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Results for “Adjustment Disorders”

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PubMed1998

Nephrolithiasis and risk of hypertension.

A positive association between nephrolithiasis and blood pressure has been suggested in previous studies. However, controversy remains, due to methodological problems in some of the previous studies and absence of prospective data. We evaluated the relationship between nephrolithiasis and the risk of hypertension in a cohort of 51,529 men followed prospectively for 8 years. Information was obtained by biennial mailed questionnaires. At baseline in 1986, 4111 (8.0%) subjects reported a history of nephrolithiasis and 11,623 (22.6%) a diagnosis of hypertension. A positive association was found between the two disorders (age adjusted odds ratio [OR]: 1.31; 95% confidence interval [CI]: 1.30 to 1.32). Among men who reported both disorders, 79.5% reported that the occurrence of nephrolithiasis was prior to or concomitant with the diagnosis of hypertension. Among men without hypertension at baseline, the odds ratio for incident hypertension in men with a history of nephrolithiasis compared with those without was 1.29 (95% CI: 1.12 to 1.41; adjusted for age, body mass index, and intake of calcium, sodium, potassium, magnesium, and alcohol). The occurrence of incident nephrolithiasis during follow-up was similar in men with hypertension at baseline compared with that in men without (adjusted OR: 0.99, 95% CI: 0.82 to 1.21). These data support the hypothesis that prior occurrence of nephrolithiasis increases the risk of subsequent hypertension.

Adult↗
PubMedDate not supplied

[Psychosocial functioning of children and adolescents dependent on inhalation of toxic substances].

Fifty persons of the age of 13 to 18 who had been stuffing themselves with steams of solvents, were medically examined. There were used medical (psychiatrical, neurological, internal) and psychological examinations--with the D. Weschler's scale of intelligence and questionnaire interviews obtaining from those who underwent the examinations and their parents. It was stated that the beginning of the intoxication was mostly preceded by the difficulties in social adjustment. Number of inter-related negative elements of biological and psychosocial nature were at the base of those difficulties from among which the substantial part was taken by disturbed family conditions and irregularly formed (for various reasons) personality of those peoples. The dependency was followed with more and more intensified social difficulties.

Adjustment Disorders↗
PubMed1998

Material standard of living, social class, and the prevalence of the common mental disorders in Great Britain.

STUDY OBJECTIVE: To test the hypothesis that poor material standard of living is independently associated with the prevalence of the common mental disorders after adjusting for occupational social class, and to estimate the population impact of poor material standard of living on the prevalence of these disorders. DESIGN: Cross sectional survey. Prevalence of the common mental disorders was assessed using the General Health Questionnaire, a self administered measure of psychiatric morbidity. PARTICIPANTS: 9064 adults aged 16-75 living in private households in England, Wales, and Scotland. MAIN RESULTS: The common mental disorders were significantly associated with poor material standard of living, including low household income (OR 1.24, 95% CI 1.00, 1.54) and not saving from income (OR 1.29, 95% CI 1.15, 1.45), after adjusting for occupational social class and other potential confounders. An independent association was also found with occupational social class of the head of household among women, but not men, after adjusting for material standard of living. The adjusted population attributable fraction for poor material standard of living (using a five item index) was 24.0%. CONCLUSIONS: Like mortality and physical morbidity, common mental disorders are associated with a poor material standard of living, independent of occupational social class. These findings support the view that recent widening of inequalities in material standards of living in the United Kingdom pose a substantial threat to health.

Adolescent↗
PubMed1988

DSM-III psychiatric disorders among Hmong refugees in the United States: a point prevalence study.

The author reports on a survey of 97 Hmong adult refugees in the United States. Thirty of these refugees showed symptoms of chronic maladjustment, and 13 showed another DSM-III axis I disorder; two manifested a paranoid psychosis, and six had a major depression. There were few axis II diagnoses. Medical conditions were frequent and often psychophysiological in nature, but they were not associated with axis I disorders. Axis IV psychosocial stressors were not associated with axis I diagnoses, but subjects with an axis I disorder tended to show lower adaptive levels on axis V. The demographic condition most strongly associated with an axis I diagnosis was current status as a welfare recipient.

Acculturation↗
PubMed1998

Is adoption a risk factor for the development of adjustment problems?

The extent to which being adopted increases a child's risk for the development of adjustment problems has been debated for decades. Results from studies examining prevalence of adopted children and adolescents in outpatient and inpatient mental health treatment suggest that the risk associated with adoption is modest or nonexistent. This body of research is reviewed and critiqued. Two possible explanations for the apparent disparate findings of the clinically based and nonclinically based studies are explored: biases in referral for mental health treatment and the influence of the shape of the distribution of adjustment problems in the adopted and nonadopted populations. Implications for clinical practice and future research are explored.

Adaptation, Psychological↗
PubMed2003

Emergency department use of persons with comorbid psychiatric and substance abuse disorders.

STUDY OBJECTIVE: This study assesses the relationship between substance abuse comorbidity and emergency department use among patients with psychiatric disorders in a large academic medical center. METHODS: Data were obtained from an administrative database including every patient visit to the ED of a large, academically affiliated county hospital from January 1994 through June 1998. This study focuses on 12,212 patients who were given a diagnosis of a primary psychiatric disorder in the ED. Diagnoses, assigned during ED visits, were made according to the Diagnostic and Statistical Manual of Mental Disorders III-R or IV. RESULTS: Primary psychiatric patients with substance use comorbidity had a significantly higher mean number of ED visits across the span of the study (mean 5.2; SD 7.4) than primary psychiatric patients without substance use comorbidity (mean 2.8; SD 3.9). In multiple logistic regression analyses predicting several categorizations of heavier use of the ED (either 4+, 8+, 12+, 16+, or 20+ visits over the span of the study), psychiatric patients with a comorbid substance use disorder had adjusted odds ratios of 2.8 to 4.9 (reference group was defined as patients with a psychiatric disorder but no substance use disorder; models controlled for age, race, and sex). CONCLUSION: Substance use comorbidity among patients presenting to an ED with a psychiatric disorder is associated with substantially increased ED service use. Improved detection, referral, and treatment of substance use disorders in this population could result in decreased ED use and improved patient outcomes.

Academic Medical Centers↗
PubMed1992

Common sleep disorders in the elderly: diagnosis and treatment.

Insomnia and daytime sleepiness in an elderly patient may be a normal consequence of aging, the result of a primary sleep disorder, or an adverse effect of medication or medical illness. Effective management requires a differential diagnosis. Adjustment sleep disorder, primary snoring, inadequate sleep hygiene, and mood disorders are common in the aged. The physician needs to review the patient history, including stressful events, medications, medical illness, and the possible presence of a psychiatric disorder. Treatment often involves behavioral changes and conservative use of medications, including antidepressants or benzodiazepines.

Aged↗
PubMed2005

The relationship between anxiety disorders and physical disorders in the U.S. National Comorbidity Survey.

Although depression has clearly been shown to be associated with physical disorders, few studies have examined whether anxiety disorders are independently associated with medical conditions after adjusting for comorbid mental disorders. We examined the relationship between anxiety disorders and a wide range of physical disorders in a nationally representative sample. Data came from the National Comorbidity Survey (N=5,877, range=age 15-54 years, response rate=82.4%). The Composite International Diagnostic Interview [Kessler et al., 1998] was used to make DSM-III-R [American Psychiatric Association, 1987] mental disorder diagnoses. Physical disorders were assessed based on a list of several conditions shown to respondents. All analyses utilized multiple logistic regression to examine the relationship between past-year anxiety disorder diagnosis and past-year chronic physical disorder. Anxiety disorders were positively associated with physical disorders even after adjusting for mood disorders, substance-use disorders, and sociodemographics. Among respondents with one or more physical disorders, a comorbid anxiety disorder diagnosis was associated with an increased likelihood of disability even after adjusting for severity of pain, comorbid mood, and substance use disorders. Among specific anxiety disorders, posttraumatic stress disorder, panic attacks, and agoraphobia were more likely to be associated with specific physical disorders than generalized anxiety disorder, social phobia, or simple phobia. There is a strong and unique association between anxiety disorders and physical disorders. Clinically, the presence of an anxiety disorder among patients with physical disorders may confer a greater level of disability.

Adolescent↗
PubMed1998

Practice parameters for the assessment and treatment of children and adolescents with depressive disorders. AACAP.

Child and adolescent major depressive disorder and dysthymic disorder are common, chronic, familial, and recurrent conditions that usually persist into adulthood. These disorders appear to be manifesting at an earlier age in successive cohorts and are usually accompanied by comorbid psychiatric disorders, increased risk for suicide, substance abuse, and behavior problems. In addition, depressed youth frequently have poor psychosocial, academic, and family functioning, which highlights the importance of early identification and prompt treatment. Both psychotherapy and pharmacotherapy have been found to be beneficial for the acute treatment of youth with depressive disorders. Opinions vary regarding which of these treatments should be offered first and whether they should be offered in combination. In general, the choice of initial therapy depends on clinical and psychosocial factors and therapist's expertise. Based on the current literature and clinical experience, psychotherapy may be the first treatment for most depressed youth. However, antidepressants must be considered for those patients with psychosis, bipolar depression, severe depressions, and those who do not respond to an adequate trial of psychotherapy. All patients need continuation therapy and some patients may require maintenance treatment. Further research is needed on the etiology of depression; the efficacy of different types of psychotherapy; the differential effects of psychotherapy, pharmacotherapy, and integrated therapies; the continuation and maintenance treatment phases; treatment for dysthymia, treatment-resistant depression, and other subtypes of major depressive disorder; and preventive strategies for high-risk children and adolescents.

Adjustment Disorders↗
PubMed1980

Psychiatric disorders in mentally handicapped children: a clinical and follow-up study.

The clinical psychiatric syndromes encountered in sixty mentally retarded children treated in a child psychiatric out-patient clinic setting are described. It was possible to classify these syndromes according to the multi-axial classification scheme for psychiatric disorders in childhood and adolescence. The children were followed-up for some years in many cases and the natural history of these disorders was in the main comparable to that of similar disorders in children of normal intelligence, although there was a tendency for some of the disorders to prove unusually persistent. Sometimes the persistence of these disorders seemed to be related to the children's continuing dependency needs arising from their mental retardation and to stresses within the family circle. The disorders responded reasonably satisfactorily to standard child psychiatric treatment techniques, and child psychiatric services should include the assessment and treatment of psychiatric disorders in mentally handicapped children within their remit.

Adjustment Disorders↗
PubMed1995

Acculturative stress among young immigrants in Norway.

The study examined the relationship between migration and the incidence of emotional disorders among 568 young Third World immigrants in Norway. Participants were 10-17 years of age. Using a questionnaire, acculturative stress (i.e., change in health status as a result of acculturation) was found to exist among the children, although having to migrate or being born in Norway was not related to mental health status. A stressful acculturative experience (i.e., difficulties in initiating friendship with Norwegian peers) alone could account for only 1% of the self reported emotional disorders. Incidence of depressive tendencies, poor self image, and psychological and somatic symptoms were found to be related to close and supportive parents, marginality, integration, gender and the number of friends the child had. These accounted for between 12 and 15% of the explained variance. The paper theoretically discusses how these factors may be related to acculturative stress, and recommends them as starting points for a primary intervention program to reduce emotional disorders among these children.

Acculturation↗