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At least 19 recordsLinked to original sources

Hysterectomy in Danish women: weight-related factors, psychologic factors, and life-style variables.

OBJECTIVE: To assess weight-related risk factors, psychologic factors, and life-styles of importance for hysterectomy performed for benign conditions. METHODS: In a prevalence study, 2301 Danish women aged 30, 40, 50, or 60 years were selected at random in 1982, and self-report questionnaires were collected from 77%. Information about weight and dieting history, life-style, psychologic factors, gynecologic history, and social background were recorded. Weight, height, and plasma lipids were measured. In an incidence study, the cohort was followed during 1982-1990 via central registers to assess the incidence of hysterectomy. Logistic and Cox regression were used to analyze the data. RESULTS: In the prevalence study, weight cycling (recurrent weight loss and weight gain of more than 5 kg) was associated with hysterectomy for benign disease (odds ratio 1.77, 95% confidence interval [CI]1.05-2.99) by multivariate analysis independent of overweight, smoking, psychologic factors, social factors, and gynecologic characteristics. In the incidence study, all the weight-related factors except slimming diets were significant risk factors for hysterectomy performed recently for benign disease in women under age 50. In the multivariate analysis, weight cycling was the only significant weight-related factor (relative risk 2.49, 95% CI 1.10-5.60), explaining the relation between hysterectomy and psychologic factors. Coffee, tea, alcohol, smoking, and plasma lipids were not related to hysterectomy in either study. CONCLUSION: Weight cycling might be an important risk factor for premenopausal hysterectomy performed for benign conditions. Whether weight cycling causes menstrual irregularities and leiomyomas, these results give us a better understanding of the pathways to hysterectomy.

Adult↗

[Hysterectomy in a Danish population. Weight-related factors, psychological factors and life style variables].

The aim was to assess risk factors for hysterectomy performed for benign conditions. In a prevalence study, 2301 Danish women were selected at random in 1982. Information about weight and slimming history, life-styles, psychological factors, gynaecological history, and social background were obtained. In an incidence study, the cohort was followed from 1982 to 1990 to assess the incidence of hysterectomy. In the prevalence study, weight cycling (recurrent weight loss and weight gain of more than 5 kg) was associated with hysterectomy for benign disease (adjusted odds ratio 1.77, 95% confidence interval 1.05-2.99) independently of overweight, smoking, oral contraceptives, psychological and social factors. In the incidence study, weight cycling was the only significant weight-related risk factor for hysterectomy performed for benign disease (adjusted relative risk 2.49, 95% confidence interval 1.10-5.60), explaining the relation between hysterectomy and psychological factors. Weight cycling might be an important risk factor for premenopausal hysterectomy performed for benign conditions.

Adult↗

Determinants of contraceptive use among women of reproductive age in Great Britain and Germany. II: Psychological factors.

Psychological determinants of contraceptive use were investigated in Great Britain and Germany, using national data obtained in 1992. It was hypothesised that current contraceptive use among sexually active, fertile women aged 15-45 was related to their attitude towards the various contraceptive methods, social influences, perceptions of being able to use a method correctly and consistently, a correct estimation of fertility, and communication with their partner. Effects of age and country were also taken into account. The attitude of respondents towards the various contraceptive methods was ambivalent and no method was seen as ideal. On medical methods (OCs, IUDs and sterilisation) many respondents expressed doubts as to their safety for health. Social influences most frequently concerned the use of OCs. Respondents considered themselves able to use oral contraceptives correctly, but expressed general fear about intrauterine devices and sterilisation, and many women believed they were not able to use condoms and periodic abstinence consistently. Multifactorial analyses revealed that current contraceptive use was principally determined by social influences, attitude and self-efficacy with respect to medical methods. Age and country, and, for use of unreliable methods, fertility awareness also played a role. Communication with the partner was less relevant. Contraceptive choice (and the use of non-medical methods) depended greatly on encouragement to use and being in favour of medical methods. A lack of social support for use of medical methods and a negative attitude towards them was related to higher use rates of condoms, periodic abstinence, withdrawal and reliance on 'luck'. In the case of withdrawal and/or no method, underestimation of fertility played an additional role. Contraceptive choice appears to be determined more by a general like or dislike of medical methods rather than on a weighing of the merits of individual available methods.

Adolescent↗

[Impact of psychological factors on development and course of coronary artery disease [corrected]: should negative psychological factors be altered?].

Psychological factors effect the development and course of coronary heart disease (CHD). Hypothalamic-pituitary-adrenal dysregulation, reduced heart rate variability, diminished baroreflex sensitivity, impaired immune function and altered platelet function are proposed as significant psychophysiologic mechanisms to explain this association. Because psychological factors may influence several different stages of long atherosclerosis period, interventional studies aiming to alter negative psychological factors by behavioral and medical ways, expecting to prevent or improve CHD, have been discussed. Complementary to the traditional treatment, this new treatment strategy could be a different perspective and a nice promise for CHD patients.

Baroreflex↗

Psychological factors related to prehospital delay during acute myocardial infarction.

BACKGROUND: Prior studies have had difficulty identifying factors that significantly explain patients' delay in responding to symptoms of acute myocardial infarction (AMI). METHODS AND RESULTS: We therefore examined factors affecting the time between symptom onset and hospital arrival for 103 AMI patients admitted to a Detroit metropolitan hospital between October 1989 and January 1990. Variables evaluated included demographic and medical history factors, psychological characteristics of somatic and emotional awareness, and type A behavior. The mean prehospital delay time was 9.0 +/- 10.8 hours (median, 5.0 hours; range, 0.25-62.0 hours). Delay time was not significantly associated with demographic or medical history categories or with type A behavior. Of study variables that can be identified prior to evolution of an AMI, somatic and emotional awareness were the only factors significantly predictive of delay time. Patients who were more capable of identifying inner experiences of emotions and/or bodily sensations sought treatment significantly earlier than patients with low emotional or somatic awareness (low emotional awareness median delay, 12.8 hours; high emotional awareness median delay, 3.8 hours; low somatic awareness median delay, 7 hours; high somatic awareness median delay, 4 hours). CONCLUSIONS: Variations in sensitivity to bodily sensations and emotions appear to play an important role in treatment seeking and thus potentially in treatment outcome for AMI patients. Assessment of these characteristics in patients with coronary risk factors could allow early identification of persons at risk of excessive delay in responding to symptoms of AMI.

Attitude to Health↗

Preterm delivery: effects of socioeconomic factors, psychological stress, smoking, alcohol, and caffeine.

OBJECTIVE: To examine the relation between preterm birth and socioeconomic and psychological factors, smoking, and alcohol, and caffeine consumption. DESIGN: Prospective study of outcome of pregnancy. SETTING: District general hospital in inner London. PARTICIPANTS: 1860 consecutive white women booking for delivery; 1513 women studied after exclusion because of multiple pregnancy and diabetes, refusals, and loss to follow up. MEASUREMENTS: Gestational age was determined from ultrasound and maternal dates; preterm birth was defined as less than 37 completed weeks. Independent variables included smoking, alcohol and caffeine consumption, and a range of indicators of socioeconomic status and psychological stress. MAIN RESULTS: Unifactorial analyses showed that lower social class, less education, single marital status, low income, trouble with "nerves" and depression, help from professional agencies, and little contact with neighbours were all significantly associated with an increased risk of preterm birth. There were no apparent effects of smoking, alcohol, or caffeine on the length of gestation overall, although there was an association between smoking and delivery before 32 weeks. Cluster analysis indicated three subgroups of women delivering preterm: two predominantly of low social status and a third of older women with higher social status who did not smoke. Mean gestational age was highest in the third group. CONCLUSIONS: Adverse social circumstances are associated with preterm birth but smoking is not, apart from an association with very early births. This runs counter to findings for fetal growth (birth weight for gestational age) in this study, where a strong effect of smoking on fetal growth was observed but there was no evidence for any association with psychosocial factors.

Alcohol Drinking↗

Influence of psychological factors on the response to clomipramine in hospitalized chronic low back pain patients. Preliminary data from a psychometric study.

BACKGROUND: Chronic low back pain is a complex condition produced by multiple factors. Psychological disturbances have been found in previous studies using a variety of psychological tests. The most widely used self-administered questionnaire was the Minnesota Multiphasic Personality Inventory (MMPI). OBJECTIVE: To assess the response to clomipramine in chronic low back pain patients according to baseline MMPI scores. PATIENTS AND METHODS: Thirty chronic low back pain patients were given clomipramine intravenously during a ten-day hospital stay, then orally for 20 days. The dose was gradually brought up to 150 mg/d. The MMPI was administered on the day before treatment initiation. MMPI scores were not looked at until the end of the study. The Saint Antoine Questionnaire, a visual analog scale for pain, Schöber's maneuver, and the global result as assessed by the patients (success or failure) were evaluated on days 0 (D0), 4 (D4), 10 (D10), and 30 (D30). RESULTS: The initial mean MMPI scores for hypochondria, depression, and hysteria were significantly lower in the 23 patients (76%) who considered their treatment successful on D30. Among the 13 patients with high hypochondria and hysteria scores, five improved during hospitalization then had a relapse after returning home. CONCLUSION: The response to treatment with clomipramine was better in nondepressive patients. The hypochondria and hysteria scores were the best predictors of the response to clomipramine. These results may provide a basis for selecting those chronic low back pain patients most likely to benefit from clomipramine therapy.

Adult↗

The association of psychological factors, physical activity, neuropathy, and quality of life in type 2 diabetes.

The objective of this study was to determine the relationship of sociodemographics; diabetes-related factors, including diabetes-related microvascular complications; cardiac risk factors; and psychological factors with quality of life (QOL). Participants enrolled at three sites in the Detection of Ischemia in Asymptomatic Diabetics (DIAD) study were invited to participate in this ancillary study. Questionnaires assessing psychological factors were completed by participants, and the remainder of the data was obtained as part of the DIAD study. Many participants had elevated levels of anxiety (n = 91; 82%), depressive symptoms (n = 16; 14%), anger (n = 38; 34%), and hostility (n = 17; 17%). Results of multivariate analyses conducted for each of the eight domains on the Medical Outcomes Study Short Form-36 and two Diabetes Quality of Life domains demonstrated that in the majority of models (42% to 68% of the variance explained), female sex, peripheral or autonomic neuropathy, physical inactivity, higher body mass index, and the presence of depressive symptoms and anxiety were associated with poorer QOL (p = .0001). These findings demonstrate that anxiety, depressive symptoms, and neuropathy are prevalent in older adults with type 2 diabetes. In addition, potentially important correlations were demonstrated between psychological factors, neuropathy, body mass index, and physical inactivity.

Aged↗

Psychological factors affecting migraine.

Psychological factors are known to increase the severity and intensity of headaches. When they are shown to be present, an appropriate psychiatric diagnosis is the Diagnostic and Statistical Manual's (DSMIII-R) category of psychological factors affecting physical condition (code no. 316.0). These factors can be differentiated into stress factors, personality traits, psychodynamic factors, learned behaviors, and mood disturbances. The factors overlap and intertwine in the average headache patient. Attention to these factors in a systematic way should enhance our understanding and treatment of the chronic headache patient.

Humans↗

Temporomandibular disorders: assessment of psychological factors.

Factors such as psychological stress, anxiety, depression, oral habits, and chronic pain behaviors have been found in subgroups of Temporomandibular Disorders (TMD) patients. This paper reviews the current status of diagnostic methods and instruments designed to identify various psychological factors. The authors offer the following general conclusions: Although the DSM-III-R has significant limitations, it is currently the most common gold standard with which other psychological instruments are compared. There are several specific assessment instruments, such as the Beck Depression Inventory and the Zung Self-Rating Depression Scale, which have been found to have acceptable sensitivity and specificity scores. In addition, certain simple screening questions may be cost-effective for the identification of psychological factors. Because of studies indicating that the dentists' recognition of psychological factors is inaccurate, a brief screening questionnaire may be useful in TMD patients. The literature does not support the routine use of the MMPI. A major conclusion of this review is that there are several psychological instruments available which have demonstrated reasonable validity through a blind comparison with a gold standard. There is need for further development and testing of brief screening instruments using clinical decision methods.

Anxiety↗

Psychological factors as mechanisms for socioeconomic disparities in health: a critical appraisal of four common factors.

Social epidemiology has increasingly looked to psychological factors as both risk factors for physical health and mechanisms behind disparities. Yet, there has been little resolution to the question of whether psychological factors explain disparities, and skepticism has begun to mount about whether psychological factors are causally linked to health. Furthermore, some have questioned the nature of the relationship: most research suggests that psychological factors mediate the relationship between socioeconomic status and health, but recent research suggests that they moderate the relationship. The present paper attempts to provide a more comprehensive appraisal of the current debate. It uses four popular psychological factors (i.e., self-esteem, mastery, neuroticism, and depressive symptoms), three health outcomes, and a nationally representative, three-panel longitudinal survey. The results illustrate the promise and limitations of psychological mechanisms. In the cross-section, the results provide evidence for substantial moderating effects, but these effects disappear entirely when estimated prospectively. The results also provide some evidence for mediating effects, but these effects are very weak and the prospective effects of psychological factors diminish over time and with controls for baseline health. Implications for theories of socioeconomic status and health are discussed and a more social psychologically sophisticated approach is encouraged.

Depression↗

[The role of microsocial and psychological factors in the development of stable psychological changes in children].

The author conducted a clinical study of 305 children with epilepsy, the results of which were correlated with stable psychic changes, microsocial, psychological factors and identical heredity. It was established that pathological personality traits in the parents, a situation of conflicts in the family and a wrong rearing were significantly higher in mentally changed epileptic children. An identical hereditary loading does not form significant correlations with stable mental changes. The conclusion is being made that an unfavourable situation may exert a certain impact on the formation of a character in children with eilepsy.

Adolescent↗

Psychological factors related to interstitial cystitis.

Psychological factors related to interstitial cystitis were studied in 31 women. The control group consisted of 24 women with acute bacterial cystitis. The subjects were tested with psychological methods. Results showed that traditional signs of psychic pathology were not related to the symptoms of interstitial cystitis but psychic helplessness and inadequacy in coping with problems was found in the patients. Sexual problems were prominent. Results do not refer to the psychological origin of interstitial cystitis but stress that psychological factors have to be taken into consideration in the treatment of these patients.

Adaptation, Psychological↗

Do psychological factors predict outcome in both low-back pain and shoulder pain?

BACKGROUND AND OBJECTIVE: Psychological factors are assumed to predict persistent or recurrent musculoskeletal pain. The influence of psychological factors in patients with low-back pain (LBP) or shoulder pain was explored to study whether there is similarity regarding the factors that predict persisting pain and disability. METHODS: Patients presenting in primary care with a new episode of shoulder pain or non-specific (sub)acute low back pain (LBP) were enrolled in a prospective study. In both patient groups, pain catastrophising, distress, somatisation and fear-avoidance beliefs were measured at baseline. Primary outcome measures at 3 months were (1) persistent symptoms, and (2) <30% reduction in functional disability. Multivariate logistic regression analysis was used to study the associations between psychological factors and outcome. RESULTS: A total of 587 patients with shoulder pain and 171 patients with LBP were enrolled in the study. In patients with shoulder pain, most associations of psychological factors with outcome were weak and not significant. Only in patients with longer symptom duration at baseline (>or=3 months) were higher scores on catastrophising significantly associated with persistent symptoms (p = 0.04). In patients with LBP, psychological factors were more strongly associated with poor outcome, although most associations were not significant. CONCLUSION: Psychological factors, with the exception of fear-avoidance beliefs, are more strongly associated with persistent pain and disability in patients with LBP than in those with shoulder pain. This seems to indicate that in a primary care population the influence of psychological factors on outcome may vary across patients with different types of pain.

Adult↗

Fear of falling limiting activity in young-old women is associated with reduced functional mobility rather than psychological factors.

BACKGROUND: many older people experience fear of falling. This is sometimes associated with activity limitation, with potential adverse health implications. The explanatory contributions of physical and psychosocial factors to this syndrome are unclear. OBJECTIVES: to examine the associations between fear of falling limiting activity (FoF-LA) among young-old women with (i) functional capacity and (ii) psychological factors. SUBJECTS AND METHODS: FoF-LA, functional difficulty and dependency, psychological factors, previous falls, visual and hearing handicap, memory, pain, and habitual physical activity were assessed using standard questionnaires in 713 community-dwelling London women, mean age 64.2 years. RESULTS: 70 women (10.1%) reported FoF-LA, of whom 21 had fallen in the previous year. Women reporting FoF-LA had higher prevalence of adverse functional and clinical characteristics. Multiple logistic regression analyses showed that both mild ('changes in the way walk half a mile') and moderate ('difficulty standing from armless chair') reduction in functional capacity were independently associated with FoF-LA (odds ratios 4.02 (95% CI 1.5-10.7) and 5.07 (CI 2.0-13.0) respectively) after adjustment for age, falls and clinical factors. Psychological factors and perceived fair/poor health were bivariately but not independently associated with FoF-LA; after adjustment for them, mild and moderate reductions in functional capacity remained strongly associated with FoF-LA (OR 4.02 (CI 1.5-10.7) and 3.83 (CI 1.4-10.5) respectively), along with visual handicap and increased health service use. CONCLUSIONS: among young-old women, FoF-LA is related to early reduction of mobility function rather than psychological factors. It may identify individuals at risk of subsequent functional decline.

Accidental Falls↗

[Etiology of bruxism: morphological, pathophysiological and psychological factors].

Bruxism is a controversial phenomenon, but there is consensus about the multifactorial nature of the etiology. Besides peripheral (morphological) factors, central (pathophysiological and psychological) factors can be distinguished. In the past, morphological factors, like occlusal discrepancies and the anatomy of the bony structures of the orofacial region, have been considered the main causative factors for bruxism. Nowadays, these factors play only a minor role, if any. Recent focus is more on the pathophysiological factors. For example, bruxism has been suggested to be part of a sleep arousal response. In addition, bruxism appears to be modulated by various neurotransmitters in the central nervous system. More specifically, disturbances in the central dopaminergic system have been linked to bruxism. Further, factors like smoking, alcohol, drugs, diseases, and trauma may be involved in the bruxism etiology. Psychological factors like stress and personality are frequently mentioned in relation to bruxism as well, but research shows controversial results. Taken all evidence together, bruxism appears to be mainly regulated centrally, not peripherally.

Bruxism↗