Biomedical subjects

D M Clarke

Publications and source records attributed to D M Clarke.

112 records · Page 7Linked to original sources

PubMedDate not supplied

The contribution of spirituality and spiritual coping to anxiety and depression in women with a recent diagnosis of gynecological cancer.

The objective of this study was to determine whether, after accounting for illness and demographic variables, spiritual involvement and beliefs and positive and negative spiritual coping could account for any of the variation in anxiety and depression among women within 1 year's diagnosis of gynecological cancer (GC). One hundred patients from outpatient GC clinics at two Melbourne-based hospitals completed a brief structured interview and self-report measures of anxiety, depression, spirituality, and spiritual coping. Using two sequential regression analyses, we found that younger women with more advanced disease, who used more negative spiritual coping, had a greater tendency towards depression and that the use of negative spiritual coping was associated with greater anxiety scores. Although not statistically significant, patients with lower levels of generalized spirituality also tended to be more depressed. The site of disease and phase of treatment were not predictive of either anxiety or depression. We conclude that spirituality and spiritual coping are important to women with GC and that health professionals in the area should consider these issues.

Adaptation, Psychological↗

PubMedDate not supplied

Dimensions of psychopathology in the medically ill. A latent trait analysis.

The authors examined the latent structure of psychiatric symptoms occurring in patients with medical illness. Symptom data were collected from 312 hospitalized medically ill patients using the Monash Interview for Liaison Psychiatry and subjected to latent trait analysis. A model with 5 dimensions provided an acceptable fit to the data. Dimensions were characterized as demoralization, anhedonia, autonomic anxiety, somatic symptoms, and grief. The demoralization dimension was similar to the concept of demoralization described by Frank and to the "giving up-given up complex" described by Engel. The concepts of demoralization, grief, and anhedonia may be useful in increasing understanding of the minor depressions in people with medical illness and in increasing the specificity of psychological and pharmacological treatments for these disorders.

Adaptation, Psychological↗

PubMedDate not supplied

Consultation-liaison psychiatrists' management of somatoform disorders.

The authors studied interventions recommended by consultation-liaison (C-L) psychiatrists when they diagnosed somatoform disorder prospectively in a cohort of 4,401 consecutive inpatients referred to the C-L psychiatry service of a general teaching hospital, using standardized MICRO-CARES methodology. A DSM-III-R somatoform disorder was diagnosed in 2.9%, somatoform pain disorder in 1.4%, conversion disorder in 0.7%, hypochondriasis or somatization disorder undifferentiated/not otherwise specified in 0.6%, and somatization disorder in 0.2%. In 3.4%, somatoform disorder was considered a differential diagnosis. Psychiatric comorbidity included mood disorder (39%), personality disorder (37%), and psychoactive substance use disorder (19%). Recommendations were made about antidepressants in 40% of the patients, anxiolytics in 18%, sedatives in 18%, and antipsychotics in 10%. Psychiatrists recommended the following: more laboratory tests for 14%; additional medical/surgical consultations for 11%; an increase in the vigor of medical treatment for 13%; and psychological treatment for 76%; also they stressed an earlier discharge of 16%. Psychiatrists were more likely to request a prolongation of inpatient stay for patients with comorbid somatoform, mood, anxiety, and personality disorder. Differences in characteristics and treatment of the subgroups tended to be consistent with their constructs and comorbid psychiatric diagnoses.

Adult↗

PubMedDate not supplied

Multiple tarsal coalitions in the same foot.

I reviewed 60 cases of tarsal coalition seen at Texas Scottish Rite Hospital for Children over the last 10 years. Twenty-nine patients had plain films only and were excluded from the study. One patient was diagnosed with synovitis at the time of surgery and was also excluded. Thirty patients with 53 coalitions had computed tomographic (CT) and, in many cases, surgical documentation of a tarsal coalition. Of these 30 patients, six had multiple coalitions in the same foot. This article briefly summarizes the six cases and reviews the literature of multiple tarsal coalitions, both before and after the use of CT. I suggest that multiple coalitions in the same foot are more common than once thought and recommend CT evaluation of both feet in transaxial and coronal planes in patients with suspected tarsal coalition.

Abnormalities, Multiple↗