Of 74 panic disorder subjects followed up after 7 years, five reported serious suicide attempts and three had completed suicide. Compared with subjects who had not made serious attempts, the serious suicide attempters (including the three suicides) were younger, and fewer of them were married. Also, the serious attempt group had an earlier, more gradual onset of illness. More of the serious attempters had personality disorders and coexisting major depression. At the time of original assessment, the serious attempters had more severe symptoms. These data suggest that among patients with panic disorder, serious suicidal behavior is associated with more severe psychopathology.

Adult↗

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Neurochemical, endocrine and immunological responses to stress in young and old Fischer 344 male rats.

Two experiments were performed. In the first, a 20 min conditioned emotional response (CER) paradigm was used to compare the neurochemical, endocrine and immunological responses to stress of 7- and 22-month-old Fischer 344 (F344) male rats. In the second, corticosterone levels 20 min following ether stress, and regional brain type I and II corticosterone receptor densities were examined using 7- and 17.5-month-old F344 male rats. Dopamine (DA) metabolism in old nonstressed rats was significantly reduced in the medial frontal cortex, neostriatum, nucleus accumbens and hypothalamus, but not in the amygdala. The CER procedure, nevertheless, increased medial frontal cortical, nucleus accumbens and amygdaloid DA turnover in both the young and old rats. The young and old nonstressed rats did not evidence differences in norepinephrine (NE) and serotonin (5-HT) concentrations. However, stress resulted in a decrease in medial frontal cortical 5-hydroxyindoleacetic acid (5-HIAA) and hypothalamic 5-HT levels in old but not in young animals. These observations suggest age-related differences in the response of central NE and 5-HT systems to stress. Ether and the CER procedure led to exaggerated corticosterone responses in the old rats (17.5 and 22 month, respectively). Hippocampal type I but not type II corticosterone receptors were decreased by 47% in the 17.5-month-old rats. Thus, age-related changes in hippocampal corticosterone receptor types do not occur in unison, and the exacerbated corticosterone response to stress precedes the reported down-regulation of hippocampal type II corticosterone receptors in aged rats. Age-related changes were not observed in the concentrations of corticosterone receptors in other brain regions, or in the prolactin response to stress. The old rats, however, evidenced a reduction in the availability of the renin substrate, angiotensinogen, and in stress-induced renin secretion. Immune function was impaired in the old nonstressed rats, and further compromised by exposure to the CER procedure. In comparison to the young control rats, the old nonstressed rats showed an increased percentage of splenic large granular lymphocytes, reduced splenic natural killer cytotoxicity, and impaired Con-A-stimulated splenic T lymphocyte proliferation. Reductions in T splenic cell proliferation and natural killer cytotoxicity were observed in the young rats subjected to the CER paradigm, but not to the same extent as in the old rats. These observations indicate that aging male F344 rats evidence major alterations in basal central monoamine, endocrine and immune functions, and an increased sensitivity of these systems to stress.

Aging↗

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The Iowa 500: precipitating factors in schizophrenia and primary affective disorder.

Explore the source record for details and available documents.

Affective Symptoms↗

PubMedDate not supplied

hsp70, hsp32, and grp78 are increased in thermally injured skin with and without antithrombin(human) concentrate infusion.

An acquired deficiency of antithrombin (AT), an anti-inflammatory protein, develops in patients with thermal injuries. Skin thermotolerance is regulated by heat shock protein (hsp) genes. hsp70, hsp32, hsp27, and glucose-regulated protein78 (grp78) were studied in burned and unburned human skin to determine whether correction of the AT deficiency modulated the intensity of expression of these proteins. Fifty-four human skin samples were prepared by Western blot analysis: 11 unburned and 22 burned control skin samples and 7 unburned and 14 burned skin samples from patients treated with AT(Human), or AT(H). The intensity of hsp32 expression in burned AT(H)-treated skin (P < .001) and in burned control skin (P < .01) was significantly increased compared with unburned control skin. The intensity of expression of hsp70 was statistically significant in burned AT(H)-treated skin compared with unburned control skin (P < .02), as was that of grp78 (P < .01). Thermally injured skin with or without AT(H) treatment had an increased expression of hsp70, hsp32, and grp78 compared with unburned control skin.

Adolescent↗

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Subjectivity of pain.

The aim of this article is to explore the sociopsychophysiological subjective nature of pain, using Melzack and Wall's gate control theory of pain. In addition, the basis of pain control will be examined.

Humans↗

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Subjectivity of stress.

Stress is a sociopsychophysiological response to environmental stressors. In this article the subjectivity of stressors and the stress response are explored. There is a critical appraisal of physiological and biological theories regarding stress.

Homeostasis↗

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Circadian rhythms. 1: Physiology.

Circadian rhythms are repeated psychophysiological patterns of the body. They are endogenously controlled and environmentally modified and are therefore a sociopsychophysiological phenomenon. Subjectivity of circadian rhythms occurs with relation to the individual circadian parameters and also within different individuals. The hypothalamus appears to be the master clock synchronizing the free-running rhythms of individual circadian control centres. Internal synchronisation occurs when the rhythms are within their homeostatic ranges.

Circadian Rhythm↗

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Relevance of the nature vs nurture debate to clinical nursing.

The philosophy of holistic care underpins nurse education, and the 'nature-nurture debate' is frequently used to facilitate discussion regarding the influence of interactions with the environment in 'shaping' the individual. A limitation to this approach is that much of the work cited in the literature relates primarily to psychosocial interactions. This conveys a narrow perspective on holism, and creates an impression that the debate cannot be applied to other aspects of health and wellbeing, yet models of nursing care emphasize the need for nurses to appreciate the interactional basis of health. This article uses examples from mental health, physical health and the influence of ageing, to argue that interactions must be viewed from a much wider perspective. Only in doing so can the principles and application of holistic care, and an understanding of the bases of health education practices, be appreciated.

Aging↗

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Clinical implications of circadian rhythmicity for nurses and patients.

Recent research suggests that our biological rhythms are regulated by the light/dark cycles and regular time cues in our environment which synchronize our internal body clocks to a 24-hour cycle. Altering these external cues can cause an imbalance, in psychophysiological variables which adversely affect an individual's performance and health. This article considers the implications of desynchronized circadian rhythms on nurses working shifts in a continually changing temporal environment. It then discusses the impact this has on patients, their illness and their care. The authors suggest ways in which an understanding of the principles of circadian rhythms can be used to reduce the negative effects of hospitalization on patients, possibly even aiding their recovery.

Adaptation, Psychological↗

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Homeostasis: a framework for integrating the life sciences.

Nurse education curricula continue to emphasize the holistic nature of health and ill-health. As a concept, holism recognizes that the interactions between a person and his/her environment are significant factors in shaping the individual, and important determinants of wellbeing. Psychosocial interactions as a basis for health now figure prominently in nursing curricula. In contrast, the applied biological sciences have increasingly become marginalized, yet knowledge of the biological construct of the individual, and an understanding of how it is influenced by psychosocial interactions, are also necessary if holistic care is the aim. Nursing models attempt to reinforce holistic principles, but the integrative nature of health and illness needs to be established before their application. This article proposes that the concept of homeostasis, and its relationship to systems theory, provides a workable framework for teaching the basis of health, and so forms a foundation for the application of nursing theory and nursing models.

Biological Science Disciplines↗

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The biosciences and fitness for practice: a time for review?

The learning of biosciences by preregistration students has been recognized as being problematic, and the need for better resourcing of education has been identified. The Project 2000 initiative (UKCC, 1988) expanded the breadth and dept of the curriculum content in order to support the delivery of holistic care, and so the resources for bioscience education seemed likely to remain limited. However, the UKCC has concluded that there has been a shortfall in the acquisition of practice skills by preregistration students (UKCC, 2001). To address this, new directives indicate that curricula should move to competency-based outcomes and use student-focused learning. However, there is a lack of clarity as to what the basic expectation is for bioscience learning at registration, and how this might be continued in postregistration programmes. The authors argue that if resources for bioscience teaching in preregistration curricula cannot be improved then it is time to review the situation to ensure that expectations are realistic and attainable. Criteria are required to establish exactly what life-long learning means in relation to the biosciences, from registration through to specialist practice.

Biological Science Disciplines↗

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Circadian rhythms. 2: Shift work and health.

Health is associated with normal synchronised psychophysiological circadian rhythms. Synchronisation is endogenously controlled and environmentally modified according to homeostatic principles. Desynchronisation occurs when the circadian rhythms are outside their homeostatic range; this is known as a phase shift. If phase shifts are imposed chronically, as in shift work, then continued desynchronisation (homeostatic imbalance) results in illness.

Circadian Rhythm↗