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At least 937 records · Page 52Linked to original sources
PubMed2006

Diagnosis of laryngopharyngeal reflux among globus patients.

OBJECTIVE: Laryngopharyngeal reflux (LPR) is suggested as one of the most common etiologic factors of globus; currently, however, only a few tools are available to carry out effective diagnosis of LPR in clinics. The goal of this study was to assess the validity of reflux finding score (RFS), reflux symptom index (RSI), and symptom checklist-90-revision (SCL-90-R) as diagnostic methods for LPR. STUDY DESIGN AND SETTING: We selected 57 globus patients who were divided into test and control groups according to the results of 24-hour double-probe ambulatory pH monitoring. RFS, RSI, and SCL-90-R were then compared between the 2 groups, and the logical products of the 3 tests were also compared. RESULTS: RFS and RSI showed low specificity and there was no significant difference between the test and control groups. However, SCL-90-R revealed significantly high scores in the control group. The logical product of combining positive RFS and negative SCL-90-R was significantly different between the groups. CONCLUSION: RFS and RSI are less valid as diagnostic tools for LPR when used independently. Patients with LPR are found to exhibit weaker psychological symptoms than non-LPR patients. EBM RATING: B-2b.

Adult↗
PubMed2004

Psychogenic nonepileptic seizures are associated with an increased risk of obesity.

Psychogenic nonepileptic seizures (NES) are somatic manifestations of psychological distress. There is some evidence that weight problems are more common in patients with psychiatric illness. We have observed that patients admitted for video-EEG monitoring who we diagnosed with NES commonly have a larger body habitus than patients with epilepsy. The goal of this study was to test our hypothesis that there was a significant difference in body mass index (BMI) in patients with nonepileptic seizures compared with their epileptic counterparts. We compared the BMIs of 46 NES patients and 46 age- and gender-matched epileptic controls and found that the NES patients had significantly higher BMIs (30.5 vs 26.1, P=0.006) than controls. This remained true after controlling for weight-gain properties of antiepileptic drugs. These results are compared with the prevalence of overweight and obesity in the general population. Possible explanations of the findings and limitations of the study are discussed.

Adolescent↗
PubMed2005

Cluster analysis of normal personality traits in patients with psychogenic nonepileptic seizures.

The literature on patients with psychogenic nonepileptic seizures (PNES) suggests that they are a heterogeneous population. This study addresses this heterogeneity by describing subtypes of PNES based on a cluster analysis of normal personality traits in patients with PNES. In addition, the identified PNES subtypes are further described on dimensions of psychopathology as measured by the Minnesota Multiphasic Personality Inventory, Second Edition (MMPI-2), and cognition. Three personality clusters emerged: (1) very high neuroticism, low extraversion, low openness, high agreeableness, low conscientiousness; (2) average on all domains; (3) very high neuroticism, average extraversion, low openness, low agreeableness, average conscientiousness. Patients in clusters 1 and 3 appear to exhibit more severe psychopathology and a broader range of symptoms than those in cluster 2. Based on NEO-PI-R and MMPI-2 findings, tentative descriptions of the clusters are offered. Cluster 1 comprises "depressed neurotics"; cluster 2, "somatic defenders"; and cluster 3, "activated neurotics." Clusters 1 and 3 also differ significantly on neurocognitive testing, with cluster 1 significantly lower than cluster 3 in memory functioning, while cluster 2 individuals show generally average cognition across domains. These results suggest the existence of personality subtypes in patients with PNES that should be considered in the design of interventions for them.

Analysis of Variance↗
PubMed1980

Diagnosing hysterical conversion reactions in children.

To assist pediatricians in the early, accurate diagnosis of conversion reactions, a biopsychosocial profile of index patients and families was established. Utilizing a chart audit, all pediatric inpatients with conversion reactions at Children's Hospital Medical Center from July, 1976, through June, 1979, were compared wih controls matched for age and socioeconomic status. Data on the medical history, physical examination, and hospital course were uniformly collected for 105 cases and contrasted with those in 105 controls. The mean age was 12.1 years; 47% were male and 53% were female. Compared to controls, the children with conversion reaction had a higher frequency of recent family stress (97%), unresolved grief reactions (58%), and family communication problems (77%). Three case reports describe the pediatrician's use of the medical history, physical examination, and hospital course to diagnose conversion symptoms.

Adolescent↗
PubMed1984

Psychogenic intractable sneezing in children.

Four preadolescent children had paroxysms of intractable sneezing. After days of hospitalization and numerous local and systemic drug treatments had failed, a psychogenic cause of their problem was entertained. This uncommon form of conversion reaction most often occurs between the ages of 9 and 15 years, and prognosis is good if the appropriate interventions are undertaken.

Child↗
PubMed2000

Patterns of referral in patients with medically unexplained motor symptoms.

OBJECTIVE: To investigate the pattern and reasons for referrals in 64 patients with a stable diagnosis of motor conversion symptoms who had been assessed at the National Hospital for Neurology and Neurosurgery (NHNN). METHOD: Patients were interviewed on average 6 years after their original admission to the NHNN. Hospital notes and GP records were consulted. RESULTS: Psychiatrists at the NHNN saw 75% of patients. Treatment was initiated in 60% of these. During the 6-year follow up, many patients continued to be referred to neurologists and other specialists, but subsequent psychiatric referral was rare. Many changed their GP after discharge from the NHNN and a disproportionate number of re-referrals was made by GPs who had known their patients for less than 6 months. Psychological attribution of symptoms was rare and did not appear to be related to the pattern of referrals. CONCLUSION: The pattern of care of these patients was inconsistent and many felt dissatisfied with the treatment they received. This led to further referrals, unnecessary use of valuable resources and unnecessary exposure to iatrogenic damage. Further studies should aim to assist GPs and other clinicians in deciding when referral is likely to be beneficial.

Adult↗
PubMed1977

Pain: the most common psychosomatic problem.

The individual who complains of pain often has a combined emotional and organic experience. Pain is the resultant symptom of organic factors, personal and developmental phenomena, as well as social and cultural characteristics of the individual. The individuals who complain of pain often have chronic histories of difficulty and disability thus creating a difficult treatment problem. The physician who faces such individuals must attend the psychological, social, and organic entities in order to adequately manage and help rehabilitate these distressed individuals.

Adaptation, Psychological↗