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What is schizophrenic in acute and transient psychotic disorder?

Acute and transient psychotic disorder (ATPD) is supposed to differ from schizophrenia, but little research has been done on the subject. In a prospective longitudinal case control study we compared all inpatients with ATPD (ICD-10 F23) treated at Halle University Hospital during a 5-year period with matched controls with "positive" schizophrenia (PS) and with mentally healthy controls. Followup investigations were performed at a mean of 2.2 years after the index episode or 8.2 years after the first episode. Female preponderance in ATPD was marked (78.6%). ATPD and PS patients were similar to each other (but different from healthy controls) in the prevalence of a "broken home" situation and a family history for mental disorders. Compared with PS patients, ATPD patients showed better premorbid social adaptation, and they more often displayed rapidly changing symptoms in the index episode and a negative life event preceding the episode. Despite comparable relapse rates, at followup ATPD patients showed better social adaptation, less psychological impairment, and better global functioning than PS patients. These data support the delineation of ATPD from schizophrenia.

Adaptation, Psychological↗

The subjective meaning of illness in severe otosclerosis: a descriptive study in three steps based on focus group interviews and written questionnaire.

The aim of this study of otosclerosis patients was to highlight the circumstances specific to an operable middle ear disease and to describe the psychologically unique aspects accompanying this disorder. In a first step five subjects participated in four focus group interviews, from which emanated a questionnaire answered in a second step by 28 randomly chosen subjects. Finally a second series of supplementary focus interviews were conducted with another group of subjects, after which the interview material was subjected to code-mapping, agreement and validation. The study results indicate that ear surgery was a very important occurrence in the lives of the patients and a unique aspect was that they were burdened by a sense of responsibility for deciding in favour of or against the ear surgery and in choosing the time for operation. An event as tangible as an operation impacts on the individual's psychological processing of the fact that one of his or her senses is damaged. The message to the person's surroundings is very clear: the operation makes others understand how serious the situation is, gives rise to a sense of sympathy. These factors together may promote adaptation to the handicap, or alternately, at least for some persons, may impede adaptation to the necessary hearing aids. To some individuals hearing aids were strongly associated with periods of deteriorating hearing and therefore had negative connotations. Thus the hearing aid was used while waiting for surgery or instead of surgery. The constant hope of regaining one's hearing through ear surgery, although not totally realistic in these cases of severe otosclerosis, always makes the hearing aid the second best solution. The overall conclusion from this study is that there are specific circumstances of an operable ear disease which have great impact upon quality of life, well-being and adaptation. The psychological situation is one of instability, feelings of responsibility and at times of anxiety. Patients with otosclerosis are sometimes told that they are better off than others with impaired hearing, because surgery can improve their hearing and because good amplification through hearing aids can be achieved in persons with conductive hearing losses. It is our hope that this study has helped to provide a fuller picture of the facts of life for persons with severe otosclerosis.

Adaptation, Psychological↗

Psychological therapies for sickle cell disease and pain.

BACKGROUND: Sickle cell disease comprises of a group of genetic blood disorders, and occurs when the sickle cell haemoglobin gene is inherited from both parents. The effects of the condition are: varying degrees of anaemia which if severe reduce the capacity for mobility; predisposition to obstruction of small blood capillaries causing pain in muscle and bone known as "crises"; damage to major organs such as the spleen, liver, kidneys, and lungs; and increased vulnerability to severe infections. There are both medical and non-medical complications, and treatment is usually symptomatic and palliative in nature. Psychological intervention for individuals with sickle cell disease seems viable in complementing current medical treatment, and studies examining their efficacy appear to have also yielded encouraging results. OBJECTIVES: To examine the evidence that in patients with sickle cell disease, psychological treatment improves the ability to cope with the condition. SEARCH STRATEGY: The Cochrane Cystic Fibrosis and Genetic Disorders Group specialist trials register which comprises references from comprehensive electronic database searches, handsearching relevant journals and handsearching abstract books of conference proceedings. Also, searches on the Internet were performed. SELECTION CRITERIA: All randomised or quasi-randomised controlled trials comparing the use of psychological intervention to no (psychological) intervention in patients with sickle cell disease. DATA COLLECTION AND ANALYSIS: The following outcomes were assessed: pain, mood, coping, health service utilisation, general health, quality of life, and life satisfaction. MAIN RESULTS: Four trials which reported results were all found to be unsuitable for inclusion at the present time, owing to incomplete data in the published papers. REVIEWER'S CONCLUSIONS: Psychological approaches are commonly used in an attempt to improve coping ability in patients with sickle cell disease. No conclusions can be made about the use of specific psychological therapies in sickle cell disease from the information currently available. This systematic review has clearly identified the need for well designed, adequately-powered, multicentre, RCTs assessing the effectiveness of specific interventions in sickle cell disease.

Adaptation, Psychological↗

Immigrants from the former Soviet Union, 5 years post-immigration to Israel: adaptation and risk factors for psychological distress.

BACKGROUND: Studies about the effect of time on the degree of psychological distress among immigrants have reported conflicting findings. We investigated this issue in Israel, which supports actively the absorption of immigrants, and also looked for risk and protective factors for psychological distress 5 years post-immigration. METHOD: A nationwide sample of 600 subjects who emigrated from the former Soviet Union to Israel in 1990 were interviewed in 1995, with the demoralization subscale of the Psychiatric Epidemiologic Research Interview (PERI-D) for psychological distress, and with a series of questions regarding sociodemographic characteristics, personal assets and their absorption experience. The results were compared with those obtained in a previous study for a sample of the same cohort of immigrants in their first year post-immigration. A multivariate analysis was carried out to examine the relation between the PERI score and the different independent variables. RESULTS: Although, 5 years after immigration, a favorable change in objective parameters of absorption was found, no decrease in psychological distress was observed. The main risk factors remaining significantly associated with psychological distress in the final model were: adverse life events, lack of perceived social support, poor family functioning, external locus of control, poor physical health status, non-identification with host society and, to a lesser degree, poor material conditions. CONCLUSION: Psychological readjustment apparently takes longer than other processes of adaptation. Several years after immigration, social and psychological factors have a more important role for the well-being of immigrants than their material conditions.

Adult↗

Consequences of dieting to lose weight: effects on physical and mental health.

Concern has been raised that negative physiological and psychological effects of dieting may outweigh aesthetic and health benefits. This review of the literature concludes the following: (a) The measurement of dieting is an important unresolved issue; (b) current dieting, chronic dieting, desire to lose weight, specific weight control behaviors, and weight changes may have different effects on health and need to be distinguished; (c) dieting is usually not associated with nutritional deficiencies, adverse physiologic adaptations, severe psychological reactions, or the development of eating disorders; and (d) recommendations against weight loss efforts involving moderate changes in eating and exercise habits are not warranted.

Adaptation, Psychological↗