Latent Classes of Symptoms related to Clinically Depressed Mood in Adolescents.

Science.gov (United States)

Blom, Eva Henje; Forsman, Mats; Yang, Tony T; Serlachius, Eva; Larsson, Jan-Olov

2014-01-01

The diagnosis of major depressive disorder (MDD), according to the Diagnostic and Statistical Manual of Mental Disorders , is based only on adult symptomatology of depression and not adapted for age and gender. This may contribute to the low diagnostic specificity and validity of adolescent MDD. In this study, we investigated whether latent classes based on symptoms associated with depressed mood could be identified in a sample of adolescents seeking psychiatric care, regardless of traditionally defined diagnostic categories. Self-reports of the Strengths and Difficulties Questionnaire and the Development and Well-Being Assessment were collected consecutively from all new patients between the ages of 13 and 17 years at two psychiatric outpatient clinics in Stockholm, Sweden. Those who reported depressed mood at intake yielded a sample of 21 boys and 156 girls. Latent class analyses were performed for all screening items and for the depression-specific items of the Development and Well-Being Assessment. The symptoms that were reported in association with depressed mood differentiated the adolescents into two classes. One class had moderate emotional severity scores on the Strengths and Difficulties Questionnaire and mainly symptoms that were congruent with the Diagnostic and Statistical Manual of Mental Disorders criteria for MDD. The other class had higher emotional severity scores and similar symptoms to those reported in the first class. However, in addition, this group demonstrated more diverse symptomatology, including vegetative symptoms, suicidal ideation, anxiety, conduct problems, body dysmorphic symptoms, and deliberate vomiting. The classes predicted functional impairment in that the members of the second class showed more functional impairment. The relatively small sample size limited the generalizability of the results of this study, and the amount of items included in the analysis was restricted by the rules of latent class analysis. No conclusions

Pediatric obsessive-compulsive disorder with tic symptoms: clinical presentation and treatment outcome.

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Højgaard, Davíð R M A; Skarphedinsson, Gudmundur; Nissen, Judith Becker; Hybel, Katja A; Ivarsson, Tord; Thomsen, Per Hove

2017-06-01

Some studies have shown that children and adolescents with obsessive-compulsive disorder (OCD) and co-morbid tics differ from those without co-morbid tics in terms of several demographic and clinical characteristics. However, not all studies have confirmed these differences. This study examined children and adolescents with OCD and with possible or definite tic specifiers according to the DSM-5 in order to see whether they differ from patients without any tic symptoms regarding clinical presentation and outcome of cognitive behavioral therapy (CBT). The full sample included 269 patients (aged 7-17) with primary DSM-IV OCD who had participated in the Nordic Long-term Treatment Study (NordLOTS). Symptoms of tics were assessed using the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS-PL). One or more tic symptoms were found in 29.9% of participants. Those with OCD and co-morbid tic symptoms were more likely male, more likely to have onset of OCD at an earlier age, and differed in terms of OCD symptom presentation. More specifically, such participants also showed more symptoms of OCD-related impairment, externalization, autism spectrum disorder (ASD), social anxiety, and attention-deficit/hyperactivity disorder (ADHD). However, the two groups showed no difference in terms of OCD severity or outcome of CBT. Children and adolescents with OCD and co-morbid tic symptoms differ from those without tic symptoms in several aspects of clinical presentation, but not in their response to CBT. Our results underscore the effectiveness of CBT for tic-related OCD. Nordic Long-term Obsessive-Compulsive Disorder (OCD) Treatment Study; www.controlled-trials.com ; ISRCTN66385119.

Self-image and eating disorder symptoms in normal and clinical adolescents.

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Forsén Mantilla, Emma; Bergsten, Katja; Birgegård, Andreas

2014-01-01

Eating disorders (ED) are psychiatric disorders of multifactorial origin, predominantly appearing in adolescence. Negative self-image is identified as risk factor, but the association between self-image and ED in adolescents or sex differences regarding such associations remains unclear. The study aimed to investigate the relationship between specific self-image aspects and ED symptoms in normal and clinical adolescents, including sex differences. Participants included 855 ED patients (girls=813, boys=42) and 482 normal adolescents (girls=238, boys=244), 13-15 years. Stepwise regression demonstrated strong associations between self-image and ED in normal adolescents (girls: R(2)=.31, boys: R(2)=.08), and stronger associations in patients (girls: R(2)=.64, boys: R(2)=.69). Qualitative sex differences were observed in patients. Connections between specific self-image aspects and ED have implications for clinical management of ED. The strong link between self-image variables and ED symptoms in normal girls, but not boys, is discussed in terms of the continuity-discontinuity hypothesis. Copyright © 2013 Elsevier Ltd. All rights reserved.

[Voice and vibration sensations in the speech forming organs: clinical and theoretical aspects of rare symptoms specific for schizophrenia].

Science.gov (United States)

Vilela, W; Lolas, F; Wolpert, E

1978-01-01

When studying 750 psychiatric in-patients with psychoses of various diagnostic groups, the symptoms of voice sensations and vibration feelings could only be found among patients with paranoid schizophrenia. In addition, these symptoms were located exclusively in body areas that are involved in the peripheral motor production of voice and speech (areas of head, throat, thorax). In 11 of 15 such cases that could be identified, the sensations of voices and vibrations occurred simultaneously and in identical body parts; in the remaining 4 cases only voices without vibration sensations were reported. Therefore these symptoms can be considered as highly specific for schizophrenia. According to the terminology of Bleuler these two symptoms are because of their rareness to be taken as accessoric symptoms; according to the terminology of Kurt Schneider they have the value of first rank symptoms because of their highly diagnostic specifity for schizophrenia. The pathogenesis of these symptoms is on the one hand discussed under the perspective of language development and the changing function of language for behaviour control; on the other hand, the pathogenesis of these symptoms is discussed from the viewpoint of cybernetic, or neurophysiological-neuroanatomical foundation of speech production and speech control. Both models of explanation have in common that the ideational component of speech is noticed as acustic halluzinations and the motor proprioceptive part of speech is noticed as sensation of vibrations, both in a typically schiphrenic manner, i.e. dissociated and ego-alienated.

Trauma and the psychosis spectrum: A review of symptom specificity and explanatory mechanisms

Science.gov (United States)

Gibson, Lauren E.; Alloy, Lauren B.; Ellman, Lauren M.

2016-01-01

Traumatic life events have been robustly associated with various psychosis outcomes, including increased risk of psychotic disorders, the prodrome of psychosis, and dimensional measures of psychotic symptoms, such as attenuated positive psychotic symptoms. However, trauma exposure has been linked to various mental disorders; therefore, the specificity of trauma exposure to psychosis remains unclear. This review focuses on two understudied areas of the trauma and psychosis literature: 1) the specificity between trauma and psychosis in relation to other disorders that often result post-trauma, and 2) proposed mechanisms that uniquely link trauma to psychosis. We begin by discussing the underlying connection between trauma exposure and the entire psychosis spectrum with a focus on the influence of trauma type and specific psychotic symptoms. We then consider how the principles of multifinality and equifinality can be useful in elucidating the trauma-psychosis relationship versus the trauma-other disorder relationship. Next, we discuss several cognitive and neurobiological mechanisms that might uniquely account for the association between trauma and psychosis, as well as the role of gender. Lastly, we review important methodological issues that complicate the research on trauma and psychosis, ending with clinical implications for the field. PMID:27632064

[Relationship between clinical symptoms and Hiragana reading ability in children with difficulties in reading and writing:usefulness of a clinical-symptoms-checklist].

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Kita, Yosuke; Kobayashi, Tomoka; Koike, Toshihide; Koeda, Tatsuya; Wakamiya, Eiji; Hosokawa, Torn; Kaga, Makiko; Inagaki, Masumi

2010-11-01

We investigated the clinical symptoms of children with developmental dyslexia (DD) and evaluated the relationship between these symptoms and their Hiragana reading abilities. In order to detect the clinical symptoms of DD, we newly developed a clinical-symptoms-checklist (CL), which consisted of a total of 30 yes/no questions regarding symptoms linked to reading (15 questions) and writing (15 questions). Subjects were 98 Japanese school grade (1 to 9) children, aged 6 to 15 years old, with normal intelligence confirmed by the Wechsler Intelligence Test for Children (WISC-Ill) and they were divided into 2 groups according to their diagnosis. Twenty four children diagnosed as developmental dyslexia consisted the DD group, and the remaining 74 children were grouped in the non-DD group. CL showed significant construct validity (pHiragana reading ability of articulation time in all Hiragana reading tasks (pJapanese children.

Core OCD Symptoms: Exploration of Specificity and Relations with Psychopathology

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Stasik, Sara M.; Naragon-Gainey, Kristin; Chmielewski, Michael; Watson, David

2012-01-01

Obsessive-compulsive disorder (OCD) is a heterogeneous condition, comprised of multiple symptom domains. This study used aggregate composite scales representing three core OCD dimensions (Checking, Cleaning, Rituals), as well as Hoarding, to examine the discriminant validity, diagnostic specificity, and predictive ability of OCD symptom scales. The core OCD scales demonstrated strong patterns of convergent and discriminant validity – suggesting that these dimensions are distinct from other self-reported symptoms – whereas hoarding symptoms correlated just as strongly with OCD and non-OCD symptoms in most analyses. Across analyses, our results indicated that Checking is a particularly strong, specific marker of OCD diagnosis, whereas the specificity of Cleaning and Hoarding to OCD was less strong. Finally, the OCD Checking scale was the only significant predictor of OCD diagnosis in logistic regression analyses. Results are discussed with regard to the importance of assessing OCD symptom dimensions separately and implications for classification. PMID:23026094

Comparing non-specific physical symptoms in environmentally sensitive patients: prevalence, duration, functional status and illness behavior.

NARCIS (Netherlands)

Baliatsas, C.; Kamp, I. van; Hooiveld, M.; Yzermans, J.; Lebret, E.

2014-01-01

Objective: Little is known about the potential clinical relevance of non-specific physical symptoms (NSPS) reported by patients with self-reported environmental sensitivities. This study aimed to assess NSPS in people with general environmental sensitivity (GES) and idiopathic environmental

Clinical utility of the Neurobehavioral Symptom Inventory validity scales to screen for symptom exaggeration following traumatic brain injury.

Science.gov (United States)

Lange, Rael T; Brickell, Tracey A; Lippa, Sara M; French, Louis M

2015-01-01

The purpose of this study was to examine the clinical utility of three recently developed validity scales (Validity-10, NIM5, and LOW6) designed to screen for symptom exaggeration using the Neurobehavioral Symptom Inventory (NSI). Participants were 272 U.S. military service members who sustained a mild, moderate, severe, or penetrating traumatic brain injury (TBI) and who were evaluated by the neuropsychology service at Walter Reed Army Medical Center within 199 weeks post injury. Participants were divided into two groups based on the Negative Impression Management scale of the Personality Assessment Inventory: (a) those who failed symptom validity testing (SVT-fail; n = 27) and (b) those who passed symptom validity testing (SVT-pass; n = 245). Participants in the SVT-fail group had significantly higher scores (pscales (range: d = 0.76 to 2.34). Similarly high sensitivity, specificity, positive predictive power (PPP), and negative predictive (NPP) values were found when using all three validity scales to differentiate SVT-fail versus SVT-pass groups. However, the Validity-10 scale consistently had the highest overall values. The optimal cutoff score for the Validity-10 scale to identify possible symptom exaggeration was ≥19 (sensitivity = .59, specificity = .89, PPP = .74, NPP = .80). For the majority of people, these findings provide support for the use of the Validity-10 scale as a screening tool for possible symptom exaggeration. When scores on the Validity-10 exceed the cutoff score, it is recommended that (a) researchers and clinicians do not interpret responses on the NSI, and (b) clinicians follow up with a more detailed evaluation, using well-validated symptom validity measures (e.g., Minnesota Multiphasic Personality Inventory-2 Restructured Form, MMPI-2-RF, validity scales), to seek confirmatory evidence to support an hypothesis of symptom exaggeration.

The relationship between autistic traits and social anxiety, worry, obsessive-compulsive, and depressive symptoms: specific and non-specific mediators in a student sample.

Science.gov (United States)

Liew, Shi Min; Thevaraja, Nishta; Hong, Ryan Y; Magiati, Iliana

2015-03-01

The high prevalence of anxiety symptoms in individuals with autism spectrum disorders has now been well documented. There is also a positive relationship between autistic traits and anxiety symptoms in unselected samples and individuals with anxiety disorders have more autistic traits compared to those without. Less is known, however, regarding which elements of autistic traits (i.e., social versus non-social/behavioral) or which other variables may mediate this relationship. This study investigated the shared and specific role of five autistic-trait related mediators (social problem-solving, social competence, teasing experiences, prevention from/punishment for preferred repetitive behaviors and aversive sensory experiences) in a non-clinical sample of 252 university students. Autistic traits positively correlated with both anxiety and depressive symptoms. Social competence mediated the relationship between autistic traits and social anxiety symptoms only, while only prevention from preferred repetitive behaviors and frequent aversive sensory experiences mediated the relationship between autistic traits, worry and obsessive-compulsive symptoms. Replication of these findings is required in longitudinal studies and with clinical samples. Limitations of the study are discussed and possible implications for intervention are tentatively suggested.

The relationship between attachment styles and internalizing or externalizing symptoms in clinical and nonclinical adolescents

Directory of Open Access Journals (Sweden)

Fernando Lacasa

2015-05-01

Full Text Available Studies regarding the relationship between attachment and psychopathology during adolescence have been performed separately for clinical and nonclinical adolescents and have used different assessment measures, which together might produce a methodological bias that increases the association between attachment and psychopathology. With the aim of avoiding this bias, the present study used identical measures to explore the relationship between attachment styles and internalizing or externalizing symptoms in clinical and nonclinical samples of adolescents. The sample consisted of 258 adolescents, 129 clinical and 129 nonclinical, aged between 14 and 18 years. The adolescents in each sample were matched for age, gender, and socioeconomic status. Attachment was assessed using the CaMir Q-sort, and psychopathological symptoms were assessed by means of the Youth Self Report (YSR. The relationships between attachment and psychopathology were similar for clinical and nonclinical adolescents. A preoccupied attachment style predicted internalizing and externalizing symptoms, somatic complaints, anxious-fearful behavior, verbal aggression, attention-seeking behavior, and thinking problems. Compared to previous studies, this research has made it possible to identify broader, stronger, and more specific associations between preoccupied attachment style and psychopathological symptoms in adolescents.

Identifying clinically meaningful symptom response cut-off values on the SANS in predominant negative symptoms.

Science.gov (United States)

Levine, Stephen Z; Leucht, Stefan

2013-04-01

The treatment and measurement of negative symptoms are currently at issue in schizophrenia, but the clinical meaning of symptom severity and change is unclear. To offer a clinically meaningful interpretation of severity and change scores on the Scale for the Assessment of Negative Symptoms (SANS). Patients were intention-to-treat participants (n=383) in two double-blind randomized placebo-controlled clinical trials that compared amisulpride with placebo for the treatment of predominant negative symptoms. Equipercentile linking was used to examine extrapolation from (a) CGI-S to SANS severity ratings, and (b) CGI-I to SANS percentage change (n=383). Linking was conducted at baseline, 8-14 days, 28-30 days, and 56-60 days of the trials. Across visits, CGI-S ratings of 'not ill' linked to SANS scores of 0-13, and ranged to 'extreme' ratings that linked to SANS scores of 102-105. The relationship between the CGI-S and the SANS severity scores assumed a linear trend (1=0-13, 2=15-56, 3=37-61, 4=49-66, 5=63-75, 6=79-89, 7=102-105). Similarly the relationship between CGI-I ratings and SANS percentage change followed a linear trend. For instance, CGI-I ratings of 'very much improved' were linked to SANS percent changes of -90 to -67, 'much improved' to -50 to -42, and 'minimally improved' to -21 to -13. The current results uniquely contribute to the debate surrounding negative symptoms by providing clinical meaning to SANS severity and change scores and so offer direction regarding clinically meaningful response cut-off scores to guide treatment targets of predominant negative symptoms. Copyright © 2013 Elsevier B.V. All rights reserved.

Specific Dysphoric Symptoms Are Predicted by Early Maladaptive Schemas

Directory of Open Access Journals (Sweden)

Roberta Trincas

2014-01-01

Full Text Available Early maladaptive schemas (EMSs are cognitive patterns resulting from unmet core emotional needs in childhood that have been linked to the development of psychopathology. As depression is a multifaceted phenomenon, we hypothesized that specific dysphoric symptoms would be predicted by different EMSs. Four hundred and fifty-six participants completed a measure of EMSs (Young Schema Questionnaire and reported on the severity of the symptoms of criterion A for major depression in DSM-IV during the occurrence of a dysphoric episode in the previous 12 months. A series of stepwise multiple regression analyses were performed to investigate the predictive power of the EMSs for the severity of each specific depressive symptom. When controlling for gender and current levels of depression, specific symptoms were predicted by different EMSs: sadness by Negativity/Pessimism; anhedonia by Failure; self-harm by Emotional Deprivation and Vulnerability to Harm or Illness; worthlessness by Failure and Negativity/Pessimism; psychomotor retardation/restlessness by Vulnerability to Harm or Illness and Entitlement/Grandiosity; and poor concentration by Insufficient Self-Control/Self-Discipline. The more physical symptoms of fatigue, insomnia/hypersomnia, and appetite loss/appetite gain were not predicted by any of the EMSs. Although the cross-sectional design of the study does not allow for conclusions about the direction of effects, results suggest that depression is not a unitary phenomenon and provide a possible explanation for previous inconsistent findings.

Temporal association of cannabis use with symptoms in individuals at clinical high risk for psychosis.

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Corcoran, Cheryl M; Kimhy, David; Stanford, Arielle; Khan, Shamir; Walsh, Julie; Thompson, Judy; Schobel, Scott; Harkavy-Friedman, Jill; Goetz, Ray; Colibazzi, Tiziano; Cressman, Victoria; Malaspina, Dolores

2008-12-01

Cannabis use is reported to increase the risk for psychosis, but no prospective study has longitudinally examined drug use and symptoms concurrently in clinical high risk cases. We prospectively followed for up to 2 years 32 cases who met research criteria for prodromal psychosis to examine the relationship between substance use and clinical measures. Cases with a baseline history of cannabis use (41%) were older, but did not differ in clinical measures. Longitudinal assessments showed these cases had significantly more perceptual disturbances and worse functioning during epochs of increased cannabis use that were unexplained by concurrent use of other drugs or medications. These data demonstrate that cannabis use may be a risk factor for the exacerbation of subthreshold psychotic symptoms, specifically perceptual disturbances, in high risk cases.

Patient-reported symptoms during radiotherapy : Clinically relevant symptom burden in patients treated with palliative and curative intent.

Science.gov (United States)

Körner, Philipp; Ehrmann, Katja; Hartmannsgruber, Johann; Metz, Michaela; Steigerwald, Sabrina; Flentje, Michael; van Oorschot, Birgitt

2017-07-01

The benefits of patient-reported symptom assessment combined with integrated palliative care are well documented. This study assessed the symptom burden of palliative and curative-intent radiation oncology patients. Prior to first consultation and at the end of RT, all adult cancer patients planned to receive fractionated percutaneous radiotherapy (RT) were asked to answer the Edmonton Symptom Assessment Scale (ESAS; nine symptoms from 0 = no symptoms to 10 = worst possible symptoms). Mean values were used for curative vs. palliative and pre-post comparisons, and the clinical relevance was evaluated (symptom values ≥ 4). Of 163 participating patients, 151 patients (90.9%) completed both surveys (116 curative and 35 palliative patients). Before beginning RT, 88.6% of palliative and 72.3% of curative patients showed at least one clinically relevant symptom. Curative patients most frequently named decreased general wellbeing (38.6%), followed by tiredness (35.0%), anxiety (32.4%), depression (30.0%), pain (26.3%), lack of appetite (23.5%), dyspnea (17.8%), drowsiness (8.0%) and nausea (6.1%). Palliative patients most frequently named decreased general wellbeing (62.8%), followed by pain (62.8%), tiredness (60.0%), lack of appetite (40.0%), anxiety (38.0%), depression (33.3%), dyspnea (28.5%), drowsiness (25.7%) and nausea (14.2%). At the end of RT, the proportion of curative and palliative patients with a clinically relevant symptom had increased significantly to 79.8 and 91.4%, respectively; whereas the proportion of patients reporting clinically relevant pain had decreased significantly (42.8 vs. 62.8%, respectively). Palliative patients had significantly increased tiredness. Curative patients reported significant increases in pain, tiredness, nausea, drowsiness, lack of appetite and restrictions in general wellbeing. Assessment of patient-reported symptoms was successfully realized in radiation oncology routine. Overall, both groups showed a high symptom

Patient-reported symptoms during radiotherapy. Clinically relevant symptom burden in patients treated with palliative and curative intent

International Nuclear Information System (INIS)

Koerner, Philipp; Ehrmann, Katja; Hartmannsgruber, Johann; Metz, Michaela; Steigerwald, Sabrina; Flentje, Michael; Oorschot, Birgitt van

2017-01-01

The benefits of patient-reported symptom assessment combined with integrated palliative care are well documented. This study assessed the symptom burden of palliative and curative-intent radiation oncology patients. Prior to first consultation and at the end of RT, all adult cancer patients planned to receive fractionated percutaneous radiotherapy (RT) were asked to answer the Edmonton Symptom Assessment Scale (ESAS; nine symptoms from 0 = no symptoms to 10 = worst possible symptoms). Mean values were used for curative vs. palliative and pre-post comparisons, and the clinical relevance was evaluated (symptom values ≥ 4). Of 163 participating patients, 151 patients (90.9%) completed both surveys (116 curative and 35 palliative patients). Before beginning RT, 88.6% of palliative and 72.3% of curative patients showed at least one clinically relevant symptom. Curative patients most frequently named decreased general wellbeing (38.6%), followed by tiredness (35.0%), anxiety (32.4%), depression (30.0%), pain (26.3%), lack of appetite (23.5%), dyspnea (17.8%), drowsiness (8.0%) and nausea (6.1%). Palliative patients most frequently named decreased general wellbeing (62.8%), followed by pain (62.8%), tiredness (60.0%), lack of appetite (40.0%), anxiety (38.0%), depression (33.3%), dyspnea (28.5%), drowsiness (25.7%) and nausea (14.2%). At the end of RT, the proportion of curative and palliative patients with a clinically relevant symptom had increased significantly to 79.8 and 91.4%, respectively; whereas the proportion of patients reporting clinically relevant pain had decreased significantly (42.8 vs. 62.8%, respectively). Palliative patients had significantly increased tiredness. Curative patients reported significant increases in pain, tiredness, nausea, drowsiness, lack of appetite and restrictions in general wellbeing. Assessment of patient-reported symptoms was successfully realized in radiation oncology routine. Overall, both groups showed a high symptom burden

Frequency and pattern of childhood symptom onset reported by first episode schizophrenia and clinical high risk youth.

Science.gov (United States)

Woodberry, Kristen A; Serur, Rachael A; Hallinan, Sean B; Mesholam-Gately, Raquelle I; Giuliano, Anthony J; Wojcik, Joanne D; Keshavan, Matcheri S; Frazier, Jean A; Goldstein, Jill M; Shenton, Martha E; McCarley, Robert W; Seidman, Larry J

2014-09-01

Psychosis prevention and early intervention efforts in schizophrenia have focused increasingly on sub-threshold psychotic symptoms in adolescents and young adults. Although many youth report symptom onset prior to adolescence, the childhood incidence of prodromal-level symptoms in those with schizophrenia or related psychoses is largely unknown. This study reports on the retrospective recall of prodromal-level symptoms from 40 participants in a first-episode of schizophrenia (FES) and 40 participants at "clinical high risk" (CHR) for psychosis. Onset of positive and non-specific symptoms was captured using the Structured Interview for Prodromal Syndromes. Frequencies are reported according to onset during childhood (prior to age 13), adolescence (13-17), or adulthood (18+). Childhood-onset of attenuated psychotic symptoms was not rare. At least 11% of FES and 23% of CHR reported specific recall of childhood-onset of unusual or delusional ideas, suspiciousness, or perceptual abnormalities. Most recalled experiencing non-specific symptoms prior to positive symptoms. CHR and FES did not differ significantly in the timing of positive and non-specific symptom onset. Other than being younger at assessment, those with childhood onset did not differ demographically from those with later onset. Childhood-onset of initial psychotic-like symptoms may be more common than previous research has suggested. Improved characterization of these symptoms and a focus on their predictive value for subsequent schizophrenia and other major psychoses are needed to facilitate screening of children presenting with attenuated psychotic symptoms. Accurate detection of prodromal symptoms in children might facilitate even earlier intervention and the potential to alter pre-illness trajectories. Copyright © 2014 Elsevier B.V. All rights reserved.

Work-specific cognitive symptoms and the role of work characteristics, fatigue and depressive symptoms in cancer patients during 18 months post return to work.

Science.gov (United States)

Dorland, H F; Abma, F I; Roelen, C A M; Stewart, R; Amick, B C; Bültmann, U; Ranchor, A V

2018-06-19

Cancer patients can experience work-specific cognitive symptoms post return to work (RTW). The study aims to: 1) describe the course of work-specific cognitive symptoms in the first 18 months post RTW, and 2) examine the associations of work characteristics, fatigue and depressive symptoms with work-specific cognitive symptoms over time. This study used data from the 18-months longitudinal "Work Life after Cancer" cohort. The Cognitive Symptom Checklist-Work, Dutch Version (CSC-W DV) was used to measure work-specific cognitive symptoms. Linear mixed models were performed to examine the course of work-specific cognitive symptoms during 18 months follow-up; linear regression analyses with generalised estimating equations (GEE) were used to examine associations over time. Working cancer patients diagnosed with different cancer types were included (n=378). Work-specific cognitive symptoms were stable over 18 months. At baseline, cancer patients reported more working memory symptoms (M=31.9, CI=23.1, 26.4) compared to executive function symptoms (M=19.3; CI=17.6, 20.9). Cancer patients holding a job with both manual and non-manual tasks reported less work-specific cognitive symptoms (unstandardized regression coefficient b=-4.80; CI=-7.76, -1.83) over time, compared to cancer patients with a non-manual job. Over time, higher depressive symptoms were related to experiencing more overall work-specific cognitive symptoms (b=1.27; CI=1.00, 1.55) and a higher fatigue score was related to more working memory symptoms (b=0.13; CI=0.04, 0.23). Job type should be considered when looking at work-specific cognitive symptoms over time in working cancer patients. To reduce work-specific cognitive symptoms, interventions targeted at fatigue and depressive symptoms might be promising. This article is protected by copyright. All rights reserved.

Next-generation negative symptom assessment for clinical trials: validation of the Brief Negative Symptom Scale.

Science.gov (United States)

Strauss, Gregory P; Keller, William R; Buchanan, Robert W; Gold, James M; Fischer, Bernard A; McMahon, Robert P; Catalano, Lauren T; Culbreth, Adam J; Carpenter, William T; Kirkpatrick, Brian

2012-12-01

The current study examined the psychometric properties of the Brief Negative Symptom Scale (BNSS), a next-generation rating instrument developed in response to the NIMH sponsored consensus development conference on negative symptoms. Participants included 100 individuals with a DSM-IV diagnosis of schizophrenia or schizoaffective disorder who completed a clinical interview designed to assess negative, positive, disorganized, and general psychiatric symptoms, as well as functional outcome. A battery of anhedonia questionnaires and neuropsychological tests were also administered. Results indicated that the BNSS has excellent internal consistency and temporal stability, as well as good convergent and discriminant validity in its relationships with other symptom rating scales, functional outcome, self-reported anhedonia, and neuropsychological test scores. Given its brevity (13-items, 15-minute interview) and good psychometric characteristics, the BNSS can be considered a promising new instrument for use in clinical trials. Copyright © 2012 Elsevier B.V. All rights reserved.

Diagnosis of Polycystic Ovary Syndrome: AMH in combination with clinical symptoms.

Science.gov (United States)

Sahmay, Sezai; Aydin, Yavuz; Oncul, Mahmut; Senturk, Levent M

2014-02-01

We assessed the utility of using anti-Müllerian hormone (AMH) and clinical features of polycystic ovary syndrome (PCOS), polycystic ovarian morphology (PCOM), oligo/amenorrhea (OA), and hyperandrogenism (HA) for diagnosing PCOS, and compared their diagnostic accuracy with those of classical diagnostic systems. A total of 606 females were admitted to a university hospital with menstrual irregularities or symptoms of hyperandrogenism were enrolled in this cross-sectional study. Fasting blood samples were collected. Pelvic and/or abdominal ultrasonography and clinical examination were performed. Patients were evaluated for the presence of PCOS according to conventional diagnostic criteria. The diagnostic performance of using serum AMH levels alone and in various combinations with the clinical features of PCOM, OA, and HA were investigated. For the diagnosis of PCOS, the combination of OA and/or HA with AMH showed 83% sensitivity and 100% specificity according to the Rotterdam criteria; 83% sensitivity and 89% specificity according to the National Institutes of Health (NIH) criteria; and 82% sensitivity and 93.5% specificity according to the Androgen Excess Society (AES) criteria. The serum AMH level is a useful diagnostic marker for PCOS and is correlated with conventional diagnostic criteria. The combination of AMH level with OA and/or HA markedly increased the clinical scope for PCOS diagnosis and can be introduced as a possible objective criterion for the diagnosis of this disease.

Specificity in mediated pathways by anxiety symptoms linking adolescent stress profiles to depressive symptoms: Results of a moderated mediation approach.

Science.gov (United States)

Anyan, Frederick; Bizumic, Boris; Hjemdal, Odin

2018-03-01

We investigated the specificity in mediated pathways that separately link specific stress dimensions through anxiety to depressive symptoms and the protective utility of resilience. Thus, this study goes beyond lumping together potential mediating and moderating processes that can explain the relations between stress and (symptoms of) psychopathology and the buffering effect of resilience. Ghanaian adolescents between 13 and 17 years (female = 285; male = 244) completed the Adolescent Stress Questionnaire (ASQ), Spielberger State Anxiety Inventory (STAI), Short Mood Feeling Questionnaire (SMFQ) and the Resilience Scale for Adolescents (READ). Independent samples t-test, multivariate analysis of covariance with follow-up tests and moderated mediation analyses were performed. Evidences were found for specificity in the associations between dimensions of adolescent stressors and depressive symptoms independent of transient anxiety. Transient anxiety partly accounted for the indirect effects of eight stress dimensions on depressive symptoms. Except stress of school attendance and school/leisure conflict, resilience moderated the indirect effects of specific stress dimensions on depressive symptoms. Results suggested differences in how Ghanaian adolescents view the various stress dimensions, and mediated pathways associated with anxiety and depressive symptoms. Use of cross-sectional data does not show causal process and temporal changes over time. Findings support and clarify the specificity in the interrelations and mediated pathways among dimensions of adolescent stress, transient anxiety, and depressive symptoms. Conditional process analyses shows that resilience does not only buffer direct, but also indirect psychological adversities. Interventions for good mental health may focus on low resilience subgroups in specific stress dimensions while minimizing transient anxiety. Copyright © 2017 Elsevier B.V. All rights reserved.

Clinical diagnosis and computer analysis of headache symptoms.

OpenAIRE

Drummond, P D; Lance, J W

1984-01-01

The headache histories obtained from clinical interviews of 600 patients were analysed by computer to see whether patients could be separated systematically into clinical categories and to see whether sets of symptoms commonly reported together differed in distribution among the categories. The computer classification procedure assigned 537 patients to the same category as their clinical diagnosis, the majority of discrepancies between clinical and computer classifications involving common mi...

Obsessive Compulsive Symptoms in Individuals at Clinical Risk for Psychosis: Association with Depressive Symptoms and Suicidal Ideation

OpenAIRE

DeVylder, Jordan E.; Oh, Amy J.; Ben-David, Shelly; Azimov, Neyra; Harkavy-Friedman, Jill; Corcoran, Cheryl M.

2012-01-01

Obsessive-compulsive symptoms, particularly aggressive obsessions, are prevalent in schizophrenia patients and associated with other symptom severity, suicidal ideation and functional impairment. In a psychosis-risk cohort, obsessive-compulsive diagnosis and symptoms were assessed in terms of prevalence and content, and for associations with clinical measures. Obsessive-compulsive symptoms were prevalent in the CHR cohort, as was suicidal ideation. The presence and severity of aggressive obse...

Clinical Symptoms and Histological Changes in Poecilia reticulata following Gamma-Ray Irradiation

Directory of Open Access Journals (Sweden)

K. Beňová

2006-01-01

Full Text Available Lethality, food intake, clinical symptoms and terminal histological changes were followed after gamma-irradiation with doses of 10, 20, 30, 35 and 40 Gy in guppy, Poecilia reticulata. Clinical symptoms, food intake and longevity were also monitored in the progeny of fish irradiated with a dose of 10 Gy. In the first days after irradiation timidity and lethargy were observed. After doses of 30, 35 and 40 Gy, these symptoms were accompanied with anorexia. The most prominent clinical symptoms observed were emaciation, hampered breathing, exophthalmia and haemorrhages. Histological findings corresponded with these symptoms. In the fish irradiated with 10 or 20 Gy the progeny survived, after a dose of 30 Gy the progeny died within 24 hours after birth and after doses of 35 and 40 Gy dead progeny was born. The survival data provide an estimate of LD50/30 equal to 29 Gy. Higher relative mortality and more severe clinical symptoms were observed in females. The progeny of irradiated parent fish grew and survived for 3 months maximum.

E-cigarette- specific symptoms of nicotine dependence among Texas adolescents.

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Case, Kathleen R; Mantey, Dale S; Creamer, MeLisa R; Harrell, Melissa B; Kelder, Steven H; Perry, Cheryl L

2018-09-01

The potential of e-cigarettes to elicit symptoms of nicotine dependence has not been adequately studied, particularly in adolescent populations. The present study examined the prevalence of e-cigarette-specific symptoms of nicotine dependence ("symptoms of e-cigarette dependence") and the associations between these symptoms, e-cigarette usage group, and e-cigarette cessation-related items among Texas adolescents. This study involved a cross-sectional analysis of adolescents from Wave 4 of the Texas Adolescent Tobacco and Marketing Surveillance System (TATAMS) (n = 2891/N = 461,069). Chi-Square analyses examined differences in the prevalence of symptoms of dependence by e-cigarette usage group (exclusive versus dual users of e-cigarettes and combustible tobacco products) and demographic characteristics. Weighted multivariable logistic regression analyses examined the associations between symptoms of e-cigarette dependence, e-cigarette usage group, and e-cigarette cessation items. Exclusive e-cigarette users experienced symptoms of e-cigarette dependence, although the prevalence of most of the symptoms was higher for dual users. Adolescents who reported more symptoms of dependence were less likely to report both wanting to quit e-cigarettes and a past-year quit attempt for e-cigarettes (adjusted odds ratio "AOR" = 0.61 (95% CI = 0.41, 0.92) and AOR = 0.52 (95% CI = 0.30, 0.92), respectively). This study is the first to demonstrate that adolescent e-cigarette users are experiencing symptoms of dependence specific to e-cigarettes. In addition, symptoms of dependence may be barriers to e-cigarette cessation. Future research is needed to determine if characteristics of e-cigarette use (e.g. frequency and intensity) are associated with dependence. Copyright © 2018. Published by Elsevier Ltd.

Insight in bipolar mania: evaluation of its heterogeneity and correlation with clinical symptoms.

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Silva, Rafael de Assis da; Mograbi, Daniel C; Bifano, Jaqueline; Santana, Cristina M T; Cheniaux, Elie

2016-07-15

Studies on insight in bipolar mania are not numerous and usually consider insight as a unitary construct. Evaluate how different facets of insight are affected in bipolar mania and investigate correlations between insight for each specific object in bipolar disorder and manic symptomatology. A group of 165 bipolar patients were followed during a year, with 51 patients having manic episodes according to DSM-IV-TR criteria. Patients underwent a clinical assessment and insight was evaluated through the Insight Scale for Affective Disorders. The study found that insight regarding symptoms is worse than insight of having bipolar disorder, social relationships and self esteem. Moreover, poor global insight (total ISAD) correlates with more severe changes in mood, speech and thought structure, with worse insight about symptoms correlating with the same alterations and also with more severe symptoms of agitation/energy. Although a large sample of bipolar patients was followed up, the final sample composed of patients with at least one manic episode was relatively smaller. Moreover, the fact that the study was performed in a university hospital may have led to selection biases. Results suggest that patients with BD are reasonably capable of identifying that their condition implies consequences but have more impaired awareness of their energy and activity levels. A lower level of insight specifically about symptoms correlates with more severe symptoms of agitation/energy, which suggests a psychomotor nucleus able to impair insight in mania. Copyright © 2016 Elsevier B.V. All rights reserved.

Clinical symptoms and risk factors in cerebral microangiopathy patients.

Directory of Open Access Journals (Sweden)

Sandra Okroglic

Full Text Available OBJECTIVE: Although the clinical manifestation and risk factors of cerebral microangiopathy (CM remain unclear, the number of diagnoses is increasing. Hence, patterns of association among lesion topography and severity, clinical symptoms and demographic and disease risk factors were investigated retrospectively in a cohort of CM patients. METHODS: Patients treated at the Department of Neurology, University of Bonn for CM (n = 223; 98m, 125f; aged 77.32±9.09 from 2005 to 2010 were retrospectively enrolled. Clinical symptoms, blood chemistry, potential risk factors, demographic data and ratings of vascular pathology in the brain based on the Wahlund scale were analyzed using Pearson's chi square test and one-way ANOVA. RESULTS: Progressive cognitive decline (38.1%, gait apraxia (27.8%, stroke-related symptoms and seizures (24.2%, TIA-symptoms (22% and vertigo (17% were frequent symptoms within the study population. Frontal lobe WMLs/lacunar infarcts led to more frequent presentation of progressive cognitive decline, seizures, gait apraxia, stroke-related symptoms, TIA, vertigo and incontinence. Parietooccipital WMLs/lacunar infarcts were related to higher frequencies of TIA, seizures and incontinence. Basal ganglia WMLs/lacunar infarcts were seen in patients with more complaints of gait apraxia, vertigo and incontinence. Age (p = .012, arterial hypertension (p<.000, obesity (p<.000 and cerebral macroangiopathy (p = .018 were positively related to cerebral lesion load. For increased glucose level, homocysteine, CRP and D-Dimers there was no association. CONCLUSION: This underlines the association of CM with neurological symptoms upon admission in a topographical manner. Seizures and vertigo are symptoms of CM which may have been missed in previous studies. In addition to confirming known risk factors such as aging and arterial hypertension, obesity appears to increase the risk as well. Since the incidence of CM is increasing, future

Symptom dimensions, clinical course and comorbidity in men and women with obsessive-compulsive disorder.

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Torresan, Ricardo C; Ramos-Cerqueira, Ana Teresa A; Shavitt, Roseli G; do Rosário, Maria Conceição; de Mathis, Maria Alice; Miguel, Euripedes C; Torres, Albina R

2013-09-30

The study aimed to compare male and female patients with obsessive-compulsive disorder (OCD) across symptom dimensions, clinical course and comorbidity. A cross-sectional study was undertaken with 858 adult OCD patients (DSM-IV) from the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders. Patients were evaluated using structured interviews, including the Dimensional Yale-Brown Obsessive-Compulsive Scale (DY-BOCS) and the Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I). The sample was composed of 504 women (58.7%) and 354 men (41.3%) with a mean age of 35.4 years-old (range: 18-77). Men were younger, more frequently single and presented more tics, social phobia and alcohol use disorders. Among men, symptom interference occurred earlier and symptoms of the sexual/religious dimension were more common and more severe. Conversely, women were more likely to present symptoms of the aggressive, contamination/cleaning and hoarding dimension and comorbidity with specific phobias, anorexia nervosa, bulimia, trichotillomania, skin picking and "compulsive" buying. In the logistic regression, female gender remained independently associated with the aggressive and contamination/cleaning dimensions. In both genders the aggressive dimension remained associated with comorbid post-traumatic stress disorder, the sexual/religious dimension with major depression and the hoarding dimension with tic disorders. Gender seems to be relevant in the determination of OCD clinical presentation and course and should be considered an important aspect when defining more homogeneous OCD subgroups. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

The Counseling Center Assessment of Psychological Symptoms (CCAPS): Merging clinical practice, training, and research.

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Youn, Soo Jeong; Castonguay, Louis G; Xiao, Henry; Janis, Rebecca; McAleavey, Andrew A; Lockard, Allison J; Locke, Benjamin D; Hayes, Jeffrey A

2015-12-01

The goal of this article is to present information about a standardized multidimensional measure of psychological symptoms, the Counseling Center Assessment of Psychological Symptoms (CCAPS; Locke et al., 2011; Locke, McAleavey, et al., 2012; McAleavey, Nordberg, Hayes, et al., 2012), developed to assess difficulties specific to college students' mental health. We provide (a) a brief review and summary of the psychometric and research support for the CCAPS; (b) examples of the use of the CCAPS for various purposes, including clinical, training, policy, and counseling center advocacy; and (c) implications of the integration of routine outcome monitoring and feedback for the future of training, research, and clinical practice. In particular, the article emphasizes how the assimilation of and symbiotic relationship between research and practice can address the scientist-practitioner gap. (c) 2015 APA, all rights reserved).

[CADASIL with clinical manifestations of baldness, lumbago and Parkinson's symptoms].

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Ren, Zhixia; Chen, Shuai; Shi, Yingying; Zhang, Yuanxing; Wang, Wan; Chen, Zuzhi; Xia, Mingrong; Shi, Xiaohong; Zhang, Jiewen

2017-12-10

To investigate a cerebral autosomal dominant arteriopathy with the subcortical infarcts and leukoencephalopathy (CADASIL) case with clinical manifestations of baldness, lumbago and Parkinson's symptoms. Clinical and imaging data of the patient were analyzed. The patient and his family members were also subjected to genetic testing. The symptoms of the patient included recurrent stroke, dementia, and mood disturbance, in addition with lumbago, baldness and Parkinson's symptoms but no migraine. Cranial MRI of the patient showed bilateral symmetric leukoencephalopathy and multiple small subcortical lacunar infarcts. A point mutation in exon 11 of the NOTCH3 gene (R558C) was discovered in the proband and four asymptomatic relatives. CADASIL is characterized by recurrent subcortical ischemic stroke, dementia, pseudobulbar palsy, and mood disturbance. Baldness, lumbago and Parkinson's symptoms may also be seen in such patients.

Gender-specific differences in depression and anxiety symptoms and help-seeking behavior among gastroenterology patients in Riyadh, Saudi Arabia.

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Alosaimi, Fahad D; Al-Sultan, Omar A; Alghamdi, Qusay A; Almohaimeed, Ibrahim K; Alqannas, Sulaiman I

2014-07-01

To evaluate the gender-specific difference in the prevalence of depression and anxiety and the help-seeking behavior among gastroenterology outpatients. A cross-sectional study was carried out in gastroenterology clinics in 4 hospitals in Riyadh, Saudi Arabia between February and September 2013. A self-administrated questionnaire was developed and administered to patients. The Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder (GAD-7) questionnaires were used to identify depression and anxiety. A total of 438 patients completed the study questionnaire; 135 (31%) females, and 303 (69%) males. Compared with males, females had more depression symptoms (44% versus 32%, p=0.012), anxiety symptoms (34% versus 24%, p=0.036), anxiety-associated difficulty (65% versus 52%, p=0.012), but similar suicidal thoughts (14% versus 11%, p=0.347). Females had similar gastrointestinal complaints but longer duration of symptoms. In both females and males, the most common first interventions were using medications (63% versus 69%), and undergoing endoscopy (19% versus 15%), while very few patients initially used herbs or Islamic incantation `Roquia` (7% versus 8%). Compared with males, females were more likely to subsequently seek help at private clinics (23% versus 14%, p=0.014), or with a Quran therapist (11% versus 5%, p=0.012). There are clear gender-specific differences in depression and anxiety symptoms and associated perceived difficulty, but modest differences in help-seeking behavior. Female patients at the gastroenterology clinic may deserve more psychological attention to diagnose depression and anxiety and to alleviate their impact.

[Clinical symptoms and immunology inspection characteristics of nasal cavity local allergy].

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Yin, Z X; Zhu, Y; Zhai, X; Zhang, J L; Liu, G

2017-08-05

Objective: To investigate the clinical symptoms and immunology inspection characteristics of nasal cavity local allergy. Method: Selected 60 patients as observation group, who had only nasal local allergy symptoms, allergen skin prick test and serum allergen specific IgE (SIgE) test were negative, 40 allergic rhinitis (AR) patients and 40 healthy volunteers as control groups. To detect Symptom scores and VAS scores, and eosinophilia counts in venous blood, allergen skin prick test (SPT), serum allergen SIgE test, nasal secretions allergen SIgE test, nasal mucous membrane excitation test in both observation group and AR group, eosinophilia counts in nasal secretion, taked the data for statistical analysis. Result: There was no difference ( P > 0.05) in the symptom scores and VAS scores of observation group and the AR group. The eosinophilia counts in venous blood in the AR group were higher than in the observation group ( P 0.05) in the eosinophilia percentages in nasal secretion in the observation group and the AR group. There was significant difference ( P < 0.05) in the eosinophilia percentages in nasal secretion in the observation group and the healthy volunteers group. There were 6 patients in observation group whose nasal secretions allergen SIgE test and nasal mucous membrane excitation test were both negative, could be diagnosised as non-allergic rhinitis (NAR). According to eosinophilia counts in venous blood and nasal secretions, 4 patients were diagnosised as vasomotor rhinitis and 2 patients were diagnosised as NAR with eosinophilia syndrome. There were 54 patients in observation group whose nasal secretions allergen SIgE test and (or) nasal mucous membrane excitation test were positive, could be diagnosised as local allergic rhinitis. After three years, all of the observation group patients were detected with SPT and serum allergen SIgE test. Five patients diagnosed as local allergic rhinitis before three years were positive. Six patients diagnosed as

Clinical use of Malay Version of Vertigo Symptom Scale (MWSS) in patients with peripheral vestibular disorder (PVD).

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Zainun, Zuraida; Zakaria, Mohd Normani; Sidek, Dinsuhaimi; Ismail, Zalina

2012-08-01

The Vertigo symptom scale (VSS) is a well established tool for the evaluation of vestibular disorders and the associated symptoms of autonomic arousal and somatosensation. By using a validated Malay version of vertigo symptom scale (MVVSS) questionnaire, the severity of the vertigo from patients' perspective can be determined and rated. Before MVVSS can be applied clinically among Malaysians, it was of interest to determine its clinical value in identifying vestibular disorders. Forty normal and 65 PVD subjects participated in this cross-sectional study. Normal subjects were recruited amongst Universiti Sains Malaysia (USM) staff and students who had no history of ear and vestibular disorders. Mean total score of MVVSS in normal and PVD subjects were 13.9 +/- 11.1 and 30.1 +/- 20.9, respectively. When the total scores of normal and PVD group were compared, the Mann-Whitney U test showed that there was a significant difference between the two groups (p PVD [benign paroxymal positional vertigo (BPPV), Meniere's disease, labyrinthitis and unknown] have different MVVSS results. However, analysis of variance (ANOVA) found no significant difference in term of outcomes of MVVSS among the different PVD pathologies. Using receiver operating characteristic curve (ROC) method, the sensitivity and specificity of MVVSS were 71% and 60%, respectively. MVVSS is able to discriminate clinically among the normal and PVD subjects. However, it is not a good indicator for differential diagnosis of PVD subtypes, at least in this study. Its sensitivity and specificity in clinical diagnosis are reasonably high. Perhaps a bigger sample size would be useful to further study the clinical usefulness of MVVSS.

Nutrition impact symptoms in advanced cancer patients: frequency and specific interventions, a case?control study

OpenAIRE

Omlin, Aurelius; Blum, David; Wierecky, Jan; Haile, Sarah R.; Ottery, Faith D.; Strasser, Florian

2013-01-01

Background Involuntary weight loss (IWL) is frequent in advanced cancer patients causing compromised anticancer treatment outcomes and function. Cancer cachexia is influenced by nutrition impact symptoms (NIS). The aim of this study was to explore the frequency of NIS in advanced patients and to assess specific interventions guided by a 12-item NIS checklist. Methods Consecutive patients from an outpatient nutrition-fatigue clinic completed the NIS checklist. The NIS checklist was developed b...

Clinical Symptoms and Risk Factors in Cerebral Microangiopathy Patients

NARCIS (Netherlands)

Okroglic, S.; Widmann, C.N.; Urbach, H.; Scheltens, P.; Heneka, M.T.

2013-01-01

Objective: Although the clinical manifestation and risk factors of cerebral microangiopathy (CM) remain unclear, the number of diagnoses is increasing. Hence, patterns of association among lesion topography and severity, clinical symptoms and demographic and disease risk factors were investigated

Clinical symptoms predict concurrent social and global functioning in an early psychosis sample.

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Cacciotti-Saija, Cristina; Langdon, Robyn; Ward, Philip B; Hickie, Ian B; Guastella, Adam J

2018-04-01

Although well established in chronic schizophrenia, the key determinants of functioning remain unknown during the early phase of a psychotic disorder. The aim of this study was to comprehensively examine the social cognitive, basic neurocognitive and clinical predictors of concurrent social functioning and global functioning in an early psychosis sample. This study examined the relationship between social cognition, basic neurocognition and clinical symptoms with concurrent functioning in 51 early psychosis individuals. Assessments included a range of self-report, observational and clinician-rated measures of cognitive, symptom severity and functioning domains. Results revealed a significant association between self-reported social function and lower levels of both social interaction anxiety and negative psychotic symptoms. A significant association was also observed between lower levels of negative psychotic symptoms and observed social functioning. Lastly, results demonstrated a significant association between reduced negative psychotic symptoms and clinician-rated global functioning. Clinical domains such as negative symptoms and social interaction anxiety significantly contribute to an optimal model predicting outcome during the early phase of a psychotic disorder. These clinical features may also provide useful markers of an individual's capacity for social participation. Clinical implications include the need for early targeted intervention to address social anxiety and negative psychotic symptoms to facilitate optimum patient outcome. © 2015 Wiley Publishing Asia Pty Ltd.

Specificity in autobiographical memory narratives correlates with performance on the Autobiographical Memory Test and prospectively predicts depressive symptoms

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Sumner, Jennifer A.; Mineka, Susan; McAdams, Dan P.

2012-01-01

Reduced autobiographical memory specificity (AMS) is an important cognitive marker in depression that is typically measured with the Autobiographical Memory Test (AMT; Williams & Broadbent, 1986). The AMT is widely used, but the overreliance on a single methodology for assessing AMS is a limitation in the field. The current study investigated memory narratives as an alternative measure of AMS in an undergraduate student sample selected for being high or low on a measure of depressive symptoms (N = 55). We employed a multi-method design to compare narrative- and AMT-based measures of AMS. Participants generated personally significant self-defining memory narratives, and also completed two versions of the AMT (with and without instructions to retrieve specific memories). Greater AMS in self-defining memory narratives correlated with greater AMS in performance on both versions of the AMT in the full sample, and the patterns of relationships between the different AMS measures were generally similar in low and high dysphoric participants. Furthermore, AMS in self-defining memory narratives was prospectively associated with depressive symptom levels. Specifically, greater AMS in self-defining memory narratives predicted fewer depressive symptoms at a 10-week follow-up over and above baseline symptom levels. Implications for future research and clinical applications are discussed. PMID:23240988

Relationship between clinical signs and symptoms of convergence insufficiency.

Science.gov (United States)

Bade, Annette; Boas, Mark; Gallaway, Michael; Mitchell, G Lynn; Scheiman, Mitchell; Kulp, Marjean T; Cotter, Susan A; Rouse, Michael

2013-09-01

The percentage of children who are symptomatic has been shown to increase with the number of signs of convergence insufficiency (CI). Our goal was to investigate whether there is a relationship between the severity of the clinical signs of CI and symptom level reported in children with a three-sign symptomatic CI. The Convergence Insufficiency Treatment Trial enrolled 221 children with symptomatic CI from ages 9 to 17 years. Inclusion criteria included the following three signs of CI: (1) exophoria at near at least 4Δ greater than at distance, (2) insufficient positive fusional vergence (PFV) at near, and (3) a receded near point of convergence (NPC) of 6 cm break or greater. The relationships between the severity of each sign of CI (mild, moderate, and severe) and the level of symptoms as measured by the Convergence Insufficiency Symptom Survey (CISS) at baseline were evaluated. Mean CISS scores were not significantly different between mild, moderate, and severe exophoria (p = 0.60), PFV blur (p = 0.99), Sheard's criterion (p = 0.89), or NPC break (p = 0.84). There was also no difference between the frequency of subjects scoring at mild, moderate, or severe levels on the CISS and the severity of each sign of CI. Correlations between individual clinical signs and the CISS score were very low and not statistically significant. Among symptomatic children with a CISS score of 16 or higher and three clinical signs of CI, there is no further association between the severity of the clinical signs and their level of symptoms.

A twin study of specific bulimia nervosa symptoms.

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Mazzeo, S E; Mitchell, K S; Bulik, C M; Aggen, S H; Kendler, K S; Neale, M C

2010-07-01

Twin studies have suggested that additive genetic factors significantly contribute to liability to bulimia nervosa (BN). However, the diagnostic criteria for BN remain controversial. In this study, an item-factor model was used to examine the BN diagnostic criteria and the genetic and environmental contributions to BN in a population-based twin sample. The validity of the equal environment assumption (EEA) for BN was also tested. Participants were 1024 female twins (MZ n=614, DZ n=410) from the population-based Mid-Atlantic Twin Registry. BN was assessed using symptom-level (self-report) items consistent with DSM-IV and ICD-10 diagnostic criteria. Items assessing BN were included in an item-factor model. The EEA was measured by items assessing similarity of childhood and adolescent environment, which have demonstrated construct validity. Scores on the EEA factor were used to specify the degree to which twins shared environmental experiences in this model. The EEA was not violated for BN. Modeling results indicated that the majority of the variance in BN was due to additive genetic factors. There was substantial variability in additive genetic and environmental contributions to specific BN symptoms. Most notably, vomiting was very strongly influenced by additive genetic factors, while other symptoms were much less heritable, including the influence of weight on self-evaluation. These results highlight the importance of assessing eating disorders at the symptom level. Refinement of eating disorder phenotypes could ultimately lead to improvements in treatment and targeted prevention, by clarifying sources of variation for specific components of symptomatology.

Prevalence of self-reported specific phobia symptoms in an Israeli sample of young conscripts.

Science.gov (United States)

Iancu, Iulian; Levin, Jennifer; Dannon, Pinhas N; Poreh, Amir; Yehuda, Yoram Ben; Kotler, Moshe

2007-01-01

Specific phobia is a very prevalent disorder with high comorbidity rates. The aim of this study was to assess prevalence of specific phobia symptoms in a sample of Israeli young adults. Eight hundred fifty young Israeli soldiers participated in the study. Measures included a questionnaire on specific phobias and a socio-demographic questionnaire. Data on eight specific fears representing DSM-IV-TR specific phobias were analyzed to evaluate prevalence of phobic symptoms and find potential socio-demographic correlates. Prevalence of fears and specific phobic symptoms was 49.1 and 8.7%, respectively. Most frequent phobic symptoms were from animals, being alone, heights, injury and closed places. The following variables were accompanied by more phobic symptoms: male gender, role of mechanic, not having completed the matriculation exams, lack of friends and romantic relationships, therapy prior to enlistment or during the military service and having received psychotropic drugs in the past. Based on a stepwise regression analysis, the following variables contributed significantly to the prediction of phobic symptoms: lack of friends and romantic relationships, school absenteeism and role of mechanic. Our findings corroborate results from other studies in the Western world regarding the high prevalence of specific phobia symptomatology, as well as its distribution and socio-demographic correlates.

GENDER-SPECIFIC CLINICAL MANIFESTATION OF UNIPOLAR DEPRESSION

Directory of Open Access Journals (Sweden)

Olivera Žikić

2016-06-01

Full Text Available It is well known that the incidence of depression is twice as often in women than in men. However, data about the clinical picture and the course of the disorder in men and in women are inconsistent. The purpose of our research is to find out if there are any differences in terms of symptomatology and course of unipolar depression in men and in women. The study included 84 subjects affected by unipolar depresson, who were divided in two groups according to the gender: a group of males, comprising 20 subjects and a group of female subjects, that comprised 64 affected persons. We used the general semistructured questionnaire with questions about the course of unipolar depression and sociodemographic data, Patient Health Questionnaire-9, Symptom Checklist-90-Revised (SCL- 90-R, Cambridge Depersonalization Scale (CDS and Beck Anxiety Inventory. Regarding symptoms occurring within unipolar depression, there was no statistically significant gender-specific difference finding. Males tended to somewhat higher frequency of anhedonia and hostility, while females tended to more frequent sleep disturbance and decrease in energy. In terms of the course of disorder, it was found that there was a statistically significant difference in the age at the onset of disorder (M:Ž=43.9:34.72 years and frequency of episodes (males had more frequent episodes. Men and women, affected by unipolar depression differ in terms of the course of unipolar depression, but not in the sense of its clinical manifestation.

Lyme neuroborreliosis in cases of non-specific neurological symptoms.

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Roaldsnes, Erlend; Eikeland, Randi; Berild, Dag

2017-01-01

Analysis of cerebrospinal fluid is required in order to diagnose Lyme neuroborreliosis. We investigated the symptoms of patients in a highly endemic area who were referred for evaluation of possible Lyme neuroborreliosis, and explored whether cerebrospinal fluid analysis confirmed or ruled out the diagnosis. We reviewed the medical records of all patients who underwent lumbar puncture at Sørlandet Hospital Arendal in the period 1 January 2013 to 31 December 2013. A total of 140 patients were referred with suspected Lyme neuroborreliosis. Of these, 110 patients had non-specific neurological symptoms (e.g. fatigue, dizziness and headache), only one of whom received a diagnosis of possible Lyme neuroborreliosis. Thirty patients had symptoms typical of the condition (such as radiculitis or peripheral facial nerve palsy). Six of these were diagnosed with definite Lyme neuroborreliosis, and one with possible Lyme neuroborreliosis. None of those diagnosed with Lyme neuroborreliosis had had symptoms lasting more than six months. The probability of Lyme neuroborreliosis is low in the absence of typical symptoms of the condition, even when anti-Borrelia antibodies are detected in serum and especially when the symptoms are of long duration.

Symptoms, diagnoses, and sporting consequences among athletes referred to a Danish sports cardiology clinic

DEFF Research Database (Denmark)

Kaiser-Nielsen, L V; Tischer, S G; Prescott, E B

2017-01-01

investigated the prevalence of cardiac symptoms and diagnoses among 201 athletes referred for cardiac evaluation at a Sports Cardiology Clinic in Denmark. To our knowledge, this is the first systematic study of athletes referred for suspected cardiac disease. The athletes were all well-trained recreational...... to elite athletes who participated in various sports with different training loads and a wide age span (13-66 years). All patients were referred by physicians, primarily their general practitioner (38%), and palpitations were the most common cardiac symptom (40%). Cardiac symptoms had a sensitivity of 86......% in detecting cardiac disease and a specificity of 13%. Cardiac disease was diagnosed in 44% of the patients, and atrial fibrillation was the most prevalent diagnosis (7.5%). Cardiac diseases with therapeutic- or sports-related consequences for the patients were diagnosed in 28% of the population, but only 1...

Links between Disorganized Attachment Classification and Clinical Symptoms in School-Aged Children

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Borelli, Jessica L.; David, Daryn H.; Crowley, Michael J.; Mayes, Linda C.

2010-01-01

Research examining the links between disorganized attachment and clinical symptoms largely has neglected middle childhood due to lack of available measurement tools. The few studies that have examined these links in other developmental phases have found higher clinical symptoms in disorganized individuals. Our study extended this research by using…

Depressive Symptoms, Exercise Capacity, and Clinical Outcomes After Lung Transplantation.

Science.gov (United States)

Smith, Patrick J; Byrd, Rebecca; Lusby, Megan; Clausen, Emily; Snyder, Laurie D

2018-05-01

Depressive symptoms are common among lung transplant recipients and have been associated with worse clinical outcomes. However, few studies have examined the association between depressive symptoms assessed at multiple time points or behavioral mechanisms by which posttransplant depressive symptoms may confer greater clinical risk. We therefore examined the associations between depressive symptoms, exercise capacity, chronic lung allograft dysfunction (CLAD), and mortality prospectively in a large sample of lung transplant recipients. Between July 2009 and February 2016, 251 lung transplant recipients were assessed before transplantation and again approximately 3 weeks and 3 months after transplant. Depressive symptoms were assessed using the Centers for Epidemiologic Studies of Depression scale. Functional exercise capacity was assessed using the 6-minute walk test. Cox proportional hazards models were used to examine the associations between depressive symptoms, exercise capacity, CLAD, and mortality. During a median (range) follow-up of 4.5 (0.1 to 6.3) years, 53 participants (21%) died. Greater depressive symptoms (hazard ratio [HR] = 1.39 [95% CI = 1.05 to 1.84], p = .021) and poorer exercise capacity (HR = 0.58 [95% CI = 0.38 to 0.90], p = .021) assessed 3 months after transplant were both independently associated with mortality. Although greater depressive symptoms were associated with lower exercise capacity (β = -0.14, p = .039), exercise capacity did not mediate the association between depressive symptoms and mortality. In secondary analyses, depressive symptoms were independently predictive of CLAD (HR = 1.29 [95% CI = 1.01 to 1.65], p = .045) and the composite outcome of CLAD and mortality in a clustered event model (HR = 1.30 [1.09 to 1.56], p = .005). Depressive symptoms are associated with mortality and CLAD after lung transplantation, independent of exercise capacity.

The Specificity of Health-Related Autobiographical Memories in Patients With Somatic Symptom Disorder.

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Walentynowicz, Marta; Raes, Filip; Van Diest, Ilse; Van den Bergh, Omer

2017-01-01

Patients with somatic symptom disorder (SSD) have persistent distressing somatic symptoms that are associated with excessive thoughts, feelings, and behaviors. Reduced autobiographical memory specificity (rAMS) is related to a range of emotional disorders and is considered a vulnerability factor for an unfavorable course of pathology. The present study investigated whether the specificity of health-related autobiographical memories is reduced in patients with SSD with medically unexplained dyspnea complaints, compared with healthy controls. Female patients with SSD (n = 30) and matched healthy controls (n = 24) completed a health-related Autobiographical Memory Test, the Beck Depression Inventory, the Ruminative Response Scale, and rumination scales concerning bodily reactions. Depressive symptoms and rumination were assessed because both variables previously showed associations with rAMS. Patients with SSD recalled fewer specific (F(1,52) = 13.63, p = .001) and more categoric (F(1,52) = 7.62, p = .008) autobiographical memories to health-related cue words than healthy controls. Patients also reported higher levels of depressive symptoms and rumination (all t > 3.00, p < .01). Importantly, the differences in memory specificity were independent of depressive symptoms and trait rumination. The present study extends findings on rAMS to a previously unstudied sample of patients with SSD. Importantly, the presence of rAMS could not be explained by increased levels of depressive symptoms and rumination. We submit that rAMS in this group reflects how health-related episodes and associated symptoms are encoded in memory.

Do symptom-specific stages of change predict eating disorder treatment outcome?

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Ackard, Diann M; Cronemeyer, Catherine L; Richter, Sara; Egan, Amber

2015-03-01

Interview methods to assess stages of change (SOC) in eating disorders (ED) indicate that SOC are positively correlated with symptom improvement over time. However, interviews require significant time and staff training and global measures of SOC do not capture varying levels of motivation across ED symptoms. This study used a self-report, ED symptom-specific SOC measure to determine prevalence of stages across symptoms and identify if SOC predict treatment outcome. Participants [N = 182; age 13-58 years; 92% Caucasian; 96% female; average BMI 21.7 (SD = 5.9); 50% ED not otherwise specified (EDNOS), 30.8% bulimia nervosa (BN), 19.2% anorexia nervosa (AN)] seeking ED treatment at a diverse-milieu multi-disciplinary facility in the United States completed stages of change, behavioral (ED symptom use and frequency) and psychological (ED concerns, anxiety, depression) measures at intake assessment and at 3, 6 and 12 months thereafter. Descriptive summaries were generated using ANOVA or Kruskal-Wallis (continuous) and χ (2) (categorical) tests. Repeated measures linear regression models with autoregressive correlation structure predicted treatment outcome. At intake assessment, 53.3% of AN, 34.0% of BN and 18.1% of EDNOS patients were in Preparation/Action. Readiness to change specific symptoms was highest for binge-eating (57.8%) and vomiting (56.5%). Frequency of fasting and restricting behaviors, and scores on all eating disorder and psychological measures improved over time regardless of SOC at intake assessment. Symptom-specific SOC did not predict reductions in ED symptom frequency. Overall SOC predicted neither improvement in Eating Disorder Examination Questionnaire (EDE-Q) scores nor reduction in depression or trait anxiety; however, higher overall SOC predicted lower state anxiety across follow-up. Readiness to change ED behaviors varies considerably. Most patients reduced eating disorder behaviors and increased psychological functioning regardless of stages

Functional symptoms in clinically definite MS--pseudo-relapse syndrome.

LENUS (Irish Health Repository)

Merwick, A

2012-02-03

Although the diagnostic criteria for multiple sclerosis (MS) have become more formalized and sensitive in the era of magnetic resonance imaging (MRI) scanning, the assessment of individual relapses may not always be straightforward or easily linked to a particular lesion seen on imaging. In addition, acute episodes often have to be assessed outside of normal working hours or when the individual patients usual medical team is not available. Often the emergency department physicians have little formal neurological training and are under time pressure to get patients through the system as quickly as possible. It is therefore possible to mislabel functional symptoms as being true relapses. To illustrate scenarios of possible pseudo-relapse, three clinical vignettes are described. Misclassification of functional symptoms as relapse carries a number of inherent risks. Functional symptoms can be multifactorial and may cause a burden of disease. A multidisciplinary approach may be useful in minimizing unnecessary harm and identify if there is more than meets the eye to an episode of clinical deterioration.

Analyzing clinical symptoms in multiple sclerosis using data mining

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Zahra Raeisi

2017-04-01

Full Text Available Background: One of the today most common and incurable diseases that is associated with central neural system is ‘MS’ disease. Multiple sclerosis (MS is a demyelinating disease in which the insulating covers of nerve cells in the brain and spinal cord are damaged. In this disease become apparent a wide spectrum of symptoms such as lose muscles control and their coordination and vision derangement. The goal of this research is to consider to two problems: 1- Recognition of effective clinical symptoms on MS disease and 2- Considering levels of effectiveness of age, sex and education levels factors on MS disease and association between these factors according to verity of categories of this disease. Methods: Data mining science in medicine is worthy of attention with main application in diagnosis, therapy and prognosis, respectively high volume of collected datum. The data that were used in this article are about patients of Chaharmahal and Bakhtiari Province and collected by cure assistance. In this paper classification and association methods in software engineering field are used. Classification is a general process related to categorization, the process in which ideas and objects are recognized, differentiated, and understood. Association rules are created by analyzing data for frequent if/then patterns and using the criteria support and confidence to identify the most important relationships. Results: In consideration of first problem in this paper, concluded vision-clinical symptoms are the most effective symptoms and in consideration of second problem, concluded that from 584 records, women affected four times more than men. In other word 70% of MS patients with high graduate are in relapsing-remitting category and 62.5% of MS patients are 20-40 years old. Conclusion: Some of symptoms are quite temporary and transitory and are ignored by people. Awareness of clinical-symptoms prevalence manner can be warning for people before starting

Spontaneously Reported Symptoms by Informants Are Associated with Clinical Severity in Dementia Help-Seekers.

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Xu, Jia-Qi; Choy, Jacky C P; Tang, Jennifer Y M; Liu, Tian-Yin; Luo, Hao; Lou, Vivian W Q; Lum, Terry Y S; Wong, Gloria H Y

2017-09-01

To investigate the predictive value of symptoms of dementia that the person or an informant noticed spontaneously in determining the clinical severity of dementia. Cross-sectional. Community-based open-referral dementia assessment service in Hong Kong between 2005 and 2013. Help-seekers for dementia assessment service and their informants (N = 965 dyads). Participants underwent a clinical dementia interview based on the Clinical Dementia Rating. Spontaneous complaints that the person and the informant made that had prompted their help-seeking of groups with interview results suggestive of no impairment, mild cognitive impairment, and dementia were compared. Logistic regression was used to evaluate the predictive value of spontaneous complaints for clinical severity. Independent raters blinded to clinical results coded spontaneously reported symptoms into theoretical themes: memory, executive function, language, time and place orientation, neuropsychiatric, mood, and avolition. Memory problems were the most frequently reported complaints for participants (87.7%) and their informants (95.5%), followed by self-reported language (33.0%) and informant-reported orientation (33.0%) difficulties. Informant-reported but not self-reported symptoms predicted clinical severity. Compared with the persons themselves, informants reported more pervasive symptoms corresponding to clinical severity. Persons with dementia self-reported fewer types of symptoms than their healthy or mildly impaired counterparts. Spontaneously reported language and orientation symptoms by the informant distinguished persons with mild or worse dementia (P < .001, Nagelkerke coefficient of determination = 29.7%, percentage correct 85.6%). The type and pervasiveness of symptoms spontaneously that informants reported predicted clinical severity. This may provide a quick reference for triage. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

[Clinical symptoms and signs in Kimmerle anomaly].

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Split, Wojciech; Sawrasewicz-Rybak, Małgorzata

2002-01-01

The aim of the study was to consider Kimmerle anomaly (ponticulus posterior of the atlas) as an anatomic variant, which can cause a set of clinical symptoms and signs. A hundred and eight patients, 58 females and 50 males at the age of 18-59 years (M. 36.9 years, SD = 9.6) with radiologically verified Kimmerle anomaly were examined. A control group comprised 40 healthy subjects at the similar age range. The diagnosis of headaches was based on the criteria proposed by the IHS. A character of headaches, their localization, frequency, duration, number of days with headaches per year, circumstances associated with their onset and concomitant symptoms were evaluated. All the patients were subjected to electrophysiological studies (ENG, EEG and VEP). The results were statistically analyzed using a SPSS/PC+ computer system. It was revealed that clinical symptoms and signs in Kimmerle anomaly occurred most frequently in the third and fourth decade of life (65% of cases). These were most often tension-type headaches (50% of cases with headaches), vascular headaches (26% of cases) and neuralgia (24% of cases). Intensity of headaches was high. Headaches were accompanied by other complaints like vertigo (59% of cases) and in one third of cases--nausea. About 10% of patients also suffered from vomiting, paresthesia, dizziness, short periods of loss of consciousness. Sporadically--tinitus, drop attack, and vegetative symptoms. In cases without pain the most frequent signs were short periods of loss of consciousness, dizziness, and also nausea and dizziness. The EEG examination revealed pathology in 40% of patients with Kimmerle anomaly. The ENG examination in more than 33% of anomaly cases showed injury in the central part of vestibular system. Improper answers were reported in about 75% of the patients during the VEP examination.

The sweet spot of clinical intuitions: Predictors of the effects of context on impressions of conduct disorder symptoms.

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Marsh, Jessecae K; Burke, Christopher T; De Los Reyes, Andres

2016-02-01

How people interpret a mental disorder symptom has been shown to depend on the contextual life factors surrounding its presentation. Specifically, people are more likely to judge a symptom as clinically relevant if that symptom presents in a high-risk environment (e.g., child associates with deviant peers) relative to a low-risk environment (e.g., child associates with normative peer group). Importantly, not all symptoms are influenced by context to the same extent, and there is low agreement across people as to how this influence manifests. In this paper, we explore what factors predict the extent to which clinicians and laypeople interpret mental disorder symptoms as a function of diagnosis-congruent versus incongruent contextual information. We tested the impact of 2 statistical factors (prevalence and diagnosticity) and 2 more intuitive factors (diagnostic importance and abnormality) on the degree to which a symptom is interpreted differently in different contexts. Clinicians' impressions of the diagnosticity and importance of a symptom evidenced a curvilinear relationship with the use of context, with extremely important and unimportant as well as extremely diagnostic and nondiagnostic symptoms being less influenced by context. Laypeople showed a similar curvilinear relation between diagnosticity judgments and context effects. Additionally, clinicians showed a linear relationship between abnormality judgments and context use, with extremely abnormal symptoms being influenced less by context, whereas laypeople showed a curvilinear relationship between symptom abnormality and context use, with extremely abnormal and normal symptoms being influenced the most by context. We discuss implications of these findings for clinical diagnosis. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Asthma Symptoms and Specific IgE Levels among Toluene Diisocyanate (TDI) Exposed Workers in Tehran, Iran.

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Sharifi, Laleh; Karimi, Akram; Shokouhi Shoormasti, Raheleh; Miri, Sara; Heydar Nazhad, Hassan; Bokaie, Saied; Fazlollahi, Mohammad Reza; Sadeghniiat Haghighi, Khosro; Pourpak, Zahra; Moin, Mostafa

2013-01-01

Toluene diisocyanate (TDI) is an imperative chemical substance used in the production of polyurethane foams, elastomers, paints and coatings that cause a variety of health problems in workers who are exposed in work places. This study aimed to determine the asthma symptoms and serum specific IgE levels in TDI exposed workers and comparing the results with healthy control group. All the plants that use TDI in the manufacturing of paint and glue in the west of Tehran Province entered to the study and all the workers (550) completed modified initial questionnaire of the NIOSH, the questions were consisted of asthma symptoms. For each symptomatic exposed worker one healthy, sex and age matched control selected. Total IgE and Specific TDI IgE tests were done for each case and control groups. Among 550 TDI exposed workers, 26(4.7%) had asthma symptoms. Nine (34.6%) of symptomatic workers who were exposed to TDI were active cigarette consumer versus 3(11.5%) unexposed workers, P=0.049(CI= 0.953-17.29) OR=4.059. Nine (34.6%) workers had positive family history of atopy versus 1(3.8%) unexposed workers, P=0.0138 (CI= 1.45-305.41) OR=13.24. TDI specific IgE was found in 2 TDI exposed workers and 1 unexposed worker (P=0.5). Mean of total IgE was 339.05 in exposed workers (P=0.201). This study provides clinical and paraclinical data of workers exposed to TDI and points to a relation between atopy and smoking habit with asthma symptoms that offer preventing recommendations for TDI exposed workers and their heath administrators.

Incompleteness as a link between obsessive-compulsive personality traits and specific symptom dimensions of obsessive-compulsive disorder.

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Ecker, Willi; Kupfer, Jochen; Gönner, Sascha

2014-01-01

This paper examines the contribution of incompleteness/'not just right experiences' (NJREs) to an understanding of the relationship between obsessive-compulsive disorder (OCD) and obsessive-compulsive personality traits (OCPTs). It investigates the association of specific OCD symptom dimensions with OCPTs, conceptualized as continuous phenomena that are also observable below the diagnostic threshold. As empirical findings and clinical observation suggest that incompleteness feelings/NJREs may play a significant affective and motivational role for certain OCD subtypes, but also for patients with accentuated OCPTs, we hypothesized that OCPTs are selectively linked with incompleteness-associated OCD symptom dimensions (ordering, checking, hoarding and counting). Moreover, we assumed that this selective relationship cannot be demonstrated any more after statistical control of incompleteness, whereas it is preserved after statistical control of anxiety, depression, pathological worry and harm avoidance. Results from a study with a large clinical sample (n = 185) partially support these hypotheses and suggest that NJREs may be an important connecting link between specific OCD symptom dimensions, in particular ordering and checking, and accentuated OCPTs. Obsessive-compulsive personality traits (OCPTs) are positively related to obsessive-compulsive disorder symptom dimensions (ordering, checking, hoarding and counting) hypothesized or found to be associated with incompleteness/'not just right experiences' (NJREs), but not to washing and obsessions. This positive relationship, which is strongest for ordering and checking, is eliminated when NJREs are statistically controlled. Ordering, checking and accentuated OCPTs may share NJREs as a common affective-motivational underpinning.Dysfunctional behaviour patterns of people with accentuated OCPTs or obsessive-compulsive personality disorder (OCPD) may be viewed as efforts to avoid or reduce subjectively intolerable NJREs

Identification of symptom clusters in cancer patients at palliative care clinic

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Gülçin Senel Özalp

2017-01-01

Full Text Available Objective: Cancer patients often experience a large number of symptoms together. The aim of this study is to determine the symptom clusters in cancer patients at palliative care clinic. Methods: Hundred and seventy consecutive patients were enrolled in the study. Memorial Symptom Assessment Scale was used for symptom assessment of the patients. Results: The most experienced symptoms by the patients during the past week before hospitalization in palliative care clinic were lack of energy (95.4%, weight loss (91.2%, lack of appetite (89.4%, pain (88.2%, dry mouth (87.6%, feeling sad (87.6%, feeling nervous (82.9%, worrying (81.2%, and feeling irritable (80.6%. Five symptom clusters were defined. First cluster: pain, feeling nervous, dry mouth, worrying, feeling irritable, weight loss; second cluster: feeling drowsy, numbness/tingling in hands/feet, difficulty in sleeping, dizziness, constipation, I do not look like myself; third cluster: nausea, vomiting; fourth cluster: shortness of breath, difficulty in swallowing, cough, change in the way food tastes; and fifth cluster: feeling bloated, problems with urination, diarrhea, itching, mouth sores, hair loss, swelling of arm or legs, change in the skin. Conclusions: We encountered various symptom clusters in advanced cancer patients. Identification of symptom clusters and knowledge of cluster composition in oncological population may particularly contribute individualization of the treatment.

Non-specific symptoms as clues to changes in emotional well-being

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Blumberg Gari

2011-07-01

Full Text Available Abstract Background - Somatic symptoms are a common reason for visits to the family physician. The aim of this study was to examine the relation between non-specific symptoms and changes in emotional well-being and the degree to which the physician considers the possibility of mental distress when faced with such patients. Methods - Patients who complained of two or more symptoms including headache, dizziness, fatigue or weakness, palpitations and sleep disorders over one year were identified from the medical records of a random sample of 45 primary care physicians. A control group matched for gender and age was selected from the same population. Emotional well-being was assessed using the MOS-SF 36 in both groups. Results - The study group and the control group each contained 110 patients. Completed MOS questionnaires were obtained from 92 patients, 48 patients with somatic symptoms and 44 controls. Sixty percent of the patients with somatic symptoms experienced decreased emotional well being compared to 25% in the control group (p = 0.00005. Symptoms of dizziness, fatigue and sleep disturbances were significantly linked with mental health impairments. Primary care physicians identified only 6 of 29 patients (21% whose responses revealed functional limitations due to emotional problems as suffering from an emotional disorder and only 6 of 23 patients (26% with a lack of emotional well being were diagnosed with an emotional disorder. Conclusions - Non-specific somatic symptoms may be clues to changes in emotional well-being. Improved recognition and recording of mental distress among patients who complain of these symptoms may enable better follow up and treatment.

Clinical and neural effects of six-week administration of oxytocin on core symptoms of autism.

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Watanabe, Takamitsu; Kuroda, Miho; Kuwabara, Hitoshi; Aoki, Yuta; Iwashiro, Norichika; Tatsunobu, Natsubori; Takao, Hidemasa; Nippashi, Yasumasa; Kawakubo, Yuki; Kunimatsu, Akira; Kasai, Kiyoto; Yamasue, Hidenori

2015-11-01

Autism spectrum disorder is a prevalent neurodevelopmental disorder with no established pharmacological treatment for its core symptoms. Although previous literature has shown that single-dose administration of oxytocin temporally mitigates autistic social behaviours in experimental settings, it remains in dispute whether such potentially beneficial responses in laboratories can result in clinically positive effects in daily life situations, which are measurable only in long-term observations of individuals with the developmental disorder undergoing continual oxytocin administration. Here, to address this issue, we performed an exploratory, randomized, double-blind, placebo-controlled, crossover trial including 20 high-functional adult males with autism spectrum disorder. Data obtained from 18 participants who completed the trial showed that 6-week intranasal administration of oxytocin significantly reduced autism core symptoms specific to social reciprocity, which was clinically evaluated by Autism Diagnostic Observation Scale (P = 0.034, PFDR intervention were not larger than those seen in our previous single-dose intervention. These findings not only provide the evidence for clinically beneficial effects of continual oxytocin administration on the core social symptoms of autism spectrum disorder with suggesting its underlying biological mechanisms, but also highlight the necessity to seek optimal regimens of continual oxytocin treatment in future studies. © The Author (2015). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Psychopathology Symptoms, Rumination and Autobiographical Memory Specificity : Do Associations Hold After Bereavement?

NARCIS (Netherlands)

Eisma, Maarten C.; Schut, Henk A. W.; Stroebe, Margaret S.; Voerman, Kim; van den Bout, Jan; Stroebe, Wolfgang; Boelen, Paul A.

Symptoms of psychopathology are associated with overgeneral memory retrieval. Overgeneral memory is hypothesized to be the result of an emotion regulatory process, dampening emotional reactions associated with retrieval of distressing specific memories. However, higher post-loss symptom severity has

Associations between purine metabolites and clinical symptoms in schizophrenia.

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Jeffrey K Yao

Full Text Available The antioxidant defense system, which is known to be dysregulated in schizophrenia, is closely linked to the dynamics of purine pathway. Thus, alterations in the homeostatic balance in the purine pathway may be involved in the pathophysiology of schizophrenia.Breakdown products in purine pathway were measured using high-pressure liquid chromatography coupled with a coulometric multi-electrode array system for 25 first-episode neuroleptic-naïve patients with schizophrenia at baseline and at 4-weeks following initiation of treatment with antipsychotic medication. Associations between these metabolites and clinical and neurological symptoms were examined at both time points. The ratio of uric acid and guanine measured at baseline predicted clinical improvement following four weeks of treatment with antipsychotic medication. Baseline levels of purine metabolites also predicted clinical and neurological symtpoms recorded at baseline; level of guanosine was associated with degree of clinical thought disturbance, and the ratio of xanthosine to guanosine at baseline predicted degree of impairment in the repetition and sequencing of actions.Findings suggest an association between optimal levels of purine byproducts and dynamics in clinical symptoms and adjustment, as well as in the integrity of sensory and motor processing. Taken together, alterations in purine catabolism may have clinical relevance in schizophrenia pathology.

Correlation of Serotype-Specific Dengue Virus Infection with Clinical Manifestations

Science.gov (United States)

Halsey, Eric S.; Marks, Morgan A.; Gotuzzo, Eduardo; Fiestas, Victor; Suarez, Luis; Vargas, Jorge; Aguayo, Nicolas; Madrid, Cesar; Vimos, Carlos; Kochel, Tadeusz J.; Laguna-Torres, V. Alberto

2012-01-01

Background Disease caused by the dengue virus (DENV) is a significant cause of morbidity throughout the world. Although prior research has focused on the association of specific DENV serotypes (DENV-1, DENV-2, DENV-3, and DENV-4) with the development of severe outcomes such as dengue hemorrhagic fever and dengue shock syndrome, relatively little work has correlated other clinical manifestations with a particular DENV serotype. The goal of this study was to estimate and compare the prevalence of non-hemorrhagic clinical manifestations of DENV infection by serotype. Methodology and Principal Findings Between the years 2005–2010, individuals with febrile disease from Peru, Bolivia, Ecuador, and Paraguay were enrolled in an outpatient passive surveillance study. Detailed information regarding clinical signs and symptoms, as well as demographic information, was collected. DENV infection was confirmed in patient sera with polyclonal antibodies in a culture-based immunofluorescence assay, and the infecting serotype was determined by serotype-specific monoclonal antibodies. Differences in the prevalence of individual and organ-system manifestations were compared across DENV serotypes. One thousand seven hundred and sixteen individuals were identified as being infected with DENV-1 (39.8%), DENV-2 (4.3%), DENV-3 (41.5%), or DENV-4 (14.4%). When all four DENV serotypes were compared with each other, individuals infected with DENV-3 had a higher prevalence of musculoskeletal and gastrointestinal manifestations, and individuals infected with DENV-4 had a higher prevalence of respiratory and cutaneous manifestations. Conclusions/Significance Specific clinical manifestations, as well as groups of clinical manifestations, are often overrepresented by an individual DENV serotype. PMID:22563516

Correlation of serotype-specific dengue virus infection with clinical manifestations.

Directory of Open Access Journals (Sweden)

Eric S Halsey

Full Text Available Disease caused by the dengue virus (DENV is a significant cause of morbidity throughout the world. Although prior research has focused on the association of specific DENV serotypes (DENV-1, DENV-2, DENV-3, and DENV-4 with the development of severe outcomes such as dengue hemorrhagic fever and dengue shock syndrome, relatively little work has correlated other clinical manifestations with a particular DENV serotype. The goal of this study was to estimate and compare the prevalence of non-hemorrhagic clinical manifestations of DENV infection by serotype.Between the years 2005-2010, individuals with febrile disease from Peru, Bolivia, Ecuador, and Paraguay were enrolled in an outpatient passive surveillance study. Detailed information regarding clinical signs and symptoms, as well as demographic information, was collected. DENV infection was confirmed in patient sera with polyclonal antibodies in a culture-based immunofluorescence assay, and the infecting serotype was determined by serotype-specific monoclonal antibodies. Differences in the prevalence of individual and organ-system manifestations were compared across DENV serotypes. One thousand seven hundred and sixteen individuals were identified as being infected with DENV-1 (39.8%, DENV-2 (4.3%, DENV-3 (41.5%, or DENV-4 (14.4%. When all four DENV serotypes were compared with each other, individuals infected with DENV-3 had a higher prevalence of musculoskeletal and gastrointestinal manifestations, and individuals infected with DENV-4 had a higher prevalence of respiratory and cutaneous manifestations.Specific clinical manifestations, as well as groups of clinical manifestations, are often overrepresented by an individual DENV serotype.

The Body Dysmorphic Disorder Symptom Scale: Development and preliminary validation of a self-report scale of symptom specific dysfunction.

Science.gov (United States)

Wilhelm, Sabine; Greenberg, Jennifer L; Rosenfield, Elizabeth; Kasarskis, Irina; Blashill, Aaron J

2016-06-01

The Body Dysmorphic Disorder Symptom Scale (BDD-SS) is a new self-report measure used to examine the severity of a wide variety of symptoms associated with body dysmorphic disorder (BDD). The BDD-SS was designed to differentiate, for each group of symptoms, the number of symptoms endorsed and their severity. This report evaluates and compares the psychometric characteristics of the BDD-SS in relation to other measures of BDD, body image, and depression in 99 adult participants diagnosed with BDD. Total scores of the BDD-SS showed good reliability and convergent validity and moderate discriminant validity. Analyses of the individual BDD-SS symptom groups confirmed the reliability of the checking, grooming, weight/shape, and cognition groups. The current findings indicate that the BDD-SS can be quickly administered and used to examine the severity of heterogeneous BDD symptoms for research and clinical purposes. Copyright © 2016. Published by Elsevier Ltd.

The psychometric properties of the Readiness and Motivation Questionnaire: a symptom-specific measure of readiness for change in the eating disorders.

Science.gov (United States)

Geller, Josie; Brown, Krista E; Srikameswaran, Suja; Piper, William; Dunn, Erin C

2013-09-01

Readiness for change, as assessed by the readiness and motivation interview (RMI), predicts a number of clinical outcome variables in eating disorders including enrollment in intensive treatment, symptom change, dropout, and relapse. Although clinically useful, the training and administration of the RMI is time consuming. The purpose of this research was to (a) develop a self-report, symptom-specific version of the RMI, the readiness and motivation questionnaire (RMQ), that can be used to assess readiness for change across all eating disorder diagnoses and (b) establish its psychometric properties. The RMQ provides stage of change, internality, and confidence scores for each of 4 eating disorder symptom domains (restriction, bingeing, and cognitive and compensatory behaviors). Individuals (N = 244) with current eating disorder diagnoses completed the RMQ and measures of convergent, discriminant, and criterion validity. Similar to the RMI scores, readiness scores on the RMQ differed according to symptom domain. Regarding criterion validity, RMQ scores were significantly associated with ratings of anticipated difficulty of recovery activities and completion of recovery activities. The RMQ contributed significant unique variance to anticipated difficulty of recovery activities, beyond those accounted for by the RMI and a questionnaire measure of global readiness. The RMQ is thus an acceptable alternative to the RMI, providing global and domain-specific readiness information when time or cost prohibits use of an interview.

Clinical symptoms in fibromyalgia are associated to overweight and lipid profile.

Science.gov (United States)

Cordero, Mario D; Alcocer-Gómez, Elísabet; Cano-García, Francisco J; Sánchez-Domínguez, Benito; Fernández-Riejo, Patricia; Moreno Fernández, Ana M; Fernández-Rodríguez, Ana; De Miguel, Manuel

2014-03-01

In order to analyze the association between body mass index (BMI), lipid profile and clinical symptoms in patients with fibromyalgia, we assessed BMI levels, lipid profile and its association with clinical symptoms in 183 patients with fibromyalgia. The patients were evaluated using tender points, FIQ and Visual Analogue Scales of pain (VAS). Serum lipid profile analysis (total cholesterol, triglyceride, HDL, LDL and VLDL), and biochemical parameters were measured in the biochemistry laboratory. The BMI distribution of the nonobese, overweight and obese patients' groups were relatively even with 37.7, 35.5 and 26.8%, respectively, with a mean BMI of 27.3 ± 4.9. The number of tender points showed significantly positive correlation with higher BMI (P BMI, total cholesterol and triglycerides showed high association with some clinical parameters. Overweight and lipid profile could be associated with fibromyalgia symptoms. A treatment program with weight loss strategies, and control in diet and increased physical activity is advised to patients.

Intensive inpatient treatment for bulimia nervosa: Statistical and clinical significance of symptom changes.

Science.gov (United States)

Diedrich, Alice; Schlegl, Sandra; Greetfeld, Martin; Fumi, Markus; Voderholzer, Ulrich

2018-03-01

This study examines the statistical and clinical significance of symptom changes during an intensive inpatient treatment program with a strong psychotherapeutic focus for individuals with severe bulimia nervosa. 295 consecutively admitted bulimic patients were administered the Structured Interview for Anorexic and Bulimic Syndromes-Self-Rating (SIAB-S), the Eating Disorder Inventory-2 (EDI-2), the Brief Symptom Inventory (BSI), and the Beck Depression Inventory-II (BDI-II) at treatment intake and discharge. Results indicated statistically significant symptom reductions with large effect sizes regarding severity of binge eating and compensatory behavior (SIAB-S), overall eating disorder symptom severity (EDI-2), overall psychopathology (BSI), and depressive symptom severity (BDI-II) even when controlling for antidepressant medication. The majority of patients showed either reliable (EDI-2: 33.7%, BSI: 34.8%, BDI-II: 18.1%) or even clinically significant symptom changes (EDI-2: 43.2%, BSI: 33.9%, BDI-II: 56.9%). Patients with clinically significant improvement were less distressed at intake and less likely to suffer from a comorbid borderline personality disorder when compared with those who did not improve to a clinically significant extent. Findings indicate that intensive psychotherapeutic inpatient treatment may be effective in about 75% of severely affected bulimic patients. For the remaining non-responding patients, inpatient treatment might be improved through an even stronger focus on the reduction of comorbid borderline personality traits.

Altered DNA Methylation Patterns Associated With Clinically Relevant Increases in PTSD Symptoms and PTSD Symptom Profiles in Military Personnel.

Science.gov (United States)

Martin, Christiana; Cho, Young-Eun; Kim, Hyungsuk; Yun, Sijung; Kanefsky, Rebekah; Lee, Hyunhwa; Mysliwiec, Vincent; Cashion, Ann; Gill, Jessica

2018-05-01

Military personnel experience posttraumatic stress disorder (PTSD), which is associated with differential DNA methylation across the whole genome. However, the relationship between these DNA methylation patterns and clinically relevant increases in PTSD severity is not yet clearly understood. The purpose of this study was to identify differences in DNA methylation associated with PTSD symptoms and investigate DNA methylation changes related to increases in the severity of PTSD in military personnel. In this pilot study, a cross-sectional comparison was made between military personnel with PTSD (n = 8) and combat-matched controls without PTSD (n = 6). Symptom measures were obtained, and genome-wide DNA methylation was measured using methylated DNA immunoprecipitation (MeDIP-seq) from whole blood samples at baseline and 3 months later. A longitudinal comparison measured DNA methylation changes in military personnel with clinically relevant increases in PTSD symptoms between time points (PTSD onset) and compared methylation patterns to controls with no clinical changes in PTSD. In military personnel with elevated PTSD symptoms 3 months following baseline, 119 genes exhibited reduced methylation and 8 genes exhibited increased methylation. Genes with reduced methylation in the PTSD-onset group relate to the canonical pathways of netrin signaling, Wnt/Ca + pathway, and axonal guidance signaling. These gene pathways relate to neurological disorders, and the current findings suggest that these epigenetic changes potentially relate to PTSD symptomology. This study provides some novel insights into the role of epigenetic changes in PTSD symptoms and the progression of PTSD symptoms in military personnel.

A Psychometric Comparison of the Clinical Assessment Interview for Negative Symptoms and the Brief Negative Symptom Scale.

Science.gov (United States)

Strauss, Gregory P; Gold, James M

2016-11-01

In 2005, the National Institute of Mental Health held a consensus development conference on negative symptoms of schizophrenia. Among the important conclusions of this meeting were that there are at least 5 commonly accepted domains of negative symptoms (blunted affect, alogia, avolition, anhedonia, asociality) and that new rating scales were needed to adequately assess these constructs. Two next-generation negative symptom scales resulted from this meeting: the Brief Negative Symptom Scale (BNSS) and Clinical Assessment Interview for Negative Symptoms (CAINS). Both measures are becoming widely used and studies have demonstrated good psychometric properties for each scale. The current study provides the first direct psychometric comparison of these scales. Participants included 65 outpatients diagnosed with schizophrenia or schizoaffective disorder who completed clinical interviews, questionnaires, and neuropsychological testing. Separate raters completed the BNSS and CAINS within the same week. Results indicated that both measures had good internal consistency, convergent validity, and discriminant validity. High correspondence was observed between CAINS and BNSS blunted affect and alogia items. Moderate convergence occurred for avolition and asociality items, and low convergence was seen among anhedonia items. Findings suggest that both scales have good psychometric properties, but that there are important distinctions among the items related to motivation and pleasure. © The Author 2016. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

High sensitivity and specificity in proposed clinical diagnostic criteria for anti-N-methyl-D-aspartate receptor encephalitis.

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Ho, Alvin C C; Mohammad, Shekeeb S; Pillai, Sekhar C; Tantsis, Esther; Jones, Hannah; Ho, Reena; Lim, Ming; Hacohen, Yael; Vincent, Angela; Dale, Russell C

2017-12-01

To determine the validity of the proposed clinical diagnostic criteria for anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis in paediatric patients. The diagnostic criteria for anti-NMDAR encephalitis proposed by Graus et al. (2016) use clinical features and conventional investigations to facilitate early immunotherapy before antibody status is available. The criteria are satisfied if patients develop four out of six symptom groups within 3 months, together with at least one abnormal investigation (electroencephalography/cerebrospinal fluid) and reasonable exclusion of other disorders. We evaluated the validity of the criteria using a retrospective cohort of paediatric patients with encephalitis. Twenty-nine patients with anti-NMDAR encephalitis and 74 comparison children with encephalitis were included. As expected, the percentage of patients with anti-NMDAR encephalitis who fulfilled the clinical criteria increased over time. During the hospital inpatient admission, most patients (26/29, 90%) with anti-NMDAR encephalitis fulfilled the criteria, significantly more than the comparison group (3/74, 4%) (panti-NMDAR encephalitis was 2 weeks from first symptom onset (range 1-6). The sensitivity of the criteria was 90% (95% confidence interval 73-98) and the specificity was 96% (95% confidence interval 89-99). The proposed diagnostic criteria for anti-NMDAR encephalitis have good sensitivity and specificity. Incomplete criteria do not exclude the diagnosis. The proposed clinical diagnostic criteria for anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis by Graus et al. (2016) have high sensitivity and specificity in paediatric patients. The median time of fulfilling the criteria in patients with anti-NMDAR was 2 weeks from first symptom onset. © 2017 Mac Keith Press.

Patient-reported symptoms during radiotherapy. Clinically relevant symptom burden in patients treated with palliative and curative intent

Energy Technology Data Exchange (ETDEWEB)

Koerner, Philipp [Universitaetsklinikum Wuerzburg, Interdisziplinaeres Zentrum Palliativmedizin, Wuerzburg (Germany); Universitaetsklinikum Wuerzburg, Klinik und Poliklinik fuer Strahlentherapie, Wuerzburg (Germany); Ehrmann, Katja [Universitaetsklinikum Wuerzburg, Medizinische Psychologie und Psychotherapie, Medizinische Soziologie und Rehabilitationswissenschaften, Wuerzburg (Germany); Hartmannsgruber, Johann [Praxis Landshut, Kinderzahnheilkunde, Landshut (Germany); Metz, Michaela; Steigerwald, Sabrina; Flentje, Michael [Universitaetsklinikum Wuerzburg, Klinik und Poliklinik fuer Strahlentherapie, Wuerzburg (Germany); Oorschot, Birgitt van [Universitaetsklinikum Wuerzburg, Interdisziplinaeres Zentrum Palliativmedizin, Wuerzburg (Germany)

2017-07-15

The benefits of patient-reported symptom assessment combined with integrated palliative care are well documented. This study assessed the symptom burden of palliative and curative-intent radiation oncology patients. Prior to first consultation and at the end of RT, all adult cancer patients planned to receive fractionated percutaneous radiotherapy (RT) were asked to answer the Edmonton Symptom Assessment Scale (ESAS; nine symptoms from 0 = no symptoms to 10 = worst possible symptoms). Mean values were used for curative vs. palliative and pre-post comparisons, and the clinical relevance was evaluated (symptom values ≥ 4). Of 163 participating patients, 151 patients (90.9%) completed both surveys (116 curative and 35 palliative patients). Before beginning RT, 88.6% of palliative and 72.3% of curative patients showed at least one clinically relevant symptom. Curative patients most frequently named decreased general wellbeing (38.6%), followed by tiredness (35.0%), anxiety (32.4%), depression (30.0%), pain (26.3%), lack of appetite (23.5%), dyspnea (17.8%), drowsiness (8.0%) and nausea (6.1%). Palliative patients most frequently named decreased general wellbeing (62.8%), followed by pain (62.8%), tiredness (60.0%), lack of appetite (40.0%), anxiety (38.0%), depression (33.3%), dyspnea (28.5%), drowsiness (25.7%) and nausea (14.2%). At the end of RT, the proportion of curative and palliative patients with a clinically relevant symptom had increased significantly to 79.8 and 91.4%, respectively; whereas the proportion of patients reporting clinically relevant pain had decreased significantly (42.8 vs. 62.8%, respectively). Palliative patients had significantly increased tiredness. Curative patients reported significant increases in pain, tiredness, nausea, drowsiness, lack of appetite and restrictions in general wellbeing. Assessment of patient-reported symptoms was successfully realized in radiation oncology routine. Overall, both groups showed a high symptom burden

Specific cerebral perfusion patterns in three schizophrenia symptom dimensions.

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Stegmayer, Katharina; Strik, Werner; Federspiel, Andrea; Wiest, Roland; Bohlhalter, Stephan; Walther, Sebastian

2017-12-01

Dimensional concepts such as the Research Domain Criteria initiative have been proposed to disentangle the heterogeneity of schizophrenia. One model introduced three neurobiologically informed behavioral dimensions: language, affectivity and motor behavior. To study the brain-behavior associations of these three dimensions, we investigated whether current behavioral alterations were linked to resting state perfusion in distinct brain circuits in schizophrenia. In total, 47 patients with schizophrenia spectrum disorders and 44 healthy controls were included. Psychopathology was assessed with the Positive And Negative Syndrome Scale and the Bern Psychopathology scale (BPS). The BPS provides severity ratings of three behavioral dimensions (language, affectivity and motor). Patients were classified according to the severity of alterations (severe, mild, no) in each dimension. Whole brain resting state cerebral blood flow (CBF) was compared between patient subgroups and controls. Two symptom dimensions were associated with distinct CBF changes. Behavioral alterations in the language dimension were linked to increased CBF in Heschl's gyrus. Altered affectivity was related to increased CBF in amygdala. The ratings of motor behavior instead were not specifically associated with CBF. Investigating behavioral alterations in three schizophrenia symptom dimensions identified distinct regional CBF changes in the language and limbic brain circuits. The results demonstrate a hitherto unknown segregation of pathophysiological pathways underlying a limited number of specific symptom dimensions in schizophrenia. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Clinical symptoms of sleep apnea syndrome and automobile accidents

DEFF Research Database (Denmark)

Haraldsson, P O; Carenfelt, C; Diderichsen, Finn

1990-01-01

Patients with clinical features of sleep apnea syndrome (SAS) and self-reported sleep spells at the wheel do poorly in simulated monotonous driving. To evaluate whether drivers with defined symptoms of SAS (heavy snoring, sleep disturbances and daytime sleepiness) compensate in real traffic...... by careful driving or not, the rate of car accidents over a 5-year period was investigated. A questionnaire was addressed to 140 patients with and 142 controls without symptoms associated to SAS. Seventy-three of the patients had a complete triad of SAS-associated symptoms. Fifty-two percent...... with a complete triad of symptoms of SAS compared to controls (p less than 0.001). When corrected for mileage driven, the total number of single-car accidents was almost 12 times higher among patients with sleep spells whilst driving, compared to controls (p less than 0.001). It is concluded that drivers...

Air pollution from biodegradable wastes and non-specific health symptoms among residents

DEFF Research Database (Denmark)

Blanes-Vidal, Victoria

2015-01-01

Adverse health effects of exposure to high levels of air pollutants from biodegradable wastes have been well-studied. However, few investigations have examined the potential effects of chronic exposure to low-to-moderate levels on non-specific health symptoms among residents. Besides, most studies...... have relied on distances to waste sites to assign exposure status, and have not investigated whether the exposure-symptoms associations are direct or mediated by odor annoyance. In this study, individual-level exposures to a proxy indicator of biodegradable waste pollution (ammonia, NH3) in non......-urban residences (n=454) during 2005-2010 were characterized by data from emission-dispersion validated models. Logistic regression and mediating analyses were used to examine associations between exposures and questionnaire-based data on annoyance and non-specific symptoms, after adjusting by person...

Symptom-specific self-referential cognitive processes in bipolar disorder: a longitudinal analysis.

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Pavlickova, H; Varese, F; Turnbull, O; Scott, J; Morriss, R; Kinderman, P; Paykel, E; Bentall, R P

2013-09-01

Although depression and mania are often assumed to be polar opposites, studies have shown that, in patients with bipolar disorder, they are weakly positively correlated and vary somewhat independently over time. Thus, when investigating relationships between specific psychological processes and specific symptoms (mania and depression), co-morbidity between the symptoms and changes over time must be taken into account. Method A total of 253 bipolar disorder patients were assessed every 24 weeks for 18 months using the Hamilton Rating Scale for Depression (HAMD), the Bech-Rafaelsen Mania Assessment Scale (MAS), the Rosenberg Self-Esteem Questionnaire (RSEQ), the Dysfunctional Attitudes Scale (DAS), the Internal, Personal and Situational Attributions Questionnaire (IPSAQ) and the Personal Qualities Questionnaire (PQQ). We calculated multilevel models using the xtreg module of Stata 9.1, with psychological and clinical measures nested within each participant. Mania and depression were weakly, yet significantly, associated; each was related to distinct psychological processes. Cross-sectionally, self-esteem showed the most robust associations with depression and mania: depression was associated with low positive and high negative self-esteem, and mania with high positive self-esteem. Depression was significantly associated with most of the other self-referential measures, whereas mania was weakly associated only with the externalizing bias of the IPSAQ and the achievement scale of the DAS. Prospectively, low self-esteem predicted future depression. The associations between different self-referential thinking processes and different phases of bipolar disorder, and the presence of the negative self-concept in both depression and mania, have implications for therapeutic management, and also for future directions of research.

Interaction between FKBP5 gene and childhood trauma on psychosis, depression and anxiety symptoms in a non-clinical sample.

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de Castro-Catala, Marta; Peña, Elionora; Kwapil, Thomas R; Papiol, Sergi; Sheinbaum, Tamara; Cristóbal-Narváez, Paula; Ballespí, Sergi; Barrantes-Vidal, Neus; Rosa, Araceli

2017-11-01

Childhood trauma has been associated with a heightened risk for presenting clinical and non-clinical psychopathology in adulthood. Genes related with the stress response, such as the FK506 binding protein 51 (FKBP5), are plausible candidates moderating the effects of childhood trauma on the emergence of such symptoms later on. The present study aimed to explore the moderating role of FKBP5 genetic variability on the association of different types of childhood trauma with subclinical psychosis, depression and anxiety in a non-clinical sample. Schizotypy, psychotic-like experiences, depression and anxiety symptoms and childhood trauma were assessed in 808 young adults. Two FKBP5 haplotypic blocks were detected: block 1 (rs3800373 - rs9296158 - rs1360780) and block 2 (rs9470080 - rs4713916). Subjects were classified in two groups according to whether they carried or not the risk haplotype previously described in the literature (block 1: CAT and block 2: TA). Linear regression analyses were used to study (i) the main effects of childhood trauma and FKBP5 haplotype blocks and (ii) their interaction effects on the mentioned forms of psychopathology. All childhood trauma scales, except sexual abuse, were associated with schizotypy, psychotic-like experiences, depression and anxiety symptoms. None of the analysed symptoms was associated with the main effects of FKBP5 genetic variability. However an interaction effect between block 1 and physical abuse was observed on anxiety, with lower scores in CAT carriers. This effect was driven by SNP 1 and 2. Moreover, an interaction effect between block 2 and physical abuse was identified on the variables tapping depressive and anxiety symptoms. Specifically, non-TA carrier subjects who were exposed to physical abuse were found to be at higher risk for depressive and anxiety symptoms. These effects were driven by SNP 5. No interaction effect was observed for the other variables. Our data suggest that exposure to childhood physical

Microstructural Changes in Compressed Nerve Roots Are Consistent With Clinical Symptoms and Symptom Duration in Patients With Lumbar Disc Herniation.

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Wu, Weifei; Liang, Jie; Ru, Neng; Zhou, Caisheng; Chen, Jianfeng; Wu, Yongde; Yang, Zong

2016-06-01

A prospective study. To investigate the association between microstructural nerve roots changes on diffusion tensor imaging (DTI) and clinical symptoms and their duration in patients with lumbar disc herniation. The ability to identify microstructural properties of the nervous system with DTI has been demonstrated in many studies. However, there are no data regarding the association between microstructural changes evaluated using DTI and symptoms assessed with the Oswestry Disability Index (ODI) and their duration. Forty consecutive patients with foraminal disc herniation affecting unilateral sacral 1 (S1) nerve roots were enrolled in this study. DTI with tractography was performed on the S1 nerve roots. Clinical symptoms were evaluated using an ODI questionnaire for each patient, and the duration of clinical symptoms was noted based on the earliest instance of leg pain and numbness. Mean fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were calculated from tractography images. The mean FA value of the compressed lumbar nerve roots was significantly lower than the FA of the contralateral nerve roots (P leg pain, indicating that the microstructure of the nerve root has been damaged. 3.

Presence of specific IgG antibody to grain dust does not go with respiratory symptoms.

Science.gov (United States)

Park, H S; Suh, C H; Nahm, D H; Kim, H Y

1999-02-01

A high prevalence of work-related symptoms in relation to grain dust exposure has been reported in grain dust workers, but the role of the specific IgG antibody is unknown. To study the possible role of specific IgG (sIgG) and specific IgG4 (sIgG4) in the development of work-related symptoms, sIgG and sIgG4 subclass antibodies against grain dust antigens were determined by ELISA in sera from 43 workers and 27 non-exposed controls. They were compared with results of specific IgE antibodies, exposure intensity and the presence of respiratory symptoms. SIgG and sIgG4 antibodies were detectable in almost all sera of exposed workers, and the prevalence were significantly higher than those of controls (pgrain dust exposure and may unlikely play a role in the etiology of respiratory symptoms.

Symptom specificity in the acute treatment of Major Depressive Disorder: a re-analysis of the treatment of depression collaborative research program.

Science.gov (United States)

Stewart, Jeremy G; Harkness, Kate L

2012-03-01

Antidepressant medications, Cognitive-Behavioral Therapy (CBT) and Interpersonal Psychotherapy (IPT) are equally efficacious in the acute treatment of Major Depressive Disorder (MDD). Nevertheless, remission rates remain unacceptably low. Examining the differential time course of remission of specific symptom clusters across treatments may provide a basis for assigning patients to treatments that have the highest chance of being effective. This study re-analyzed data from the NIMH Treatment of Depression Collaborative Research Project (TDCRP), which included 250 adult outpatients with MDD randomized to 16 weeks of CBT, IPT, imipramine+clinical management (IMI-CM), or pill placebo (PLA-CM). We derived four symptom factors from the 23-item Hamilton Depression Rating Scale, and three symptom factors from the Beck Depression Inventory. Within-subject hierarchical regression models were specified to examine the linear and quadratic patterns of symptom remission over five assessment points. IMI-CM produced a more rapid rate of remission than CBT or IPT for both the somatic/vegetative and cognitive-affective symptoms of MDD. There were no statistically significant differences in the rates of improvement of any of the symptom factors between the IMI-CM and PLA-CM groups. Some core symptoms of depression were excluded due to low factor loadings. Past research has argued that the CBT arm in the TDCRP may have been weak. We failed to find evidence that treatments act preferentially on specific symptom clusters. Therefore, the symptoms of MDD may be inter-dependent when it comes to their courses of remission in treatment. Copyright © 2011 Elsevier B.V. All rights reserved.

Clinical features of obsessive-compulsive disorder with hoarding symptoms: a multicenter study.

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Torres, Albina R; Fontenelle, Leonardo F; Ferrão, Ygor A; do Rosário, Maria Conceição; Torresan, Ricardo C; Miguel, Eurípedes C; Shavitt, Roseli G

2012-06-01

Factor analyses indicate that hoarding symptoms constitute a distinctive dimension of obsessive-compulsive disorder (OCD), usually associated with higher severity and limited insight. The aim was to compare demographic and clinical features of OCD patients with and without hoarding symptoms. A cross sectional study was conducted with 1001 DSM-IV OCD patients from the Brazilian Research Consortium of Obsessive-Compulsive Spectrum Disorders (CTOC), using several instruments. The presence and severity of hoarding symptoms were determined using the Dimensional Yale-Brown Obsessive-Compulsive Scale. Statistical univariate analyses comparing factors possibly associated with hoarding symptoms were conducted, followed by logistic regression to adjust the results for possible confounders. Approximately half of the sample (52.7%, n = 528) presented hoarding symptoms, but only four patients presented solely the hoarding dimension. Hoarding was the least severe dimension in the total sample (mean score: 3.89). The most common lifetime hoarding symptom was the obsessive thought of needing to collect and keep things for the future (44.0%, n = 440). After logistic regression, the following variables remained independently associated with hoarding symptoms: being older, living alone, earlier age of symptoms onset, insidious onset of obsessions, higher anxiety scores, poorer insight and higher frequency of the symmetry-ordering symptom dimension. Concerning comorbidities, major depressive, posttraumatic stress and attention deficit/hyperactivity disorders, compulsive buying and tic disorders remained associated with the hoarding dimension. OCD hoarding patients are more likely to present certain clinical features, but further studies are needed to determine whether OCD patients with hoarding symptoms constitute an etiologically discrete subgroup. Copyright © 2012 Elsevier Ltd. All rights reserved.

[Basic symptoms in schizophrenia, their clinical study and relevance in research].

Science.gov (United States)

Miret, Salvador; Fatjó-Vilas, Mar; Peralta, Víctor; Fañanás, Lourdes

2016-01-01

Basic symptoms consist of subtle sub-clinical disturbances subjectively experienced by schizophrenia patients. These are mainly related to drive, affect, thinking and language, perception, memory, motor action, central vegetative functions, control of cognitive processes, and stress tolerance. Initially described by Huber, from a phenomenological approach, basic symptoms are part of the earliest features of schizophrenia, and they can evolve along the course of the disorder. Their assessment during the prodromal phase of the disease (together with ultra-high risk criteria) is one of the 2 main approaches that allow the definition of states of clinical risk for the development of psychosis. The present review provides an updated view of the concept of basic symptoms, highlighting its potential value in establishing neurobiological correlates of interest in aetiopathogenic research. Copyright © 2015 SEP y SEPB. Published by Elsevier España. All rights reserved.

Systematic review of type-specific pathophysiological symptoms of Sasang typology

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Yoo Ri Han

2016-06-01

Full Text Available Previous studies on the Sasang typology have focused on the differential diagnosis of each Sasang type with type-specific pathophysiological symptoms (TSPS. The purpose of this study was to elucidate the latent physiological mechanism related to these clinical indicators. We searched six electronic databases for articles published from 1990 to 2015 using the Sasang typology-related keywords, and found and analyzed 35 such articles. The results were summarized into six TSPS categories: perspiration, temperature preference, sleep, defecation, urination, and susceptibility to stress. The Tae-Eum and So-Eum types showed contrasting features with TSPS, and the So-Yang type was in the middle. The Tae-Eum type has good digestive function, regular bowel movement and defecation, high sleep quality, and low susceptibility to stress and cold. The Tae-Eum type has relatively large volumes of sweat and feels fresh after sweating; however, the urine is highly concentrated. These clinical features might be related to the biopsychological traits of the Tae-Eum type, including a low trait anxiety level and high ponderal and body mass indices. This study used the autonomic reactivity hypothesis for explaining the pathophysiological predispositions in the Sasang typology. The Tae-Eum and So-Eum Sasang types have a low threshold in parasympathetic and sympathetic activation, respectively. This study provides a foundation for integrating traditional Korean personalized medicine and Western biomedicine.

Formaldehyde-related clinical symptoms reported by medical students during gross anatomy cadaver dissection

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Łukasz Pietrzyk

2016-09-01

Full Text Available Introduction . Formaldehyde is a noxious gas used as a tissue preservative of cadavers in autopsy rooms. Therefore, exposure to higher concentrations applies particularly to laboratory staff, anatomists and medical students. Prolonged exposure to formaldehyde is associated with clinical complications. Objective. To assess whether exposure to repeated inhalation of low concentrations of formaldehyde (FA experienced during a gross anatomy course triggers subjective clinical symptoms in medical students. Material and methods . All 198 first-year medical students of the Medical University of Lublin, Poland (28% with allergy history and 72% without allergy history; 69% male and 31% female responded to a questionnaire concerning their subjective FA-related clinical symptoms. Differences in proportions of experienced symptoms between allergic vs. nonallergic, and female vs. males were compared by the Mann-Whitney U test. Results . Even though formaldehyde concentrations in the gross anatomy laboratory were relatively low (0.47–0.57 mg/m3, medical students experienced various reactions (lacrimation in 85.9%, red eyes, dry and itchy eyes, runny nose, sneezing, and headache in > 50% of students, cough in 44%, and dry throat or throat irritation in 42% of students. Among students with a history of allergy, eye, nose, skin and respiratory system symptoms occurred more frequently in comparison to nonallergic students. Female individuals demonstrated higher sensitivity to FA exposure. Conclusions . Exposure to formaldehyde may result in development of clinical symptoms in medical students. Particularly unpleasant symptoms may be experienced by individuals with allergy history. It is necessary to decrease formaldehyde concentrations in the anatomy dissection laboratory.

Paediatric Obsessive-Compulsive Disorder and Depressive Symptoms: Clinical Correlates and CBT Treatment Outcomes.

Science.gov (United States)

Brown, H M; Lester, K J; Jassi, A; Heyman, I; Krebs, G

2015-07-01

Depression frequently co-occurs with paediatric obsessive-compulsive disorder (OCD), yet the clinical correlates and impact of depression on CBT outcomes remain unclear. The prevalence and clinical correlates of depression were examined in a paediatric specialist OCD-clinic sample (N = 295; Mean = 15 [7 - 18] years, 42 % female), using both dimensional (Beck Depression Inventory-youth; n = 261) and diagnostic (Development and Wellbeing Assessment; n = 127) measures of depression. The impact of depressive symptoms and suspected disorders on post-treatment OCD severity was examined in a sub-sample who received CBT, with or without SSRI medication (N = 100). Fifty-one per-cent of patients reported moderately or extremely elevated depressive symptoms and 26 % (95 % CI: 18 - 34) met criteria for a suspected depressive disorder. Depressive symptoms and depressive disorders were associated with worse OCD symptom severity and global functioning prior to CBT. Individuals with depression were more likely to be female, have had a psychiatric inpatient admission and less likely to be attending school (ps depressive symptom severity significantly decreased after CBT. Depressive symptoms and depressive disorders predicted worse post-treatment OCD severity (βs = 0.19 and 0.26, ps Depression is common in paediatric OCD and is associated with more severe OCD and poorer functioning. However, depression severity decreases over the course of CBT for OCD and is not independently associated with worse outcomes, supporting the recommendation for treatment as usual in the presence of depressive symptoms.

Reasons for Seeking Clinical Care for Lower Urinary Tract Symptoms: A Mixed Methods Study.

Science.gov (United States)

Griffith, James W; Messersmith, Emily E; Gillespie, Brenda W; Wiseman, Jonathan B; Flynn, Kathryn E; Kirkali, Ziya; Kusek, John W; Bavendam, Tamara; Cella, David; Kreder, Karl J; Nero, Jasmine J; Corona, Maria E; Bradley, Catherine S; Kenton, Kimberly S; Helfand, Brian T; Merion, Robert M; Weinfurt, Kevin P

2018-02-01

The primary objective of this study was to evaluate reasons for seeking care among men and women with lower urinary tract symptoms. Participants were recruited from urology and urogynecology clinics, and the community. The sample was enriched with persons expected to have abnormal or diminished bladder sensations (eg participants with lower back surgery and participants 65 years old or older). Interviews were performed in person beginning with an open-ended assessment of urinary symptoms and associated bother followed by more directed questions, including reasons for seeking or not seeking treatment. We also examined the relationship between symptom frequency and bother using the LUTS (Lower Urinary Tract Symptoms) Tool. A total of 88 participants, including 38 men and 50 women, with a mean ± SD age of 52.2 ± 14.3 years provided information about urinary symptoms, including a range of quality of life consequences and coping behaviors. They sought treatment mostly because of new, continuing or bothersome symptoms. Factors associated with not seeking treatment included low symptom severity and concerns about the costs vs the benefits of treatment (eg side effects of medication). Symptom frequency and bother were associated with each other across symptoms assessed by the LUTS Tool. In this large qualitative study we obtained useful insights into the impact of lower urinary tract symptoms from the perspective of the person with the symptoms. Removing barriers and misconceptions about the treatment of lower urinary tract symptoms may increase the number of people who seek clinical care and improve the clinical course of men and women who experience lower urinary tract symptoms. Copyright © 2018 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Prepartum autobiographical memory specificity predicts post-traumatic stress symptoms following complicated pregnancy

NARCIS (Netherlands)

Hauer, Beatrijs J. A.; Wessel, Ineke; Engelhard, Iris M.; Peeters, Louis L.; Dalgleish, Tim

2009-01-01

Prior research has shown that reduced autobiographical memory specificity predicts an increase in post-traumatic stress severity in traumatised individuals. Studies have also demonstrated that reduced memory specificity predicts later symptoms of depression after pregnancy-related life stress. So

Sciatica-like symptoms and the sacroiliac joint: clinical features and differential diagnosis

NARCIS (Netherlands)

Visser, L.H.; Nijssen, P.G.; Tijssen, C.C.; Middendorp, J.J. van; Schieving, J.H.

2013-01-01

PURPOSE: To compare the clinical features of patients with sacroiliac joint (SIJ)-related sciatica-like symptoms to those with sciatica from nerve root compression and to investigate the necessity to perform radiological imaging in patients with sciatica-like symptoms derived from the SIJ. METHODS:

Clinical Significance of the Number of Depressive Symptoms in Major Depressive Disorder: Results from the CRESCEND Study.

Science.gov (United States)

Park, Seon-Cheol; Sakong, Jeongkyu; Koo, Bon Hoon; Kim, Jae-Min; Jun, Tae-Youn; Lee, Min-Soo; Kim, Jung-Bum; Yim, Hyeon-Woo; Park, Yong Chon

2016-04-01

Our study aimed to establish the relationship between the number of depressive symptoms and the clinical characteristics of major depressive disorder (MDD). This would enable us to predict the clinical significance of the number of depressive symptoms in MDD patients. Using data from the Clinical Research Center for Depression (CRESCEND) study in Korea, 853 patients with DSM-IV MDD were recruited. The baseline and clinical characteristics of groups with different numbers of depressive symptoms were compared using the χ(2) test for discrete variables and covariance (ANCOVA) for continuous variables. In addition, the scores of these groups on the measurement tools were compared by ANCOVA after adjusting the potential effects of confounding variables. After adjusting the effects of monthly income and history of depression, a larger number of depressive symptoms indicated higher overall severity of depression (F [4, 756] = 21.458, P depressive symptoms (F [4, 767] = 19.145, P depressive symptoms can be used as an index of greater illness burden in clinical psychiatry.

Beyond the CRAB symptoms: a study of presenting clinical manifestations of multiple myeloma.

Science.gov (United States)

Talamo, Giampaolo; Farooq, Umar; Zangari, Maurizio; Liao, Jason; Dolloff, Nathan G; Loughran, Thomas P; Epner, Elliot

2010-12-01

Although the typical clinical manifestations of multiple myeloma (MM) are summarized by the CRAB symptoms (hypercalcemia, renal insufficiency, anemia, and bone lesions), a significant proportion of patients with MM present with a variety of other clinical manifestations. We conducted a study evaluating the presenting symptoms that led to the diagnosis of MM. We conducted a retrospective review of 170 consecutive patients with MM seen at the Penn State Hershey Cancer Institute. Among patients with symptomatic MM, 74% presented with CRAB symptoms, 20% presented with non-CRAB manifestations, and 6% had both clinical features. Ten categories of non-CRAB manifestations were found, in order of decreasing frequency: neuropathy (because of spinal cord compression, nerve root compression, or peripheral neuropathy), extramedullary involvement, hyperviscosity syndrome, concomitant amyloidosis (eg, nephrotic syndrome or cardiopathy), hemorrhage/coagulopathy, systemic symptoms (eg, fever or weight loss), primary plasma cell leukemia, infections, cryoglobulinemia, and secondary gout. Kaplan-Meier estimates of survival in patients with non-CRAB manifestations did not show a significant difference from the survival of patients presenting with CRAB symptoms. Presenting symptoms of MM may be grouped in a total of 14 categories, 4 for the CRAB and 10 for the less common non-CRAB features. Grouped together, non-CRAB manifestations do not appear to confer a negative effect on the prognosis of patients with MM.

Specific parental depression symptoms as risk markers for new-onset depression in high-risk offspring.

Science.gov (United States)

Mars, Becky; Harold, Gordon T; Elam, Kit K; Sellers, Ruth; Owen, Michael J; Craddock, Nicholas; Thapar, Ajay K; Rice, Frances; Collishaw, Stephan; Thapar, Anita

2013-09-01

To disaggregate the depression construct and investigate whether specific depression symptoms in parents with a history of recurrent depression are clinical risk markers for future depression in their high-risk offspring. Our hypothesis was that parental symptoms of the type that might impact offspring would most likely be of greatest importance. Data were drawn from a longitudinal high-risk family study. Families were mainly recruited from primary care and included 337 parent-child dyads. Parents had a history of recurrent DSM-IV unipolar depression and were aged 26-55 years. Their offspring (197 female and 140 male) were aged 9-17 years. Three assessments were conducted between April 2007 and April 2011. Ninety-one percent of families (n = 305) provided full interview data at baseline and at least 1 follow-up, of which 291 were included in the primary analysis. The main outcome measure was new-onset DSM-IV mood disorder in the offspring, which was assessed using the Child and Adolescent Psychiatric Assessment. Of the 9 DSM-IV depression symptoms, parental change in appetite or weight, specifically loss of appetite or weight, most strongly predicted new-onset mood disorder (odds ratio [OR] = 4.47; 95% CI, 2.04-9.79; P appetite or weight in parents with a history of recurrent depression is a marker of risk for depression in their offspring. The findings highlight the importance of examining depression heterogeneity. The biological and environmental mechanisms underlying this finding require investigation. © Copyright 2013 Physicians Postgraduate Press, Inc.

Depressive symptoms, HIV medication adherence, and HIV clinical outcomes in Tanzania: a prospective, observational study.

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Nadya M Belenky

Full Text Available Depressive symptoms have been shown to independently affect both antiretroviral therapy (ART adherence and HIV clinical outcomes in high-income countries. We examined the prospective relationship between depressive symptoms and adherence, virologic failure, and suppressed immune function in people living with HIV/AIDS in Tanzania. Data from 403 study participants who were on stable ART and engaged in HIV clinical care were analyzed. We assessed crude and adjusted associations of depressive symptoms and ART adherence, both at baseline and at 12 months, using logistic regression. We used logistic generalized estimating equations to assess the association and 95% confidence intervals (CI between depressive symptoms and both virologic failure and suppressed immune function. Ten percent of participants reported moderate or severe depressive symptoms at baseline and 31% of participants experienced virologic failure (>150 copies/ml over two years. Depressive symptoms were associated with greater odds of reported medication nonadherence at both baseline (Odds Ratio [OR] per 1-unit increase = 1.18, 95% CI [1.12, 1.24] and 12 months (OR = 1.08, 95% CI [1.03, 1.14]. By contrast, increases in depressive symptom score were inversely related to both virologic failure (OR = 0.93, 95% CI [0.87, 1.00] and immune system suppression (OR = 0.88, 95% CI [0.79, 0.99], though the association between depressive symptoms and clinical outcomes was less precise than for the association with nonadherence. Findings indicate a positive association between depressive symptoms and nonadherence, and also an inverse relationship between depressive symptoms and clinical outcomes, possibly due to informative loss to follow-up.

Premenstrual symptoms and remedies practiced by Malaysian women attending a rural primary care clinic

Directory of Open Access Journals (Sweden)

Khairani Omar

2009-06-01

Method: This was a cross-sectional study conducted at a rural primary care clinic situated in Hulu Langat, Malaysia. All women of reproductive age (18 to 44 years old attending the clinic during the study period and who fit the selection criteria were included. Premenstrual symptoms and severity were assessed using a self-report questionnaire, the Shortened Premenstrual Assessment Form (SPAF. It consists of 10 items that measure changes in mood, behaviour and physical symptoms. The respondents were also asked if they had used any remedy to relieve their symptoms. Results: A total of 158 women were included in the study. The majority of the respondents were Malay (70.3%, followed by Indian (16.5% and Chinese (10.8% women. About 75% of the women experienced at least one of the premenstrual symptoms. Approximately 7% of them reported experiencing severe symptoms in all three subscales of the SPAF. The frequently reported symptoms were body ache (75.3%, abdominal pain (75.3%, irritable feeling (63.9% and breast discomfort (61.4%. The symptom score was higher among Malay women (p = 0.034, and those with a higher household income (p = 0.037 and higher educational level (p = 0.01. There was no significant association between premenstrual symptoms and age, marital status, menstrual cycle and age of menarche. The common remedies used were vitamins (19%, a healthy diet (15.8% and analgesics (13.3%. Approximately 60% of the women did not use any remedy to reduce their premenstrual symptoms. Conclusion: Premenstrual symptoms were common among women attending the clinic. The symptoms affect them significantly both physically and emotionally. Thus, it is essential for primary care providers to take an active role in identifying, educating and managing premenstrual symptoms among women.

Symptom report in detecting breast cancer-related lymphedema

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Fu MR

2015-10-01

Full Text Available Mei R Fu,1 Deborah Axelrod,2,3 Charles M Cleland,1 Zeyuan Qiu,4 Amber A Guth,2,3 Robin Kleinman,2 Joan Scagliola,2 Judith Haber1 1College of Nursing, New York University, 2Department of Surgery, NYU School of Medicine, 3NYU Clinical Cancer Center, New York, NY, 4Department of Chemistry and Environmental Science, New Jersey Institute of Technology, Newark, NJ, USA Abstract: Breast cancer-related lymphedema is a syndrome of abnormal swelling coupled with multiple symptoms resulting from obstruction or disruption of the lymphatic system associated with cancer treatment. Research has demonstrated that with increased number of symptoms reported, breast cancer survivors' limb volume increased. Lymphedema symptoms in the affected limb may indicate a latent stage of lymphedema in which changes cannot be detected by objective measures. The latent stage of lymphedema may exist months or years before overt swelling occurs. Symptom report may play an important role in detecting lymphedema in clinical practice. The purposes of this study were to: 1 examine the validity, sensitivity, and specificity of symptoms for detecting breast cancer-related lymphedema and 2 determine the best clinical cutoff point for the count of symptoms that maximized the sum of sensitivity and specificity. Data were collected from 250 women, including healthy female adults, breast cancer survivors with lymphedema, and those at risk for lymphedema. Lymphedema symptoms were assessed using a reliable and valid instrument. Validity, sensitivity, and specificity were evaluated using logistic regression, analysis of variance, and areas under receiver operating characteristic curves. Count of lymphedema symptoms was able to differentiate healthy adults from breast cancer survivors with lymphedema and those at risk for lymphedema. A diagnostic cutoff of three symptoms discriminated breast cancer survivors with lymphedema from healthy women with a sensitivity of 94% and a specificity of 97

Perspectives on creating clinically relevant blast models for mild traumatic brain injury and post traumatic stress disorder symptoms

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Lisa eBrenner

2012-03-01

Full Text Available Military personnel are returning from Iraq and Afghanistan and reporting non-specific physical (somatic, behavioral, psychological, and cognitive symptoms. Many of these symptoms are frequently associated with mild traumatic brain injury (mTBI and/or post traumatic stress disorder (PTSD. Despite significant attention and advances in assessment and intervention for these two conditions, challenges persist. To address this, clinically relevant blast models are essential in the full characterization of this type of injury, as well as in the testing and identification of potential treatment strategies. In this publication, existing diagnostic challenges and current treatment practices for mTBI and/or PTSD will be summarized, along with suggestions regarding how what has been learned from existing models of PTSD and traditional mechanism (e.g., non-blast TBI can be used to facilitate the development of clinically relevant blast models.

Rhinovirus-induced VP1-specific Antibodies are Group-specific and Associated With Severity of Respiratory Symptoms

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Katarzyna Niespodziana

2015-01-01

Interpretation: Our results demonstrate that increases of antibodies towards the VP1 N-terminus are group-specific and associated with severity of respiratory symptoms and suggest that it may be possible to develop serological tests for identifying causative RV groups.

Attacking Heterogeneity in Schizophrenia by Deriving Clinical Subgroups From Widely Available Symptom Data.

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Dickinson, Dwight; Pratt, Danielle N; Giangrande, Evan J; Grunnagle, MeiLin; Orel, Jennifer; Weinberger, Daniel R; Callicott, Joseph H; Berman, Karen F

2018-01-13

Previous research has identified (1) a "deficit" subtype of schizophrenia characterized by enduring negative symptoms and diminished emotionality and (2) a "distress" subtype associated with high emotionality-including anxiety, depression, and stress sensitivity. Individuals in deficit and distress categories differ sharply in development, clinical course and behavior, and show distinct biological markers, perhaps signaling different etiologies. We tested whether deficit and distress subtypes would emerge from a simple but novel data-driven subgrouping analysis, based on Positive and Negative Syndrome Scale (PANSS) negative and distress symptom dimensions, and whether subgrouping was informative regarding other facets of behavior and brain function. PANSS data, and other assessments, were available for 549 people with schizophrenia diagnoses. Negative and distress symptom composite scores were used as indicators in 2-step cluster analyses, which divided the sample into low symptom (n = 301), distress (n = 121), and deficit (n = 127) subgroups. Relative to the low-symptom group, the deficit and distress subgroups had comparably higher total PANSS symptoms (Ps symptom, cognitive and personality variables, among others. Initial analyses of functional magnetic resonance imaging (fMRI) data from a 182-participant subset of the full sample also suggested distinct patterns of neural recruitment during working memory. The field seeks more neuroscience-based systems for classifying psychiatric conditions, but these are inescapably behavioral disorders. More effective parsing of clinical and behavioral traits could identify homogeneous target groups for further neural system and molecular studies, helping to integrate clinical and neuroscience approaches. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center 2017.

Association between clinically important depressive symptoms and academic achivement among students in Cartagena, Colombia

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Zuleima Cogollo

2007-06-01

Full Text Available Background: Some studies show a strongassociation between depressive symptoms andacademic achievement in the adolescent population.However, there are few Colombian publicationsabout this topic.Objective: To establish the association betweenclinically important depressive symptoms and academic achievement among low socioeconomicstatus adolescent students.Method: A group of 13 to 17 year-aged adolescentswas studied. Meaningful clinically depressivesymptoms were measured with Zung’self-rating depression scale (40/80. Academicachievement was evaluated according to Colombianqualitative model.Results: A total of 43.5% of students reportedclinically important depressive symptoms and30.7% accomplished a poor academic achievement,according to teacher report. The academicachievement was independent of meaningfulclinically depressive symptoms, after controllingother variables.Conclusion: Meaningful clinically depressivesymptoms are frequent in low socioeconomic statusadolescent students. But, meaningful clinicallydepressive symptoms are not associatedwith academic performance. Further investigationsare needed.

[Network clusters of symptoms as elementary syndromes of psychopathology: implications for clinical practice].

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Goekoop, R; Goekoop, J G

2016-01-01

In a recent publication we reported the existence of around 11 (to 15) 'elementary syndromes' that may combine in various ways, rather like 'building blocks', to explain the wide range of psychiatric symptoms. 'Bridge symptoms' seem to be responsible both for combining large sets of symptoms into elementary syndromes and for combining the various elementary syndromes to form one globally connected network structure. To discuss the implication of these findings for clinical practice. We performed a network analysis of symptom scores. Elementary syndromes provide a massive simplification of the description of psychiatric disease. Instead of the more than 300 categories in DSM-5, we now need to consider only a handful of elementary syndromes and personality domains. This modular representation of psychiatric illnesses allows us to make a complete, systematic and efficient assessment of patients and a systematic review of treatment options. Clinicians, patients, managerial staff and insurance companies can verify whether symptom reduction is taking place in the most important domains of psychopathology. Unlike classic multidimensional methods of disease description, network models of psychopathology can be used to explain comorbidity patterns, predict the clinical course of psychopathology and to designate primary targets for therapeutic interventions. A network view on psychopathology could significantly improve everyday clinical practice.

Practical clinical tool to monitor dementia symptoms: the HABC-Monitor

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Monahan PO

2012-06-01

Full Text Available Patrick O Monahan,1 Malaz A Boustani,1–3,6 Catherine Alder,2,3,6 James E Galvin,7 Anthony J Perkins,2,3 Patrick Healey,4 Azita Chehresa,5 Polly Shepard,8 Corby Bubp,8 Amie Frame,2,3 Chris Callahan1–3,61Indiana University School of Medicine, 2Indiana University Center for Aging Research, 3Regenstrief Institute Inc, 4St Vincent’s Health Network, 5Community Health Network, 6Wishard Health Services, Eskenazi Health, Indianapolis IN, 7Alzheimer Disease Center, Departments of Neurology and Psychiatry, New York University School of Medicine, New York, NY, 8Memory Clinic of Indianapolis, Indianapolis, IN, USABackground: Dementia care providers need a clinical assessment tool similar to the blood pressure cuff (sphygmomanometer used by clinicians and patients for managing hypertension. A “blood pressure cuff” for dementia would be an inexpensive, simple, user-friendly, easily standardized, sensitive to change, and widely available multidomain instrument for providers and informal caregivers to measure severity of dementia symptoms. The purpose of this study was to assess the reliability and validity of the Healthy Aging Brain Care Monitor (HABC-Monitor for measuring and monitoring the severity of dementia symptoms through caregiver reports.Methods: The first prototype of the HABC-Monitor was developed in collaboration with the Indianapolis Discovery Network for Dementia, which includes 200 members representing 20 disciplines from 20 local organizations, and an expert panel of 22 experts in dementia care and research. The HABC-Monitor has three patient symptom domains (cognitive, functional, behavioral/psychological and a caregiver quality of life domain. Patients (n = 171 and their informal caregivers (n = 171 were consecutively approached and consented during, or by phone shortly following, a patient’s routine visit to their memory care provider.Results: The HABC-Monitor demonstrated good internal consistency (0.73–0.92; construct validity

Predicting clinical symptoms of attention deficit hyperactivity disorder based on temporal patterns between and within intrinsic connectivity networks.

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Wang, Xun-Heng; Jiao, Yun; Li, Lihua

2017-10-24

Attention deficit hyperactivity disorder (ADHD) is a common brain disorder with high prevalence in school-age children. Previously developed machine learning-based methods have discriminated patients with ADHD from normal controls by providing label information of the disease for individuals. Inattention and impulsivity are the two most significant clinical symptoms of ADHD. However, predicting clinical symptoms (i.e., inattention and impulsivity) is a challenging task based on neuroimaging data. The goal of this study is twofold: to build predictive models for clinical symptoms of ADHD based on resting-state fMRI and to mine brain networks for predictive patterns of inattention and impulsivity. To achieve this goal, a cohort of 74 boys with ADHD and a cohort of 69 age-matched normal controls were recruited from the ADHD-200 Consortium. Both structural and resting-state fMRI images were obtained for each participant. Temporal patterns between and within intrinsic connectivity networks (ICNs) were applied as raw features in the predictive models. Specifically, sample entropy was taken asan intra-ICN feature, and phase synchronization (PS) was used asan inter-ICN feature. The predictive models were based on the least absolute shrinkage and selectionator operator (LASSO) algorithm. The performance of the predictive model for inattention is r=0.79 (p<10 -8 ), and the performance of the predictive model for impulsivity is r=0.48 (p<10 -8 ). The ICN-related predictive patterns may provide valuable information for investigating the brain network mechanisms of ADHD. In summary, the predictive models for clinical symptoms could be beneficial for personalizing ADHD medications. Copyright © 2017 IBRO. Published by Elsevier Ltd. All rights reserved.

Specificity of posttraumatic stress disorder symptoms: an investigation of comorbidity between posttraumatic stress disorder symptoms and depression in treatment-seeking veterans.

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Gros, Daniel F; Simms, Leonard J; Acierno, Ron

2010-12-01

In response to high levels of comorbidity and symptom overlap between posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and other disorders, much attention has been devoted to the role of specific and nonspecific symptoms among the disorders. The present study investigated the overlapping symptoms of PTSD and MDD in treatment-seeking veterans. Exploratory factor analyses were used to identify latent factors of both self-reported and clinician-rated symptoms of PTSD and MDD. Results of exploratory factor analyses supported a 2-factor model representing symptoms of depression and PTSD; however, a subset of PTSD symptoms, characterized by emotional numbing and dysphoria, loaded onto the depression factor, rather than the PTSD factor. These nonspecific PTSD symptoms were predictive of comorbid MDD and increased depression symptomatology in patients with PTSD. Together, these findings demonstrate the importance of accounting for nonspecific symptoms in diagnosis and treatment of PTSD, highlighting a need for revisions to our current diagnostics.

Subscales measuring symptoms of non-specific depression, anhedonia, and anxiety in the Edinburgh Postnatal Depression Scale.

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Tuohy, Alan; McVey, Cynthia

2008-06-01

There has been considerable research and clinical interest in the comorbidity of anxiety and depression in the post-partum period, and specifically in the possibility that the commonly used Edinburgh Postnatal Depression Scale (EPDS) incorporates an anxiety component. We hypothesized that the recommended version of factor analysis (Fabrigar, Wegener, MacCallum, & Strahan, 1999) would identify such covert dimensions more reliably than the commonly used principal components analysis with varimax rotation and eigenvalues greater than 1. Principal axis factor extraction with parallel analysis and oblique (direct quartimin) factor rotation was applied to the 10 EPDS items. The study used a sample of recent mothers recruited and assessed via e-mail and the Internet (N=440). In addition to the EPDS, the Hospital Anxiety and Depression Scale (HADS) and the Positive and Negative Affect Scales (PANAS) were also administered. Three factors were found, which were identified as 'non-specific depressive symptoms', 'anhedonia', and 'anxietal symptoms' subscales, respectively. These subscales were regressed on the HADS anxiety and depression and the PANAS positive and negative affectivity scales, with results substantially consistent with current structural models of the taxonomy of the emotional disorders. The data were obtained from a self-selected non-clinical sample. In addition, it is known that the use of computer-based assessment may tend to inflate self-report scores. It was concluded that there is now sufficient evidence that clinicians should not assume the EPDS to be unidimensional, but should assess all three subscales when screening for susceptibility to post-partum depression and/or post-partum anxiety.

The relationship between dysfunctional family patterns and symptom severity among adolescent patients with eating disorders: A gender-specific approach.

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Anastasiadou, Dimitra; Sepulveda, Ana R; Parks, Melissa; Cuellar-Flores, Isabel; Graell, Montserrat

2016-01-01

The objective of the authors in this study was to identify factors related to dysfunctional family functioning that may be associated with the severity of symptoms among adolescent patients with an eating disorder (ED) at first-contact care. A total of forty-eight mothers and forty-five fathers of fifty patients with EDs were recruited from an ED unit in Madrid, Spain, between October 2011 and July 2012. Parents completed self-report assessments related to family functioning and psychological wellbeing. Patients went through clinical interviews and completed a self-report questionnaire assessing symptom severity. Compared to fathers, mothers showed higher levels of anxiety and emotional over-involvement and perceived to a greater degree the positive and negative aspects of their experience as caregivers. Regarding the relationship between family functioning and symptom severity, mothers' perceptions of their family relationships as enmeshed and less adaptive, along with anxiety, accounted for 39% of variance in the severity of ED symptoms. Anxiety and symptom accommodation by the fathers accounted for 27% of variance in the symptom severity. Interventions that help parents to cope with their caregiving role should target behavioral, cognitive, and emotional aspects of their functioning and be gender-specific, to improve the outcome of ED in patients.

Clinical Validity of the Counseling Center Assessment of Psychological Symptoms-62 (CCAPS-62): Further Evaluation and Clinical Applications

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McAleavey, Andrew A.; Nordberg, Samuel S.; Hayes, Jeffrey A.; Castonguay, Louis G.; Locke, Benjamin D.; Lockard, Allison J.

2012-01-01

Self-report instruments of psychological symptoms are increasingly used in counseling centers but rely on rigorous evaluation of their clinical validity. Three studies reported here (total N = 26,886) investigated the validity of the Counseling Center Assessment of Psychological Symptoms-62 (CCAPS-62; Locke et al., 2011) as an assessment and…

Ethnic variations regarding clinical profiles and symptom representation in prisoners with psychotic disorders.

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Denzel, A Dorina; Harte, Joke M; van den Bergh, Mattis; Scherder, Erik J A

2018-01-01

Black and minority ethnic (BME) groups are known to have higher prevalences of psychotic disorders and are over-represented in western penitentiaries and forensic psychiatric institutions. Research from regular mental healthcare settings suggests that they could show different and more severe psychotic symptoms. Aims To explore ethnic variations in severity of symptomatology of BME and non-BME detainees with psychotic disorders. In this study, 824 patients with psychotic disorders from seven different ethnic groups, imprisoned in a penitentiary psychiatric centre in the Netherlands, were compared on symptom severity and symptom representation using the BPRS-E clinical interview. Data were analysed by means of a multilevel analysis. BME patients with psychotic disorders are over-represented in forensic psychiatry, and symptom profiles of prisoners with psychotic disorders vary by ethnicity. Additionally, severity levels of overall psychopathology differ between ethnic groups: patients with an ethnic majority status show more severe levels of psychopathology compared with BME patients. There are differences in symptom severity and symptom profiles between BME patients and non-BME patients. Disregarding these differences could have an adverse effect on the outcome of the treatment. Possible explanations and clinical impact are discussed. Declaration of interest None.

Spontaneous esophageal rupture - Boerhaave's syndrome: Clinical symptoms and radiographic findings

International Nuclear Information System (INIS)

Gaa, J.; Deininger, H.K.

1989-01-01

Spontaneous transmural rupture of the esophagus (Boerhaave's syndrome) is a life-threatening emergency. Prompt diagnosis is essential to a better prognosis, successful operative outcome and patient survival. The chest roentgenogram and the contrast esophagograms to follow are the most helpful diagnostic tests. The clinical manifestations are variable and may be misleading and thus delay accurate recognition. In our case report the major clinical features and radiological signs of Boerhaave's syndrome are described. The pathogenesis, characteristic clinical symptoms and the signs and radiological evaluation are reviewed. (orig.) [de

Preoperative and postoperative evaluation of clinical symptoms of cervical myelopathy

International Nuclear Information System (INIS)

Ito, Tomokazu; Oshima, Yoshihiko; Ota, Yoshio

1993-01-01

To evaluate the clinical significance of signal changes on T2-weighted magnetic resonance (MR) images in myelopathy, the relationship between characteristics of clinical symptoms and postoperative recovery was examined. The subjects were a total of 52 patients (37 men and 15 women) with cervical myelopathy (n=44) or ossification of the posterior longitudinal ligament (n=8), who underwent extended surgery of Yamagata University's style. They ranged in age from 33 to 81 years (mean, 60.8). The degree of spinal compression and signal changes in the spinal cord were classified on T1-weighted and T2-weighted sagittal images, respecstively. Hyperintense on T2-weighted images tended to be associated with lower preoperative JOA's scores especially for exercise, legs and bladder or rectum function, as compared with isointense. T2-weighted images seemed to reflect, to some degree, the severity of preoperative clinical symptoms. For the rate of postoperative improvement, however, there was no significant difference between the hyperintense and isointense groups on T2-weighted images. (N.K.)

Caregivers’ resilience is independent from the clinical symptoms of dementia

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Rachel Dias

Full Text Available ABSTRACT Resilience is the capacity for successful adaptation when faced with the stress of adversity. We aimed to investigate the relationship between caregivers’ resilience and the sociodemographic and clinical factors of people with dementia. Cross-sectional assessment of 58 people with dementia and their caregiver dyads showed that most caregivers were female adult children. The caregivers reported moderate to higher levels of resilience, lower levels of anxiety and depressive symptoms and moderate levels of burden. Resilience was not related to the caregiver’s gender (p = 0.883, nor clinical (p = 0.807 or emotional problems (p = 0.420. The regression showed that resilience was related to the caregiver’s quality of life (p < 0.01 and inversely associated with their depressive symptoms (p < 0.01. There was no relationship between caregivers’ resilience and the sociodemographic and clinical characteristics of people with dementia. We can assume that resilience is an individual characteristic. Support groups should also focus on the factors that may increase resilience among caregivers.

Treating prolonged symptoms of mild traumatic brain injury: neuropharmacology.

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Lercher, Kirk; Camiolo Reddy, Cara

2014-01-01

The clinical presentation of concussion can vary widely as patients experience any number of symptoms including headache, dizziness, cognitive symptoms of difficulty with concentration and memory, sleep dysregulation, and mood disturbances. The variability in clinical presentation underscores the importance of thorough history-taking to clearly understand the clinical picture and to allow individualization of the treatment plan. Most postconcussive symptoms are transient in nature and respond to conservative measures, including education of the patient and their caregivers. For those individuals whose symptoms persist or significantly impair quality of life, pharmacologic intervention may be warranted. Though few studies have investigated the use of pharmacology for treatment of postconcussion syndrome specifically, targeted treatment of medications known to improve selected symptoms can be considered. © 2014 S. Karger AG, Basel.

[Negative symptoms of schizophrenia: historical aspects].

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Pringuey, D; Paquin, N; Cherikh, F; Giordana, B; Belzeaux, R; Cermolacce, M; Adida, M; Azorin, J-M

2015-12-01

The history of negative symptoms of schizophrenia rises early days of medicine in clinical and pathophysiological differences between positive and negative and their complex joint. Forming a set of typical core of symptoms, and some feature of a syndrome belonging to a specific pathophysiological mechanism, negative symptoms of schizophrenia emerge from old descriptions of clinical pictures, related to the overall look of madness, the heart of alienation, a central sign of early dementia, gradually more precisely describing the strange nature of the autistic withdrawal and schizophrenic apragmatism. At therapeutic era, negative symptoms have taken over the positive symptoms to establish an operational criteria whose importance lies in the progressive severity of this clinical type and in their contribution to therapeutic resistance. Despite the efforts of modern typological classifications, this work rehabilitates the old concept of "unitary psychosis" by defining a common symptomatic core to multiple clinical forms of psychosis, combining deficit of emotional expression and avolition, meaning a native psychopathology and a pathophysiology possibly in a common final way, and calling the arrival of new treatment strategies. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Age-specific symptom prevalence in women 35–64 years old: A population-based study

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Wedel Hans

2009-01-01

Full Text Available Abstract Background Symptom prevalence is generally believed to increase with age. The aim of this study was to evaluate the age specific prevalence of 30 general symptoms among Swedish middle-aged women. Methods A cross-sectional postal questionnaire study in seven Swedish counties in a random sample of 4,200 women 35–64 years old, with 2,991 responders. Thirty general symptoms included in the Complaint Score subscale of the Gothenburg Quality of Life Instrument were used. Results Four groups of age specific prevalence patterns were identified after adjustment for the influence of educational level, perceived health and mood, body mass index, smoking habits, use of hormone replacement therapy, and use of other symptom relieving therapy. Only five symptoms (insomnia, leg pain, joint pain, eye problems and impaired hearing increased significantly with age. Eleven symptoms (general fatigue, headache, irritability, melancholy, backache, exhaustion, feels cold, cries easily, abdominal pain, dizziness, and nausea decreased significantly with age. Two symptoms (sweating and impaired concentration had a biphasic course with a significant increase followed by a significant decrease. The remaining twelve symptoms (difficulty in relaxing, restlessness, overweight, coughing, breathlessness, diarrhoea, chest pain, constipation, nervousness, poor appetite, weight loss, and difficulty in urinating had stable prevalence with age. Conclusion Symptoms did not necessarily increase with age instead symptoms related to stress-tension-depression decreased.

Comorbidity variation in patients with obsessive-compulsive disorder according to symptom dimensions: Results from a large multicentre clinical sample.

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Torres, Albina R; Fontenelle, Leonardo F; Shavitt, Roseli G; Ferrão, Ygor A; do Rosário, Maria Conceição; Storch, Eric A; Miguel, Euripedes C

2016-01-15

Obsessive-compulsive disorder (OCD) has a heterogeneous and complex phenomenological picture, characterized by different symptom dimensions and comorbid psychiatric disorders, which frequently co-occur or are replaced by others over the illness course. To date, very few studies have investigated the associations between specific OCD symptom dimensions and comorbid disorders. Cross-sectional, multicenter clinical study with 1001 well-characterized OCD patients recruited within the Brazilian Research Consortium on Obsessive-Compulsive and Related Disorders. The primary instruments were the Dimensional Yale-Brown Obsessive Compulsive Scale (DY-BOCS) and the Structured Clinical Interview for DSM-IV Axis I Disorders. Bivariate analyses between symptom dimensions and comorbidities were followed by logistic regression. The most common comorbidities among participants (56.8% females) were major depression (56.4%), social phobia (34.6%), generalized anxiety disorder (34.3%), and specific phobia (31.4%). The aggressive dimension was independently associated with posttraumatic stress disorder (PTSD), separation anxiety disorder, any impulse-control disorder and skin picking; the sexual-religious dimension was associated with mood disorders, panic disorder/agoraphobia, social phobia, separation anxiety disorder, non-paraphilic sexual disorder, any somatoform disorder, body dysmorphic disorder and tic disorders; the contamination-cleaning dimension was related to hypochondriasis; and the hoarding dimension was associated with depressive disorders, specific phobia, PTSD, impulse control disorders (compulsive buying, skin picking, internet use), ADHD and tic disorders. The symmetry-ordering dimension was not independently associated with any comorbidity. Cross-sectional design; participants from only tertiary mental health services; personality disorders not investigated. Different OCD dimensions presented some specific associations with comorbid disorders, which may influence

Hepatitis A - frequency in children with non-specific abdominal symptoms

International Nuclear Information System (INIS)

Malik, R.; Ghafoor, T.; Sarfraz, M.; Hasan, N.

2004-01-01

Objective: To study the frequency of subclinical hepatitis 'A' in children having non-specific abdominal symptoms. Subjects and Methods: Three hundred and sixty children of either gender, < 12 years of age, presenting with vague abdominal symptoms and no jaundice were evaluated for hepatitis. Eighty-eight (24.4%) children meeting the inclusion criteria of elevated serum alanine aminotransferase (ALT), twice the upper limits of normal (90 IU/L), and normal serum bilirubin were labeled as subclinical hepatitis. Results: A total of 360 children were evaluated for vague abdominal symptoms and 96 (26.7%) of them had hepatitis on laboratory profile. Eight patients developed early jaundice and were excluded from the study. Out of 88 (24.4%) cases of subclinical hepatitis, 82 (93.2%) had hepatitis-A, 03 (3.4%) had hepatitis-B, while no causative agent was found in 03 (3.4%) children. The common presenting symptoms were abdominal pain/discomfort, loss of appetite, nausea, vomiting, malaise, fatigue and fever. Hepatomegaly and splenomegaly was documented in 56% and 43% cases respectively. A history of exposure to a patient with hepatitis was present in 14/88 (15.9%) cases whereas no child was vaccinated against HAV. Serum ALT level declined to normal limits within 4 weeks for 77/88 (87.5%) cases and within 6 weeks for 84/88 (95.4%). All cases recovered spontaneously with out any complication. Conclusion: Hepatitis-A was rampant in children presenting with vague abdominal symptoms in our series. (author)

Testing Specificity: Associations of Stress and Coping with Symptoms of Anxiety and Depression in Youth

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Bettis, Alexandra H.; Forehand, Rex; McKee, Laura; Dunbar, Jennifer P.; Watson, Kelly H.; Compas, Bruce E.

2015-01-01

Research has documented the co-occurrence of symptoms of anxiety and depression across the lifespan, suggesting that these symptoms share common correlates and etiology. The present study aimed to examine potential specific and/or transdiagnostic correlates of symptoms of anxiety and depression in at-risk youth. The present study examined youth stress associated with parental depression and youth coping as potential correlates of symptoms of anxiety and depression in a sample of children of d...

Nasal symptoms and clinical findings in adult patients treated for unilateral cleft lip and palate.

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Morén, Staffan; Mani, Maria; Lundberg, Kristina; Holmström, Mats

2013-10-01

The aim of the study was to investigate self-experienced nasal symptoms among adults treated for UCLP and the association to clinical findings, and to evaluate whether palate closure in one-stage or two-stages affected the symptoms or clinical findings. All people with UCLP born between 1960-1987, treated at Uppsala University Hospital, were considered for participation in this cross-sectional population study with long-term follow-up. Eighty-three patients (76% participation rate) participated, a mean of 37 years after the first operation. Fifty-two patients were treated with one-stage palate closure and 31 with two-stage palate closure. An age-matched group of 67 non-cleft controls completed the same study protocol, which included a questionnaire regarding nasal symptoms, nasal inspection, anterior rhinoscopy, and nasal endoscopy. Patients reported a higher frequency of nasal symptoms compared with the control group, e.g., nasal obstruction (81% compared with 60%) and mouth breathing (20% compared with 5%). Patients also rated their nasal symptoms as having a more negative impact on their daily life and physical activities than controls. Nasal examination revealed higher frequencies of nasal deformities among patients. No positive correlation was found between nasal symptoms and severity of findings at nasal examination. No differences were identified between patients treated with one-stage and two-stage palate closure regarding symptoms or nasal findings. Adult patients treated for UCLP suffer from more nasal symptoms than controls. However, symptoms are not associated with findings at clinical nasal examination or method of palate closure.

Clinical anxiety, cortisol and interleukin-6: evidence for specificity in emotion-biology relationships.

LENUS (Irish Health Repository)

O'Donovan, Aoife

2012-02-01

Anxiety confers increased risk for inflammatory diseases, and elevated inflammatory activity in anxious individuals may contribute to this increased risk. One complication, however, is that anxiety could be associated with inflammatory activity either through a specific anxiety pathway or through a more general negative emotionality pathway. To investigate, we measured levels of the stress hormone cortisol, the pro-inflammatory cytokine interleukin-6 (IL-6), and the systemic inflammatory marker C-reactive protein (CRP), as well as depression and neuroticism, in clinically anxious and non-anxious adults. Compared with non-anxious participants, clinically anxious participants exhibited significantly lower levels of morning cortisol and significantly higher levels of IL-6, independent of age, sex, and depressive symptoms. These group differences were robust when controlling for neuroticism. Conversely, the groups had equivalent levels of CRP in all analyses. Results are indicative of anxiety-specific effects on inflammatory activity, and highlight a pathway by which anxiety may increase risk for inflammatory diseases.

Do specific early-life adversities lead to specific symptoms of psychosis? A study from the 2007 the Adult Psychiatric Morbidity Survey.

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Bentall, Richard P; Wickham, Sophie; Shevlin, Mark; Varese, Filippo

2012-06-01

Previous studies have reported associations between childhood adversities, eg, loss of a parent, being raised in institutional care, sexual and other kinds of abuse by adults and bullying by peers, and psychosis in adulthood. However, the mechanisms by which these adversities lead to psychotic experiences are poorly understood. From models of the psychological processes involved in positive symptoms, it was predicted that childhood sexual abuse would be specifically associated with auditory hallucinations in adulthood, and that disruption of early attachment relations and more chronic forms of victimization such as bullying would be specifically associated with paranoid ideation. We therefore examined the associations between sexual trauma, physical abuse, bullying, and being brought up in institutional or local authority care and reports of auditory hallucinations and paranoid beliefs in the 2007 Adult Psychiatric Morbidity Survey. All simple associations between childhood adversities and the two symptom types were significant. Childhood rape was associated only with hallucinations (OR 8.9, CI = 1.86-42.44) once co-occurring paranoia was controlled for. Being brought up in institutional care (OR = 11.08, CI = 3.26-37.62) was specifically associated with paranoia once comorbid hallucinations had been controlled for. For each symptom, dose-response relationships were observed between the number of childhood traumas and the risk of the symptom. The specific associations observed are consistent with current psychological theories about the origins of hallucinations and paranoia. Further research is required to study the psychological and biological mediators of these associations.

Time to improve and recover from depressive symptoms and interpersonal problems in a clinical trial.

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Lopes, Rodrigo T; Gonçalves, Miguel M; Fassnacht, Daniel; Machado, Paulo P P; Sousa, Inês

2015-01-01

Results from an earlier clinical trial comparing narrative therapy with cognitive-behavioural therapy (Lopes et al., 2013) suggested that narrative therapy is efficacious for depression. However, there were significant differences in symptom reduction on the Beck Depression Inventory-II, favouring cognitive-behavioural therapy, if dropouts were included in the analysis, suggesting that time to recovery or improvement would differ in both treatments. Contrarily, results showed that treatment assignment was not a predictor for differential effect. Using a survival analytic approach, it was found that four sessions were necessary for 50% improvement and 16 sessions for 50% recovery. Additionally, depressive symptoms changes occurred significantly faster than interpersonal changes, again regardless of treatment assignment. These results support previous findings of the dose-response literature and of the phase model of change, with the advantage of being specific to psychotherapy with depressive clients. Copyright © 2013 John Wiley & Sons, Ltd.

Schizophrenia-like symptoms in narcolepsy type 1: shared and distinctive clinical characteristics.

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Plazzi, Giuseppe; Fabbri, Chiara; Pizza, Fabio; Serretti, Alessandro

2015-01-01

The occurrence of psychotic symptoms in narcolepsy type 1 (NT1) has been reported as responsible for delayed diagnosis due to the misdiagnosis of schizophrenia. This study aimed to identify shared and distinctive clinical characteristics between NT1 and schizophrenia, with the focus on psychotic symptoms. A total of 28 NT1 and 21 schizophrenia patients were included. Hallucination characteristics and PANSS (Positive and Negative Syndrome Scale), HRSD (Hamilton Rating Scale for Depression), DES (Dissociative Experiences Scale), and STAI (State-Trait Anxiety Inventory) scores were collected. Symptom overlap was investigated by χ(2), Fisher's or t tests and multiple logistic regression models. Hallucinations and illusions frequently occurred in both diseases. Unimodal hallucinations were more common in schizophrenia (p = 6.30e-07) and multimodal hallucinations in NT1, but no clear difference was identified in their sensory modality. Hypnagogic/hypnopompic hallucinations were typical of NT1 (p = 5.22e-07), and 25% of NT1 patients exhibited some degree of insight deficit. Hypnagogic/hypnopompic hallucinations, unimodal hallucinations and PANSS score were the most distinctive clinical characteristics. Clinical overlap was found in the dissociative and anxiety domains, while higher depressive scores were observed in schizophrenia. The overlap between NT1 and schizophrenia should be further investigated under a clinical and pathogenetic point of view to improve diagnostic and therapeutic approaches. © 2015 S. Karger AG, Basel.

Initial development and preliminary validation of a new negative symptom measure: the Clinical Assessment Interview for Negative Symptoms (CAINS).

Science.gov (United States)

Forbes, Courtney; Blanchard, Jack J; Bennett, Melanie; Horan, William P; Kring, Ann; Gur, Raquel

2010-12-01

As part of an ongoing scale development process, this study provides an initial examination of the psychometric properties and validity of a new interview-based negative symptom instrument, the Clinical Assessment Interview for Negative Symptoms (CAINS), in outpatients with schizophrenia or schizoaffective disorder (N = 37). The scale was designed to address limitations of existing measures and to comprehensively assess five consensus-based negative symptoms: asociality, avolition, anhedonia (consummatory and anticipatory), affective flattening, and alogia. Results indicated satisfactory internal consistency reliability for the total CAINS scale score and promising inter-rater agreement, with clear areas identified in need of improvement. Convergent validity was evident in general agreement between the CAINS and alternative negative symptom measures. Further, CAINS subscales significantly correlated with relevant self-report emotional experience measures as well as with social functioning. Discriminant validity of the CAINS was strongly supported by its small, non-significant relations with positive symptoms, general psychiatric symptoms, and depression. These preliminary data on an early beta-version of the CAINS provide initial support for this new assessment approach to negative symptoms and suggest directions for further scale development. Copyright © 2010 Elsevier B.V. All rights reserved.

Effect of silodosin on specific urinary symptoms associated with benign prostatic hyperplasia: analysis of international prostate symptom scores in 2 phase III clinical studies

Directory of Open Access Journals (Sweden)

Lawrence A Hill

2010-12-01

Full Text Available Marc C Gittelman1, Leonard S Marks2, Lawrence A Hill3, Weining Volinn3, Gary Hoel31South Florida Medical Research, Aventura, Florida, USA; 2University of California at Los Angeles and Urological Sciences Research Foundation, Los Angeles, California, USA; 3Watson Laboratories, Salt Lake City, Utah, USAPurpose: Pooled results from 2 randomized, placebo-controlled, US phase III studies (NCT00224107, NCT00224120 showed that silodosin, a uroselective α-blocker, significantly improved International Prostate Symptom Scores (IPSS in men with symptomatic benign prostatic hyperplasia (BPH. This analysis evaluated the effect of silodosin on each symptom assessed by IPSS questionnaire.Materials and methods: Study participants (N = 923 were men aged ≥50 years with IPSS ≥13 and Qmax 4–15 mL/s. They received silodosin 8 mg or placebo once daily for 12 weeks. Patient responses to 7 IPSS questions were collected at weeks 0 (baseline, 0.5, 1, 2, 4, and 12 and scored on a 6-point scale. Efficacy of silodosin versus placebo was assessed by analysis of covariance.Results: For each symptom, the 2 treatment groups had similar mean baseline scores. Decrease in score from baseline (mean ± standard deviation to last observation was significantly greater with silodosin than with placebo for all symptoms (P < 0.005; symptom improvement with silodosin (versus placebo was greatest for weak stream (silodosin, -1.1 ± 1.4 versus placebo, -0.5 ± 1.2; P < 0.0001 and smallest for nocturia (silodosin, -0.6 ± 1.1 versus placebo, -0.4 ± 1.2; P = 0.0037. Compared with placebo, silodosin significantly improved nocturia within 1 week (silodosin, -0.5 ± 1.07 versus placebo, -0.3 ± 1.05; P = 0.009 and all other symptoms within 3 to 4 days (P < 0.01.Conclusions: Silodosin significantly improved all BPH-associated symptoms assessed by IPSS questionnaire within the first week of treatment. All improvements were maintained over the 12-week study period.Keywords: BPH, symptoms

Demographic and clinical correlates of autism symptom domains and autism spectrum diagnosis

OpenAIRE

Frazier, Thomas W; Youngstrom, Eric A; Embacher, Rebecca; Hardan, Antonio Y; Constantino, John N; Law, Paul; Findling, Robert L; Eng, Charis

2013-01-01

Demographic and clinical factors may influence assessment of autism symptoms. This study evaluated these correlates and also examined whether social communication and interaction and restricted/repetitive behavior provided unique prediction of autism spectrum disorder diagnosis. We analyzed data from 7352 siblings included in the Interactive Autism Network registry. Social communication and interaction and restricted/repetitive behavior symptoms were obtained using caregiver-reports on the So...

Respiratory symptoms in insect breeders.

Science.gov (United States)

Harris-Roberts, J; Fishwick, D; Tate, P; Rawbone, R; Stagg, S; Barber, C M; Adisesh, A

2011-08-01

A number of specialist food suppliers in the UK breed and distribute insects and insect larvae as food for exotic pets, such as reptiles, amphibians and invertebrates. To investigate the extent of work-related (WR) symptoms and workplace-specific serum IgE in workers potentially exposed to a variety of biological contaminants, including insect and insect larvae allergens, endotoxin and cereal allergens at a UK specialist insect breeding facility. We undertook a study of respiratory symptoms and exposures at the facility, with subsequent detailed clinical assessment of one worker. All 32 workers were assessed clinically using a respiratory questionnaire and lung function. Eighteen workers consented to provide serum for determination of specific IgE to workplace allergens. Thirty-four per cent (11/32) of insect workers reported WR respiratory symptoms. Sensitization, as judged by specific IgE, was found in 29% (4/14) of currently exposed workers. Total inhalable dust levels ranged from 1.2 to 17.9 mg/m(3) [mean 4.3 mg/m(3) (SD 4.4 mg/m(3)), median 2.0 mg/m(3)] and endotoxin levels of up to 29435 EU/m(3) were recorded. Exposure to organic dusts below the levels for which there are UK workplace exposure limits can result in respiratory symptoms and sensitization. The results should alert those responsible for the health of similarly exposed workers to the potential for respiratory ill-health and the need to provide a suitable health surveillance programme.

Relations between behavioral inhibition, big five personality factors, and anxiety disorder symptoms in non-clinical and clinically anxious children

NARCIS (Netherlands)

L.J. Vreeke (Leonie); P.E.H.M. Muris (Peter)

2012-01-01

textabstractThis study examined the relations between behavioral inhibition, Big Five personality traits, and anxiety disorder symptoms in non-clinical children (n = 147) and clinically anxious children (n = 45) aged 6-13 years. Parents completed the Behavioral Inhibition Questionnaire-Short Form,

Effects of Ramadan fasting on spirometric values and clinical symptoms in asthmatic patients

Directory of Open Access Journals (Sweden)

Abdolreza Norouzy

2013-03-01

Full Text Available Introduction: Ramadan is the 9th  Islamic lunar month during which Muslims avoid eating and drinking from sunrise to sunset.  The effect of Ramadan intermittent fasting on asthma control is controversial.  The aim of this study was to investigate the effects of Ramadan fasting on the spirometric variables and clinical symptoms on well-controlled asthmatic patients during Ramadan. Material and Methods: a cohort study was conducted in Mashhad, Khorasan Razavi, Iran. Twenty-nine (19 females and 10 males well-controlled asthmatic patients aged 47 (12 years completed the study.  The average duration of fasting was 26.5 days. Assessment of spirometric variables (daily peak expiratory flow, peak expiratory flow variability, peak expiratory flow home monitoring as well as asthma clinical symptoms including dyspnea, cough, wheezing, and chest tightness were carried out. Results: No significant changes in clinical symptoms were reported in asthmatic patients at the end of Ramadan fasting.  Among spirometric variables, only peak expiratory flow improved after Ramadan (p

Specificity of genetic and environmental risk factors for symptoms of cannabis, cocaine, alcohol, caffeine, and nicotine dependence.

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Kendler, Kenneth S; Myers, John; Prescott, Carol A

2007-11-01

Although genetic risk factors have been found to contribute to dependence on both licit and illicit psychoactive substances, we know little of how these risk factors interrelate. To clarify the structure of genetic and environmental risk factors for symptoms of dependence on cannabis, cocaine, alcohol, caffeine, and nicotine in males and females. Lifetime history by structured clinical interview. General community. Four thousand eight hundred sixty-five members of male-male and female-female pairs from the Virginia Adult Twin Study of Psychiatric and Substance Use Disorders. Main Outcome Measure Lifetime symptoms of abuse of and dependence on cannabis, cocaine, alcohol, caffeine, and nicotine. Controlling for greater symptom prevalence in males, genetic and environmental parameters could be equated across sexes. Two models explained the data well. The best-fit exploratory model contained 2 genetic factors and 1 individual environmental factor contributing to all substances. The first genetic factor loaded strongly on cocaine and cannabis dependence; the second, on alcohol and nicotine dependence. Nicotine and caffeine had high substance-specific genetic effects. A confirmatory model, which also fit well, contained 1 illicit drug genetic factor--loading only on cannabis and cocaine--and 1 licit drug genetic factor loading on alcohol, caffeine, and nicotine. However, these factors were highly intercorrelated (r = + 0.82). Large substance-specific genetic effects remained for nicotine and caffeine. The pattern of genetic and environmental risk factors for psychoactive substance dependence was similar in males and females. Genetic risk factors for dependence on common psychoactive substances cannot be explained by a single factor. Rather, 2 genetic factors-one predisposing largely to illicit drug dependence, the other primarily to licit drug dependence-are needed. Furthermore, a large proportion of the genetic influences on nicotine and particularly caffeine dependence

Mental and somatic symptoms related to suicidal ideation in patients visiting a psychosomatic clinic in Japan

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Kouichi Yoshimasu

2009-08-01

Full Text Available Kouichi Yoshimasu1, Tetsuya Kondo2,4, Shoji Tokunaga3, Yoshio Kanemitsu2, Hideyo Sugahara2, Mariko Akamine2, Kanichiro Fujisawa2, Kazuhisa Miyashita1, Chiharu Kubo21Department of Hygiene, School of Medicine, Wakayama Medical University, Wakayama, Japan; 2Department of Psychosomatic Medicine, Graduate school of Medical Sciences, Kyushu University, Fukuoka, Japan; 3Department of Medical Informatics, Kyushu University Hospital, Fukuoka, Japan; 4Department of Acupuncture and Moxibustion, Kansai University of Health Sciences, Osaka, JapanAbstract: Patients with suicidal ideation (SI have various mental or somatic symptoms. A questionnaire-based interview elicited details concerning mental and somatic symptoms in patients visiting a psychosomatic clinic in Japan. Univariate logistic regression analyses followed by multiple regression models using a stepwise method were selected for identifying the candidate symptoms. Overall, symptoms related to depression were associated with SI in both sexes. Although women showed more various somatic symptoms associated with SI than men, many of those associations were diminished once severity of the depression was controlled. The current results suggest that a variety of self-reported symptoms, mainly related to depression, might reveal suicidal risk in outpatients with an urban hospital clinical setting.Keywords: suicidal ideation, psychosomatic clinic, subjective symptoms

The Influence of BMX Gene Polymorphisms on Clinical Symptoms after Mild Traumatic Brain Injury

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Yu-Jia Wang

2014-01-01

Full Text Available Mild traumatic brain injury (mTBI is one of the most common neurological disorders. Most patients diagnosed with mTBI could fully recover, but 15% of patients suffer from persistent symptoms. In recent studies, genetic factors were found to be associated with recovery and clinical outcomes after TBI. In addition, results from our previous research have demonstrated that the bone marrow tyrosine kinase gene in chromosome X (BMX, a member of the Tec family of kinases, is highly expressed in rats with TBI. Therefore, our aim in this study was to identify the association between genetic polymorphisms of BMX and clinical symptoms following mTBI. Four tagging single nucleotide polymorphisms (tSNPs of BMX with minimum allele frequency (MAF >1% were selected from the HapMap Han Chinese database. Among these polymorphisms, rs16979956 was found to be associated with the Beck anxiety inventory (BAI and dizziness handicap inventory (DHI scores within the first week after head injury. Additionally, another SNP, rs35697037, showed a significant correlation with dizziness symptoms. These findings suggested that polymorphisms of the BMX gene could be a potential predictor of clinical symptoms following mTBI.

Variables influencing presenting symptoms of patients with eating disorders at psychiatric outpatient clinics.

Science.gov (United States)

Tseng, Mei-Chih Meg; Chen, Kuan-Yu; Chang, Chin-Hao; Liao, Shih-Cheng; Chen, Hsi-Chung

2016-04-30

Eating disorders (EDs) have been underdiagnosed in many clinical settings. This study investigates the influence of clinical characteristics on presenting symptoms of patients with EDs. Psychiatric outpatients, aged 18-45, were enrolled sequentially and received a two-phase survey for EDs in August 2010-January 2013. Their primary reasons for seeking psychiatric help were obtained at their first encounter with outpatient psychiatrists. Patients' clinical and demographic characteristics were compared according to presenting symptoms with or without eating/weight problems. Of 2140 patients, 348 (16.3%) were diagnosed with an ED (22.6% of women and 6.3% of men). The three most common reasons for seeking psychiatric help were eating/weight problems (46.0%), emotional problems (41.3%), and sleep disturbances (19.3%). The multivariate analyses suggest that when patients with EDs presented symptoms that were less related to eating/weight problems, they were significantly more likely to be those having diagnoses other than anorexia nervosa or bulimia nervosa and less severe degree of binge-eating. Further, patients with EDs who demonstrated more impulsive behaviors and poorer functioning were less likely to report their eating problems when visiting psychiatric clinics. Thus, ED should be assessed routinely in patients with complex psychopathology to facilitate comprehensive treatment. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Effect of silodosin on specific urinary symptoms associated with benign prostatic hyperplasia: analysis of international prostate symptom scores in 2 phase III clinical studies.

Science.gov (United States)

Gittelman, Marc C; Marks, Leonard S; Hill, Lawrence A; Volinn, Weining; Hoel, Gary

2010-01-01

Pooled results from 2 randomized, placebo-controlled, US phase III studies (NCT00224107, NCT00224120) showed that silodosin, a uroselective α-blocker, significantly improved International Prostate Symptom Scores (IPSS) in men with symptomatic benign prostatic hyperplasia (BPH). This analysis evaluated the effect of silodosin on each symptom assessed by IPSS questionnaire. Study participants (N = 923) were men aged ≥50 years with IPSS ≥13 and Qmax 4-15 mL/s. They received silodosin 8 mg or placebo once daily for 12 weeks. Patient responses to 7 IPSS questions were collected at weeks 0 (baseline), 0.5, 1, 2, 4, and 12 and scored on a 6-point scale. Efficacy of silodosin versus placebo was assessed by analysis of covariance. For each symptom, the 2 treatment groups had similar mean baseline scores. Decrease in score from baseline (mean ± standard deviation) to last observation was significantly greater with silodosin than with placebo for all symptoms (P silodosin (versus placebo) was greatest for weak stream (silodosin, -1.1 ± 1.4 versus placebo, -0.5 ± 1.2; P nocturia (silodosin, -0.6 ± 1.1 versus placebo, -0.4 ± 1.2; P = 0.0037). Compared with placebo, silodosin significantly improved nocturia within 1 week (silodosin, -0.5 ± 1.07 versus placebo, -0.3 ± 1.05; P = 0.009) and all other symptoms within 3 to 4 days (P Silodosin significantly improved all BPH-associated symptoms assessed by IPSS questionnaire within the first week of treatment. All improvements were maintained over the 12-week study period.

Clinical and non-clinical depressive symptoms and risk of long-term sickness absence among female employees in the Danish eldercare sector

DEFF Research Database (Denmark)

Hjarsbech, PU; Andersen, Rikke Voss; Christensen, Karl Bang

2011-01-01

was stronger for each subsequent group: MDI scores of 5–9: HR=1.07 (95% CI: 0.93–1.24); 10–14: 1.38 (1.15–1.66); 15–19: 1.54 (1.20–1.98); =20: 1.96 (1.45–2.64); clinical depression: 2.32 (1.59–3.38); after adjustment for previous LTSA, age, family status, smoking, leisure time physical activity, BMI......Background: Depression has a high point and life time prevalence and is a major cause of reduced work ability and long-term sickness absence (LTSA). Less is known of the extent to which non-clinical depressive symptoms are related to the risk of LTSA. The aim of this study was to investigate how...... non-clinical and clinical depressive symptoms are prospectively associated to subsequent LTSA. Methods: In a cohort study of 6985 femaleemployees fromthe Danish eldercare sector depressive symptoms were measured by the Major Depression Inventory (MDI) and scores (0–50) were divided into groups of 0...

[EBOLA HEMORRHAGIC FEVER; ETIOLOGY, EPIDEMIOLOGY, PATHOGENESIS, AND CLINICAL SYMPTOMS].

Science.gov (United States)

Zhdanov, K W; Zakharenko, S M; Kovalenko, A N; Semenov, A V; Fusin, A Ya

2015-01-01

The data on the prevalence of disease caused by Ebola virus, biological features of its pathogen, character of the epidemiological process, pathogenesis and clinical symptoms are presented. The disease is characterized by suppression of protective immunological mechanisms and systemic inflammatory reaction accounting for the lesions of vascular endothelium, hemostatic and immune systems. It eventually leads to polyorgan insufficiency and severe shock. Lethality amounts to 50%.

[Long QT syndrome. History, genetics, clinical symptoms, causes and therapy].

Science.gov (United States)

Krönauer, T; Friederich, P

2015-08-01

The long QT syndrome is caused by a change in cardiac repolarization due to functional ion channel defects. A differentiation is made between a congenital (cLQTS) and an acquired (aLQTS) form of the disease. The disease results in the name-giving prolongation of the QT interval in the electrocardiogram and represents a predisposition for cardiac arrhythmia and sudden cardiac death. This article summarizes the current knowledge on the history, pathophysiology, clinical symptoms and therapy of cLQTS and aLQTS. This knowledge of pathophysiological features of the symptoms allows the underlying anesthesiological approach for individualized perioperative concepts for patients suffering from LQTS to be derived.

Sciatica-like symptoms and the sacroiliac joint: clinical features and differential diagnosis.

Science.gov (United States)

Visser, L H; Nijssen, P G N; Tijssen, C C; van Middendorp, J J; Schieving, J

2013-07-01

To compare the clinical features of patients with sacroiliac joint (SIJ)-related sciatica-like symptoms to those with sciatica from nerve root compression and to investigate the necessity to perform radiological imaging in patients with sciatica-like symptoms derived from the SIJ. Patients with pain radiating below the buttocks with a duration of 4 weeks to 1 year were included. After physical and radiological examinations, a diagnosis of SI joint-related pain, pain due to disk herniation, or a combination of these two causes was made. Patients with SIJ-related leg pain (n = 77/186) were significantly more often female, had shorter statue, a shorter duration of symptoms, and had more often pain radiating to the groin and a history of a fall on the buttocks. Muscle weakness, corkscrew phenomenon, finger-floor distance ≥25 cm, lumbar scoliosis, positive Bragard or Kemp sign, and positive leg raising test were more often present when radiologic nerve root compression was present. Although these investigations may help, MRI of the spine is necessary to discriminate between the groups. Sciatica-like symptoms derived from the SIJ can clinically mimic a radiculopathy. We suggest to perform a thorough physical examination of the spine, SI joints, and hips with additional radiological tests to exclude other causes.

Outcome, general, and symptom-specific quality of life after various types of parotid resection.

Science.gov (United States)

Ciuman, Raphael Richard; Oels, Wolfgang; Jaussi, Rolf; Dost, Philipp

2012-06-01

To document the outcome and impact on general and symptom-specific quality of life (QOL) after various types of parotid resection. General and symptom-specific QOL assessment at least 1 year after performed surgery. Retrospective data and outcome analysis of patients. Between 2004 and 2010, 353 parotid resections in 337 patients were conducted at the Department of Otorhinolaryngology, University Teaching Hospital, St. Mary's Hospital Gelsenkirchen, Gelsenkirchen, Germany. A total of 196 patients fit the inclusion criteria and were available for postoperative evaluation. The general QOL assessment was based on both the global health status and global QOL scales of the European Organisation for Research and Treatment of Cancer (EORTC) Quality-of-Life Questionnaire in 34 patients. Symptom-specific QOL was assessed with the Parotidectomy Outcome Inventory-8 (POI-8). In addition, aesthetic outcome was evaluated with an ordinal scale. Outcome of parotidectomies in benign disease has little impact on general QOL and global health status. However, hypoesthesia or dysesthesia, Frey's syndrome, and cosmetic discontent are quite common and may affect symptom-specific and general QOL. Correlation with extent of surgery and statistically significant differences of patient evaluation for aesthetic outcome, sensory impairment, and Frey's syndrome between various types of limited parotid surgery (enucleation, extracapsular dissection, partial superficial parotidectomy) and superficial parotidectomy could be shown. An adequate parotid resection technique must be chosen to achieve the least disturbing outcome. In addition, in our patient collective, there was no increased recurrence rate found after limited parotid resection for pleomorphic adenoma or cystadenolymphoma. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

Individual negative symptoms and domains - Relevance for assessment, pathomechanisms and treatment.

Science.gov (United States)

Kaiser, Stefan; Lyne, John; Agartz, Ingrid; Clarke, Mary; Mørch-Johnsen, Lynn; Faerden, Ann

2017-08-01

The negative symptoms of schizophrenia can be divided into two domains. Avolition/apathy includes the individual symptoms of avolition, asociality and anhedonia. Diminished expression includes blunted affect and alogia. Until now, causes and treatment of negative symptoms have remained a major challenge, which is partially related to the focus on negative symptoms as a broad entity. Here, we propose that negative symptoms may become more tractable when the different domains and individual symptoms are taken into account. There is now increasing evidence that the relationship with clinical variables - in particular outcome - differs between the domains of avolition/apathy and diminished expression. Regarding models of negative symptom formation, those relevant to avolition/apathy are now converging on processes underlying goal-directed behavior and dysfunctions of the reward system. In contrast, models of the diminished expression domains are only beginning to emerge. The aim of this article is to review the specific clinical, behavioral and neural correlates of individual symptoms and domains as a better understanding of these areas may facilitate specific treatment approaches. Copyright © 2016 Elsevier B.V. All rights reserved.

The relationship of social function to depressive and negative symptoms in individuals at clinical high risk for psychosis.

Science.gov (United States)

Corcoran, C M; Kimhy, D; Parrilla-Escobar, M A; Cressman, V L; Stanford, A D; Thompson, J; David, S Ben; Crumbley, A; Schobel, S; Moore, H; Malaspina, D

2011-02-01

Social dysfunction is a hallmark symptom of schizophrenia which commonly precedes the onset of psychosis. It is unclear if social symptoms in clinical high-risk patients reflect depressive symptoms or are a manifestation of negative symptoms. We compared social function scores on the Social Adjustment Scale-Self Report between 56 young people (aged 13-27 years) at clinical high risk for psychosis and 22 healthy controls. The cases were also assessed for depressive and 'prodromal' symptoms (subthreshold positive, negative, disorganized and general symptoms). Poor social function was related to both depressive and negative symptoms, as well as to disorganized and general symptoms. The symptoms were highly intercorrelated but linear regression analysis demonstrated that poor social function was primarily explained by negative symptoms within this cohort, particularly in ethnic minority patients. Although this study demonstrated a relationship between social dysfunction and depressive symptoms in clinical high-risk cases, this association was primarily explained by the relationship of each of these to negative symptoms. In individuals at heightened risk for psychosis, affective changes may be related to a progressive decrease in social interaction and loss of reinforcement of social behaviors. These findings have relevance for potential treatment strategies for social dysfunction in schizophrenia and its risk states and predict that antidepressant drugs, cognitive behavioral therapy and/or social skills training may be effective.

Prevalence and clinical symptoms of human metapneumovirus infection in hospitalized patients

NARCIS (Netherlands)

B.G. van den Hoogen (Bernadette); G.J.J. van Doornum (Gerard); J.C. Fockens (John); J.J. Cornelissen (Jan); W.E.Ph. Beyer (Walter); R. de Groot (Ronald); A.D.M.E. Osterhaus (Albert); R.A.M. Fouchier (Ron)

2003-01-01

textabstractDuring a 17-month period, we performed retrospective analyses of the prevalence of and clinical symptoms associated with human metapneumovirus (hMPV) infection, among patients in a university hospital in The Netherlands. All available nasal-aspirate, throat-swab, sputum, and

Eating disorders, substance use disorders and multiple symptoms: three clinical vignettes.

Science.gov (United States)

Fava Vizziello, Graziella; Bellin, Laura

2018-04-01

During the longitudinal study of three patients, referred to services at 3, 13, 15 years for eating disorders, reduced food intake and anorexia nervosa, other symptoms appeared depending on difficult development, relational and personality problems. The patients showed the interweaving of symptoms at different times: they were dealing with modified developmental needs and contexts, included new possibilities of attachment that might produce different internal organizations. These changes required different treatments. Anorexia started early in life for these girls, but presented different steps of organization. We wanted to start finding some aspects of a staging model to map the course of ED, because many patients arrived later in life, reported untreated early symptoms, actually personality traits. Mapping the evolution, could allow to take care of patients at the very early stage of problems when few symptoms are present, and better patients' evolution might be possible. Level V opinions of respected authorities based on clinical experience.

Individuals with clinically significant insomnia symptoms are characterised by a negative sleep-related expectancy bias: Results from a cognitive-experimental assessment.

Science.gov (United States)

Courtauld, Hannah; Notebaert, Lies; Milkins, Bronwyn; Kyle, Simon D; Clarke, Patrick J F

2017-08-01

Cognitive models of insomnia consistently suggest that negative expectations regarding the consequences of poor sleep contribute to the maintenance of insomnia. To date, however, no research has sought to determine whether insomnia is indeed characterised by such a negative sleep-related expectancy bias, using objective cognitive assessment tasks which are more immune to response biases than questionnaire assessments. Therefore, the current study employed a reaction-time task assessing biased expectations among a group with clinically significant insomnia symptoms (n = 30) and a low insomnia symptoms group (n = 40). The task involved the presentation of scenarios describing the consequences of poor sleep, and non-sleep related activities, which could be resolved in a benign or a negative manner. The results demonstrated that the high insomnia symptoms group were disproportionately fast to resolve sleep-related scenarios in line with negative outcomes, as compared to benign outcomes, relative to the low insomnia symptoms group. The two groups did not differ in their pattern of resolving non-sleep related scenarios. This pattern of findings is entirely consistent with a sleep-specific expectancy bias operating in individuals with clinically significant insomnia symptoms, and highlights the potential of cognitive-experimental assessment tasks to objectively index patterns of biased cognition in insomnia. Copyright © 2017 Elsevier Ltd. All rights reserved.

Oxidative stress correlates with headache symptoms in fibromyalgia: coenzyme Q₁₀ effect on clinical improvement.

Science.gov (United States)

Cordero, Mario D; Cano-García, Francisco Javier; Alcocer-Gómez, Elísabet; De Miguel, Manuel; Sánchez-Alcázar, José Antonio

2012-01-01

Fibromyalgia (FM) is a chronic pain syndrome with unknown etiology and a wide spectrum of symptoms such as allodynia, debilitating fatigue, joint stiffness and migraine. Recent studies have shown some evidences demonstrating that oxidative stress is associated to clinical symptoms in FM of fibromyalgia. We examined oxidative stress and bioenergetic status in blood mononuclear cells (BMCs) and its association to headache symptoms in FM patients. The effects of oral coenzyme Q(10) (CoQ(10)) supplementation on biochemical markers and clinical improvement were also evaluated. We studied 20 FM patients and 15 healthy controls. Clinical parameters were evaluated using the Fibromyalgia Impact Questionnaire (FIQ), visual analogues scales (VAS), and the Headache Impact Test (HIT-6). Oxidative stress was determined by measuring CoQ(10), catalase and lipid peroxidation (LPO) levels in BMCs. Bioenergetic status was assessed by measuring ATP levels in BMCs. We found decreased CoQ(10), catalase and ATP levels in BMCs from FM patients as compared to normal control (P headache parameters were observed (r  = -0.59, P headache symptoms (P stress in the headache symptoms associated with FM. CoQ10 supplementation should be examined in a larger placebo controlled trial as a possible treatment in FM.

Mindfulness and Coping Are Inversely Related to Psychiatric Symptoms in Patients and Informal Caregivers in the Neuroscience ICU: Implications for Clinical Care.

Science.gov (United States)

Shaffer, Kelly M; Riklin, Eric; Jacobs, Jamie M; Rosand, Jonathan; Vranceanu, Ana-Maria

2016-11-01

To assess the correlation of psychosocial resiliency factors (mindfulness and coping) with symptoms of posttraumatic stress, anxiety, and depression in patients recently admitted to the neuroscience ICU and their primary informal caregivers. A descriptive, cross-sectional correlational study. Neuroscience ICU in a major medical center. A total of 78 dyads of patients (total n = 81) and their primary caregivers (total n = 92) from June to December 2015. Study enrollment occurred within the first 2 weeks of patient admission to the neuroscience ICU. None. Dyads completed self-report measures of mindfulness (Cognitive and Affective Mindfulness Scale-Revised), coping (Measure of Coping Status-A), posttraumatic stress (Posttraumatic Checklist-Specific Stressor), anxiety (Hospital Anxiety and Depression Scale-A), and depression (Hospital Anxiety and Depression Scale-D). Rates of clinically significant posttraumatic stress, anxiety, and depressive symptoms were high and comparable between patient and caregiver samples. Own psychological resilience factors and psychiatric symptoms were strongly correlated for both patients and caregivers. Depressive symptoms were interdependent between patients and their caregivers, and one's own mindfulness was independently related to one's partner's depressive symptoms. Rates of clinically significant psychiatric symptoms were high, equally prevalent in patients and caregivers, and interdependent between patients and their caregivers. For both patients and caregivers, psychological resiliency factors were associated with both self and partner psychiatric symptoms. Findings suggest that attending to the psychiatric health of both patients and caregivers in the neuroscience ICU is a priority and that patients and their caregivers must be considered together in a system to fully address either individual's psychiatric symptoms.

Levothyroxine Poisoning - Symptoms and Clinical Outcome

DEFF Research Database (Denmark)

Nygaard, Birgitte; Saedder, Eva A; Dalhoff, Kim

2015-01-01

Levothyroxine (LT), T4, poisoning is rarely associated with a severe outcome. However, cases with significant complications have been reported. The aim of this study was to identify factors associated with symptoms of poisoning including late-onset symptoms. All enquiries to the Danish Poison...... Information Centre (DPIC) concerning LT poisoning between March 2007 and September 2012 were reviewed and the following parameters were recorded: age, dose, time from ingestion, multiple drug intake and symptoms. To evaluate the frequency of late-onset symptoms, a subgroup of patients without initial symptoms...... patients, neither in children nor in adults (age 16-92 years) (p poisoning at the time of enquiry; however, in 9 of 21 (43%) patients, we were able to contact, late-onset symptoms existed. In none of the cases...

The Association of Insight and Change in Insight with Clinical Symptoms in Depressed Inpatients.

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He, Hongbo; Chang, Qing; Ma, Yarong

2018-04-25

Lack of insight has been extensively studied and was found to be adversely correlated with impaired treatment compliance and worse long term clinical outcomes among patients with schizophrenia, while not much is known about this phenonmenon in patients with severe depression. To explore the correlates of insight and its relation to symptom changes among the most seriously ill patients with affective disorders, those who require hospitalization. Patients hospitalized in a large psychiatric hospital in south China with either major depressive disorder (MDD)(N=55) or bipolar depression (BD) (N=85) based on ICD-10 diagnostic criteria were assessed with the Insight and Treatment Attitudes Questionnaire (ITAQ) one week after admission and at the time of discharge. Clinical symptoms were measured at the same time with the Hamilton Rating Scale for Depression (HAMD-17) and the Depression subscale of the Symptom Check list-90 (SCL-90). Length of stay (LOS), duration of illness, duration of untreated mood disorder, number of previous episodes of depression and previous admissions for depression were documented during interviews with patients and their families and from a review of medical records. Bivariate correlations and multiple regression analysis were used to examine the relationship of sociodemographic characteristics, clinical symptomatology and clinical history, to insight at the time of admission. The relationships between change in clinical symptoms and change in insight from admission to discharge were also examined. Stepwise multiple regression models suggested that any previous admissions for depression and higher anxiety factor scores on the HAMD-17 are significant independent predictors of insight accounting for 22.9% of the variance. Multiple regression analysis residual change scores (change scores adjusted for baseline values) on the ITAQ showed that improved insight over average stays of 51 days were inversely related to the residual psychomotor

The Development of a Patient-Reported Outcome Measure for Assessment of Genital Psoriasis Symptoms: The Genital Psoriasis Symptoms Scale (GPSS).

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Gottlieb, Alice B; Kirby, Brian; Ryan, Caitriona; Naegeli, April N; Burge, Russel; Potts Bleakman, Alison; Anatchkova, Milena D; Yosipovitch, Gil

2018-03-01

Patient-reported outcome measures (PROs) specific for genital psoriasis (GenPs) have not been described. In this cross-sectional, qualitative study in patients with moderate-to-severe GenPs, we sought to develop a PRO useful for GenPs symptom assessment. A literature review was performed to identify relevant psoriasis or GenPs symptoms and existing PROs that may be useful in the evaluation of symptom severity in GenPs patients. The literature review findings were discussed with clinicians, and then patients with GenPs. Relevant psoriasis or GenPs symptoms from the literature review included itch, pain, scaling, redness/erythema, and stinging/burning. The validity of these symptoms for GenPs and potentially relevant PROs was corroborated by clinical experts. After gap analysis, a draft symptom scale consisting of Numeric Rating Scale (NRS) items was constructed. We then conducted interviews with GenPs patients (n = 20) to support content validity and use of the draft symptom NRS items in routine practice and in clinical trials. Participants identified and confirmed relevant symptoms and evaluated the utility of the draft PRO. A new PRO was developed: the Genital Psoriasis Symptoms Scale (GPSS). Cognitive debriefing and cultural adaptation/translation interviews with a second group of patients confirmed cultural appropriateness of the GPSS. The GPSS may be useful for assessing symptoms before, during, and after treatment in routine clinical practice and in clinical trials involving patients with GenPs. Eli Lilly & Company. Plain language summary available for this article.

Monitoring somatic symptoms in patients with mental disorders: Sensitivity to change and minimal clinically important difference of the Somatic Symptom Scale - 8 (SSS-8).

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Gierk, Benjamin; Kohlmann, Sebastian; Hagemann-Goebel, Marion; Löwe, Bernd; Nestoriuc, Yvonne

2017-09-01

The SSS-8 is a brief questionnaire for the assessment of somatic symptom burden. This study examines its sensitivity to change and the minimal clinically important difference (MCID) in patients with mental disorders. 55 outpatients with mental disorders completed the SSS-8 and measures of anxiety, depression, and disability before and after receiving treatment. Effect sizes and correlations between the change scores were calculated. The MCID was estimated using a one standard error of measurement threshold and the change in disability as an external criterion. There was a medium decline in somatic symptom burden for the complete sample (n=55, d z =0.53) and a large decline in a subgroup with very high somatic symptom burden at baseline (n=11, d z =0.94). Decreases in somatic symptom burden were associated with decreases in anxiety (r=0.68, pSSS-8 is sensitive to change. A 3-point decrease reflects a clinically important improvement. Due to its brevity and sound psychometric properties, the SSS-8 is useful for monitoring somatic symptom burden. Copyright © 2017 Elsevier Inc. All rights reserved.

Hepatitis A--frequency in children with non-specific abdominal symptoms.

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Malik, Rahat; Ghafoor, Tariq; Sarfraz, Muhammad; Hasan, Najmul

2004-06-01

To study the frequency of subclinical hepatitis 'A' in children having non-specific abdominal symptoms. A descriptive study. This study was conducted at Combined Military Hospital (CMH), Peshawar from June to December 2000. Three hundred and sixty children of either gender, hepatitis. Eighty eight (24.4%) children meeting the inclusion criteria of elevated serum alanine aminotransferase (ALT), twice the upper limits of normal (90 IU/L), and normal serum bilirubin were labelled as subclinical hepatitis. A total of 360 children were evaluated for vague abdominal symptoms and 96 (26.7%) of them had hepatitis on laboratory profile. Eight patients developed early jaundice and were excluded from the study. Out of 88 (24.4%) cases of subclinical hepatitis, 82 (93.2%) had hepatitis-A, 03 (3.4%) had hepatitis-B, while no causative agent was found in 03 (3.4%) children. The common presenting symptoms were abdominal pain/discomfort, loss of appetite, nausea, vomiting, malaise, fatigue and fever. Hepatomegaly and splenomegaly was documented in 56% and 43% cases respectively. A history of exposure to a patient with hepatitis was present in 14/88 (15.9%) cases whereas no child was vaccinated against HAV. Serum ALT level declined to normal limits within 4 weeks for 77/88 (87.5%) cases and within 6 weeks for 84/88 (95.4%). All cases recovered spontaneously with out any complication. Hepatitis-A was rampant in children presenting with vague abdominal symptoms in our series.

Relation of Symptom-Induced Impairment with Other Illness Parameters in Clinic-Referred Youth

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Gadow, Kenneth D.; Kaat, Aaron J.; Lecavalier, Luc

2013-01-01

Objective: To examine the relation of caregiver ratings of psychiatric symptom-induced impairment with number and severity of symptoms and informant agreement in consecutive child psychiatry outpatient referrals. Methods: Parents and teachers completed a broadband "DSM-IV"-referenced rating scale with disorder-specific impairment for 636…

From Clinical Symptoms to MR Imaging: Diagnostic Steps in Adenomyosis

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H. Krentel

2017-01-01

Full Text Available Adenomyosis or endometriosis genitalis interna is a frequent benign disease of women in fertile age. It causes symptoms like bleeding disorders and dysmenorrhea and seems to have a negative effect on fertility. Adenomyosis can be part of a complex genital and extragenital endometriosis but also can be found as a solitary uterine disease. While peritoneal endometriosis can be easily diagnosed by laparoscopy with subsequent biopsy, the determination of adenomyosis is difficult. In the following literature review, the diagnostic methods clinical history and symptoms, gynecological examination, 2D and 3D transvaginal ultrasound, MRI, hysteroscopy, and laparoscopy will be discussed step by step in order to evaluate their predictive value in the diagnosis of adenomyosis.

Personalized Symptom Goals and Patient Global Impression on Clinical Changes in Advanced Cancer Patients.

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Mercadante, Sebastiano; Adile, Claudio; Lanzetta, Gaetano; Mystakidou, Kyriaki; Maltoni, Marco; Soares, Luiz Guilherme; De Santis, Stefano; Ferrera, Patrizia; Valenti, Marco; Rosati, Marta; Rossi, Romina; Cortegiani, Andrea; Masedu, Francesco; Marinangeli, Franco; Aielli, Federica

2018-05-16

The aim of this study was to assess the patients' global impression (PGI) after symptom management, as well as the achievement of personalized symptom goals (PSG). The secondary outcome was to assess related factors. Subjects, Materials, and Methods . Advanced cancer patients admitted to palliative care units rated symptom intensity by using the Edmonton Symptom Assessment Score (ESAS) at admission and then after 1 week. For each symptom, patient-reported PGI and PSG, as well as the rate of PSG response, were evaluated. Eight hundred seventy-six patients were taken into consideration for this study. A mean of 1.71-2.16 points was necessary to perceive a bit better improvement of symptom intensity. Most patients had a PSG of ≤3. A statistically significant number of patients achieved their PSG after starting palliative care. Patients with high intensity of ESAS items at admission achieved a more favorable PGI response. In the multivariate analysis, symptom intensity and PSG were the most frequent factors independently associated to a best PGI, whereas high levels of Karnofsky had a lower odd ratio. PSG and PGI seem to be relevant for patients' assessment and decision-making process, translating in terms of therapeutic intervention. Some factors may be implicated in determining the individual target and clinical response. Personalized symptom goals and global impression of change are relevant for patients' assessment and decision-making process, translating in terms of therapeutic intervention. Some factors may be implicated in determining the individual target and clinical response. © AlphaMed Press 2018.

Relations between Behavioral Inhibition, Big Five Personality Factors, and Anxiety Disorder Symptoms in Non-Clinical and Clinically Anxious Children

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Vreeke, Leonie J.; Muris, Peter

2012-01-01

This study examined the relations between behavioral inhibition, Big Five personality traits, and anxiety disorder symptoms in non-clinical children (n = 147) and clinically anxious children (n = 45) aged 6-13 years. Parents completed the Behavioral Inhibition Questionnaire-Short Form, the Big Five Questionnaire for Children, and the Screen for…

Behavioral Indicators on a Mobile Sensing Platform Predict Clinically Validated Psychiatric Symptoms of Mood and Anxiety Disorders.

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Place, Skyler; Blanch-Hartigan, Danielle; Rubin, Channah; Gorrostieta, Cristina; Mead, Caroline; Kane, John; Marx, Brian P; Feast, Joshua; Deckersbach, Thilo; Pentland, Alex Sandy; Nierenberg, Andrew; Azarbayejani, Ali

2017-03-16

There is a critical need for real-time tracking of behavioral indicators of mental disorders. Mobile sensing platforms that objectively and noninvasively collect, store, and analyze behavioral indicators have not yet been clinically validated or scalable. The aim of our study was to report on models of clinical symptoms for post-traumatic stress disorder (PTSD) and depression derived from a scalable mobile sensing platform. A total of 73 participants (67% [49/73] male, 48% [35/73] non-Hispanic white, 33% [24/73] veteran status) who reported at least one symptom of PTSD or depression completed a 12-week field trial. Behavioral indicators were collected through the noninvasive mobile sensing platform on participants' mobile phones. Clinical symptoms were measured through validated clinical interviews with a licensed clinical social worker. A combination hypothesis and data-driven approach was used to derive key features for modeling symptoms, including the sum of outgoing calls, count of unique numbers texted, absolute distance traveled, dynamic variation of the voice, speaking rate, and voice quality. Participants also reported ease of use and data sharing concerns. Behavioral indicators predicted clinically assessed symptoms of depression and PTSD (cross-validated area under the curve [AUC] for depressed mood=.74, fatigue=.56, interest in activities=.75, and social connectedness=.83). Participants reported comfort sharing individual data with physicians (Mean 3.08, SD 1.22), mental health providers (Mean 3.25, SD 1.39), and medical researchers (Mean 3.03, SD 1.36). Behavioral indicators passively collected through a mobile sensing platform predicted symptoms of depression and PTSD. The use of mobile sensing platforms can provide clinically validated behavioral indicators in real time; however, further validation of these models and this platform in large clinical samples is needed. ©Skyler Place, Danielle Blanch-Hartigan, Channah Rubin, Cristina Gorrostieta

Recognition of depressive symptoms by physicians

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Sergio Gonçalves Henriques

2009-01-01

Full Text Available OBJECTIVE: To investigate the recognition of depressive symptoms of major depressive disorder (MDD by general practitioners. INTRODUCTION: MDD is underdiagnosed in medical settings, possibly because of difficulties in the recognition of specific depressive symptoms. METHODS: A cross-sectional study of 316 outpatients at their first visit to a teaching general hospital. We evaluated the performance of 19 general practitioners using Primary Care Evaluation of Mental Disorders (PRIME-MD to detect depressive symptoms and compared them to 11 psychiatrists using Structured Clinical Interview Axis I Disorders, Patient Version (SCID I/P. We measured likelihood ratios, sensitivity, specificity, and false positive and false negative frequencies. RESULTS: The lowest positive likelihood ratios were for psychomotor agitation/retardation (1.6 and fatigue (1.7, mostly because of a high rate of false positive results. The highest positive likelihood ratio was found for thoughts of suicide (8.5. The lowest sensitivity, 61.8%, was found for impaired concentration. The sensitivity for worthlessness or guilt in patients with medical illness was 67.2% (95% CI, 57.4-76.9%, which is significantly lower than that found in patients without medical illness, 91.3% (95% CI, 83.2-99.4%. DISCUSSION: Less adequately identified depressive symptoms were both psychological and somatic in nature. The presence of a medical illness may decrease the sensitivity of recognizing specific depressive symptoms. CONCLUSIONS: Programs for training physicians in the use of diagnostic tools should consider their performance in recognizing specific depressive symptoms. Such procedures could allow for the development of specific training to aid in the detection of the most misrecognized depressive symptoms.

A cluster analysis of tic symptoms in children and adults with Tourette syndrome: clinical correlates and treatment outcome.

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McGuire, Joseph F; Nyirabahizi, Epiphanie; Kircanski, Katharina; Piacentini, John; Peterson, Alan L; Woods, Douglas W; Wilhelm, Sabine; Walkup, John T; Scahill, Lawrence

2013-12-30

Cluster analytic methods have examined the symptom presentation of chronic tic disorders (CTDs), with limited agreement across studies. The present study investigated patterns, clinical correlates, and treatment outcome of tic symptoms. 239 youth and adults with CTDs completed a battery of assessments at baseline to determine diagnoses, tic severity, and clinical characteristics. Participants were randomly assigned to receive either a comprehensive behavioral intervention for tics (CBIT) or psychoeducation and supportive therapy (PST). A cluster analysis was conducted on the baseline Yale Global Tic Severity Scale (YGTSS) symptom checklist to identify the constellations of tic symptoms. Four tic clusters were identified: Impulse Control and Complex Phonic Tics; Complex Motor Tics; Simple Head Motor/Vocal Tics; and Primarily Simple Motor Tics. Frequencies of tic symptoms showed few differences across youth and adults. Tic clusters had small associations with clinical characteristics and showed no associations to the presence of coexisting psychiatric conditions. Cluster membership scores did not predict treatment response to CBIT or tic severity reductions. Tic symptoms distinctly cluster with little difference across youth and adults, or coexisting conditions. This study, which is the first to examine tic clusters and response to treatment, suggested that tic symptom profiles respond equally well to CBIT. Clinical trials.gov. identifiers: NCT00218777; NCT00231985. © 2013 Elsevier Ireland Ltd. All rights reserved.

Aspartame Attenuates 2, 4-Dinitrofluorobenzene-Induced Atopic Dermatitis-Like Clinical Symptoms in NC/Nga Mice.

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Kim, Gun-Dong; Park, Yong Seek; Ahn, Hyun-Jong; Cho, Jeong-Je; Park, Cheung-Seog

2015-11-01

Atopic dermatitis (AD) is a common multifactorial chronic skin disease that has a multiple and complex pathogenesis. AD is gradually increasing in prevalence globally. In NC/Nga mice, repetitive applications of 2, 4-dinitrofluorobenzene (DNFB) evoke AD-like clinical symptoms similar to human AD. Aspartame (N-L-α-aspartyl-L-phenylalanine 1-methyl ester) is a methyl ester of a dipeptide, which is used as an artificial non-nutritive sweetener. Aspartame has analgesic and anti-inflammatory functions that are similar to the function of nonsteroidal anti-inflammatory drugs such as aspirin. We investigated whether aspartame can relieve AD-like clinical symptoms induced by DNFB treatment in NC/Nga mice. Sucrose did not relieve AD-like symptoms, whereas aspartame at doses of 0.5 μg kg(-1) and 0.5 mg kg(-1) inhibited ear swelling and relieved AD-like clinical symptoms. Aspartame inhibited infiltration of inflammatory cells including eosinophils, mast cells, and CD4(+) T cells, and suppressed the expression of cytokines including IL-4 and IFN-γ, and total serum IgE levels. Aspartame may have therapeutic value in the treatment of AD.

Core Components for a Clinically Integrated mHealth App for Asthma Symptom Monitoring.

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Rudin, Robert S; Fanta, Christopher H; Predmore, Zachary; Kron, Kevin; Edelen, Maria O; Landman, Adam B; Zimlichman, Eyal; Bates, David W

2017-10-01

Background mHealth apps may be useful tools for supporting chronic disease management. Objective Our aim was to apply user-centered design principles to efficiently identify core components for an mHealth-based asthma symptom–monitoring intervention using patient-reported outcomes (PROs). Methods We iteratively combined principles of qualitative research, user-centered design, and “gamification” to understand patients' and providers' needs, develop and refine intervention components, develop prototypes, and create a usable mobile app to integrate with clinical workflows. We identified anticipated benefits and burdens for stakeholders. Results We conducted 19 individual design sessions with nine adult patients and seven clinicians from an academic medical center (some were included multiple times). We identified four core intervention components: (1) Invitation—patients are invited by their physicians. (2) Symptom checks—patients receive weekly five-item questionnaires via the app with 48 hours to respond. Depending on symptoms, patients may be given the option to request a call from a nurse or receive one automatically. (3) Patient review—in the app, patients can view their self-reported data graphically. (4) In-person visit—physicians have access to patient-reported symptoms in the electronic health record (EHR) where they can review them before in-person visits. As there is currently no location in the EHR where physicians would consistently notice these data, recording a recent note was the best option. Benefits to patients may include helping decide when to call their provider and facilitating shared decision making. Benefits to providers may include saving time discussing symptoms. Provider organizations may need to pay nurses extra, but those costs may be offset by reduced visits and hospitalizations. Conclusion Recent systematic reviews show inconsistent outcomes and little insight into functionalities required for mHealth asthma

An algorithm for management of deep brain stimulation battery replacements: devising a web-based battery estimator and clinical symptom approach.

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Montuno, Michael A; Kohner, Andrew B; Foote, Kelly D; Okun, Michael S

2013-01-01

Deep brain stimulation (DBS) is an effective technique that has been utilized to treat advanced and medication-refractory movement and psychiatric disorders. In order to avoid implanted pulse generator (IPG) failure and consequent adverse symptoms, a better understanding of IPG battery longevity and management is necessary. Existing methods for battery estimation lack the specificity required for clinical incorporation. Technical challenges prevent higher accuracy longevity estimations, and a better approach to managing end of DBS battery life is needed. The literature was reviewed and DBS battery estimators were constructed by the authors and made available on the web at http://mdc.mbi.ufl.edu/surgery/dbs-battery-estimator. A clinical algorithm for management of DBS battery life was constructed. The algorithm takes into account battery estimations and clinical symptoms. Existing methods of DBS battery life estimation utilize an interpolation of averaged current drains to calculate how long a battery will last. Unfortunately, this technique can only provide general approximations. There are inherent errors in this technique, and these errors compound with each iteration of the battery estimation. Some of these errors cannot be accounted for in the estimation process, and some of the errors stem from device variation, battery voltage dependence, battery usage, battery chemistry, impedance fluctuations, interpolation error, usage patterns, and self-discharge. We present web-based battery estimators along with an algorithm for clinical management. We discuss the perils of using a battery estimator without taking into account the clinical picture. Future work will be needed to provide more reliable management of implanted device batteries; however, implementation of a clinical algorithm that accounts for both estimated battery life and for patient symptoms should improve the care of DBS patients. © 2012 International Neuromodulation Society.

Cognitive-behavioral therapy for somatization and symptom syndromes: a critical review of controlled clinical trials.

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Kroenke, K; Swindle, R

2000-01-01

Few treatments for somatization have been proven effective. In the past decade, however, clinical trials of cognitive-behavioral therapy (CBT) have been promising. Our aim was to critically review and synthesize the evidence from these trials. A search of the Medline database from 1966 through July 1999 was conducted to identify controlled trials designed to evaluate the efficacy of CBT in patients with somatization or symptom syndromes. A total of 31 controlled trials (29 randomized and 2 nonrandomized) were identified. Twenty-five studies targeted a specific syndrome (e.g. chronic fatigue, irritable bowel, pain) while 6 focused on more general somatization or hypochondriasis. Primary outcome assessment included physical symptoms, psychological distress and functional status in 28, 26 and 19 studies, respectively. Physical symptoms appeared the most responsive: CBT-treated patients improved more than control subjects in 71% of the studies and showed possibly greater improvement (i.e., a trend) in another 11% of the studies. A definite or possible advantage of CBT for reducing psychological distress was demonstrated in only 38 and 8% of studies, and for improving functional status in 47 and 26%. Group therapy and interventions as brief as 5 sessions proved efficacious. Benefits were sustained for up to 12 months. CBT can be an effective treatment for patients with somatization or symptom syndromes. Benefits can occur whether or not psychological distress is ameliorated. Since chronic symptoms are exceptionally common and most studies were conducted in referral populations, the optimal sequencing of CBT in treating primary care patients and the identification of those most likely to accept and respond to therapy should be further evaluated. Copyright 2000 S. Karger AG, Basel.

Clinical utility of the mBIAS and NSI validity-10 to detect symptom over-reporting following mild TBI: A multicenter investigation with military service members.

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Armistead-Jehle, Patrick; Cooper, Douglas B; Grills, Chad E; Cole, Wesley R; Lippa, Sara M; Stegman, Robert L; Lange, Rael T

2018-04-01

Self-report measures are commonly relied upon in military healthcare environments to assess service members following a mild traumatic brain injury (mTBI). However, such instruments are susceptible to over-reporting and rarely include validity scales. This study evaluated the utility of the mild Brain Injury Atypical Symptoms scale (mBIAS) and the Neurobehavioral Symptom Inventory Validity-10 scale to detect symptom over-reporting. A total of 359 service members with a reported history of mTBI were separated into two symptom reporting groups based on MMPI-2-RF validity scales (i.e., non-over-reporting versus symptom over-reporting). The clinical utility of the mBIAS and Validity-10 as diagnostic indicators and screens of symptom over-reporting were evaluated by calculating sensitivity, specificity, positive test rate, positive predictive power (PPP), and negative predictive power (NPP) values. An mBIAS cut score of ≥10 was optimal as a diagnostic indicator, which resulted in high specificity and PPP; however, sensitivity was low. The utility of the mBIAS as a screening instrument was limited. A Validity-10 cut score of ≥33 was optimal as a diagnostic indicator. This resulted in very high specificity and PPP, but low sensitivity. A Validity-10 cut score of ≥7 was considered optimal as a screener, which resulted in moderate sensitivity, specificity, NPP, but relatively low PPP. Owing to low sensitivity, the current data suggests that both the mBIAS and Validity-10 are insufficient as stand-alone measures of symptom over-reporting. However, Validity-10 scores above the identified cut-off of ≥7should be taken as an indication that further evaluation to rule out symptom over-reporting is necessary.

Effects of Ramadan Fasting on Spirometric Values and Clinical Symptoms in Asthmatic Patients

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Abdolreza Norouzy

2013-07-01

Full Text Available Introduction: Ramadan is the 9th Islamic lunar month during which Muslims avoid eating and drinking from sunrise to sunset. The effect of Ramadan intermittent fasting on asthma control is controversial. The aim of this study was to investigate the effects of Ramadan fasting on the spirometric variables and clinical symptoms on well-controlled asthmatic patients during Ramadan. Material and Methods: a cohort study was conducted in Mashhad, Khorasan Razavi, Iran. Twenty-nine (19 females and 10 males well-controlled asthmatic patients aged 47 (12 years completed the study. The average duration of fasting was 26.5 days. Assessment of spirometric variables (daily peak expiratory flow, peak expiratory flow variability, peak expiratory flow home monitoring as well as asthma clinical symptoms including dyspnea, cough, wheezing, and chest tightness were carried out. Results: No significant changes in clinical symptoms were reported in asthmatic patients at the end of Ramadan fasting. Among spirometric variables, only peak expiratory flow improved after Ramadan (p <0.05. There was a reduction in the mean peak expiratory flow variability from 13% at the first week of fasting to 10% at the fourth week (p <0.05. Conclusion: In well-controlled asthmatic patients, Ramadan fasting resulted in improvement in peak expiratory flow and peak expiratory flow variability.

Affective temperaments are associated with specific clusters of symptoms and psychopathology: a cross-sectional study on bipolar disorder inpatients in acute manic, mixed, or depressive relapse.

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Iasevoli, Felice; Valchera, Alessandro; Di Giovambattista, Emanuela; Marconi, Massimo; Rapagnani, Maria Paola; De Berardis, Domenico; Martinotti, Giovanni; Fornaro, Michele; Mazza, Monica; Tomasetti, Carmine; Buonaguro, Elisabetta F; Di Giannantonio, Massimo; Perugi, Giulio; de Bartolomeis, Andrea

2013-11-01

The aim of this study was to assess whether different affective temperaments could be related to a specific mood disorder diagnosis and/or to different therapeutic choices in inpatients admitted for an acute relapse of their primary mood disorder. Hundred and twenty-nine inpatients were consecutively assessed by means of the Structured and Clinical Interview for axis-I disorders/Patient edition and by the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego auto-questionnaire, Young Mania Rating Scale, Hamilton Scale for Depression and for Anxiety, Brief Psychiatry Rating Scale, Clinical Global impression, Drug Attitude Inventory, Barratt Impulsiveness Scale, Toronto Alexithymia Scale, and Symptoms Checklist-90 items version, along with records of clinical and demographic data. The following prevalence rates for axis-I mood diagnoses were detected: bipolar disorder type I (BD-I, 28%), type II (31%), type not otherwise specified (BD-NOS, 33%), major depressive disorder (4%), and schizoaffective disorder (4%). Mean scores on the hyperthymic temperament scale were significantly higher in BD-I and BD-NOS, and in mixed and manic acute states. Hyperthymic temperament was significantly more frequent in BD-I and BD-NOS patients, whereas depressive temperament in BD-II ones. Hyperthymic and irritable temperaments were found more frequently in mixed episodes, while patients with depressive and mixed episodes more frequently exhibited anxious and depressive temperaments. Affective temperaments were associated with specific symptom and psychopathology clusters, with an orthogonal subdivision between hyperthymic temperament and anxious/cyclothymic/depressive/irritable temperaments. Therapeutic choices were often poorly differentiated among temperaments and mood states. Cross-sectional design; sample size. Although replication studies are needed, current results suggest that temperament-specific clusters of symptoms severity and psychopathology domains could be

Childhood Familial Environment, Maltreatment and Borderline Personality Disorder Symptoms in a Non-Clinical Sample: A Cognitive Behavioural Perspective

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Carr, Steven; Francis, Andrew

2009-01-01

The present study sought to determine if cognitive beliefs and schemas mediated the relationship between retrospectively reported childhood events and adult borderline personality disorder (BPD) symptoms in a non-clinical sample. One hundred and seventy-eight non-clinical participants completed questionnaires measuring BPD symptoms, core beliefs,…

Hypertensive thalamic hemorrhage. Clinical symptoms and outcomes in 40 cases

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Munaka, Masahiro; Nishikawa, Michio; Hirai, Osamu; Kaneko, Takaaki; Watanabe, Syu; Fukuma, Jun; Handa, Hajime

1988-12-01

In the past six years, we have had experience with 40 patients with hypertensive thalamic hemorrhages, as verified by CT scan at our hospital within 24 hours. These patients were classified into the following three groups according to the location of the bleeding point and the size of the hematoma: (1) anteromedial (4 cases), (2) posterolateral (16 cases), and (3) massive (20 cases). The (1) and (2) hematomas were small (less than 3 cm in diameter), while those in (3) were large (more than 3 cm in diameter). Twenty cases (50% of all the thalamic hematomas) were small hematomas. The characteristic clinical symptoms of the anteromedial type were a mild disturbance of consciousness and thalamic dementia, while those of the posterolateral type were motor and sensory disturbance, and thalamic aphasia, respectively. Twenty cases (50%) were large hematomas. The clinical symptoms of these cases were mainly consciousness disturbance; 7 of them expired. Based on this experience, it may be considered that the patients whose hematoma size was larger than 3 cm had a poor prognosis and that the patients with the posterolateral type had a poor functional diagnosis.

The noradrenergic symptom cluster: clinical expression and neuropharmacology

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Blier P

2011-06-01

Full Text Available Pierre Blier1, Mike Briley21Institute of Mental Health Research, University of Ottawa, Ottawa, Ontario, Canada; 2NeuroBiz Consulting and Communication, Castres, FranceAbstract: Signs and symptoms of depression can be linked to one or more monoaminergic systems, specifically the norepinephrine (NE, the dopamine (DA, and the serotonin (5-HT systems. In particular, the modulation of energy, vigilance, and arousal can be directly linked to the NE system. There is, however, a great deal of overlap in the modulation of the symptoms of depression between these monoaminergic systems. There are considerable reciprocal interactions between the NE, DA, and the 5-HT systems. When using a selective serotonin reuptake inhibitor (SSRI, for example, 5-HT transmission is enhanced, but at the same time there is a dampening of the activity of NE and DA neurons through inhibitory 5-HT2A and 5-HT2C receptors, respectively. This could explain the residual symptoms of fatigue, lack of energy, and anhedonia, often seen after patients present an overall positive response to a SSRI. Using a dual 5-HT and NE reuptake inhibitor (SNRI, such as milnacipran, would result in an additional increase in NE activity. Futhermore, inhibiting NE reuptake increases DA availability in the frontal cortex since DA is mainly cleared by the NE transporters in several brain regions. A risk inherent in increased NE activity is that of provoking anxiety. This is avoided however by the attenuation of the phasic reactivity of the firing of NE neurons through prolonged administration of SSRI and SNRI.Keywords: norepinephrine, dopamine, serotonin, residual symptoms, norepinephrine paradox

Clinical symptoms in fibromyalgia are better associated to lipid peroxidation levels in blood mononuclear cells rather than in plasma.

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Cordero, Mario D; Alcocer-Gómez, Elísabet; Cano-García, Francisco J; De Miguel, Manuel; Carrión, Angel M; Navas, Plácido; Sánchez Alcázar, José A

2011-01-01

We examined lipid peroxidation (LPO) in blood mononuclear cells (BMCs) and plasma, as a marker of oxidative damage, and its association to clinical symptoms in Fibromyalgia (FM) patients. We conducted a case-control and correlational study comparing 65 patients and 45 healthy controls. Clinical parameters were evaluated using the Fibromyalgia Impact Questionnaire (FIQ), visual analogues scales (VAS), and the Beck Depression Inventory (BDI). Oxidative stress was determined by measuring LPO in BMCs and plasma. We found increased LPO levels in BMCs and plasma from FM patients as compared to normal control (PBMI, and sex, showed that both LPO in cells and plasma were independently associated to clinical symptoms. However, LPO in cells, but not LPO in plasma, was independently associated to clinical symptoms when controlling for depression (BDI scores). The results of this study suggest a role for oxidative stress in the pathophysiology of fibromyalgia and that LPO in BMCs rather than LPO in plasma is better associated to clinical symptoms in FM.

Randomised clinical trial: an assessment of acupuncture on specific meridian or specific acupoint vs. sham acupuncture for treating functional dyspepsia.

Science.gov (United States)

Ma, T T; Yu, S Y; Li, Y; Liang, F R; Tian, X P; Zheng, H; Yan, J; Sun, G J; Chang, X R; Zhao, L; Wu, X; Zeng, F

2012-03-01

Functional dyspepsia (FD) is a common disease without an established optimal treatment. To determine (i) the effect of acupuncture in relieving FD symptoms and improving life quality; (ii) the effect difference between acupoint and non-acupoint; and (iii) the effect difference among different acupoints. A total of 712 eligible patients were included and randomly assigned to six groups (Group A: specific acupoints of the stomach meridian; Group B: non-specific acupoints of the stomach meridian; Group C: specific acupoints of alarm and transport points; Group D: specific acupoints of the gallbladder meridian; Group E: sham acupuncture of non-acupoints; and Group F: itopride). A treatment period of 4 weeks (continuous five sessions per week), and a follow-up period of 12 weeks were arranged. The outcomes were the (i) patients' response, (ii) symptoms improvement measured using the Symptom Index of Dyspepsia and (iii) quality-of-life improvement based on Nepean Dyspepsia Index. All groups had an improvement in dyspepsia symptoms and the QoL at the end of treatment, and the improvement was sustained for 4 weeks and 12 weeks. The overall response rate was significantly higher in acupuncture group A (70.69%), and lower in sham acupuncture group (34.75%), compared with itopride and other acupuncture groups. Similarly, the difference in symptoms and QoL improvement was significant between group A and the other acupuncture groups. Acupuncture is effective in the treatment of functional dyspepsia, and is superior to non-acupoint puncture. The benefit of acupuncture relies on acupoint specificity. © 2012 Blackwell Publishing Ltd.

Clinical Utility of Noninvasive Method to Measure Specific Gravity in the Pediatric Population.

Science.gov (United States)

Hall, Jeanine E; Huynh, Pauline P; Mody, Ameer P; Wang, Vincent J

2018-04-01

Clinicians rely on any combination of signs and symptoms, clinical scores, or invasive procedures to assess the hydration status in children. Noninvasive tests to evaluate for dehydration in the pediatric population are appealing. The objective of our study is to assess the utility of measuring specific gravity of tears compared to specific gravity of urine and the clinical assessment of dehydration. We conducted a prospective cohort convenience sample study, in a pediatric emergency department at a tertiary care children's hospital. We approached parents/guardians of children aged 6 months to 4 years undergoing transurethral catheterization for evaluation of urinary tract infection for enrollment. We collected tears and urine for measurement of tear specific gravity (TSG) and urine specific gravity (USG), respectively. Treating physicians completed dehydration assessment forms to assess for hydration status. Among the 60 participants included, the mean TSG was 1.0183 (SD = 0.007); the mean USG was 1.0186 (SD = 0.0083). TSG and USG were positively correlated with each other (Pearson Correlation = 0.423, p = 0.001). Clinical dehydration scores ranged from 0 to 3, with 87% assigned a score of 0, by physician assessment. Mean number of episodes of vomiting and diarrhea in a 24-hour period were 2.2 (SD = 3.9) and 1.5 (SD = 3.2), respectively. Sixty-two percent of parents reported decreased oral intake. TSG measurements yielded similar results compared with USG. Further studies are needed to determine if TSG can be used as a noninvasive method of dehydration assessment in children. Copyright © 2017 Elsevier Inc. All rights reserved.

Investigation of the causes of clinical symptom aggravation in process of intravenous thrombolysis with alteplase

Directory of Open Access Journals (Sweden)

LI Chen-hua

2013-04-01

Full Text Available Objective To explore the causes of aggravation of microcirculation disorders in the process of intravenous thrombolysis with alteplase and the clinical outcomes. Methods The clinical data of the aggravated signs and symptoms of 13 cases treated by alteplase were reported, and the onset characteristics and clinical outcomes were analysed to summarize emergency experiences. Results There were 13 patients with stenosis of intracranial large arteries occurred perforating branch infarctions caused by the blocking of carried arteries (8 cases in internal carotid system, 5 cases in vertebral-basilar system. In the process of thrombolytic therapy, main aggravated presentations including cortical ischemic symptom, quadriplegia, exacerbated disturbance of consciousness were seen. Imaging examinations showed multiple new petechial ischemic foci in cortex and watershed region or increasing of infarct foci in cerebellum and brain stem. The prognosis was favorable after expectant treatment. NIHSS score was 8.69 ± 3.42 at 24 h after treatment, and mRS score was 0.94 ±0.37 at 3 month-follow-up. Neurologic deficit and quality of life were evidently improved. Conclusion In the course of intravenous thrombolytic therapy with alteplase. Aggravated clinical signs and symptoms may be related to various factors. Emboli disintegration inducing microcirculation disorder is inferred to be the main cause. For patients presenting aggravated signs and symptoms in thrombolysis process, favorable outcomes may occur as long as intensive care and timely treatment are performed.

Specific immunotherapy ameliorates ulcerative colitis.

Science.gov (United States)

Cai, Min; Zeng, Lu; Li, Lin-Jing; Mo, Li-Hua; Xie, Rui-Di; Feng, Bai-Sui; Zheng, Peng-Yuan; Liu, Zhi-Gang; Liu, Zhan-Ju; Yang, Ping-Chang

2016-01-01

Hypersensitivity reaction to certain allergens plays a role in the pathogenesis of inflammatory bowel disease (IBD). This study aims to observe the effect of specific immunotherapy in a group of IBD patients. Patients with both ulcerative colitis (UC) and food allergy were recruited into this study. Food allergy was diagnosed by skin prick test and serum specific IgE. The patients were treated with specific immunotherapy (SIT) and Clostridium butyricum (CB) capsules. After treating with SIT and CB, the clinical symptoms of UC were markedly suppressed as shown by reduced truncated Mayo scores and medication scores. The serum levels of specific IgE, interleukin (IL)-4 and tumor necrosis factor (TNF)-α were also suppressed. Treating with SIT alone or CB alone did not show appreciable improvement of the clinical symptoms of UC. UC with food allergy can be ameliorated by administration with SIT and butyrate-production probiotics.

Evaluation of the measurement model and clinically important differences for menopause-specific quality of life associated with bazedoxifene/conjugated estrogens.

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Bushmakin, Andrew G; Abraham, Lucy; Pinkerton, JoAnn V; Cappelleri, Joseph C; Mirkin, Sebastian

2014-08-01

This study aims to confirm the factor structure of the Menopause-Specific Quality of Life (MENQOL) questionnaire by using confirmatory factor analysis (CFA) and to determine whether improvements in menopause-specific health-related quality of life (HRQOL) observed with bazedoxifene (BZA)/conjugated estrogens (CE) relative to placebo are clinically meaningful. Postmenopausal women with seven or more moderate to severe hot flushes per day (or ≥50 per wk) received BZA 20 mg/CE 0.45 mg, BZA 20 mg/CE 0.625 mg, or placebo for 12 weeks. HRQOL and treatment satisfaction were evaluated using the MENQOL questionnaire and the Menopause Symptoms Treatment Satisfaction Questionnaire, respectively. The structure of the MENQOL questionnaire was evaluated using CFA. To estimate clinically important differences (CIDs) in HRQOL, we used a repeated-measures model to estimate changes in MENQOL domain and total scores using Menopause Symptoms Treatment Satisfaction Questionnaire items as anchors. The CFA model fits the MENQOL data (Bentler's comparative fit index >0.9). CID estimates ranged from 0.5 to 1.2 for the MENQOL domains and total score. Change from baseline in MENQOL vasomotor domain score for BZA 20 mg/CE 0.45 mg and BZA 20 mg/CE 0.625 mg compared with placebo was greater than the estimated CID, as were changes in MENQOL physical domain and total scores for BZA 20 mg/CE 0.625 mg compared with placebo. CFA confirms the factor structure of the MENQOL questionnaire. Treatment with BZA/CE provides clinically meaningful improvements in HRQOL in a population of postmenopausal women with bothersome vasomotor symptoms.

Clinical features of functional somatic symptoms in children and referral patterns to child and adolescent mental health services

DEFF Research Database (Denmark)

Tøt-Strate, Simone; Dehlholm-Lambertsen, Gitte; Lassen, Karin

2016-01-01

AIM: Functional somatic symptoms (FSS) are common in paediatric patients who are referred to Child and Adolescent Mental Health Service (CAMHS), but little is known about current referral practices. The aim of this study was to systematically investigate clinical features of paediatric inpatients...... who had been referred and 44 children who had not. RESULTS: Most paediatric records lacked information on psychosocial factors and symptoms. Referred children were significantly more multisymptomatic of FSS (p controls, had longer symptom duration, underwent more clinical...... reasons were generally vague and psychosocial information was frequently missing. Clinical guidelines are needed to improve and systematise mental health referrals for children with FSS....

Prevalence of clinically elevated depressive symptoms in college athletes and differences by gender and sport.

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Wolanin, Andrew; Hong, Eugene; Marks, Donald; Panchoo, Kelly; Gross, Michael

2016-02-01

There are approximately 400,000 National Collegiate Athletic Association (NCAA) student athletes and 5-7 million high school student athletes competing each year. According to the US Department of Health and Human Services, the depression prevalence rate for young adults, which ranges from 10% to 85% across studies, is higher than that of other age groups. Given the relatively high prevalence of depression in individuals of collegiate age in the general population, the prevalence of depression among athletes in this age group warrants further study. This multiyear study examined the prevalence of depressive symptoms in college athletes, as well as demographic factors related to increased or decreased rates of depressive symptoms by gender and sport. To describe the prevalence of depression symptoms among NCAA division I student athletes at a single institution over 3 consecutive years. Participants (n=465) completed a battery of measures during their yearly spring sports medicine physical across 3 consecutive years. The battery included the Center for Epidemiological Studies Depression Scale (CES-D) and a demographic questionnaire, administered during the course of routine sports medicine physical examinations. Differences in depressive symptoms prevalence and relative risk ratios were calculated by gender and sport. The prevalence rate for a clinically relevant level of depressive symptoms, as measured on the CES-D (CES-D ≥16), was 23.7%. A moderate to severe level of depressive symptoms was reported by 6.3%. There was a significant gender difference in prevalence of depressive symptoms, χ(2) (1)=7.459, p=0.006, with female athletes exhibiting 1.844 times the risk of male athletes for endorsing clinically relevant symptoms. The CES-D identified clinically relevant levels of depressive symptoms in nearly one-quarter of college student athletes in this large cross-sectional sample. Female college athletes reported significantly more depressive symptoms than males

Mental symptoms and cause-specific mortality among midlife employees

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Eero Lahelma

2016-11-01

Full Text Available Abstract Background Mental symptoms are prevalent among populations, but their associations with premature mortality are inadequately understood. We examined whether mental symptoms contribute to cause-specific mortality among midlife employees, while considering key covariates. Methods Baseline mail survey data from 2000–02 included employees, aged 40–60, of the City of Helsinki, Finland (n = 8960, 80 % women, response rate 67 %. Mental symptoms were measured by the General Health Questionnaire 12-item version (GHQ-12 and the Short Form 36 mental component summary (MCS. Covariates included sex, marital status, social support, health behaviours, occupational social class and limiting long-standing illness. Causes of death by the end of 2013 were obtained from Statistics Finland (n = 242 and linked individually to survey data pending consent (n = 6605. Hazard ratios (HR and 95 % confidence intervals (95 % CI were calculated using Cox regression analysis. Results For all-cause mortality, only MCS showed a weak association before adjustments. For natural mortality, no associations were found. For unnatural mortality (n = 21, there was a sex adjusted association with GHQ (HR = 1.96, 95 % CI = 1.45–2.64 and MCS (2.30, 95 % CI = 1.72–3.08. Among unnatural causes of death suicidal mortality (n = 11 was associated with both GHQ (2.20, 95 % CI = 1.47–3.29 and MCS (2.68, 95 % CI = 1.80–3.99. Of the covariates limiting long-standing illness modestly attenuated the associations. Conclusions Two established measures of mental symptoms, i.e. GHQ-12 and SF-36 MCS, were both associated with subsequent unnatural, i.e. accidental and violent, as well as suicidal mortality. No associations were found for natural mortality due to diseases. These findings need to be corroborated in further populations. Supporting mental health through workplace measures may help counteract subsequent suicidal and other

A Cluster Analysis of Tic Symptoms in Children and Adults with Tourette Syndrome: Clinical Correlates and Treatment Outcome

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McGuire, Joseph F.; Nyirabahizi, Epiphanie; Kircanski, Katharina; Piacentini, John; Peterson, Alan L.; Woods, Douglas W.; Wilhelm, Sabine; Walkup, John T.; Scahill, Lawrence

2013-01-01

Cluster analytic methods have examined the symptom presentation of chronic tic disorders (CTDs), with limited agreement across studies. The present study investigated patterns, clinical correlates, and treatment outcome of tic symptoms. 239 youth and adults with CTDs completed a battery of assessments at baseline to determine diagnoses, tic severity, and clinical characteristics. Participants were randomly assigned to receive either a comprehensive behavioral intervention for tics (CBIT) or psychoeducation and supportive therapy (PST). A cluster analysis was conducted on the baseline Yale Global Tic Severity Scale (YGTSS) symptom checklist to identify the constellations of tic symptoms. Four tic clusters were identified: Impulse Control and Complex Phonic Tics; Complex Motor Tics; Simple Head Motor/Vocal Tics; and Primarily Simple Motor Tics. Frequencies of tic symptoms showed few differences across youth and adults. Tic clusters had small associations with clinical characteristics and showed no associations to the presence of coexisting psychiatric conditions. Cluster membership scores did not predict treatment response to CBIT or tic severity reductions. Tic symptoms distinctly cluster with few difference across youth and adults, or coexisting conditions. This study, which is the first to examine tic clusters in relation to treatment, suggested that tic symptom profiles respond equally well to CBIT. PMID:24144615

Nutrition impact symptoms in advanced cancer patients: frequency and specific interventions, a case-control study.

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Omlin, Aurelius; Blum, David; Wierecky, Jan; Haile, Sarah R; Ottery, Faith D; Strasser, Florian

2013-03-01

Involuntary weight loss (IWL) is frequent in advanced cancer patients causing compromised anticancer treatment outcomes and function. Cancer cachexia is influenced by nutrition impact symptoms (NIS). The aim of this study was to explore the frequency of NIS in advanced patients and to assess specific interventions guided by a 12-item NIS checklist. Consecutive patients from an outpatient nutrition-fatigue clinic completed the NIS checklist. The NIS checklist was developed based on literature review and multiprofessional clinical expert consensus. Chart review was performed to detect defined NIS typical interventions. Oncology outpatients not seen in the nutrition-fatigue clinic were matched for age, sex, and tumor to serve as controls. In 52 nutrition-fatigue clinic patients, a mixed cancer population [IWL in 2 months 5.96 % (mean)], the five most frequent NIS were taste and smell alterations 27 %, constipation 19 %, abdominal pain 14 %, dysphagia 12 %, and epigastric pain 10 %. A statistically significant difference for NIS typical interventions in patients with taste and smell alterations (p = 0.04), constipation (p = 0.01), pain (p = 0.0001), and fatigue (p = 0.0004) were found compared to the control population [mixed cancer, 3.53 % IWL in 2 months (mean)]. NIS are common in advanced cancer patients. The NIS checklist can guide therapeutic nutrition-targeted interventions. The awareness for NIS will likely evoke more research in assessment, impact, and treatment.

The effects of the Kumamoto earthquake on the clinical symptoms of patients with Parkinson's disease.

Science.gov (United States)

Hori, Hiroko; Kuratomi, Aki; Ishizaki, Masatoshi; Sakamoto, Tetsuro; Nishida, Yasuto; Ando, Yukio

2017-08-31

Our hospital is the designated treatment base for intractable neurological diseases in the Kumamoto Prefecture. It is located in the center of the prefecture where the major 7.3-magnitude Kumamoto earthquake was recorded in 2016. In order to examine whether this earthquake affected the clinical symptoms of patients with Parkinson's disease in this hospital, we investigated outpatients examined up to 4 weeks after the earthquake. The subjects were 26 consecutive patients without any changes in anti-Parkinson's disease treatment or their attending physician during the examination period. All of the items in Part III of the Unified Parkinson's Disease Rating Scale (UPDRS), which is a clinician-scored scale for monitoring and evaluating motor function, were confirmed with the subjects before and after the earthquakes. After the earthquakes, worsened symptoms were found in 7 patients and 7 patients felt better. On the UPDRS, worsened symptoms were most commonly found among the items examining "muscle rigidity" and "slowness of movement and decreased movement" among the 7 patients with exacerbated symptoms. After the earthquake, clinical symptoms worsened significantly in women (P = 0.0188), patients with mild symptoms (P = 0.0111), and those who suffered a high degree of personal loss, such as those whose homes were damaged, who were forced to take refuge, or who had to sleep in their car (P = 0.0184). The mental and emotional burden due to the earthquake might be particularly high in the group of patients with worsened symptoms, suggestive of a relationship between stress and the exacerbation of parkinsonian symptoms.

Oxidative Stress Correlates with Headache Symptoms in Fibromyalgia: Coenzyme Q10 Effect on Clinical Improvement

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Cordero, Mario D.; Cano-García, Francisco Javier; Alcocer-Gómez, Elísabet; De Miguel, Manuel; Sánchez-Alcázar, José Antonio

2012-01-01

Background Fibromyalgia (FM) is a chronic pain syndrome with unknown etiology and a wide spectrum of symptoms such as allodynia, debilitating fatigue, joint stiffness and migraine. Recent studies have shown some evidences demonstrating that oxidative stress is associated to clinical symptoms in FM of fibromyalgia. We examined oxidative stress and bioenergetic status in blood mononuclear cells (BMCs) and its association to headache symptoms in FM patients. The effects of oral coenzyme Q10 (CoQ10) supplementation on biochemical markers and clinical improvement were also evaluated. Methods We studied 20 FM patients and 15 healthy controls. Clinical parameters were evaluated using the Fibromyalgia Impact Questionnaire (FIQ), visual analogues scales (VAS), and the Headache Impact Test (HIT-6). Oxidative stress was determined by measuring CoQ10, catalase and lipid peroxidation (LPO) levels in BMCs. Bioenergetic status was assessed by measuring ATP levels in BMCs. Results We found decreased CoQ10, catalase and ATP levels in BMCs from FM patients as compared to normal control (P<0.05 and P<0.001, respectively) We also found increased level of LPO in BMCs from FM patients as compared to normal control (P<0.001). Significant negative correlations between CoQ10 or catalase levels in BMCs and headache parameters were observed (r = −0.59, P<0.05; r = −0.68, P<0.05, respectively). Furthermore, LPO levels showed a significant positive correlation with HIT-6 (r = 0.33, P<0.05). Oral CoQ10 supplementation restored biochemical parameters and induced a significant improvement in clinical and headache symptoms (P<0.001). Discussion The results of this study suggest a role for mitochondrial dysfunction and oxidative stress in the headache symptoms associated with FM. CoQ10 supplementation should be examined in a larger placebo controlled trial as a possible treatment in FM. PMID:22532869

Oxidative stress correlates with headache symptoms in fibromyalgia: coenzyme Q₁₀ effect on clinical improvement.

Directory of Open Access Journals (Sweden)

Mario D Cordero

Full Text Available BACKGROUND: Fibromyalgia (FM is a chronic pain syndrome with unknown etiology and a wide spectrum of symptoms such as allodynia, debilitating fatigue, joint stiffness and migraine. Recent studies have shown some evidences demonstrating that oxidative stress is associated to clinical symptoms in FM of fibromyalgia. We examined oxidative stress and bioenergetic status in blood mononuclear cells (BMCs and its association to headache symptoms in FM patients. The effects of oral coenzyme Q(10 (CoQ(10 supplementation on biochemical markers and clinical improvement were also evaluated. METHODS: We studied 20 FM patients and 15 healthy controls. Clinical parameters were evaluated using the Fibromyalgia Impact Questionnaire (FIQ, visual analogues scales (VAS, and the Headache Impact Test (HIT-6. Oxidative stress was determined by measuring CoQ(10, catalase and lipid peroxidation (LPO levels in BMCs. Bioenergetic status was assessed by measuring ATP levels in BMCs. RESULTS: We found decreased CoQ(10, catalase and ATP levels in BMCs from FM patients as compared to normal control (P < 0.05 and P < 0.001, respectively We also found increased level of LPO in BMCs from FM patients as compared to normal control (P < 0.001. Significant negative correlations between CoQ(10 or catalase levels in BMCs and headache parameters were observed (r  = -0.59, P < 0.05; r  =  -0.68, P < 0.05, respectively. Furthermore, LPO levels showed a significant positive correlation with HIT-6 (r = 0.33, P<0.05. Oral CoQ(10 supplementation restored biochemical parameters and induced a significant improvement in clinical and headache symptoms (P < 0.001. DISCUSSION: The results of this study suggest a role for mitochondrial dysfunction and oxidative stress in the headache symptoms associated with FM. CoQ10 supplementation should be examined in a larger placebo controlled trial as a possible treatment in FM.

POEM a core instrument to measure symptoms in clinical trials: a HOME statement

OpenAIRE

Spuls, Ph.I.; Gerbens, L.A.A.; Simpson, E.; Apfelbacher, C.J.; Chalmers, J.R.; Thomas, K.S.; Prinsen, C.A.C.; Kobyletzki, L.B. von; Singh, J.A.; Williams, Hywel C.; Schmitt, J.

2016-01-01

Background: The Harmonising Outcome Measures for Eczema (HOME) initiative has defined four core outcome domains for a core outcome set (COS) to be measured in all atopic eczema (AE) trials to ensure cross-trial comparison: clinical signs, symptoms, quality of life and longterm control. Objectives: The aim of this paper is to report on the consensus process that was used to select the core instrument to consistently assess symptoms in all future AE trials. Methods: Following the HOME roa...

Biofeedback efficacy to improve clinical symptoms and endoscopic signs of solitary rectal ulcer syndrome.

Science.gov (United States)

Forootan, Mojgan; Shekarchizadeh, Masood; Farmanara, Hamedreza; Esfahani, Ahmad Reza Shekarchizadeh; Esfahani, Mansooreh Shekarchizadeh

2018-01-12

Solitary rectal ulcer syndrome (SRUS) is often resistant to medical and surgical treatment. This study assessed the effect of biofeedback in decreasing the symptoms and the healing of endoscopic signs in SRUS patients. Before starting the treatment, endoscopy and colorectal manometry was performed to evaluate dyssynergic defecation. Patients were followed every four weeks, and during each visit their response to treatment was evaluated regarding to manometry pattern. After at least 50% improvement in manometry parameters, recipients underwent rectosigmoidoscopy. Endoscopic response to biofeedback treatment and clinical symptoms were investigated. Duration of symptoms was 43.11±36.42 months in responder and 63.9 ± 45.74 months in non-responder group (P=0.22). There were more ulcers in non-responder group than responder group (1.50 ±0.71 versus 1.33±- 0.71 before and 1.30 ± 0.95 versus 0.67 ±0.50 after biofeedback), although the difference was not significant (P=0.604, 0.10 respectively). The most prevalent symptoms were constipation (79%), rectal bleeding (68%) and anorectal pain (53%). The most notable improvement in symptoms after biofeedback occured in abdominal pain and incomplete evacuation, and the least was seen in mucosal discharge and toilet waiting as shown in the bar chart. Endoscopic cure was observed in 4 of 10 patients of the non-responder group while 8 patients in responder group experienced endoscopic improvement. It seems that biofeedback has significant effect for pathophysiologic symptoms such as incomplete evacuation and obstructive defecation. Improvement of clinical symptoms does not mean endoscopic cure; so to demonstrate remission the patients have to go under rectosigmoidoscopy.

Biofeedback efficacy to improve clinical symptoms and endoscopic signs of solitary rectal ulcer syndrome

Directory of Open Access Journals (Sweden)

Mojgan Forootan

2018-03-01

Full Text Available Solitary rectal ulcer syndrome (SRUS is often resistant to medical and surgical treatment. This study assessed the effect of biofeedback in decreasing the symptoms and the healing of endoscopic signs in SRUS patients. Before starting the treatment, endoscopy and colorectal manometry was performed to evaluate dyssynergic defecation. Patients were followed every four weeks, and during each visit their response to treatment was evaluated regarding to manometry pattern. After at least 50% improvement in manometry parameters, recipients underwent rectosigmoidoscopy. Endoscopic response to biofeedback treatment and clinical symptoms were investigated. Duration of symptoms was 43.11±36.42 months in responder and 63.9±45.74 months in non-responder group (P=0.22. There were more ulcers in non-responder group than responder group (1.50±0.71 versus 1.33±-0.71 before and 1.30 ± 0.95 versus 0.67±0.50 after biofeedback, although the difference was not significant (P=0.604, 0.10 respectively. The most prevalent symptoms were constipation (79%, rectal bleeding (68% and anorectal pain (53%. The most notable improvement in symptoms after biofeedback occured in abdominal pain and incomplete evacuation, and the least was seen in mucosal discharge and toilet waiting as shown in the bar chart. Endoscopic cure was observed in 4 of 10 patients of the non-responder group while 8 patients in responder group experienced endoscopic improvement. It seems that biofeedback has significant effect for pathophysiologic symptoms such as incomplete evacuation and obstructive defecation. Improvement of clinical symptoms does not mean endoscopic cure; so to demonstrate remission the patients have to go under rectosigmoidoscopy.

Effectiveness of nutritional treatment and synbiotic use on gastrointestinal symptoms reduction in HIV-infected patients: Randomized clinical trial.

Science.gov (United States)

Santos, Annelisa Silva E Alves de Carvalho; Silveira, Erika Aparecida da; Falco, Marianne Oliveira; Nery, Max Weyler; Turchi, Marilia Dalva

2017-06-01

Gastrointestinal symptoms are among the most frequent reported complaints by people living with HIV and AIDS (PLWHA). Treatments that aim to attenuate these symptoms are important to avoid low adherence to antiretroviral therapy and to improve the quality of life. This study aimed to evaluate the effectiveness of nutritional treatment and synbiotic use in PLWHA on reducing gastrointestinal symptoms. A randomized clinical trial nested to an outpatient cohort was conducted to evaluate the effectiveness of two treatments for gastrointestinal symptoms reduction in adult patients with antiretroviral therapy presenting at least one gastrointestinal symptom: 1) nutritional treatment + placebo (6 g maltodextrin) and 2) nutritional treatment + synbiotic (Lactobacillus and Bifidobacterium strains + 6 g fructooligosaccharides). Placebo and synbiotic were consumed twice a day during six months. The primary outcome variable was percentage reduction in the incidence of diarrhea, and secondary outcomes the decrease in the incidence of nausea and/or vomiting, dyspepsia, heartburn, constipation, flatulence, and the presence of three or more gastrointestinal symptoms. Out of 283 patients evaluated for eligibility, 64 met inclusion criteria to enter in this study with 1:1 allocation ratio. Both analyzed groups were homogeneous regarding sociodemographic, clinical and lifestyle variables at baseline. In the intergroup analysis, no difference was found between groups except for heartburn, which had a higher reduction in the placebo group (0.01). Regarding the intragroup analysis, in the placebo group a significant decrease in diarrhea (p = 0.02) and heartburn (p symptoms although there were no statistical differences in the intergroup analysis. This clinical trial was registered at ClinicalTrials.gov (NCT02180035). Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Demographic and Clinical Correlates of Autism Symptom Domains and Autism Spectrum Diagnosis

Science.gov (United States)

Frazier, Thomas W.; Youngstrom, Eric A.; Embacher, Rebecca; Hardan, Antonio Y.; Constantino, John N.; Law, Paul; Findling, Robert L.; Eng, Charis

2014-01-01

Demographic and clinical factors may influence assessment of autism symptoms. This study evaluated these correlates and also examined whether social communication and interaction and restricted/repetitive behavior provided unique prediction of autism spectrum disorder diagnosis. We analyzed data from 7352 siblings included in the Interactive…

Sleep quantity, quality, and insomnia symptoms of medical students during clinical years

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Alsaggaf, Mohammed A.; Wali, Siraj O.; Merdad, Roah A.; Merdad, Leena A.

2016-01-01

Objectives: To determine sleep habits and sleep quality in medical students during their clinical years using validated measures; and to investigate associations with academic performance and psychological stress. Methods: In this cross-sectional study, medical students (n=320) were randomly selected from a list of all enrolled clinical-year students in a Saudi medical school from 2011-2012. Students filled a questionnaire including demographic and lifestyle factors, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and Perceived Stress Scale. Results: Students acquired on average, 5.8 hours of sleep each night, with an average bedtime at 01:53. Approximately 8% reported acquiring sleep during the day, and not during nighttime. Poor sleep quality was present in 30%, excessive daytime sleepiness (EDS) in 40%, and insomnia symptoms in 33% of students. Multivariable regression models revealed significant associations between stress, poor sleep quality, and EDS. Poorer academic performance and stress were associated with symptoms of insomnia. Conclusion: Sleep deprivation, poor sleep quality, and EDS are common among clinical years medical students. High levels of stress and the pressure of maintaining grade point averages may be influencing their quality of sleep. PMID:26837401

Auditory agnosia as a clinical symptom of childhood adrenoleukodystrophy.

Science.gov (United States)

Furushima, Wakana; Kaga, Makiko; Nakamura, Masako; Gunji, Atsuko; Inagaki, Masumi

2015-08-01

To investigate detailed auditory features in patients with auditory impairment as the first clinical symptoms of childhood adrenoleukodystrophy (CSALD). Three patients who had hearing difficulty as the first clinical signs and/or symptoms of ALD. Precise examination of the clinical characteristics of hearing and auditory function was performed, including assessments of pure tone audiometry, verbal sound discrimination, otoacoustic emission (OAE), and auditory brainstem response (ABR), as well as an environmental sound discrimination test, a sound lateralization test, and a dichotic listening test (DLT). The auditory pathway was evaluated by MRI in each patient. Poor response to calling was detected in all patients. Two patients were not aware of their hearing difficulty, and had been diagnosed with normal hearing by otolaryngologists at first. Pure-tone audiometry disclosed normal hearing in all patients. All patients showed a normal wave V ABR threshold. Three patients showed obvious difficulty in discriminating verbal sounds, environmental sounds, and sound lateralization and strong left-ear suppression in a dichotic listening test. However, once they discriminated verbal sounds, they correctly understood the meaning. Two patients showed elongation of the I-V and III-V interwave intervals in ABR, but one showed no abnormality. MRIs of these three patients revealed signal changes in auditory radiation including in other subcortical areas. The hearing features of these subjects were diagnosed as auditory agnosia and not aphasia. It should be emphasized that when patients are suspected to have hearing impairment but have no abnormalities in pure tone audiometry and/or ABR, this should not be diagnosed immediately as psychogenic response or pathomimesis, but auditory agnosia must also be considered. Copyright © 2014 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

Perceived social stress and symptom severity among help-seeking adolescents with versus without clinical high-risk for psychosis.

Science.gov (United States)

Millman, Zachary B; Pitts, Steven C; Thompson, Elizabeth; Kline, Emily R; Demro, Caroline; Weintraub, Marc J; DeVylder, Jordan E; Mittal, Vijay A; Reeves, Gloria M; Schiffman, Jason

2018-02-01

Research suggests that social stress exposure influences illness presentation and course among youth at clinical high-risk (CHR) for psychosis, though less is known about the extent to which self-reported perceptions of social stress relate to the severity of positive symptoms. Importantly, despite the notion that youth at CHR are especially susceptible to elevations in positive symptoms under conditions of stress, no study has examined this presumption relative to other psychiatric groups. Extending previous work demonstrating that perceived social stress was higher in a CHR group than in a clinical group of non-CHR, help-seeking controls, the current study aimed to: (1) examine whether perceived social stress is related to the severity of attenuated positive symptoms in the full sample (N=110); and (2) determine whether CHR status moderates the stress-symptom relation. Exploratory analyses examined relations of perceived social stress to negative, disorganized, and general symptoms. Greater perceptions of social stress were associated with more severe positive symptoms in the entire sample; however, although positive symptoms and perceived social stress were higher in the CHR group, the strength of this relation was statistically indistinguishable across groups. No differential effect of perceived social stress was observed for any symptom domain. Results provide some support for the diathesis-stress model of psychosis, while also suggesting that social stress and symptomatology are related independent of clinical vulnerability to psychosis. Future research would benefit from longitudinal studies of stress-symptom relations across CHR and help-seeking control groups. Copyright © 2017 Elsevier B.V. All rights reserved.

Identifying a system of predominant negative symptoms: Network analysis of three randomized clinical trials.

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Levine, Stephen Z; Leucht, Stefan

2016-12-01

Reasons for the recent mixed success of research into negative symptoms may be informed by conceptualizing negative symptoms as a system that is identifiable from network analysis. We aimed to identify: (I) negative symptom systems; (I) central negative symptoms within each system; and (III) differences between the systems, based on network analysis of negative symptoms for baseline, endpoint and change. Patients with chronic schizophrenia and predominant negative symptoms participated in three clinical trials that compared placebo and amisulpride to 60days (n=487). Networks analyses were computed from the Scale for the Assessment of Negative Symptoms (SANS) scores for baseline and endpoint for severity, and estimated change based on mixed models. Central symptoms to each network were identified. The networks were contrasted for connectivity with permutation tests. Network analysis showed that the baseline and endpoint symptom severity systems formed symptom groups of Affect, Poor responsiveness, Lack of interest, and Apathy-inattentiveness. The baseline and endpoint networks did not significantly differ in terms of connectivity, but both significantly (Psymptom group split into three other groups. The most central symptoms were Decreased Spontaneous Movements at baseline and endpoint, and Poverty of Speech for estimated change. Results provide preliminary evidence for: (I) a replicable negative symptom severity system; and (II) symptoms with high centrality (e.g., Decreased Spontaneous Movement), that may be future treatment targets following replication to ensure the curent results generalize to other samples. Copyright © 2016 Elsevier B.V. All rights reserved.

Symptoms of depression as possible markers of bipolar II disorder.

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Benazzi, Franco

2006-05-01

Underdiagnosis and misdiagnosis of bipolar-II disorder (BP-II) as a major depressive disorder (MDD) are frequently reported. The study aim was to find which symptoms of depression could be possible cross-sectional markers of BP-II, in order to reduce underdiagnosing BP-II. Consecutive 379 BP-II and 271 MDD major depressive episode (MDE) outpatients were interviewed with the Structured Clinical Interview for DSM-IV, the Hypomania Interview Guide, and the Family History Screen, by a senior psychiatrist in a private practice. Inside-MDE hypomanic symptoms (elevated mood and increased self-esteem always absent by definition) were systematically assessed. Mixed depression was defined as an MDE plus 3 or more inside-MDE hypomanic symptoms, a definition validated by Akiskal and Benazzi. The MDE symptoms significantly more common in BP-II versus MDD were weight gain, increased eating, hypersomnia, psychomotor agitation, worthlessness, and diminished ability to concentrate. The inside-MDE hypomanic symptoms significantly more common in BP-II were distractibility, racing/crowded thoughts, irritability, psychomotor agitation, more talkativeness, increased risky and goal-directed activities. Multiple logistic regression showed that hypersomnia, racing/crowded thoughts, irritability, and psychomotor agitation were independent predictors of BP-II. Irritability had the most balanced combination of sensitivity and specificity predicting BP-II. Psychomotor agitation had the highest specificity but the lowest sensitivity. Racing/crowded thoughts had the highest sensitivity but the lowest specificity. These symptoms had a similar positive predictive value (PPV) for BP-II, which was around 70% (PPV is more clinically useful than sensitivity and specificity), which in turn was similar to the PPV of mixed depression and atypical depression (two diagnostic clinical markers of BP-II). All possible combinations of these symptoms had a PPV similar to that of the individual symptoms. The

Internet addiction: a descriptive clinical study focusing on comorbidities and dissociative symptoms.

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Bernardi, Silvia; Pallanti, Stefano

2009-01-01

Internet addiction (IAD) is an emerging cause of morbidity and has been recently considered to merit inclusion in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Given the paucity of knowledge about IAD, we conducted a descriptive clinical analysis of patients focusing on clinical, demographic features, and comorbidities. The detachment has been suggested as a reason for the attractiveness of the Internet; thus, we assessed dissociative symptoms and their association with IAD disability. A cohort of 50 adult outpatients were screened using the Internet Addiction Scale. Exclusion criterion was using the Internet for only one purpose such as gaming or gambling. Nine women and 6 men constituted the sample of Internet addicts; each of them had a score of 70 or higher on the Internet Addiction Scale. Comorbidities and subthreshold symptoms were screened carefully. Dissociative symptoms were analyzed with the Dissociative Experience Scale, and disability was assessed using the Sheehan Disability Scale. Hours/week spent on the Internet were 42.21 +/- 3.09. Clinical diagnoses included 14% attention deficit and hyperactivity disorder, 7% hypomania, 15% generalized anxiety disorder, 15% social anxiety disorder; 7% dysthymia, 7% obsessive compulsive personality disorder, 14% borderline personality disorder, and 7% avoidant personality disorder. One patient met criteria for binge eating disorder. Severity measures of IAD were associated with higher perception of family disability (r = 0.814; P

Ethnic Variation in the Cross-sectional Association between Domains of Depressive Symptoms and Clinical Depression

Directory of Open Access Journals (Sweden)

Shervin eAssari

2016-04-01

Full Text Available BackgroundThe degree by which depressive symptoms and clinical depression reflect each other may vary across populations. The present study compared Blacks and Whites for the magnitude of the cross-sectional associations between various domains of depressive symptoms and endorsement of clinical disorders of depression. MethodsData came from the National Survey of American Life (NSAL, 2001–2003. We included 3,570 Black (African Americans, and 891 Non-Hispanic Whites. Predictors were positive affect, negative affect, and interpersonal problems measured using the 12-item Center for Epidemiologic Studies Depression Scale (CES-D. Outcomes were lifetime MDD, lifetime MDE, 12 month MDE, 30 days MDE, and 30 days MDDH based on the Composite International Diagnostic Interview (CIDI. Logistic regression models were applied in the pooled sample, as well as Blacks and Whites.ResultsRegarding CES-D, Blacks had lower total scores, positive affect, negative affect, and interpersonal problems compared to Whites (p < 0.05 for all comparisons. Blacks also had lower odds of meeting criteria for lifetime MDD and MDE, 12 month MDE, and 30 days MDE and MDDH (p < 0.05 for all comparisons. For most depressive diagnoses, ethnicity showed a positive and significant interaction with the negative affect and interpersonal domains, suggesting stronger associations for Blacks compared to Whites. CES-D total and CES-D positive affect did not interact with ethnicity on CIDI based diagnoses.ConclusionStronger associations between multiple domains of depressive symptoms and clinical MDD may be due to higher severity of depression among Blacks, when they endorse the disorder. This finding may explain some of previously observed ethnic differences in social, psychological, and medical correlates of depressive symptoms and clinical depression in the general population as well as clinical settings.

[Correlation between specific and nonspecific posttraumatic stress disorder symptoms with healthcare consumption among 340 French soldiers].

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Holterbach, L; Baumann, C; Andreani, B; Desré, D; Auxéméry, Y

2015-10-01

The psychotraumatic disorders are often difficult to diagnose because the specific symptoms of posttraumatic stress disorder (revival, hyperarousal, avoidance) are rarely a direct demand for health care: for reasons determined by the psychopathological structure of trauma, its symptomatology and course, the psychotraumatised subjects seek a care system for nonspecific psychological or somatoform symptoms: depressive episode, cognitive disorders, other anxiety disorders, histrionic and obsessive symptoms, changes in personality, pain disorders and somatization. Somatic pain may also result from a war injury and psychosomatic complications, addictive or consequences of risk behaviours during the evolution of posttraumatic stress disorder. To establish a correlation between the PCLS and the evaluation of the healthcare consumption in a military population. We conducted a multicenter epidemiological study analyzing the PCLS and a questionnaire assessing health care consumption. The PCLS has been studied in various forms: quantitative (17 to 85), in qualitative classes (disorders, could be developed a score of health care consumption which would include the number of days of sick leave and unavailability, the number and quality of medical consultations, the number and quality of drug and laboratory requirements, the number of hospitalisations. To the identification of posttraumatic stress disorder, the PCLS score as well as the consumer healthcare score are valuable tools but do not replace the subjectivity of the clinical relationship: return to this shared subjectivity with the practitioner remains a diagnostic dimension, but also therapeutic, fundamental. Copyright © 2015 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

The Influence of Preoperative and Postoperative Psychological Symptoms on Clinical Outcome after Shoulder Surgery: A Prospective Longitudinal Cohort Study.

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Koorevaar, Rinco C T; van 't Riet, Esther; Gerritsen, Marleen J J; Madden, Kim; Bulstra, Sjoerd K

2016-01-01

Psychological symptoms are highly prevalent in patients with shoulder complaints. Psychological symptoms in patients with shoulder complaints might play a role in the aetiology, perceived disability and pain and clinical outcome of treatment. The aim of this study was to assess whether preoperative symptoms of distress, depression, anxiety and somatisation were associated with a change in function after shoulder surgery and postoperative patient perceived improvement of pain and function. In addition, the change of psychological symptoms after shoulder surgery was analyzed and the influence of postoperative symptoms of psychological disorders after surgery on the change in function after shoulder surgery and perceived postoperative improvement of pain and function. A prospective longitudinal cohort study was performed in a general teaching hospital. 315 consecutive patients planned for elective shoulder surgery were included. Outcome measures included change of Disabilities of the Arm, Shoulder and Hand (DASH) score and anchor questions about improvement in pain and function after surgery. Psychological symptoms were identified before and 12 months after surgery with the validated Four-Dimensional Symptom Questionnaire (4DSQ). Psychological symptoms were encountered in all the various shoulder diagnoses. Preoperative symptoms of psychological disorders persisted after surgery in 56% of patients, 10% of patients with no symptoms of psychological disorders before surgery developed new psychological symptoms. Preoperative symptoms of psychological disorders were not associated with the change of DASH score and perceived improvement of pain and function after shoulder surgery. Patients with symptoms of psychological disorders after surgery were less likely to improve on the DASH score. Postoperative symptoms of distress and depression were associated with worse perceived improvement of pain. Postoperative symptoms of distress, depression and somatisation were

Cognitive correlates of verbal memory and verbal fluency in schizophrenia, and differential effects of various clinical symptoms between male and female patients.

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Brébion, Gildas; Villalta-Gil, Victoria; Autonell, Jaume; Cervilla, Jorge; Dolz, Montserrat; Foix, Alexandrina; Haro, Josep Maria; Usall, Judith; Vilaplana, Miriam; Ochoa, Susana

2013-06-01

Impairment of higher cognitive functions in patients with schizophrenia might stem from perturbation of more basic functions, such as processing speed. Various clinical symptoms might affect cognitive efficiency as well. Notably, previous research has revealed the role of affective symptoms on memory performance in this population, and suggested sex-specific effects. We conducted a post-hoc analysis of an extensive neuropsychological study of 88 patients with schizophrenia. Regression analyses were conducted on verbal memory and verbal fluency data to investigate the contribution of semantic organisation and processing speed to performance. The role of negative and affective symptoms and of attention disorders in verbal memory and verbal fluency was investigated separately in male and female patients. Semantic clustering contributed to verbal recall, and a measure of reading speed contributed to verbal recall as well as to phonological and semantic fluency. Negative symptoms affected verbal recall and verbal fluency in the male patients, whereas attention disorders affected these abilities in the female patients. Furthermore, depression affected verbal recall in women, whereas anxiety affected it in men. These results confirm the association of processing speed with cognitive efficiency in patients with schizophrenia. They also confirm the previously observed sex-specific associations of depression and anxiety with memory performance in these patients, and suggest that negative symptoms and attention disorders likewise are related to cognitive efficiency differently in men and women. Copyright © 2013 Elsevier B.V. All rights reserved.

Validation of a 4-item Negative Symptom Assessment (NSA-4): a short, practical clinical tool for the assessment of negative symptoms in schizophrenia.

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Alphs, Larry; Morlock, Robert; Coon, Cheryl; Cazorla, Pilar; Szegedi, Armin; Panagides, John

2011-06-01

The 16-item Negative Symptom Assessment (NSA-16) scale is a validated tool for evaluating negative symptoms of schizophrenia. The psychometric properties and predictive power of a four-item version (NSA-4) were compared with the NSA-16. Baseline data from 561 patients with predominant negative symptoms of schizophrenia who participated in two identically designed clinical trials were evaluated. Ordered logistic regression analysis of ratings using NSA-4 and NSA-16 were compared with ratings using several other standard tools to determine predictive validity and construct validity. Internal consistency and test--retest reliability were also analyzed. NSA-16 and NSA-4 scores were both predictive of scores on the NSA global rating (odds ratio = 0.83-0.86) and the Clinical Global Impressions--Severity scale (odds ratio = 0.91-0.93). NSA-16 and NSA-4 showed high correlation with each other (Pearson r = 0.85), similar high correlation with other measures of negative symptoms (demonstrating convergent validity), and lesser correlations with measures of other forms of psychopathology (demonstrating divergent validity). NSA-16 and NSA-4 both showed acceptable internal consistency (Cronbach α, 0.85 and 0.64, respectively) and test--retest reliability (intraclass correlation coefficient, 0.87 and 0.82). This study demonstrates that NSA-4 offers accuracy comparable to the NSA-16 in rating negative symptoms in patients with schizophrenia. Copyright © 2011 John Wiley & Sons, Ltd.

Could clinical symptoms of the gastrointestinal tract disguise a life threatening condition?

International Nuclear Information System (INIS)

Rajzak, E.; Kostalova, L.; Kovacs, L.; Bereczkova, E.; Rajzak, R.

2016-01-01

In paediatric practice encountering symptoms such as nausea, vomiting, lack of appetite, diarrhoea, abdominal pain are generally associated with and credited to maladies of the gastrointestinal tract. This paper focuses on a case study of a nine-year-old boy tracing the causal background of his deteriorating condition. Within a period of two months he was admitted twice for ambulatory treatment of nausea and vomiting. First he was hospitalized for impaired digestion, however upon symptomatic treatment and rehydration he quickly recovered. Two months following his first hospitalization, he was yet again admitted for aggravated albeit similar and additional symptoms such as fatigue, weight loss, emotional instability and an excessive use of salt. Given the thoroughly assessed anamnesis and study of his clinical symptoms along with the laboratory results, our team’s assumption of Addison’s disease had been confirmed. (author)

Elimination of pain improves specificity of clinical diagnostic criteria for adult chronic rhinosinusitis.

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Hirsch, Scott D; Reiter, Evan R; DiNardo, Laurence J; Wan, Wen; Schuman, Theodore A

2017-05-01

Determine whether the elimination of pain improves accuracy of clinical diagnostic criteria for adult chronic rhinosinusitis. Retrospective cohort study. History, symptoms, nasal endoscopy, and computed tomography (CT) results were analyzed for 1,186 adults referred to an academic otolaryngology clinic with presumptive diagnosis of chronic rhinosinusitis. Clinical diagnosis was rendered using the 1997 Rhinosinusitis Taskforce (RSTF) Guidelines and a modified version eliminating facial pain, ear pain, dental pain, and headache. Four hundred seventy-nine subjects (40%) met inclusion criteria. Among subjects positive by RSTF guidelines, 45% lacked objective evidence of sinonasal inflammation by CT, 48% by endoscopy, and 34% by either modality. Applying modified RSTF diagnostic criteria, 39% lacked sinonasal inflammation by CT, 38% by endoscopy, and 24% by either modality. Using either abnormal CT or endoscopy as the reference standard, modified diagnostic criteria yielded a statistically significant increase in specificity from 37.1% to 65.1%, with a nonsignificant decrease in sensitivity from 79.2% to 70.3%. Analysis of comorbidities revealed temporomandibular joint disorder, chronic cervical pain, depression/anxiety, and psychiatric medication use to be negatively associated with objective inflammation on CT or endoscopy. Clinical diagnostic criteria overestimate the prevalence of chronic rhinosinusitis. Removing facial pain, ear pain, dental pain, and headache increased specificity without a concordant loss in sensitivity. Given the high prevalence of sinusitis, improved clinical diagnostic criteria may assist primary care providers in more accurately predicting the presence of inflammation, thereby reducing inappropriate antibiotic use or delayed referral for evaluation of primary headache syndromes. 4. Laryngoscope, 127:1011-1016, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Anxiety and depression symptoms and migraine: a symptom-based approach research.

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Peres, Mario Fernando Prieto; Mercante, Juliane P P; Tobo, Patricia R; Kamei, Helder; Bigal, Marcelo Eduardo

2017-12-01

Anxiety and mood disorders have been shown to be the most relevant psychiatric comorbidities associated with migraine, influencing its clinical course, treatment response, and clinical outcomes. Limited information is available on how specific anxiety and depression symptoms are related to migraine. Symptoms-based approach, a current trend in mental health research, may improve our understanding in migraine comorbidity. The purpose of this study was to analyze how anxiety and depression aspects are related to migraine through a symptom-based approach. We studied 782 patients from the general population who completed a self-administered questionnaire assessing demographics, headache features, anxiety and depression symptoms. A binary logistic regression analyses were conducted to test the association between all four ratings in GAD-7 (anxiety) and PHQ-9 (depression) scales subitems as covariates, and migraine vs no headache as the outcome. The leading Odd Ratios (OR) observed in individuals with migraine relative to those without migraine were anxiety related, "Not being able to stop or control worrying" on a daily basis [OR (CI 95%)] 49.2 (13.6-178.2), "trouble relaxing" 25.7 (7.1-92.6), "Feeling nervous, anxious or on edge" on a daily basis 25.4 (6.9-93.8), and "worrying too much about different things" 24.4 (7.7-77.6). Although the hallmark symptoms of depression are emotional (hopelessness and sadness), the highest scores found were physical: apetite, fatigue, and poor sleep. Irritability had a significant increase in migraine risk [OR 3.8 (1.9-7.8) if experienced some days, 7.5 (2.7-20.7) more than half the days, and 22.0 (5.7-84.9) when experienced nearly every day]. Anxiety was more robustly associated with increase in migraine risk than depression. Lack of ability to properly control worrying and to relax are the most prominent issues in migraine psychiatric comorbidity. Physical symptoms in depression are more linked to migraine than emotional symptoms. A

Impulsivity and clinical symptoms among adolescents with non-suicidal self-injury with or without attempted suicide.

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Dougherty, Donald M; Mathias, Charles W; Marsh-Richard, Dawn M; Prevette, Kristen N; Dawes, Michael A; Hatzis, Erin S; Palmes, Guy; Nouvion, Sylvain O

2009-08-30

This study examined clinical characteristics and laboratory-measured impulsive behavior of adolescents engaging in either non-suicidal self-injury with (NSSI+SA; n=25) or without (NSSI-Only; n=31) suicide attempts. We hypothesized that adolescent with NSSI+SI would exhibit more severe clinical symptoms and higher levels of behavioral impulsivity compared to adolescents with NSSI-Only. Adolescents were recruited from an inpatient psychiatric hospital unit and the two groups were compared on demographic characteristics, psychopathology, self-reported clinical ratings, methods of non-suicidal self-injury, and two laboratory impulsivity measures. Primary evaluations were conducted during psychiatric hospitalization, and a subset of those tested during hospitalization was retested 4-6 weeks after discharge. During hospitalization, NSSI+SA patients reported worse depression, hopelessness, and impulsivity on standard clinical measures, and demonstrated elevated impulsivity on a reward-directed laboratory measure compared to NSSI-Only patients. In the follow-up analyses, depression, hopelessness, suicidal ideation, and laboratory impulsivity were improved for both groups, but the NSSI+SA group still exhibited significantly more depressive symptoms, hopelessness, and impulsivity than the NSSI-Only group. Risk assessments for adolescents with NSSI+SA should include consideration not only of the severity of clinical symptoms but of the current level impulsivity as well.

Implant Strategy-Specific Changes in Symptoms in Response to Left Ventricular Assist Devices.

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Lee, Christopher S; Gelow, Jill M; Chien, Christopher V; Hiatt, Shirin O; Bidwell, Julie T; Denfeld, Quin E; Grady, Kathleen L; Mudd, James O

Although we know that the quality of life generally improves after left ventricular assist device (LVAD) implantation, we know little about how symptoms change in response to LVAD. The purpose of this study was to compare the changes in symptoms between bridge and destination therapy patients as part of a prospective cohort study. Physical (dyspnea and wake disturbances) and affective symptoms (depression and anxiety) were measured before LVAD and at 1, 3, and 6 months after LVAD. Multiphase growth modeling was used to capture the 2 major phases of change: initial improvements between preimplant and 1 month after LVAD and subsequent improvements between 1 and 6 months after LVAD. The sample included 64 bridge and 22 destination therapy patients as the preimplant strategy. Destination patients had worse preimplant dyspnea and wake disturbances, and they experienced greater initial improvements in these symptoms compared with bridge patients (all P .05). Destination patients had worse preimplant depression (P = .042) but experienced similar initial and subsequent improvements in depression in response to LVAD compared with bridge patients (both P > .05). Destination patients had similar preimplant anxiety (P = .279) but experienced less initial and greater subsequent improvements in anxiety after LVAD compared with bridge patients (both P < .05). There are many differences in the magnitude and timing of change in symptom responses to LVAD between bridge and destination therapy patients. Detailed information on changes in specific symptoms may better inform shared decision-making regarding LVAD.

Depression symptoms in boys with autism spectrum disorder and comparison samples.

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Gadow, Kenneth D; Guttmann-Steinmetz, Sarit; Rieffe, Carolien; Devincent, Carla J

2012-07-01

This study compares severity of specific depression symptoms in boys with autism spectrum disorder (ASD), attention-deficit hyperactivity disorder (ADHD), or chronic multiple tic disorder (CMTD) and typically developing boys (Controls). Children were evaluated with parent and teacher versions of the Child Symptom Inventory-4 (CSI-4) and a demographic questionnaire. Mothers' and teachers' ratings generally indicated the most severe symptoms in boys with ASD ± ADHD. Associations of depression with ASD severity and IQ varied considerably for specific symptoms of depression, ASD functional domain, and informant. Findings provide additional support for the differential influence of neurobehavioral syndromes on co-occurring symptom severity and illustrate how more fine-grained analyses of clinical phenotypes may contribute to a better understanding of etiology and current nosology.

Psychiatric Symptoms in Adults with Down Syndrome and Alzheimer's Disease

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Urv, Tiina K.; Zigman, Warren B.; Silverman, Wayne

2010-01-01

Changes in psychiatric symptoms related to specific stages of dementia were investigated in 224 adults 45 years of age or older with Down syndrome. Findings indicate that psychiatric symptoms are a prevalent feature of dementia in the population with Down syndrome and that clinical presentation is qualitatively similar to that seen in Alzheimer's…

Parkinson's Disease Subtypes Identified from Cluster Analysis of Motor and Non-motor Symptoms.

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Mu, Jesse; Chaudhuri, Kallol R; Bielza, Concha; de Pedro-Cuesta, Jesus; Larrañaga, Pedro; Martinez-Martin, Pablo

2017-01-01

Parkinson's disease is now considered a complex, multi-peptide, central, and peripheral nervous system disorder with considerable clinical heterogeneity. Non-motor symptoms play a key role in the trajectory of Parkinson's disease, from prodromal premotor to end stages. To understand the clinical heterogeneity of Parkinson's disease, this study used cluster analysis to search for subtypes from a large, multi-center, international, and well-characterized cohort of Parkinson's disease patients across all motor stages, using a combination of cardinal motor features (bradykinesia, rigidity, tremor, axial signs) and, for the first time, specific validated rater-based non-motor symptom scales. Two independent international cohort studies were used: (a) the validation study of the Non-Motor Symptoms Scale ( n = 411) and (b) baseline data from the global Non-Motor International Longitudinal Study ( n = 540). k -means cluster analyses were performed on the non-motor and motor domains (domains clustering) and the 30 individual non-motor symptoms alone (symptoms clustering), and hierarchical agglomerative clustering was performed to group symptoms together. Four clusters are identified from the domains clustering supporting previous studies: mild, non-motor dominant, motor-dominant, and severe. In addition, six new smaller clusters are identified from the symptoms clustering, each characterized by clinically-relevant non-motor symptoms. The clusters identified in this study present statistical confirmation of the increasingly important role of non-motor symptoms (NMS) in Parkinson's disease heterogeneity and take steps toward subtype-specific treatment packages.

Relationship between Metabolic Syndrome and Predictors for Clinical Benign Prostatic Hyperplasia Progression and International Prostate Symptom Score in Patients with Moderate to Severe Lower Urinary Tract Symptoms.

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Zhao, Sicong; Chen, Chao; Chen, Zongping; Xia, Ming; Tang, Jianchun; Shao, Sujun; Yan, Yong

2016-06-28

To investigate the association between metabolic syndrome (MetS) and the predictors of the progression of benign prostatic hyperplasia (BPH) and the corresponding frequency and severity of lower urinary tract symptoms (LUTS). A total of 530 men with moderate to severe International Prostate Symptom Score (IPSS) > 7 were recruited in the present study. The predictors for clinical BPH progression were defined as the total prostate volume (TPV) ≥ 31 cm3, prostate-specific antigen level (PSA) ≥ 1.6 ng/mL, maximal flow rate (Qmax) < 10.6 mL/s, postvoid residual urine volume (PVR) of ≥ 39 mL, and age 62 years or older. LUTS were defined according to the IPSS and MetS with the National Cholesterol Education Program-Adult Treatment Panel III guidelines. The Mantel-Haenszel extension test and the multivariate logistic regression analyses were used to statistically examine their relationships. The percentage of subjects with ≥ 1 predictors for clinical BPH progression, the percentage of subjects with a TPV ≥ 31 cm3, the percentage of subjects with a PVR ≥ 39 mL, and the percentage of subjects with a Qmax < 10.6 mL/s increased significantly with the increasing in the number of MetS components (all P < .05). After adjusting for age and serum testosterone level, the MetS were independently associated with the presence of TPV ≥ 31 cm3 (OR = 17.030, 95% CI: 7.495-38.692). Moreover, MetS was positively associated with the severity of LUTS (P < .001) and voiding scores (P < .001), and each individual MetS component appeared as an independent risk factor for severe LUTS (IPSS > 19, all P < .001). Our data have shown that the MetS significantly associated with the predictors for clinical BPH progression and the frequency and severity of LUTS, especially the voiding symptoms. The prevention of such modifiable factors by promotion of dietary changes and regular physical activity practice may be of great importance for public health. .

Specific insomnia symptoms and self-efficacy explain CPAP compliance in a sample of OSAS patients.

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Philip, Pierre; Bioulac, Stéphanie; Altena, Elemarije; Morin, Charles M; Ghorayeb, Imad; Coste, Olivier; Monteyrol, Pierre-Jean; Micoulaud-Franchi, Jean-Arthur

2018-01-01

This study explores the association between specific insomnia symptoms (sleep onset, sleep maintenance and early morning awakenings symptoms) and self-efficacy (perceived self-confidence in the ability to use CPAP) with CPAP compliance in French patients with obstructive sleep apnea syndrome (OSAS). We performed a retrospective, cross-sectional analysis of CPAP compliance in a cohort of 404 patients diagnosed with OSAS. Patients completed mailed questionnaires on sleepiness (ESS), insomnia (ISI) and self-efficacy in sleep apnea (SEMSA). Linear regression modeling analyses were performed to explore the impact of measured variables on the number of hours of CPAP use. Of the initial pool of 404 patients, 288 returned the questionnaires (71% response rate). Their mean age was 63.16±12.73 yrs, 31% were females, mean BMI was 30.39±6.31 kg/m2, mean daily CPAP use was 6.19±2.03 h, mean number of years of use was 6.58±6.03 yrs, and mean initial AHI before CPAP use was 34.61±20.71 /h. Age (pCPAP use. We found that specific insomnia symptoms and self-efficacy were associated with CPAP compliance. Our findings underline the need to demonstrate that interventions that reduce insomnia symptoms and improve self-efficacy will increase CPAP compliance.

Prenatal Pregnancy Complications and Psychiatric Symptoms: Children with ASD versus Clinic Controls

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Tudor, Megan E.; DeVincent, Carla J.; Gadow, Kenneth D.

2012-01-01

The current study examined the association between prenatal pregnancy complications (PPC) and childhood psychiatric symptoms in children with an autism spectrum disorder (ASD) and non-ASD children who were referred to a psychiatric clinic (Controls). Parents completed a "DSM-IV"-referenced rating scale and developmental history questionnaire.…

Digestive system-related pathophysiological symptoms of Sasang typology: Systematic review.

Science.gov (United States)

Lee, Mi Suk; Sohn, Kyungwoo; Kim, Yun Hee; Hwang, Min-Woo; Kwon, Young Kyu; Bae, Na Young; Chae, Han

2013-06-01

The purpose of this study was to review clinical studies on digestive system-related pathophysiological symptoms of each Sasang type to obtain the generalizable typespecific clinical features, which are important for the diagnosis of the Sasang type and subsequent disease treatment. Sasang typology and digestive system symptom-related keywords were used to search through eight domestic and foreign databases up to March 2012. The results were organized and analyzed based on four categories [digestive function, appetite, eating pattern, and body mass index (BMI)] to elucidate type-specific symptoms. Sasang type-specific digestive system-related symptoms were identified by reviewing 30 related articles that were gathered by searching through the databases. The Tae-Eum (TE) type had the highest digestive functions and the So-Eum (SE) type had the lowest. The TE type appeared to have larger volume with fast eating speed compared with the SE type and individuals in the TE category preferred fatty or salty food, which is responsible for the high occurrence rates of organic digestive diseases such as gastritis. Moreover, BMI was higher in the TE type and lower in the SE type. We systematically reviewed previously published clinical reports on digestive functions, which can be used to meet the objective of Sasang-type differentiation and pathophysiological pattern identification.

Digestive system-related pathophysiological symptoms of Sasang typology: Systematic review

Directory of Open Access Journals (Sweden)

Mi Suk Lee

2013-06-01

Full Text Available The purpose of this study was to review clinical studies on digestive system-related pathophysiological symptoms of each Sasang type to obtain the generalizable typespecific clinical features, which are important for the diagnosis of the Sasang type and subsequent disease treatment. Sasang typology and digestive system symptom-related keywords were used to search through eight domestic and foreign databases up to March 2012. The results were organized and analyzed based on four categories [digestive function, appetite, eating pattern, and body mass index (BMI] to elucidate type-specific symptoms. Sasang type-specific digestive system-related symptoms were identified by reviewing 30 related articles that were gathered by searching through the databases. The Tae-Eum (TE type had the highest digestive functions and the So-Eum (SE type had the lowest. The TE type appeared to have larger volume with fast eating speed compared with the SE type and individuals in the TE category preferred fatty or salty food, which is responsible for the high occurrence rates of organic digestive diseases such as gastritis. Moreover, BMI was higher in the TE type and lower in the SE type. We systematically reviewed previously published clinical reports on digestive functions, which can be used to meet the objective of Sasang-type differentiation and pathophysiological pattern identification.

Clinical symptoms of food allergy/intolerance in children

DEFF Research Database (Denmark)

Halken, S

1997-01-01

Food allergy is principally a problem in infancy and early childhood. Food allergy/intolerance may cause a broad spectrum of symptoms and signs in children, including generalized reactions, such as anaphylactic shock. Reactions are localized mainly in the gastrointestinal tract, but food allergy....../intolerance may also cause local symptoms in other organs such as the skin and the respiratory tract. About 50-70% demonstrate cutaneous symptoms, 50-60% gastrointestinal symptoms, and 20-30% respiratory symptoms. Among young children with food allergy/intolerance the majority have two or more symptoms...... with symptoms occurring in two or more organ systems. The symptoms occur primarily within a few minutes after food exposure (immediate reactions), however delayed reactions in the skin, gastrointestinal tract and lungs may also occur. Among children with symptoms suggestive of food allergy...

Specific collaborative group intervention for patients with medically unexplained symptoms in general practice: a cluster randomized controlled trial.

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Schaefert, R; Kaufmann, C; Wild, B; Schellberg, D; Boelter, R; Faber, R; Szecsenyi, J; Sauer, N; Guthrie, E; Herzog, W

2013-01-01

Patients with medically unexplained symptoms (MUS) are frequent in primary care and substantially impaired in their quality of life (QoL). Specific training of general practitioners (GPs) alone did not demonstrate sustained improvement at later follow-up in current reviews. We evaluated a collaborative group intervention. We conducted a cluster randomized controlled trial. Thirty-five GPs recruited 304 MUS patients (intervention group: 170; control group: 134). All GPs were trained in diagnosis and management of MUS (control condition). Eighteen randomly selected intervention GPs participated in training for a specific collaborative group intervention. They conducted 10 weekly group sessions and 2 booster meetings in their practices, together with a psychosomatic specialist. Six and 12 months after baseline, QoL was assessed with the Short-Form 36. The primary outcome was the physical composite score (PCS), and the secondary outcome was the mental composite score (MCS). At 12 months, intention-to-treat analyses showed a significant between-group effect for the MCS (p = 0.023) but not for the PCS (p = 0.674). This effect was preceded by a significant reduction of somatic symptom severity (15-item somatic symptom severity scale of the Patient Health Questionnaire, PHQ-15) at 6 months (p = 0.008) that lacked significance at 12 months (p = 0.078). As additional between-group effects at 12 months, per-protocol analyses showed less health anxiety (Whiteley-7; p = 0.038) and less psychosocial distress (PHQ; p = 0.024); GP visits were significantly (p = 0.042) reduced in the intervention group. Compared to pure GP training, collaborative group intervention achieved a progressive, clinically meaningful improvement in mental but not physical QoL. It could bridge gaps between general practice and mental health care. Copyright © 2012 S. Karger AG, Basel.

Impact of symptom burden in post-surgical non-small cell lung cancer survivors.

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Lowery, Amy E; Krebs, Paul; Coups, Elliot J; Feinstein, Marc B; Burkhalter, Jack E; Park, Bernard J; Ostroff, Jamie S

2014-01-01

Pain, fatigue, dyspnea, and distress are commonly reported cancer-related symptoms, but few studies have examined the effects of multiple concurrent symptoms in longer-term cancer survivors. We examined the impact of varying degrees of symptom burden on health-related quality of life (HRQOL) and performance status in surgically treated non-small cell lung cancer (NSCLC) survivors. A sample of 183 NSCLC survivors 1-6 years post-surgical treatment completed questionnaires assessing five specific symptoms (pain, fatigue, dyspnea, depression, and anxiety), HRQOL, and performance status. The number of concurrent clinically significant symptoms was calculated as an indicator of symptom burden. Most survivors (79.8 %) had some degree of symptom burden, with 30.6 % reporting one clinically significant symptom, 27.9 % reporting two symptoms, and 21.3 % reporting three or more symptoms. Physical HRQOL significantly decreased as the degree of symptom burden increased, but mental HRQOL was only significantly decreased in those with three or more symptoms. Receiver-operating characteristic (ROC) curves showed that having multiple concurrent symptoms (two or more) was most likely associated with limitations in functioning (area under a ROC curve = 0.75, sensitivity = 0.81, specificity = 0.54). Two or more clinically significant symptoms are identified as the "tipping point" for showing adverse effects on HRQOL and functioning. This highlights the need for incorporating multiple-symptom assessment into routine clinical practice. Comprehensive symptom management remains an important target of intervention for improved post-treatment HRQOL and functioning among lung cancer survivors.

Caregivers' resilience is independent from the clinical symptoms of dementia.

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Dias, Rachel; Simões-Neto, José Pedro; Santos, Raquel Luiza; Sousa, Maria Fernanda Barroso de; Baptista, Maria Alice Tourinho; Lacerda, Isabel Barbeito; Kimura, Nathalia Ramos Santos; Dourado, Marcia Cristina Nascimento

2016-12-01

Resilience is the capacity for successful adaptation when faced with the stress of adversity. We aimed to investigate the relationship between caregivers' resilience and the sociodemographic and clinical factors of people with dementia. Cross-sectional assessment of 58 people with dementia and their caregiver dyads showed that most caregivers were female adult children. The caregivers reported moderate to higher levels of resilience, lower levels of anxiety and depressive symptoms and moderate levels of burden. Resilience was not related to the caregiver's gender (p = 0.883), nor clinical (p = 0.807) or emotional problems (p = 0.420). The regression showed that resilience was related to the caregiver's quality of life (p caregivers' resilience and the sociodemographic and clinical characteristics of people with dementia. We can assume that resilience is an individual characteristic. Support groups should also focus on the factors that may increase resilience among caregivers.

Online-specific fear of missing out and Internet-use expectancies contribute to symptoms of Internet-communication disorder.

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Wegmann, Elisa; Oberst, Ursula; Stodt, Benjamin; Brand, Matthias

2017-06-01

Some of the most frequently used online applications are Facebook, WhatsApp, and Twitter. These applications allow individuals to communicate with other users, to share information or pictures, and to stay in contact with friends all over the world. However, a growing number of users suffer from negative consequences due to their excessive use of these applications, which can be referred to as Internet-communication disorder. The frequent use and easy access of these applications may also trigger the individual's fear of missing out on content when not accessing these applications. Using a sample of 270 participants, a structural equation model was analyzed to investigate the role of psychopathological symptoms and the fear of missing out on expectancies towards Internet-communication applications in the development of symptoms of an Internet-communication disorder. The results suggest that psychopathological symptoms predict higher fear of missing out on the individual's Internet-communication applications and higher expectancies to use these applications as a helpful tool to escape from negative feelings. These specific cognitions mediate the effect of psychopathological symptoms on Internet-communication disorder. Our results are in line with the theoretical model by Brand et al. (2016) as they show how Internet-related cognitive bias mediates the relationship between a person's core characteristics (e.g., psychopathological symptoms) and Internet-communication disorder. However, further studies should investigate the role of the fear of missing out as a specific predisposition, as well as specific cognition in the online context.

Online-specific fear of missing out and Internet-use expectancies contribute to symptoms of Internet-communication disorder

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Elisa Wegmann

2017-06-01

Full Text Available Some of the most frequently used online applications are Facebook, WhatsApp, and Twitter. These applications allow individuals to communicate with other users, to share information or pictures, and to stay in contact with friends all over the world. However, a growing number of users suffer from negative consequences due to their excessive use of these applications, which can be referred to as Internet-communication disorder. The frequent use and easy access of these applications may also trigger the individual's fear of missing out on content when not accessing these applications. Using a sample of 270 participants, a structural equation model was analyzed to investigate the role of psychopathological symptoms and the fear of missing out on expectancies towards Internet-communication applications in the development of symptoms of an Internet-communication disorder. The results suggest that psychopathological symptoms predict higher fear of missing out on the individual's Internet-communication applications and higher expectancies to use these applications as a helpful tool to escape from negative feelings. These specific cognitions mediate the effect of psychopathological symptoms on Internet-communication disorder. Our results are in line with the theoretical model by Brand et al. (2016 as they show how Internet-related cognitive bias mediates the relationship between a person's core characteristics (e.g., psychopathological symptoms and Internet-communication disorder. However, further studies should investigate the role of the fear of missing out as a specific predisposition, as well as specific cognition in the online context.

Investigating Treatment Outcomes Across OCD Symptom Dimensions in a Clinical Sample of OCD Patients.

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Chase, Tannah; Wetterneck, Chad T; Bartsch, Robert A; Leonard, Rachel C; Riemann, Bradley C

2015-01-01

Despite the heterogeneous nature of obsessive-compulsive disorder (OCD), many self-report assessments do not adequately capture the clinical picture presenting within each symptom dimension, particularly unacceptable thoughts (UTs). In addition, obsessions and ordering/arranging compulsions are often underrepresented in samples of treatment outcome studies for OCD. Such methodological discrepancies may obscure research findings comparing treatment outcomes across OCD symptom dimensions. This study aimed to improve upon previous research by investigating treatment outcomes across OCD symptom dimensions using the Dimensional Obsessive-Compulsive Scale, which offers a more comprehensive assessment of UTs. The study included a primarily residential sample of 134 OCD patients. Results indicated that there were no significant differences in treatment outcomes across symptom dimensions. However, the severity of UTs remained significantly greater than other symptom dimensions at both admission and discharge. Thus, it is possible that UTs may exhibit uniquely impairing features, compared with other symptom dimensions. It is also possible that these findings may reflect the characteristics of the residential OCD samples. These speculations as well as implications for OCD treatment and future research are discussed.

Clinical Symptoms in Fibromyalgia Are Better Associated to Lipid Peroxidation Levels in Blood Mononuclear Cells Rather than in Plasma

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Cano-García, Francisco J.; De Miguel, Manuel; Carrión, Angel M.; Navas, Plácido; Sánchez Alcázar, José A.

2011-01-01

Background We examined lipid peroxidation (LPO) in blood mononuclear cells (BMCs) and plasma, as a marker of oxidative damage, and its association to clinical symptoms in Fibromyalgia (FM) patients. Methods We conducted a case–control and correlational study comparing 65 patients and 45 healthy controls. Clinical parameters were evaluated using the Fibromyalgia Impact Questionnaire (FIQ), visual analogues scales (VAS), and the Beck Depression Inventory (BDI). Oxidative stress was determined by measuring LPO in BMCs and plasma. Results We found increased LPO levels in BMCs and plasma from FM patients as compared to normal control (P<0.001). A significant correlation between LPO in BMCs and clinical parameters was observed (r = 0.584, P<0.001 for VAS; r = 0.823, P<0.001 for FIQ total score; and r = 0.875, P<0.01 for depression in the BDI). We also found a positive correlation between LPO in plasma and clinical symptoms (r = 0.452, P<0.001 for VAS; r = 0.578, P<0.001 for FIQ total score; and r = 0.579, P<0.001 for depression in the BDI). Partial correlation analysis controlling for age and BMI, and sex, showed that both LPO in cells and plasma were independently associated to clinical symptoms. However, LPO in cells, but not LPO in plasma, was independently associated to clinical symptoms when controlling for depression (BDI scores). Discussion The results of this study suggest a role for oxidative stress in the pathophysiology of fibromyalgia and that LPO in BMCs rather than LPO in plasma is better associated to clinical symptoms in FM. PMID:22046409

Clinical symptoms in fibromyalgia are better associated to lipid peroxidation levels in blood mononuclear cells rather than in plasma.

Directory of Open Access Journals (Sweden)

Mario D Cordero

Full Text Available BACKGROUND: We examined lipid peroxidation (LPO in blood mononuclear cells (BMCs and plasma, as a marker of oxidative damage, and its association to clinical symptoms in Fibromyalgia (FM patients. METHODS: We conducted a case-control and correlational study comparing 65 patients and 45 healthy controls. Clinical parameters were evaluated using the Fibromyalgia Impact Questionnaire (FIQ, visual analogues scales (VAS, and the Beck Depression Inventory (BDI. Oxidative stress was determined by measuring LPO in BMCs and plasma. RESULTS: We found increased LPO levels in BMCs and plasma from FM patients as compared to normal control (P<0.001. A significant correlation between LPO in BMCs and clinical parameters was observed (r = 0.584, P<0.001 for VAS; r = 0.823, P<0.001 for FIQ total score; and r = 0.875, P<0.01 for depression in the BDI. We also found a positive correlation between LPO in plasma and clinical symptoms (r = 0.452, P<0.001 for VAS; r = 0.578, P<0.001 for FIQ total score; and r = 0.579, P<0.001 for depression in the BDI. Partial correlation analysis controlling for age and BMI, and sex, showed that both LPO in cells and plasma were independently associated to clinical symptoms. However, LPO in cells, but not LPO in plasma, was independently associated to clinical symptoms when controlling for depression (BDI scores. DISCUSSION: The results of this study suggest a role for oxidative stress in the pathophysiology of fibromyalgia and that LPO in BMCs rather than LPO in plasma is better associated to clinical symptoms in FM.

Informative content of clinical symptoms of acute appendicitis in different terms of pregnancy

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Kutovoy A.B.

2015-09-01

Full Text Available With the purpose to evaluate diagnostic efficacy of some clinical symptoms of acute appendicitis 75 women in different terms of pregnancy were examined. Informative content of such symptoms as Kocher- Volkovich, Rovsing, Bartomje - Michelson, Sitkovsky, Gabay, Brendo, Michelson, Ivanov was studied. Pain syndrome was fixed in all examined women. Pain localization was various and depended on the pregnancy term. During the I trimester of pregnancy the most often pain was manifestated in epigastrium and right lower quadrant, rarely in other abdomen regions. In the II trimester in majority of cases pain occurred in right lower quadrant. During III trimester pain prevailed in right upper quadrant of abdomen. Analyzing informative component of researching symptoms there was noted significant decrease (р<0,05; р<0,01; р<0,001 of their diagnostic value with growth of pregnancy term. Therefore Kocher – Volkovich and Rovsing symptoms were the most informative in the I trimester of pregnancy. Diagnostic efficacy of Brendo(67,3%, Michelson(55,7%, Ivanov(59,6% symptoms was higher than that of Kocher – Volkovich (36,5%, Rovsing (28,8%, Sitkovsky (51,9%, Bartomje – Michelson (55,7% symptoms, their value was diminishing together with increase of pregnancy terms.

Joint hypermobility: incidence and some clinical symptoms

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M P Isaev

2003-01-01

Full Text Available Objective. To study joint mobility range among urban population aged 18 to 30 years and to assess association of joint and other connective tissue structures disorders clinical signs with hypermobility. Material and methods. 769 randomly selected individuals aged 18 to 30 (mean - 25,56 years (419 female and 350 male were examined. Hypermobility was assessed with 9-point Beighton scale. Examination included skin stretchability evaluation at elbow back surface, determination of flat feet, high palate, joint pain and deformities of knee joints, joint luxation and subluxation, hand and feet vasospastic disturbances, cardiac pain, oculist examination. Methods of variational statistics were used (x2, Student's test, Spirmen's correlation. Results. Hypermobility incidence and joint mobility in population aged 18 to 30 years in Orenburg largely comply with data received in Moscow. Joint mobility up to 5 points in women and up to 4 points in men is usual for persons of this age and in absence of additional clinical symptoms cannot be considered as pathological. Knee joint deformities, presence of high palate, cardiac pain accompanied by signs of vegetative dysfunction, hand and feet vasospastic disturbances are significantly connected with degree of joint mobility and in some cases can help in hypermobility syndrome diagnosis.

Associations between specific psychotic symptoms and specific childhood adversities are mediated by attachment styles: an analysis of the National Comorbidity Survey.

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Sitko, Katarzyna; Bentall, Richard P; Shevlin, Mark; O'Sullivan, Noreen; Sellwood, William

2014-07-30

Accumulated evidence over the past decade consistently demonstrates a relationship between childhood adversity and psychosis in adulthood. There is some evidence of specific associations between childhood sexual abuse and hallucinations, and between insecure attachment and paranoia. Data from the National Comorbidity Survey were used in assessing whether current attachment styles influenced the association between adverse childhood experiences and psychotic symptoms in adulthood. Hallucinations and paranoid beliefs were differentially associated with sexual abuse (rape and sexual molestation) and neglect, respectively. Sexual abuse and neglect were also associated with depression. The relationship between neglect and paranoid beliefs was fully mediated via anxious and avoidant attachment. The relationship between sexual molestation and hallucinations was independent of attachment style. The relationship between rape and hallucinations was partially mediated via anxious attachment; however this effect was no longer present when depression was included as a mediating variable. The findings highlight the importance of addressing and understanding childhood experiences within the context of current attachment styles in clinical interventions for patients with psychosis. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Clinical neuropsychiatric symptoms in perpetrators of severe crimes against persons.

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Söderström Anckarsäter, Henrik

2005-01-01

The objective of the study was to explore the possibility of common signs and symptoms of childhood-onset neuropsychiatric disorders and personality disorders, especially psychopathy, in a cohort of violent offenders. A structured neuropsychiatric status comprising features recorded in childhood-onset neuropsychiatric disorders and adult personality disorders was assessed in 89 perpetrators of severe crimes against other persons, analysed for factor structure, and compared to clinical diagnostics of neuropsychiatric disorders and independent assessments of psychopathy rated by the Psychopathy Checklist Revised (PCL-R). One or several childhood-onset neuropsychiatric disorders [autism, attention-deficit/hyperactivity disorder (AD/HD), tics and learning disability] affected the majority of adult offenders. A factor analysis yielded four higher-order problem constellations: Executive Dysfunction, Compulsivity, Social Interaction Problems and Superficiality. All four constellations were positively correlated with life histories of aggression, stressing the clinical importance of these problems in adult forensic psychiatry. Compulsivity and Social Interaction Problems were associated with autistic traits and tics, Executive Dysfunction with AD/HD, conduct disorder and psychopathic as well as autistic traits. Superficiality was a distinct aspect of AD/HD and psychopathic traits, especially the PCL-R factor reflecting interpersonal callousness. Neuropsychiatric disorders and personality disorders such as psychopathy share common symptoms. The various facets of psychopathy are associated with executive dysfunction and empathy deficits with superficial understanding of self, others and the rules of communication.

Specificity of peer difficulties to social anxiety in early adolescence: categorical and dimensional analyses with clinical and community samples.

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Early, Martha C; Biggs, Bridget K; Makanui, Kalani P; Legerski, John Paul; Van Allen, Jason; Elledge, Allison R; Whiteside, Stephen P

2017-11-01

We investigated the specificity of social difficulties to social anxiety by testing associations of social anxiety and other anxiety presentations with peer acceptance and victimization in community and treatment-seeking samples of adolescents aged 12-14 years. Cross-sectional, quantitative survey. Adolescents from the community (n = 116) and a clinical setting (n = 154) completed ratings of anxiety symptoms, perceived social acceptance, and peer victimization. Their parents also completed ratings of the adolescents' anxiety and social acceptance. Social acceptance was lowest among adolescents with social anxiety disorder (SAD) and lower among adolescents with other anxiety disorders than in the community sample. Anxiety symptoms were negatively correlated with social acceptance, but these associations were not unique to social anxiety symptoms. Girls in the community sample reported more overt victimization than girls with SAD and with other anxiety diagnoses. Relational victimization was associated with social and nonsocial anxiety symptoms only in the community sample. Our findings supplement recent laboratory-based observational studies on social functioning among adolescents with SAD and other anxiety disorders. Although social anxiety may be associated with unique social skill deficits and impairment, concerns about peer relations should also be considered among adolescents with other anxiety symptoms.

Real-Life Validation of Reduced Reward Processing in Emerging Adults With Depressive Symptoms

NARCIS (Netherlands)

Bakker, Jindra Myrthe; Goossens, Liesbet; Lange, Iris; Michielse, Stijn; Schruers, Koen; Lieverse, Ritsaert; Marcelis, Machteld; van Amelsvoort, Therese; van Os, Jim; Myin-Germeys, Inez; Wichers, Marieke

Subclinical symptoms of depression are common in emerging adults. Anhedonia is one such symptom that specifically puts one at risk for developing clinical depression. Recently, important progress has been made in elucidating the underlying neurobiology of anhedonia. This progress rests on many

Accuracy of Clinical Tests in Detecting Disk Herniation and Nerve Root Compression in Subjects With Lumbar Radicular Symptoms.

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Ekedahl, Harald; Jönsson, Bo; Annertz, Mårten; Frobell, Richard B

2018-04-01

To investigate the accuracy of 3 commonly used neurodynamic tests (slump test, straight-leg raise [SLR] test, femoral neurodynamic test) and 2 clinical assessments to determine radiculopathy (radiculopathy I, 1 neurologic sign; radiculopathy II, 2 neurologic signs corresponding to 1 specific nerve root) in detecting magnetic resonance imaging (MRI) findings (extrusion, subarticular nerve root compression, and foraminal nerve root compression). Validity study. Secondary care. We included subjects (N=99; mean age, 58y; 54% women) referred for epidural steroid injection because of lumbar radicular symptoms who had positive clinical and MRI findings. Positive clinical findings included the slump test (n=67), SLR test (n=50), femoral neurodynamic test (n=7), radiculopathy I (n=70), and radiculopathy II (n=33). Positive MRI findings included extrusion (n=27), subarticular nerve compression (n=14), and foraminal nerve compression (n=25). Not applicable. Accuracy of clinical tests in detecting MRI findings was evaluated using sensitivity, specificity, and receiver operating characteristics analysis with area under the curve (AUC). The slump test had the highest sensitivity in detecting extrusion (.78) and subarticular nerve compression (1.00), but the respective specificity was low (.36 and .38). Radiculopathy I was most sensitive in detecting foraminal nerve compression (.80) but with low specificity (.34). Only 1 assessment had a concurrent high sensitivity and specificity (ie, radiculopathy II) in detecting subarticular nerve compression (.71 and .73, respectively). The AUC for all tests in detecting extrusion, subarticular nerve compression, and foraminal nerve compression showed ranges of .48 to .60, .63 to .82, and .33 to .57, respectively. In general, the investigated neurodynamic tests or assessments for radiculopathy lacked diagnostic accuracy. The slump test was the most sensitive test, while radiculopathy II was the most specific test. Most interestingly, no

Comparison of the clinical symptoms of myocardial infarction in the middle-aged and elderly

Directory of Open Access Journals (Sweden)

Behzad Taghipour

2014-08-01

Full Text Available Background: Myocardial infarction is a fatal symbol of cardiovascular diseases, which usually occurs in people over 45 years. However, the incidence of factors such as obesity, high blood pressure, diabetes and metabolic syndrome has increased the risk of developing early cardiovascular diseases in the middle-aged people. This study was conducted to compare the clinical manifestation of myocardial infarction in the middle-aged and elderly people. Methods: In this cross-sectional study, the participants were 366 patients less and more than 55 years old with acute myocardial infarction admitted to the CCU of Imam Reza Hospital in Amol. Data were collected using demographic form and a checklist of clinical symptoms. Statistical analysis was performed by SPSS (version 20 using descriptive statistics, chi-square, odds ratio and the Mantel-Haenszel (α= 0.05 and d=0.3. Results: The results showed that patients over 55 years manifested the symptoms of shortness of breath (1.66, weakness (2.62, vomiting (1.98 and hiccups (2.19 more than the patients under55 years. Also, by controlling the confounding effect of gender, these symptoms had emerged in >55 year-old patients than in <55 year-old ones. Conclusion: According to the results, the elderly patients have more chance of manifesting nonspecific symptoms. Therefore, the healthcare providers, especially nurses should be more careful in this regard during the initial assessment.

Predictors of symptom congruence among patients with acute myocardial infarction.

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Fox-Wasylyshyn, Susan

2012-01-01

The extent of congruence between one's symptom experience and preconceived ideas about the nature of myocardial infarction symptoms (ie, symptom congruence) can influence when acute myocardial infarction (AMI) patients seek medical care. Lengthy delays impede timely receipt of medical interventions and result in greater morbidity and mortality. However, little is known about the factors that contribute to symptom congruence. Hence, the purpose of this study was to examine how AMI patients' symptom experiences and patients' demographic and clinical characteristics contribute to symptom congruence. Secondary data analyses were performed on interview data that were collected from 135 AMI patients. Hierarchical multiple regression analyses were used to examine how specific symptom attributes and demographic and clinical characteristics contribute to symptom congruence. Chest pain/discomfort and other symptom variables (type and location) were included in step 1 of the analysis, whereas symptom severity and demographic and clinical factors were included in step 2. In a second analysis, quality descriptors of discomfort replaced chest pain/discomfort in step 1. Although chest pain/discomfort, and quality descriptors of heaviness and cutting were significant in step 1 of their respective analyses, all became nonsignificant when the variables in step 2 were added to the analyses. Severe discomfort (β = .29, P congruence in the first analysis. Only severe discomfort (β = .23, P congruence in the second analysis. Although the location and quality of discomfort were important components of symptom congruence, symptom severity outweighed their importance. Nonsevere symptoms were less likely to meet the expectations of AMI symptoms by those experiencing this event. Those without a previous history of AMI also experienced lower levels of symptom congruence. Implications pertaining to these findings are discussed.

Impact of childhood adversities on specific symptom dimensions in first-episode psychosis.

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Ajnakina, O; Trotta, A; Oakley-Hannibal, E; Di Forti, M; Stilo, S A; Kolliakou, A; Gardner-Sood, P; Gaughran, F; David, A S; Dazzan, P; Pariante, C; Mondelli, V; Morgan, C; Vassos, E; Murray, R M; Fisher, H L

2016-01-01

The relationship between childhood adversity (CA) and psychotic disorder is well documented. As the adequacy of the current categorical diagnosis of psychosis is being increasingly questioned, we explored independent associations between different types of CA and specific psychotic symptom dimensions in a well-characterized sample of first-episode psychosis (FEP) patients. This study involved 236 FEP cases aged 18-65 years who presented for the first time to psychiatric services in South London, UK. Psychopathology was assessed with the Positive and Negative Syndrome Scale and confirmatory factor analysis was used to evaluate the statistical fit of the Wallwork/Fortgang five-factor model of psychosis. CA prior to 17 years of age (physical abuse, sexual abuse, parental separation, parental death, and being taken into care) was retrospectively assessed using the Childhood Experience of Care and Abuse Questionnaire. Childhood sexual abuse [β = 0.96, 95% confidence interval (CI) 0.40-1.52], childhood physical abuse (β = 0.48, 95% CI 0.03-0.93) and parental separation (β = 0.60, 95% CI 0.10-1.11) showed significant associations with the positive dimension; while being taken into care was associated with the excited dimension (β = 0.36, 95% CI 0.08-0.65), independent of the other types of CA. No significant associations were found between parental death and any of the symptom dimensions. A degree of specificity was found in the relationships between different types of CA and psychosis symptom dimensions in adulthood, suggesting that distinct pathways may be involved in the CA-psychosis association. These potentially different routes to developing psychosis merit further empirical and theoretical exploration.

Twenty-four-hour duration of effect of intranasal corticosteroids for seasonal allergic rhinitis symptoms: clinical evidence and relevance.

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DuBuske, Lawrence M

2012-01-01

Seasonal allergic rhinitis (SAR) symptoms are often most severe and/or disruptive during overnight and morning hours, resulting in cognitive/performance impairments and reduced quality of life throughout the following day. Surveys of allergy patients and health care practitioners reveal a common perception that intranasal steroids (INSs), many of which are dosed q.d., fail to adequately relieve symptoms for a full 24 hours. This review assessed whether perceptions of the 24-hour duration of action of INSs correspond with duration of action documented in clinical literature. SAR clinical trial literature of the last 5 years was reviewed to identify studies of INSs incorporating morning instantaneous (A.M. NOW) or instantaneous assessments of 24-hour duration of action. In numerous placebo-controlled trials of INSs in patients with SAR, treatment was associated with significantly greater improvements in A.M. NOW symptoms from baseline versus placebo. For congestion, this is noteworthy, because patients often cite this symptom, especially in the morning, as the most bothersome symptom. Comparison of A.M. NOW and daily scores suggests minimal drop in efficacy at 24 hours postdose. In several studies, INS treatment was found superior to intranasal or oral antihistamines in A.M. NOW symptom improvement. Once-daily INSs have potential for effective 24-hour symptom relief; however, there is an apparent disconnect between these findings and patient/physician perceptions. This discrepancy may be explained, in part, by less-than-ideal treatment adherence among "real-world" patients versus subjects treated in clinical trials. Proactive counseling can encourage proper INS use and help maximize treatment benefits.

[Analysis of clinical features and allergic status of asthmatic patients with positive serum mycosis-specific IgE].

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Mou, Yan; Ye, Ling; Gong, Ying; Zhang, Zhi-feng; Jin, Mei-ling

2013-08-01

To improve understanding of the clinical characteristics and diagnosis of allergic bronchopulmonary mycosis (ABPM). We retrospectively analyzed the clinical data, including clinical symptoms, laboratory tests, pulmonary function tests and chest CT imaging of 95 asthmatic patients with positive serum mycosis-specific IgE from January 2010 to September 2012 in Zhongshan Hospital Affiliated to Fudan University. Of the 95 patients, 59 cases met the diagnostic criteria of ABPM. There were 34 males and 25 females, with a mean age of (53 ± 4) years and a duration of asthma for (21 ± 4) years. Thirty-six cases showed mycosis hypersensitivity (MH). There were 10 males and 26 females, with a mean age of (46 ± 6) years and a duration of asthma for (16 ± 5) years. Clinical symptoms such as wheeze (52 vs 21, χ(2) = 11.159, P = 0.001), cough (54 vs 27, χ(2) = 4.859, P = 0.030) and expectoration (43 vs 9, χ(2) = 25.731, P = 0.000) were more common in the ABPM group compared to the MH group.In the ABPM group, 58 were A. fumigatus-specific IgE antibody positive, 34 Penicillium-specific IgE antibody positive and 1 only Penicillium-specific IgE antibody positive.While in the MH group, 15 were A.fumigatus-specific IgE antibody positive, 24 Penicillium-specific IgE antibody positive and 17 only Penicillium-specific IgE antibody positive.In the ABPM group, the percentage of positive fumigatus-specific IgE antibody was higher (58 vs 15, χ(2) = 24.500, P = 0.000), while the percentages of dermatophagoides pteronyssinus(21 vs 20, χ(2) = 3.632, P = 0.045) and Dermatophagoides farinae(17 vs 21, χ(2) = 8.118, P = 0.004) were lower. Total serum IgE [(4395 ± 1437) IU/ml vs (276 ± 133) IU/ml, T = 4.384, P = 0.000], peripheral eosinophil percentage[(12.56 ± 1.20)% vs (1.30 ± 0.15)%, t = 8.175, P = 0.000] and count [(2.09 ± 0.43)×10(9)/L vs (0.19 ± 0.04)×10(9)/L, t = 7.032, P = 0.000] were higher in the ABPM group as compared to the MH group.FEV1% slightly declined in the ABPM

Cigarette smoking and schizophrenia: a specific clinical and therapeutic profile? Results from the FACE-Schizophrenia cohort.

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Mallet, J; Le Strat, Y; Schürhoff, F; Mazer, N; Portalier, C; Andrianarisoa, M; Aouizerate, B; Berna, F; Brunel, L; Capdevielle, D; Chereau, I; D'Amato, T; Denizot, H; Dubreucq, J; Faget, C; Gabayet, F; Lançon, C; Llorca, P M; Misdrahi, D; Rey, R; Roux, P; Schandrin, A; Urbach, M; Vidailhet, P; Fond, G; Dubertret, C

2017-10-03

Tobacco use is common in patients with schizophrenia (SZ) but little is known on the role of tobacco in the physiopathology or on the course of the disease. Only few studies embrace an extensive examination of clinical and therapeutic characteristics in stabilized patients. The objective of the present study was to determine the prevalence of tobacco smoking in stabilized SZ outpatients and the clinical and treatment characteristics associated with daily tobacco use in a large community-dwelling sample of patients. Three-hundred-and-sixty-one patients were included in the network of the FondaMental Expert Centers for Schizophrenia. Current tobacco status was self-declared. 53.7% were smokers. Mean age at tobacco onset was 17.2years old. In multivariate analyses, after adjustment for confounding factors, positive symptoms and mean daily antipsychotic dose were associated with a higher frequency of tobacco use (OR=1.06 95%IC[1.02-1.12], for positive symptoms, OR=1.1, 95%IC[1.02-1.18] for daily antipsychotic dose). Education level, negative symptoms, anticholinergic agents, clozapine or aripiprazole administration were independently associated with a lower frequency of tobacco use (respectively OR=0.87, 95%IC [0.79, 0.95], OR=0.95, 95%IC[0.91-0.98], OR=0.41, 95%IC[0.22-0.76], OR=0.56, 95%IC=[0.32, 0.99] and OR=0.49, 95%IC [0.26-0.91]). The prevalence of current tobacco smoking in a French community-dwelling SZ patients is higher that observed in the general population. Patients with tobacco use present clinical and therapeutic specificities that may involve interaction between cholinergic-nicotinic and dopaminergic systems. The present study suggests that some therapeutics may improve daily smoking behavior in smokers. These results should be confirmed in longitudinal studies. Copyright © 2017 Elsevier Inc. All rights reserved.

Difference of achalasia subtypes based on clinical symptoms, radiographic findings, and stasis scores

Directory of Open Access Journals (Sweden)

A. Meillier

2018-01-01

Conclusions: Achalasia subtypes had similar clinical symptoms, except for increased vomiting severity in subtype i. The maximum esophageal diameter in subtype ii was significantly greater than in subtype iii. Esophageal stasis scores were similar. Thus, high-resolution esophageal manometry remains essential in assessing achalasia subtypes.

Brief assessment of priority symptoms in hormone refractory prostate cancer: The FACT Advanced Prostate Symptom Index (FAPSI

Directory of Open Access Journals (Sweden)

Banik Donald

2003-11-01

Full Text Available Abstract Background The objective of this study was to construct and validate a brief, clinically-relevant symptom index for advanced prostate cancer. Methods Questions were extracted from a commonly-used multi-dimensional cancer quality of life instrument with prostate-specific items, the Functional Assessment of Cancer Therapy-Prostate (FACT-P. Surveys of disease-related symptoms were presented to an international sample of 44 expert physicians. Each expert narrowed the list to no more than five of the most important symptoms or concerns to monitor when assessing the value of treatment for advanced prostate cancer. Symptoms/concerns endorsed at a frequency greater than chance probability (17% were retained for the symptom index and called the FACT Advanced Prostate Symptom Index-8 (FAPSI-8: pain (three items, fatigue, weight loss, urinary difficulties (two items, and concern about the condition becoming worse. The FAPSI-8 was validated using data from a clinical trial of 288 men being treated for hormone refractory prostate cancer. Results The FAPSI-8 showed good internal consistency (r = 0.67–0.80; association with existing FACT scales (e.g., FACT-P, Physical Well-being, Functional Well-being; r = 0.44–0.85, p Conclusions This project produced a reliable and valid list of the eight most important clinician-rated targets of drug therapy for advanced prostate cancer. These questions perform comparably to the longer derivative questionnaire. Examination of patient agreement with this priority list and the extent to which changes in these 8 targets are related to meaningful clinical benefit to the patient are important next steps for future research.

Clinical importance of non-specific lipid transfer proteins as food allergens

NARCIS (Netherlands)

van Ree, R.

2002-01-01

Non-specific lipid transfer proteins (nsLTPs) have recently been identified as plant food allergens. They are good examples of true food allergens, in the sense that they are capable of sensitizing, i.e. inducing specific IgE, as well as of eliciting severe symptoms. This is in contrast with most

Specificity of executive function and theory of mind performance in relation to attention-deficit/hyperactivity symptoms in autism spectrum disorders.

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Lukito, Steve; Jones, Catherine R G; Pickles, Andrew; Baird, Gillian; Happé, Francesca; Charman, Tony; Simonoff, Emily

2017-01-01

Individuals with autism spectrum disorder (ASD) frequently demonstrate symptoms of attention-deficit/hyperactivity disorder (ADHD). Previous findings in children with ASD have suggested that these symptoms are associated with an impairment in executive function (EF) abilities. However, studies rarely considered this association within a single framework that controls for other related factors such as Theory of Mind (ToM) abilities and ASD symptoms. We used structural equation modeling to explore the relations among EF, ToM, and symptoms of ASD and ADHD, using data from a population-based sample of 100 adolescents with ASD and full-scale IQ ≥ 50 (the Special Needs and Autism Project (SNAP) cohort). The study used a multi-measure and multi-informant approach, where performance of inhibition, planning, switching, and working memory tasks indexed EF and performance on tasks involving mentalizing indexed ToM. Measures of ASD and ADHD symptoms included parent and teacher reports and direct observation of the children. Shared source of symptom reporting was accounted for with a parental rating latent factor indexed by symptom measures reported by parents. Impairments in EF abilities were specifically associated with ADHD symptoms while impaired ToM was specifically associated with ASD symptoms, when accounting for the associations of each cognitive domain with the other factors. ASD and ADHD symptom latent factors were also correlated, but this association became nonsignificant once the shared source of reporting from parents was accounted for and within a model that also controlled for the correlated pathway between EF and ToM factors. The specific relations between the cognitive domains and behavioral symptoms remained even after controlling for IQ. In this ASD sample, symptoms of ADHD and ASD are underpinned by separate cognitive domains. The association between EF and ToM impairments is a likely partial explanation for the co-occurrence of ADHD symptoms in ASD

Clinical symptoms according to genotype amongst patients with hereditary haemorrhagic telangiectasia

DEFF Research Database (Denmark)

Kjeldsen, A D; Møller, T R; Brusgaard, K

2005-01-01

BACKGROUND: Hereditary haemorrhagic telangiectasia (HHT) is a dominantly inherited disease, characterized by a wide variety of clinical manifestations, including epistaxis, gastrointestinal (GI) bleeding, pulmonary arteriovenous malformations (PAVMs) and neurological symptoms. HHT is a genetically...... patients had experienced more severe GI bleeding than HHT2 patients. There was no significant difference in severity of epistaxis or age at debut. Finally the mortality over a 90-month observation period was not significantly increased....

Anxiety and psychosomatic symptoms in palliative care: from neuro-psychobiological response to stress, to symptoms' management with clinical hypnosis and meditative states.

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Satsangi, Anirudh Kumar; Brugnoli, Maria Paola

2018-01-01

Psychosomatic disorder is a condition in which psychological stresses adversely affect physiological (somatic) functioning to the point of distress. It is a condition of dysfunction or structural damage in physical organs through inappropriate activation of the involuntary nervous system and the biochemical response. In this framework, this review will consider anxiety disorders, from the perspective of the psychobiological mechanisms of vulnerability to extreme stress in severe chronic illnesses. Psychosomatic medicine is a field of behavioral medicine and a part of the practice of consultation-liaison psychiatry. Psychosomatic medicine in palliative care, integrates interdisciplinary evaluation and management involving diverse clinical specialties including psychiatry, psychology, neurology, internal medicine, allergy, dermatology, psychoneuroimmunology, psychosocial oncology and spiritual care. Clinical conditions where psychological processes act as a major factor affecting medical outcomes are areas where psychosomatic medicine has competence. Thus, the psychosomatic symptom develops as a physiological connected of an emotional state. In a state of rage or fear, for example, the stressed person's blood pressure is likely to be elevated and his pulse and respiratory rate to be increased. When the fear passes, the heightened physiologic processes usually subside. If the person has a persistent fear (chronic anxiety), however, which he is unable to express overtly, the emotional state remains unchanged, though unexpressed in the overt behavior, and the physiological symptoms associated with the anxiety state persist. This paper wants highlight how clinical hypnosis and meditative states can be important psychosocial and spiritual care, for the symptom management on neuro-psychobiological response to stress.

Self-reported lactose intolerance in clinic patients with functional gastrointestinal symptoms: prevalence, risk factors, and impact on food choices.

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Zheng, X; Chu, H; Cong, Y; Deng, Y; Long, Y; Zhu, Y; Pohl, D; Fried, M; Dai, N; Fox, M

2015-08-01

Many patients complain of abdominal symptoms with dairy products; however, clinical and psychosocial factors associated with self-reported lactose intolerance (SLI) have not been assessed in large studies. In particular, data are lacking from lactase deficient populations. This prospective cohort study assessed the prevalence of, and risk factors for, SLI in Chinese patients attending a gastroenterology clinic. Consecutive patients completed questionnaires to assess digestive health (Rome III), psychological state (HADS), life event stress (LES), food intake, and quality-of-life (SF-8). A representative sample completed genetic studies and hydrogen breath testing (HBT) at the clinically relevant dose of 20 g lactose. SLI was present in 411/910 (45%) clinic patients with functional abdominal symptoms. The genotype in all subjects was C/C-13910. A small number of novel SNPs in lactase promoter region were identified, including C/T-13908 which appeared to confer lactase persistence. Over half of the patients (54%) completed the 20 g lactose HBT with 58% (285/492) reporting typical symptoms. Positive and negative predictive values of SLI for abdominal symptoms during HBT were 60% and 44%, respectively. Psychological state and stress were not associated with SLI in clinic patients. SLI impacted on physical quality-of-life and was associated with reduced ingestion of dairy products, legumes, and dried fruit (p ≤ 0.05). In a lactase deficient population, approximately half of patients attending clinic with functional gastrointestinal symptoms reported intolerance to dairy products; however, SLI did not predict findings on 20 g lactose HBT. Independent of psychosocial factors, SLI impacted on quality-of-life and impacted on food choices with restrictions not limited to dairy products. © 2015 John Wiley & Sons Ltd.

Beyond pain in fibromyalgia: insights into the symptom of fatigue

Science.gov (United States)

2013-01-01

Fatigue is a disabling, multifaceted symptom that is highly prevalent and stubbornly persistent. Although fatigue is a frequent complaint among patients with fibromyalgia, it has not received the same attention as pain. Reasons for this include lack of standardized nomenclature to communicate about fatigue, lack of evidence-based guidelines for fatigue assessment, and a deficiency in effective treatment strategies. Fatigue does not occur in isolation; rather, it is present concurrently in varying severity with other fibromyalgia symptoms such as chronic widespread pain, unrefreshing sleep, anxiety, depression, cognitive difficulties, and so on. Survey-based and preliminary mechanistic studies indicate that multiple symptoms feed into fatigue and it may be associated with a variety of physiological mechanisms. Therefore, fatigue assessment in clinical and research settings must consider this multi-dimensionality. While no clinical trial to date has specifically targeted fatigue, randomized controlled trials, systematic reviews, and meta-analyses indicate that treatment modalities studied in the context of other fibromyalgia symptoms could also improve fatigue. The Outcome Measures in Rheumatology (OMERACT) Fibromyalgia Working Group and the Patient Reported Outcomes Measurement Information System (PROMIS) have been instrumental in propelling the study of fatigue in fibromyalgia to the forefront. The ongoing efforts by PROMIS to develop a brief fibromyalgia-specific fatigue measure for use in clinical and research settings will help define fatigue, allow for better assessment, and advance our understanding of fatigue. PMID:24289848

Depressive symptoms among patients at a clinic in the Red Light District of Tijuana, Mexico

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Ferraiolo, Natalie; Pinedo, Miguel; McCurley, Jessica; Burgos, Jose Luis; Vargas-Ojeda, Adriana Carolina; Rodriguez, Michael A.; Ojeda, Victoria D.

2016-01-01

Little is known about depression among structurally vulnerable groups living in Tijuana (e.g., migrants, deportees, substance users, sex workers, homeless) who may be at high risk for poor mental health. This study investigates the prevalence and correlates of depressive symptoms among vulnerable patients receiving services at a free clinic in Tijuana, Mexico. A convenience sample of 584 adult Mexican patients completed an interviewer-administered questionnaire in English or Spanish that included the 8-item NIH PROMIS depression short form and measures of individual, social, and structural factors affecting health. The prevalence of clinically significant depressive symptoms in our sample was 55%. In the multivariate analysis, female gender, poor/fair self-rated health, recent illicit drug use (past six months), feeling rejected (past six months), history of forced sex, and history of violence were independently associated with increased odds of experiencing depressive symptoms. When stratified by gender, we found important differences in significant factors, including recent illicit drug use in men and deportation in women. Among study participants, prevalence of depressive symptoms exceeds prevalence rates reported elsewhere in the U.S.-Mexico border region. These findings suggest that public health efforts to support mental health services in the border region are needed. PMID:28042307

Depressive symptoms among patients at a clinic in the Red Light District of Tijuana, Mexico.

Science.gov (United States)

Ferraiolo, Natalie; Pinedo, Miguel; McCurley, Jessica; Burgos, Jose Luis; Vargas-Ojeda, Adriana Carolina; Rodriguez, Michael A; Ojeda, Victoria D

2016-01-01

Little is known about depression among structurally vulnerable groups living in Tijuana (e.g., migrants, deportees, substance users, sex workers, homeless) who may be at high risk for poor mental health. This study investigates the prevalence and correlates of depressive symptoms among vulnerable patients receiving services at a free clinic in Tijuana, Mexico. A convenience sample of 584 adult Mexican patients completed an interviewer-administered questionnaire in English or Spanish that included the 8-item NIH PROMIS depression short form and measures of individual, social, and structural factors affecting health. The prevalence of clinically significant depressive symptoms in our sample was 55%. In the multivariate analysis, female gender, poor/fair self-rated health, recent illicit drug use (past six months), feeling rejected (past six months), history of forced sex, and history of violence were independently associated with increased odds of experiencing depressive symptoms. When stratified by gender, we found important differences in significant factors, including recent illicit drug use in men and deportation in women. Among study participants, prevalence of depressive symptoms exceeds prevalence rates reported elsewhere in the U.S.-Mexico border region. These findings suggest that public health efforts to support mental health services in the border region are needed.

Mothers' and fathers' ratings of family relationship quality: associations with preadolescent and adolescent anxiety and depressive symptoms in a clinical sample.

Science.gov (United States)

Queen, Alexander H; Stewart, Lindsay M; Ehrenreich-May, Jill; Pincus, Donna B

2013-06-01

This study examined the independent associations among three family relationship quality factors--cohesion, expressiveness, and conflict--with youth self-reported depressive and anxiety symptoms in a clinical sample of anxious and depressed youth. Ratings of family relationship quality were obtained through both mother and father report. The sample included families of 147 preadolescents and adolescents (56.6 % female; 89.8 % Caucasian), 11-18 years old (M = 13.64, SD = 1.98) assigned a principal diagnosis of an anxiety or depressive disorder. When controlling for age and concurrent anxiety symptoms, regression analyses revealed that for boys, both father- and mother-rated family cohesion predicted depressive symptoms. For girls, mother-rated family expressiveness and conflict predicted depressive symptoms. Youth anxiety symptoms were not significantly associated with any family relationship variables, controlling for concurrent depressive symptoms. Findings suggest that parent-rated family relationship factors may be more related to youth depressive than anxiety symptoms in this clinical sample. In addition, family cohesion, as perceived by parents, may be more related to boys' depression, whereas expressiveness and conflict (as rated by mothers) may be more related to girls' depression. Clinical implications and recommendations for future research are discussed.

Satisfaction with tolterodine: assessing symptom-specific patient-reported goal achievement in the treatment of overactive bladder in female patients (STARGATE study).

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Choo, M-S; Doo, C K; Lee, K-S

2008-02-01

Open-label study to evaluate the effect of tolterodine extended-release (ER) on symptom-specific patient-reported goal achievement (PGA) of overactive bladder (OAB) symptoms in females. Eligible patients who had frequency >or= 8 and urgency >or= 2 episodes per 24 h with or without urgency incontinence were treated with 12-week tolterodine ER (4 mg once daily). Primary end-point was the rate of PGA by a visual analogue scale compared with initial expectation with treatment. At baseline, patients were asked to set their personal goals for each OAB symptom with treatment. Secondary efficacy variables were changes in symptom severity, voiding diary and patient perception of bladder condition (PPBC), global impression of improvement (GII), and willingness to continue treatment. A total of 56 patients were entered. The median rate of symptom-specific PGA and reductions in symptom severity were for frequency (60%, 45%), episodes of urgency 60%, 55%), urge incontinence (80%, 71%), nocturia (50%, 52%) and tenesmus (30%, 26%) after 12 weeks treatment. There was a significant improvement in all OAB symptoms in voiding diary. Thirty-five patients (62.5%) experienced an improvement of >or= 2 points in PPBC. Thirty (53.6%) and 22 (39.3%) of patients reported much and little improvement of their symptoms in GII. A total of 41 (73.2%) patients wanted to continue taking the medication at the end of the study. Most OAB patients reported improvement of their OAB symptoms with 12-week tolterodine ER 4 mg treatment. There was a significant achievement of symptom-specific goal on the key OAB symptoms. But, PGA did not correlate with objective outcomes.

Utilization of Patient-Reported Outcomes to Guide Symptom Management during Stereotactic Body Radiation Therapy for Clinically Localized Prostate Cancer

Directory of Open Access Journals (Sweden)

Malika Danner

2017-10-01

Full Text Available IntroductionUtilization of patient-reported outcomes (PROs to guide symptom management during radiation therapy is increasing. This study focuses on the use of the Expanded Prostate Cancer Index Composite for Clinical Practice (EPIC-CP as a tool to assess urinary and bowel bother during stereotactic body radiation therapy (SBRT and its utility in guiding medical management.MethodsBetween September 2015 and January 2017, 107 patients with clinically localized prostate cancer were treated with 35–36.25 Gy via SBRT in five fractions. PROs were assessed using EPIC-CP 1 h prior to the first fraction and after each subsequent fraction. Symptom management medications were prescribed based on the physician clinical judgment or if patients reported a moderate to big problem. Clinical significance was assessed using a minimally important difference of 1/2 SD from baseline score.ResultsA median baseline EPIC-CP urinary symptom score of 1.5 significantly increased to 3.7 on the day of the final treatment (p < 0.0001. Prior to treatment, 9.3% of men felt that their overall urinary function was a moderate to big problem that increased to 28% by the end of the fifth treatment. A median baseline EPIC-CP bowel symptom score of 0.3 significantly increased to 1.4 on the day of the final treatment (p < 0.0001. Prior to treatment, 1.9% of men felt that their overall bowel function was a moderate to big problem that increased to 3.7% by the end of the fifth treatment. The percentage of patients requiring an increased dose of alpha-antagonist increased to 47% by the end of treatment, and an additional 28% of patients required a short steroid taper to manage moderate to big urinary problems. Similarly, the percentage of patients requiring antidiarrheals reached 12% by the fifth treatment.ConclusionDuring the course of SBRT, an increasing percentage of patients experienced clinically significant symptoms many of which required medical management

Depicting Changes in Multiple Symptoms Over Time.

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Muehrer, Rebecca J; Brown, Roger L; Lanuza, Dorothy M

2015-09-01

Ridit analysis, an acronym for Relative to an Identified Distribution, is a method for assessing change in ordinal data and can be used to show how individual symptoms change or remain the same over time. The purposes of this article are to (a) describe how to use ridit analysis to assess change in a symptom measure using data from a longitudinal study, (b) give a step-by-step example of ridit analysis, (c) show the clinical relevance of applying ridit analysis, and (d) display results in an innovative graphic. Mean ridit effect sizes were calculated for the frequency and distress of 64 symptoms in lung transplant patients before and after transplant. Results were displayed in a bubble graph. Ridit analysis allowed us to maintain the specificity of individual symptoms and to show how each symptom changed or remained the same over time. The bubble graph provides an efficient way for clinicians to identify changes in symptom frequency and distress over time. © The Author(s) 2014.

Evaluating symptom outcomes in gastroparesis clinical trials: validity and responsiveness of the Gastroparesis Cardinal Symptom Index-Daily Diary (GCSI-DD).

Science.gov (United States)

Revicki, D A; Camilleri, M; Kuo, B; Szarka, L A; McCormack, J; Parkman, H P

2012-05-01

Patient-reported symptom scales are needed to evaluate treatments for gastroparesis. The Gastroparesis Cardinal Symptom Index-Daily Diary (GCSI-DD) was developed to assess daily symptoms of gastroparesis. This study evaluated the validity and responsiveness of the GCSI-DD in patients with gastroparesis. Symptomatic patients were started with a new treatment for gastroparesis. Patients completed the GCSI-DD each evening during a baseline week and for 8 weeks of treatment. Responders were defined based on patient and clinician global rating of change. Minimal important differences (MID) were estimated based on baseline to 4 week changes in symptoms scores for small improvements. Of 69 patients participating, 46 had idiopathic, 19 diabetic, and four postfundoplication gastroparesis. Excellent test-retest reliability was seen for GCSI-DD scores, and there were significant correlations between GCSI-DD scores and clinician ratings of symptom severity. Responders to treatment reported improvements in nausea [effect size (ES) = 0.42, P < 0.001], postprandial fullness, ES = 0.83, P < 0.001), bloating (ES = 0.34, P < 0.001), early satiety (ES = 0.53, P < 0.001), but lower responses for upper abdominal pain (ES = 0.29), and vomiting (ES = 0.22; P = 0.119). MIDs were 0.55 for nausea, 0.97 for excessive fullness, 0.63 for bloating, 0.77 for postprandial fullness, and 0.30 for abdominal pain. A composite score of four symptoms (Composite-1; nausea, bloating, excessive fullness, postprandial fullness) had ES of 0.61 and MID of 0.73. Composite-2 score (nausea, early satiety, bloating, abdominal pain) had a lower ES of 0.47. Symptoms of early satiety, nausea, postprandial fullness, and bloating were responsive to treatment for gastroparesis. A composite of these symptoms also demonstrates validity and responsiveness to treatment for gastroparesis, and may represent an acceptable endpoint for evaluating the effectiveness of medical treatments in clinical trials for gastroparesis. �

Symptom validity testing in memory clinics: Hippocampal-memory associations and relevance for diagnosing mild cognitive impairment.

Science.gov (United States)

Rienstra, Anne; Groot, Paul F C; Spaan, Pauline E J; Majoie, Charles B L M; Nederveen, Aart J; Walstra, Gerard J M; de Jonghe, Jos F M; van Gool, Willem A; Olabarriaga, Silvia D; Korkhov, Vladimir V; Schmand, Ben

2013-01-01

Patients with mild cognitive impairment (MCI) do not always convert to dementia. In such cases, abnormal neuropsychological test results may not validly reflect cognitive symptoms due to brain disease, and the usual brain-behavior relationships may be absent. This study examined symptom validity in a memory clinic sample and its effect on the associations between hippocampal volume and memory performance. Eleven of 170 consecutive patients (6.5%; 13% of patients younger than 65 years) referred to memory clinics showed noncredible performance on symptom validity tests (SVTs, viz. Word Memory Test and Test of Memory Malingering). They were compared to a demographically matched group (n = 57) selected from the remaining patients. Hippocampal volume, measured by an automated volumetric method (Freesurfer), was correlated with scores on six verbal memory tests. The median correlation was r = .49 in the matched group. However, the relation was absent (median r = -.11) in patients who failed SVTs. Memory clinic samples may include patients who show noncredible performance, which invalidates their MCI diagnosis. This underscores the importance of applying SVTs in evaluating patients with cognitive complaints that may signify a predementia stage, especially when these patients are relatively young.

Cortisol in schizophrenia: No association with tobacco smoking, clinical symptoms or antipsychotic medication.

Science.gov (United States)

Nedic Erjavec, Gordana; Uzun, Suzana; Nikolac Perkovic, Matea; Kozumplik, Oliver; Svob Strac, Dubravka; Mimica, Ninoslav; Hirasawa-Fujita, Mika; Domino, Edward F; Pivac, Nela

2017-07-03

Cigarette smoking is associated with higher cortisol levels in healthy subjects. In schizophrenia this relationship is not clear. There are divergent results on the association between cortisol with smoking, clinical symptoms and medication in schizophrenia. This study evaluated this association in 196 Caucasian inpatients with schizophrenia (51.30±26.68years old), subdivided into 123 smokers and 73 non-smokers. Basal salivary cortisol levels were measured twice, at 08.00 and 09.00AM, 90-120min after awakening. The effect of smoking on cortisol was evaluated according to current smoking status, the number of cigarettes/day and the nicotine addiction intensity. The influence of clinical symptoms and/or antipsychotic medication on cortisol was determined using the Positive and Negative Syndrome Scale (PANSS), and chlorpromazine equivalent doses. Non-smokers were older, received lower doses of antipsychotics, had higher PANSS scores, and had longer duration of illness than smokers. Salivary cortisol was similar in schizophrenic patients subdivided according to the smoking status, the number of cigarettes/day and nicotine addiction intensity. No significant correlation was found between salivary cortisol and PANSS scores, chlorpromazine equivalent doses, age of onset or the duration of illness. The findings revealed no association between salivary cortisol and smoking, nicotine addiction intensity, or clinical symptoms. Our preliminary data showed no correlation between salivary cortisol and chlorpromazine equivalent doses and/or antipsychotic medication. Our findings suggest that smoking does not affect the cortisol response in schizophrenic patients as it has been shown in healthy individuals. Future studies should investigate a possible desensitization of the stress system to smoking. Copyright © 2017. Published by Elsevier Inc.

Does Work Stress Predict the Occurrence of Cold, Flu and Minor Illness Symptoms in Clinical Psychology Trainees?

OpenAIRE

Phillips, Anna C.; Sheffield, David

2005-01-01

Objectives: The present study examined the three/four-day lagged relationship between daily work stress and upper respiratory tract infection (URTI) and other minor illness symptoms. Methods: Twenty-four postgraduate clinical psychology trainees completed work stress, cold/flu symptoms and somatic symptoms checklists daily for four weeks. Results: Increases in work stress were observed two days prior to a cold/flu episode but not three or four days preceding a cold/flu episode. Work stress wa...

Comparison of MRI findings with clinical symptoms in temporomandibular joint internal derangement

Energy Technology Data Exchange (ETDEWEB)

Kwon, Ki Jeong [Chonbuk National University College of Medicine, Gwangju (Korea, Republic of)

2005-06-15

To determine the clinical correlation of magnetic resonance imaging (MRI) findings of temporomandibular joint internal derangements. The MR images of 150 TMJs in 75 patients were analyzed. The clinical symptoms were pain in the pre auricular area and masticatory muscles and TMJ sounds. There was a statistically significant relationship between the MRI diagnoses of different types of disc displacements and clinical findings of pain, clicking, and crepitus. The risk of TMJ pain was increased when the disc displacement without reduction occurred at the same time in combination with the osteoarthrosis and effusion. Regardless of the results, the data indicate that each of these MR imaging variables may not be regarded as the unique and dominant factor in defining TMJ pain occurrence.

[The specific microbiological and clinical features of acute otitis media].

Science.gov (United States)

Gurov, A V; Levina, Yu V; Guseva, A L; Elchueva, Z G; Efimova, S P; Gordienko, M V

The objective of the present study was to elucidate the specific features of the clinical course of acute otitis media as well as the peculiarities of the vestibular function and the microbial paysage associated with this pathological condition under the present-day conditions. The study included 135 patients presenting with acute otitis media (AOM) at different stages of the disease. The discharge obtained from the tympanic cavity of all the patients was examined with the use of polymerase chain reaction in real time, audiological and vestibulogical methods. The distinctive features of acute otitis medium associated with Streptococcus pneumoniae infection were found to be the intense pain syndrome with the symptoms of intoxication, well apparent inflammatory changes in the tympanic membrane as revealed by otoscopy, the increased frequency of sensorineural impairment of hearing, and the characteristic type B tympanometric curve. Typical of AOM associated with Haemophilus influenza infection are the mild pain syndrome, weak changes in the tympanic membrane as revealed by otoscopy, conductive hearing loss, and the type C tympanometric curve.

Effect of aromatherapy massage on menopausal symptoms: a randomized placebo-controlled clinical trial.

Science.gov (United States)

Darsareh, Fatemeh; Taavoni, Simin; Joolaee, Soodabeh; Haghani, Hamid

2012-09-01

Menopause is a significant event in most women's lives because it marks the end of a woman's natural reproductive life. The purpose of this study was to determine the effect of aromatherapy massage on menopausal symptoms. A randomized placebo-controlled clinical trial was conducted at a menopausal clinic at a gynecology hospital in Tehran. The study population comprised 90 women who were assigned to an aromatherapy massage group, a placebo massage group, or a control group. Each participant in the aromatherapy massage group received 30-minute aromatherapy treatment sessions twice a week for 4 weeks with aroma oil, whereas participants in the placebo massage group received the same treatment with plain oil. No treatment was provided to participants in the control group. The outcome measures in this study were menopausal symptoms, as obtained through the Menopause Rating Scale. The mean baseline level of the menopausal score did not differ among all groups. However, after eight sessions of intervention, the Menopause Rating Scale score differed significantly among the three groups (P aromatherapy massage group and the placebo massage group had a lower menopausal score than the control group (P aromatherapy massage and the placebo massage groups were compared, the menopausal score for the aromatherapy massage group was found to be significantly lower (P aromatherapy massage were effective in reducing menopausal symptoms. However, aromatherapy massage was more effective than only massage.

Spectrum of acute clinical characteristics of diagnosed concussions in college athletes wearing instrumented helmets: clinical article.

Science.gov (United States)

Duhaime, Ann-Christine; Beckwith, Jonathan G; Maerlender, Arthur C; McAllister, Thomas W; Crisco, Joseph J; Duma, Stefan M; Brolinson, P Gunnar; Rowson, Steven; Flashman, Laura A; Chu, Jeffrey J; Greenwald, Richard M

2012-12-01

Concussive head injuries have received much attention in the medical and public arenas, as concerns have been raised about the potential short- and long-term consequences of injuries sustained in sports and other activities. While many student athletes have required evaluation after concussion, the exact definition of concussion has varied among disciplines and over time. The authors used data gathered as part of a multiinstitutional longitudinal study of the biomechanics of head impacts in helmeted collegiate athletes to characterize what signs, symptoms, and clinical histories were used to designate players as having sustained concussions. Players on 3 college football teams and 4 ice hockey teams (male and female) wore helmets instrumented with Head Impact Telemetry (HIT) technology during practices and games over 2-4 seasons of play. Preseason clinical screening batteries assessed baseline cognition and reported symptoms. If a concussion was diagnosed by the team medical staff, basic descriptive information was collected at presentation, and concussed players were reevaluated serially. The specific symptoms or findings associated with the diagnosis of acute concussion, relation to specific impact events, timing of symptom onset and diagnosis, and recorded biomechanical parameters were analyzed. Data were collected from 450 athletes with 486,594 recorded head impacts. Forty-eight separate concussions were diagnosed in 44 individual players. Mental clouding, headache, and dizziness were the most common presenting symptoms. Thirty-one diagnosed cases were associated with an identified impact event; in 17 cases no specific impact event was identified. Onset of symptoms was immediate in 24 players, delayed in 11, and unspecified in 13. In 8 cases the diagnosis was made immediately after a head impact, but in most cases the diagnosis was delayed (median 17 hours). One diagnosed concussion involved a 30-second loss of consciousness; all other players retained

Clinical validity of a disease-specific health status questionnaire: the peripheral artery questionnaire.

Science.gov (United States)

Hoeks, Sanne E; Smolderen, Kim G; Scholte Op Reimer, Wilma J M; Verhagen, Hence J M; Spertus, John A; Poldermans, Don

2009-02-01

Measuring patient-centered outcomes is becoming increasingly important in patients with peripheral arterial disease (PAD), both as a means of determining the benefits of treatment and as an aid for disease management. In order to monitor health status in a reliable and sensitive way, the disease-specific measure Peripheral Artery Questionnaire (PAQ) was developed. However, to date, its correlation with traditional clinical indices is unknown. The primary aim of this study was to better establish the clinical validity of the PAQ by examining its association with functional indices related to PAD. Furthermore, we hypothesized that the clinical validity of this disease-specific measure is better as compared with the EuroQol-5-dimensional (EQ-5D), a standardized generic instrument. Data on 711 consecutive PAD patients undergoing surgery were collected from 11 Dutch hospitals in 2004. At 3-year follow-up, questionnaires including the PAQ, EQ-5D, and EuroQol-Visual Analogue Scale (EQ VAS) were completed in 84% of survivors. The PAQ was analyzed according to three domains, as established by a factor analyses in the Dutch population, and the summary score. Baseline clinical indices included the presence and severity of claudication intermittent (CI) and the Lee Cardiac Risk Index. All three PAQ domains (Physical Function, Perceived Disability, and Treatment Satisfaction) were significantly associated with CI symptoms (P values PAQ summary scores as compared with asymptomatic patients (58.6 +/- 27.8 vs 68.6 +/- 27.8, P = PAQ summary score and the subscale scores for Physical Functioning and Perceived Disability demonstrated a clear dose-response relation for walking distance and the Lee Risk Index (P values PAQ proved to be good as the PAQ subscales discriminated well between patients with or without symptomatic PAD and its severity as defined by walking distance. Furthermore, the PAQ subscales were directly proportional to the presence and number of risk factors relevant

Common Versus Specific Correlates of Fifth-Grade Conduct Disorder and Oppositional Defiant Disorder Symptoms: Comparison of Three Racial/Ethnic Groups.

Science.gov (United States)

Wiesner, Margit; Elliott, Marc N; McLaughlin, Katie A; Banspach, Stephen W; Tortolero, Susan; Schuster, Mark A

2015-07-01

The extent to which risk profiles or correlates of conduct disorder (CD) and oppositional defiant disorder (ODD) symptoms overlap among youth continues to be debated. Cross-sectional data from a large, representative community sample (N = 4,705) of African-American, Latino, and White fifth graders were used to examine overlap in correlates of CD and ODD symptoms. About 49 % of the children were boys. Analyses were conducted using negative binomial regression models, accounting for several confounding factors (e.g., attention deficit/hyperactivity disorder symptoms), sampling weights, stratification, and clustering. Results indicated that CD and ODD symptoms had very similar correlates. In addition to previously established correlates, several social skills dimensions were significantly related to ODD and CD symptoms, even after controlling for other correlates. In contrast, temperamental dimensions were not significantly related to CD and ODD symptoms, possibly because more proximal correlates (e.g., social skills) were also taken into account. Only two factors (gender and household income) were found to be specific correlates of CD, but not ODD, symptoms. The pattern of common and specific correlates of CD and ODD symptoms was replicated fairly consistently across the three racial/ethnic subgroups. Implications of these findings for further research and intervention efforts are discussed.

Changes in depressive symptoms and correlates in HIV+ people at An Hoa Clinic in Ho Chi Minh City, Vietnam.

Science.gov (United States)

Huynh, Van-Anh N; To, Kien G; Do, Dung Van; To, Quyen G; Nguyen, Mai T H

2017-01-21

Understanding of depression among Vietnamese people living with HIV (PLWH) is limited. This longitudinal study examines changes in depressive symptoms and identifies its correlates among people living with HIV under antiretroviral therapy at An Hoa Clinic. People living with HIV ≥18 years and undergoing antiretroviral therapy for ≥3 months were eligible. Those at final AIDS stage, too ill, or illiterate were excluded due to their inability to complete the self-administered questionnaire. One researcher was present in the clinic for a month inviting PLWH to participate. Data were collected from 242 PLWH at baseline (T1) and 234 after three months (T2). Depressive symptoms was measured by the Center for Epidemiologic Studies Depression Scale (CESD). Social relationship was measured using questions created by World Health Organization. Generalized Estimating Equations were used examining changes in depressive symptoms with CESD cut-off symptoms at T2 compared to T1 (OR = 1.15, p > 0.05). Those with a co-morbidity were more likely to have depressive symptoms than those without a co-morbidity (OR = 1.76, p symptoms than those with lower scores (OR = 0.76, p symptoms at T2 compared to T1 (OR = 1.6, p symptoms than those with lower scores (OR = 0.73, p HIV were not more likely to have depressive symptoms (symptoms (symptoms. Associations between age, individual income status, and co-morbidity with depressive symptoms were not decisive. Gender, ethnicity, education, religion, marriage, household economy, and adherence were not correlates.

[Hemoglobinopathies--clinical symptoms and diagnosis of thalassemia and abnormal hemoglobins].

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Herklotz, R; Risch, L; Huber, A R

2006-01-01

Haemoglobinopathies constitute entities that are generated by either an abnormal haemoglobin or thalassaemias. While abnormal haemoglobins are caused by a qualitative structural abnormality of the haemoglobin molecule, thalassaemias result by diminished synthesis of the globin chain. Due to increased immigration from Asia, Africa and the Mediterranean to Northern Europe, haemoglobin S, haemoglobin C, haemoglobin E are also encountered commonly in Switzerland, while other abnormal haemoglobins are rare, yet can cause clinically relevant symptoms. This include haemolysis, polyglobulia, cyanosis or a combination thereof Thalassaemia-syndroms constitute with two million affected individuals to the most prelevant monogenetic diseases worldwide. Due to migration into Switzerland, they are also found quite commonly among our patients with 10-15 per cent of all hypochromic, microcytic, anemia second only to iron deficiency. Importantly, thalassaemias and haemoglobinopathies can occur concomitantly sometimes even with a normal haemoglobin variant. This results in wide-spread presentations, making diagnosis and clinical judgement difficult. We describe in this article not only physiological mechanisms and clinical presentation but also propose a step-wise diagnostic algorithm including selective use of molecular biology methods.

Symptom prevalence in a cohort of 65 patients improved with the homoeopathic medicine Mangifera indica: A multicentric open observational clinical verification study

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Raj K Manchanda

2017-01-01

Full Text Available Introduction: Clinical verification is an ongoing research program of the Council that verified many rare homoeopathic drugs. Aim: To clinically verify the ‘symptomatology’ of Mangifera indica by ascertaining the symptoms improved during verification. Materials and Methods: The study was a multicentric open label observational trial. Total 114 patients were enrolled after matching with the available symptom compendium and eligibility criteria in five centres of the Council. The medicine was prescribed in 6C, 30C, 200C and 1M potencies, as per need of the patient following the homoeopathic principles and protocol developed by the Council. The collected data were presented in terms of descriptive statistics. Prevalence of symptoms in the responding and non-responding population has been compared using Chi-square test. Results: Among the total 114 patients enrolled in the study, 77 patients who completed the follow up were analysed, as there were 37 drop out cases. The demographic analysis shows, male/female: 41/36, mean age 28.61 years. There was “clinical success” in 65 cases (84.41% and failures in 12 cases (15.59%, judged subjectively by the physicians. A minimum of two prescriptions were considered for pick listing each symptom as a rule of thumb. Conclusions: Total 16 CCRH proving symptoms were verified, 4 symptoms from other literatures were also verified. 51 new clinical symptoms/symptom components were identified. Further replication and estimation of likelihood ratio in general practice setting is crucial for confirmation and inclusion of such symptoms in homoeopathic literatures.

Clinical Symptoms as a Function of Client Personality in College Students: Incorporating the Five-Factor Model of Personality

Science.gov (United States)

Hammond, Marie S.; Lockman, Jennifer D.; Temple, Rebecca A.

2013-01-01

In this study, the relationship between personality characteristics and presenting clinical symptoms of individuals at a college counseling center was examined. Analysis of assessments of personality (Costa & McCrae, 1992) and mental health symptoms (Farrell & McCullough, 1989) suggests that the personality characteristics of individuals…

Impacted Lower Second Permanent Molars at the Ramus and Coronoid Process: A New Clinical Symptom of the WNT10A Mutation in Ectodermal Dysplasia.

Science.gov (United States)

Sfeir, Elia; Aboujaoude, Samia

2017-01-01

Hidrotic ectodermal dysplasia (ED) with the WNT10A mutation produces variable dentofacial symptoms. The aim of this study was to describe a new clinical symptom, i.e., specific to the WNT10A mutation in hidrotic ED. The study investigated the migratory trend of the lower second permanent molars to the ramus or coronoid process. To the best of authors' knowledge, no data in the literature describe this trend in cases of hidrotic ED. A three-generation family pedigree was established for seven families after the diagnosis of hidrotic ED in a 10-year-old boy. Thereafter, a genetic and clinical study was conducted on three families with at least one individual affected by hidrotic ED (20 individuals). We selected the children with molar germs 37 and 47. The eruption axes of these germs were then traced on the panoramic images at the initial time (T 0 ) and 1 year later (T 0 + 1 year), and the deviations between these axes were measured. A significant familial consanguinity was shown. Eight subjects presented with the hidrotic ED phenotype. Among them, three individuals carried germs 37 and 47. Over time, the measured deviations between the eruption axes of the latter displayed, in the majority of the cases, a distal inclination toward the ramus. A larger sample size is mandatory to assess the frequencies and treatment modalities. The presence of germs in the lower second permanent molars in patients with hidrotic ED is an important clinical symptom that should be monitored to detect and prevent ectopic migration of these teeth. In hidrotic ED cases, the study of the presence of the second lower permanent germs must include clinical and radiological examinations. Establishing an inter-ceptive treatment is necessary to prevent the migration of the molars in question. How to cite this article: Sfeir E, Aboujaoude S. Impacted Lower Second Permanent Molars at the Ramus and Coronoid Process: A New Clinical Symptom of the WNT10A Mutation in Ectodermal Dysplasia. Int J Clin

THE APPROACH OF CANCER RELATED FATIGUE IN RHEABILITATION MEDICINE: PART I – MECHANISMS, SYMPTOMS, CLINICAL EVALUATION AND SCREENING

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SALCA Amalia

2015-05-01

Full Text Available Cancer related fatigue (CRF is the most disabling and distressing symptom in cancer, throughout the whole history of the illness, including successfully treated cases. Rehabilitation medicine could have a positive impact on these patients’ outcomes, if well targeted. With these purpose, the rehabilitation clinician needs to correctly assess fatigue using standard, reliable scales. This review of articles and trials synthesizes the epidemiology, mechanics (including causes and effects, clinical presentation and means of assessment in CRF. CRF causes and mechanisms are not well known. Understanding them would provide specific targets to fatigue management. Clinical presentation is very variable, a wide range of features being found in literature. Poorly medical reports in assessing fatigue offer variable percentages of prevalence, inconsistent with patients’ daily burden due to CRF. There are many tools used to assess fatigue in clinical research and on them depends the percentages reported as fatigue prevalence. The hereby gathered information are useful in the approach of a patient that addresses to a rehabilitation clinician for CRF management.

Persistent physical symptoms as perceptual dysregulation

DEFF Research Database (Denmark)

Henningsen, Peter; Gündel, Harald; Kop, Willem J

2018-01-01

OBJECTIVE: The mechanisms underlying the perception and experience of persistent physical symptoms are not well understood, and in the models, the specific relevance of peripheral input versus central processing, or of neurobiological versus psychosocial factors in general, is not clear.In this a......OBJECTIVE: The mechanisms underlying the perception and experience of persistent physical symptoms are not well understood, and in the models, the specific relevance of peripheral input versus central processing, or of neurobiological versus psychosocial factors in general, is not clear.......In this article, we propose a model for this clinical phenomenon that is designed to be coherent with an underlying, relatively new model of the normal brain functions involved in the experience of bodily signals. METHODS: Based on a review of recent literature we describe central elements of this model and its...... of predictions and sensory input. Two possibilities exist: adaptation of the generative model underlying the predictions or alteration of the sensory input via autonomic nervous activation (in the case of interoception). Following this model, persistent physical symptoms can be described as "failures...

Clinical profile, outcomes and improvement in symptoms and productivity in rhinitic patients in Karachi, Pakistan

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Sherwani Ubaid

2009-12-01

Full Text Available Abstract Background Rhinitis can cause a heavy toll on patients because of its bothersome effects on productivity. This retrospective study was conducted to explore the clinical profile, outcomes and improvement in the symptoms and productivity resulting from treatment of allergic rhinitis in Pakistan. Methods We carried out a retrospective file review of all allergic rhinitis patients who presented to the Ear, Nose, Throat Consulting Clinic from January, 2006 to June, 2008 using a structured proforma especially designed for this purpose. Data was entered and analyzed using SPSS v. 16.0. Results The charts of 169 patients were reviewed. The mean age of the patients was 35.2 ± 9.1 years. Sixty percent patients were male. Ninety eight patients (58% reported allergy symptoms to be present at both home and work. One hundred and two patients (60.4% had symptoms severe enough to cause absence from work or academic activities. Up to seventy one percent patients were spending between 1000 - 3000 Pakistani Rupees (1 US$= 83.3 Pakistani rupees on the treatment of allergic rhinitis per year. One hundred and fifty one patients (89.3% reported an improvement in rhinitic symptoms and productivity while 18 patients (10.7% didn't. This improvement was significantly associated with satisfaction with treatment (p Conclusion Allergic rhinitis, a ubiquitous disease, was seen to cause a strain on patients in the form of recurrent treatment-related expenses as well as absenteeism from work or other daily activities. Symptoms and productivity improved significantly after treatment.

Symptoms of anxiety and depression in type 2 diabetes: Associations with clinical diabetes measures and self-management outcomes in the Norwegian HUNT study.

Science.gov (United States)

Naicker, Kiyuri; Øverland, Simon; Johnson, Jeffrey A; Manuel, Douglas; Skogen, Jens C; Sivertsen, Børge; Colman, Ian

2017-10-01

To determine if symptoms of depression and anxiety are differentially associated with clinical diabetes measures and self-management behaviours in individuals with Type 2 diabetes, and whether these associations vary by patient sex. A cross-sectional analysis using data from 2035 adults with Type 2 diabetes in the Nord-Trøndelag Health Study. Multivariate logistic regression was used to explore associations between symptoms of depression and anxiety and waist girth, HDL cholesterol, systolic blood pressure, triglycerides, c-reactive protein, glycemic control, diet adherence, exercise, glucose monitoring, foot checks for ulcers, and the subjective patient experience. Analyses were stratified by sex. Depression was associated with a lower likelihood of avoiding saturated fats (OR=0.20 [95% CI: 0.06, 0.68]) and increased odds of physical inactivity (OR=1.69 [95% CI: 1.37, 2.72]). Anxiety was associated with increased odds of eating vegetables (OR=1.66 [95% CI: 1.02, 2.73]), and an over two-fold increase of feeling that having diabetes is difficult. In women, anxiety was associated with elevated c-reactive protein levels (OR=1.57 [95% CI: 1.05, 2.34]). In men, depressive symptoms were associated with elevated HbA1c (OR=5.00 [95% CI: 1.15, 8.23). Symptoms of depression and anxiety were differentially associated with some key diabetes-related measures. Our results suggest sex-specific differences with respect to two important clinical outcomes (i.e., anxiety and CRP in women and depression and glycemic control in men). These findings should alert practitioners to the importance of detection and management of psychological symptoms in individuals with Type 2 diabetes. Copyright © 2017. Published by Elsevier Ltd.

Relationship between symptom dimensions and brain morphology in obsessive-compulsive disorder.

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Hirose, Motohisa; Hirano, Yoshiyuki; Nemoto, Kiyotaka; Sutoh, Chihiro; Asano, Kenichi; Miyata, Haruko; Matsumoto, Junko; Nakazato, Michiko; Matsumoto, Koji; Masuda, Yoshitada; Iyo, Masaomi; Shimizu, Eiji; Nakagawa, Akiko

2017-10-01

Obsessive-compulsive disorder (OCD) is known as a clinically heterogeneous disorder characterized by symptom dimensions. Although substantial numbers of neuroimaging studies have demonstrated the presence of brain abnormalities in OCD, their results are controversial. The clinical heterogeneity of OCD could be one of the reasons for this. It has been hypothesized that certain brain regions contributed to the respective obsessive-compulsive dimensions. In this study, we investigated the relationship between symptom dimensions of OCD and brain morphology using voxel-based morphometry to discover the specific regions showing alterations in the respective dimensions of obsessive-compulsive symptoms. The severities of symptom dimensions in thirty-three patients with OCD were assessed using Obsessive-Compulsive Inventory-Revised (OCI-R). Along with numerous MRI studies pointing out brain abnormalities in autistic spectrum disorder (ASD) patients, a previous study reported a positive correlation between ASD traits and regional gray matter volume in the left dorsolateral prefrontal cortex and amygdala in OCD patients. We investigated the correlation between gray and white matter volumes at the whole brain level and each symptom dimension score, treating all remaining dimension scores, age, gender, and ASD traits as confounding covariates. Our results revealed a significant negative correlation between washing symptom dimension score and gray matter volume in the right thalamus and a significant negative correlation between hoarding symptom dimension score and white matter volume in the left angular gyrus. Although our result was preliminary, our findings indicated that there were specific brain regions in gray and white matter that contributed to symptom dimensions in OCD patients.

Effect of specific resistance training on musculoskeletal pain symptoms

DEFF Research Database (Denmark)

Pedersen, Mogens Theisen; Andersen, Lars Louis; Jørgensen, Marie Birk

2013-01-01

.16, p = 0.045), and there was a significant dose-response relationship between training volume per session and change in pain index (ß = -0.20, p = 0.034). In contrast, training attendance (mean 1.69 sessions per week, SD = 0.8) was not significantly related to the change in pain index. In conclusion......, achieving higher accumulated training volumes was important for reducing musculoskeletal pain in female office workers. The training volume per session should be optimized by securing a load at 10-15 repetition maximum and adhering to principles of progressive overload.......ABSTRACT: Pedersen, MT, Andersen, LL, Jørgensen, MB, Søgaard, K, and Sjøgaard, G. Effect of specific resistance training on musculoskeletal pain symptoms: Dose-response relationship. J Strength Cond Res 27(1): 229-235, 2013-The purpose of this study was to investigate the dose-response of strength...

Association between forkhead-box P2 gene polymorphism and clinical symptoms in chronic schizophrenia in a Chinese population.

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Rao, Wenwang; Du, Xiangdong; Zhang, Yingyang; Yu, Qiong; Hui, Li; Yu, Yaqin; Kou, Changgui; Yin, Guangzhong; Zhu, Xiaomin; Man, Lijuan; Soares, Jair C; Zhang, Xiang Yang

2017-07-01

The forkhead-box P2 (FOXP2) gene polymorphism has been reported to be involved in the susceptibility to schizophrenia; however, few studies have investigated the association between FOXP2 gene polymorphism and clinical symptoms in schizophrenia. This study investigated whether the FOXP2 gene was associated with the development and symptoms of schizophrenia in relatively genetically homogeneous Chinese population. The FOXP2 rs10447760 polymorphism was genotyped in 1069 schizophrenia inpatients and 410 healthy controls using a case-control design. The patients' psychopathology was assessed by the Positive and Negative Syndrome Scale (PANSS). We found no significant differences in the genotype and allele distributions between the patient and control groups. Interestingly, we found significant differences in PANSS total, positive symptom, and general psychopathology scores between genotypic subgroups in patients, with the higher score in patients with CC genotype than those with CT genotype (all p schizophrenia, but may contribute to the clinical symptoms of schizophrenia among Han Chinese.

Sleep quality as a mediator of problematic smartphone use and clinical health symptoms.

Science.gov (United States)

Xie, Xiaochun; Dong, Yan; Wang, Jinliang

2018-05-23

Background and aims Although smartphone use brings many benefits for adolescents, it is also associated with many serious health problems. This study examined the relationship between problematic smartphone use (PSU) and clinical health symptoms (e.g., body dysfunction) and the mediating effects of sleep quality on this relationship in adolescents. Methods Participants in this cross-sectional survey were 686 middle- and high-school students (girls = 55.7%, M age  = 12.98 ± 1.38 years). Participants completed self-report measures of PSU, sleep quality, and physical symptoms. Correlation analyses and structural equation modeling between adolescents' PSU and the variables of interest were conducted. Results This study indicated that there was a significant positive correlation between PSU and health symptoms. Furthermore, sleep quality mediated the relationship between PSU and health symptoms. Discussion and conclusions Findings suggest that to promote health and wellness in adolescents, individuals should be encouraged to place boundaries on smartphone use, especially at bedtime. Reducing adolescents' exposure to smartphone use in this way may hold promise for improving the efficacy of PSU prevention efforts for adolescents.

Clinical and manometric characteristics of patients with Parkinson's disease and esophageal symptoms.

Science.gov (United States)

Su, A; Gandhy, R; Barlow, C; Triadafilopoulos, G

2017-04-01

Dysphagia is a common problem in patients with Parkinson's disease (PD); its etiology is multifactorial and its management is challenging. In this retrospective cohort analysis using prospectively collected data, we aimed to objectively characterize dysphagia and/or other esophageal symptoms in patients with PD, assess the prevalence of outflow obstruction as well as major or minor disorders of esophageal peristalsis leading to impaired esophageal clearance and highlight objective parameters that can help in the current management algorithm. Thirty-three consecutive patients with PD presenting with dysphagia, odynophagia, heartburn, regurgitation, chest pain, and weight loss underwent clinical and functional evaluation by high-resolution manometry (HRM). Esophagogastric junction (EGJ) outflow obstruction and major as well as minor disorders of peristalsis were then assessed using the Chicago classification (v3). Thirty-three PD patients with esophageal symptoms were enrolled in the study; 12 of them reported weight loss that was considered as potentially reflecting underlying esophageal dysfunction. The median age of the patients was 70 years (range: 53-89 years), 24 (75%) were men. The majority (62%) experienced dysphagia, likely contributing to weight loss in 41% of patients. Odynophagia was rare (6%) while GER symptoms, such as heartburn, regurgitation, and chest pain were noted in 37%, 31%, and 28% of patients, respectively. Using the hierarchy of the Chicago classification, 12 patients (39%) exhibited EGJ outflow obstruction, 16 (48%) diffuse esophageal spasm (DES), 18 (55%), ineffective esophageal peristalsis (IEM), 16 (48%) fragmented peristalsis, and only 2 patients (6%) had normal HRM tracings. There were no patients with HRM features of achalasia. Dysphagia is common in patients with PD and is associated with a high prevalence of underlying motility disturbances as identified by HRM. The exact impact of these motility abnormalities on symptom induction

Factors influencing mother-child reports of depressive symptoms and agreement among clinically referred depressed youngsters in Hungary.

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Kiss, Eniko; Gentzler, Amy M; George, Charles; Kapornai, Krisztina; Tamás, Zsuzsanna; Kovacs, Maria; Vetró, Agnes

2007-06-01

Psychiatric assessments of children typically involve two informants, the child and the parent. Understanding discordance in their reports has been of interest to clinicians and researchers. We examine differences between mothers' and children's report of children's depressive symptom severity, and factors that may influence their reports and level of agreement. We hypothesized that agreement between mother and child would improve if (1) the mother is depressed, due to improved recall of mood congruent symptoms, (2) the child is older, due to better social-cognitive and communication skills, and (3) the child is a female. Subjects were 354 children (158 girls; mean age 11.69 years, SD: 2.05 years) with Major Depressive Disorder. Depressive symptoms were evaluated by a semi-structured interview separately with the mother and the child. Agreement on symptom severity was based on concordance of the presence and extent of symptoms. Maternal reports were significantly higher than their son's but not daughters'. Girls, particularly with increasing age, reported higher levels of symptoms; however mothers' reports were not affected by child sex or age. Maternal depression predicted more severe symptom reports for both children and mothers. Agreement between the mother and the child increased as children got older. The same clinician interviewed the mother and the child, which might inflate rates of agreement. However, this method mirrors clinical evaluation. During a clinical interview one must consider the age and sex of the child and the depressive state of the mother in assimilating information about the child.

Upper gastrointestinal symptoms in autoimmune gastritis

Science.gov (United States)

Carabotti, Marilia; Lahner, Edith; Esposito, Gianluca; Sacchi, Maria Carlotta; Severi, Carola; Annibale, Bruno

2017-01-01

Abstract Autoimmune gastritis is often suspected for its hematologic findings, and rarely the diagnosis is made for the presence of gastrointestinal symptoms. Aims of this cross-sectional study were to assess in a large cohort of patients affected by autoimmune gastritis the occurrence and the pattern of gastrointestinal symptoms and to evaluate whether symptomatic patients are characterized by specific clinical features. Gastrointestinal symptoms of 379 consecutive autoimmune gastritis patients were systematically assessed and classified following Rome III Criteria. Association between symptoms and anemia pattern, positivity to gastric autoantibodies, Helicobacter pylori infection, and concomitant autoimmune disease were evaluated. In total, 70.2% of patients were female, median age 55 years (range 17–83). Pernicious anemia (53.6%), iron deficiency anemia (34.8%), gastric autoantibodies (68.8%), and autoimmune disorders (41.7%) were present. However, 56.7% of patients complained of gastrointestinal symptoms, 69.8% of them had exclusively upper symptoms, 15.8% only lower and 14.4% concomitant upper and lower symptoms. Dyspepsia, subtype postprandial distress syndrome was the most represented, being present in 60.2% of symptomatic patients. Univariate and multivariate analyses showed that age gastritis is associated in almost 60% of cases with gastrointestinal symptoms, in particular dyspepsia. Dyspepsia is strictly related to younger age, no smoking, and absence of anemia. PMID:28072728

Explore the Possibility of Early Clinical Diagnosis of Endocrine Ophthalmopathy Based on Eye Symptoms of Hyperthyroidism

OpenAIRE

V. G. Likhvantseva; E. A. Rudenko; S. G. Kapkova; V. A. Vygodin

2016-01-01

Purpose: to study the possibility of early clinical diagnosis of endocrine ophthalmopathy based on ocular symptoms of hyperthyroidism. Patients and methods: we analyzed the prevalence of ocular symptoms of hyperthyroidism in 139 patients (278 orbits) with newly diagnosed endocrine ophthalmopathy (group 1), developed on the background of diffuse toxic goiter. The comparison group consisted of 80 patients (160 orbits) with newly diagnosed diffuse toxic goiter with no radiographic evidence of en...

Clinical features and symptom recovery on a gluten-free diet in Canadian adults with celiac disease.

Science.gov (United States)

Pulido, Olga; Zarkadas, Marion; Dubois, Sheila; Macisaac, Krista; Cantin, Isabelle; La Vieille, Sebastien; Godefroy, Samuel; Rashid, Mohsin

2013-08-01

Celiac disease can present with mild or nongastrointestinal symptoms, and may escape timely recognition. The treatment of celiac disease involves a gluten-free diet, which is complex and challenging. To evaluate clinical features and symptom recovery on a gluten-free diet in a Canadian adult celiac population. All adult members (n=10,693) of the two national celiac support organizations, the Canadian Celiac Association and Fondation québécoise de la maladie coeliaque, were surveyed using a questionnaire. A total of 5912 individuals (≥18 years of age) with biopsy-confirmed celiac disease and⁄or dermatitis herpetiformis completed the survey. The female to male ratio was 3:1, and mean (± SD) age at diagnosis was 45.2 ± 16.4 years. Mean time to diagnosis after onset of symptoms was 12.0 ± 14.4 years. Abdominal pain and bloating (84.9%), extreme weakness⁄tiredness (74.2%), diarrhea (71.7%) and anemia (67.8%) were the most commonly reported symptoms at the time of diagnosis. Many respondents continued to experience symptoms after being on a gluten-free diet for >5 years. Sex differences were reported in clinical features before diagnosis, recovery after being on gluten-free diet and perceived quality of life, with women experiencing more difficulties than men. Delays in diagnosis of celiac disease in Canada remain unacceptably long despite wider availability of serological screening tests. Many patients report continuing symptoms despite adhering to a gluten-free diet for >5 years, with women experiencing more symptoms and a lower recovery rate than men. Awareness of celiac disease needs improvement, and follow-up with a physician and a dietitian is essential for all patients with celiac disease.

Symptoms of Children with Autism Spectrum Disorder,a clinical sample

Directory of Open Access Journals (Sweden)

Ali Alavi Shooshtari

2009-12-01

Full Text Available "n Objective: "n "nThe aim of this report was to study the gender role on autismsymptoms distribution and severity in a clinical sample from Iran. Then, the results were compared with the published study from the same community population sample, Iran. "nMethod: The subjects of this retrospective study were a convenient clinical sample of the referrals of children with pervasive developmental disorders. The diagnosis was made according to DSM-IV diagnostic criteria. "nResults: "nMost of the subjects were boys. Boys were referred for evaluation more frequently than girls. The sample included 61 children and adolescents aged 2.1 to 15 years; of whom, 49 had autism. The mean age of children with autism was 7.2(SD=3.2 years. The mean of age, the diagnosis and severity of the symptoms were not related to gender . "n "n "nConclusion: Usually, those with severe cases of autism refer to clinics for treatment. Therefore, the clinical sample of children with autism is just the tip of the iceberg and they may not be the actual representative of community sample of children with autism. Preventive programs should be more focused on the screening and referring of inflected girls for service utilization .

Clinically defined non-specific symptoms in the vicinity of mobile phone base stations: A retrospective before-after study

International Nuclear Information System (INIS)

Baliatsas, Christos; Kamp, Irene van; Bolte, John; Kelfkens, Gert; Dijk, Christel van; Spreeuwenberg, Peter; Hooiveld, Mariette; Lebret, Erik; Yzermans, Joris

2016-01-01

The number of mobile phone base station(s) (MPBS) has been increasing to meet the rapid technological changes and growing needs for mobile communication. The primary objective of the present study was to test possible changes in prevalence and number of NSS in relation to MPBS exposure before and after increase of installed MPBS antennas. A retrospective cohort study was conducted, comparing two time periods with high contrast in terms of number of installed MPBS. Symptom data were based on electronic health records from 1069 adult participants, registered in 9 general practices in different regions in the Netherlands. All participants were living within 500 m from the nearest bases station. Among them, 55 participants reported to be sensitive to MPBS at T1. A propagation model combined with a questionnaire was used to assess indoor exposure to RF-EMF from MPBS at T1. Estimation of exposure at T0 was based on number of antennas at T0 relative to T1. At T1, there was a > 30% increase in the total number of MPBS antennas. A higher prevalence for most NSS was observed in the MPBS-sensitive group at T1 compared to baseline. Exposure estimates were not associated with GP-registered NSS in the total sample. Some significant interactions were observed between MPBS-sensitivity and exposure estimates on risk of symptoms. Using clinically defined outcomes and a time difference of > 6 years it was demonstrated that RF-EMF exposure to MPBS was not associated with the development of NSS. Nonetheless, there was some indication for a higher risk of NSS for the MPBS-sensitive group, mainly in relation to exposure to UMTS, but this should be interpreted with caution. Results have to be verified by future longitudinal studies with a particular focus on potentially susceptible population subgroups of large sample size and integrated exposure assessment. - Highlights: • There was an important increase in the total number of MPBS at T1 compared to T0. • Prevalence of NSS was

Clinically defined non-specific symptoms in the vicinity of mobile phone base stations: A retrospective before-after study

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Baliatsas, Christos, E-mail: c.baliatsas@nivel.nl [Netherlands Institute for Health Services Research (NIVEL), Utrecht (Netherlands); Kamp, Irene van, E-mail: irene.van.kamp@rivm.nl [National Institute for Public Health and the Environment (RIVM), Bilthoven (Netherlands); Bolte, John, E-mail: john.bolte@rivm.nl [National Institute for Public Health and the Environment (RIVM), Bilthoven (Netherlands); Kelfkens, Gert, E-mail: gert.kelfkens@rivm.nl [National Institute for Public Health and the Environment (RIVM), Bilthoven (Netherlands); Dijk, Christel van, E-mail: Christel.Van.Dijk@amsterdam.nl [Department of Research, Information and Statistics (OIS), Municipality of Amsterdam, Amsterdam (Netherlands); Spreeuwenberg, Peter, E-mail: p.spreeuwenberg@nivel.nl [Netherlands Institute for Health Services Research (NIVEL), Utrecht (Netherlands); Hooiveld, Mariette, E-mail: m.hooiveld@nivel.nl [Netherlands Institute for Health Services Research (NIVEL), Utrecht (Netherlands); Lebret, Erik, E-mail: erik.lebret@rivm.nl [National Institute for Public Health and the Environment (RIVM), Bilthoven (Netherlands); Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht (Netherlands); Yzermans, Joris, E-mail: J.Yzermans@nivel.nl [Netherlands Institute for Health Services Research (NIVEL), Utrecht (Netherlands)

2016-09-15

The number of mobile phone base station(s) (MPBS) has been increasing to meet the rapid technological changes and growing needs for mobile communication. The primary objective of the present study was to test possible changes in prevalence and number of NSS in relation to MPBS exposure before and after increase of installed MPBS antennas. A retrospective cohort study was conducted, comparing two time periods with high contrast in terms of number of installed MPBS. Symptom data were based on electronic health records from 1069 adult participants, registered in 9 general practices in different regions in the Netherlands. All participants were living within 500 m from the nearest bases station. Among them, 55 participants reported to be sensitive to MPBS at T1. A propagation model combined with a questionnaire was used to assess indoor exposure to RF-EMF from MPBS at T1. Estimation of exposure at T0 was based on number of antennas at T0 relative to T1. At T1, there was a > 30% increase in the total number of MPBS antennas. A higher prevalence for most NSS was observed in the MPBS-sensitive group at T1 compared to baseline. Exposure estimates were not associated with GP-registered NSS in the total sample. Some significant interactions were observed between MPBS-sensitivity and exposure estimates on risk of symptoms. Using clinically defined outcomes and a time difference of > 6 years it was demonstrated that RF-EMF exposure to MPBS was not associated with the development of NSS. Nonetheless, there was some indication for a higher risk of NSS for the MPBS-sensitive group, mainly in relation to exposure to UMTS, but this should be interpreted with caution. Results have to be verified by future longitudinal studies with a particular focus on potentially susceptible population subgroups of large sample size and integrated exposure assessment. - Highlights: • There was an important increase in the total number of MPBS at T1 compared to T0. • Prevalence of NSS was

Symptom severity prediction from neuropsychiatric clinical records: Overview of 2016 CEGS N-GRID shared tasks Track 2.

Science.gov (United States)

Filannino, Michele; Stubbs, Amber; Uzuner, Özlem

2017-11-01

The second track of the CEGS N-GRID 2016 natural language processing shared tasks focused on predicting symptom severity from neuropsychiatric clinical records. For the first time, initial psychiatric evaluation records have been collected, de-identified, annotated and shared with the scientific community. One-hundred-ten researchers organized in twenty-four teams participated in this track and submitted sixty-five system runs for evaluation. The top ten teams each achieved an inverse normalized macro-averaged mean absolute error score over 0.80. The top performing system employed an ensemble of six different machine learning-based classifiers to achieve a score 0.86. The task resulted to be generally easy with the exception of two specific classes of records: records with very few but crucial positive valence signals, and records describing patients predominantly affected by negative rather than positive valence. Those cases proved to be very challenging for most of the systems. Further research is required to consider the task solved. Overall, the results of this track demonstrate the effectiveness of data-driven approaches to the task of symptom severity classification. Copyright © 2017 Elsevier Inc. All rights reserved.

Tract-Specific Diffusion Tensor Imaging Reveals Laterality of Neurological Symptoms in Patients with Cervical Compression Myelopathy.

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Maki, Satoshi; Koda, Masao; Saito, Junya; Takahashi, Sho; Inada, Taigo; Kamiya, Koshiro; Ota, Mitsutoshi; Iijima, Yasushi; Masuda, Yoshitada; Matsumoto, Koji; Kojima, Masatoshi; Takahashi, Kazuhisa; Obata, Takayuki; Yamazaki, Masashi; Furuya, Takeo

2016-12-01

Patients with cervical compression myelopathy (CCM) generally present bilateral neurological symptoms in their extremities. However, a substantial portion of patients with CCM exhibit laterality of neurological symptoms. The aim of this study was to assess the correlation between intrinsic structural damage and laterality of symptoms using spinal cord diffusion tensor imaging (DTI) of the corticospinal tract. We enrolled 10 healthy volunteers and 40 patients with CCM in this study. We evaluated motor function using the American Spinal Injury Association (ASIA) motor score for left and right extremities. For DTI acquisitions, a 3.0-T magnetic resonance imaging system with diffusion-weighted spin-echo sequence was used. Regions-of-interest in the lateral column tracts were determined. We determined the correlations between fractional anisotropy (FA) and ASIA motor scores. An FA asymmetry index was calculated using left and right regions-of-interest. Four patients exhibited laterality of symptoms in their extremities, for which left and right ASIA scores correlated moderately with FA in the left and right lateral columns, respectively (left: ρ = 0.64, P laterality of symptoms. Using tract-specific DTI, we demonstrated that microstructural damages in the left and right corticospinal tracts correlated with corresponding neurological symptoms in the ipsilateral side and the FA asymmetry index could indicate laterality in neurological symptoms of patients with CCM. Copyright © 2016 Elsevier Inc. All rights reserved.

Allergen-specific immunotherapy

Directory of Open Access Journals (Sweden)

Moote William

2011-11-01

Full Text Available Abstract Allergen-specific immunotherapy is a potentially disease-modifying therapy that is effective for the treatment of allergic rhinitis/conjunctivitis, allergic asthma and stinging insect hypersensitivity. However, despite its proven efficacy in these conditions, it is frequently underutilized in Canada. The decision to proceed with allergen-specific immunotherapy should be made on a case-by-case basis, taking into account individual patient factors such as the degree to which symptoms can be reduced by avoidance measures and pharmacological therapy, the amount and type of medication required to control symptoms, the adverse effects of pharmacological treatment, and patient preferences. Since this form of therapy carries the risk of anaphylactic reactions, it should only be prescribed by physicians who are adequately trained in the treatment of allergy. Furthermore, injections must be given under medical supervision in clinics that are equipped to manage anaphylaxis. In this article, the authors review the indications and contraindications, patient selection criteria, and the administration, safety and efficacy of allergen-specific immunotherapy.

Study on clinical symptoms in canine cardiac diseases

Directory of Open Access Journals (Sweden)

F. Karlette Anne

Full Text Available Cardiac diseases in canines are an extensively studied phenomenon all over the world but meagre information has been reported in India. Certain problems, including historical, physical, and laboratory abnormalities, are associated with cardiovascular or pulmonary disease. In India however, the recognition of canine cardiac diseases has been delayed, and ignored on account of lack of awareness and knowledge by the owner and inadequate diagnostic facility to a field veterinarian. Considering the above facts, the present study was undertaken in Gujarat to survey the prevalence of common cardiac diseases in hospital population of dogs along with the clinical symptoms which often goes undetected due to lack of proper diagnostic techniques to be implied and the most forms of heart disease may be present for many years before any evidence of failure develops. In the present study most of the clinical cases of cardiac diseases were presented with a history of nocturnal coughing (seven cases; 2.55%, exercise intolerance (five cases; 1.82%, partial or complete anorexia (five cases; 1.82%, swelling in abdominal area (four cases; 1.45%, dullness and depression (two cases; 0.72%, cachexia and hepatojugular pulsation (one case each; 0.36% each at times. [Vet World 2009; 2(8.000: 307-309

Rewards of bridging the divide between measurement and clinical theory: demonstration of a bifactor model for the Brief Symptom Inventory.

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Thomas, Michael L

2012-03-01

There is growing evidence that psychiatric disorders maintain hierarchical associations where general and domain-specific factors play prominent roles (see D. Watson, 2005). Standard, unidimensional measurement models can fail to capture the meaningful nuances of such complex latent variable structures. The present study examined the ability of the multidimensional item response theory bifactor model (see R. D. Gibbons & D. R. Hedeker, 1992) to improve construct validity by serving as a bridge between measurement and clinical theories. Archival data consisting of 688 outpatients' psychiatric diagnoses and item-level responses to the Brief Symptom Inventory (BSI; L. R. Derogatis, 1993) were extracted from files at a university mental health clinic. The bifactor model demonstrated superior fit for the internal structure of the BSI and improved overall diagnostic accuracy in the sample (73%) compared with unidimensional (61%) and oblique simple structure (65%) models. Consistent with clinical theory, multiple sources of item variance were drawn from individual test items. Test developers and clinical researchers are encouraged to consider model-based measurement in the assessment of psychiatric distress.

Are there clinical signs and symptoms of infection to indicate the presence of multidrug-resistant bacteria in venous ulcers?

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Dos Santos, Silvana de Lima Vieira; Martins, Marlene Andrade; do Prado, Marinésia Aparecida; Soriano, José Verdú; Bachion, Maria Márcia

2017-12-01

The selection of topical and systemic therapies for the treatment of venous ulcers with signs of infection is challenging and should be accompanied by specific precautionary measures to protect against cross-contamination in the presence of multidrug-resistant microorganisms. However, there are still no clinical indicators for this situation, and confirmation of resistant strains occurs through culture and sensitivity, which can take up to 14 days. During this period, protective measures may no longer be taken, contributing to the spread of these pathogens. This study aimed to analyze the relationship between clinical signs and symptoms of infection in venous ulcers and the presence of antimicrobial-resistant Staphylococcus aureus and/or Pseudomonas spp. A cross-sectional study was developed including 69 patients with 98 venous ulcers. Clinical observation protocol was applied to detect infection indicators established by the European Wound Management Association and microbiological analysis of samples of the lesions. Fisher's exact test and χ 2 were used for analyses (P 70%): discoloration of the opaque type and/or dark brick red and increased exudate volume; 31 (31.6%) ulcer samples showed positive culture for the bacteria studied. There was no relationship between signs and symptoms of infection and the presence of multidrug-resistant microorganisms. Taking into account the percentage of lesions with resistant strains, for safe care, contact precautionary measures should be implemented in the treatment rooms, in addition to standard precautions. Copyright © 2017 Society for Vascular Nursing, Inc. Published by Elsevier Inc. All rights reserved.

Does collateral retrospective information about childhood attention-deficit/hyperactivity disorder symptoms assist in the diagnosis of attention-deficit/hyperactivity disorder in adults? Findings from a large clinical sample.

Science.gov (United States)

Breda, Vitor; Rovaris, Diego Luiz; Vitola, Eduardo Schneider; Mota, Nina Roth; Blaya-Rocha, Paula; Salgado, Carlos Alberto Iglesias; Victor, Marcelo Moraes; Picon, Felipe Almeida; Karam, Rafael Gomes; Silva, Katiane Lilian; Rohde, Luis Augusto; Bau, Claiton Henrique Dotto; Grevet, Eugenio Horacio

2016-06-01

In accordance with consolidated clinical practice, Diagnostic and Statistical Manual of Mental Disorders, 5th edition suggests a key role of collateral information in the evaluation of retrospective childhood attention-deficit/hyperactivity disorder symptoms in adults despite poor evidence supporting its use. This study aims to assess the incremental value of collateral information on the presence of childhood attention-deficit/hyperactivity disorder symptoms when evaluating adults with attention-deficit/hyperactivity disorder. Adult patients with attention-deficit/hyperactivity disorder (n = 449) and non-attention-deficit/hyperactivity disorder subjects (n = 143) underwent an extensive clinical assessment based on Diagnostic and Statistical Manual of Mental Disorders, 4th edition criteria. For patients, retrospective collateral information regarding childhood attention-deficit/hyperactivity disorder was obtained and used to sort them into two groups: agreement (n = 277) and disagreement (n = 172) between self- and collateral reports. We compared demographic, clinical and response to treatment profiles among groups to test the relevance of collateral information on the specific issue of childhood attention-deficit/hyperactivity disorder symptoms. Both attention-deficit/hyperactivity disorder groups had higher rates of several comorbidities (oppositional defiant, conduct, substance use and bipolar disorders; all p attention-deficit/hyperactivity disorder symptoms occurred in 38% of patients. Overall, attention-deficit/hyperactivity disorder disagreement and agreement groups had similar profiles in response to treatment and comorbidity, and the few differences detected in impairment measures were of small magnitude (Eta(2) attention-deficit/hyperactivity disorder in children, it has no incremental value in the evaluation of childhood attention-deficit/hyperactivity disorder symptoms in adults with a self-reported history of attention

Fractional exhaled nitric oxide as a predictor of response to inhaled corticosteroids in patients with non-specific respiratory symptoms and insignificant bronchodilator reversibility

DEFF Research Database (Denmark)

Price, David B; Buhl, Roland; Chan, Adrian

2018-01-01

BACKGROUND: Chronic non-specific respiratory symptoms are difficult to manage. This trial aimed to evaluate the association between baseline fractional exhaled nitric oxide (FeNO) and the response to inhaled corticosteroids in patients with non-specific respiratory symptoms. METHODS: In this doub...

Relating ASD symptoms to well-being: moving across different construct levels.

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Deserno, M K; Borsboom, D; Begeer, S; Geurts, H M

2018-05-01

Little is known about the specific factors that contribute to the well-being (WB) of individuals with autism spectrum disorder (ASD). A plausible hypothesis is that ASD symptomatology has a direct negative effect on WB. In the current study, the emerging tools of network analysis allow to explore the functional interdependencies between specific symptoms of ASD and domains of WB in a multivariate framework. We illustrate how studying both higher-order (total score) and lower-order (subscale) representations of ASD symptomatology can clarify the interrelations of factors relevant for domains of WB. We estimated network structures on three different construct levels for ASD symptomatology, as assessed with the Adult Social Behavior Questionnaire (item, subscale, total score), relating them to daily functioning (DF) and subjective WB in 323 adult individuals with clinically identified ASD (aged 17-70 years). For these networks, we assessed the importance of specific factors in the network structure. When focusing on the highest representation level of ASD symptomatology (i.e. a total score), we found a negative connection between ASD symptom severity and domains of WB. However, zooming in on lower representation levels of ASD symptomatology revealed that this connection was mainly funnelled by ASD symptoms related to insistence on sameness and experiencing reduced contact and that those symptom scales, in turn, impact different domains of WB. Zooming in across construct levels of ASD symptom severity into subscales of ASD symptoms can provide us with important insights into how specific domains of ASD symptoms relate to specific domains of DF and WB.

Depression symptoms in people with diabetes attending outpatient podiatry clinics for the treatment of foot ulcers

OpenAIRE

Pearson, Sue; Nash, Toni; Ireland, Vanessa

2014-01-01

Background The purpose of this study was to examine the prevalence of depressive symptoms, diabetes self-management, and quality of life in people with diabetes and foot ulcers. Ulcer status, mortality and amputations were also assessed at six months follow-up. Methods This was a cross-sectional survey of people attending outpatient podiatry clinics at a major tertiary referral hospital. Depressive symptoms were measured using the Patient Health Questionnaire (PHQ). Diabetes self-care was ass...

The Influence of Preoperative and Postoperative Psychological Symptoms on Clinical Outcome after Shoulder Surgery : A Prospective Longitudinal Cohort Study

NARCIS (Netherlands)

Koorevaar, Rinco C T; van 't Riet, Esther; Gerritsen, Marleen J J; Madden, Kim; Bulstra, Sjoerd K.

2016-01-01

BACKGROUND: Psychological symptoms are highly prevalent in patients with shoulder complaints. Psychological symptoms in patients with shoulder complaints might play a role in the aetiology, perceived disability and pain and clinical outcome of treatment. The aim of this study was to assess whether

The Influence of Preoperative and Postoperative Psychological Symptoms on Clinical Outcome after Shoulder Surgery: A Prospective Longitudinal Cohort Study

NARCIS (Netherlands)

Koorevaar, R.C.; Riet, E. van 't; Gerritsen, M.J.P.; Madden, K.; Bulstra, S.K.

2016-01-01

BACKGROUND: Psychological symptoms are highly prevalent in patients with shoulder complaints. Psychological symptoms in patients with shoulder complaints might play a role in the aetiology, perceived disability and pain and clinical outcome of treatment. The aim of this study was to assess whether

Are activity limitations associated with lower urinary tract symptoms in stroke patients? A cross-sectional, clinical survey

DEFF Research Database (Denmark)

Tibaek, Sigrid; Gard, Gunvor; Klarskov, Peter

2009-01-01

stroke patients were invited to complete four activity limitations measurements: Barthel Index, mobility velocity, mobility distance, mobility aids and one LUTS measurement: the Danish Prostatic Symptom Score (DAN-PSS-1) questionnaire. Of 519 stroke patients, 482 subjects were eligible. Results......Objective. To assess self-reported activity limitations in a clinical sample of stroke patients and to identify their association with prevalence, severity and impact on daily life of lower urinary tract symptoms (LUTS). Material and methods. A cross-sectional, clinical survey was initiated whereby...... time that activity limitations are closely related to LUTS in stroke patients and that rehabilitation should also be directed towards the treatment of LUTS....

Trajectories of Attention Deficit Hyperactivity Disorder and Oppositional Defiant Disorder Symptoms as Precursors of Borderline Personality Disorder Symptoms in Adolescent Girls

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Stepp, Stephanie D.; Burke, Jeffrey D.; Hipwell, Alison E.; Loeber, Rolf

2011-01-01

Little empirical evidence exists regarding the developmental links between childhood psychopathology and borderline personality disorder (BPD) in adolescence. The current study addresses this gap by examining symptoms of attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) as potential precursors. ADHD and BPD share clinical features of impulsivity, poor self-regulation, and executive dysfunction, while ODD and BPD share features of anger and interpersonal turmoil. The study is based on annual, longitudinal data from the two oldest cohorts in the Pittsburgh Girls Study (N = 1233). We used piecewise latent growth curve models of ADHD and ODD scores from age 8–10 and 10–13 years to examine the prospective associations between dual trajectories of ADHD and ODD symptom severity and later BPD symptoms at age 14 in girls. To examine the specificity of these associations, we also included conduct disorder (CD) and depression symptom severity at age 14 as additional outcomes. We found that higher levels of ADHD and ODD scores at age 8 uniquely predicted BPD symptoms at age 14. Additionally, the rate of growth in ADHD scores from age 10–13 and the rate of growth in ODD scores from 8–10 uniquely predicted higher BPD symptoms at age 14. This study adds to the literature on the early development of BPD by providing the first longitudinal study to examine ADHD and ODD symptom trajectories as specific childhood precursors of BPD symptoms in adolescent girls. PMID:21671009

Parenting and Children's Internalizing Symptoms: How Important are Parents?

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van der Sluis, Cathy M; van Steensel, Francisca J A; Bögels, Susan M

Parenting behaviors are associated with children's internalizing symptoms, however, it is not often examined which factors could possibly influence this relationship. The goals of this study were twofold. One goal was to examine whether the association between parenting and children's internalizing symptoms would increase if parenting behaviors were assessed behaviorally and in a context where the child displayed specific anxious behaviors. Another goal was to examine whether this relationship was influenced by the age and gender of the child, and by possible parenting differences between mothers and fathers. These questions were examined in a sample of 211 children aged 4-12 years; 140 community children and 71 clinically referred anxious children. Parents completed questionnaires regarding children's internalizing symptoms and parenting behaviors (positive reinforcement, punishment, force, reinforcement of dependency, and modeling/reassurance). In line with expectations, more punishment and less modeling/reassurance by parents were related to more internalizing symptoms in children. Child gender, child age, parent gender and clinical anxiety status were not found to influence the relationship between parenting and children's internalizing symptoms. Our results suggest that paternal parenting is as important as maternal parenting with respect to children's internalizing symptoms, and therefore, fathers could be included in child treatment as well.

Prevalence and predictors of clinically significant depressive symptoms among Chinese and Malawian children: a cross-cultural comparative cross-sectional study.

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Zgambo, Maggie; Kalembo, Fatch Welcome; Wang, Honghong; He, Guoping; Chen, Sanmei

2014-08-14

Multicultural comparative studies have recently increased scientific knowledge base regarding the mental health of diverse populations. This cross-cultural study was cross-sectionally designed to assess differences in the prevalence and predictors of clinically significant depressive symptoms between Chinese and Malawian children. A total of 478 children (237 Chinese and 241 Malawians) were randomly recruited in the study. The participants completed a Children Depression Inventory in the dimensions of Negative Mood, Interpersonal Problems, Ineffectiveness, Anhedonia, and Negative Self- Esteem. They further provided demographic and family structure information. Data were analyzed by Student's t-test, Chi-square test, and logistic regression. The prevalence of clinically significant depressive symptoms was 16% and 12.4% for Chinese and Malawian study participants, respectively. Multivariate logistic regression analysis showed that fighting among siblings (adjusted odds ratio [aOR] = 4.1, 95% CI, 3.5-5.9), fighting among children and parents (aOR = 7.7, 95% CI, 4.6-9.8) and living with father only (aOR = 4.1, 95% CI, 3.4-6.7) were significant predictors of clinically significant depressive symptoms among Chinese study participants. On the other hand, clinically significant depressive symptoms were predicted by employment status of a mom only among Malawian study participants (aOR = 3.0, 95% CI, 2.3-5.9). We conclude that diverse cultures affect children's mental health differently and this cluster of children has a noticeable amount of depressive symptoms that in the least requires further diagnosis and preventive measures.

Electroencephalogram, cognitive state, psychological disorders, clinical symptom, and oxidative stress in horticulture farmers exposed to organophosphate pesticides.

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Bayrami, Mansour; Hashemi, Touraj; Malekirad, Ali Akbar; Ashayeri, Hassan; Faraji, Fardin; Abdollahi, Mohammad

2012-02-01

The aim of this paper was to study the toxicity of organophosphate (OP) pesticides in exposed farmers for electroencephalography, cognitive state, psychological disorders, clinical symptom, oxidative stress, acetylcholinesterase, and DNA damage. A comparative cross-sectional analysis was carried out in 40 horticulture farmers who were exposed to OPs in comparison to a control group containing 40 healthy subjects with the same age and sex and education level. Lipid peroxidation (LPO), superoxide dismutase (SOD), catalase, glutathione peroxidase, DNA damage, total antioxidant capacity (TAC), total thiol molecules, and acetylcholinesterase (AChE) activity were measured in the blood of subjects. Clinical examination and complete blood test were undertaken in order to record any abnormal sign or symptoms. Cognitive function, psychological symptoms, and psychological distress were examined and recorded. Comparing with controls, the farmers showed higher blood levels of SOD and LPO while their TAC decreased. Farmers showed clinical symptoms such as eczema, breathing muscle weakness, nausea, and saliva secretion. Regarding cognitive function, the orientation, registration, attention and calculation, recall, and language were not significantly different in farmers and controls. Among examinations for psychological distress, only labeled somatization was significantly higher in farmers. The present findings indicate that oxidative stress and inhibition of AChE can be seen in chronically OP-exposed people but incidence of neuropsychological disorders seems a complex multivariate phenomenon that might be seen in long-term high-dose exposure situations. Use of supplementary antioxidants would be useful in the treatment of farmers.

SymptomCare@Home: Developing an Integrated Symptom Monitoring and Management System for Outpatients Receiving Chemotherapy.

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Beck, Susan L; Eaton, Linda H; Echeverria, Christina; Mooney, Kathi H

2017-10-01

SymptomCare@Home, an integrated symptom monitoring and management system, was designed as part of randomized clinical trials to help patients with cancer who receive chemotherapy in ambulatory clinics and often experience significant symptoms at home. An iterative design process was informed by chronic disease management theory and features of assessment and clinical decision support systems used in other diseases. Key stakeholders participated in the design process: nurse scientists, clinical experts, bioinformatics experts, and computer programmers. Especially important was input from end users, patients, and nurse practitioners participating in a series of studies testing the system. The system includes both a patient and clinician interface and fully integrates two electronic subsystems: a telephone computer-linked interactive voice response system and a Web-based Decision Support-Symptom Management System. Key features include (1) daily symptom monitoring, (2) self-management coaching, (3) alerting, and (4) nurse practitioner follow-up. The nurse practitioner is distinctively positioned to provide assessment, education, support, and pharmacologic and nonpharmacologic interventions to intensify management of poorly controlled symptoms at home. SymptomCare@Home is a model for providing telehealth. The system facilitates using evidence-based guidelines as part of a comprehensive symptom management approach. The design process and system features can be applied to other diseases and conditions.

Insight change in psychosis: Relationship with neurocognition, social cognition, clinical symptoms and phase of illness

NARCIS (Netherlands)

P.J. Quee (P.); L. van der Meer (Lisette); L. Krabbendam (Lydia); L. de Haan (Lieuwe); W. Cahn (Wiepke); D. Wiersma (Durk); N.J.M. van Beveren (Nico); G.H.M. Pijnenborg (G. H M); C.L. Mulder (Niels); R. Bruggeman (Richard); A. Aleman (André)

2014-01-01

textabstractObjective: Impaired insight is an important and prevalent symptom of psychosis. It remains unclear whether cognitive disturbances hamper improvements in insight. We investigated the neurocognitive, social cognitive, and clinical correlates of changes in insight. Method: One hundred and

Sensitivity, Specificity, and Public-Health Utility of Clinical Case Definitions Based on the Signs and Symptoms of Cholera in Africa.

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Nadri, Johara; Sauvageot, Delphine; Njanpop-Lafourcade, Berthe-Marie; Baltazar, Cynthia S; Banla Kere, Abiba; Bwire, Godfrey; Coulibaly, Daouda; Kacou N'Douba, Adele; Kagirita, Atek; Keita, Sakoba; Koivogui, Lamine; Landoh, Dadja E; Langa, Jose P; Miwanda, Berthe N; Mutombo Ndongala, Guy; Mwakapeje, Elibariki R; Mwambeta, Jacob L; Mengel, Martin A; Gessner, Bradford D

2018-04-01

During 2014, Africa reported more than half of the global suspected cholera cases. Based on the data collected from seven countries in the African Cholera Surveillance Network (Africhol), we assessed the sensitivity, specificity, and positive and negative predictive values of clinical cholera case definitions, including that recommended by the World Health Organization (WHO) using culture confirmation as the gold standard. The study was designed to assess results in real-world field situations in settings with recent cholera outbreaks or endemicity. From June 2011 to July 2015, a total of 5,084 persons with suspected cholera were tested for Vibrio cholerae in seven different countries of which 35.7% had culture confirmation. For all countries combined, the WHO case definition had a sensitivity = 92.7%, specificity = 8.1%, positive predictive value = 36.1%, and negative predictive value = 66.6%. Adding dehydration, vomiting, or rice water stools to the case definition could increase the specificity without a substantial decrease in sensitivity. Future studies could further refine our findings primarily by using more sensitive methods for cholera confirmation.

Cluster Analysis of the Yale Global Tic Severity Scale (YGTSS): Symptom Dimensions and Clinical Correlates in an Outpatient Youth Sample

OpenAIRE

Kircanski, Katharina; Woods, Douglas W.; Chang, Susanna W.; Ricketts, Emily J.; Piacentini, John C.

2010-01-01

Tic disorders are heterogeneous, with symptoms varying widely both within and across patients. Exploration of symptom clusters may aid in the identification of symptom dimensions of empirical and treatment import. This article presents the results of two studies investigating tic symptom clusters using a sample of 99 youth (M age = 10.7, 81% male, 77% Caucasian) diagnosed with a primary tic disorder (Tourette?s disorder or chronic tic disorder), across two university-based outpatient clinics ...

Cancer Palliation: Layered Hypnotic Approaches Mending Symptoms, Minding Hope, and Meaning.

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Handel, Daniel L; Néron, Sylvain

2017-07-01

Advanced cancer often produces significant symptoms such as pain, anxiety, insomnia, nausea, and cachexia; many symptoms require medication adjustments in dose and route of administration, and most patients have significant symptom burdens near the end of life. Treatment strategies that integrate mind-body approaches, such as hypnosis, to improve symptoms are increasingly being studied and utilized. The current article addresses the role for adjunctive hypnotic approaches to relieve suffering from pain and other symptoms, while fostering hope, even in the midst of advancing illness, similar to Snyder's (2002) metaphorical painting of "a personal rainbow of the mind" (p. 269). We describe specific clinical indications, technical modifications, and imagistic language used in formulating hypnotic suggestions in the face of illness progression. Furthermore, we specifically describe formulation of layered hypnotic suggestions with intent to intentionally weave suggestions to modify symptoms and link to suggestions to enhance hope and alter time perception. This approach offers the opportunity to transform an experience often defined by its losses to one in which hidden opportunities for growth and change emerge within this transitional life experience.

Association of Schizophrenia Spectrum and Autism Spectrum Disorder (ASD) Symptoms in Children with ASD and Clinic Controls

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Gadow, Kenneth D.

2013-01-01

Objective: This study examines relations between the severity of specific symptoms of schizophrenia spectrum disorder (SSD) and severity of the three defining symptom domains of autism spectrum disorder (ASD) in children with ASD (N = 147) and child psychiatry outpatient referrals (Controls; N = 339). Method: Participants were subdivided into four…

Prevalence of Lower Urinary Tract Symptoms (LUTS) in Stroke Patients. A cross-sectional, clinical survey

DEFF Research Database (Denmark)

Tibæk, Sigrid; Gard, Gunvor; Klarskov, Peter

2008-01-01

AIMS: The aims of this study were primarily to investigate the prevalence, severity and impact on daily life of Lower Urinary Tract Symptoms (LUTS) in a clinical sample of stroke patients and secondly to identify factors associated with LUTS. MATERIALS AND METHODS: This was a cross......, symptoms of urinary incontinence on admission, and use of analgesics were significantly associated with severity, whereas the prevalence and bother of LUTS could not be associated with other patient characteristics. CONCLUSION: LUTS are highly prevalent in stroke patients and have a major impact on daily...

Insight change in psychosis : relationship with neurocognition, social cognition, clinical symptoms and phase of illness

NARCIS (Netherlands)

Quee, P. J.; van der Meer, L.; Krabbendam, L.; de Haan, L.; Cahn, W.; Wiersma, D.; van Beveren, N.; Pijnenborg, G. H. M.; Mulder, C. L.; Bruggeman, R.; Aleman, A.

Objective: Impaired insight is an important and prevalent symptom of psychosis. It remains unclear whether cognitive disturbances hamper improvements in insight. We investigated the neurocognitive, social cognitive, and clinical correlates of changes in insight. Method: One hundred and fifty-four

Autism and ADHD Symptoms in Patients with OCD: Are They Associated with Specific OC Symptom Dimensions or OC Symptom Severity?

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Anholt, Gideon E.; Cath, Danielle C.; van Oppen, Patricia; Eikelenboom, Merijn; Smit, Johannes H.; van Megen, Harold; van Balkom, Anton J. L. M.

2010-01-01

In obsessive-compulsive disorder (OCD), the relationship between autism spectrum disorders (ASD), attention-deficit/hyperactivity disorder (ADHD) symptom, and obsessive-compulsive (OC) symptom dimensions and severity has scarcely been studied. Therefore, 109 adult outpatients with primary OCD were compared to 87 healthy controls on OC, ADHD and…

Negative symptoms in first episode non-affective psychosis.

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Malla, Ashok K; Takhar, Jatinder J; Norman, Ross M G; Manchanda, Rahul; Cortese, Leonard; Haricharan, Raj; Verdi, Mary; Ahmed, Rashid

2002-06-01

To determine the prevalence of negative symptoms and to examine secondary sources of influence on negative symptoms and the role of specific negative symptoms in delay associated with seeking treatment in first episode non-affective psychosis. One hundred and ten patients who met Diagnostic Statistical Manual-IV (DSM-IV) criteria for a first episode of schizophrenia spectrum psychoses were rated for assessment of negative, positive, depressive and extrapyramidal symptoms, the premorbid adjustment scale and assessment of demographic and clinical characteristics including duration of untreated psychosis (DUP). Alogia/flat affect and avolition/anhedonia were strongly influenced by parkinsonian and depressive symptoms, respectively. A substantial proportion (26.8%) of patients showed at a least moderate level of negative symptoms not confounded by depression and Parkinsonism. DUP was related only to avolition/anhedonia while flat affect/alogia was related to male gender, diagnosis of schizophrenia, age of onset and the length of the prodrome. Negative symptoms that are independent of the influence of positive symptoms, depression and extra pyramidal symptoms (EPS) are present in a substantial proportion of first episode psychosis patients and delay in seeking treatment is associated mainly with avolition and anhedonia.

Neuropathic sensory symptoms: association with pain and psychological factors

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Shaygan M

2014-05-01

Full Text Available Maryam Shaygan,1 Andreas Böger,2 Birgit Kröner-Herwig11Department of Clinical Psychology and Psychotherapy, University of Göttingen, Germany; 2Pain Management Clinic at the Red Cross Hospital, Kassel, GermanyBackground: A large number of population-based studies of chronic pain have considered neuropathic sensory symptoms to be associated with a high level of pain intensity and negative affectivity. The present study examines the question of whether this association previously found in non-selected samples of chronic pain patients can also be found in chronic pain patients with underlying pathology of neuropathic sensory symptoms.Methods: Neuropathic sensory symptoms in 306 patients with chronic pain diagnosed as typical neuropathic pain, radiculopathy, fibromyalgia, or nociceptive back pain were assessed using the Pain DETECT Questionnaire. Two separate cluster analyses were performed to identify subgroups of patients with different levels of self-reported neuropathic sensory symptoms and, furthermore, to identify subgroups of patients with distinct patterns of neuropathic sensory symptoms (adjusted for individual response bias regarding specific symptoms.Results: ANOVA (analysis of variance results in typical neuropathic pain, radiculopathy, and fibromyalgia showed no significant differences between the three levels of neuropathic sensory symptoms regarding pain intensity, pain chronicity, pain catastrophizing, pain acceptance, and depressive symptoms. However, in nociceptive back pain patients, significant differences were found for all variables except pain chronicity. When controlling for the response bias of patients in ratings of symptoms, none of the patterns of neuropathic sensory symptoms were associated with pain and psychological factors.Conclusion: Neuropathic sensory symptoms are not closely associated with higher levels of pain intensity and cognitive-emotional evaluations in chronic pain patients with underlying pathology of

Validation of the Rome III criteria and alarm symptoms for recurrent abdominal pain in children.

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Gijsbers, Carolien F M; Benninga, Marc A; Schweizer, Joachim J; Kneepkens, C M Frank; Vergouwe, Yvonne; Büller, Hans A

2014-06-01

Rome criteria were formulated to define functional gastrointestinal disorders (Rome III criteria, 2006) excluding organic diagnoses when alarm symptoms were absent. The aims of the study were to validate the Rome III criteria as to their capacity to differentiate between organic and functional abdominal pain and to assess the role of alarm symptoms in this differentiation. During 2 years all of the patients (ages 4-16 years) presenting with recurrent abdominal pain (Apley criteria) and referred to secondary care were included. Clinical diagnoses were based on protocolized evaluation and intervention with 6-month follow-up. Alarm symptoms were registered. Rome III criteria for functional pain syndromes were assigned independently. Descriptive statistical analyses were performed. In 200 patients (87 boys, mean age 8.8 years), organic (17%), functional (40%), combined organic and functional (9%), spontaneous recovery (27%), and other (8%) clinical diagnoses were established. Alarm symptoms were found in 57.5% (organic causes 56%, functional causes 61%). The evaluation for Rome symptom clusters revealed symptoms of irritable bowel syndrome in 27%, functional dyspepsia in 15%, functional abdominal pain in 28%, functional abdominal pain syndrome in 14.5%, and no pain syndrome in 15.5%. Rome diagnoses, based on symptoms and absence of alarm symptoms, predicted functional clinical diagnosis with sensitivity 0.35 (95% confidence interval 0.27-0.43), specificity 0.60 (0.46-0.73), positive predictive value 0.71 (0.61-0.82), and negative predictive value of 0.24 (0.17-0.32). The Rome III criteria for abdominal pain are not specific enough to rule out organic causes. Alarm symptoms do not differentiate between organic and functional abdominal pain.

French version validation of the psychotic symptom rating scales (PSYRATS for outpatients with persistent psychotic symptoms

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Favrod Jerome

2012-09-01

Full Text Available Abstract Background Most scales that assess the presence and severity of psychotic symptoms often measure a broad range of experiences and behaviours, something that restricts the detailed measurement of specific symptoms such as delusions or hallucinations. The Psychotic Symptom Rating Scales (PSYRATS is a clinical assessment tool that focuses on the detailed measurement of these core symptoms. The goal of this study was to examine the psychometric properties of the French version of the PSYRATS. Methods A sample of 103 outpatients suffering from schizophrenia or schizoaffective disorders and presenting persistent psychotic symptoms over the previous three months was assessed using the PSYRATS. Seventy-five sample participants were also assessed with the Positive And Negative Syndrome Scale (PANSS. Results ICCs were superior to .90 for all items of the PSYRATS. Factor analysis replicated the factorial structure of the original version of the delusions scale. Similar to previous replications, the factor structure of the hallucinations scale was partially replicated. Convergent validity indicated that some specific PSYRATS items do not correlate with the PANSS delusions or hallucinations. The distress items of the PSYRATS are negatively correlated with the grandiosity scale of the PANSS. Conclusions The results of this study are limited by the relatively small sample size as well as the selection of participants with persistent symptoms. The French version of the PSYRATS partially replicates previously published results. Differences in factor structure of the hallucinations scale might be explained by greater variability of its elements. The future development of the scale should take into account the presence of grandiosity in order to better capture details of the psychotic experience.

Giant intracranial aneurysms; Magnetic resonance imaging follow-up and clinical symptoms

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Kondoh, Takeshi; Fujita, Katsuzo; Tamaki, Norihiko; Matsumoto, Satoshi [Kobe Univ. (Japan). School of Medicine; Yamashita, Haruo; Shirakata, Masaya

1991-06-01

Twenty-four intracranial aneurysms over 20 mm in diameter were studied with magnetic resonance (MR) imaging. MR imaging follow-up of eight cases revealed induced thrombus with homogeneous intensity and decreased size even after complete intraluminal thrombosis. Most cases demonstrated homogeneous intensity thrombus in contrast to the heterogeneous intensity of spontaneous thrombus. The clinical symptoms could not be explained retrospectively by the thrombus characteristics. Perianeurysmal high intensity, indicating cerebral edema, was detected in one case presenting with a rapid increase in size. MR imaging is useful for following these pathological intra- and perianeurysmal changes. (author).

Early psychosis symptoms

International Nuclear Information System (INIS)

Naqvi, H.A.; Hussain, S.; Islam, M.

2014-01-01

Objective: To determine the prodromal symptoms of schizophrenia in the pathways to help-seeking. Study Design: A cross-sectional study. Place and Duration of Study: The Department of Psychiatry, the Aga Khan University, Karachi, from 2008 to 2009. Methodology: A total of 93 patients were interviewed in the pathways to care of schizophrenia. The diagnosis was based on ICD-10 criteria. The pathways to care were assessed through a semi-structured questionnaire. The onset, course and symptoms of psychosis were assessed through Interview for Retrospective Assessment at Age at Onset of Psychosis (IROAS). Results: Fifty five (59%) participants were male while 41% (n=38%) were female. Using IROAS, 108 symptoms were identified as concerning behaviour. Alternatively, 60 (55%) concerning behaviours were reported in the open-ended inquiry of the reasons for help seeking as assessed by the pathways to care questionnaire with a statistically significant difference between most symptoms category. The difference was most pronounced (p < 0.001) for depressed mood (66%), worries (65%), tension (63%), withdrawal/mistrust (54%) and loss of self-confidence (53%). Thought withdrawal (22%) and passivity (15%) were elicited only through structured interview (IROAS). When symptoms were categorized together, about 83% of the subjects presented with affective and non-specific prodromal symptoms. Roughly, 10% of the subjects presented with positive symptoms and 3% presented with the negative symptoms of psychosis. The non-specific, affective symptoms appear to predominate the prodromal phase of the illness. Conclusion: Prodromal symptoms of schizophrenia include non-specific, affective symptoms. Attention needs to be paid on identifying the prodromal symptoms and change in social functioning in order to identify those who are at risk of long term psychosis. (author)

Randomized clinical trial of symptom control after stapled anopexy or diathermy excision for haemorrhoid prolapse

DEFF Research Database (Denmark)

Nyström, P-O; Qvist, N; Raahave, D

2010-01-01

BACKGROUND: : This multicentre randomized clinical trial studied how symptoms improved after either stapled anopexy or diathermy excision of haemorrhoids. METHODS: : The study involved 18 hospitals in Sweden, Denmark and the UK. Some 207 patients were randomized to either anopexy or Milligan-Morg...

Can personality traits predict increases in manic and depressive symptoms?

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Lozano, B E; Johnson, S L

2001-03-01

There has been limited research investigating personality traits as predictors of manic and depressive symptoms in bipolar individuals. The present study investigated the relation between personality traits and the course of bipolar disorder. The purpose of this study was to identify specific personality traits that predict the course of manic and depressive symptoms experienced by bipolar individuals. The sample consisted of 39 participants with bipolar I disorder assessed by the Structured Clinical Interview for DSM-IV. Personality was assessed using the NEO Five-Factor Inventory. The Modified Hamilton Rating Scale for Depression and the Bech-Rafaelsen Mania Rating Scale were used to assess symptom severity on a monthly basis. Consistent with previous research on unipolar depression, high Neuroticism predicted increases in depressive symptoms across time while controlling for baseline symptoms. Additionally, high Conscientiousness, particularly the Achievement Striving facet, predicted increases in manic symptoms across time. The current study was limited by the small number of participants, the reliance on a shortened version of a self-report personality measure, and the potential state-dependency of the personality measures. Specific personality traits may assist in predicting bipolar symptoms across time. Further studies are needed to tease apart the state-dependency of personality.

Deficits in agency in schizophrenia, and additional deficits in body image, body schema and internal timing, in passivity symptoms.

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Kyran Trent Graham

2014-09-01

Full Text Available Individuals with schizophrenia, particularly those with passivity symptoms, may not feel in control of their actions, believing them to be controlled by external agents. Cognitive operations that contribute to these symptoms may include abnormal processing in agency, as well as body representations that deal with body schema and body image. However, these operations in schizophrenia are not fully understood, and the questions of general versus specific deficits in individuals with different symptom profiles remain unanswered. Using the projected hand illusion (a digital video version of the rubber hand illusion with syn-chronous and asynchronous stroking (500 ms delay, and a hand laterality judgment task, we assessed sense of agency, body image and body schema in 53 people with clinically stable schizophrenia (with a current, past, and no history of passivity symptoms and 48 healthy controls. The results revealed a stable trait in schizophrenia with no difference be-tween clinical subgroups (sense of agency, and some quantitative (specific differences de-pending on the passivity symptom profile (body image and body schema. Specifically, a reduced sense of self-agency was a common feature of all clinical subgroups. However, subgroup comparisons showed that individuals with passivity symptoms (both current and past had significantly greater deficits on tasks assessing body image and body schema, relative to the other groups. In addition, patients with current passivity symptoms failed to demonstrate the normal reduction in body illusion typically seen with a 500 ms delay in visual feedback (asynchronous condition, suggesting internal timing problems. Altogether, the results underscore self-abnormalities in schizophrenia, provide evidence for both trait abnormalities and state changes specific to passivity symptoms, and point to a role for internal timing deficits as a mechanistic explanation for external cues becoming a possible source of self

Specificity of dysfunctional thinking in children with symptoms of social anxiety, separation anxiety and generalised anxiety

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Bogels, S.M.; Snieder, N.; Kindt, M.

2003-01-01

The present study investigated whether children with high symptom levels of either social phobia (SP), separation anxiety disorder (SAD), or generalised anxiety disorder (GAD) are characterised by a specific set of dysfunctional interpretations that are consistent with the cognitive model of their

Development of the measure of ovarian symptoms and treatment concerns: aiming for optimal measurement of patient-reported symptom benefit with chemotherapy for symptomatic ovarian cancer.

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King, Madeleine T; Stockler, Martin R; Butow, Phyllis; O'Connell, Rachel; Voysey, Merryn; Oza, Amit M; Gillies, Kim; Donovan, Heidi S; Mercieca-Bebber, Rebecca; Martyn, Julie; Sjoquist, Katrin; Friedlander, Michael L

2014-06-01

The aim of this study was to determine the optimal patient-reported outcome measure (PROM) for assessing symptom benefit in trials of palliative chemotherapy for women with symptomatic ovarian cancer. Candidate PROMs were EORTC QLQ-C30 plus ovarian-specific QLQ-OV28, Functional Assessment of Cancer Therapy-Ovarian (FACT-O), FACT Ovarian Symptom Index (FOSI), and gynecologic cancer-specific Symptom Representation Questionnaire. Predefined optimality criteria were inclusion of all symptoms necessary for the specified purpose, recall period covering typical length of palliative chemotherapy, numerical item rating scales, and all necessary symptoms included in a single symptom index. Qualitative and quantitative methods were applied to data from stage 1 of the Gynecologic Cancer Intergroup Symptom Benefit Study to determine the set of necessary symptoms and to objectively assess candidate PROMs against the optimality criteria. Ten necessary symptoms were identified: pain, fatigue, abdominal bloating/discomfort, sleep disturbance, bowel disturbance, nausea and vomiting, shortness of breath, poor appetite, urinary symptoms, and weight changes. Although QLQ-C30 and QLQ-OV28 together cover all these symptoms, they split them into numerous scales, dissipating potential symptom-benefit signal. Conversely, FACT-O does not cover all necessary symptoms and contains many other HRQoL-related items and treatment side effects, diluting potential symptom-benefit signal when summed into scales. Item response scales and composite scoring of all candidate PROMs were suboptimal to our specific purpose. We therefore developed a new PROM, the Measure of Ovarian Symptoms and Treatment (MOST) concerns, to provide optimal measurement for the specified purpose. This article documents the development of the MOST, a new PROM designed to assess patient-reported benefits and burden as end points in clinical trials of palliative chemotherapy for women with symptomatic ovarian cancer. The validity

Clinical symptoms of psychotic episodes and 25-hydroxy vitamin D serum levels in black first-generation immigrants.

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Dealberto, M-J

2013-12-01

Dark-skinned immigrants have a higher risk for schizophrenia and other psychoses than other immigrants. The first British studies reported that first-generation immigrants (FGIs) from the Caribbean presented atypical psychoses. This study examines the characteristics of psychotic episodes in black FGIs to Canada. The charts of 18 FGIs from Africa and Haiti, extracted from a series of 20 black patients consecutively admitted to Psychiatry, were retrospectively reviewed regarding clinical features, diagnoses and vitamin D levels. Young FGIs presented acute psychotic episodes with abrupt onset, florid positive symptoms, few negative symptoms and good evolution. The onset was more insidious in older FGIs. Overall, catatonia was very frequent (28%), and mood symptoms still more frequent (44%). No cognitive decline was observed during follow-up. Serum levels of 25-hydroxy vitamin D were in the insufficiency range. Supplementation at 1000 IU/day did not restore normal levels. The clinical features of psychotic episodes in black FGIs are similar to those reported in dark-skinned FGIs to other countries. They are also observed in other immigrants and in non-immigrants. These atypical psychoses are possibly related to a recent vitamin D deficit. This hypothesis should be tested by clinical trials of sufficient vitamin D supplementation. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Influence of specific obsessive-compulsive symptom dimensions on strategic planning in patients with obsessive-compulsive disorder.

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Pinto, Paula Sanders Pereira; Iego, Sandro; Nunes, Samantha; Menezes, Hemanny; Mastrorosa, Rosana Sávio; Oliveira, Irismar Reis de; Rosário, Maria Conceição do

2011-03-01

This study investigates obsessive-compulsive disorder patients in terms of strategic planning and its association with specific obsessive-compulsive symptom dimensions. We evaluated 32 obsessive-compulsive disorder patients. Strategic planning was assessed by the Rey-Osterrieth Complex Figure Test, and the obsessive-compulsive dimensions were assessed by the Dimensional Yale-Brown Obsessive-Compulsive Scale. In the statistical analyses, the level of significance was set at 5%. We employed linear regression, including age, intelligence quotient, number of comorbidities, the Yale-Brown Obsessive-Compulsive Scale score, and the Dimensional Yale-Brown Obsessive-Compulsive Scale. The Dimensional Yale-Brown Obsessive-Compulsive Scale "worst-ever" score correlated significantly with the planning score on the copy portion of the Rey-Osterrieth Complex Figure Test (r = 0.4, p = 0.04) and was the only variable to show a significant association after linear regression (β = 0.55, t = 2.1, p = 0.04). Compulsive hoarding correlated positively with strategic planning (r = 0.44, p = 0.03). None of the remaining symptom dimensions presented any significant correlations with strategic planning. We found the severity of obsessive-compulsive symptoms to be associated with strategic planning. In addition, there was a significant positive association between the planning score on the copy portion of the Rey-Osterrieth Complex Figure Test copy score and the hoarding dimension score on the Dimensional Yale-Brown Obsessive-Compulsive Scale. Our results underscore the idea that obsessive-compulsive disorder is a heterogeneous disorder and suggest that the hoarding dimension has a specific neuropsychological profile. Therefore, it is important to assess the peculiarities of each obsessive-compulsive symptom dimension.

A Longitudinal Evaluation of the Effects of Orthodontic Treatment on Clinical Signs and Symptoms of Temporomandibular Disorders.

Science.gov (United States)

1992-05-01

factors in the development of TMD have increased in number (Reynders, 1990). The consequence of these " case studies" and " clinical viewpoints" was a well...0.3, were found between morphological malocclusions and the presence of frequent headaches, bruxism , symptoms or clinical signs of TMD (Egermark...differ significantly enough to allow distinguishing clinical cases from controls, they found lateral excursions, anterior and posterior occlusion, extent

To what extent does the anxiety scale of the Four-Dimensional Symptom Questionnaire (4DSQ) detect specific types of anxiety disorder in primary care?

NARCIS (Netherlands)

Terluin, B.; Oosterbaan, D.B.; Brouwers, E.P.; van Straten, A.; van de Ven, P.M.; Langerak, W.; van Marwijk, H.W.

2014-01-01

Background: Anxiety scales may help primary care physicians to detect specific anxiety disorders among the many emotionally distressed patients presenting in primary care. The anxiety scale of the Four-Dimensional Symptom Questionnaire (4DSQ) consists of an admixture of symptoms of specific anxiety

Diabetes insipidus as the first symptom caused by lung cancer metastasis to the pituitary glands: Clinical presentations, diagnosis, and management

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J F Mao

2011-01-01

Full Text Available Background : Central diabetes insipidus (CDI, secondary to pituitary metastatic lesions, is uncommon; however, lung and breast cancer are the commonest malignancies to have metastases to the pituitary. Early management of systemic chemotherapy and pituitary irradiation might improve the prognosis of patients. Aims : To investigate the clinical features, diagnosis, and management of CDI caused by lung cancer metastasis to the pituitary glands. Materials and Methods : We retrospectively reviewed 10 patients who had CDI as their first symptom before their lung cancers were diagnosed. Their clinical presentations, anterior pituitary gland function, sellar magnetic resonance imaging (MRI, management, and prognosis were described. Settings and Design : This retrospective cross-sectional clinical study was conducted in a medical college hospital. Results : The patient′s mean age was 58.6±7.8 years. Diabetes insipidus was the main complaint when they were referred to our hospital. MRI revealed specific dumbbell-shaped masses in the sella turcica in five patients. In seven patients whose hormones were measured, the levels of hormones from adenohypophysis were abnormally low in six patients. The main treatments included surgery, systemic chemotherapy, and sellar irradiation. Although nine patients had poor prognoses, one patient has survived for more than 3 years, suggesting benefit from early diagnosis and treatment. Conclusions : New-onset CDI might be the only symptom presented by the patients with pituitary metastasis (PM from lung cancer. Dumbbell-shaped sellar masses in MRI are prone to the diagnosis of PM. A thorough examination for primary cancer should be carried out in these aged and elderly patients.

Characteristics and determinants of clinical symptoms in radiographic lumbar spinal stenosis in a tertiary health care centre in sub-Saharan Africa.

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Doualla-Bija, Marie; Takang, Mbeng Ashu; Mankaa, Emmanuella; Moutchia, Jude; Ongolo-Zogo, Pierre; Luma-Namme, Henry

2017-11-28

Lumbar spinal stenosis (LSS) refers to narrowing of the lumbar central spinal canal, lateral recess, and/or neuro-foramina. Radiographic LSS plays an important role in clinical LSS but is not solely accountable for the presence of symptoms. We sought to characterise clinical LSS and to determine factors associated with presence of symptoms of LSS in patients with radiographic LSS in a sub Saharan Africa setting. After prior ethical clearance, a case control study was done in a tertiary hospital in Douala-Cameroon, including 105 patients with radiographic LSS: 57 with symptoms of LSS (cases) and 58 with no symptoms (controls). Spinal stenosis was assessed using computed tomography (CT) scans. Data were analysed using SPSS version 23. The mean age of our study participants was 53.4 ± 13.1 years. The mean age of onset of symptoms of LSS was 50.3 ± 11.6 years and the most common symptoms were Low back pain (100.0%), radicular symptoms (98.2%) and neurogenic claudication (98.2%). Obesity (p history of low back pain (p = 0.004), vertebra lesion at L2 (p = 0.034), L3 (p = 0.002), L4 (p = 0.025) and multiple (p = 0.008) levels, degenerative disc protrusion (p = 0.044), disc lesion at L3-L4 (p = 0.001), L4-L5 (p = 0.011) and multiple (p = 0.046) levels were significantly associated with presence of symptoms of LSS in persons with radiographic LSS. Characteristics of clinical LSS have been described in this sub-Saharan Africa population. Obesity, a high waist circumference and a positive family history of low back pain are significantly associated with presence of symptoms of LSS in persons with radiographic LSS.

Investigating the Prevalence, Determining the Effects of Immunologic Sensitization and Clinical Symptoms Related to Allergens Existing in Khuzestan Province

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hadi zaremarzouni

2016-04-01

Conclusion: According to this study, the amount of allergens and the rate of clinical symptoms is very high among the inhabitants of this area, therefore, it is recommended to conduct more studies in order to decrease the allergic symptoms and to identify the antigenic function of allergens in different climates.

Multicenter, open-label, exploratory clinical trial with Rhodiola rosea extract in patients suffering from burnout symptoms

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Kasper S

2017-03-01

Full Text Available Siegfried Kasper,1 Angelika Dienel2 1Universitätsklinik für Psychiatrie und Psychotherapie, Medizinische Universität Wien, Wien, Austria; 2Dr Willmar Schwabe GmbH & Co. KG, Karlsruhe, Germany Purpose: This study is the first clinical trial aiming to explore the clinical outcomes in burnout patients treated with Rhodiola rosea. The reported capacity of R. rosea to strengthen the organism against stress and its good tolerability offer a promising approach in the treatment of stress-related burnout. The aim of the treatment was to increase stress resistance, thus addressing the source rather than the symptoms of the syndrome and preventing subsequent diseases associated with a history of burnout. The objective of the trial was to provide the exploratory data required for planning future randomized trials in burnout patients in order to investigate the clinical outcomes of treatment with R. rosea dry extract in this target group.Methods: The study was planned as an exploratory, open-label, multicenter, single-arm trial. A wide range of rating scales were assessed and evaluated in an exploratory data analysis to generate hypotheses regarding clinical courses and to provide a basis for the planning of subsequent studies. A total of 118 outpatients were enrolled. A daily dose of 400 mg R. rosea extract (WS® 1375, Rosalin was administered over 12 weeks. Clinical outcomes were assessed by the German version of the Maslach Burnout Inventory, Burnout Screening Scales I and II, Sheehan Disability Scale, Perceived Stress Questionnaire, Number Connection Test, Multidimensional Mood State Questionnaire, Numerical Analogue Scales for different stress symptoms and impairment of sexual life, Patient Sexual Function Questionnaire, and the Clinical Global Impression Scales. Results: The majority of the outcome measures showed clear improvement over time. Several parameters had already improved after 1 week of treatment and continued to improve further up to

Considerations for Clinical Neuropsychological Evaluation in Amyotrophic Lateral Sclerosis.

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Woolley, Susan C; Rush, Beth K

2017-11-01

The clinical neuropsychologist has the opportunity to be uniquely involved in the evaluation and treatment of individuals with amyotrophic lateral sclerosis (ALS). We review the current literature that defines cognitive and behavioral symptoms in ALS, including current knowledge of the neuropathological and genetic underpinning for these symptoms. There are unique considerations for clinical neuropsychological evaluation and clinical research in ALS and we highlight these in this review. Specifically, we shed light on special factors that contribute to our understanding of cognitive and behavioral impairment in ALS, including co-morbid symptoms, differential diagnosis, and considerations for longitudinal tracking of phenotypes. We discuss the rationale for proposing a specific approach to such as cognitive screening, test selection, response modality consideration, and test-retest intervals. With this didactic overview, the clinical neuropsychologist has the potential to learn more about the heterogeneous presentation of motor and neuropsychological symptoms in ALS. Furthermore, the reader has the opportunity to understand what it takes to develop a valid assessment approach particularly when the phenotype of ALS remains undefined in some regards. This clinical practice review sets the stage for the clinical neuropsychologist to further contribute to our clinical and scientific understanding of ALS and cognition. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

School-associated problem behavior in childhood and adolescence and development of adult schizotypal symptoms: a follow-up of a clinical cohort.

Science.gov (United States)

Fagel, Selene; de Sonneville, Leo; van Engeland, Herman; Swaab, Hanna

2014-01-01

How school-associated behavioral problems in childhood and adolescence precede distinctive adult schizotypal symptoms was examined. Gender specific findings were explored. After 11.6 (SD = 3.1) years, 159 patients of the Department of Child and Adolescent Psychiatry of the University Medical Centre Utrecht, the Netherlands were reassessed for adult schizotypal symptoms. Severity of behavioral symptoms in childhood and adolescence using Teacher Report Form (TRF; Verhulst et al. 1997) and adult schizotypal symptoms using Schizotypal Personality Questionnaire-Revised (Raine in Schizophrenia Bulletin 17:555-564, 1991) were examined by Spearman's bivariate correlations. Multiple regression analyses were performed to determine the combined predictive value of significant TRF subscales for schizotypal symptomatology. Moderation was tested by adding the interactions of gender with TRF subscales to the models. Disregarding gender, correlational analyses revealed that TRF Total problems, in specific thought problems, social problems, and attentional problems were associated with disorganized schizotypal symptoms in adult life. TRF thought problems was also associated with future positive schizotypal symptoms. When gender was taken into account, for boys only thought problems was associated with adult positive schizotypal symptoms, whereas for girls externalizing problems, specifically attentional and aggressive problems, were associated with the higher levels of adult disorganized schizotypal symptoms. Moderated regression analyses provided trend significant evidence confirming that in girls externalizing problems were positively associated with general and disorganized schizotypal symptoms. When using teachers as informants, it was found that juvenile behavioral abnormalities were differentially associated with type of adult schizotypal symptoms, with these associations being further modified by gender.

[Negative symptoms in schizophrenia: psychotherapeutic approaches].

Science.gov (United States)

Azorin, J-M; Adida, M; Belzeaux, R; Pringuey, D; Micoulaud Franchi, J-A; Simon, N; Cermolacce, M; Kaladjian, A; Fakra, E

2015-12-01

Although negative symptoms are recognized as a central feature of schizophrenia, their definition as well as phenomenology have long been a vexing issue. During these last years, a major progress has been made with the delineation of two underlying subdomains of negative symptoms: diminished expression and anhedonia-avolition-apathy. As current guidelines are not always in accord on the efficacy of treatments on negative symptoms, it may be tempting to re-interpret the findings of clinical trials by looking at the effects of treatments on these two subdomains. This could concern both psychotropic treatments and psychotherapeutic interventions. Furthermore, neuroimaging as well as emotional response studies have permitted to better understand the mechanism which could be at the root of diminished expression and anhedonia in schizophrenia. On this basis, new psychotherapeutic methods have been devised which, by specifically targeting these two subdomains, are likely to be more efficient on negative symptoms. Further research is warranted to test their efficacy in randomized controlled trials. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Sensitivity and Specificity of Clinical and Laboratory Otolith Function Tests.

Science.gov (United States)

Kumar, Lokesh; Thakar, Alok; Thakur, Bhaskar; Sikka, Kapil

2017-10-01

To evaluate clinic based and laboratory tests of otolith function for their sensitivity and specificity in demarcating unilateral compensated complete vestibular deficit from normal. Prospective cross-sectional study. Tertiary care hospital vestibular physiology laboratory. Control group-30 healthy adults, 20-45 years age; Case group-15 subjects post vestibular shwannoma excision or post-labyrinthectomy with compensated unilateral complete audio-vestibular loss. Otolith function evaluation by precise clinical testing (head tilt test-HTT; subjective visual vertical-SVV) and laboratory testing (headroll-eye counterroll-HR-ECR; vesibular evoked myogenic potentials-cVEMP). Sensitivity and specificity of clinical and laboratory tests in differentiating case and control subjects. Measurable test results were universally obtained with clinical otolith tests (SVV; HTT) but not with laboratory tests. The HR-ECR test did not indicate any definitive wave forms in 10% controls and 26% cases. cVEMP responses were absent in 10% controls.HTT test with normative cutoff at 2 degrees deviations from vertical noted as 93.33% sensitive and 100% specific. SVV test with normative cutoff at 1.3 degrees noted as 100% sensitive and 100% specific. Laboratory tests demonstrated poorer specificities owing primarily to significant unresponsiveness in normal controls. Clinical otolith function tests, if conducted with precision, demonstrate greater ability than laboratory testing in discriminating normal controls from cases with unilateral complete compensated vestibular dysfunction.

Web intervention for OEF/OIF veterans with problem drinking and PTSD symptoms: a randomized clinical trial.

Science.gov (United States)

Brief, Deborah J; Rubin, Amy; Keane, Terence M; Enggasser, Justin L; Roy, Monica; Helmuth, Eric; Hermos, John; Lachowicz, Mark; Rybin, Denis; Rosenbloom, David

2013-10-01

Veterans who served in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) commonly experience alcohol misuse and symptoms of posttraumatic stress disorder (PTSD) following their return from deployment to a war zone. We conducted a randomized clinical trial to evaluate the efficacy of a newly developed, 8-module, self-management web intervention (VetChange) based on motivational and cognitive-behavioral principles to reduce alcohol consumption, alcohol-related problems, and PTSD symptoms in returning combat veterans. Six hundred participants, recruited through targeted Facebook ads, were randomized to either an Initial Intervention Group (IIG; n = 404) or a Delayed Intervention Group (DIG; n = 196) that waited 8 weeks for access to VetChange. Primary outcome measures were Drinks per Drinking Day, Average Weekly Drinks, Percent Heavy Drinking Days, and PTSD symptoms. Intent-to-treat analyses compared changes in outcome measures over time between IIG and DIG as well as within-group changes. IIG participants demonstrated greater reductions in drinking (p < .001 for each measure) and PTSD symptoms (p = .009) between baseline and end-of-intervention than did DIG participants between baseline and the end of the waiting period. DIG participants showed similar improvements to those in IIG following participation in VetChange. Alcohol problems were also reduced within each group between baseline and 3-month follow-up. Results indicate that VetChange is effective in reducing drinking and PTSD symptoms in OIF/OEF veterans. Further studies of VetChange are needed to assess web-based recruitment and retention methods and to determine VetChange's effectiveness in demographic and clinical sub-populations of returning veterans. (c) 2013 APA, all rights reserved.

Negative symptoms of schizophrenia: A historical, contemporary, and futuristic view

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Shae-Leigh Cynthia Vella

2015-01-01

Full Text Available This paper explores the evolution of the conceptualization of schizophrenia. Specifically, the paper focuses upon negative symptomology and the emphasis that such symptoms have garnered over time. Negative symptoms are associated with higher levels of impairment and poorer outcomes in schizophrenia. Historically, negative symptoms were the core feature of schizophrenia in the early conceptualizations of Kraepelin and Bleuler, holding precedence until the emergence of Schneiderian theory in the 1970′s. The focus on negative symptoms then changed to positive symptoms; which is still the key focus today. This shift in emphasis has resulted in a dearth of knowledge and treatment for such symptoms and as such an area requiring further research. The paper also addresses the conceptual changes in the nosology of Schizophrenia and other psychosis with respect to the Diagnostic and Statistical Manual of Mental Disorders-5. Further the potential for the clinical assessment interview for negative symptoms to facilitate understanding and treatments for negative symptomology in schizophrenia is also discussed.

Completion of Multidisciplinary Treatment for Persistent Postconcussive Symptoms Is Associated With Reduced Symptom Burden.

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Janak, Jud C; Cooper, Douglas B; Bowles, Amy O; Alamgir, Abul H; Cooper, Sharon P; Gabriel, Kelley P; Pérez, Adriana; Orman, Jean A

To investigate the pre- to posttreatment changes in both posttraumatic stress disorder (PTSD) and persistent postconcussive symptoms (PPCSs). We studied 257 active-duty patients with a history of mild traumatic brain injury (mTBI) who completed multidisciplinary outpatient treatment at Brooke Army Medical Center TBI Clinic from 2008 to 2013. This treatment program included cognitive rehabilitation; vestibular interventions; headache management; and integrated behavioral healthcare to address co-occurring psychiatric conditions such as PTSD, depression, and sleep disturbance. A 1-group; preexperimental, pre- to posttreatment study. The Neurobehavioral Symptom Inventory (NSI) was used to assess PPCSs, and the PTSD Checklist-Military Version (PCL-M) was used to asses PTSD symptoms. Global PPCS resolution (mean NSI: 35.0 pre vs 23.8 post; P < .0001; d = 0.72) and PTSD symptom resolution (mean PCL-M: 43.2 pre vs 37.7 post; P < .0001; d = 0.34) were statistically significant. Compared with those with only mTBI, patients with mTBI and PTSD reported greater global PPCS impairment both pretreatment (mean NSI: 48.7 vs 27.9; P < .0001) and posttreatment (mean NSI: 36.2 vs 17.4; P < .0001). After adjusting for pretreatment NSI scores, patients with comorbid PTSD reported poorer PPCS resolution than those with mTBI alone (mean NSI: 27.9 pre vs 21.7 post; P = .0009). We found a reduction in both self-reported PPCSs and PTSD symptoms; however, future studies are needed to identify specific components of care associated with symptom reduction.

Management of somatic symptoms

DEFF Research Database (Denmark)

Schröder, Andreas; Dimsdale, Joel

2014-01-01

on the recognition and effective management of patients with excessive and disabling somatic symptoms. The clinical presentation of somatic symptoms is categorized into three groups of patients: those with multiple somatic symptoms, those with health anxiety, and those with conversion disorder. The chapter provides...

Using Smartphones to Monitor Bipolar Disorder Symptoms: A Pilot Study.

Science.gov (United States)

Beiwinkel, Till; Kindermann, Sally; Maier, Andreas; Kerl, Christopher; Moock, Jörn; Barbian, Guido; Rössler, Wulf

2016-01-06

Relapse prevention in bipolar disorder can be improved by monitoring symptoms in patients' daily life. Smartphone apps are easy-to-use, low-cost tools that can be used to assess this information. To date, few studies have examined the usefulness of smartphone data for monitoring symptoms in bipolar disorder. We present results from a pilot test of a smartphone-based monitoring system, Social Information Monitoring for Patients with Bipolar Affective Disorder (SIMBA), that tracked daily mood, physical activity, and social communication in 13 patients. The objective of this study was to investigate whether smartphone measurements predicted clinical symptoms levels and clinical symptom change. The hypotheses that smartphone measurements are (1) negatively related to clinical depressive symptoms and (2) positively related to clinical manic symptoms were tested. Clinical rating scales were administered to assess clinical depressive and manic symptoms. Patients used a smartphone with the monitoring app for up to 12 months. Random-coefficient multilevel models were computed to analyze the relationship between smartphone data and externally rated manic and depressive symptoms. Overall clinical symptom levels and clinical symptom changes were predicted by separating between-patient and within-patient effects. Using established clinical thresholds from the literature, marginal effect plots displayed clinical relevance of smartphone data. Overall symptom levels and change in clinical symptoms were related to smartphone measures. Higher overall levels of clinical depressive symptoms were predicted by lower self-reported mood measured by the smartphone (beta=-.56, Psmartphone (ie, cell tower movements: beta=-.11, P=.03). Higher overall levels of clinical manic symptoms were predicted by lower physical activity on the smartphone (ie, distance travelled: beta=-.37, Psmartphone (beta=-.17, Psmartphone measurements, but not all smartphone measures predicted the occurrence of

Is the development of Modic changes associated with clinical symptoms?

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Jensen, Rikke Krüger; Leboeuf-Yde, Charlotte; Wedderkopp, Niels

2012-01-01

/or the pathological type of MCs were associated with changes in clinical symptoms in a cohort of patients with persistent LBP and MCs. METHODS: Information on LBP intensity and detailed information from MRI on the presence, type and size of MCs was collected at baseline and follow-up. Changes in type (Type I, II, III...... developmental path from Type I (here Type I or I/II) to Type II (here Type II or II/III) or Type I to Type I/II. In general, the bigger the size of the MC at baseline, the more likely it was that it remained unchanged in size after 14 months. Patients who had MC Type I at both baseline and 14-month follow......PURPOSE: Modic changes (MCs) have been suggested to be a diagnostic subgroup of low back pain (LBP). However, the clinical implications of MCs remain unclear. For this reason, the aims of this study were to investigate how MCs developed over a 14-month period and if changes in the size and...

Theory of mind in schizophrenia: error types and associations with symptoms.

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Fretland, Ragnhild A; Andersson, Stein; Sundet, Kjetil; Andreassen, Ole A; Melle, Ingrid; Vaskinn, Anja

2015-03-01

Social cognition is an important determinant of functioning in schizophrenia. However, how social cognition relates to the clinical symptoms of schizophrenia is still unclear. The aim of this study was to explore the relationship between a social cognition domain, Theory of Mind (ToM), and the clinical symptoms of schizophrenia. Specifically, we investigated the associations between three ToM error types; 1) "overmentalizing" 2) "reduced ToM and 3) "no ToM", and positive, negative and disorganized symptoms. Fifty-two participants with a diagnosis of schizophrenia or schizoaffective disorder were assessed with the Movie for the Assessment of Social Cognition (MASC), a video-based ToM measure. An empirically validated five-factor model of the Positive and Negative Syndrome Scale (PANSS) was used to assess clinical symptoms. There was a significant, small-moderate association between overmentalizing and positive symptoms (rho=.28, p=.04). Disorganized symptoms correlated at a trend level with "reduced ToM" (rho=.27, p=.05). There were no other significant correlations between ToM impairments and symptom levels. Positive/disorganized symptoms did not contribute significantly in explaining total ToM performance, whereas IQ did (B=.37, p=.01). Within the undermentalizing domain, participants performed more "reduced ToM" errors than "no ToM" errors. Overmentalizing was associated with positive symptoms. The undermentalizing error types were unrelated to symptoms, but "reduced ToM" was somewhat associated to disorganization. The higher number of "reduced ToM" responses suggests that schizophrenia is characterized by accuracy problems rather than a fundamental lack of mental state concept. The findings call for the use of more sensitive measures when investigating ToM in schizophrenia to avoid the "right/wrong ToM"-dichotomy. Copyright © 2015 Elsevier B.V. All rights reserved.

Antidepressant Controlled Trial For Negative Symptoms In Schizophrenia (ACTIONS): a double-blind, placebo-controlled, randomised clinical trial.

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Barnes, Thomas R E; Leeson, Verity C; Paton, Carol; Costelloe, Céire; Simon, Judit; Kiss, Noemi; Osborn, David; Killaspy, Helen; Craig, Tom K J; Lewis, Shôn; Keown, Patrick; Ismail, Shajahan; Crawford, Mike; Baldwin, David; Lewis, Glyn; Geddes, John; Kumar, Manoj; Pathak, Rudresh; Taylor, Simon

2016-04-01

Negative symptoms of schizophrenia represent deficiencies in emotional responsiveness, motivation, socialisation, speech and movement. When persistent, they are held to account for much of the poor functional outcomes associated with schizophrenia. There are currently no approved pharmacological treatments. While the available evidence suggests that a combination of antipsychotic and antidepressant medication may be effective in treating negative symptoms, it is too limited to allow any firm conclusions. To establish the clinical effectiveness and cost-effectiveness of augmentation of antipsychotic medication with the antidepressant citalopram for the management of negative symptoms in schizophrenia. A multicentre, double-blind, individually randomised, placebo-controlled trial with 12-month follow-up. Adult psychiatric services, treating people with schizophrenia. Inpatients or outpatients with schizophrenia, on continuing, stable antipsychotic medication, with persistent negative symptoms at a criterion level of severity. Eligible participants were randomised 1 : 1 to treatment with either placebo (one capsule) or 20 mg of citalopram per day for 48 weeks, with the clinical option at 4 weeks to increase the daily dosage to 40 mg of citalopram or two placebo capsules for the remainder of the study. The primary outcomes were quality of life measured at 12 and 48 weeks assessed using the Heinrich's Quality of Life Scale, and negative symptoms at 12 weeks measured on the negative symptom subscale of the Positive and Negative Syndrome Scale. No therapeutic benefit in terms of improvement in quality of life or negative symptoms was detected for citalopram over 12 weeks or at 48 weeks, but secondary analysis suggested modest improvement in the negative symptom domain, avolition/amotivation, at 12 weeks (mean difference -1.3, 95% confidence interval -2.5 to -0.09). There were no statistically significant differences between the two treatment arms over 48-week

Diagnostic yield of MRI for audiovestibular dysfunction using contemporary referral criteria: correlation with presenting symptoms and impact on clinical management

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Vandervelde, C. [Department of Radiology, Guy' s and St Thomas' NHS Foundation Trust (United Kingdom)], E-mail: clivevandervelde@gmail.com; Connor, S E.J. [Department of Radiology, Guy' s and St Thomas' NHS Foundation Trust (United Kingdom); Department of Neuroradiology, King' s College Hospital NHS Foundation Trust, London (United Kingdom)

2009-02-15

Aim: To investigate the diagnostic yield of T2-weighted magnetic resonance imaging (MRI) screening for vestibular schwannoma and other relevant conditions in the setting of audiovestibular symptoms, given the more liberal contemporary referral criteria. To determine whether presenting clinical symptoms correlate with imaging outcome in order to guide future protocols for MRI referral. Materials and methods: Eight hundred and eighty-one consecutive MRI examinations performed in patients with audiovestibular dysfunction were reviewed. Clinical indications and findings were recorded. Case notes were reviewed in patients with positive imaging findings. Two-way, cross-tabulation, Chi-square analysis was performed to assess the relationship between presenting symptoms and imaging outcome. Results: Twelve of the 881 (1.4%) were positive for vestibular schwannoma. A further four of 881 (0.4%) revealed other relevant conditions. Incidental conditions, felt to be irrelevant to the presenting symptoms, were noted in 12 of the 881 (1.4%). In all 12 cases that were positive for vestibular schwannoma, either tinnitus or hearing loss was present. Conclusion: The yield for T2-weighted MRI to diagnose vestibular schwannoma and other relevant retrocochlear conditions was lower than for previous studies, which is likely to reflect trends in referral criteria. No single audiovestibular symptom or combination of symptoms is a statistically significant predictor of imaging outcome.

Diagnostic yield of MRI for audiovestibular dysfunction using contemporary referral criteria: correlation with presenting symptoms and impact on clinical management

International Nuclear Information System (INIS)

Vandervelde, C.; Connor, S.E.J.

2009-01-01

Aim: To investigate the diagnostic yield of T2-weighted magnetic resonance imaging (MRI) screening for vestibular schwannoma and other relevant conditions in the setting of audiovestibular symptoms, given the more liberal contemporary referral criteria. To determine whether presenting clinical symptoms correlate with imaging outcome in order to guide future protocols for MRI referral. Materials and methods: Eight hundred and eighty-one consecutive MRI examinations performed in patients with audiovestibular dysfunction were reviewed. Clinical indications and findings were recorded. Case notes were reviewed in patients with positive imaging findings. Two-way, cross-tabulation, Chi-square analysis was performed to assess the relationship between presenting symptoms and imaging outcome. Results: Twelve of the 881 (1.4%) were positive for vestibular schwannoma. A further four of 881 (0.4%) revealed other relevant conditions. Incidental conditions, felt to be irrelevant to the presenting symptoms, were noted in 12 of the 881 (1.4%). In all 12 cases that were positive for vestibular schwannoma, either tinnitus or hearing loss was present. Conclusion: The yield for T2-weighted MRI to diagnose vestibular schwannoma and other relevant retrocochlear conditions was lower than for previous studies, which is likely to reflect trends in referral criteria. No single audiovestibular symptom or combination of symptoms is a statistically significant predictor of imaging outcome

Somatoform symptoms and treatment nonadherence in depressed family medicine outpatients.

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Keeley, R; Smith, M; Miller, J

2000-01-01

To examine whether somatoform symptoms, specifically symptoms of conversion, somatization, and hypochondriasis, are associated with side-effect reporting and treatment nonadherence in depressed family medicine outpatients, and to measure whether symptoms improve with pharmacotherapy. Inception cohort study with 14-week follow-up. Inner-city family medicine residency clinic. Thirty-nine consecutive adults with major depressive disorder were asked to participate, and 30 consented. Antidepressants for 14 weeks. The Personality Assessment Inventory (PAI) was administered before treatment. The PAI is a self-reported inventory compatible with the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, designed to measure a broad range of personality characteristics. After 14 weeks, the side-effect incidence and treatment nonadherence rates were determined, and 12 patients were readministered the PAI. Depressed family medicine patients demonstrated trends toward elevated Somatic Complaints scale and conversion subscale scores and a lower Suicidal Ideation scale score relative to those of a standardized depressed psychiatric patient profile. Conversion and hypochondriacal symptoms were associated with side-effect reporting and treatment nonadherence. Somatization and hypochondriacal symptoms improved clinically and statistically during treatment for depression. Somatoform distress is a complex, common, and understudied phenomenon in primary care that can adversely affect the treatment of depression. Somatoform symptoms of conversion and hypochondriasis, but not somatization, were found to be risk factors for treatment nonadherence. Somatization and hypochondriacal symptoms may represent personality states that improve with pharmacotherapy, and conversion symptoms may be a personality trait resistant to medical treatment for depression.

Coenzyme Q10 Supplementation Decreases Statin-Related Mild-to-Moderate Muscle Symptoms: A Randomized Clinical Study

OpenAIRE

Skarlovnik, Ajda; Janić, Miodrag; Lunder, Mojca; Turk, Martina; Šabovič, Mišo

2014-01-01

Background Statin use is frequently associated with muscle-related symptoms. Coenzyme Q10 supplementation has yielded conflicting results in decreasing statin myopathy. Herein, we tested whether coenzyme Q10 supplementation could decrease statin-associated muscular pain in a specific group of patients with mild-to-moderate muscle symptoms. Material/Methods Fifty patients treated with statins and reporting muscle pain were recruited. The Q10 group (n=25) received coenzyme Q10 supplementation o...

Endotyping early childhood asthma by quantitative symptom assessment

DEFF Research Database (Denmark)

Bisgaard, Hans; Pipper, Christian Bressen; Bønnelykke, Klaus

2011-01-01

Asthmatic symptoms in young children reflect a heterogeneous group of diseases. Symptoms remain the primary end-point in both research and clinical management, but there is a need for standardized symptom assessment.......Asthmatic symptoms in young children reflect a heterogeneous group of diseases. Symptoms remain the primary end-point in both research and clinical management, but there is a need for standardized symptom assessment....

Developmental Change and Time-Specific Variation in Global and Specific Aspects of Self-Concept in Adolescence and Association with Depressive Symptoms

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Kuzucu, Yasar; Bontempo, Daniel E.; Hofer, Scott M.; Stallings, Michael C.; Piccinin, Andrea M.

2014-01-01

Previous research has demonstrated that adolescents make differential self-evaluations in multiple domains that include physical appearance, academic competence, and peer acceptance. We report growth curve analyses over a seven year period from age 9 to age 16 on the six domains of the Harter Self-Perception Profile for Children. In general, we find little change in self-concept, on average, but do find substantial individual differences in level, rate of change, and time-specific variation in these self- evaluations. The results suggest that sex differences and adoptive status were related to only certain aspects of the participants’ self-concept. Depressive symptoms were found to have significant effects on individual differences in rate of change and on time-specific variation in general self-concept, as well as on some of the specific domains of self-concept. PMID:25143664

CLINICAL PRESENTATION OF LENS INDUCED GLAUCOMA: STUDY OF EPIDEMIOLOGY, DURATION OF SYMPTOMS, INTRAOCULAR PRESSURE AND VISUAL ACUITY

Directory of Open Access Journals (Sweden)

Venkataratnam

2015-10-01

Full Text Available BACKGROUND: Lens Induced Glaucoma is a common cause of ocular morbidity. OBJECTIVES: Our study was to know the Epidemiological factors, Duration of Symptoms, Visual Acuity and Intraocular Pressure in the clinical Presentation of Lens Induced Glaucoma. MATERIALS AND METHODS : This w as a tertiary hospital based prospective study in the department of Glaucoma, Sarojini Devi Eye Hospital and Regional Institute of Ophthalmology (RIO, Osmania Medical College, Hyderabad over a period from March 2015 to August 2015. 50 Patients clinically diagnosed as Lens Induced Glaucoma (LIG were studied with the data of Age, Sex, literacy, Laterality and Rural / Urban status with the duration of symptoms, Intraocular pressure and Visual Acuity. The data was analyzed by simple statistical methods. RESULT S: 50 patients, clinically diagnosed as Lens Induced Glaucoma (LIG were studied. Age group distribution was 1(2.0% in 40 - 50yrs, 13 ( 26.0% in >50 - 60yrs, 26(52.0% in >60 - 70yrs and 10(20.0% in > 70 yrs. Sex distribution was 23(46.0% of Males and 27(54.0% of Females. Urban / Rural status was 15(30.0% of Urban and 35(70.0% of Rural. Literacy status was 7(14.0% of Literate and 43(86.0% of Illiterate. Laterality was RE in 24(48.0% and LE in 26(52.0%. Duration of the presenting symptoms before re porting to the Hospital was 12.0% in 2wks. Intraocular pressure (IOP in mm of Hg showed no case (0.0% in 20 – 40, 27(54.0% in >40 - 60 and 5(10.0% >60 wit h the Mean IOP of 42.12 mm of Hg. Visual Acuity (VA was PL +ve in 24(48.0 and HM - 3/60. CONCLUSIONS: Increasing age, female gender, rural, illiterate, and delayed reporting to the hospital after the pre senting symptoms were the common risk factors with increased Intraocular pressure and poor visual acuity in the clinical presentation of Lens induced Glaucoma.

OARSI Clinical Trials Recommendations

DEFF Research Database (Denmark)

McAlindon, T. E.; Driban, J. B.; Henrotin, Y.

2015-01-01

The goal of this document is to update the original OARSI recommendations specifically for the design, conduct, and reporting of clinical trials that target symptom or structure modification among individuals with knee osteoarthritis (OA). To develop recommendations for the design, conduct...

Dosha phenotype specific Ayurveda intervention ameliorates asthma symptoms through cytokine modulations: Results of whole system clinical trial.

Science.gov (United States)

Joshi, Kalpana S; Nesari, Tanuja M; Dedge, Amrish P; Dhumal, Vikram R; Shengule, Sushant A; Gadgil, Maithili S; Salvi, Sundeep; Valiathan, Marthanda Varma Sankaran

2017-02-02

Over the past few decades, there have been significant scientific advances leading to improved understanding of asthma as a disease and treatment providing immediate relief. However, prevention of recurrent attacks, exacerbations and disease cure remains a challenge. Ayurveda refers to bronchial asthma as Tamaka Swasa and it is well explained in Charaka Samhita. Management of asthma in Ayurveda includes removal of vitiated Kapha through Shodhana, Shamana procedures, herbal and herbomineral formulations in addition to advising a healthy lifestyle and diet. Several clinical trials on Ayurvedic formulations for treatment of asthma are reported, however, whole system management of asthma has rarely been studied in the manner in which it is actually being practiced. Ayurveda therapeutics provides Dosha specific approaches, which needs biological investigation. The objective of our study was to investigate lung functions and cytokine changes in Asthmatic individuals in response to Ayurvedic intervention. The study design was approved by the Institutional Ethics Committee of Tilak Ayurveda Mahavidyalaya (TAMV) & Sheth Tarachand Ramnath Charitable Ayurveda Hospital and followed guidelines of the Declaration of Helsinki and Tokyo for humans. It was conducted as a whole system individualized pragmatic clinical trial and written consent of patients was collected before enrollment. One hundred and fifteen patients with mild-to-moderate asthma were divided into 2 sub-groups depending on their disease subsets and administered phenotype specific ayurvedic interventions. Seventy six asthma patients completed the treatment. Serum IgE levels, blood eosinophil counts, spirometry and blood cytokine levels were measured before the start of treatment and six months at the end of treatment. Age and sex matched healthy participants (n=69) were recruited in the study for comparison of cytokines levels. Significant improvements in FEV1(% predicted) (p<0.0001) and FVC (% predicted) (p=0

SPECIFIC MOOD SYMPTOMS CONFER RISK FOR SUBSEQUENT SUICIDAL IDEATION IN BIPOLAR DISORDER WITH AND WITHOUT SUICIDE ATTEMPT HISTORY: MULTI-WAVE DATA FROM STEP-BD.

Science.gov (United States)

Stange, Jonathan P; Kleiman, Evan M; Sylvia, Louisa G; Magalhães, Pedro Vieira da Silva; Berk, Michael; Nierenberg, Andrew A; Deckersbach, Thilo

2016-06-01

Little is known about specific mood symptoms that may confer risk for suicidal ideation (SI) among patients with bipolar disorder (BD). We evaluated prospectively whether particular symptoms of depression and mania precede the onset or worsening of SI, among adults with or without a history of a suicide attempt. We examined prospective data from a large (N = 2,741) cohort of patients participating in the Systematic Treatment Enhancement Program for BD (STEP-BD). We evaluated history of suicide attempts at baseline, and symptoms of depression and mania at baseline and follow-up visits. Hierarchical linear modeling tested whether specific mood symptoms predicted subsequent levels of SI, and whether the strength of the associations differed based on suicide attempt history, after accounting for the influence of other mood symptoms and current SI. Beyond overall current depression and mania symptom severity, baseline SI, and illness characteristics, several mood symptoms, including guilt, reduced self-esteem, psychomotor retardation and agitation, increases in appetite, and distractibility predicted more severe levels of subsequent SI. Problems with concentration, distraction, sleep loss and decreased need for sleep predicted subsequent SI more strongly among individuals with a suicide attempt history. Several specific mood symptoms may confer risk for the onset or worsening of SI among treatment-seeking patients with BD. Individuals with a previous suicide attempt may be at greater risk in part due to greater reactivity to certain mood symptoms in the form of SI. However, overall, effect sizes were small, suggesting the need to identify additional proximal predictors of SI. © 2016 Wiley Periodicals, Inc.

Accuracy of nurse documentation of delirium symptoms in medical charts.

Science.gov (United States)

Voyer, Philippe; Cole, Martin G; McCusker, Jane; St-Jacques, Sylvie; Laplante, Johanne

2008-04-01

The purpose of this study undertaken in an acute care hospital was to evaluate sensitivity and specificity of the documentation of nurse-reported delirium symptoms in medical charts. This is a descriptive study based on the clinical assessments of a study nurse and nursing notes in the medical charts of 226 delirious older patients newly admitted to an acute care hospital. The results of this prospective validation study indicated that documentation of delirium symptoms is poor. Disorientation, agitation and altered level of consciousness were the three symptoms yielding a higher level of sensitivity, but even so said symptoms were reported in less than a third of the medical charts. Univariate analysis suggested that higher comorbidity level, more severe symptoms of delirium and the use of physical restraints were associated with more valid documentation of delirium symptoms in medical charts. Lastly, this study corroborates results of previous studies, indicating that documentation of delirium symptoms in medical charts can be improved. Future study should target improving nurse documentation of delirium symptoms in medical charts.

Clinical symptoms and laboratory findings supporting early diagnosis of Crimean-Congo hemorrhagic fever in Iran.

Science.gov (United States)

Mostafavi, Ehsan; Pourhossein, Behzad; Chinikar, Sadegh

2014-07-01

Crimean-Congo hemorrhagic fever (CCHF) is a zoonotic disease, which is usually transmitted to humans by tick bites or contact with blood or other infected tissues of livestock. Patients suffering from CCHF demonstrate an extensive spectrum of clinical symptoms. As it can take considerable time from suspecting the disease in hospital until reaching a definitive diagnosis in the laboratory, understanding the clinical symptoms and laboratory findings of CCHF patients is of paramount importance for clinicians. The data were collected from patients who were referred to the Laboratory of Arboviruses and Viral Hemorrhagic Fevers at the Pasteur institute of Iran with a primary diagnosis of CCHF between 1999 and 2012 and were assessed by molecular and serologic tests. Referred patients were divided into two groups: patients with a CCHF positive result and patients with a CCHF negative result. The laboratory and clinical findings of these two groups were then compared. Two-thousand five hundred thirty-six probable cases of CCHF were referred to the laboratory, of which 871 cases (34.3%) were confirmed to be CCHF. Contact with infected humans and animals increased the CCHF infection risk (P important role in patient survival and the application of the findings of this study can prove helpful as a key for early diagnosis. © 2014 Wiley Periodicals, Inc.

Quantifying the importance of disease burden on perceived general health and depressive symptoms in patients within the Mayo Clinic Biobank.

Science.gov (United States)

Ryu, Euijung; Takahashi, Paul Y; Olson, Janet E; Hathcock, Matthew A; Novotny, Paul J; Pathak, Jyotishman; Bielinski, Suzette J; Cerhan, James R; Sloan, Jeff A

2015-07-03

Deficits in health-related quality of life (HRQOL) may be associated with worse patient experiences, outcomes and even survival. While there exists evidence to identify risk factors associated with deficits in HRQOL among patients with individual medical conditions such as cancer, it is less well established in more general populations without attention to specific illnesses. This study used patients with a wide range of medical conditions to identify contributors with the greatest influence on HRQOL deficits. Self-perceived general health and depressive symptoms were assessed using data from 21,736 Mayo Clinic Biobank (MCB) participants. Each domain was dichotomized into categories related to poor health: deficit (poor/fair for general health and ≥3 for PHQ-2 depressive symptoms) or non-deficit. Logistic regression models were used to test the association of commonly collected demographic characteristics and disease burden with each HRQOL domain, adjusting for age and gender. Gradient boosting machine (GBM) models were applied to quantify the relative influence of contributors on each HRQOL domain. The prevalence of participants with a deficit was 9.5 % for perception of general health and 4.6 % for depressive symptoms. For both groups, disease burden had the strongest influence for deficit in HRQOL (63 % for general health and 42 % for depressive symptoms). For depressive symptoms, age was equally influential. The prevalence of a deficit in general health increased slightly with age for males, but remained stable across age for females. Deficit in depressive symptoms was inversely associated with age. For both HRQOL domains, risk of a deficit was associated with higher disease burden, lower levels of education, no alcohol consumption, smoking, and obesity. Subjects with deficits were less likely to report that they were currently working for pay than those without a deficit; this association was stronger among males than females. Comorbid health burden has the

Preliminary psychometric properties of the brief Negative Symptom Scale in youth at Clinical High-Risk for psychosis.

Science.gov (United States)

Strauss, Gregory P; Chapman, Hannah C

2018-03-01

Preliminary psychometric properties of an adapted version of the Brief Negative Symptom Scale (BNSS) are reported in youth at Clinical High-Risk for psychosis (CHR). Participants included 29 CHR youth who met criteria for a prodromal syndrome on the Structured Interview for Prodromal Syndromes (SIPS). The adapted BNSS demonstrated excellent internal consistency, convergent validity, and discriminant validity, suggesting that the BNSS has utility for assessing negative symptoms in a CHR population. Copyright © 2017 Elsevier B.V. All rights reserved.

Cerebellar ataxia of early onset. Clinical symptoms and MRI findings

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Yamashita, Sumimasa; Miyake, Shota; Yamada, Michiko; Iwamoto, Hiroko (Kanagawa Children' s Medical Center, Yokohama (Japan)); Yamada, Kazuhiko

1989-07-01

Eight cases of childhood cerebellar ataxia were reported. All these cases showed chronic cerebellar ataxia with early onset, and the other diseases of cerebellum such as infections, neoplasms and storage diseases were excluded by clinical symptoms and laboratory findings including blood counts, blood chemistry, lactate, pyruvate, ceruloplasmine, urinalysis, serum immunoglobulins, amino acid analysis in blood and urine, CSF analysis, leukocyte lysosomal enzymes, MCV, EMG, EEG and brain X-CT. Two pairs of siblings were included in this study. The clinical diagnosis were cerebellar type (5), spinocerebellar type (1), one Marinesco-Sjoegren syndrome and undetermined type (1). The age of onset was 1 to 5 years. The chief complaint was motor developmental delay in 6 cases; among them 5 patients could walk alone at the ages of 2 to 3 years'. Mental retardation was observed in 7 cases and epilepsy in 2. TRH was effective in 5 cases. The MRI study revealed that the area of medial sagittal slice of the cerebellum was reduced significantly in all cases and also that of pons was reduced in 5 cases. Different from typical adult onset spinocerebellar degenerations, most of the present cases have achieved slow developmental milestones and the clinical course was not progressive. Genetic factors are suspected in the pathogenesis of this disease in some cases. (author).

Eating disorder symptoms and parenting styles.

Science.gov (United States)

Haycraft, Emma; Blissett, Jackie

2010-02-01

This study aimed to examine associations between symptoms of eating disorders and parenting style, in a non-clinical sample. One hundred and five mothers completed self-report measures of eating disorder symptoms and parenting style. Higher levels of eating disorder symptoms were associated with more authoritarian and permissive parenting styles. Authoritative parenting was not significantly related to eating disorder symptoms. The findings demonstrate that eating disorder symptoms in non-clinical individuals are related to less adaptive parenting styles. These findings have potential implications for clinicians working with mothers with eating disorders. 2009 Elsevier Ltd. All rights reserved.

Symptom clustering and quality of life in patients with ovarian cancer undergoing chemotherapy.

Science.gov (United States)

Nho, Ju-Hee; Reul Kim, Sung; Nam, Joo-Hyun

2017-10-01

The symptom clusters in patients with ovarian cancer undergoing chemotherapy have not been well evaluated. We investigated the symptom clusters and effects of symptom clusters on the quality of life of patients with ovarian cancer. We recruited 210 ovarian cancer patients being treated with chemotherapy and used a descriptive cross-sectional study design to collect information on their symptoms. To determine inter-relationships among symptoms, a principal component analysis with varimax rotation was performed based on the patient's symptoms (fatigue, pain, sleep disturbance, chemotherapy-induced peripheral neuropathy, anxiety, depression, and sexual dysfunction). All patients had experienced at least two domains of concurrent symptoms, and there were two types of symptom clusters. The first symptom cluster consisted of anxiety, depression, fatigue, and sleep disturbance symptoms, while the second symptom cluster consisted of pain and chemotherapy-induced peripheral neuropathy symptoms. Our subgroup cluster analysis showed that ovarian cancer patients with higher-scoring symptoms had significantly poorer quality of life in both symptom cluster 1 and 2 subgroups, with subgroup-specific patterns. The symptom clusters were different depending on age, age at disease onset, disease duration, recurrence, and performance status of patients with ovarian cancer. In addition, ovarian cancer patients experienced different symptom clusters according to cancer stage. The current study demonstrated that there is a specific pattern of symptom clusters, and symptom clusters negatively influence the quality of life in patients with ovarian cancer. Identifying symptom clusters of ovarian cancer patients may have clinical implications in improving symptom management. Copyright © 2017 Elsevier Ltd. All rights reserved.

Age- and gender-specific prevalence and risk factors for depressive symptoms in the elderly: a population-based study.

Science.gov (United States)

Glaesmer, H; Riedel-Heller, S; Braehler, E; Spangenberg, L; Luppa, M

2011-10-01

Information on the prevalence and risk factors for depressive disorders in old age is of considerable interest for the assessment of future needs of the health care system. The aim of the study is to determine age- and gender-specific prevalence of major depression (MD), minor depression (MiD), and depressive symptoms, and to analyze risk factors associated with depressive symptoms. A representative sample of the German population of 1,659 individuals aged 60 to 85 years were visited at home and answered self-rating questionnaires. Depressive symptoms and syndromes (MD, MiD) were assessed using the Patient Health Questionnaire (PHQ-9). Factors associated with depressive symptoms were determined with linear regression models for the total sample and for men and women separately. Depressive symptoms were found in 28.7% of the participants, while 6.6% were affected by MD or MiD. The highest prevalence of MD and depressive symptoms was found in the oldest age groups. MiD showed an unsteady course across age groups in both sexes. In the total sample as well as in the male subsample, depressive symptoms were significantly associated with increasing age, lower household income, an increasing number of medical conditions, and lower social support. In women only, the number of medical conditions and lacking social support were significantly associated with depressive symptoms. Depressive symptoms are common in old age and occur on a spectrum ranging from very mild forms to MD. The potential modifiability of a number of risk factors for depressive symptoms opens possibilities of secondary prevention such as treatment of chronic diseases as well as support in requirements of daily living.

Undergoing Diagnostic Evaluation for Possible Cancer Affects the Health-Related Quality of Life in Patients Presenting with Non-Specific Symptoms

DEFF Research Database (Denmark)

Larsen, Ellen Frøsig Moseholm; Rydahl Hansen, Susan; Lindhardt, Bjarne Ørskov

2016-01-01

Aim Undergoing diagnostic evaluation for possible cancer can affect health-related quality of life (HRQoL). The aims of this study were to examine the HRQoL in patients undergoing a diagnostic evaluation for possible cancer due to non-specific symptoms and further to investigate the impact of socio...... diagnosis had the greatest effect on HRQoL around the time of diagnosis. Conclusions Patients with non-specific symptoms reported an affected HRQoL while undergoing a diagnostic evaluation for possible cancer. Morbidity, being unemployed and receiving a cancer diagnosis had the greatest effect on HRQo...... in the study; 680 (81%) also completed follow-up. Twenty-two percent of the patients received a cancer diagnosis at the end of follow-up. Patients presented initially with a high burden of symptoms, less role and emotional functioning and a lower global health/QoL. Most domains improved after diagnosis...

Clinical utility of the Chinese Strengths and Weaknesses of ADHD-Symptoms and Normal-behaviors questionnaire (SWAN when compared with DISC-IV

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Chan GFC

2014-08-01

Full Text Available Grace Fong-Chun Chan,1 Kelly Yee-Ching Lai,2 Ernest Siu-Luen Luk,3 Se-Fong Hung,2 Patrick Wing-Leung Leung4 1Department of Psychiatry, Alice Ho Miu Ling Nethersole Hospital, 2Department of Psychiatry, The Chinese University of Hong Kong, 3Private practice, 4Clinical and Health Psychology Centre, Department of Psychology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region Background: Attention-deficit/hyperactivity disorder (ADHD is a common and impairing child and adolescent psychiatric disorder. Early identification and prompt treatment are essential. Rating scales are commonly used by clinicians and researchers to assess ADHD children. Objective: In the current study, we aimed to examine the clinical utility of the Chinese version of the Strengths and Weaknesses of ADHD Symptoms and Normal Behaviors (SWAN questionnaire. We validated its subscale scores against the Diagnostic Interview Schedule for Children Version IV (DISC-IV and looked into its ability to identify ADHD in a psychiatric clinic setting. We also tested age and gender effects on SWAN scores. Specific subscale cutoff scores of SWAN were subsequently determined.Method: A total of 290 children aged 6–12 years old studying in local mainstream primary schools were recruited from a clinic setting and interviewed with the parent version of DISC-IV. Their parents and teachers completed the corresponding version of SWAN.Results: Both parent and teacher versions of SWAN were found to have good concurrent validity with DISC-IV. It could identify ADHD well in a clinic sample. Gender-specific cutoff scores were determined. Sensitivities and specificities were found to be satisfactory. SWAN was also found to perform equally well in identifying ADHD in those with and without comorbid Autistic Spectrum Disorder.Conclusion: SWAN was proven to be a useful tool to aid the assessment of ADHD in a clinic sample. Keywords: ADHD, SWAN, DISC-IV, validity

Systematic review: probiotics in the management of lower gastrointestinal symptoms in clinical practice – an evidence-based international guide

Science.gov (United States)

Hungin, A P S; Mulligan, C; Pot, B; Whorwell, P; Agréus, L; Fracasso, P; Lionis, C; Mendive, J; Philippart de Foy, J-M; Rubin, G; Winchester, C; Wit, N

2013-01-01

BackgroundEvidence suggests that the gut microbiota play an important role in gastrointestinal problems. AimTo give clinicians a practical reference guide on the role of specified probiotics in managing particular lower gastrointestinal symptoms/problems by means of a systematic review-based consensus. MethodsSystematic literature searching identified randomised, placebo-controlled trials in adults; evidence for each symptom/problem was graded and statements developed (consensus process; 10-member panel). As results cannot be generalised between different probiotics, individual probiotics were identified for each statement. ResultsThirty seven studies were included; mostly on irritable bowel syndrome [IBS; 19 studies; treatment responder rates: 18–80% (specific probiotics), 5–50% (placebo)] or antibiotic-associated diarrhoea (AAD; 10 studies). Statements with 100% agreement and ‘high’ evidence levels indicated that: (i) specific probiotics help reduce overall symptom burden and abdominal pain in some IBS patients; (ii) in patients receiving antibiotics/Helicobacter pylori eradication therapy, specified probiotics are helpful as adjuvants to prevent/reduce the duration/intensity of AAD; (iii) probiotics have favourable safety in patients in primary care. Items with 70–100% agreement and ‘moderate’ evidence were: (i) specific probiotics help relieve overall symptom burden in some patients with diarrhoea-predominant IBS, and reduce bloating/distension and improve bowel movement frequency/consistency in some IBS patients and (ii) with some probiotics, improved symptoms have led to improvement in quality of life. ConclusionsSpecified probiotics can provide benefit in IBS and antibiotic-associated diarrhoea; relatively few studies in other indications suggested benefits warranting further research. This study provides practical guidance on which probiotic to select for a specific problem. PMID:23981066

Heterogeneity in Clinical Symptoms and Cognitive Functioning of Children with Hyperactivity-Impulsivity and Inattention: Dimensional and Person-Centered Perspectives

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Gambin Małgorzata J.

2016-06-01

Full Text Available The goal of this study was to investigate heterogeneity in clinical symptoms and cognitive functioning among children with hyperactivity-impulsivity and inattention using a novel approach that combined dimensional and person-centered perspectives. Executive, verbal and visuo-spatial functioning, hyperactivity-impulsivity, inattention, externalizing and internalizing symptoms were examined in 102 children (37 girls and 65 boys at risk for ADHD and 62 children (31 girls and 31 boys not at risk for ADHD in the age range of 8–10 years. We extracted seven groups with various profiles of psychopathological symptoms and cognitive functioning. We propose that symptoms of inattention and hyperactivity-impulsivity in these groups are related to different cognitive and affective-motivational problems.

Tele-Interpersonal Psychotherapy Acutely Reduces Depressive Symptoms in Depressed HIV-Infected Rural Persons: A Randomized Clinical Trial.

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Heckman, Timothy G; Heckman, Bernadette D; Anderson, Timothy; Lovejoy, Travis I; Markowitz, John C; Shen, Ye; Sutton, Mark

2017-01-01

Human immunodeficiency virus (HIV)-positive rural individuals carry a 1.3-times greater risk of a depressive diagnosis than their urban counterparts. This randomized clinical trial tested whether telephone-administered interpersonal psychotherapy (tele-IPT) acutely relieved depressive symptoms in 132 HIV-infected rural persons from 28 states diagnosed with Diagnostic and Statistical Manual of Mental Disorders-IV major depressive disorder (MDD), partially remitted MDD, or dysthymic disorder. Patients were randomized to either 9 sessions of one-on-one tele-IPT (n = 70) or standard care (SC; n = 62). A series of intent-to-treat (ITT), therapy completer, and sensitivity analyses assessed changes in depressive symptoms, interpersonal problems, and social support from pre- to postintervention. Across all analyses, tele-IPT patients reported significantly lower depressive symptoms and interpersonal problems than SC controls; 22% of tele-IPT patients were categorized as a priori "responders" who reported 50% or higher reductions in depressive symptoms compared to only 4% of SC controls in ITT analyses. Brief tele-IPT acutely decreased depressive symptoms and interpersonal problems in depressed rural people living with HIV.

Clinical efficacy of sublingual and subcutaneous birch pollen allergen-specific immunotherapy

DEFF Research Database (Denmark)

Khinchi, M S; Poulsen, Lars K.; Carat, F

2004-01-01

Both sublingual allergen-specific immunotherapy (SLIT) and subcutaneous immunotherapy (SCIT) have a documented clinical efficacy, but only few comparative studies have been performed.......Both sublingual allergen-specific immunotherapy (SLIT) and subcutaneous immunotherapy (SCIT) have a documented clinical efficacy, but only few comparative studies have been performed....

Autobiographical memory specificity and the persistence of depressive symptoms in HIV-positive patients: rumination and social problem-solving skills as mediators.

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Yanes, Paula K; Morse, Gene; Hsiao, Chiu-Bin; Simms, Leonard; Roberts, John E

2012-01-01

Individuals infected with human immunodeficiency virus (HIV) are at elevated risk for depressive conditions, which in turn can negatively impact health-related behaviours and the course of illness. The present study tested the role of autobiographical memory specificity and its interaction with perceived stress in the persistence of depressive symptoms among dysphoric HIV-positive individuals. Additionally, we examined whether rumination and social problem solving mediated these effects. Results indicated that memory specificity moderated the impact of perceived stress, such that perceived stress was more strongly associated with follow-up depressive symptoms among those with greater memory specificity. Rumination, but not social problem solving, mediated this effect. Implications of these findings are discussed.

A disease-specific measure of health-related quality of life in adults with chronic immune thrombocytopenic purpura: psychometric testing in an open-label clinical trial.

Science.gov (United States)

Mathias, Susan D; Bussel, James B; George, James N; McMillan, Robert; Okano, Gary J; Nichol, Janet L

2007-05-01

The Immune Thrombocytopenic Purpura Patient Assessment Questionnaire (ITP-PAQ) was developed to assess disease-specific quality of life (QoL) in adults with ITP. It is a 44-item questionnaire that includes scales for physical health (symptoms, fatigue/sleep, bother, and activity), emotional health (psychological and fear), overall QoL, social activity, women's reproductive health, and work. A previous study reported preliminary evidence of its reliability and validity. The present study was conducted to ascertain the responsiveness (ability to detect a clinically important treatment effect), reliability, and validity of the ITP-PAQ and to corroborate the earlier findings. The women's reproductive health scale was evaluated for psychometric evidence of the existence of separate menstrual symptoms and fertility subscales. The ITP-PAQ was evaluated in the context of an ongoing open-label extension study assessing the tolerability and durability of increases in the platelet count with AMG 531 (a thrombopoiesis peptibody that increases platelet production by targeting the thrombopoietin receptor) administered by subcutaneous injection once weekly in adult patients with ITP It was self-administered at baseline and at weeks 4, 12, and 24. The responsiveness of the questionnaire was evaluated by calculating and comparing the change scores of patients who showed clinical improvement-categorized as platelet responders (those with a platelet count > or =50 x 10(9) cells/L and a doubling of baseline values at week 24) and durable platelet responders (those with a platelet count > or =50 x 10(9) cells/L and a doubling of baseline values on > or =6 occasions during weeks 17-24)-with the change scores of patients wh did not show clinical improvement. The reliability (internal consistency and test-retest) and validity (convergent, discriminant, and known groups) of the questionnaire were also evaluated. Validity was examined in terms of correlations between the ITP-PAQ and the 36

From the Child’s Word to Clinical Intervention: Novel, New, and Innovative Approaches to Symptoms in Pediatric Palliative Care

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Katharine E. Brock

2018-03-01

Full Text Available Despite vast improvements in disease-based treatments, many children live with life-threatening disorders that cause distressing symptoms. These symptoms can be difficult to comprehensively assess and manage. Yet, frequent and accurate symptom reporting and expert treatment is critical to preserving a patient’s physical, psychological, emotional, social, and existential heath. We describe emerging methods of symptom and health-related quality-of-life (HRQOL assessment through patient-reported outcomes (PROs tools now used in clinical practice and novel research studies. Computer-based and mobile apps can facilitate assessment of symptoms and HRQOL. These technologies can be used alone or combined with therapeutic strategies to improve symptoms and coping skills. We review technological advancements, including mobile apps and toys, that allow improved symptom reporting and management. Lastly, we explore the value of a pediatric palliative care interdisciplinary team and their role in assessing and managing distressing symptoms and minimizing suffering in both the child and family. These methods and tools highlight the way that novel, new, and innovative approaches to symptom assessment and management are changing the way that pediatrics and pediatric palliative care will be practiced in the future.

Clinical symptoms, signs and tests for identification of impending and current water-loss dehydration in older people.

Science.gov (United States)

Hooper, Lee; Abdelhamid, Asmaa; Attreed, Natalie J; Campbell, Wayne W; Channell, Adam M; Chassagne, Philippe; Culp, Kennith R; Fletcher, Stephen J; Fortes, Matthew B; Fuller, Nigel; Gaspar, Phyllis M; Gilbert, Daniel J; Heathcote, Adam C; Kafri, Mohannad W; Kajii, Fumiko; Lindner, Gregor; Mack, Gary W; Mentes, Janet C; Merlani, Paolo; Needham, Rowan A; Olde Rikkert, Marcel G M; Perren, Andreas; Powers, James; Ranson, Sheila C; Ritz, Patrick; Rowat, Anne M; Sjöstrand, Fredrik; Smith, Alexandra C; Stookey, Jodi J D; Stotts, Nancy A; Thomas, David R; Vivanti, Angela; Wakefield, Bonnie J; Waldréus, Nana; Walsh, Neil P; Ward, Sean; Potter, John F; Hunter, Paul

2015-04-30

each index test study data were presented in forest plots of sensitivity and specificity. The primary target condition was water-loss dehydration (including either impending or current water-loss dehydration). Secondary target conditions were intended as current (> 300 mOsm/kg) and impending (295 to 300 mOsm/kg) water-loss dehydration, but restricted to current dehydration in the final review.We conducted bivariate random-effects meta-analyses (Stata/IC, StataCorp) for index tests where there were at least four studies and study datasets could be pooled to construct sensitivity and specificity summary estimates. We assigned the same approach for index tests with continuous outcome data for each of three pre-specified cut-off points investigated.Pre-set minimum sensitivity of a useful test was 60%, minimum specificity 75%. As pre-specifying three cut-offs for each continuous test may have led to missing a cut-off with useful sensitivity and specificity, we conducted post-hoc exploratory analyses to create receiver operating characteristic (ROC) curves where there appeared some possibility of a useful cut-off missed by the original three. These analyses enabled assessment of which tests may be worth assessing in further research. A further exploratory analysis assessed the value of combining the best two index tests where each had some individual predictive ability. There were few published studies of the diagnostic accuracy of state (one time), minimally invasive clinical symptoms, signs or tests to be used as screening tests for detecting water-loss dehydration in older people. Therefore, to complete this review we sought, analysed and included raw datasets that included a reference standard and an index test in people aged ≥ 65 years.We included three studies with published diagnostic accuracy data and a further 21 studies provided datasets that we analysed. We assessed 67 tests (at three cut-offs for each continuous outcome) for diagnostic accuracy of water

Randomized clinical trial of cognitive behavioral social skills training for schizophrenia: improvement in functioning and experiential negative symptoms.

Science.gov (United States)

Granholm, Eric; Holden, Jason; Link, Peter C; McQuaid, John R

2014-12-01

Identifying treatments to improve functioning and reduce negative symptoms in consumers with schizophrenia is of high public health significance. In this randomized clinical trial, participants with schizophrenia or schizoaffective disorder (N = 149) were randomly assigned to cognitive behavioral social skills training (CBSST) or an active goal-focused supportive contact (GFSC) control condition. CBSST combined cognitive behavior therapy with social skills training and problem-solving training to improve functioning and negative symptoms. GFSC was weekly supportive group therapy focused on setting and achieving functioning goals. Blind raters assessed functioning (primary outcome: Independent Living Skills Survey [ILSS]), CBSST skill knowledge, positive and negative symptoms, depression, and defeatist performance attitudes. In mixed-effects regression models in intent-to-treat analyses, CBSST skill knowledge, functioning, amotivation/asociality negative symptoms, and defeatist performance attitudes improved significantly more in CBSST relative to GFSC. In both treatment groups, comparable improvements were also found for positive symptoms and a performance-based measure of social competence. The results suggest CBSST is an effective treatment to improve functioning and experiential negative symptoms in consumers with schizophrenia, and both CBSST and supportive group therapy actively focused on setting and achieving functioning goals can improve social competence and reduce positive symptoms.

Symptom assessment in early psychosis: the use of well-established rating scales in clinical high-risk and recent-onset populations.

Science.gov (United States)

Fulford, Daniel; Pearson, Rahel; Stuart, Barbara K; Fisher, Melissa; Mathalon, Daniel H; Vinogradov, Sophia; Loewy, Rachel L

2014-12-30

Symptom assessment in early psychosis research typically relies on scales validated in chronic schizophrenia samples. Our goal was to inform investigators who are selecting symptom scales for early psychosis research. We described measure characteristics, baseline scores, and scale inter-relationships in clinical-high-risk (CHR) and recent-onset psychotic disorder (RO) samples using the Positive and Negative Syndrome Scale, Brief Psychiatric Rating Scale, Scale for the Assessment of Positive Symptoms, and Scale for the Assessment of Negative Symptoms; for the CHR group only, we included the Scale of Prodromal Symptoms. For investigators selecting symptom measures in intervention or longitudinal studies, we also examined the relationship of symptom scales with psychosocial functioning. In both samples, symptom subscales in the same domain, across measures, were moderately to highly intercorrelated. Within all measures, positive symptoms were not correlated with negative symptoms, but disorganized symptoms overlapped with both positive and negative symptoms. Functioning was significantly related to negative and disorganized, but not positive, symptoms in both samples on most measures. Findings suggest strong overlap in symptom severity ratings among the most common scales. In recent-onset samples, each has strengths and weaknesses. In CHR samples, they appear to add little information above and beyond the SOPS. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Treating panic symptoms within everyday clinical settings: the feasibility of a group cognitive behavioural intervention

DEFF Research Database (Denmark)

Austin, S.F.; Sumbundu, A.D.; Lykke, J.

2008-01-01

of significant clinical change displayed and resources required to carry out the intervention. A small sample of GP-referred patients displaying panic symptoms completed a 2-week intensive cognitive-behavioural intervention. Results collected post-intervention revealed significant clinical reductions in panic......Panic disorder is a common and debilitating disorder that has a prevalence rate of 3-5% in the general population. Cognitive-behavioural interventions have been shown to be an efficacious treatment for panic, although a limited number of studies have examined the effectiveness of such interventions...... implemented in everyday clinical settings. The aim of the following pilot study was to examine the feasibility of a brief group cognitive-behavioural intervention carried out in a clinical setting. Salient issues in determining feasibility include: representativeness of patient group treated, amount...

Lesion correlates of patholinguistic profiles in chronic aphasia: comparisons of syndrome-, modality- and symptom-level assessment.

Science.gov (United States)

Henseler, Ilona; Regenbrecht, Frank; Obrig, Hellmuth

2014-03-01

One way to investigate the neuronal underpinnings of language competence is to correlate patholinguistic profiles of aphasic patients to corresponding lesion sites. Constituting the beginnings of aphasiology and neurolinguistics over a century ago, this approach has been revived and refined in the past decade by statistical approaches mapping continuous variables (providing metrics that are not simply categorical) on voxel-wise lesion information (voxel-based lesion-symptom mapping). Here we investigate whether and how voxel-based lesion-symptom mapping allows us to delineate specific lesion patterns for differentially fine-grained clinical classifications. The latter encompass 'classical' syndrome-based approaches (e.g. Broca's aphasia), more symptom-oriented descriptions (e.g. agrammatism) and further refinement to linguistic sub-functions (e.g. lexico-semantic deficits for inanimate versus animate items). From a large database of patients treated for aphasia of different aetiologies (n = 1167) a carefully selected group of 102 first ever ischaemic stroke patients with chronic aphasia (∅ 12 months) were included in a VLSM analysis. Specifically, we investigated how performance in the Aachen Aphasia Test-the standard clinical test battery for chronic aphasia in German-relates to distinct brain lesions. The Aachen Aphasia Test evaluates aphasia on different levels: a non-parametric discriminant procedure yields probabilities for the allocation to one of the four 'standard' syndromes (Broca, Wernicke, global and amnestic aphasia), whereas standardized subtests target linguistic modalities (e.g. repetition), or even more specific symptoms (e.g. phoneme repetition). Because some subtests of the Aachen Aphasia Test (e.g. for the linguistic level of lexico-semantics) rely on rather coarse and heterogeneous test items we complemented the analysis with a number of more detailed clinically used tests in selected mostly mildly affected subgroups of patients. Our results