Biomedical subjects

S Kisely

Publications and source records attributed to S Kisely.

20 records · Page 2Linked to original sources

PubMedDate not supplied

Somatic symptoms of distress: an international primary care study.

The objective of this study was to examine cross-national differences in somatic symptoms associated with psychological distress. Data from the World Health Organization (WHO) collaborative study of psychological problems in general health care (5438 patients at 15 sites) were used to examine somatic symptoms associated with psychological distress. At each site, a stratified random sample of consecutive primary care patients completed the 28-item General Health Questionnaire (GHQ) and the Composite International Diagnostic Interview (CIDI). At all sites, the number of current CIDI somatic symptoms (whether medically explained or not) was strongly associated with current psychological distress (measured by selected GHQ-28 items). Pearson correlation of somatic symptom count with psychological distress score was .42 for all sites and ranged from .20 to .58 (p < .0001 at all sites). Across all sites, anxiety and depressive symptoms showed roughly the same association with somatic symptom counts, and specific somatic symptoms or symptom clusters did not show differential association with anxiety or depression. Although somatic symptoms did cluster into meaningful groups (gastrointestinal, neurological/conversion, autonomic, and musculoskeletal), these symptom groups did not show differential association with psychological distress. Examination of individual somatic symptoms and symptom clusters across sites did not reveal clear patterns of association according to geography or level of economic development. These data show a strong association between somatic symptoms and psychological distress, which did not vary across disparate cultures and levels of economic development. Cultural factors, however, may influence the meaning attached to symptoms or the likelihood of presentation for health care.

Adolescent↗

PubMedDate not supplied

Predictors of mortality and morbidity following admission with chest pain.

This study aimed to identify the predictors of outcome in 102 patients following their first admission with acute chest pain. Outcome was measured at three months by interview and at five years by questionnaire. Chest pain, change in physical activity, return to work, smoking, psychiatric disorder, and mortality were assessed. The principal predictors of chest pain and smoking were previous psychiatric disorder and a diagnosis of non-specific chest pain; a previous history of psychiatric disorder was associated with a five-fold increase in the risk of continued chest pain at five-year follow-up (95% CI = 1.1-25.0). Psychiatric disorder at five years was predicted by psychiatric disorder at admission (adjusted odds ratio (adj OR) = 3.2; 95% CI 1.0-11.0) and non-specific chest pain (adj OR = 7.5; 95% CI = 1.7-32.1). Mortality at five-year follow-up was independently associated with older age (adj OR = 1.1; 95% CI = 1.01-1.2), an elevated Norris score (adj OR = 1.41; 95% CI = 1.01-1.96) and a previous history of psychiatric disorder (adj OR = 5.06; 95% CI = 1.13-22.0). These findings suggest that prediction of outcome, irrespective of underlying diagnosis, requires careful assessment of previous or current psychiatric symptoms in patients admitted with chest pain. Early intervention with psychological treatment for patients with non-specific chest pain should be considered; this may also involve help to reduce smoking. The study provides further evidence that mortality following myocardial infarction is closely linked to psychiatric disorder, but suggests that prior psychiatric disorder may be more important than 'post-infarction' depression. A larger study is needed to confirm these results.

Adult↗