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Biomedical subjects

M A Dew

Publications and source records attributed to M A Dew.

At least 91 records · Page 5Linked to original sources
PubMed1994

Awareness of cognitive deficits and anosognosia in probable Alzheimer's disease.

We examined the relationship between unawareness of cognitive deficits and psychiatric and neuropsychological manifestations in 181 patients with probable Alzheimer's disease (AD). Patients unaware of their cognitive deficits were more cognitively impaired, as measured by the Mini-Mental State Examination, and had a specific defect in 'frontal/executive' functions. The presence of major depression, delusions and hallucinations was no more likely among patients who were aware of their cognitive impairment than among those who were not. These findings have important implications for the understanding of anosognosia and deficit awareness in dementia.

Aged↗
PubMed1994

Speech motor control disorder after HIV infection.

We examined the clinical characteristics of six right-handed patients who developed speech motor control disorders after human immunodeficiency virus (HIV) infection. They exhibited an ataxic dysarthria, characterized by irregular articulatory breakdowns in consonant and vowel timing; were slow in timed decision-making tasks; and had impaired procedural learning. Other aspects of the neurologic examination revealed signs of diffuse CNS involvement including action-intention tremors, ataxic gait, and release signs. None developed HIV-associated dementia during 1 year of follow-up. Motor speech control disorder appears to be related to a cerebellar dysfunction.

Adult↗
PubMed1994

Psychosocial factors associated with risky sexual behavior among HIV-seropositive gay men.

The present study examines sociodemographic characteristics, levels of psychological distress, and coping styles among HIV-seropositive (HIV+) gay men who either did or did not engage in sexual activity which placed others at risk for HIV infection. Risky sexual behavior was defined as engaging in insertive anal intercourse. Respondents were 156 HIV+ men enrolled at the Pittsburgh site of the Multicenter AIDS Cohort Study in 1989-90. HIV+ men who engaged in risky sexual behavior, while similar to remaining HIV+ men on most sociodemographic characteristics, showed lower levels of psychological distress and somewhat higher feelings of control over their lives. Risky men were less likely to employ active, behavioral strategies for day-to-day coping with the issues of HIV infection and AIDS, and were more likely to report using recreational drugs to reduce tension associated with thoughts about HIV. This profile of psychosocial characteristics associated with risky sexual activity may lead to further refinement of educational and other intervention strategies with HIV+ men. Implications for such strategies are discussed.

Adult↗
PubMed1993

Depressive symptoms as predictors of medical outcomes in HIV infection. Multicenter AIDS Cohort Study.

OBJECTIVE: To ascertain whether depressive symptoms as determined by the Center for Epidemiologic Studies-Depression scale (CES-D) predict accelerated mortality and worse medical outcomes in patients infected with human immunodeficiency virus (HIV). DESIGN: Eight-year cohort study with semiannual follow-up. SETTING: Community volunteers. PARTICIPANTS: A total of 1809 HIV-seropositive homosexual men without the acquired immunodeficiency syndrome (AIDS) who entered the Multicenter AIDS Cohort Study in 1984 or 1985. Eight-year follow-up data were available on 75% of eligible participants. OUTCOME MEASURES: Times to AIDS, death, and prophylactic treatment, and slopes describing the decline in CD4 count for each individual participant. RESULTS: Using a conventional definition of depression (CES-D > or = 16 at the first study visit), 21.3% of participants were classified as depressed. Depressed participants had lower CD4 counts and reported more AIDS-related symptoms. There were no significant differences between depressed and nondepressed participants on any of the outcome measures (P > .05 in all cases). In contrast, men reporting AIDS-related symptoms had shorter times to AIDS and to death even after adjusting for CD4 counts (P < .01). The analyses were repeated, with similar results, using different definitions of depression based on the CES-D. CONCLUSIONS: We find no evidence that depressive symptoms independently prognosticate worse outcomes in HIV infection. Because of associations of depression with symptom reports, CD4 counts, and indicators of socioeconomic status, future studies of the relationship between depression and HIV outcome should consider these variables as confounders.

Adult↗
PubMed1993

Predictors of temporal patterns of psychiatric distress during 10 years following the nuclear accident at Three Mile Island.

The present study examines psychiatric symptom levels during a 10-year period in a community sample of mothers of young children. All were identified in the early aftermath of the 1979 Three Mile Island nuclear accident, and followed through the accident's 1989 anniversary. Cluster analysis was used to identify long-term distress profiles during the study period; women's temporal profiles were found to be either (a) stable and at low, clinically nonsignificant levels of distress across all measurement points or (b) at consistently elevated, clinically significant levels that varied with the timing of postaccident events such as the restart of the undamaged reactor and the 10th anniversary. Subsequent multivariate analyses indicated that preaccident characteristics, as well as parameters reflecting respondents' initial involvement with, and reactions to the accident, were important for distinguishing between women within the two temporal profile groups. Implications of the results for both policy formulation and continued research on significant environmental stressors is discussed.

Accidents↗
PubMed1992

Hand preference, immune system disorder and cognitive function among gay/bisexual men: the Multicenter AIDS Cohort Study (MACS).

This study evaluated the self-reported patterns of handedness among a large subsample (n = 1612) of the gay/bisexual men comprising the Multicenter AIDS Cohort Study (MACS). There was a small but significant elevation in left-handedness among gay/bisexual men compared to available normative data. However, there were no differences within the cohort in measures of immune function, self-reported autoimmune disorders, asthma, or hay fever, although there was an association between handedness and allergy. Performance on neuropsychological tests also did not differ as a function of handedness.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Effects of occupational stress on the physical and psychological health of women in a microelectronics plant.

Physical and psychological effects of occupational stress were examined in a sample of 552 female blue collar employees of a microelectronics facility. After controlling for demographic and biological risk factors, non-work life events, and solvent exposure, job-related conflict was associated with depressive symptomatology, severe headaches, lightheadedness weakness/fatigue, rashes, and presence of multiple symptoms. Job demands were only associated with multiple symptoms. Solvent exposure did not interact with either of the job stress measures synergistically to increase symptom reports. Although the main effects of social support, when present, were in the direction of reducing symptomatology, the interactive effects of social support and stress on health were inconsistent and dependent on the source of support.

Adult↗
PubMed1992

Mental health effects of job loss in women.

This paper reviews literature on the mental health effects of involuntary job loss among women. In addition, a prospective study of the effects of job loss on psychological distress in a cohort of blue-collar women is described. A total of 141 women, of whom 73 were laid off during the 12-month study period, were examined. The occurrence and duration of lay-off was significantly associated with increased depressive symptoms, but not anxiety-related symptoms, even after effects of pre-lay-off psychological symptoms, social supports and occupational stress were considered. There was no evidence that these effects of lay-off were moderated by other characteristics measured prior to lay-off. Among women who were laid off, those who reported poor levels of support from their husband or partner in the immediate aftermath of lay-off and those experiencing more financial difficulties during the lay-off had higher depression levels at follow-up. The nature of the lay-off as a chronic psychosocial stressor is discussed.

Adult↗
PubMed1991

Factors affecting service utilization for depression in a white collar population.

The present study examines rates of mental health service utilization among depressed individuals in a large white collar cohort. Clinical and psychosocial features of a recent depressive episode, as well as preexisting psychiatric and psychosocial characteristics, are examined for their ability to distinguish between individuals who (a) did and did not seek help during their episode and (b) chose to consult one professional source rather than another. Results showed that approximately one-third of the sample sought professional help. Respondents consulting mental health specialists were more clinically impaired and had poorer work performance and fewer psychosocial assets than both those consulting nonpsychiatric physicians and those seeking no help. Respondents in the latter two groups were indistinguishable from one another on many of the assessed variables.

Adult↗
PubMed1991

Work stress, family stress and depression in professional and managerial employees.

Detailed interviews were conducted with 1523 married professional and managerial employees of a major US corporation to test associations of acute and chronic occupational and domestic stress with DSM-III-R major depression and current depressive symptoms. After controlling for demographic and clinical risk factors, both sources of stress were significantly associated with the two measures of depression. On the other hand, neither the demographic and clinical risk factors, nor several psychosocial characteristics (social support, sense of mastery and organizational commitment) moderated the relationship between stress and depression.

Adaptation, Psychological↗
PubMed1991

Correlates of psychiatric distress among wives of hemophilic men with and without HIV infection.

OBJECTIVE: The authors' objectives were 1) to examine symptoms of depression, anxiety, and anger-hostility among the wives of men with hemophilia, a major risk group for AIDS, and 2) to identify psychosocial characteristics of the women and/or their husbands that were associated with elevated distress in the women. METHOD: Thirty-six women married to men with hemophilia were studied; the husbands of 17 of these women were HIV-seropositive. The men were drawn from the population of adults with hemophilia residing in a 24-county region of western Pennsylvania. Measures of wives' psychiatric symptoms were obtained, as were measures in three psychosocial domains: predispositional sociodemographic characteristics, psychosocial stressors, and husbands' strategies for coping. RESULTS: The psychiatric symptoms of the women did not differ as a function of their husbands' serostatus or across subgroups defined according to stages of HIV infection or clinical severity of hemophilia. Instead, other factors--perceptions of personal risk of AIDS, husbands' use of particular coping styles with respect to HIV infection, and the experience of other life events--were the principal correlates of psychiatric distress. CONCLUSIONS: HIV infection acted primarily as an indirect source of stress for these women, mediated by other psychosocial characteristics of both the women and their HIV-seropositive husbands. Mental health interventions for caregivers of HIV-seropositive individuals should target the identified psychosocial correlates of psychiatric distress.

Adaptation, Psychological↗
PubMed1991

Effects of unemployment on mental health in the contemporary family.

This article summarizes research conducted in the past 20 years concerning mental health effects of involuntary job loss. The majority of studies and previous reviews focus on unemployment effects on men. Although these studies are also reviewed, this article highlights studies of (a) the involuntarily unemployed woman, (b) the spouse of the unemployed person, and (c) their children. Within each of these research areas, the authors consider studies grouped according to their methodological strength for drawing causal inferences about the impact of job loss on psychological status, ranging from cross-sectional to longitudinal to prospective studies. The implications of the unemployment literature not only for future research but also for clinical practice are addressed. Knowledge of family effects of this stressful life circumstance is critical to developing effective treatment plans for patients who, although perhaps not the direct victims of job loss themselves, may nevertheless present with problems indirectly caused or exacerbated by unemployment within the family.

Adaptation, Psychological↗
PubMed1991

Behavioral, health and psychosocial factors and risk for HIV infection among sexually active homosexual men: the Multicenter AIDS Cohort Study.

We examined whether 644 homosexual men who engaged in receptive anal intercourse were at particularly elevated risk for seroconversion if they also possessed specific behavioral, health or psychosocial vulnerability characteristics. Of 11 potential factors examined, heavy drinking, moderate to heavy drug use, and younger age were significantly related to seroconversion. These variables were also associated with an increased number of sexual partners, anonymous sex, and failure to use condoms.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Infection with human immunodeficiency virus and vulnerability to psychiatric distress. A study of men with hemophilia.

We examined psychiatric correlates of human immunodeficiency virus (HIV) infection in a major risk group for acquired immunodeficiency syndrome, men with hemophilia. A central goal was to identify psychosocial factors associated with increased vulnerability to psychiatric distress after infection with HIV. Seventy-five hemophiliacs, 31 of whom were HIV seropositive (HIV+), were studied. The HIV+ men had elevated depression, anxiety, and anger-hostility symptom scores relative to those of men who were seronegative for HIV. There were no additional symptom differences among men according to infection stage or clinical severity of hemophilia. Men with any of eight psychosocial characteristics were particularly susceptible to effects of infection on mental health: a personal history of psychiatric distress before HIV diagnosis; familial psychiatric history; a high school education or less; low social support from one's wife; low family support; low friend support; a poor sense of mastery over one's life; and experiencing recent life events involving loss. The HIV+ men with one or more such characteristics were highly symptomatic; remaining HIV+ men had significantly lower symptom levels, similar to the low levels noted in the men seronegative for HIV. The findings provide initial empiric support for the notion that clinical services to alleviate emotional distress should be targeted to intervene on HIV+ persons' psychosocial assets and liabilities.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Health effects of long-term solvent exposure among women in blue-collar occupations.

The relationship of solvent exposure to self-reported neurologic and somatic symptoms as well as neuropsychological performance was examined in a sample of 567 female blue collar workers who were members of the International Brotherhood of Electrical Workers (IBEW). Structured interviews were conducted at IBEW offices. Five solvent exposure categories were derived--never exposed, exposed prior to but not during the past year, exposed during the past year but not currently, currently exposed less than 50% of the time, and currently exposed more than 50% of the time. No differences among the groups on neuropsychological performance were found. On the other hand, heightened exposure was significantly related to depression, severe headaches, light-headedness, room spinning, appetite difficulties, funny taste in mouth, weakness/fatigue, rashes, and abdominal pain after controlling for the effects of seven risk factors (age, smoking, moderate-heavy alcohol consumption, severe obesity, history of physician-diagnosed chronic illness, working in a clean room, and exposure to other chemicals). These findings are consistent with Scandinavian studies of solvent-exposed male workers and point to the need for careful prospective research.

Adult↗
PubMed1990

The advantage of multiple measures of quality of life.

The concept of "quality of life" is rich and multi-faceted. In the present paper, we argue that the very richness of the concept requires that we (a) evaluate multiple dimensions of quality of life in our studies and (b) include multi-item assessments of each dimension selected for study. Conceptual and psychometric advantages which accrue by using multiple measures are delineated. We discuss the way in which the use of multiple measures affects the selection of instruments, the source of information, and the mode of data collection. In addition, the application of multi-item assessments to the construction of health status indices is considered along with their use in health policy and cost-benefit analyses.

Data Collection↗
PubMed1990

Epidemiology of depression and alcohol abuse/dependence in a managerial and professional work force.

Detailed clinical interviews focusing on depression and alcohol abuse/dependence were conducted with 1870 managers and professionals drawn from a major US corporation. Among men, the lifetime and 1-year prevalence rates of DSM-III-R major depression were 23% and 9%, respectively. Among women, the rates were 36% and 17%, respectively. Lifetime and 1-year prevalence rates of DSM-III-R alcohol abuse/dependence were 16% and 4% for men, and 9% and 4% for women. Imposing a requirement that alcohol-related symptoms cluster together in time reduced the lifetime and 1-year prevalence rates to 11% and 3% for men and 5% and 2% for women. The odds ratio for the lifetime occurrence of depression and alcohol abuse/dependence with such clustering was 2.28. The three most important risk factors for depression were being female, separated or divorced, and having a family history of depression. For alcohol abuse/dependence, the most important risk factors were being male, unmarried, and having a family history of alcoholism. Manager/professional status, length of employment, hours worked per day, and supervisory responsibility were not statistically associated with either DSM-III-R major depression or alcohol abuse/dependence.

Administrative Personnel↗