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Biomedical subjects

I Pilowsky

Publications and source records attributed to I Pilowsky.

At least 55 records · Page 3Linked to original sources
PubMed1982

Depression and illness behavior in a general hospital: a prevalence study.

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, obstetrics and gynecology, orthopedics and ophthalmology) and represented about 90% of their actual population during a 1-week period. Two self-report scales were used for screening: the CES-D for measuring depression developed by the NIMH and the Illness Behavior Questionnaire (IBQ) developed by Pilowsky and Spence. Both scales were administered in their validated Italian translations. Applying the generally used cut-off point of 16 in the CES-D score, about 58% of the patients were classified as depressed. This cut-off was derived from community studies in the US. Applying a rather more conservative cut-off point of 23 (derived from the scores of psychiatrically depressed patients in Italy), still 33.5% of the patients emerged 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. There were no relevant differences 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, etc.) and treatment (consultation-liaison psychiatry) are discussed.

Adult↗
PubMed1982

Pain and depression.

This paper explores the relationship between depression and chronic intractable pain in which somatic pathology is playing a minor role. In this study, 114 patients with chronic pain were compared with 53 patients with depression. Patients with chronic pain were older, more likely to be married, more frequently attributed difficulties in activity and sleep to pain, and reported greater impairment of motor functions. They had less dysphoria and an illness behaviour profile (on the Illness Behaviour Questionnaire) suggestive of a conversion reaction. Depressed patients recalled more life events in the year prior to presentation, whilst pain patients recalled more events of nine and ten years earlier. It is concluded that the two patient groups cannot be considered identical. It is argued that the concept of abnormal illness behavior helps to distinguish the two groups.

Attitude to Health↗
PubMed1982

Childhood hospitalization and chronic intractable pain in adults: a controlled retrospective study.

Three groups of patients have been studied in order to elucidate the relationship between childhood hospitalization and chronic intractable pain in adults. The groups were: patients referred to a pain clinic, psychiatric patients with a depressive illness, and patients attending a rheumatology clinic. The findings suggest that early hospitalization is related to the genesis of both depressive illness and intractable pain: in the former occurring in the preschool years and in the latter, during school age. The significance of these relationships is discussed.

Adolescent↗
PubMed1981

Intractable facial pain and illness behaviour.

Management of intractable facial pain (IFP) patients is time consuming and potentially frustrating. Earlier identification of IFP patients may be helped by considering such cases in terms of their illness behaviour rather than a large rang of other diagnostic labels. A group of 24 IFP patients, with diagnoses including temporomandibular joint dysfunction pain, atypical facial pain and facial neuralgia, completed a questionnaire designed to measure illness behaviour. Compared to a control group of patients with minor odontogenic pain, IFP patients were more somatically preoccupied, could not accept reassurance from a doctor as easily, and were less likely to acknowledge psychological aspects of illness. These attitudes, similar to those reported by other intractable pain patients, are unlikely to be related to degree of organic pathology or chronicity of pain. Use of a discriminant function resulted in three-quarters of the total sample being correctly separated into the two clinical groups on the basis of their IBQ scores.

Adult↗
PubMed1981

Which science for psychiatry? The challenge of the behavioural therapies.

The advent of behavioural medicine has presented psychiatry with the need to re-examine its relationships to the human sciences on the one hand, and the natural sciences on the other. This paper discusses the essential differences between these two approaches as they are applied in the clinical situation. It is suggested that a need exists to marry these two ways of approaching patient problems and, in particular, for psychiatrists to improve their understanding of the hermeneutic mode of achieving understanding.

Behavior Therapy↗
PubMed1980

Depression in young women who have attempted suicide.

Findings from a questionnaire assessment of depression in three groups of young women whose suicide attempts were of widely differing medical lethality are reported. No significant difference in the degree of depression between patients whose suicide attempt required intensive care unit resuscitation, those who required some cautionary medical observation, and those whose attempt produced negligible physical effect was found. Furthermore, on the basis of a decision-rule applied to their questionnaire responses, one-third of patients in each lethality group were allocated to the "endogenous" category of depression. Recent literature delineating depression in younger patients is noted, and comment is made on the possible therapeutic implications.

Adolescent↗
PubMed1979

Further validation of a questionnaire method for classifying depressive illness.

A total of 367 patients admitted to a psychiatric facility completed the LPD questionnaire. By application a decision rule to their responses, they were classified as 'non-endogenous depression', 'endogenous depression' and 'non-depressive syndrome'. This classification was found to be associated significantly with their categorization on the basis of clinical diagnosis. The findings suggest that this method of classification on the basis of responses to the LPD may have a useful research and clinical role.

Adult↗
PubMed1979

The diagnostic utility index.

A method for quantifying the value placed on diagnostic accuracy is described. Named the Diagnostic Utility Index (DUI), it was completed by fifty subjects (including pathologists, physicians and medical students). Analysis of the responses reveals that attitudes to diagnostic perfectionism differ from one disease to another. It is suggested that the DUI may be useful in the clarifying of subjective factors which influence medical attitudes to the diagnosis and investigation of disease.

Attitude↗
PubMed1979

Personality and depressive illness.

This paper reports an investigation into the relationship between personality (as measured by the Sixteen Personality Factor Questionnaire) and depressive illness type, as determined by responses to the Levine-Pilowsky Depression Questionnaire. When the effects of age and depressive severity are accounted for, a significant difference emerges between "endogenous" and "non-endogenous" depressive states in that the former are associated with a lower score on Factor E, indicating a more submissive, dependent personality. The possible implications of this finding are discussed.

Adult↗
PubMed1978

Pain as abnormal illness behaviour.

In this article, the concept of abnormal illness behaviour is described, and chronic pain syndromes which represent variants of such behaviour are reviewed. Research using the Illness Behaviour Questionnaire has helped to elucidate aspects of chronic pain states, especially where a discrepancy exists between the patient's illness behaviour and the objectively assessed somatic pathology. Some comments are offered concerning the management of patients showing abnormal illness behaviour.

Attitude to Health↗
PubMed1977

Pain, depression, and illness behavior in a pain clinic population.

The relationship between depression, illness behavior and persistent pain was studied in 100 patients referred to the University of Washington Hospital Pain Clinic. The instruments used were the Illness Behavior Questionnaire (IBQ) and the Levine-Pilowsky Depression Questionnaire (LPD). To delineate those aspects of illness behavior characteristic of the Pain Clinic group, their scores were compared to those attained on the IBQ by a Family Medicine Clinic sample. The Pain Clinic group showed greater conviction of disease and somatic preoccupation than the comparison group. Further, they were reluctant to consider their health problems in psychologic terms, and denied current life problems. The Pain Clinic group's performance on the LPD indicated a low degree of depressive affect overall and few patients manifesting a depressive syndrome. The association between IBQ and depression scores suggests that the predominant clinical pattern presented by pain clinic patients is best characterized as a form of "abnormal illness behavior".

Adjustment Disorders↗
PubMed1977

Ethnicity and illness behaviour.

The 52-item Illness Behaviour Questionnaire (IBQ) was administered to 134 general practice patients of Greek, Anglo-Greek, and Anglo-Saxon origin. Responses were scored on 7 dimensions of illness behaviour labelled general hypochondriasis, disease conviction, psychological versus somatic perception of illness, affective inhibition, affective disturbance, denial and irritability. Results of a three-way analysis of variance (ethnicity, age and sex) indicated that Greek patients were significantly more likely to differ from Their Anglo-Saxon counterparts on the initial 3 IBQ scales. Compared with the Anglo-Saxon group, the Greek sample showed greater hypochrondriacal concern, were more likely to manifest conviction as to the presence of serious physical disease, and took a more somatic view of illness. Anglo-Greek patients varied from one scale to another in the degree to which their responses resembled the pattern of illness behaviour reported by Greek patients. They were most similar to the latter in their hypochondriacal attitude, and least similar in their psychological perception of illness. Although the IBQ responses to the Greek sample were consistent with patterns described in other studies of Mediterranean cultural groups, it was found that relationships observed between ethnicity and illness behaviour were to some extent dependent upon age and sex.

Adult↗