 6-18 years) with TS, of whom 17 had the comorbid diagnosis of ADHD. RESULTS: Patients with a comorbid ADHD diagnosis evidenced poorer performance than those with TS alone with respect to severity of TS symptoms, psychosocial functioning, verbal and performance intelligence, and word fluency, but not on tests of cognitive flexibility. Psychosocial functioning was predicted by symptom severity, but not by intelligence or fluency. CONCLUSIONS: Results confirm prior findings that comorbid ADHD is associated with more TS symptoms and worse psychosocial and cognitive functioning, and motivate whether cognitive flexibility plays a role in moderating the deleterious psychosocial effects of Tourette's syndrome and ADHD.

Adolescent↗
PubMedDate not supplied

Psychosocial outcome in juvenile chronic arthritis: a nine-year follow-up.

OBJECTIVE: To describe the long-term psychosocial outcome in a prospectively followed cohort of patients with juvenile chronic arthritis (JCA), to assess the associations between psychosocial outcome and disease variables and to explore family stressors as predictors of long-term psychosocial and physical outcome. METHODS: Fifty-two patients with JCA were assessed psychosocially at first admission to a pediatric rheumatology clinic and were reassessed 9 years later. Assessment methods included semi-structured psychiatric interviews and standardized parental questionnaires and self-reports. RESULTS: At follow-up, 9 patients (17%) fulfilled the criteria for a psychiatric diagnosis and 8 (15%) had mild to moderate impairment in psychosocial functioning (children's or adult Global Assessment Scale). Mental health and psychosocial functioning were significantly improved from the first hospital admission to follow-up. In patients < 18 years of age (n = 26), psychosocial functioning at follow-up correlated with physical disability according to the Childhood Health Assessment Questionnaire (r = -0.52, p < 0.01). Psychosocial outcome was unrelated to other measures of disease severity. Chronic family difficulties in the disease course predicted psychosocial functioning at follow-up in patients < 18 years old (R2 = 0.22). Chronic family difficulties at disease onset, together with gender and chronic family difficulties in the disease course, predicted psychosocial functioning at follow-up in patients > or = 18 years old (R2 = 0.61). Family stressors were unrelated to the physical outcome. CONCLUSION: The long-term psychosocial outcome was favorable in most of the patients. Psychosocial outcome was predicted by chronic family difficulties, but was not closely related to disease severity at follow-up.

Adolescent↗
PubMed1992

[The functional assessment of chronic pain patients activity of daily living and psychosocial disability].

The purpose of this study was to investigate the impact of activity of daily living and psychosocial function in patients with chronic nonmalignant pain. From Jun. 1989 to Nov. 1989, one hundred and eleven cases were assessed by Sickness Impact Profile (SIP) and Taita Symptom Check List (TSCL) to evaluate the disabilities associated with chronic pain. Patients showed significant impairment in the functions of physical psychosocial work and recreational activities. It was also apparent that the psychosocial disabilities were more severe than physical disabilities. Specifically, they showed anxiety depression and significant somatization. Analysis by stepwise multiple regression indicates that sex age educational level employment status diagnosis and pain intensity were the significant influencing factors related to the disabilities of activity of daily living and psychosocial function. The results supported the validity of the SIP as a measurement of functional status with chronic pain patients. Specifically, the psychosocial dimension was significantly correlated with the psychological and psychosocial distress categories of the TSCL. Based upon its reliability validity breadth of assessment and ease of administration, the SIP appeared to be well suited for the assessment of patients with chronic pain and for evaluating the efficacy of multidisciplinary pain treatment.

Activities of Daily Living↗
PubMedDate not supplied

Quality of life following cardiac surgery: impact of the severity and course of depressive symptoms.

OBJECTIVES: The purpose of this study was to examine the impact of the severity and course of depressive symptoms on change in quality of life (QOL) 6 months after cardiac surgery. METHODS: Ninety patients were interviewed before heart surgery and 2 and 6 months after surgery. Depressive symptoms were assessed using the Beck Depression Inventory, and QOL was assessed using physical and psychosocial functioning indices derived from the Medical Outcomes Study instrument. Multiple regression examined the effects of the severity and course of depressive symptoms on QOL adjusting for demographic and biomedical predictors. RESULTS: Higher levels of presurgical depressive symptoms predicted poorer physical functioning after cardiac surgery. A similar effect on psychosocial functioning fell short of significance. An increase in depressive symptoms 2 months after surgery was significantly predictive of poorer physical and psychosocial functioning at 6 months. The effect of increased depressive symptoms on psychosocial functioning was significantly stronger in patients with high presurgical Beck Depression Inventory scores. CONCLUSIONS: Both preoperative depressive symptoms and postoperative increases in depressive symptoms seem associated with poorer QOL 6 months after cardiac surgery. Further examination of these associations and the mechanisms they reflect may provide a basis for guiding treatment decisions before and after coronary artery bypass graft surgery.

Adaptation, Psychological↗
PubMed1989

Cued recall and memory disorders in dementia.

Memory functioning of normal elderly subjects and patients with suspected malignant memory disorders were examined using a cued recall memory assessment procedure. Levels of psychosocial functioning were rated by a multidisciplinary team. Ability to engage in free and cued recall was studied to determine the relationship between problems of acquisition and retrieval. Normal and impaired elderly showed strong differences on free recall and total recall resulting in 90.58% and 79.06% rates of accuracy of prediction of group membership. There were significant multivariate and univariate differences among the memory-impaired groups defined in terms of their psychosocial functioning. These findings indicate that differences in acquisition and retrieval are associated with increasing impairment of psychosocial functioning. Patients whose psychosocial functioning was rated as falling within the questionable range exhibited only deficits in retrieval. Patients whose psychosocial functioning was rated as more severely impaired, exhibited problems of retrieval and acquisition.

Aged↗
PubMed2003

Treatment adherence of youth and young adults with and without a chronic illness.

The present study was undertaken to explore the psychosocial functioning of young people with chronic illness, their beliefs about treatment adherence, difficulties with adherence and concerns about living with their illness. A small correlational study was undertaken to compare the psychosocial functioning of young people, with and without chronic illness, aged between 12 and 24 years. Subjects were recruited from a metropolitan teaching hospital. Group 1 included 44 young people with chronic illness; Group 2 included 41 young people without chronic illness. Both groups were divided on the basis of age: younger (12-18 years, n = 24); older (19-24 years, n = 61) and sex (female = 43; male = 42). Subjects completed the Achenbach self-report questionnaire as a measure of psychosocial functioning, and a second questionnaire constructed for this study to explore treatment adherence. Psychosocial functioning scores were found to be similar on the majority of subscales. Young women with chronic illness were, however, found to have significantly higher internalizing scores than young women without chronic illness. A significant negative relationship was found for the chronic illness group between internalizing scores and treatment adherence. The findings highlight potential areas of difficulty in psychosocial functioning of some young people with chronic illness. They also suggest the existence of a subgroup of young people with chronic illness who experience more problems than their peers. More research is needed to generate evidence about this possible subgroup to determine predictors of psychosocial functioning and test the timing and efficacy of psychosocial interventions.

Acute Disease↗
PubMedDate not supplied

[Psychosocial adaptation in children and adolescents with craniofacial malformations].

To determine children's perception of their own psychosocial functioning, to compare it with their parents' perception, and determine the type and rate of their psychopathological syndromes and family functioning, and to investigate correlation among these data. Nineteen children with craniofacial deformities and their parents responded to the Columbia Impairment Scale, the Child Behavior Checklist and the McMaster General Functioning Subscale. Psychosocial impairment is a trend in children with craniofacial deformities. There is a correlation between children's and parents' perception of the patient's psychosocial adaptation, global psychopathology and externalizing and aggressive syndromes. A less strong correlation was found with internalizing, somatization and attention deficit syndromes, and with family functioning. Craniofacial deformities in childhood pose special risks for psychosocial adjustment due to type of illness and environmental and family factors.

Adaptation, Psychological↗
PubMed2000

Factors related to sleep disturbance in older adults experiencing knee pain or knee pain with radiographic evidence of knee osteoarthritis.

OBJECTIVES: To describe the types and frequencies of sleep complaints and the biopsychosocial factors associated with sleep disturbance in a large community sample of older adults experiencing knee pain or knee pain with radiographic evidence of knee osteoarthritis (OA). DESIGN: Baseline analyses of an observational prospective study. SETTING AND PARTICIPANTS: Participants were 429 men and women aged 65 years and older experiencing knee pain or knee pain with radiographic evidence of OA enrolled in the Observational Arthritis Study in Seniors (OASIS). MEASUREMENTS: Demographic variables (age, gender, ethnicity, education), health (X-rays of knee rated for OA severity, medical conditions, medication use, smoking status, body mass index, self-rated health), physical functioning (self-rated physical functioning, physical performance), knee pain, and psychosocial functioning (social support, depression) were measured. RESULTS: Problems with sleep onset, sleep maintenance, and early morning awakenings occurred at least weekly among 31%, 81%, and 51% of participants, respectively. Bivariate correlates of greater sleep disturbance in those with OA were less education, cardiovascular disease, more arthritic joints, poorer self-rated health, poorer physical functioning, poorer physical performance, knee pain, depression, and less social support. In regression analyses, each set of variables representing the domains of health, physical functioning, pain, and psychosocial functioning contributed to the prediction of sleep disturbance beyond the demographic set. Finally, in a simultaneous model, white race (trend, P = .06), poorer self-rated health, poorer physical functioning, and depressive symptoms were predictive of sleep disturbance. CONCLUSIONS: Sleep disturbance is common in older adults experiencing knee pain or knee pain with radiographic evidence of OA and is best understood through the consideration of demographic, physical health, physical functioning, pain, and psychosocial variables. Interventions that take into account the multidetermined nature of sleep disturbance in knee pain or knee OA are most likely to be successful.

Activities of Daily Living↗
PubMed2002

Psychological correlates of functional status in chronic fatigue syndrome.

BACKGROUND: The present study was designed to test a cognitive model of impairment in chronic fatigue syndrome (CFS) in which disability is a function of severity of fatigue and depressive symptoms, generalized somatic symptom attributions and generalized illness worry. METHODS: We compared 45 CFS and 40 multiple sclerosis (MS) outpatients on measures of functional ability, fatigue severity, depressive symptoms, somatic symptom attribution and illness worry. RESULTS: The results confirmed previous findings of lower levels of functional status and greater fatigue among CFS patients compared to a group of patients with MS. Fatigue severity was found to be a significant predictor of physical functioning but not of psychosocial functioning in both groups. In CFS, when level of fatigue was controlled, making more somatic attributions was associated with worse physical functioning, and both illness worry and depressive symptoms were associated with worse psychosocial functioning. CONCLUSIONS: Our findings support the role of depression and illness cognitions in disability in CFS sufferers. Different cognitive factors account for physical and psychosocial disability in CFS and MS. The SF-36 may be sensitive to symptom attributions, suggesting caution in its interpretation when used with patients with ill-defined medical conditions.

Adult↗
PubMed2003

Treatment of incarcerated, sexually-abused adolescent females: an outcome study.

This study examined the psychosocial functioning of 100 adolescent females (ages 12-17) sentenced to secure care in a southeastern state and the impact of gender-specific, cognitive-behavioral therapy (CBT) intervention on the psychosocial functioning of subjects who reported a history of sexual abuse. The Multidimensional Adolescent Assessment Scale (MAAS) was used to assess psychosocial functioning. Pre-test scores on the MAAS revealed significantly higher scores on 12 of 16 dimensions of psychosocial functioning and higher rates of serious criminal behavior for youth who subsequently disclosed sexual abuse histories as compared to those without such histories. At post-test, statistically significant improvements in psychosocial functioning were observed on 14 of 16 MAAS subscales for those who received the CBT intervention. Thus, incarcerated female adolescents who reported a history of sexual abuse demonstrated more impairment in their functioning as compared to those without a reported history of sexual abuse and responded positively to gender-specific, CBT-based intervention.

Adolescent↗
PubMedDate not supplied

Size and complexity of social networks among substance abusers: childhood and current correlates.

The objective of this study was to identify parental, childhood, demographic, and social function factors associated with social network size and complexity among substance abusers using retrospective data regarding family and childhood history and current data regarding demographic characteristics and psychosocial function. The authors interviewed 505 voluntary patients with substance abuse at two university medical centers in Minnesota and Oklahoma with alcohol-drug programs located within departments of psychiatry. Data collection instruments included a childhood questionnaire, a demographic checklist, and two psychiatric rating scales of psychosocial function. The authors found that years of education, current residence with others, being actively occupied at work or school, and higher psychosocial function on two psychiatrist-rated scales were associated with increased social network size and complexity. Loss of mother, out-of-home placement, and runaway before age 18 were associated with smaller social networks in adulthood. Age, gender, and current marital status were not associated with social network. Regression analysis indicated that network size (i.e., the number of individuals in the network) was associated with higher psychosocial function over the last year but not over the last two weeks, whereas network complexity (ie, the number of subgroups in the network) was related to psychosocial function over both the last year and the last two weeks. These data indicate that in addicted persons, both childhood factors and current social factors affect network size and complexity. Network complexity may be amenable to short-term change, whereas network size may be more related to longer-term coping.

Adaptation, Psychological↗
PubMed2006

Subjective life satisfaction and living situations of persons in Finland with long-term schizophrenia.

OBJECTIVE: This study measured subjective life satisfaction among patients with long-term schizophrenia who were living in the community. METHODS: A representative national sample of 2,221 persons with schizophrenia who were discharged from psychiatric hospitals in Finland in 1986, 1990, and 1994 were interviewed three years after discharge. Subjective life satisfaction was measured; patients were asked about their current level of satisfaction and the level of satisfaction they recalled having at the time of discharge. RESULTS: Patients tended to report more satisfaction at follow-up if they were female, had good psychosocial functioning, had several confidants, or were living in group homes or dormitories. Patients tended to be less satisfied at follow-up if they were divorced or had mental and physical symptoms. Patients with depressive symptoms or with low psychosocial functioning and those who were currently hospitalized reported the smallest changes in levels of satisfaction between the two time points. Patients with low psychosocial functioning who were living with their parents, in group homes or dormitories, or in institutions were relatively satisfied, whereas patients with good psychosocial functioning were more satisfied if they lived with their spouse or partner. CONCLUSIONS: Being female and having good psychosocial functioning, confidants, good physical health, and living arrangements in the community that offer support corresponding to the patient's psychosocial state are important factors of life satisfaction among patients with long-term schizophrenia.

Adaptation, Psychological↗
PubMed1994

One-year prospective replication study of an untreated sample of community dysthymia subjects.

This study replicates an earlier naturalistic-prospective investigation of nontreatment, community DSM-III-R dysthymia subjects. Major goals were to determine spontaneous remission rates and monitor the stability of psychosocial functioning levels over time. Twenty-four dysthymia subjects were followed for 1 year. Three remissions (13%) were diagnosed at the final interview. At a 4-year diagnostic follow-up contact with the remitters only, one remitter had relapsed and two remained in remission. Subjects were monitored for depressive symptom intensity, personality functioning, general medical distress, cognitive functioning, coping stylistics, interpersonal functioning, quality of their social support resources, and general family functioning. Stable levels of psychosocial functioning were maintained across all measures over the 1-year period. Current psychometric findings confirm the conclusions of the earlier nontreatment prospective study that dysthymia is a chronic mood disorder with stable psychosocial features and is unlikely to remit spontaneously over time.

Adaptation, Psychological↗
PubMed2006

Developing brief scales for use in clinical practice: the reliability and validity of single-item self-report measures of depression symptom severity, psychosocial impairment due to depression, and quality of life.

OBJECTIVE: Reliable, valid, user-friendly measurement is necessary to successfully implement an outcomes evaluation program in clinical practice. Self-report questionnaires, which generally correlate highly with clinician ratings, are a cost-effective assessment option. However, even self-administered questionnaires can be burdensome to patients because many are lengthy. Consequently, we developed and determined the reliability and validity of ultra-brief, single-item assessments of 3 domains important to consider when treating depressed patients: symptom severity, psychosocial functioning, and quality of life. METHOD: In the first study (conducted June 1997 to March 2002), 1278 psychiatric outpatients with various DSM-IV diagnoses completed single-item assessments of psychosocial functioning and quality of life as well as more detailed measures of these constructs. In the second study (conducted August 2003 to July 2004), 562 psychiatric outpatients who were in ongoing treatment for a DSM-IV major depressive episode completed a depression symptom scale and a measure of global severity of depression. RESULTS: The test-retest reliability of the psychosocial functioning and quality-of-life items was high. The single-item measures of symptom severity, psychosocial functioning, and quality of life were significantly correlated with the total scores and individual item scores of longer measures of the same constructs (p < .001). The single-item measures significantly discriminated between depressed patients in full remission, in partial remission, and in a current depressive episode (p < .001). CONCLUSION: These studies provide evidence of the reliability and validity of single-item measures of symptom severity, psychosocial functioning, and quality of life. Very brief measures, such as the ones described in the present report, are not burdensome for patients to complete and can be easily incorporated into a busy clinical practice in order to collect data on treatment effectiveness.

Adaptation, Psychological↗
PubMed2002

Comparison of recovery patterns for patients undergoing coronary artery bypass grafting and minimally invasive direct coronary artery bypass in the early discharge period.

The purpose of this pilot study was to compare the postoperative problems, evaluation and response of symptoms, and functional status (physiologic and psychosocial functioning) during the early recovery period (2, 4, and 6 weeks after surgery) in 35 individuals who underwent coronary artery bypass grafting (n=24) or minimally invasive direct coronary artery bypass (n=11). The most frequent postoperative problem reported by the coronary artery bypass grafting group was an incisional infection (either sternal or leg); 26% reported infection at 2 and 4 weeks, and 21% at 6 weeks after surgery. Respiratory problems (pleural effusion, pneumonia) were the second most frequently reported problem, reported by 10% of the subjects at 2 and 4 weeks and by 16% at 6 weeks. Other, less frequent problems were severe nervousness, rhythm problems, and pericarditis. Minimally invasive direct coronary artery bypass patients reported fewer postoperative or cardiac-related problems, as only 5% indicated a problem with heart failure at both 2 and 4 weeks, and 36% reported being very nervous or having emotional problems at 4 weeks. Unlike postoperative problems, there were numerous similarities in postprocedural symptoms between these two groups. Fatigue, shortness of breath, and pain were the major symptoms reported postdischarge by both groups in this study. In addition, sleeping problems were also fairly prevalent in the coronary artery bypass grafting group, which is understandable, considering the fatigue ratings. Physiologic and psychosocial functioning varied minimally between the two procedures. While there were many similarities in the recovery patterns of both groups, the occurrence of postprocedural problems and symptoms of these two patient groups should be considered by clinicians to further tailor patient education.

Adult↗