ISSN:0033-3174    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

ObjectiveResearch findings suggest that, in addition to hostility, social dominance-related variables may be related to morbidity and mortality. The purposes of the present study were to evaluate a) whether pressured social dominance (defined as a pattern of structured-interview-defined characteristics of verbal competition, immediateness of response, and fast speaking rate) was related to long-term health outcomes, namely, all-cause mortality, and b) whether individuals characterized by other patterns of structured-interview-derived characteristics also varied in terms of mortality.MethodThe present study represents an analysis of the data from the 22-year mortality follow-up of 750 men from the Western Collaborative Group Study. Cluster analytic techniques were used to classify individuals according to their speech and behavioral characteristics during a structured interview. Cox proportional hazards models were used to test the association between the behavioral characteristics and the risk of all-cause mortality.ResultsThe pattern of characteristics reflecting pressured social dominance was found to be positively related to mortality (RR = 1.6, 95% CI = 1.1 - 2.4, p <.02); this relation held after controlling for diastolic blood pressure, total cholesterol, and smoking status at study entry, and also after controlling for hostility. In addition, the pattern of characteristics in which hostility was salient was found to be positively related to mortality (RR = 1.5, 95% CI = 1.1 - 2.2, p <.02). Finally, a pattern of characteristics that suggests placid individuals who are neither hostile nor socially dominant was found to be significantly negatively related to mortality (RR =.638, 95% CI =.419 -.974, p <.04).ConclusionsThese results suggest that, in future research concerning psychosocial factors and long-term survival, attention should be given to social dominance as well as to hostility.

ISSN:0033-3174    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

ObjectiveAssuming a subjective similarity between the experience of a hyperventilation episode and inhaling CO2-enriched air, we tested whether a respiratory challenge in association with a particular stimulus could result in altered respiratory behavior and associated somatic complaints upon presenting the stimulus only.MethodPsychosomatic patients (N = 28) reporting hyperventilation complaints participated in a differential conditioning paradigm using odors with a positive or negative valence as conditioned stimuli (CS+ or CS-) and 7.4% CO2-enriched air as the unconditioned stimulus (US). Three CS+ and three CS- acquisition trials were run. During the test phase, two CS+- and two CS-only trials were run, followed by two new test odors (with a positive or negative valence). Respiratory frequency, tidal volume, end-tidal fractional concentration of CO2, and heart rate were measured throughout the experiment. Somatic complaints were registered after each trial.ResultsWe observed a) increased respiratory frequency and an elevated level of somatic complaints upon presenting the CS+ only; b) a selective association effect: conditioning was only apparent with the negatively valenced CS+ odor; (c) no generalization of respiratory responses and complaints to the new odors; (d) no conditioning effect on dummy complaints that are usually not reported when inhaling CO2; (e) in exploratory comparisons with normal subjects, stronger conditioning effects on typical hyperventilation complaints in patients, and, in female subjects, on respiratory frequency.ConclusionRespiratory responses and psychosomatic complaints can be elicited by conditioned stimuli in a highly specific way. The findings are relevant for disorders in which respiratory abnormalities and/or psychosomatic complaints may play a role and for multiple chemical sensitivity.

ISSN:0033-3174    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

ObjectiveThe purpose of this study was to determine the utility of the Beck Depression Inventory (BDI) as a screening tool for major depression in diabetes.MethodOne hundred seventy-two diabetic outpatients (insulin-dependent diabetes mellitus [IDDM] = 59, or non-insulin-dependent diabetes mellitus [NIDDM] = 113) being evaluated for a treatment trial were studied. BDI scores were calculated for the complete 21-item measure as well as for the cognitive (13 items) and somatic (eight items) symptom subgroups. The presence of depression was determined using the National Institute of Mental Health Diagnostic Interview Schedule in accordance with the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) criteria. Receiver operating characteristic (ROC) analyses were used to evaluate the performance of the screening test in relation to the diagnostic standard.Results70% certainly that a person screening positive actually has the psychiatric disorder.ConclusionThe BDI is an effective screening test for major depression in diabetic patients. Prospective studies are needed to confirm the test's precise performance characteristics in the general clinical setting.

ISSN:0033-3174    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

ObjectiveThe physical and mental symptomatology of 99 self-referred patients complaining of multiple somatic and mental symptoms attributed to dental amalgam fillings were compared with patients with known chronic medical disorders seen in alternative (N = 93) and ordinary (N = 99) medical family practices and patients with dental amalgam fillings (N = 80) seen in an ordinary dental practice.MethodThe assessments included written self-reports, a 131-item somatic symptom checklist; Eysenck Personality Questionnaire, the General Health Questionnaire, and Toronto Alexithymia Scale.ResultsThe dental amalgam sample reported significantly more physical symptoms from all body regions. Self-reports suggested that 62% suffered from a chronic anxiety disorder (generalized anxiety disorder or panic). Forty-seven percent suffered from a major depression compared with 14% in the two clinical-comparison samples and none in the dental control sample. Symptoms suggesting somatization disorder were found in 29% of the dental amalgam sample compared with only one subject in the 272 comparison subjects. One third of the dental amalgam patients reported symptoms of chronic fatigue syndrome compared with none in the dental control sample and only 2 and 6%, respectively, in the two clinical comparison samples. The dental amalgam group reported higher mean neuroticism and lower lie scores than the comparison groups.ConclusionSelf-referred patients with health complaints attributed to dental amalgam are a heterogeneous group of patients who suffer multiple symptoms and frequently have mental disorders. There is a striking similarity with the multiple chemical sensitivity syndrome.

ISSN:0033-3174    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

ObjectiveThe purpose of this study is to examine the circadian pattern of specific immunologic measures and to compare observed circadian rhythms of these measures with the well-established circadian rhythms of hypothalamic-pituitary-adrenal axis hormones and sympathetic neurotransmitters.MethodsBlood samples were collected every 2 hours for a total of 24 hours from nine healthy volunteers. The blood samples were assayed for hormones and immune measures, including adrenocorticotropic hormone (ACTH), cortisol, norepinephrine, and epinephrine. The immune measures included percentage and absolute number of neutrophils, lymphocytes, the lymphocyte subsets CD3+ (T cells), CD4+ (T helper/inducer), CD8+ (T suppressor/cytotoxic), CD56+ (natural killer [NK] cells) and NK cell activity (NKCA).ResultsThe following immune measures exhibited a significant circadian rhythm: the percentages of neutrophils, CD4+ cells, and CD56+ cells; the absolute numbers of total lymphocytes, CD3+ cells, CD4+ cells, and CD8+ cells; and NKCA. Cross-correlations between the circadian rhythms of selected hormones and immune measures indicated a strong inverse association between the circadian rhythms of cortisol and the different T cell subsets on the one hand, and a strong direct association between the rhythms of cortisol and the percentage of CD56+ and NKCA on the other. Cross-correlations involving the circadian rhythms of norepinephrine and the same immune measures were in general much weaker and statistically nonsignificant.ConclusionIn healthy individuals, both enumerative and functional immune measures exhibit circadian rhythms that seem to be associated most closely with the circadian rhythm of cortisol.

ISSN:0033-3174    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

ObjectiveOur previous work showed that stress sensitized the vessels of cardiomyopathic hamsters (CMHs), but only hamsters in the lesion-forming period of their life. We hypothesized that we would find an interaction between stressor intensity and microvascular vulnerability.MethodMale CMHs at ages of 1.5, 2.5, and 3.5 months were stressed with supine immobilization for five consecutive days. Stressor intensity was manipulated by immobilizing groups of CMHs at room temperature for 0 minutes, 15 minutes, 30 minutes, 1 hour, or 2 hours. CMHs were anesthetized and sacrificed 5 days after stress, and their hearts were perfused using a modified Langendorff system. Body weight changes and baseline coronary vascular resistance (CVR) were recorded, and CVR was also measured after coronary artery infusion of arginine vasopressin (AVP).ResultsStress produced no effect on coronary vasculature in 1.5-month-old CMHs. In 2.5-month-old CMHs, only the two highest-intensity stressors enhanced coronary reactivity to AVP. In 3.5-month-old CMHs, higher-intensity stressors produced a marginal AVP-induced increase in CVR; but this marginal increase was significantly lower than the increases seen with the two highest-stressor intensities in the 2.5-month-old CMHs.ConclusionThe stress-induced coronary hyperreactivity to AVP seen in 2.5-month-old CMHs diminished when microvascular vulnerability was lower in 3.5-month-old CMHs. For 1.5-month-old CMHs, the resting CVR was extremely high, so that the addition of stress produced no further increase. Thus, stressor intensity interacted with microvascular vulnerability to alter the consequences of stress.

ISSN:0033-3174    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

ObjectivePatients with chronic fatigue syndrome (CFS) commonly report problems with attention, memory, learning, and speed of cognitive processing. This study attempted to evaluate these complaints using objective test criteria.MethodA test battery composed of six tests assessing these cognitive functions was given on two consecutive days. Twenty CFS patients were compared with 20 healthy control subjects and 14 patients with a history of major depression or dysthymia matched by age, intelligence, education level, and sex.ResultsCompared with control subjects, CFS patients consistently scored lower on tests in which motor and cognitive processing speeds were a critical factor, eg, reaction-time tasks. They also had more difficulty on working-memory tests in which rapid cognitive processing speed is also an important factor. The effort made on the first day of testing did not result in a decline in cognitive function on the following day. CFS patients did not qualify as having affective disorder by several different diagnostic criteria. Nonetheless, CFS patients' test performances did not differ from patients with a history of major depression or dysthymia.ConclusionsIt is concluded that, although CFS and major depression and dysthymia have distinct clinical features, these disorders have slowed motor and cognitive processing speed in common.

ISSN:0033-3174    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

ObjectiveAn association of "globus hystericus" with depressive illness has already been established. Successful treatment with antidepressants has been previously reported but this is the first report of globus symptom responding to electroconvulsive therapy (ECT) followed by long-term remission on maintenance dose with tricyclic antidepressant.MethodA detailed retrospective study of an elderly patient's General Practice medical notes revealed 45-year history of recurrent globus symptom, interspersed with other somatic complaints. Patient's frequency of consultations with her family physician was noted before treatment and during the 5-year follow-up period. Using DSM-III diagnostic categories, the patient was diagnosed as suffering from major depressive disorder with globus symptom. The notes were insufficient to ascertain whether past episodes of globus occurred in a setting of depressive disorder.ResultsA prompt response of globus symptom to ECT was observed with 5-year symptom-free follow-up period as long as the patient remained on a maintenance dose of antidepressant. A marked reduction in frequency of medical consultations for other somatic complaints was noted.ConclusionsThe case illustrates a strong association of globus symptom with depressive disorder and other somatic concerns. Patients with recurrent globus symptom and family history of depressive illness should be screened for a possibility of depressive disorder. ECT and antidepressants may be successfully used in treatment of globus in a setting of depressive illness. Long-term maintenance with antidepressive medication may keep at least some of these patients symptom-free. It is suggested that globus hystericus could be more appropriately viewed as a somatic symptom of depression rather than a conversion disorder.

ISSN:0033-3174    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0033-3174    

出版商:OVID    

年代:1997

数据来源: OVID