Biomedical subjects

S Zisook

Publications and source records attributed to S Zisook.

115 records · Page 7Linked to original sources

PubMedDate not supplied

Symptoms of interpersonal sensitivity in depression.

Six self-rated items of interpersonal sensitivity (IPS) were examined in 174 depressed outpatients. These items were "feeling critical of others," "your feelings being easily hurt," "feeling others do not understand you or are unsympathetic," "feeling others are unfriendly," "feeling inferior to others," "feeling shy or uneasy with the opposite sex." The population was grouped into tertiles based on their pretreatment IPS score. High levels of IPS were associated with earlier onset and greater chronicity of depression, higher Hamilton Rating Scale for Depression (HRSD) score, more severe depressed mood, guilt, suicidality, impaired work and interest, retardation, depersonalization, paranoia, and cognitive symptoms of depression. More frequent atypical features were found, e.g., overeating/weight gain, self-pity, phobic avoidance, and panic attacks. Response to a monoamine oxidase (MAO) inhibitor drug increased at higher levels of IPS, while the response to a placebo decreased.

Clinical Trials as Topic↗

PubMedDate not supplied

Psychiatric disorders in patients with fibromyalgia. A multicenter investigation.

The authors conducted an investigation in four tertiary-care centers to determine if psychiatric comorbidity and psychological variables were predictive of functional impairment in patients with fibromyalgia syndrome (FMS). Seventy-three individuals were administered the Structured Clinical Interview for DSM-III-R, the Rand 36-item Health Survey (SF-36), and multiple self-report measures. The patients with FMS were found to have a high lifetime and current prevalence of major depression and panic disorder. The most common disorders were major depression (lifetime [L] = 68%, current [C] = 22%); dysthymia (10% [C only]); panic disorder (L = 16%, C = 7%); and simple phobia (L = 16%, C = 12%). The self-report scales revealed significant elevations in depression, anxiety, neuroticism, and hypochondriasis. Functional impairment on all measures of the SF-36 was severe (e.g., physical functioning = 45.5 and role limitations due to physical problems = 20.0). Stepwise multiple-regression analysis revealed that current anxiety was the only variable that predicted a significant proportion of the variance (29%) in SF-36 physical functioning. Thus, in this multicenter study, the persons with FMS exhibited marked functional impairment, high levels of some lifetime and current psychiatric disorders, and significant current psychological distress. Current anxiety level appears to be an important correlate of functional impairment in individuals with FMS.

Adult↗

PubMedDate not supplied

The influence of HIV-related support groups on survival in women who lived with HIV. A pilot study.

To determine the effect of support groups on survival, the authors retrospectively studied 21 HIV-seropositive women who died during the course of participation in a natural history study of HIV. Groups were composed of women who self-selected HIV support groups before death (n = 11) and a comparison group (n = 10). Survival analysis found group participation to be associated with increased longevity (73 months vs. 45 months; P = 0.011). Proportional-hazards regression demonstrated that HIV-related support groups and smaller family size significantly influenced survival (P = 0.0002). Factors related to group participation and ways in which support groups might promote longevity are discussed.

Adaptation, Psychological↗

PubMedDate not supplied

Aging and bereavement.

This paper compares the grief responses of widows and widowers of different age groups over the 1st year of bereavement. The results strongly suggest that older widows and widowers perceive themselves as adjusting better to their loss and suffering from less depression and fewer anxiety symptoms than their younger counterparts. Furthermore, the oldest widows/widowers demonstrate the most consistent improvement in their levels of distress over time. Thus, when it comes to coping, older persons are not at the disadvantage that certain stereotypes and "clinical wisdoms" have previously suggested. Seniors are every bit as adaptive and able to cope with the severest forms of stress as anyone else, and they are, if anything, less prone to depression than are younger individuals.

Adaptation, Psychological↗

PubMedDate not supplied

Outpatient requests, initial sessions and attrition.

Treatment attrition in a psychiatric outpatient department was evaluated. Of eighty-two consecutive new patients, fifty-three (65%) showed up for a second appointment while twenty-nine (35%) failed to return. None of the demographic variables or specific categories of patient requests differentiated continuers from non-continuers; nor was attrition significantly influenced by feeling one's problems were understood, symptomatic improvement or receiving the kind of intervention originally desired. Treatment continuers were more likely to have been referred by other hospital clinics or psychiatric care facilities, and more often had previous outpatient contact, but these differences did not reach statistical significance. The only outcome measures significantly related to continuation were: perceiving one's feelings understood in the initial session, feeling satisfied with the interview, and planning to return for the next appointment. Theoretical and practical implications of these findings are discussed.

Adolescent↗

PubMedDate not supplied

Grief-related facsimile illness.

One aspect of the grief process which is frequently mentioned in the literature on mourning but has not yet received adequate clinical attention is the tendency for the bereaved to assume symptoms and behavior of the deceased. This paper presents evidence that pathologic identificantion 1) is an important clinical syndrome that is frequently misdiagnosed and mistreated, 2) defines a population at high medical and surgical risk, 3) can be diagnosed by history alone, and 4) carries a good prognosis when identified and properly managed. Four of a series of ten clinical cases are presented and discussed. Analysis of the cases reveals a number of common features, including 1) an arrest of the normal grief process; 2) a presentation of symptoms identical or nearly identical to those experienced by the deceased; 3) previous ineffective and inappropriate treatment endeavors; 4) referral for reasons other than a recognition of an abnormal grief state; and 5) improvement or recovery during treatment aimed at facilitating the grief response. Based on a survey of the literature and the clinical material analyzed, the authors conclude that patients who present with psychologic identification with the deceased have a distinct clinical syndrome (grief-related facsimile illness) for which recognition is important to institute proper management. Contrary to the reports in the literature, it frequently presents as other than hypochondriasis. When identified, this syndrome carries a good prognosis.

Adult↗

PubMedDate not supplied

Medical noncompliance.

Increasingly recognized as a major medical health problem, non-compliant patient behavior remains on e of the least understood and most frustrating phenomena facing today's physicians. Although no single characteristic of behavior adequately defines the potential non-complier, a variety of factors raises the index of physician suspicion. This papaer examined four general categories affecting non-compliant behavior: patient factors, illness factors, therapeutic regimen factors, and physician-patient interaction factors. Based on these elements, a set of management implications is defined and discussed as possible deterrents to non-compliant behavior.

Appointments and Schedules↗