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At least 163 records · Page 9Linked to original sources
PubMed2006

Incidence and outcomes of mental disorders in a regional population: the Northern Rivers Mental Health Study.

OBJECTIVES: To estimate the incidence of mental disorders in a cohort of previously symptom-free individuals who are representatives of a regional Australian population. To map changing patterns of diagnosis and comorbidity within the cohort over a 2 year period. METHOD: Two year follow-up of a community-based cohort drawn from a telephone screening of 9191 randomly selected adults. Subjects were administered a comprehensive face-to-face interview which included the Composite International Diagnostic Interview. A total of 1407 subjects were interviewed at baseline, and 968 subjects were reinterviewed (a 68.8% follow-up rate). RESULTS: There was considerable change in disorder status over the study period, and analysis of the Composite International Diagnostic Interview scoring suggests that these changes reflected real changes in symptomatology. Of subjects interviewed at both baseline and follow-up, 638 were classified as disorder-free at their entry to the study. After 2 years, 98 of these met criteria for a mental disorder during the preceding 12 months. After adjusting for sampling and gender, the 12 month incidence of any mental disorder among subjects who had been disorder-free 2 years previously was 9.95 per hundred person-years at risk. At baseline, a further 330 subjects met ICD-10 criteria for a mental disorder during the previous 12 months. Two years later, 167 of these subjects (50.6%) were disorder-free, and 163 still met the criteria for a mental disorder, although there had often been considerable change in their diagnosis. Subjects with a mental disorder at the commencement of the study were significantly more likely than those without a disorder to have a positive diagnosis 2 years later (p < 0.001). The number of diagnoses at baseline was a strong predictor of the number of diagnoses at follow-up (p < 0.001), and each additional comorbid diagnosis at baseline also increased the probability of a persisting disorder at follow-up (p < 0.001). CONCLUSIONS: Over a 2 year period, the majority of subjects with a mental disorder will become disorder-free, while a significant number of previously disorder-free individuals will develop a positive diagnosis. Health services need to be designed to meet this labile demand.

Absenteeism↗
PubMed2005

Telepsychiatry program for rural victims of domestic violence.

Domestic violence is a significant public health problem and is correlated with serious mental and physical disorders. Victims' fear and isolation seriously limit access to psychiatric evaluation and treatment. Telemedicine provides a means to overcome these obstacles. This article describes a telemedicine program that provides psychiatric screening, evaluation, treatment, and referral for ongoing care to clients of a rural women's crisis center. Psychiatric evaluation and treatment were provided to a rural women's shelter program using telepsychiatry. The shelter program had difficulty accessing traditional mental health service. All new clients entering the program were screened for mental health problems. Those requiring further evaluation received a physical examination with medical history and initial psychological interview on site, followed by psychiatric evaluation by videoconference. Appropriate treatment was initiated, and referral for ongoing psychiatric care through the local community mental health clinic was arranged. Of the 38 women referred for mental health services by clinic staff, 35 completed a psychiatric evaluation using telepsychiatry and 31 entered treatment. The most commonly identified disorders were anxiety and major affective disorders, followed by substance use disorders. Telepsychiatry can provide rapid crisis intervention and effective mental health services to victims of domestic violence in a rural setting.

Adult↗
PubMed1984

An examination of the psychological aspects of bite marks.

The intent of this paper is to present some psychological threads which appear to be operative for the perpetrator of bite marks. In the catalogue of multiple motivations, there appears to be a current theme of power, control, potency, and the attempt to have a psychological symbolization of the perpetrator's omniscient capacity for absorbing life essences. In an examination of these highly complex needs, the modern perpetrator appears to act out consistently with cultural biases coupled with immediate psychological needs which have pressed for expression. Due to a pattern of psychologically expressed ritualism, the perpetrator will often inadvertently leave important psychological clues at the crime scene. The attack style, mode of death, characteristics of the victim, etc.--these components reveal the information on the type of psychological needs that the perpetrator is trying to satisfy. In the cases of bite marks associated with violent crime, it becomes crucial to an "investigator" what type of personality characteristics are welded together to form this kind of need complex. After reviewing cases reported in the literature and after conducting psychological interviews with perpetrators, three major groups of perpetrators seem to be apparent. The first group is motivated out of an anger track, the second group is motivated out of sadistic biting, and the third is out of the more traditional "cannibal complex" motif.

Adult↗
PubMed1992

Early detection measures and triage procedures for suicide ideation in chronic pain patients.

There is a dearth of writings about early detection of potential suicide patients in chronic pain centers. Early detection measures used at the Vanderbilt Pain Control Center include a Symptom Checklist-90, with questions about depressive symptomatology and "Thoughts of Ending Your Life"; medical and psychological interviews; monitoring of changes in emotional disturbance; and, if warranted, administration of the Scale of Suicidal Ideation. Three case studies are presented that indicate that the results of an assessment measure should be tempered with clinical judgment. Suicidal behavior, including suicidal ideation, is a medical emergency; therefore, there is great need for early detection and triage measures.

Adult↗
PubMedDate not supplied

Psychiatric disorders and asthma outcomes among high-risk inner-city patients.

OBJECTIVE: The purpose of this study was to examine the rate of psychiatric disorders among patients attending an ethnically diverse, inner-city asthma clinic for an initial visit and assess the association between psychiatric disorders and asthma morbidity. METHODS: A semistructured psychological interview was conducted to assess for psychiatric diagnoses. A pulmonary physician, who was blind to psychiatric disorder, established diagnosis of asthma based on national guidelines. RESULTS: Sixty-four percent of 85 participants received at least 1 psychiatric diagnosis. The pulmonary physician rated patients with a psychiatric disorder as achieving fewer goals (M = 2.3 +/- 1.3) for asthma control than patients without a psychiatric disorder (M = 3.6 +/- 1.5, p = .0002). Patients with a psychiatric diagnosis more frequently reported an emergency room visit for asthma during the past 6 months (OR = 4.89; 95% CI, 1.76-13.39) and greater use of short-acting beta2-agonist medication (M = 1.5 +/- 0.9 canisters per month) than patients without a psychiatric diagnosis (M = 0.9 +/- 0.8, p = .003). These findings were independent of demographics, health insurance, and asthma severity. No differences emerged between patients with and without a mental disorder on percent predicted FEV1. Patients with a psychiatric disorder reported a higher severity level for asthma symptoms than the severity level indicated by their pulmonary function in comparison to patients without a psychiatric diagnosis (OR = 3.52; 95% CI, 1.23-10.10). Health insurance appeared to be a confounding factor in this relationship. CONCLUSION: A high rate of psychiatric disorders was found among inner-city asthma patients. Psychiatric diagnoses were associated with greater perceived impairment from asthma but not objective measurement of pulmonary function.

Adolescent↗
PubMed2006

Participants' experiences of being interviewed about an emotive topic.

AIM: The aim of this paper was to report the experience of in-depth interviewing about emotive topics from the perspectives of participants. BACKGROUND: We both undertook qualitative, longitudinal studies investigating emotive topics using repeated in-depth interviews as the data collection method. Recruitment and some of the interviews took place at a potentially distressing time for participants, which raised concerns for us about issues relating to consent and the impact of the interviews on participants' emotional well-being. METHOD: At the end of the two studies, 55 participants were asked about their experiences of the recruitment and interview processes. The tape-recorded responses were transcribed verbatim. We both independently analysed the data before agreeing on the final thematic framework arising from participants' accounts. The data were collected in 1998 and 1999 (Study 1) and 2003 and 2005 (Study 2). FINDINGS: Some participants had initial reservations about participating in the studies. The primary reason for consenting was altruism, i.e. a belief that their participation might somehow help other families. Many participants often found it difficult to discuss emotive issues, particularly soon after the actual event, but all found it helpful to be given the opportunity to talk about their experiences to someone interested in what they had to say. None of the participants had concerns about, or regretted, being interviewed. CONCLUSION: Participants can find in-depth interviewing about emotive topics a helpful, even 'therapeutic', experience. However, the purpose of the research interview is not to intentionally offer any form of therapy and researchers need to recognize and carefully consider this potential outcome at an early stage of the research process. Researchers studying emotive topics should also be aware of the possible impact of participants' experiences on their own emotional well-being.

Communication↗
PubMed1995

Sex hormones and pituitary function in male epileptic patients with altered or normal sexuality.

Male epileptic patients frequently complain of sexual dysfunction, particularly impotence and loss of libido. Epilepsy itself, antiepileptic drugs (AEDs), and psychosocial factors are believed to contribute to impaired sexuality. We studied luteinizing hormone (LH) pulsatile secretion, gonadotropin, and prolactin (PRL) responses to LH-releasing hormone (LHRH) and thyrotropin-releasing hormone (TRH) in 37 adult male epileptic patients receiving AED monotherapy who were seizure-free and had normal EEGs. Sexuality was assessed by psychological interview. Impotence was diagnosed in 8 patients (in 2 combined with loss of sexual desire). The occurrence of hyposexuality (approximately 20%) was independent of epilepsy syndrome or AED. No change in total testosterone (T) level was observed. Free T (fT) and dihydrotestosterone (DHT) levels were lower and sex hormone binding globulin (SHBG) levels were higher in epileptic subjects than in healthy controls, but a statistically significant difference was not observed between hypo- and normosexual patients. In impotent epileptic patients, estradiol (E2) levels were significantly increased as compared with those of patients with preserved sexuality and of healthy controls. The unbalanced relation between androgen and E2 levels was emphasized by decreased T/E2, fT/E2, and DHT/E2 ratios obtained in hyposexual epileptic patients. In this group, LHRH induced blunted LH peaks. No changes were noted in LH pulsatility features. These findings of higher E2 levels and of decreased LH response to LHRH administration in some epileptic patients with impaired sexuality, may suggest they have subclinical hypogonadotropic hypogonadism.

Adult↗
PubMed1981

Children's acquisition of sex-role behavior in lesbian-mother families.

Children's play and activity interests as indices of sex-role behavior were compared for a sample of lesbian and heterosexual single mothers and their children. More striking than any differences were the similarities between the two groups of children on acquisition of sex-role behavior and between the two groups of mothers on encouragement of sex-role behavior.

Adult↗
PubMed2002

Hirschsprung's disease: functional and psychological follow up comparing total colonic and rectosigmoid aganglionosis.

AIMS: To compare the long term functional and psychosocial outcomes following surgical treatment for total colonic aganglionosis (TCA) with those in an age and gender matched group of patients with rectosigmoid aganglionosis (RSA). METHODS: Fifteen patients with TCA matched for age and gender with 15 patients with RSA were studied 7-17 years after the definitive operation. The internal and external sphincters were examined using anal endosonography. Functional outcome (faecal continence) was assessed by a surgeon not involved in the patients' care, and by a research psychologist in separate assessment sessions. The behavioural and emotional status of the patients was also assessed. RESULTS: Based on the surgeon's assessment, 6/15 TCA and 7/15 RSA patients were continent. In comparison, based on the psychological interview, 2/15 TCA and 6/15 RSA patients were continent. The TCA patients reported significantly more behavioural/emotional problems and lower levels of self esteem than the RSA patients. The parent and teacher assessments of psychosocial status revealed no differences between the groups. There was no association between incontinence and psychosocial adjustment in either group. There was no association between the assessments of functional outcome and the endosonographic appearance of the anal sphincters. CONCLUSIONS: The proportion of patients with faecal incontinence 7-17 years after definitive surgery was high in both groups, but no association was found between incontinence and the psychosocial outcome measures. TCA patients perceived themselves as less well adjusted than their matched pairs. Differences between the groups in length of hospitalisation and severity of illness, especially in infancy and early childhood, may account for these differences.

Adolescent↗
PubMed2005

Prevalence of pathological gambling in Quebec in 2002.

OBJECTIVE: To assess gambling behaviours and the problems associated with pathological gambling among the adult population of Quebec in 2002. METHOD: In Phase 1 of this 2-phase study, a total sample of 8842 adults was assessed. We used the South Oaks Gambling Screen (SOGS), adapted for telephone interview, to assess one-half of the sample; the other one-half was evaluated with the Canadian Problem Gambling Index (CPGI). In the study's second phase, we compared the classifications obtained from these screening instruments with classifications obtained by a psychologist using a semistructured clinical telephone interview. RESULTS: The results indicate that the prevalence of pathological gambling in 2002 (at which time 0.8% of the adult population were classified as probable pathological gamblers) did not differ from the proportion obtained in 1996 (1.0%), despite the significant decrease in gambling participation in 2002 (81% vs 90% in 1996). The most popular gambling activities were buying lottery tickets (68%), participating in fundraising draws (40%), gambling in casinos (18%), playing cards with family or with friends (10%), playing bingo (9%), and playing video lotteries (8%). The findings obtained from the SOGS and the CPGI revealed that the 2 instruments perform similarly when identifying pathological gambling prevalence. However, the results of the semistructured clinical telephone interviews differed from the results obtained with the screening instruments: 82% of the gamblers initially identified as probable pathological gamblers by the SOGS or the CPGI were not confirmed by a clinical interview. CONCLUSION: The discrepancy between the results of the screening questionnaires and the clinical evaluation is significant, and this difference needs to be addressed before further cross-sectional or longitudinal studies are conducted.

Adult↗