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PubMed1989

[The significance of psychosocial complaints in the initial interview--a study of unselected patients of an internal medicine/polyclinic university ambulatory service].

In clinical practice one is repeatedly confronted with patients, who report psycho-social problems during the first interview. In this study 128 patients have been examined in the outpatient clinic at the Department of Medicine 1 of the University Hospital in Vienna. The most important issue investigated was to clarify whether or not the psycho-social complaints expressed at the initial interview could be correlated with either functional disorders or somatic disease. Further we tried to determine whether or not the complaints influenced the course of the disease and gave any indication for the presence of a depressive disorder or complicated a somatic disorder by additional psychosomatic complaints. Our results indicate that the expression of psycho-social problems indeed correlates with stronger psychosomatically conditioned body dysfunctions, but do not sufficiently explain whether or not functional disease can be expected. However, the reported psycho-social problems result in a stronger inclination towards depressive mood and lead the patient to his/her own explanation how the illness has developed. Both facts are of importance for the patient-physician relationship and constitute an integral part of the (non-)compliance.

Adolescent↗
PubMedDate not supplied

[The social hygiene problems of the prevention of venereal diseases].

The article is devoted to the questions of venereal diseases prophylaxis. The results presented allowed to elaborate united prophylactic system which includes different aspects of the problem. Complex prophylactic system worked up by the authors when implemented into public health practice yields exceptionally good results.

Female↗
PubMedDate not supplied

Shiftwork and cardiovascular disease: review of disease mechanisms.

This paper reviews the main findings concerning mechanisms explaining the increased risk of coronary heart disease (CHD) in shiftworkers. We discuss a conceptual model, in which three main shiftwork pathways to CHD are postulated--social problems, behavioral change, and disturbed circadian rhythm. Social problems that are associated with shiftwork might lead to stress. Significant shiftwork-related behavioral problems are smoking and unhealthy food habits. Disturbed circadian rhythm might result in sleep deprivation. Unphysiologic timing of physical activity and food intake in relation to circadian rhythms is another possible explanation for the negative impact on the cardiovascular system.

Cardiovascular Diseases↗
PubMed1982

Sexual abuse: a sociological perspective.

How have contemporary social changes affected the problem of child sexual abuse? The rapid rise of this problem to public attention in the United States is in part due to the mobilization around the problem by the women's movement and the child welfare movement there. But factors shown by research to be associated with the problem--social isolation and patriarchal authority--are so widespread as to suggest that this is a problem of international proportions, as well. The rising divorce rate in the U.S. and worldwide, would appear to put more children at risk at the same time that it has also made it easier for children and their mothers to escape from the most oppressive and intolerable family situations. The sexual revolution and the erosion of external controls on sexual behavior have also in all likelihood aggravated the problem, too. Sexual abuse needs to be seen as a problem distinct from physical child abuse--characterized by the preponderance of offenders who are males. This suggests searching for the sources of the problem in male sexual socialization rather than in problems of inadequate and disaffected parenting.

Adult↗
PubMed2006

Parent-rated behavior problems associated with overweight before and after controlling for sleep disordered breathing.

BACKGROUND: Researchers and clinicians are seeking to develop efficacious behavioral interventions to treat overweight children; however, few studies have documented the behavioral correlates of overweight children in community samples. The goal of this study was to determine the nature and prevalence of behavior problems for overweight school-aged children versus normal weight peers before and after controlling for the effect of sleep disordered breathing. METHODS: Hispanic and Caucasian children were invited to participate in a study of sleep through public elementary school classrooms. Anthropometric evaluation and behavioral ratings were collected for 402 children aged 6-11 years. Overweight was calculated using the Centers for Disease Control age- and gender-specific guidelines. Children were classified as overweight if they were at or above the 95th percentile for their age and gender group. Behavior problems were measured using the Conners' Parent Rating Scales-Revised and the Child Behavior Checklist. Sleep disordered breathing was assessed using in-home overnight polysomnography. RESULTS: Approximately 15% (59/402) of the sample was classified as overweight. Simple odds ratios indicated that overweight children were more likely to have clinically relevant levels of internalizing symptoms (OR 2.23, CI 1.05-4.72), psychosomatic complaints (OR 2.15, CI 1.02-4.54), withdrawal (OR 4.69, CI 2.05-10.73), and social problems (3.18, 1.53-6.60). When odds ratios were adjusted for level of sleep disordered breathing, withdrawal (OR 3.83 CI 1.59-9.22) and social problems (OR 2.49 CI 1.14-5.44) remained significantly higher for overweight subjects. CONCLUSION: After controlling for the effect of sleep disordered breathing, behaviors such as withdrawal and social problems, are common in overweight children and need to be taken into account in the design of interventions and services as they may act to moderate the efficacy of behavioral treatments.

Body Weight↗
PubMed2006

Grandchild, grandparent, and parent coresidence from 1970 to 1990: structural factors affecting state patterns.

This study analyzes structural forces affecting state patterns of parental presence within grandparent-grandchild coresidence by testing demographic, social change, policy environment, and social problems models. The project combines published state-level data with the 1970, 1980, and 1990 Census Public Use Microdata Samples. While factors differentially affect the proportion of children living in each household structure, coresidence seems to be encouraged by social contexts in which people are poor, the middle generation is likely to die, and which have higher rates of births to teens. State policy environment only affects proportions of children living in three generation households for 1980 and 1990. Structural variables other than social problems matter more for percent of children living in three generation households than for proportion of children living only with grandparents. Structural variables explain more variation in proportion of children living in skipped generation households than in proportion of children living with both parents and grandparents.

Demography↗
PubMed2006

School bullying and youth violence: causes or consequences of psychopathologic behavior?

CONTEXT: The causal relation between school bullying and psychopathologic behavior has been the focus of substantial debate. Previous studies have failed to garner causal evidence in either direction, largely because of methodologic constraints such as cross-sectional study designs, shared method variance, and analytic shortfalls. OBJECTIVE: To determine the direction of the causal relation between psychopathologic behavior and school bullying. DESIGN: Prospective cohort study. SETTING: Two Korean middle schools. PARTICIPANTS: A total of 1655 seventh- and eighth-grade students were studied between 2000 and 2001. MAIN OUTCOME MEASURES: School bullying was assessed by peer nomination, and 7 subscales of the Korean Youth Self Report were used to identify symptoms of psychopathologic behaviors. School bullying was categorized into 4 groups: victims, perpetrators, victim-perpetrators, and neither. A T-score on the Korean Youth Self Report greater than 65 was regarded as a clinically significant indicator. RESULTS: Social problems increased the risk of becoming a victim or a victim-perpetrator (odds ratio [OR], 2.3 and 2.7, respectively), and these associations disappeared when baseline bullying status was adjusted. Ten months later, individuals who were victims at baseline showed increased risk of social problems (OR, 3.9), those who were perpetrators had increased aggression (OR, 1.8), and victim-perpetrators had increased aggression and externalizing problems (OR, 4.9 and 4.6, respectively). Analyses that examined exposure history provided additional evidence for the causal effect of bullying experience on the later development of psychopathologic behaviors because most forms of psychopathologic behavior that led to new-onset bullying at follow-up were also present at follow-up, making it impossible to distinguish the temporal sequence of these variables and their causal relationship. However, most forms of new-onset psychopathologic behaviors at follow-up were associated with antecedent bullying experience. CONCLUSIONS: Our study results support the conclusion that psychopathologic behavior, including social problems, aggression, and externalizing behavioral problems, is a consequence rather than a cause of bullying experiences. This causal relation is supported by the strength and specificity of the association and the temporal antecedence of bullying. Because school bullying is a known correlate of youth violence, such a finding adds greater urgency to the search for programs to prevent or diminish bullying among schoolchildren.

Adolescent↗
PubMed1995

[Hospital discharge planning and length of hospital stay in elderly patients admitted through the emergency department].

A prospective study was organized in two teaching hospitals in Paris, including 426 elderly patients aged 75 and more, who had been hospitalized through the medical emergency department. The goal of the study was to assess the influence of difficulties of orientation at discharge on the length of stay, independently of other risk factors. The mean length of stay was 18.3 +/- 15.4 days. Orientation at discharge toward a social or a nursing care institution was associated with a 12 days longer mean length of stay than a home discharge. A longer length of stay was also associated with: a strictly social problem at admission, the diagnoses of dementia, confusion, social problem, fall or general health impairment, a short or long-term fatal prognosis, a poor mental status, refusal of home discharge as expressed by the referent person. Multivariate analysis showed that discharge toward a social or a nursing care institution was the first explanatory factor, explaining 12% of variance. These results suggest that the hospital discharge management has a major influence on the elderly length of hospital stay. Therefore, an interdisciplinary care management, including social and geriatric evaluation as soon as the patient is admitted at the emergency department, should be evaluated, in order to avoid problems of orientation that may occur at discharge.

Age Factors↗
PubMed1995

Predictive capacity of the AUDIT questionnaire for alcohol-related harm.

The Alcohol Use Disorders Identification Test (AUDIT) is a 10-item questionnaire designed to screen for hazardous and harmful alcohol consumption. We examined its ability to predict alcohol-related illness and social problems, hospital admission and mortality over a 2-3-year period. At initial interview, 330 ambulatory care patients were assessed using a detailed interview including the AUDIT questions and laboratory tests. After 2-3 years, 250 (76%) subjects were reassessed and their experience of alcohol-related harm determined. Of those who scored eight or more on AUDIT at initial interview, 61% experienced alcohol-related social problems compared with 10% of those with lower scores (p < 0.0001); they also had a significantly greater experience of alcohol-related medical disorders and hospitalization. AUDIT score was a better predictor of social problems and of hypertension than laboratory markers. Its ability to predict other alcohol-related illnesses was similar to the laboratory tests. However, gamma glutamyltransferase was the only significant predictor of mortality. We conclude that AUDIT should prove a valuable tool in screening for hazardous and harmful alcohol consumption so that intervention can be provided to those at particular risk of adverse consequences.

Adult↗
PubMedDate not supplied

[The prevention of HIV infection in abusers of psychoactive substances as a social behavioral problem].

This research has made it possible to outline and illuminate a range of problems which should be solved in planning concrete measures for the prophylaxis of HIV infection among the users of psychoactive substances. Such measures should also include those aimed at preventing children and adolescents from getting accustomed to the use of drugs at an early age, as well as the search of ways for providing adequate and effective information on the consequences of using narcotic drugs, the prevention of passage from single cases of the tentative use of drugs to systematic narcotization, etc.

Adolescent↗
PubMed2004

[Social support by an academic meeting].

This report is made for the Japanese Society of Child Neurology to determine the social problems regarding handicapped children and youngsters. In 2002, Social Activity and Public Relations Committee was organized in the Society, and immediately pointed out some social problems, such as medical care for severely handicapped children in special schools.

Child↗
PubMed1996

A profile of acute asthma patients presenting to the emergency room.

We conducted a three-month prospective study on the profile of 70 acute adult asthmatic patients presenting to the Accident and Emergency Unit of a general hospital. The overall background asthmatic activity, clinical features of current exacerbation, maintenance drug treatment, gross psycho-social problems, previous experience of near-fatal asthma, and admission and relapse rates were documented. Ninety percent of the presentations were within 24 hours of the initial attack, with an average pre-hospital therapy duration of 6.5 hours. Sixty-seven percent sought further treatment after failure to find relief from their salbutamol metered-dose inhalers. Sixteen percent did not receive any treatment before presentation. Ten percent gave a past history of mechanical ventilation for severe or near fatal asthma. The majority (94%) had asthmatic symptoms in the mild to moderate range. About half (46%) had attended the Emergency Room (ER) at least once in the previous six months. On average, patients were on two items of drugs and 23% were on maintenance inhaled steroids. One-third (33%) of the patients were found to have psycho-social problems relating to their condition. The admission rate was 37% with relapse rate following ER discharge of 13%. The study showed a high proportion of patients with psycho-social problems relating to asthma, and a subset of patients with frequent visits to the ER. It also revealed the infrequent use of prophylactic therapy.

Acute Disease↗
PubMed2004

Rumination, mood and social problem-solving in major depression.

BACKGROUND: Ruminating when depressed is thought to lower mood and impair problem-solving, while distraction is thought to alleviate mood and assist problem-solving. The present study investigates each of these proposals using both naturally occurring and experimentally induced rumination and distraction in a sample of patients with major depression. METHOD: Thirty-six patients with major depression and 36 control participants were randomly allocated to either a rumination or distraction induction condition. Levels of trait rumination and distraction were measured at baseline, mood and problem-solving were measured before and after the inductions. RESULTS: In terms of trait measures, depressed patients with higher levels of trait rumination reported poorer mood and gave less effective problem solutions than those who were less ruminative. Trait distraction was not associated with mood or problem-solving. In terms of induced responses, depressed patients who were made to ruminate experienced a deterioration in their mood and gave poorer problem solutions. For those receiving the distraction induction, mood improved in all patients and problem-solving improved in patients who were not naturally ruminating at a high level. Neither induction had an impact on mood or problem-solving in control participants. CONCLUSIONS: Treatment for depression associated with adverse life events may need to target rumination as well as problem-solving deficits if interventions are to be effective. The differential effects of self-applied versus experimentally induced distraction require further investigation. Future research will need to consider that high levels of trait rumination may interfere with the impact of experimental inductions.

Adolescent↗
PubMed2005

Cultural aspects of suicide.

Undefined cultural factors cannot be dismissed and significantly contribute to the worldwide incidence of death by suicide. Culture is an all embracing term and defines the relationship of an individual to his environment. This study seeks to investigate the effect of culture on suicide both regionally and internationally. Culture-bound syndrome with suicidal behaviours specific to a particular culture or geographical region are discussed. Opinions are divided as to the status of religious martyrs. The law itself is silent on many aspects of suicidal behaviour and despite decriminalization of suicide as self-murder, the latter remains on the statutes of many developing countries. The Caribbean region is of concern due to its steady rise in mean suicide rate, especially in Trinidad and Tobago where socio-cultural factors are instrumental in influencing suicidal behaviour. These include transgenerational cultural conflicts, psycho-social problems, media exposure, unemployment, social distress, religion and family structure. The methods used are attributed to accessibility and lethality. Ingestion of poisonous substances is most popular followed by hanging. The gender differences seen with regard to suicidality can also be attributed to gender related psychopathology and psychosocial differences in help-seeking behaviour. These are influenced by the cultural environment to which the individual is exposed. Culture provides coping strategies to individuals; as civilization advances many of these coping mechanisms are lost unclothing the genetic predisposition of vulnerable groups. In the management of suicidal behaviour, a system of therapeutic re-culturation is needed with an emphasis on relevant culture- based therapies.

Adolescent↗