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Results for “Adjustment Disorders”

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PubMed1977

[Psychodynamic of depressions].

Chronic depressive reactions are seen especially in patients who cannot react adequately in the face of loss, because for psychological reasons they cannot give expression to their unhappiness. Examples are the abnormal grief reactions following severe loss, and also reactions to experiences which appear outwardly trivial, but which nevertheless are damaging to self-esteem. Inability to show dissatisfaction and inhibition of one's own aggressive tendencies are characteristic of depressive neurosis. The analysis of the relevant factors, which is important for differential diagnosis, and above all in treatment, should take into account the current personal and social situation of the individual, his earlier psychological development, his constitution, any supervening physical disorder, and the influence of environmental and cultural forces.

Adjustment Disorders↗
PubMed2006

Awareness of driving while sleepy and road traffic accidents: prospective study in GAZEL cohort.

OBJECTIVES: To examine the association between self assessed driving while sleepy and the risk of serious road traffic accidents (RTAs). DESIGN: Prospective cohort study. SETTING: France. PARTICIPANTS: 13 299 of the 19 894 living members of the GAZEL cohort, workers and recent retirees of a French national utility company followed up since 1989. MAIN OUTCOME MEASURES: Frequency of driving while sleepy in the previous 12 months, reported in 2001; rate ratios for serious RTAs in 2001-3, estimated by using generalised linear Poisson regression models with time dependent covariates. RESULTS: The risk of serious RTAs increased proportionally with the frequency of self reported driving while sleepy. After adjustment for sociodemographic characteristics, driving behaviour variables, work conditions, retirement, medical conditions and treatments, depressive symptoms, and sleep disorders, the adjusted rate ratios of serious RTAs for participants who reported driving while sleepy in the previous 12 months "a few times" or "once a month or more often" were 1.5 (95% confidence interval 1.2 to 2.0) and 2.9 (1.3 to 6.3) respectively compared with those who reported not driving while sleepy over the same period. These associations were not explained by any reported sleep disorders. CONCLUSIONS: Self assessed driving while sleepy was a powerful predictor of serious RTAs, suggesting that drivers' awareness of their sleepiness while driving is not sufficient to prevent them from having RTAs. Messages on prevention should therefore focus on convincing sleepy drivers to stop driving and sleep before resuming their journey.

Accidents, Traffic↗
PubMed1979

Comparison of the clinical effectiveness of "short" versus "long" stay psychiatric hospitalization. IV. Predictors of differential benefit.

One hundred seventy-three patients were randomly assigned to LT (long term, unlimited length of stay, mean 179 days) vs. ST (short term, 90-day limit) psychiatric hospitalization. Three-year follow-up results showed few between-group differences, although LT patients tended to be rehospitalized more and had superior relative ratings of psychopathology. Demographic and clinical data did not predict differential benefit from LT or ST hospitalization. Diagnosis did not generally predict differential benefit either, except that clinically diagnosed personality disorders, given LT as opposed to ST hospitalization, had poorer role functioning and less psychiatric treatments after discharge. Patients with a history of drug abuse did worse if given LT hospitalization in terms of role functioning and rehospitalization. Overall, this study agrees with other relevant studies in indicating that hospitalization should be kept as short as feasible.

Adjustment Disorders↗
PubMed1998

Psychiatric illness in patients with end-stage renal disease.

PURPOSE: We sought to determine the prevalence of psychiatric illness in hospitalized patients with end-stage renal disease. We also examined the association between end-stage renal disease treatment modality and risk of hospitalization with a diagnosis of a mental disorder, and compared rates of hospitalization with a diagnosis of psychiatric illness in renal failure patients to patients with other chronic medical illnesses. SUBJECTS AND METHODS: We performed a cohort study of all Medicare-enrolled dialysis patients in 1993. Risk of hospitalization with a diagnosis of a mental disorder among renal failure patients was compared with Medicare patients with diabetes mellitus, ischemic heart disease, cerebrovascular disease, and peptic ulcer disease. RESULTS: Almost 9% of all dialysis patients were hospitalized with a mental disorder. Men, African-Americans, and younger patients were more likely to be hospitalized with a mental disorder. The adjusted risk of hospitalization for peritoneal dialysis patients was lower compared with hemodialysis patients for any mental disorder, depression, and alcohol and drug use. Hospitalization with mental disorders was 1.5 to 3.0 times higher for renal failure patients compared with other chronically ill patients. CONCLUSIONS: Hospitalization with a psychiatric illness is common among the US end-stage renal disease population. Depression, dementia and drug-related disorders were especially common. The coexistence of psychiatric illness in patients with renal failure who require specialized medical regimens represents a challenge to nephrologists in diagnosis and treatment. Disparities between hospitalization rates of psychiatric illnesses among end-stage renal disease patients compared with other chronically ill populations warrant further research.

Aged↗
PubMed1999

Soluble cytokine receptor CD30 in atopic disorders: a case-control study.

BACKGROUND: The cytokine receptor CD30 is an activation marker of T cells which preferentially associates with the production of the TH2 cytokine IL-4. Therefore, it may potentially be a candidate marker for atopic disorders and a target molecule for new therapeutic approaches. OBJECTIVE: To test the hypothesis that elevated levels of soluble CD30 (sCD30) are significantly associated with atopic disorders after adjustment for other predictors of atopy. METHODS: The presence of elevated sCD30 (> or = 20 U/mL) in atopic disorders was evaluated in a nested case-control study. Cases (n = 60) were blood donors with specific IgE antibodies, total serum levels of IgE > or = 100kU/L and presence or history of allergic symptoms. Controls (n = 59) were blood donors without presence or history of allergic symptoms and serum levels of IgE < 50 kU/L. sCD30 was determined from serum samples by an enzyme-linked immunosorbent assay. Odds ratios (OR) and confidence intervals (CI) were calculated from logistic regression coefficients. RESULTS: Mean sCD30 levels for cases were 75 U/mL (SD 110U/mL) as compared with 35 U/mL (SD 59 U/mL) for controls. Serum levels of sCD30 were elevated in 65% of cases and 32% of controls (OR 3.9, 95% CI 1.8-8.4). The odds ratio for elevated sCD30 as a predictor of atopic disorders slightly decreased to 3.7 after controlling for smoking, age and gender. Blood eosinophilia which was a strong predictor of atopy (OR 11.7) was a weak confounder of the association between sCD30 levels and atopic disorders. Family history of allergy, another strong predictor of atopy (OR 8.6), did not confound the association. CONCLUSIONS: The results are consistent with the hypothesis that CD30 is involved in the pathogenesis of atopic disorders independent of eosinophilia and family history of allergy.

Adolescent↗
PubMed1983

Judging change in psychotherapy. Reliability of clinical formulations.

Careful clinical formulation describing the dimensions of core neurotic conflicts is integral to the practice of psychodynamic psychotherapy. Therefore, a method for reliable and valid formulation is a necessary precursor for the empirical investigation of the impact of such therapy. Our study evaluated a method of outcome assessment based on clinical formulations. Results from 18 patients indicate that independently derived formulations of a central conflict do not agree and that these disagreements in formulation are reflected in disagreements in the change ratings that are based on them. Additional analyses suggested that symptomatic change represents the major component in outcome rating.

Adjustment Disorders↗
PubMed1984

Coping with stress: naturalistic observations of the Polish crisis.

Naturalistic observations were made while the author was living and working in Poland as a visiting professor at the Institute of Psychology, Warsaw University, from October through December 1981. Social, political, economic, and interpersonal elements of the Polish "crisis" and reactions of the Polish people to these stressors are described. Individual patterns of coping with stress are categorized in terms of people's beliefs about the causes of stress and beliefs about personal control over the causes of stress. Three groups are identified: People who were certain that they could or could not modify the causes of stress and, therefore, coped by taking action ("fight" or "flight"); people who were uncertain about their capacity to modify the causes of stress, but believed that they could manage their daily lives; and people who believed that their only realm of influence was over intrapsychic events and coped via control over intake of information (repression or sensitization). The relative success of the different coping strategies is considered. Finally, the imposition of martial law and people's reactions to it are described.

Adaptation, Psychological↗
PubMed1986

Current and lifetime incidence of psychiatric disorders among a group of extremity sarcoma survivors.

Thirty-five survivors of extremity sarcomas being followed in a University-Hospital orthopedic clinic were evaluated for current and lifetime presence of psychiatric disorders. Patients were assessed for cognitive abilities using the Cognitive Capacity Screening Examination and for psychiatric disorders using a structured interview format, the Schedule for Affective Disorders and Schizophrenia-Lifetime version. The criteria for psychiatric disorders were the Research Diagnostic Criteria. Two patients were excluded because of cognitive deficiencies; thirty-three patients (mean age = 37.7 yr) were formally evaluated at a mean time of 2.6 yr following cancer diagnosis and surgery. Forty-five per cent of patients were given the diagnosis of at least one lifetime psychiatric disorder. Fifteen per cent of patients reported a current episode. Affective disorders and alcoholism were the most frequently reported disorders.

Adaptation, Psychological↗
PubMedDate not supplied

Depression in the medically ill. Critical issues in diagnostic assessment.

Diagnosing depression in the medically ill is a difficult diagnostic task that will not be clarified appreciably by DSM-IV. The author reviews diagnostic validity as it relates to depressive disorders in the medically ill. Suggested guidelines for using the DSM-IV to diagnose depressive disorders in the medically ill also are reviewed.

Adjustment Disorders↗
PubMed1990

Reliability and validity of the structured interview for personality disorders in adolescents.

The Structured Interview for the DSM-III Personality Disorders was administered to 23 currently affectively ill adolescents and their parents. Interviews were videotaped and rerated; interrater agreement was moderate (weighted K = 0.49; unweighted K = 0.59). Moreover, there was evidence of convergent validity for Cluster II traits and disorders (borderline, histrionic, narcissistic), insofar as these diagnoses were associated with higher scores on the novelty-seeking subscale of the Tridimensional Personality Questionnaire as predicted. Cluster II patients tended to have higher rates of attention deficit disorder and bipolar disorder, and higher rates of suicidal gestures among second-degree relatives. Some difficulty was encountered differentiating symptoms of affective illness from those of personality disorder and in deciding when personality traits were impairing enough to call them disorders. Reliability may be improved by: (1) interviewing patients when out of affective episode; and (2) using standardized functional impairment criteria for differentiating personality style from disorder. Additional work is advocated to learn if personality disorders are precursors, epiphenomena, or the consequences of affective disorder.

Adjustment Disorders↗
PubMed1982

Early life experiences and psychiatric disorders: an adoptee study.

The aim of this study was to investigate whether there is any correlation between negative experiences in early infancy and the later occurrence of psychiatric disorders. The subjects in this study were a cohort of 2,215 adoptees born 1930-1949. Information about the probands' early experiences has been obtained from the files of the Child Welfare Office, which include age at time of placement in the adoptive home and type of care before placement. 136 of the probands had been treated in a psychiatric department or mental hospital. From the case records a uniform classification of diagnoses was made. The analyses have been carried out in two steps; first as repeated univariate analyses and secondly as series of discriminant function analyses. Reactive neurotic depression was significantly correlated with placement at the age of 6-12 months, but with this sole exception there was no support for the hypothesis of a correlation between psychiatric disorders and early experiences.

Adjustment Disorders↗
PubMed1995

Marital adjustment and depression.

Twenty patients diagnosed major depression and 20 matched normal control subjects were compared in terms of marital adjustment and other related features. Marital adjustment reported by the depressed group was significantly worse than that of the normal group. Both groups, however, had adjustment scores above the cut-off point for maladjustment. These results question the causal role ascribed to marital maladjustment in the genesis of depression.

Adjustment Disorders↗