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PubMed1994

The course of psychological distress following threatened and actual conjugal bereavement.

We measured multiple dimensions of distress among spouses (N = 440) of patients hospitalized for serious illness or elective surgery and compared the course of distress over 2 years of follow-up among five groups according to whether and when spouses were bereaved. Distress was related to the severity of the patient's illness, the actuality and timing of the bereavement, as well as the gender and age of the respondent.

Anxiety↗
PubMed1976

Recessive hypophosphataemic rickets, and possible aetiology of the 'vitamin D-resistant' syndrome.

Two out of 3 children of a first-cousin marriage presented with severe rickets in infancy and are now adult. Their disease has shown continued activity, marked resistance to treatment with vitamin D, early fusion of cranial sutures, greatly increased bone density, nerve deafness, and life-long hypophosphataemia unaffected by treatment. Both parents and a third sib were normal clinically and biochemically. Blood grouping supported both stated paternity and parental consanguinity. Genetics of this unique disease can only be explained satisfactorily on the basis of autosomal recessive transmission, a mode not previously reported in primary hypophosphataemia. This homozygous disease resembles an exaggerated form of common X-linked rickets, though it is caused by a different gene. Although rare, it is particularly important because of the information it provides on the pathogenesis of both forms. We propose that both syndromes may result from multiple target organ unresponsiveness to 1,25-dihydroxycholecalciferol in intestine, kidney, bone, and parathyroid gland.

Adolescent↗
PubMed1997

Predictors and outcome in panic disorder: a 2-year prospective follow-up study.

53 patients presenting at an outpatient unit for anxiety disorders were included in the present prospective 2-year follow-up study. Sociodemographic, illness history, index rating, and 2-year follow-up data were evaluated. A multiple stepwise regression analysis was carried out in order to find predictors of the 2-year outcome. Results indicate that panic patients without episode at follow-up show less symptoms and a better psychosocial functioning than patients with episode at follow-up. Comorbid generalized anxiety disorder, duration of illness, and phobic avoidance behavior were found to be the best predictors of outcome. Conclusively, the present study confirms the most important predictors in patients with panic disorder.

Adult↗
PubMedDate not supplied

Permanent total parenteral nutrition: psychological and social responses of the early stages.

Permanent Total Parenteral Nutrition (TPN) is a life-saving but complicated procedure which has profound effects upon the lives of patients and their families, but there is a dearth of information on the the psychosocial consequences of this unique form of therapy. The authors worked with 19 consecutive TPN patients in hospital and after discharge and observed their reactions. It was found that the earliest stages were the most difficult, with anxiety, depression, fear, and negative body image predictable and universal experiences. Major adjustment problems centered around the loss of the basic function, eating. This artificial form of feeding forced multiple alterations in the patients' life styles. Their ability to cope with this intrusive procedure was related to the level of restitution of physical health, ego strength, and the family and hospital support systems. If, in addition to being a life-sustaining procedure, TPN is to restore the psychological stability of patients, all team members must be aware of the psychosocial factors involved.

Adaptation, Psychological↗
PubMedDate not supplied

Multivariate analysis of factors associated with smoking cessation in women.

BACKGROUND: Appropriate smoking cessation techniques, including counseling patients to stop smoking, could prevent multiple health-related problems. Identification of relevant factors in patients that smoke may be beneficial in targeting smoking cessation efforts. This investigation explores various factors associated with smoking cessation, specifically in women. METHODS: All women (n = 675) presenting to a breast health center over a one year period were surveyed regarding their tobacco use. Any association between smoking cessation and various factors was determined by multivariate analysis. RESULTS: Our population consisted of 47% African American women, 43% Caucasian women, and 10% women of other ethnicities. Sixty percent of all women never smoked. Of the women who had smoked, 57% quit. Except for alcohol use and exercise, no factor, including ethnicity, was associated with never smoking. Smoking cessation was associated with being married, being Caucasian, not using alcohol, and exercising. However, only Caucasian race and marriage were independently associated with smoking cessation. DISCUSSION: In our population, African American women had a lower proportion of smoking cessation than Caucasian women. In patients with similar access to care, specifically preventive care, there are ethnic and social differences in smoking cessation.

Adult↗
PubMedDate not supplied

Reproductive characteristics and the risk of breast cancer--a case-control study in Iran.

Breast cancer is a common malignancy for women in most parts of the world and the incidence in Iranian women is growing. The patients are relatively younger than their western counterparts. The present hospital based case-control study was designed to determine roles of reproductive factors for breast cancer among women in Iran. Conducted at a teaching hospital in Tehran, Iran, in 2004, the study covered a total of 303 cases of breast cancer and 303 healthy controls. Cases were identified through the Oncology Department of a university hospital and controls were collected from other wards or out-patient clinics at the same hospital. Control subjects were matched to patients for age. Informed consent was obtained from all cases and controls then demographic and reproductive factors were ascertained by in-person interview using a constructed questionnaire. Odds ratios and their 95% confidence intervals for breast cancer were derived using logistic regression analysis. The mean +/-SD ages of cases and controls were 48.8 +/- 9.8 and 50.2 +/- 11.1 years, respectively, (range 24-84). The final model for multiple analysis indicated that never married, post menopause, age at first live birth, number of live births, use of oral contraceptive pills, and history of chest X-rays between adolescence and 30 yrs of age, were significantly associated with breast cancer. Variables such as higher education, early age at menarche, abortion, breast feeding and its duration were not significant risk factors.

Adult↗
PubMed2006

Same-sex domestic partnerships and lower-risk behaviors for STDs, including HIV infection.

To determine the association between domestic partnership status and risk behaviors for sexually transmitted diseases, including HIV infection, we analyzed data from a population-based interviewer-administered telephone survey of 2,881 gay men in San Francisco, Los Angeles, New York and Chicago conducted in November 1996 to February 1998. Men in domestic partnerships had a statistically significantly lower prevalence of multiple partnerships, "one-night stands," and unprotected anal intercourse with a non-primary partner than either men with steady partners not identified as domestic partners or men without a steady partner. These findings were independent of age. Men in domestic partnerships had decreased risk behaviors for sexually transmitted diseases, including HIV infection, suggesting but not proving, that conferring legal status to same-sex unions might decrease sexual risk behavior.

Adolescent↗
PubMed1989

Spouses and children of disabled elders: how large a constituency for long-term care reform?

Over 13 million adults in the United States have disabled elderly parents or spouses and are potential providers of long-term care, financial assistance, or emotional support. Articles in the popular press notwithstanding, data from the 1984 National Long-term Care Survey indicate that a relatively small number of adult children and spouses assume the multiple responsibilities of elder care and child care or employment. These individuals form a subset of a much larger group of 4.2 million persons, however, who care for disabled parents or spouses. Current and future availability of spouses and children need to be considered in estimating the demand for formal long-term care and the costs of public programs.

Activities of Daily Living↗
PubMed1979

Degree of sobriety in male alcoholics and coping styles used by their wives.

The 'Coping With Drinking' questionnaire, administered to 124 A1-anon members, was factor analyzed and revealed nine identifiable styles of coping. Multiple regression analyses between three measures of sobriety and each of the nine styles of coping factors provide support for the general hypothesis that the coping styles used by wives of alcoholics are related to drinking outcome. Further, those modes of coping in which the wife communicates her feelings of distress and frustration to the drinking husband in a way which is minimally threatening for him seem to be most positively related to his attainment of sobriety.

Adaptation, Psychological↗
PubMed1991

Sedative-hypnotic drug use in Canada.

Although many studies of sedative-hypnotic drug use have been performed in Canada, there has been no national study of the use of these drugs. We have attempted to correct this deficit in our knowledge by using data from an international survey of health care utilization performed in 1968-9 and from the Canada Health Survey (1978-9), the Health Promotion Survey (1985) and the National Alcohol and Other Drugs Survey (1989) to examine sedative-hypnotic use among individuals aged 15 or more. The results suggest that the use of these drugs in Canada is about average for an industrialized society. Several socioeconomic and health care correlates of sedative-hypnotic use were found. The rate of use of these drugs was higher among women, the elderly, separated, divorced or widowed individuals, those who had a secondary school education or less, individuals with a low family income, the retired, and the unemployed. Among women, higher rates of use were reported by those whose main activity was keeping house (as compared with those who were employed outside the home) and by those who lived alone. Higher rates of use were also found for individuals who had consulted a physician or been hospitalized recently, individuals taking multiple drugs, those who scored highly on an anxiety scale, persons in whom negative feelings predominated, and those who had experienced a high frequency of psycho-physiological symptoms of anxiety and depression. From a regional point of view, the highest rates of use for women were consistently reported from Quebec, while the lowest were consistently found in the Prairie provinces. No consistent pattern was found for men.

Adolescent↗
PubMed1993

A community survey of neurological disorders in Saudi Arabia: the Thugbah study.

We report the findings of a total population survey of Thugbah community in the Eastern Province of Saudi Arabia (SA) to determine its point prevalence of neurological diseases. During this two-phase door-to-door study, all Saudi nationals living in Thugbah were first screened by trained interviewers using a pretested questionnaire (sensitivity 98%, specificity 89%) administered at a face-to-face interview. Individuals with abnormal responses were then evaluated by a neurologist using specific guidelines and defined diagnostic criteria to document neurological disease. The questionnaire was readministered blind by a neurologist to all those with abnormal responses and a 1-in-20 random sample of those without abnormal responses, respectively. The family members of an individual with an abnormal response were also screened to improve accuracy. A total of 23,227 Saudis (98% of the eligible subjects) were screened and those residing in Thugbah on the reference date (22,630) were used to calculate the point prevalence rates. Forty-two percent of those screened were in the first decade of life and only 1.5% were more than 60 years old. There were marginally more females (50.2%) than males (49.8%). Consanguineous marriages especially between first cousins were present in 54.6%. The demographic characteristics of Thugbah community were similar to those in other parts of SA. The overall crude prevalence ratio (PR) for all forms of neurological disease was 131/1,000 population. All subsequent PRs are per 1,000 population. Headache syndromes were the most prevalent disorder (PR 20.7). The PR for all seizure disorders was 7.60, and the epilepsies (6.54) were more frequent than febrile convulsions (0.84). Mental retardation, cerebral palsy syndrome, and microcephaly were common pediatric problems with PRs of 6.27, 5.30 and 1.99, respectively. Stroke, Parkinson's disease, and Alzheimer's disease were uncommon with respective PRs of 1.8, 0.27 and 0.22. Central nervous system (CNS) malformations (0.49) such as hydrocephalus and meningomyelocele were more prevalent than spinal muscular atrophy (0.13), congenital brachial palsy (0.13) and narcolepsy (0.04). Multiple sclerosis was rare (0.04). Osteoarthritis and low back pain syndromes were the main non-neurological conditions seen. The major medical diseases that may be neurologically relevant were diabetes mellitus, hypertension, and connective tissue disorders.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1980

Assessment of personality and demographic aspects of cohabitation and marital success.

The outcomes of 68 marriages of four-year duration were compared on the basis of whether the partners had or had not cohabited premaritally. Background characteristics and personality data were assessed on those couples when there were newly married, and they were followed-up four years later to determine their current marital status, level of satisfaction, difficulty with various problem areas and the number of children born to them. No reliable differences on marital satisfaction or divorce rates between premarital cohabitors and noncohabitors were found. Cohabitors who divorced did so while reporting less marital distress than noncohabitors who divorced. Premarital cohabitors had significantly fewer children than noncohabitors. Degree of difficulty experienced on various problem areas differed between the groups. Certain personality and background variables predicted marital success differently for the two groups. Using the same selected set of six predictor variables, multiple regression equations were generated for cohabitors and noncohabitors. The cohabitors equation (R2 = .56) predicted marital success significantly more effectively than the noncohabitors equation (R2 = .28), When comparing the tri-weight vectors for these two equations, none of the predictor variables had the same influence in both groups. Theoretical implications of the findings were discussed.

Journal Article↗
PubMedDate not supplied

Centripetal and centrifugal family life cycle factors in long-term outcome following traumatic brain injury.

The family life cycle model categorizes stresses on family systems in terms of their source and their effects on family members. Centripetal forces bring members together while centrifugal forces lead to loosened intrafamilial ties. This study examined the association of normative, developmental and centripetal illness-related family forces with patient outcome. Hypothesized centripetal and centrifugal forces acting on 65 families of married male TBI patients were used as independent variables in stepwise multiple regressions with criterion measures of quality of life outcome used as dependent measures. Centripetal variables included measures of family coping, marital adjustment, and number of years married. Centrifugal variables included number of children, age of oldest child, and amount of perceived financial strain. Regression equations obtained had multiple R's ranging from 0.623 to 0.407 (p values < 0.017). Results suggest that families normatively dealing with the developmental stage of the family with young children may face unique challenges when a husband sustains a TBI, particularly when financial strain exists. Stages in family development involving conflict between centripetal and centrifugal forces may be most problematic for families to resolve, and potentially the most effective periods for intervention.

Adaptation, Psychological↗
PubMed1990

Fanconi syndrome, ichthyosis, dysmorphism, jaundice and diarrhoea--a new syndrome.

We describe six infants, from consanguineous marriages, with a new syndrome comprising the Fanconi syndrome, ichthyosis, musculoskeletal abnormalities, jaundice and diarrhoea. In addition two of the infants were found to have abnormal platelet morphology--the grey platelet syndrome. No evidence of a recognised metabolic disorder was found in any of the six infants, nor did they appear to be typical of any previously described syndromes. Their progress was poor: they required high fluid and bicarbonate intakes and all died by the age of 6 months of dehydration, acidosis and sepsis.

Abnormalities, Multiple↗
PubMed1993

Familial Hirschsprung's disease: 20 cases in 12 kindreds.

This report describes 20 infants and children with a family history of Hirschsprung's disease in 12 kindreds. A total of 260 patients were treated for Hirschsprung's disease (1972 to 1991), yielding a familial incidence of 8%. There were no families with consanguineous marriage. Sixteen patients were male and four were female. The mean age at diagnosis was 18 days. Clinical presentation included delayed passage of meconium in 15, abdominal distention in 11, vomiting in 9, feeding abnormalities in 3, and complete bowel obstruction in 1. Associated congenital anomalies occurred in 25% of the patients. The extent of aganglionosis was rectal in 4, sigmoid in 4, left colon in 2, transverse or right colon in 2, and total colonic in 8. Enterocolitis occurred in 7 patients (35%); 2 at diagnosis, 2 after an ostomy, and 3 after a pull-through procedure. There were no deaths associated with enterocolitis. All patients had a proximal diverting colostomy or ileostomy, and 19 of 20 underwent a definitive pull-through procedure. Three patients were lost to follow-up and one patient died of complications of multiple congenital anomalies unassociated with Hirschsprung's disease. Of the remaining 16 patients, all of whom have undergone a pull-through procedure, 11 are fully continent, 2 have nighttime soiling, 2 are too young to evaluate bowel function, and 1 still has an ostomy.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Distribution↗
PubMed1991

Linking family characteristics with poor peer relations: the mediating role of conduct problems.

Parent, teacher, and peer ratings were collected for 75 grade school boys to test the hypothesis that certain family interaction patterns would be associated with poor peer relations. Path analyses provided support for a mediational model, in which punitive and ineffective discipline was related to child conduct problems in home and school settings which, in turn, predicted poor peer relations. Further analyses suggested that distinct subgroups of boys could be identified who exhibited conduct problems at home only, at school only, in both settings, or in neither setting. Boys who exhibited cross-situational conduct problems were more likely to experience multiple concurrent problems (e.g., in both home and school settings) and were more likely than any other group to experience poor peer relations. However, only about one-third of the boys with poor peer relations in this sample exhibited problem profiles consistent with the proposed model (e.g., experienced high rates of punitive/ineffective home discipline and exhibited conduct problems in home and school settings), suggesting that the proposed model reflects one common (but not exclusive) pathway to poor peer relations.

Child↗
PubMedDate not supplied

Increased depression and anxiety in infertile Japanese women resulting from lack of husband's support and feelings of stress.

We report that infertile women in Japan as well as in the Western world have high levels of emotional distress, anxiety, and depression. The reasons for anxiety and depression in infertile women are easy to presume but remain unclear. We conducted the present study to assess the relationship between the anxiety and depression of infertile Japanese women and their thought processes and emotional well-being with regard to their infertility. A cross-sectional questionnaire was administered to 101 infertile Japanese women who visited the infertility clinic at Tokai University. Inventories included the Hospital Anxiety and Depression Scale (HADS) and our original infertility questionnaire, which is composed of 22 questions to assess attitudes and emotional status in facing the stigma of infertility. After factor analysis, comparison between the HADS and the infertility questionnaire was made with simultaneous multiple regression analyses. Anxiety and depression in childless Japanese women were significantly associated with lack of husband's support and feeling stress. Our findings should prove useful in designing and implementing psychological support programs for infertile Japanese women. Psychological interventions to relieve or diminish these conditions might have significant therapeutic benefits for women attending infertility clinics in Japan.

Adaptation, Psychological↗
PubMed1991

Conflict in married couples: personality predictors of anger and upset.

This research had two central goals: to examine the role of personality in (a) performing actions that anger spouses, and (b) eliciting anger-provoking actions from spouses. Personality data on a sample of married persons (N = 214) were obtained from three sources--self-report, spouse-observer report, and independent interviewers' reports. In a separate session, subjects recorded which of 147 upsetting actions their spouses had performed in the past year. A series of hierarchical multiple regressions revealed the effects of Surgency, Agreeableness, Conscientiousness, Emotional Stability, and Intellect on evoking upset in spouses through condescension (e.g., treating spouse as stupid or inferior), possessiveness (demanding too much time and attention), abuse (slapping spouse), unfaithfulness (having sex with others), inconsiderateness (leaving toilet seat up), moodiness (crying a lot), alcohol abuse (drinking too much alcohol), emotional constriction (hiding emotions to act tough), and self-centeredness (acting selfishly). Discussion of this research focuses on the implications of personality for conflict in marital relationships.

Adult↗