摘要:

Although consultation-liaison psychiatry grew out of the general hospital psychiatry movement, the American Psychosomatic Society has played a vital role in nurturing the discipline. Through the Society's journal, Psychosomatic Medicine, and its meetings, consultation psychiatry continues to stay in the mainstream. The subspecialty has developed in both content and strength to merit a focused organization, the Academy of Psychosomatic Medicine. The role of both organizations in the development of consultation-liaison psychiatry is discussed and recommendations for future collaborative activities are suggested.

ISSN:0033-3174    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

This study examined the effects of Hurricane Andrew on physical symptoms and functional impairments in a sample of chronic fatigue syndrome (CFS) patients residing in South Florida.In the months after Hurricane Andrew (September 15-December 31, 1992), 49 CFS patients were assessed for phychosocial and physical functioning with questionnaires, interviews, and physical examinations. This sample was made up of 25 CFS patients living in Dade county, a high impact area, and 24 patients in Broward and Palm Beach counties, areas less affected by the hurricane. Based on our model for stress-related effects on CFS, we tested the hypothesis that the patients who had the greatest exposure to this natural disaster would show the greatest exacerbation in CFS symptoms and related impairments in activities of daily living (illness burden). In support of this hypothesis, we found that the Dade county patients showed significant increases in physician-rated clinical relapses and exacerbations in frequency of several categories of self-reported CFS physical symptoms as compared to the Broward/Palm Beach county patients. Illness burden, as measured on the Sickness Impact Profile, also showed a significant increase in the Dade county patients. Although extent of disruption due to the storm was a significant factor in predicting relapse, the patient's posthurricane distress response was the single strongest predictor of the likelihood and severity of relapse and functional impairment. Additionally, optimism and social support were significantly associated with lower illness burden after the hurricane, above and beyond storm-related disruption and distress responses. These findings provide information on the impact of environmental stressors and psychosocial factors in the exacerbation of CFS symptoms.

ISSN:0033-3174    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The present investigation studied the relationship between symptoms of menstrual distress and macronutrient intake, eating behavior, and exercise in healthy women.Twenty-six normally menstruating women with no complaints of menstrual distress completed a disguised questionnaire on menstrual symptoms and monitored the type and amount of food consumed as well as the type and duration of exercise during a full menstrual cycle. Menstrual cycle phases were determined by the presence of menses, ovarian hormonal assays, and basal temperature monitoring. Reports of pain, water retention, negative affect, behavior change, and arousal were significantly higher (p <.05 or better) in the perimenstruum when compared to the follicular and luteal phases. During the perimenstruum, a higher energy intake of carbohydrate was associated with higher ratings of negative affect (p <.01) and impaired performance/decreased activity (p <.05). Lower energy intake of protein was associated with higher ratings of well being (p <.05). Overeating and dieting behavior were related to greater water retention (p <.01), autonomic reactions (p <.05), and appetite (p <.05). The amount of aerobic exercise in contrast to the intensity was related to lower water retention (p <.01), autonomic reactions (p <.05), and appetite (p <.01). Carbohydrate consumption, eating behavior, and regular exercise are reliably associated with menstrual distress and deserving of experimental evaluation as treatment interventions for menstrual distress.

ISSN:0033-3174    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

This study investigated the fluctuations of autonomic nervous activities during the menstrual cycle.Twenty college females were tested for cardiovascular reactivity to mental challenge during both follicular and luteal phases across two menstrual cycles. Power spectral analysis of heart rate variability (HRV) was used to examine the autonomic nervous activities. At baseline, although heart rate and blood pressure did not differ across the menstrual cycle, the low-frequency (LF) component in the HRV was higher and the high-frequency (HF) component in the HRV was lower during the luteal phase than during the follicular phase. The LF/HF ratio was also significantly greater in the luteal phase. These data suggest that sympathetic nervous activities are predominant in the luteal phase as compared with follicular phase. In addition, the power spectral analysis of HRV has more sensitivity than heart rate or blood pressure in assessing the slight fluctuations of autonomic nervous activities during the menstrual cycle.

ISSN:0033-3174    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The erectile response to intracavernosal injection (ICI) of smooth muscle relaxants is often impaired in men with presumed psychogenic erectile dysfunction.This study tests the hypothesis that such impairment results from stress-related increase in circulating norepinephrine (NE). Fifty-nine men with erectile dysfunction had their nocturnal penile tumescence (NPT) monitored over 2 nights, and ICI of 10 microg prostaglandin E1was given on the second morning. Psychometric and neuroendocrine measures of stress, including plasma and urinary catecholamines, were taken on both mornings. Inhibition of the ICI response was determined by the difference between NPT and ICI responses, and two groups of "high inhibition" and "low inhibition" men were compared. The high inhibition group showed higher "Trait" and "State" anxiety and a neuroendocrine profile of higher initial cortisol and lower plasma catecholamine levels than the low inhibition group. These differences were evident on both mornings and hence were not specifically related to the ICI. There was no support for the hypothesis that inhibition of response to ICI results from increased circulating NE, though the possibility that increased NE release occurred specifically in the erectile tissues could not be excluded.

ISSN:0033-3174    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

47 years). There was an age-related increase in the proportion of total sleep in rapid eye movement (REM), which was only apparent in the older age group. In the volunteers, there was a curvilinear dose-response effect on NPT. The lower dose modestly increased erectile response, particularly during non-REM sleep, whereas the higher dose reduced erectile response, most noticeably during REM. The only positive effect of the higher dose was an increase in spontaneous erections after lights out before sleep onset. The older dysfunctional group showed no drug effects on NPT. The younger dysfunctional men showed increased erectile response during non-REM with the higher dose, an effect that was also significant in the interval between sleep onset (Stage 2) and first REM.

ISSN:0033-3174    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The purpose of this research was to examine the role of gender in hemodynamic response patterns to stress.Sixty-four male and 55 female young adults were administered a protocol of rest, mental arithmetic, video game, and anger recall interview while blood pressure, heart rate, and cardiac impedance measures were obtained. Men had higher levels of systolic blood pressure and cardiac output and greater reactivity to tasks, indexed by increases in cardiac output and diastolic blood pressure. Extreme groups of myocardial and vascular reactors were formed from cardiac output and total peripheral resistance change scores during mental arithmetic. The myocardial reactors exhibited greater sensitivity to task demands, whereas vascular reactors exhibited comparable total peripheral resistance increases to all tasks. Vascular reactors exhibited greater diastolic blood pressure reactivity than myocardial reactors. Future studies should address the predictive validity of these reactor patterns for the subsequent development of coronary heart disease.

ISSN:0033-3174    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

This study evaluated the sympathoadrenal modulation of behaviorally evoked immune responses by administration of a nonselective adrenoceptor antagonist (labetalol) to subjects exposed to mental stress.In a 2 X 2 factorial design, subjects were assigned to a labetalol or saline condition and, within each condition, were exposed either to acute laboratory stress or no stress (control). Lymphocyte subsets, natural killer (NK) cell cytotoxicity, and T cell proliferation to phytohemagglutinin and concanavalin A were assessed pre-experimentally, at baseline after infusion and after 18 minutes of mental stress (or rest). By comparison with the other three conditions, the saline-stress group showed a greater peripheral NK cell number and cytotoxicity, lower mitogenic response to phytohemagglutinin and concanavalin A, and diminished ratio of CD4:CD8 cells after the stressor. As predicted, immune responses did not differ among the remaining groups (labetalol-stress, saline-rest, labetalol-rest). Group differences in NK cell cytotoxicity were not significant after controlling for differences in NK cell numbers. These findings demonstrate that the occurrence of certain immunologic responses to acute psychological stress are dependent on concomitant activation of the sympathetic nervous system.

ISSN:0033-3174    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

This study tested the hypothesis that breathing at the upper end of the normal range of end tidal CO2decreases renal sodium excretion.Normotensive human subjects learned to self-regulate end tidal CO2using a respiratory gas monitor and feedback procedure. Urine flow rates were increased by a standardized water drinking regimen. Urinary volume and sodium and potassium excretion were decreased during 30 minutes of inhibited (i.e. high normal end tidal CO2) breathing, compared with levels preceding and after task performance. Blood pressure, but not heart rate, increased during task performance. Plasma volume increase under these conditions is indicated by the observation that urinary excretion of an endogenous digoxin-like factor was increased. The physiological mechanism by which inhibited breathing elicits renal sodium retention remains to be determined. This breathing pattern could mediate the role of behavioral stress in some forms of hypertension.

ISSN:0033-3174    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Parental history of hypertension, dietary sodium, and psychological stress have all been implicated in the development of essential hypertension and may interact in elevating disease risk.The mechanism by which this might occur is unclear, but it may be related to changes in the peripheral vasculature. The present study examined the effects of parental history and sodium on cardiovascular responses to an extended stressor. Eighteen normotensive offspring of hypertensives and 18 offspring of normotensives were exposed to a 1-hour shock-avoidance video-game procedure after 14 days of sodium loading (10 1-g tablets/day) and again after 14 days of placebo tablets. Order of sessions was counterbalanced between subjects in a double-blind design. In offspring of hypertensives, sodium loading elevated total peripheral resistance and norepinephrine responses to stress relative to placebo conditions and compared with offspring of normotensives. These increases were accompanied by decreases in stroke volume and cardiac output, which may explain the absence of familial differences in blood pressure responses to stress and sodium. Sodium loading had no effect on offspring of normotensives. The elevated resistance in offspring of hypertensives may suggest the initiation of pathological processes. The absence of sodium effects on resting values indicates the importance of research under conditions of stress.

ISSN:0033-3174    

出版商:OVID    

年代:1995

数据来源: OVID