ISSN:0748-8386    

DOI:10.1002/smi.2460050202

出版商:John Wiley&Sons, Ltd    

年代:1989

数据来源: WILEY

ISSN:0748-8386    

DOI:10.1002/smi.2460050203

出版商:John Wiley&Sons, Ltd    

年代:1989

数据来源: WILEY

摘要:

AbstractPsychological and immunological assessments were performed concurrently on 33 spouses who had each been bereaved at least one year previously. The sample of bereaved spouses showed a high incidence of psychiatric morbidity, with 46 per cent having a Catego score of 5 or above using the Present State Examination (PSE); 30 per cent showed excessive rumination about the deceased, using the Grief Experience Inventory. There was also a high incidence of physical complaints within the group but the majority of these antedated the bereavement and no significant correlations were found between physical complaints and either psychological or immunological variables. There were no significant differences in cellular or humoral immune profile between subjects with high and low Catego scores. However, measures of emotional responsiveness using the Courtauld Emotional Control Scale were significantly correlated with helper T‐lymphocyte and natural killer cell numbers. It is proposed that these data support the concept of neuroendocrine modulation of the immune system but do not suggest either that the overall effect of bereavement is immunosuppressive or that immune changes are responsible for an increase in mortality following bereavemen

ISSN:0748-8386    

DOI:10.1002/smi.2460050204

出版商:John Wiley&Sons, Ltd    

年代:1989

数据来源: WILEY

摘要:

AbstractThe literature concerning unemployment and mortality is reviewed. Studies on the aggregate level do not show a systematic relation between unemployment and mortality on a societal level. Longitudinal studies in which cohorts of unemployed and employed people are followed up for 10 years show SMR values from about 110 to 200. These studies do not include information on health status before the onset of unemployment and therefore do not present adequate possibilities for evaluating the extent and significance of health‐related selection. Unemployment is a psychosocial stressor that threatens the identity, self‐esteem, social network and economy of unemployed people. Studies on psychological well‐being show that unemployment as a stressor is modified by a number of factors, such as various coping patterns. We put forward the hypothesis that when unemployment is an element of downward mobility it is particularly damaging and may be associated with increased morbidity and mortality. Finally, we emphasize the need for a more flexible theory on unemployment as a stressor and for regarding unemployment as a dynamic element in a person's relation to the labour m

ISSN:0748-8386    

DOI:10.1002/smi.2460050205

出版商:John Wiley&Sons, Ltd    

年代:1989

数据来源: WILEY

摘要:

AbstractThere is some evidence to suggest that the pattern of serious suicide attempts is changing and that this change is influenced by the public awareness of the efficacy of particular methods as reported by the media. Railway suicide is only one of several popular means, but at least three studies suggest that its use is increasing both in England and in Canada. This method of suicide has definite effects upon the train drivers, who may suffer long‐term stress‐related disability. More research is needed into the motivation of psychiatrically ill patients to commit suicide and for better means to detect early warning signs which may lead to such an ev

ISSN:0748-8386    

DOI:10.1002/smi.2460050206

出版商:John Wiley&Sons, Ltd    

年代:1989

数据来源: WILEY

摘要:

AbstractThe literature on depression in marriage and the effects of depression on the patient's spouse is reviewed. Current treatments for depression frequently do not result in long‐term recovery. Relatives experience a considerable burden but their needs are often ignored. Typically, they receive very little information from professionals about the patient's illness or how to cope with the difficulties they face. Marital difficulties are sometimes present and may either result from or contribute to one partner's depression. However, problems of an interpersonal nature are usually not addressed once clinical improvement has been achieved. Psychosocial interventions are used only following several relapses. The need for broader assessment and outcome criteria is emphasized. Long‐term recovery may be more likely if interventions are directed at the various problems which exist, rather than concentrating solely on symptom relief. The methods used in the schizophrenia intervention studies and and with “normal” couples may be applicable when one partner is depressed. The few studies which have employed marital therapy as a treatment for depression, either alone or in combination with other therapies, show promising results. Further research is needed to ascertain which approach or combination of approaches is most successful in achieving long‐term recovery in d

ISSN:0748-8386    

DOI:10.1002/smi.2460050207

出版商:John Wiley&Sons, Ltd    

年代:1989

数据来源: WILEY

摘要:

AbstractThere are stresses peculiar to being a medical practitioner, and superadded stressors applicable to women doctors. Some are extrinsic, some intrinsic. An interacting model is suggested: stresses that are inherent in the practice of medicine precipitate mental disorder in those predisposed to it; practice is particularly stressful to the ambitious, inflexible individual with a family history of mental disturbance and unhappy or unstable childhood.

ISSN:0748-8386    

DOI:10.1002/smi.2460050208

出版商:John Wiley&Sons, Ltd    

年代:1989

数据来源: WILEY

摘要:

AbstractWe compared aerobic and non‐aerobic forms of exercise in the treatment of anxiety disorders. Seventy‐nine inpatients took part in the study. All met the DSM‐III‐R criteria for anxiety disorders, 71 per cent had the diagnosis panic disorder with agorphobia. Patients were randomly assigned to the two physical training conditions, aerobic and non‐aerobic, by block randomization with respect to sex. Seventy patients completed the trial, and exercised for one hour three times a week for eight weeks. There was a significant increase in aerobic capacity in the aerobic group, but no change in the non‐aerobic group. Both groups achieved similar and significant reductions in anxiety scores, but the differences between the groups were small and not statistically significant. There were four exercise‐related dropouts in the aerobic group, none in the non‐aerobic. All dropouts had the diagnosis panic disorder with agoraphobia. The study indicates that intensive aerobic exercise, with resulting increase in aerobic capacity, has no specific effect on the anxiety level in patients with anxiety disorders. The reductions in anxiety scores which in previous studies have been shown to be associated with physical fitness training are most probably mediated via psychological mechanisms, like distractio

ISSN:0748-8386    

DOI:10.1002/smi.2460050209

出版商:John Wiley&Sons, Ltd    

年代:1989

数据来源: WILEY

摘要:

AbstractThis study uses a qualitative approach to look at stress and coping in a group of 173 pre‐registration doctors. Asking them to describe a recent stressful event and the way they coped with it revealed the largest group of events to concern death, followed by relationships with senior doctors, mistakes seen as personally caused, and overwork. The majority of coping strategies involved tackling the problem or asking for help. From longitudinal data on this sample a consistently stressed group was isolated and shown to report significantly more perceived mistakes than a consistently unstressed group, and to try to cope with the event significantly more by dismissing it from their minds. No sex differences were found. The implications for medical training and future impairment are discusse

ISSN:0748-8386    

DOI:10.1002/smi.2460050210

出版商:John Wiley&Sons, Ltd    

年代:1989

数据来源: WILEY

ISSN:0748-8386    

DOI:10.1002/smi.2460050212

出版商:John Wiley&Sons, Ltd    

年代:1989

数据来源: WILEY