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Biomedical subjects

I Pilowsky

Publications and source records attributed to I Pilowsky.

At least 37 records · Page 2Linked to original sources
PubMed1988

A study of facial expression in Parkinson's disease using a novel microcomputer-based method.

The aim of this study was to compare the smiling behaviour of a group of Parkinson's disease sufferers with a control group of a similar age using a novel microcomputer-based approach, which utilises a mathematical model of the face to quantify facial expression. The findings indicate that the Parkinson's group differed from the control group in the frequency of smiling while watching a series of cartoons and in the degree of mouth opening during smiling. Both groups completed the Levine-Pilowsky Depression questionnaire, and patients with Parkinson's disease had significantly higher depression scores than those of the control group. Significant negative correlations between depression score and frequency of smiling, and depression score and inner eyebrow separation were also found.

Aged↗
PubMed1987

Illness behaviour and general practice utilisation: a prospective study.

The Illness Behaviour Questionnaire (IBQ) was used to compare general practice patients who presented physical complaints in the absence of objective pathology, with those in whom the presence of pathology was established. Patients without pathology showed a greater conviction as to the presence of disease, and greater degrees of anxiety, depression and irritability. Males and females differed on their IBQ scores: males showing more disease conviction, somatic focusing and hypochondriasis. Utilisation of general practitioner services (as indicated by the number of visits in the six months subsequent to completing the IBQ) was associated with greater age, and for the group as a whole, utilisation was predicted by higher scores on the following IBQ scales: disease conviction, affective disturbance and disease affirmation. This was also the case for males, but in females only affective disturbance correlated with a greater number of visits. Four patterns were delineated in the relationship between age, illness behaviour variables, the presence or absence of objective pathology, and G.P. contacts.

Adult↗
PubMed1986

Abnormal illness behaviour (dysnosognosia).

This paper reviews the concept of abnormal illness behaviour (dysnosognosia). The need for a multidisciplinary approach is emphasized, especially for patients who affirm the presence of somatic illness in an inappropriate way. Taking the multidisciplinary pain clinic as a model of this approach, the range of treatments available is discussed. It is suggested that 'thymologia' and 'somatologia' may be more value-free ways of describing patients' verbal behaviour than alexithymia, and that psychotherapeutic methods can be utilized if a flexible style is adopted.

Combined Modality Therapy↗
PubMed1985

A study of brief psychotherapy for chronic pain.

Twenty-six patients attending the pain clinic of a large metropolitan general hospital were randomly assigned to receive either twelve sessions of psychodynamic psychotherapy or six sessions of cognitively orientated supportive psychotherapy. Questionnaires measuring aspects of illness behaviour, depression and anxiety were administered before and after treatment, but did not reveal any significant differences between the treatment groups at any time. Global subjective estimates of outcome reported to an independent observer were made after completion of therapy and showed no significant differences. All measures were repeated six and twelve months after completion of therapy and revealed significant improvement in the dynamic therapy group only with respect to levels of activity. These findings suggest that brief psychodynamically oriented psychotherapy may have a role in the management of chronic pain but further evaluation of this approach is clearly necessary, involving larger numbers of patients, before a more definitive conclusion can be reached.

Adult↗
PubMed1985

Sleep disturbance in pain clinic patients.

One hundred out-patients, referred to a multidisciplinary pain clinic for the management of chronic pain, were questioned regarding their sleeping habits and were grouped according to whether they reported 'good,' 'fair' or 'poor' sleep. All patients were administered questionnaires to measure illness behaviour, depression and anxiety. Information was also obtained regarding the site, intensity and quality of pain as well as amount of general activity. 'Good' and 'poor' sleepers were found to differ on most measures, particularly depression, pain intensity, activity levels and hypochondriasis. These findings suggest that reported sleep disturbance may provide an index of impairment and act as an indicator of psychological disturbance in chronic pain patients.

Adult↗
PubMed1985

Cryptotrauma and "accident neurosis".

Accidents may often have been far more traumatic psychologically and emotionally than appears to be the case at first sight. Attention is drawn to such "Cryptotrauma" and illustrated with three clinical vignettes. Emphasis is placed on the need for painstaking analysis of the accident in all its details. Without such careful investigation "Post traumatic stress disorders" can easily be overlooked, since patients tend not to offer the information spontaneously.

Accidents, Occupational↗
PubMed1984

The Illness Behavior Questionnaire as an aid to clinical assessment.

The Illness Behavior Questionnaire (IBQ) is a 62-item self-report instrument that provides information relevant to the delineation of a patient's attitudes, ideas, affects, and attributions in relation to illness. The scores generated are described, and nine clinical vignettes are presented, together with IBQ score profiles and interpretations to illustrate the manner in which the latter may complement other clinical data. The ways in which individuals react to their own health status is becoming of greater importance as the taking of responsibility for one's own health is increasingly emphasized. The IBQ provides information that should be relevant to the management of patients, regardless of the specific nature of their illness.

Adult↗
PubMed1984

Patterns of depression and illness behaviour in general hospital patients.

Little interest has been taken in the characteristics of depression in medical and surgical patients and its correlations with syndromes which may be subsumed under the rubric of abnormal illness behaviour. Depressive symptoms and abnormal illness behaviour as measured by self-rating scales were studied among 325 inpatients of a general hospital. A principal component analysis was carried out. A first factor reflecting general severity was characterized by depressed affect, somatic symptoms, retardation, hypochondriasis, and disease conviction and showed considerable stability within the group. A second factor suggested that in contrast to the younger patients, older patients had a tendency to focus on somatic problems and not psychological determinants, were likely to attribute all difficulties to physical illness, and lacked readiness to report interpersonal friction.

Age Factors↗
PubMed1983

Temporo-mandibular joint dysfunction: pain and illness behaviour.

This study investigated prospectively the illness behaviour of 100 patients with temporo-mandibular (TMJ) dysfunction and 100 asymptomatic patients. It has previously been shown that a simple illness behaviour questionnaire (IBQ) can discriminate between patients with intractable facial pain and minor odontogenic pain [28]. The purpose of this study was to determine whether it was possible to prospectively identify those patients who may be resistant to conservative therapy. The results showed that the TMJ dysfunction patients had significantly increased levels of disease conviction (P less than 0.001), anxiety or depression (P less than 0.005), and were less likely to deny the existence of problems in their life (P less than 0.05) compared to control patients. However, the TMJ population was much closer to the control population than to a pain clinic population. In the small percentage (13%) of patients who failed to respond to conservative therapy, over half showed abnormal illness behaviour. Seventy-five percent of all the TMJ patients could be excluded from further assessment of abnormal illness behaviour at little risk of incorrect classification. Thus the illness behaviour questionnaire can be used as a screening device to identify those patients who require psychologic treatment rather than more aggressive surgical treatment.

Adult↗
PubMed1983

Depressive illness and dependency.

The relationship has been examined in depressed in-patients between type of depression (as categorised by the Levine-Pilowsky Depression Questionnaire) and dependency (as measured by the Interpersonal Dependency Inventory) at time of discharge. No relationship could be demonstrated between dependency and depressive category.

Adaptation, Psychological↗
PubMed1982

Depressive symptoms and abnormal illness behavior in general hospital patients.

There have been many accounts of depression and abnormal illness behavior in medical inpatients, but systematic studies of their prevalence and features in a general hospital are lacking. Occurrence and characteristics of depression and illness behavior were studied in 325 inpatients of a general hospital in the northern part of Italy. Patients were surveyed in six separate wards (medicine, surgery, dermatology, OB-GYN, orthopedics, and ophthalmology) and represented about 90% of their actual population during a one-week period. Two self-report scales were used for screening: the CES-D (scale devised by the Center for Epidemiologic Studies of Depression at NIMH) for measuring depression and the Illness Behavior Questionnaire (IBQ), developed by Pilowsky and Spence. Both scales were administered in their validated Italian translations. The customary cut-off point of 16 in the CES-D score revealed about 58% of the patients as depressed. A more conservative cut-off point of 23 still showed 33.5% of the patients as depressed. The IBQ scores of the depressed patients showed significantly (p less than 0.001) higher levels of general hypochondriasis, disease conviction, dysphoria, and irritability than the nondepressed patients. No relevant differences existed between wards in the amount of depression and IBQ scores, even when differences were adjusted for age, sex, marital status, and social class. Implications for psychosomatic research (sociodemographic characteristics of depression and illness behavior, bias in comparing hospital patients and controls in the general population, and so on) and treatment (consultation-liaison psychiatry) are discussed.

Depression↗
PubMed1982

A controlled study of amitriptyline in the treatment of chronic pain.

This paper reports a study in which a double-blind controlled cross-over study of amitriptyline vs. placebo was carried out in a group of patients referred to a multidisciplinary pain clinic for the management of chronic intractable pain for which no substantial organic cause could be demonstrated. Of 52 patients entering the 12-week trial, 20 withdrew before completion. No differences were found in terms of global improvement on either agent. Subjective reports indicated a greater reduction in pain at 2 and 4 weeks on amitriptyline, but no difference at 6 weeks. None of the baseline measures was predictive of response.

Amitriptyline↗
PubMed1982

The response to treatment in a multidisciplinary pain clinic.

Reports of the results obtained by multidisciplinary pain clinics are reviewed. The outcome of management of a cohort of patients referred to the Royal Adelaide Hospital Pain Clinic is described. Thirty-seven percent of patients reported partial or complete relief. The problems of assessing outcome are discussed, as well as the difficulty of making meaningful comparisons between pain clinics. The evidence thus far available suggests that multidisciplinary pain clinics make a useful and important contribution to the management of pain syndromes.

Adult↗