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PubMed1991

[Disability pensions among immigrants in Oslo].

The prevalence of vocational disability pensions is now much higher among immigrants from Pakistan, Turkey and Morocco who settled in Norway in the late 1960' and early 1970' in order to find work than among the Norwegian population in general. The present study covers two cohorts of males and females aged 40-44 and 50-54 years of age in receipt of disability pensions. Musculoskeletal pain syndromes are far more prevalent among the immigrants as basis for a pension than among the Norwegian disabled population. In contrast, psychiatric diagnoses are less frequent among the immigrants. The above differences are discussed. The living conditions and particularly the working conditions of the immigrants, whose jobs are characterized by physical hardships and long working hours, may be an important reason for the high prevalence of vocational disability. Psychiatric diagnoses may be concealed because of their stigmatizing nature. Early retirement from work is more common in the countries from where the immigrants came and they thus tend to apply for a disability pension. This means that the Norwegian insurance system, with its rather liberal policy of consent, takes over many of the social and economic obligations which were traditionally part of family and kinship obligations in the former culture of the immigrants.

Adult↗
PubMed1991

[Local therapy measures in HIV-associated Kaposi's sarcoma with special reference to fractionation radiotherapy].

In 23 patients with HIV-associated Kaposi's sarcoma 53 tumor lesions were treated with fractioned radiotherapy. Indication for the radiotherapy were mostly cosmetic reasons in stigmatizing tumors, but also in several cases pain, oedema or functional deficits as a result of the tumor lesions. 21 patients received orthovoltage irradiation, the remaining four patients were treated with telecobalt therapy. A complete response was observed in 17%, a partial response in 76% and unchanged lesions in 4%. In two cases (4%), both were treated with telecobalt-therapy by large tumor masses, there occurred a further tumor progression inspite of the radiotherapy. In ten lesions, all with partial remission, we later observed a repeated tumor progression. Important side effects were signs of inflammation as mucositis and edema or hyperpigmentation. The occurrence of acute side effects can be reduced by fractionating of the radiotherapy.

Adult↗
PubMed1991

The stigma of port-wine stains.

Patients with port-wine stains are now able to receive treatment to improve significantly their birthmark. Questionnaire studies of these patients have revealed considerable psychological distress. This article reviews the nature of that distress and the stigmatization suffered by patients with disfiguring birthmarks.

Attitude to Health↗
PubMed1990

[Psychological and social stress in children with cleft lip and palate].

UNLABELLED: The authors analyzed representative data on the increase of inborn developmental defects in Czechoslovakia; in 1970-1980 the increment was + 50%. Inborn developmental defects are studied from the psychiatric aspect as a stimulus causing a reaction of the family to the breakdown of their parenteral expectations of a healthy child and the problem of continuation of the family. The reaction of the mothers is usually post-partum depression and impaired development of attachment to the child. The handicapped child is stressed by operations, rehabilitation, the awareness of his own insufficiency and problems of parenteral attitudes. The authors investigated the family-history, development of the health status of the children, social status of the children and personality of mother and child. PRINCIPAL FINDINGS: children with cleft lip and palate suffer from social stigmatization and specific disorders of self-evaluation. In these children problems associated with adaptation in the child community, manifestations of depression, low self-esteem, impaired ego identity and a tendency of a negative attitude to the world were recorded. These phenomena increase with the severity of the damage and the visibility of the defect. If the mother bagatellizes or refutes the defect to achieve social desirability, the psychic position of the child is even worse. Approximately half the mothers and children expressed the need of special psychological care of problems associated with the defect. Actual areas are defined on which the need of care is focused in different stages of the family life cycle. The authors discuss the need of a realist attitude and acceptance of the defect in the interest of satisfactory adaptation, and the possibility of the paeditrician to assist families.

Adolescent↗
PubMed1990

[Suggestions for criteria for uniform evaluation of changes in the spine in vertebral dysostosis of the Scheuermann type].

The author recommends in his proposal of uniform criteria to evaluate pathological changes of the spine according to a pattern where the first place is held by morphological changes (unevenness of the covering plates, changes in the shape of bodies of the vertebrae, changes in the height of disc and changes in the curvature of the spine). The second place in held by functional changes and the third one by the general extent and quality of pathological changes. In the latter group the author draws attention to the appearance of a stigmatized spine. It is essentially an abortive form of vertebral dysostosis with frust not very marked morphological symptoms. He draws attention to the importance of this form for explanation of an obscure vertebral algic syndrome, in particular in children. The unform evaluation of these pathological changes should help to establish order in the hitherto controversial problem of evaluation of vertebral dysostosis.

Adolescent↗
PubMed1990

[A survey of the social and psychological effects of psoriasis].

338 patients with psoriasis (male: 213, female: 125) who have been treated in our department from 1979 to 1988 answered a questionnaire concerning social and psychological effects of the disease. The mean age of onset was 33 years; 35 years for the male and 29 years for the female. Social and emotional morbidity was present for many patients despite the access to modern treatments. The worst feeling about having psoriasis was general appearance of the skin (41.7%), itching (19.5%), flaking of the skin (16.9%) and time-consuming or messy treatment programs (13.3%). A large percentage of patients avoided common social activities, for example, communal baths, swimming, and sports. Triggering factors of psoriasis were climate (60.3%), stress (46.9%), sleeping disturbance (34.6%), irregular life (32.2%), and low humidity (22.5%). 18.6% of patients were affected in choosing the occupation by having psoriasis. Many patients felt stigmatized as the disease is contagious or genetic. Most of the patients learned psoriasis through doctors, however, 75.7% of them wanted to get more informations. Finally, since only 26.3% of patients were satisfied with current therapeutics, dermatologists seem to be too self satisfied with present managements. It is important for us to understand what the patients are really suffering from and what the patients really want. And, it also is important to make efforts for a better understanding of psoriasis in society.

Activities of Daily Living↗
PubMed1990

Psychiatric morbidity in the infertile population: a reconceptualization.

The understanding of psychiatric morbidity in the infertile population relies to a great extent upon the instruments used to measure psychopathology. The present study investigated the distinction between psychiatric morbidity and infertility strain reactions in a sample of 104 infertile couples using the SCL-90-R. Some symptoms ordinarily indicative of psychopathology can represent normal side effects or reactions to infertility treatment, thus causing spurious estimates of pathology. Alternately, item analyses revealed a profile of infertility strain reflecting tension, depressive symptoms, worry, and interpersonal alienation frequently occurring among both male and female infertility patients. The concept of infertility strain is suggested as a vehicle for understanding the functioning of infertile patients and to circumvent the stigmatizing effects of psychiatric labels while providing appropriate intervention.

Adult↗
PubMedDate not supplied

The cystic fibrosis gene: medical and social implications for heterozygote detection.

The primary goal of mass screening programs for cystic fibrosis carriers should be to allow people to make more informed reproductive decisions. However, previous experience with genetic screening programs, including those for phenylketonuria and sickle cell disease, have revealed complex problems including error, confusion, and stigmatization. These problems could be greater with cystic fibrosis, since more than 8 million Americans may be carriers and entrepreneurial interests can be expected to promote screening in what could become a billion-dollar industry. The present frequency of the detectable mutation (delta F508), 75%, will complicate the counseling process. The sensitivity of the test to detect at-risk couples would be 56%. The cost of screening could be as much as $2.2 million for each cystic fibrosis birth avoided. Regardless of improvements in the detection rate, implementation of population screening should be delayed until pilot studies that demonstrate its safety and effectiveness are completed. While studies are in progress, preconception testing should be offered to adult relatives of cystic fibrosis patients as part of a comprehensive program following institutional review board approval for "compassionate use." The purpose of such review should be to ensure that strict standards of informed consent, education, quality control of the testing procedure, and counseling are followed. Primary care physicians who are unable to offer screening as part of such a comprehensive program should refer high-risk patients who would like to consider being tested to established centers.

Cystic Fibrosis↗
PubMed1990

[Psychological and social problems in families with children with congenital defects].

The authors investigated a group of 109 mothers whose children with a cleft (dg. 749) were up to the age of 13-15 years in the care of the Clinic of Plastic Surgery. The cleft served as a model situation for investigation of the parents' reaction, in particular the mother's reaction, to the birth of the child with a developmental defect. The main findings: three quarters of the mothers described the birth of a damaged child as a psychic shock followed by a series of neurotic symptoms. Some mothers suffered from reactive depression which was not diagnosed and therefore not treated. It was confirmed that the poor mental condition of the mother persist in the majority of the investigated group to the time of the child's adolescence and has a marked effect on its mental prosperity. Latent or manifest negative attitudes of the parents cause mental handicapping phenomena in the children (impaired self-esteem, impaired sexual identification etc.). Aggravating factors are stigmatizing manifestations from the environment of the family and child community, which affect some three quarters of mothers and children. The authors discuss suitable forms of medical and counseling care which after delivery and later would help to reduce the psychic trauma of the parents and promote adequate somatic and mental development of the child.

Child↗
PubMed1990

The implicated and the immune: cultural responses to AIDS.

Unlike previous epidemics in American history, AIDS has spawned a host of creative works in the arts and mass media. Representations in the fine arts have emphasized perspectives of the insider or the "implicated," i.e., people with AIDS, while commercial programs and performers in popular culture have adopted the vantage point of the "immune," viewing AIDS as emblematic of a stigmatized "other." These cultural responses embody tensions between contemporary and traditional approaches to social life. Some television and commercial films are beginning to portray AIDS from the "implicated" perspective, however; this tentative change suggests that the epidemic is becoming more broadly experienced in the United States.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Educational requirements of human sexuality in the counseling for and prevention of sexually transmitted diseases.

Sexually transmitted diseases (STDs) are usually stigmatizing, displaying not only medical but also social, psychological, and/or sexual consequences. Thus, it is of importance to provide STD patients with qualified counseling including three goals (1) providing comprehensive medical care; (2) providing information aimed at preventing spread of disease or reinfection; and (3) reducing social, psychological, and/or sexual sequelae. To accomplish these goals, health professionals need to be comfortable with their own sexuality, sensitive to patients' sexual concerns or problems, familiar with basic sexological knowledge, aware of their professional limitations, and warm, supportive, genuine, and empathic in the professional patient relationship. It is of further importance to not imply that sexual partners are necessarily of the opposite sex. Professionals often feel incapable of giving help as to sexual issues partly because a lack of basic knowledge and skills and partly because professionals are affected, like their patients, by taboos and constraints that make it difficult to talk about sexuality. Therefore, there is a need for including sexuality issues in professional training courses, focusing on preparing health personnel to provide patients with permission to talk about individual sexual concerns, as well as with information and specific suggestions related to a given sexual topic. Through increased awareness of one's own sexual affective attitudinal orientation combined with sexological knowledge and clinical skills, health professionals will become better counselors in human sexuality and hence in primary prevention of STDs.

Attitude of Health Personnel↗
PubMed1986

[Features of the relation between preclinical dysontogeny, the Kanner syndrome of early infantile autism and early childhood schizophrenia (according to the results of catamnestic examinations)].

The article is devoted to the correlation between manifestations of congenital dysontogenesis, the syndrome of Kanner's early infantile autism and early infantile schizophrenia. The article is largely based on the materials of a follow-up study of a cohort of schizophrenics (n = 268) and patients with Kanner's early infantile autism (n = 32). The authors established developmental deviations in the form of a stigmatized, distorted, retarded type in the premanifest premorbid period in patients with early infantile schizophrenia (in 78% of cases). It has been shown that Kanner's early infantile autism is characterized by disorders in the hierarchy of the development of functional systems and their underdevelopment, which allows some authors to refer it to unprogressive dysontogenesis, while others may refer it to congenital apsychotic schizophrenia.

Adolescent↗
PubMed1989

[The concept of developmentally-induced structural ego disorders--a reference frame for working with extremely borderline patients?].

The concept of developmental-structural ego defects provides a therapeutic framework for the treatment of patients who have, in the past, largely been classified as untreatable. With emphasis on individual therapeutic treatment, this paper provides a critical introduction to the concept and discusses the applicability of this therapeutic approach for extremely lower-lower class patients: patients doubly stigmatized by psychological illness and criminality who are treated in a forensic-psychiatric clinic.

Antisocial Personality Disorder↗
PubMed1989

[Argyria in children].

A case of argyria in a 14 year-old child caused by abuse of silver containing pulveriser for sore throat is described. The distinctive skin blue gray discoloration that occurs in argyria is due to deposition of silver. Pigmentation is permanent. Self treatment is stigmatized.

Adolescent↗
PubMedDate not supplied

[Attitudes toward epilepsy in Majorca].

We created a questionnaire in order to evaluate the attitude toward epilepsy among the general population in Majorca Island, Spain. We made 1,164 interviews, divided fifty per cent between city and rural inhabitants. We studied the level of epilepsy knowledge in the population, and we compared the evolution of positive attitude of our study with others from Spain and the USA. We also studied the relationship between the variables considered and the two basic attitudes (integration-positive and stigmatization-negative). These two patterns were suggested to be associated with several trends of the population.

Attitude to Health↗
PubMed1989

Ageing, status politics and sociological theory.

As a feature of social change and as an aspect of social stratification, ageing and age groups have been seriously neglected by sociological theory. This article attempts to conceptualize age groups in a multi-dimensional model of stratification which considers ageing in relation to economic class, political entitlement, or citizenship, and cultural life-styles. This multi-dimensional model provides an analytical basis for rejecting functionalist theories of ageing, which emphasize the positive functions of social disengagement, activity theories, which show that self-esteem in ageing is an effect of continuing social involvement, and Marxist social gerontology, which argues that retirement is determined by labour-market requirements in capitalism. The article concludes by developing a reciprocity-maturation curve of ageing which explains age stigmatization through exchange theory as an effect of declining social reciprocity. Both young and elderly social groups in a period of economic recession are perceived to be socially dependent, and become the targets of 'the politics of resentment'. The processes of social ageing can be located in the core of sociological theory, because they are connected fundamentally to the conditions of social solidarity.

Aging↗
PubMed1989

The homosexual escort agency: deviance disavowal.

This article examines the management of deviance disavowal techniques by a commercial organization. Ball's abortion clinic ethnography (1972:158-86) paved the way for an analysis of the neutralization of disreputable encounters. This study, based on research conducted in London, England during 1981, attempts to explore how stigmatizing sexual liaisons are routinely managed by an escort agency. The article is based on interviews conducted with one homosexual escort agency owner and twenty-eight male escorts and discusses the neutralization of moral approbrium through the organization of names, space and structure.

Attitude↗
PubMed1989

[Self-help: new concepts in health care. I. The situation worldwide].

In the first part of the paper devoted to the possibilities of self-help in health care the author gives an account of experience with self-help, in particular with mutual aid groups in the world. This concerns groups which have some common problem and which associate to tackle the problem. The author explains the basic terms of self-help (self-sufficiency, relying on its own strength, knowledge, abilities, experience) and functions of self-help groups (social and emotional support, defence against the feeling of isolation and loneliness; against stigmatization; source of information and practices pertaining to a given disease or state). The author emphasizes the importance of self-help in the sense of more active participation of patients or affected people in the protection and development of their health, i.e. greater responsibility for health. The author analyzes the relations between self-help and professional health services which should not be antagonistic but complementary and should lead to mutually useful collaboration. The author also mentions the importance ascribed to self-help in WHO documents, in particular in the programme "Health for all by the year 2000".

Humans↗