Résumé
OBJECTIVES: Fall is a major cause of morbidity and mortality among older adults. Falls result from many various causes, and dizziness is important risk for falls, especially in the elderly. Research on the relationship between chronic dizziness and falls in elderly people has been rarely performed and these were no studies that analyzed the risk of falls according to subtypes of chronic dizziness. METHODS: We conducted a prospective study of the association between subtypes of chronic dizziness and falls in the elderly between 65 to 75 years. We divided dizzy patients into 5 groups according to the results of symptom, vestibular and autonomic function test. Falls and new events (acute dizziness or other medical conditions) were checked monthly by telephone or out patient department follow-up for 6 months. RESULTS: Thirty-four patients were enrolled and all completed follow-up for 6 months. Nine patients classified as the falling groups and 34 patients as nonfalling group. Whereas the frequencies of orthostatic hypotension (n=6, 67%) and vestibular dysfunction (n=1, 11%) were higher in fall group, psychogenic dizziness (n=12, 35%), and vestibular migraine (n=3, 9%) were more frequent in nonfall group. CONCLUSIONS: The presence of dizziness in the elderly is a strong predictor of fall, especially orthostatic hypotension is an important predictor of fall. In order to lower the risk of falls in the elderly, an approach based on the cause of dizziness is needed.
Sujets)
Adulte , Sujet âgé , Humains , Chutes accidentelles , Classification , Sensation vertigineuse , Études de suivi , Hypotension orthostatique , Migraines , Mortalité , Études prospectives , TéléphoneRésumé
OBJECTIVES: Early maladaptive schemas (EMS) are assumed to be stable emotional and cognitive patterns that begin early in our development and are repeated throughout life. The primary aim of this study was to examine the two-year stability of EMS using the Young Schema Questionnaire (YSQ). In addition, we investigated the relationship between EMS and depressive symptoms over time. METHODS: Seventy-nine medical students completed the YSQ-short form 3, the Beck Depression Inventory, and the Symptom Checklist-90-Revised during their first and third years of medical school. RESULTS: After controlling for depression severity, YSQ subscales showed significant test-retest correlations for all of the subscales (r between 0.49 and 0.77, ps<0.001). Mean scores for all of the subscales did not differ significantly at retest, with the exception of a significant reduction of vulnerability to harm/illness (t=3.71, p<0.001). Concerning the relationship with depression, some YSQ subscales showed association with the severity of depressive symptoms at each time point, as well as changes between two time points. In particular, the schemas of Defectiveness/Shame and Dependence/Incompetence showed a strong association with changes of depressive symptoms. CONCLUSION: These findings demonstrated that EMS measured using the YSQ may show con-siderable temporal stability over time, but, in part, may be affected by an individual's state, such as depression.