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Biomedical subjects

R Mayou

Publications and source records attributed to R Mayou.

At least 37 records · Page 2Linked to original sources
PubMed1998

Psychological consequences of road traffic accidents in children.

Questionnaire information about possible psychological changes in the months following their accident was obtained for 45 school age children who had attended an Accident and Emergency Department because of their involvement in road traffic accidents. Central nervous system involvement was rare in this group. Short-term psychological consequences were common, but even after 4-7 months 33% were considered by their parents to still have a moderate reaction and a further 11% were considered to be severely affected. The children had high levels of post-traumatic stress symptoms, particularly avoidance in over 50%. Travel anxiety was described in 39%, 23% were depressed and 14% highly anxious--features which were considered by parents to have appeared following the accident, often with increasing disturbance over time. Other apparent repercussions were nightmares and other sleep difficulties in 17%, accident related fears, irritability, anger and emotionally regressed behaviour. As head injury was very uncommon in this series, such psychological consequences were attributable to non-neurological factors. Parents had become more protective of their children and placed greater restrictions on their travel, causing conflict. Younger children, those who had not fully recovered from their accident injuries, and children who also had a parent involved in the same accident, were most at risk. Greater awareness of these psychological consequences of road traffic accidents is required on the part of parents and professionals. Prospective studies are also needed to delineate more precisely those at greatest risk and to assess the effectiveness of treatment approaches.

Accidents, Traffic↗
PubMed1998

Chest pain, palpitations and panic.

Chest pain and palpitations are commonly described in the general population and are frequent presenting symptoms in all medical settings. Although often transient, they can be persistent and are associated with considerable disability, distress, and concern about heart disease and use of medical resources. Both symptoms are associated with panic but also with other psychiatric disorders. It is most useful to consider etiology as multicausal and interactive; psychological factors affect interpretation of bodily perceptions and have deleterious effects on quality of life and use of medical resources. There is evidence that general measures and specific drug and psychological treatments can be effective. There is still uncertainty about the most appropriate ways of providing effective care to large numbers of patients.

Arrhythmias, Cardiac↗
PubMed1998

Temporal relationships between physical symptoms and psychiatric disorder. Results from a national birth cohort.

BACKGROUND: Physical symptoms and psychiatric disorder are associated. We aimed to investigate which comes first. METHODS: Data from the Medical Research Council National Survey of Health and Development, a population-based birth cohort study were used at two time points: 36 and 43 years. Six physical symptoms were reported at both time points. The Present State Examination and Psychiatric Symptom Frequency interviews were administered at 36 and 43 years respectively. Odds ratios corrected for a variety of confounders were used to describe the associations between physical symptoms and psychiatric disorder across these two time points. RESULTS: Psychiatric disorder increased the odds of reporting symptoms 3-7-fold. The relationship strengthened when the outcome was defined as suffering from multiple symptoms. Population attributable risk of psychiatric disorder and subsyndromal disorder in causing multiple somatic symptoms was 40.3%. Prospectively, psychiatric disorder at 36 years was a predictor for five of the six physical symptoms. Three physical symptoms at 36 years predicted new onset of psychiatric symptoms at 43 years. CONCLUSIONS: Psychiatric disorder is strongly related to physical symptoms. The direction of causality may operate in both directions. Assuming a causal relationship, psychiatric disorder (including sub-threshold disorders) could account for at most 40% of cases of multiple physical symptoms.

Abdominal Pain↗
PubMed1998

GP frequent consulters: their prevalence, natural history, and contribution to rising workload.

A small proportion of patients use a disproportionate amount of general practitioners' (GPs') time. We demonstrate here that such frequent attending behaviour tends to persist through five-year follow-up, suggesting the need for the development of specific management strategies. We also show that, at any rate in one practice, total workload is increasing dramatically, and that frequent consulters make up a large part of the increase.

Adolescent↗
PubMed1997

Compensation claims following road accidents: a six-year follow-up study.

Systematic information was obtained on 96 subjects who were all those seeking compensation from a cohort of 172 consecutive road accident injury victims. Subjects were interviewed immediately after the accident, and again at three months and one year. Further telephone or postal information was obtained about compensation proceedings for up to six years. Compensation proceedings were often prolonged and final settlements were modest and late in relation to the losses suffered. Awards were largely used to make up financial losses. However, they failed to meet needs, especially the considerable early financial problems. There was no evidence that subjects exaggerated their losses; many preferred not to claim or to settle early. There was no evidence that settlement was followed by significant change in clinical state. There was considerable dissatisfaction with the procedures for obtaining compensation. Subjects were often more concerned with recognition of their distress and suffering than with the size of financial settlements. Seeking compensation was not a major predictor of medical and social outcome.

Accidents, Traffic↗
PubMed1996

Whiplash neck injury.

Whiplash, or post-traumatic, neck injury is an increasingly frequent clinical problem. Large numbers of patients present with both acute and chronic physical symptoms. It has frequently been alleged that psychological factors and social variables (especially the influence of possible compensation) are major causes of persistent physical complaints and disability. There have been few methodologically satisfactory studies, and very little attention has been paid to mental state and quality of life issues. Epidemiology, clinical features, prognosis, and aetiology are all reviewed with a special emphasis on psychological outcome and variables. It is argued that such factors are as important in relation to whiplash injuries as are other physical conditions, especially musculoskeletal disorders. In addition, specific posttraumatic symptoms are common but usually unrecognized.

Adaptation, Psychological↗
PubMed1996

Psychiatric aspects of food-related physical symptoms: a community study.

Beliefs about symptoms, food and health, mood disturbance, consulting behavior, and eating habits and attitudes were assessed by postal questionnaire in 273 adults who complained of food intolerance in a community study. In contrast to previous studies conducted in allergy clinics, most subjects who reported symptoms related to foods that were judged not to be allergic on clinical grounds did not manifest significant mood disturbance, impaired social adjustment, or excessive consultation for other nonspecific physical or psychological symptoms. Subjects attributing symptoms to food sensitivity suffered less psychological impairment than those attributing symptoms to other causes such as stress, stomach or bowel disorder, or food contamination. However, an important subgroup of patients did report marked impact of symptoms on everyday life, frequent consultation in traditional and complementary medical contexts, and appreciable mood disturbance. The reported association between perceived food intolerance and psychiatric disorder in allergy clinic patients is likely to be an artifact of referral bias.

Adult↗
PubMed1996

Outcome of 'whiplash' neck injury.

Psychological factors have been alleged to be important in the course and outcome of 'whiplash' neck injury but there is little quantitative evidence. This study uses quantitative methods involving a prospective interview assessment to describe psychological and quality of life predictors, and 3 and 12 month outcome. Consecutive attenders to the Accident and Emergency department of a teaching district hospital with a clinical diagnosis of 'whiplash' neck injury were included and there were follow-up interviews at home. Neck symptoms were recorded, and there was a standard mental-state interview with added questions about post-traumatic symptoms and a semi-structured interview for disability and consequences for quality of life. There was a wide individual variation in course and outcome; the majority of subjects complained of persistent neck symptoms and a sizeable minority reported specific post-traumatic psychological symptoms (intrusive memory, phobic travel anxiety), similar to those described by patients suffering multiple injuries. Social impairment, including effects on travel, were considerable in one-quarter. Reports of persistent neck symptoms were not associated with any baseline psychological variables or with compensation proceedings; psychological factors appeared to be more important in determining the extent of social impairment. We conclude that travel, social and psychological morbidity is substantially greater than previously recognized.

Adolescent↗
PubMed1995

Alcohol and road traffic accidents.

Twenty per cent of a prospective representative sample of subjects suffering road accident injury were classified as 'problem drinkers'. A third had blood alcohol levels > 80 mg/dl at admission. There were few changes in alcohol consumption or drinking in relation to driving at 1 year follow-up. No specialist help was offered during initial or follow-up hospital care.

Accidents, Traffic↗