[Selected aspects of psychological and social functioning of patients after surgical treatment of laryngeal cancer].
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The impact of partial-thickness facial burns on the behavior of adults was investigated. Burn injuries of the face often have a deleterious effect on the psychologic well-being of the patient. Even when no skin grafting is performed, there seems to be significant deterioration of the physical and emotional function of adults after they have incurred partial-thickness burns of the face.
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OBJECTIVE: Long duration of untreated psychosis (DUP) is associated with poorer outcome. The TIPS study demonstrated that DUP can be reduced through early detection (ED). As quality of life (QoL) is associated with DUP it is expected that reduction of DUP leads to better QoL. METHOD: Consecutive first-episode patients with a DSM-IV diagnosis of non-organic, non-affective psychosis were included, 281 patients gave informed consent and 263 completed a full evaluation of QoL. RESULTS: There were no differences in subjective QoL between ED and No-ED groups attributable to reduction in DUP. There were significant bivariate differences in frequency of family and social contacts in favor of the ED group, but multivariate analyses indicated that these differences were based on differences in sample characteristics. CONCLUSION: Deterioration in QoL may precede overt symptom formation. Focus on functional loss in ED educational campaigns may identify risk subjects earlier in the course of the disorder.
After controlled treatment with either imipramine or doxepin with additional psychotherapy, 30 patients with pure panic disorder and 20 with concomitant depression were followed under ordinary treatment conditions over a 5-year period. While the overall level of illness severity was mild in both groups (slightly worse in the group with comorbidity), social impairment as well as fluctuation of symptoms were similar in both groups. Therefore, comorbidity of panic disorder and depression does not necessarily imply a poorer outcome in a self-referred patient sample initially treated with psychotropic drugs combined with supportive psychotherapy.
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Cognitive impairment is present in the majority of schizophrenic patients, even at the onset of psychosis. It is a relatively stable characteristic in most patients, usually with little progression over the course of illness, but sometimes progresses to severe dementia. The results of studies of the effects of typical neuroleptic drugs on cognitive functioning in schizophrenia are conflicting. Clozapine, which has superior antipsychotic effects compared to typical neuroleptic drugs, has been reported to improve executive function, verbal fluency, attention, and recall memory in two of three studies. Cognitive measures predict work function and overall outcome on clozapine as assessed by the Global Assessment Scale and Quality-of-Life Scale in neuroleptic--resistant schizophrenia. Improvement in cognitive function by clozapine may be a major reason for expanding its currently limited utilization.
In order to identify the psychosocial factors that lead to the demand for medical care related to the menopause, we carried out a case/control study. A case was defined as a woman who sought gynaecological care due to "menopausal complaints" (n = 85) and a control referred to a woman drawn at random from the general population. The cases showed greater psychiatric morbidity and social dissatisfaction, a lower level of diffused social support and a higher frequency of severe life events and the controls showed greater social maladjustment in objective conditions. The multivariate analysis (logistic regression) carried out after adjusting all the relevant variables, indicated that the demand for medical care due to menopausal complaints was not only determined by the menopausal status itself but also by a set of social and demographic variables, especially dissatisfaction and a lack of social support.
OBJECTIVE: To evaluate the behavioral reputation and peer acceptance of pediatric bone marrow transplant (BMT) survivors. METHODS: Forty-eight BMT survivors (8-16 years of age) were compared to 48 nonchronically ill, same-classroom, same-gender comparison peers (COMP). Peer, teacher, and self-report data were collected. RESULTS: Relative to COMP, BMT survivors had fewer friends and were described by peers, but not teacher or self-report, as more socially isolated. In addition, peers described BMT survivors as being less physically attractive and athletically skilled. Further analyses suggested that these nonsocial attributes (physical appearance and athletic ability) and treatment variables (whether cranial irradiation was received) mediated the social difficulties of BMT survivors. CONCLUSIONS: These data are suggestive of an unremitting pattern of difficulties with peers that has the potential to disrupt normal social and emotional development. Differences between peer, teacher and self-reports highlight the need for multiple informants in future work.
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PURPOSE: The current study aimed to establish the management for biliary atresia (BA) patients in the late postoperative period. METHODS: Of 165 BA patients operated on in the authors' department, 44 patients (16 boys, 28 girls) with a follow-up period of more than 15 years were reviewed retrospectively. RESULTS: Forty-one of 44 patients (93.2%) currently are employed or highly educated, 7 are married, whereas 2 (4.5%) died, and 10 (22.7%) required liver transplantation after puberty. Four babies have been born from BA parents without congenital anomalies. Four girls conceived 5 times and delivered 3 newborns weighing 2,330 to 2,474 g including one delivered after transplantation. Maternal portal hypertension uniformly deteriorated during pregnancy, and one pregnancy was terminated. Menstrual disorder correlated significantly with the biochemical data related to liver function at puberty such as serum choline esterase (266 +/- 70.4 in 19 normal patients v 159 +/- 34.3 IU/L in 9 abnormal patients, P =.00057), asparate aminotransferase (42 +/- 30.8 v 96.0 +/- 63.6 IU/L; P =.0031), and serum albumin (4.6 +/- 0.4 v 3.9 +/- 0.6 g/dL; P =.013). CONCLUSIONS: The long-term survivors of Kasai's operation, with or without liver transplantation, have reached the next generation. Transgenerational follow-up and management including conception and perinatal care should be required for BA patients.
Observations of stumptail monkeys revealed frequent prolonged, intensive genital stimulation between individuals of the same sex, both males and females, adults and infants. These homosexual interactions occurred in positive emotional contexts, were accompanied by positive emotional facial expressions, and often were evidently elictied by the observation of heterosexual behavior. Infants' first copulations were performed with adults of the same or opposite sex who actively aided them. This suggests that homosexual and heterosexual encounters function as training for adult sexual roles, and that homosexual behavior is a basic primate pattern not exclusive to man.
This study investigated a diverse sample of girls (6-12 years of age) with attention-deficit/hyperactivity disorder (ADHD), combined type (n = 93) and inattentive type (n = 47), plus age- and ethnicity-matched comparison girls (n = 88), who participated in research summer programs. Speech and language problems, grade retention, and adoption characterized the ADHD sample; documented abuse characterized the combined type. Girls with ADHD showed dysfunction in terms of externalizing and internalizing behaviors and comorbidities, cognitive and academic performance, authoritarian parenting, and peer status. The inattentive type was more socially isolated but less rejected by peers than the combined type. ADHD-related impairment was independent of age and disruptive comorbidity. Further examination of processes related to psychopathology and competencies in girls with ADHD is needed.
The apomorphine-induced growth hormone (GH) response of 16 drug-free schizophrenic patients and nine control subjects were studied. The subgroup of nine patients with poor premorbid psychosocial functioning had a significantly lower GH response than the controls. Additional evidence for state dependent effects is provided.