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PubMed2005

Psychological distress among Bam earthquake survivors in Iran: a population-based study.

BACKGROUND: An earthquake measuring 6.3 on the Richter scale struck the city of Bam in Iran on the 26th of December 2003 at 5.26 A.M. It was devastating, and left over 40,000 dead and around 30,000 injured. The profound tragedy of thousands killed has caused emotional and psychological trauma for tens of thousands of people who have survived. A study was carried out to assess psychological distress among Bam earthquake survivors and factors associated with severe mental health in those who survived the tragedy. METHODS: This was a population-based study measuring psychological distress among the survivors of Bam earthquake in Iran. Using a multi-stage stratified sampling method a random sample of individuals aged 15 years and over living in Bam were interviewed. Psychological distress was measured using the 12-item General Health Questionnaire (GHQ-12). RESULTS: In all 916 survivors were interviewed. The mean age of the respondents was 32.9 years (SD = 12.4), mostly were males (53%), married (66%) and had secondary school education (50%). Forty-one percent reported they lost 3 to 5 members of their family in the earthquake. In addition the findings showed that 58% of the respondents suffered from severe mental health as measured by the GHQ-12 and this was three times higher than reported psychological distress among the general population. There were significant differences between sub-groups of the study sample with regard to their psychological distress. The results of the logistic regression analysis also indicated that female gender; lower education, unemployment, and loss of family members were associated with severe psychological distress among earthquake victims. CONCLUSION: The study findings indicated that the amount of psychological distress among earthquake survivors was high and there is an urgent need to deliver mental health care to disaster victims in local medical settings and to reduce negative health impacts of the earthquake adequate psychological counseling is needed for those who survived the tragedy.

Adolescent↗
PubMed1986

Long-term effects on personality development in patients with adolescent idiopathic scoliosis. Influence of type of treatment.

In a series of 157 patients treated surgically and/or with Milwaukee braces, constituting 83% of the original criterion patients with adolescent idiopathic scoliosis, treated in the Department of Orthopaedics in Gothenburg, Sweden, from 1969 to 1974, a specific psychologic interview was carried out an average of 9 years after treatment. The 92 surgical patients all wore a Milwaukee brace postoperatively for 6-9 months and were gradually weaned over the next year (17 +/- 2 months). The brace-treated patients wore their braces full time for 18 months and part time for another 8 months (26 +/- 3 months). The psychologic portion of the study was a semistructured interview aimed at evaluating reactions in connection with the diagnostic phase, attitudes and reactions to the treatment, attitudes to the hospital staff, and body image concepts at follow-up. The brace-treated patients more often said that they experienced more fear and anxiety when informed about the diagnosis than did the surgical patients (53% and 38%, respectively). In both groups, nearly all patients initially had negative attitudes to the brace treatment. Most of the surgically treated patients gradually accepted the brace, whereas very few of the other group did so. Forty percent in the brace group had negative experiences with the hospital staff, but only 15% in the other group reported negative experience. Several years after completed treatment, one-half of the brace group had definite signs of negative body image concept, whereas this emotional disturbance was found in 33% of the surgically treated patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1998

Non-compliance following renal transplantation in children and adolescents.

Reported frequencies of non-compliance in children with end-stage renal disease range from 8% to 70% with a mean around 40%. Sequelae amount to momentous emotional and financial burdens, including the loss of 7% of transplanted organs. Reasons for non-compliance have too often been attributed selectively to the patients (e.g., emotional, mental, social, or communication problems). Compared with general compliance research, this selective attribution appears to be too simplistic. Selective attribution neglects the patients' experiences within the context of disease and treatment and prevents open communication about non-compliance. Research on personal reasons for non-compliance is scarce. In psychological interviews, a third of our 85 patients with end-stage renal disease (34 boys, 51 girls, mean age 12.7 years, range 7.4-19.3 years) communicated psychologically meaningful reasons for non-compliance, frequently related to interrelational and systemic treatment conditions. Patients indirectly asked for more communication about their subjective reasons for non-compliance.

Adolescent↗
PubMed2006

Psychological defense styles, childhood adversities and psychopathology in adulthood.

OBJECTIVE: The present study explores the link between reported sexual and/or physical abuse and psychological defense styles, as well as the association of both with psychological distress in adulthood. In two patient samples that differ in psychological distress and somatization, we examine whether the adversities reported and immature defense styles are associated with psychopathological symptoms. METHOD: We examined 266 consecutive inpatients in the psychosomatic department and 109 consecutive inpatients who had been treated for low-back pain in the orthopedic department of a German university hospital. Psychological defense styles were assessed by a two-factor solution of the German modified adaptation of the Defense Mechanism Inventory (DMI), childhood adversities by a structured interview, psychological distress by the SCL-90-R, and somatization by the Screening for Somatoform Disorders (SOMS). RESULTS: Both samples demonstrated a significant link between immature defense styles and the extent of overall psychological distress as well as somatization. Reported sexual and/or physical abuse of patients in both patient samples was directly associated with somatization. CONCLUSION: Recollections of sexual and/or physical abuse in childhood and immature defense styles have an association with psychopathology in adulthood. This finding suggests that immature defense styles may act, in part, as mediators between the adversities investigated and adult psychopathology.

Adult↗
PubMed1995

Psychologic stress in the workplace and spontaneous abortion.

The relation of work-related psychologic stress to spontaneous abortion was examined in a prospective study of 3,953 pregnant, employed members of a prepaid health plan in California, recruited between 1990 and 1991. Information on occupation, psychologic stress-related factors at work, social support at work, physical exertion at work, life events, pregnancy worries, and potential confounders was obtained by a telephone interview. Psychologic job stress and social support at work were assessed using an abbreviated version of the instrument developed by Karasek and colleagues (Los Angeles: University of Southern California, 1986). Results from the multivariate model indicated that, overall, stressful work was not associated with an increased risk of spontaneous abortion. However, interactions were observed between stressful work and maternal age over 32 years (p = 0.04), cigarette smoking (p = 0.02), and primigravidity (p = 0.06). Relative to the odds ratio for stressful work in young, nonsmoking, multigravid women without a history of two or more spontaneous abortions, the odds ratios for spontaneous abortion given stressful work were higher by 2.45 (95% confidence interval (CI) 1.03-5.81) for older women, 2.96 (95% CI 1.16-7.52) for smokers, and 2.27 (95% CI 0.97-5.27) for primigravid women.

Abortion, Spontaneous↗
PubMed1983

Pain relief associated with a religious visitation: a case report.

A 68-year-old black woman tolerated partial colectomy for resection of a carcinoma with minimal postoperative discomfort and without the need of any analgesia. She attributed her positive experience to the presence of protective angels. Psychologic interviews and testing revealed her to be fully in touch with reality. Her experience, as well as those of similar patients reported in the medical literature, has biological, sociocultural, and psychological components. The role of religious belief in the pain experience has received scant attention, but it constitutes a challenging area for future research.

Adenocarcinoma↗
PubMed1985

[Psychological aspects of requests for artificial insemination using a donor. Data on 740 couples].

The authors present the problems that have been raised by psychologically interviewing 740 couples who ask for A.I.D. They describe the procedure that they adopted and the features that came up during the interview and particularly in the way the couples experienced their sterility. They conclude by pointing out how important a consultation is, both from the point of view of evaluating the couple psychologically in regard to the treatment and from the point of view of clarifying the needs, the doubts and the expectations that the two partners have when they decide to undertake A.I.D.

Adult↗
PubMed2003

Formal support, mental disorders and personal characteristics: a 25-year follow-up study of a total cohort of older people.

The present study was designed to describe the pattern of long-term formal support received by people with mental disorders, and to investigate the relationship between the medical, psychological and social characteristics of the participants and types of formal support. This study is based on a cohort (n = 192) of people born in 1902 and 1903 in a community in Southern Sweden. The research participants were assessed using interviews, psychological tests and medical examinations. Information was collected about the use of primary healthcare and social services. The first assessment took place when the cohort was aged 67 years, and then on eight further occasions until they were 92. The participation rate ranged from 72% to 100%. During the observation period of 25 years, 53% of people with dementia eventually received both home help and institutional care compared to 34% of people with other psychiatric diagnoses and 12% of people with good mental health. The last group had all physical health problems and/or problems with activities of daily living. However, 35% of the dementia group, 46% with other psychiatric diagnoses and 52% of people with good mental health did not receive any formal support. Males and self-employed people were significantly less likely to use formal support. The institutionalised group reported loneliness significantly more often than the other two groups. In a logistic regression analysis, loneliness, low social class, high blood pressure and low problem-solving ability were predictors of formal support use. People with a mental disorder, including dementia, were significantly more likely to use formal support compared to people with good mental health. Social factors were the main factors predicting formal support.

Activities of Daily Living↗
PubMed1990

Psychosocial aspects of ambulatory pediatrics.

The ability to interview is an essential skill that continues to develop throughout a pediatrician's professional life. Interviewing is a complex procedure that requires in-depth understanding of medical illness, child development, individual and family dynamics, cultural variations, and self-awareness--your personal values and response to crisis, serious illness, and stress. Interviewing is learned by thoughtful reflection of each interview as well as more formally through the use of videotape and attending observation. Each interview is an opportunity to develop a relationship and add a bit of experience that is unique to the patient or parent and potentially useful in understanding more in the future. Although this procedure receives little formal attention, the interview is often the primary vehicle for making the diagnosis, relating to the child and family, and easing emotional suffering and can be a source of satisfaction for the many hours of hard work.

Ambulatory Care Facilities↗
PubMed1992

[Measurement of quality of life. Application to the screening of psychological distress in cancer patients].

As cancer treatments are becoming more and more traumatic the quality of life of these patients must be taken into consideration. This study was set up in 1982 and aimed at screening patients suffering from major psychological distress using a quantitative assessment of the quality of life. A self-administered questionnaire (QLQ) and linear analogues (LA) were developed and validated. The patient's acceptance of these two measuring instruments was tested on a sample group of patients in the Oncology Department of Besançon University Hospital and gave a result of 94% which was higher than that of a psychological interview (64%). A comparison of the assessment of the quality of life by the patient, the psychologist and the physician is an important phase in this concept. Agreement by the doctor and the patient using the Karnofsky indices was moderate (62% of the cases using a simplified scale): patients tended to overstate the extremes. The overall scores and the different questionnaire items completed by the patient and the psychologist were correlated, but agreement varied according to each item. An attempt was made to establish a predictive value for the questionnaire and the linear analogues to identify patients suffering from major psychological distress and requiring psychosocial support by comparing the results of the tests with the assessment of the psychologist during an interview. A stepwise logistical regression selected a combination of three items which screened more than 80% of these patients. The linear analogues were not sufficiently discriminatory to be used. The overall results suggest that a quality of life measurement can be integrated into daily clinical practice.

Humans↗
PubMed2007

Are there gender-specific pathways from early adolescence psychological distress symptoms toward the development of substance use and abnormal eating behavior?

The aim of the present longitudinal community study was to test whether psychological distress at 13 years of age predicted reported substance use problems in boys and abnormal eating behavior in girls 2 years later. The sample consisted of 500 male and 576 female students. The use of substances was evaluated using a semi-structured interview, psychological distress with the General Health Questionnaire (GHQ) and eating psychopathology with the Eating Attitudes Test (EAT-40), and the Bulimic Investigatory Test Edinburgh (BITE). Controlling the effect of initial substance use problems, psychological distress predicted later reported substance use problems in males. Girls with an initial score above the cut-off point on the GHQ were two times more likely to be at risk of having an eating disorder 2 years later. Therefore, psychological distress might take different developmental pathways in males and females, leading toward eating problems in the latter versus substance use in the former.

Adolescent↗
PubMed1996

Hormonal response to stress in brittle diabetes.

Acute psychological stress may play a role in the glycaemic instability of some patients with type I diabetes through an increased secretion of insulin-counteracting hormones. To examine the validity of this hypothesis, we subjected to a video-recorded public-speaking stress seven healthy persons, six type I diabetics with stable blood glucose levels and six type I diabetics with unstable or brittle diabetes (with more than 10 hypoglycaemia/month and frequent hyperglycaemia). During the test and on a control day, heart rate, blood pressure, plasma ACTH, cortisol, catecholamines and prolactin were measured. The comparison between the stable and unstable diabetics during the stress session by two-way analysis of variance (group/time) showed a significant difference for heart rate, blood pressure, ACTH and cortisol. Psychological interview showed that most unstable diabetics perceived a link between life stress and their blood glucose control. The unstable patients had much more difficulty in verbalizing their emotions. Our study shows that the two groups of diabetic patients display distinct cardiovascular and neuroendocrine responses to psychological stress, as well as distinct psychological profiles. In conclusion, hormonal response to an acute psychological stress is more pronounced in brittle diabetes and might be one of its pathogenic factors.

Adolescent↗
PubMed1994

[Psychological aspects of infertile couples in China].

From March 1991 to February 1992, a psychological interview survey was performed among 652 women and 425 of their husbands who came to the Female Infertility Clinic in PUMC Hospital to seek consultation and treatment for their infertility. The results showed that more than 80 percent of the couples had been tolerating various psychological stresses caused by infertility. Disapproval was the most common feeling. The couples' emotion was influenced by each other. Emotional scores of husbands and wives were significantly positive correlated (P < 0.001). However, men are more capable to cope with this problem than women. Men's attitude to infertility is more positive and optimistic than women. There is no significant difference between women and men in their attitude to the treatment and forecasting of prognosis. Cultural background is a major factor associated with psychological stresses of infertile couples. Infertility has more severe impact on people living in rural areas as well as ones with lower level education. Infertility also affected couple's sexual and marital relationships. The relationship between women and their parents in-laws became worse among 8.6 percent of infertile women. About one-third of female participants thought the examination and the treatment for infertility also developed some emotional stresses and psychological burdens. Infertility may create various psychological stresses and influence the effect of treatment. Therefore, the management of infertility should not only include physical treatment but also understanding, sympathy and support, all above should not be neglected.

Adult↗
PubMed1992

Patient acceptance and differential perceptions of quality of life measures in a French oncology setting.

A three-part study evaluated French cancer patients' acceptance of self-rated quality of life measures, the predictive value of these measures, and the agreement between patient and health provider ratings of patient quality of life. In part one, 93% of 137 patients indicated a willingness to complete the Qualite de la Vie-Questionnaire (QOL-Q) and Analogues Lineaires pour la Mesure de la Qualite de vie (LA), and 63.6% indicated a willingness to be interviewed by a psychologist. Willingness to complete the scales was related to hospitalization status and treatment modality. In parts two and three, 100 patients were asked to complete the QOL-Q, LA, the Karnofsky Index (KI) and a side-effects checklist, and to undergo a psychological interview. Following interview, a psychologist rated the patients using the QOL-Q, and classified patient level of emotional distress. Oncologists rated the patient using the KI and the side-effects checklist. The results indicate that the patients' ratings of their quality of life were higher than the psychologist's ratings, and that the QOL-Q has predictive value in identifying severe emotional distress. Low level of patient and physician agreement on the KI was partially explained by patient age and cancer site. A moderate level of agreement was found between patient and physician perceptions of side effects. The study suggests that the QOL-Q, not the LA, may be useful as a screening tool to identify patients with impaired quality of life, and that self-rated measures should be included in quality of life assessments.

Adult↗
PubMed2002

Gender differences in psychopathology, functional impairment, and familial risk factors among adjudicated delinquents.

OBJECTIVE: To test the hypotheses that female juvenile delinquents would have higher rates of psychological symptoms, DSM-IVpsychiatric and substance use disorders, functional impairment, and familial risk factors than male juvenile delinquents. METHOD: A stratified random sample of adjudicated delinquents (n = 513 males, n = 112 females) was drawn from San Diego County administrative databases. Of those sampled youths who could be located, 65.7% completed interviews. Psychological symptoms, DSM-lVdiagnoses, and familial risk factors were assessed between October 1997 and January 1999. RESULTS: Female delinquents scored higher on parent and self-report measures of psychological symptoms and had higher rates of DSM-IVmental disorders than did male delinquents. Girls also experienced greater incidences of physical, emotional, and sexual abuse; physical neglect; and family history of mental illness than their male counterparts. No gender differences were found on parental ratings of youth functional impairment, substance use disorders, comorbidity, or parental history of antisocial behavior. CONCLUSIONS: Findings indicated that female adjudicated delinquents have significantly higher rates of psychopathology, maltreatment history, and familial risk factors than males and suggest that the mental health needs of girls in juvenile justice deserve increased attention.

Adolescent↗
PubMed2002

Hypospadias: incidence and effects on psychosexual development as evaluated with the Minnesota Multiphasic Personality Inventory test in a sample of 11,649 young Italian men.

PURPOSE: We evaluated the incidence of hypospadias and its effects on psychosexual development in a sample of 11,649 young Italian males. Over the last 30 years only about 30 major publications have addressed these issues and the results of many studies have been contrasting. Some defects in methodology, such as low response rates, heterogeneity of age ranges and the choice of controls, have been the main limitations. Our study was designed to take these problems into account. MATERIALS AND METHODS: Forty-two hypospadic subjects and a random sample of 500 nonaffected males selected from the large sample of 11,649 young men (>90% of the 18-year-old males living in the Italian region of Tuscany) were screened by the Minnesota Multiphasic Personality Inventory (MMPI) test, psychological interview and clinical evaluation. RESULTS: The incidence of hypospadias in this representative group of Italian men is 3.6/1,000. No difference was noted in the percentage with altered MMPI compared with the control group. The age at surgical corrections and the number of operations are not related to an abnormal global psychological adjustment. Severity of disease influences a more negative genital appraisal and the number of operations is correlated only with more difficulty in initiating contact with the opposite sex. CONCLUSIONS: Surgery for hypospadias has to be strongly pursued in as many cases as possible. In addition, we strongly recommend following up all hypospadics, independently of the severity of their genital malformations, through adolescence to early adulthood, to ensure early detection of subjects with impaired psychological profiles.

Adolescent↗