Exploring the relationships among spiritual well-being, quality of life, and psychological adjustment in women with breast cancer.

This study examined the relationships among spiritual well-being, quality of life, and psychological adjustment in 142 women diagnosed with breast cancer who were participating in a larger study designed to compare the efficacy of two psychosocial support programs. Participants were given a set of questionnaires that measured spiritual well-being, quality of life, and adjustment to cancer. Results revealed a positive correlation between spiritual well-being and quality of life, as well as significant correlations between spiritual well-being and specific adjustment styles (e.g. fighting spirit). There was also a negative correlation between quality of life and use of a helpless/hopeless adjustment style, and a positive correlation between quality of life and fatalism. In regression analyses, after controlling for demographic variables and adjustment styles, spiritual well-being contributed very little additional variance in quality of life. These findings suggest that while spiritual well-being is correlated with both quality of life and psychological adjustment, the relationships among these variables are more complex and perhaps indirect than previously considered.

A randomized double-blind study of the effect of distant healing in a population with advanced AIDS. Report of a small scale study.

Various forms of distant healing (DH), including prayer and "psychic healing," are widely practiced, but insufficient formal research has been done to indicate whether such efforts actually affect health. We report on a double-blind randomized trial of DH in 40 patients with advanced AIDS. Subjects were pair-matched for age, CD4+ count, and number of AIDS-defining illnesses and randomly selected to either 10 weeks of DH treatment or a control group. DH treatment was performed by self-identified healers representing many different healing and spiritual traditions. Healers were located throughout the United States during the study, and subjects and healers never met. Subjects were assessed by psychometric testing and blood draw at enrollment and followed for 6 months. At 6 months, a blind medical chart review found that treatment subjects acquired significantly fewer new AIDS-defining illnesses (0.1 versus 0.6 per patient, P = 0.04), had lower illness severity (severity score 0.8 versus 2.65, P = 0.03), and required significantly fewer doctor visits (9.2 versus 13.0, P = 0.01), fewer hospitalizations (0.15 versus 0.6, P = 0.04), and fewer days of hospitalization (0.5 versus 3.4, P = 0.04). Treated subjects also showed significantly improved mood compared with controls (Profile of Mood States score -26 versus 14, P = 0.02). There were no significant differences in CD4+ counts. These data support the possibility of a DH effect in AIDS and suggest the value of further research.

Evaluating distant healing: a research review.

The term "distant healing" describes any purely mental effort undertaken by one person with the intention to improve physical or emotional well-being in another. Various forms of distant healing including prayer and "psychic healing" are widely used throughout the United States and other parts of the world. There currently exist numerous, well-controlled experimental trials demonstrating distant mental effects on humans, animals, and other biological systems. At this time, however, insufficient formal research trials have been completed to definitively determine whether such activities do in fact have a clinical impact independent of psychological effects. The key in studying the concept of distant healing is separating the putative distant effect from changes that may be due to causes such as hope, expectation, relaxation, or other participation activities. This review discusses some of the most compelling evidence for a genuine distant healing effect and identifies correctable methodological issues that frequently confound research in this area.

Structured group therapy and fluoxetine to treat depression in HIV-positive persons.

In 1990, 20 asymptomatic persons diagnosed with the human immunodeficiency virus (HIV-positive) and mild-to-moderate depression were divided into 2 comparison groups. One group received structured group therapy plus fluoxetine, while the other received the same therapy plus a placebo. Affective, neurocognitive, and immune variables were measured before and after the intervention. In the patients receiving group therapy and fluoxetine, its administration did not improve treatment outcome compared to the therapy and placebo group. No significant differences between the two groups were noted on immune variables. However, symptoms of depression decreased in both groups, and both groups showed significant incorporation of the skills in active behavioral coping taught in therapy.

Physiological effects of 4-aminopyridine on demyelinated mammalian motor and sensory fibers.

The selective response of demyelinated sensory fibers to 4-aminopyridine (4-AP) has been proposed as a mechanism underlying the reported paresthesias that complicate the use of this potassium-channel blocking agent in clinical trials for the treatment of multiple sclerosis and neuromuscular disorders. To identify differences in the electrophysiological response of specific fiber types to the application of 4-AP, rat ventral and dorsal spinal roots, demyelinated by intrathecal injections of lysophosphatidylcholine, were examined in vitro before and during potassium-channel blockade. The compound action potentials of demyelinated ventral roots showed a prominent postspike negativity associated with a broadening of single action potentials following application of 4-AP. Under similar conditions, whole root responses of demyelinated dorsal root axons also developed a late negativity, but individual fibers were observed to fire repetitively in response to a single stimulus. The data support the hypothesis that the prominent sensory dysfunctions reported in clinical trials of 4-AP are due to the selective response characteristics of sensory fibers.

Action potential characteristics of demyelinated rat sciatic nerve following application of 4-aminopyridine.

The sciatic nerves of rats were demyelinated by microinjection of lysophosphatidylcholine. A variety of abnormalities such as conduction slowing and block were present. Application of the potassium channel blocker 4-aminopyridine (4-AP) to the lesion site, led to an increase in area of the compound action potential recorded across the site of demyelination. Single axon recordings revealed three types of changes that may account for the 4-AP-induced increase in the compound response. One group showed broadening of the action potential. Other axons showed hyperexcitability following 4-AP, as manifest by spontaneous firing and multiple spike discharge following a single stimulus. In some of the axons studied, 4-AP led to overcoming of conduction block. Although many axons showed increased excitability properties in the presence of 4-AP, the frequency-following ability of the axons was reduced, and the absolute refractory period of the axons was increased. These results indicate that pharmacological blockade of potassium channels with 4-AP not only leads to action potential broadening in demyelinated axons, but to a variety of excitability changes. These heterogeneous effects of 4-AP should be considered in the rationale for its clinical use.

4-Aminopyridine leads to restoration of conduction in demyelinated rat sciatic nerve.

Whole nerve and single axon recordings were obtained in vitro from rat sciatic nerve demyelinated with lysophosphatidyl choline. Compound action potentials recorded across the lesion site were attenuated in amplitude, and showed conduction slowing and temporal dispersion. Application of the potassium channel blocker 4-aminopyridine (4-AP), markedly enhanced the response recorded through the lesion demonstrating both an increase in amplitude and duration of the response. From single axon recordings, we observed two patterns of change in spike waveform following application of 4-AP: broadening of single axon spikes, and bursting of single axon spikes. Some axons that displayed conduction block along demyelinated segments before 4-AP was applied, showed restoration of conduction.

Retrograde impulse activity and horseradish peroxidase tracing of nerve fibers entering neuroma studied in vitro.

Neuroma formation was induced in rat sciatic nerve by tight ligature. At various times after placement of the ligature, the nerves were excised, desheathed, split longitudinally proximal to the neuroma, and studied in vitro in a nerve chamber. Stimulation of one of the arbitrarily formed proximal branches was found to generate impulse activity in the other branch. Since similar branch to branch activation did not occur in control preparations, it appeared that some form of axon to axon interaction occurred within the neuroma, or alternatively that retrograde regeneration allowed continuity of nerve fibers in proximal divisions of the nerve trunk. Attempts at morphological demonstration of the continuity alternative were made by applying horseradish peroxidase to cut fibers of one proximal division. Although labeled axons did turn retrogradely within the neuroma, they were not found to enter the other nerve division.

Electroencephalographic sleep in unipolar depressive subtypes: support for a biological and familial classification.

A tripartite classification of unipolar disease based on family history has been proposed by Winokur. In this study, we sought to investigate whether the familial pure depressive disorder (FPDD) and the sporadic depressive disorder (SDD) populations could be differentiated on the basis of baseline EEG sleep as effected by a tricyclic pharmacological probe. A subject group consisting of 26 females and 10 males yielding 18 FPDD/SDD pairs matched for age was selected. Both groups of patients demonstrated a considerable amount of sleep continuity disturbance with an overall sleep efficiency of 80.5 per cent in the pure depressive (FPDD) group and 83 per cent in the sporadic (SDD) group. Examination of the rapid eye movement (REM) sleep variables revealed the usual shortened REM latency as well as increased REM activity and REM density changes. However, the only significant difference between the two groups on baseline was the presence of more stage 3 and 4 sleep in the sporadic group, but stage 3 and 4 sleep was found in less than 40 per cent of the total sample. In contrast, analysis of the first two nights of EEG sleep on 50 mg of amitriptyline demonstrated several significant findings between the two groups. While considerable REM sleep suppression occurred in both groups, REM activity, REM intensity, and the number of REM periods were significantly more suppressed in the pure group than the sporadic group. Application of these variables led to a successful discrimination of 75 per cent of all the cases. These findings suggest a hyper-reactivity of sleep in patients with FPDD to a pharmacological probe.