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1.
Niger J Clin Pract ; 23(8): 1033-1038, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32788477

RESUMO

Background: Inhaler corticosteroids (ICS) are the most commonly used antiinflammatory drugs in the treatment of asthma. Although systemic adverse effects are minimal, patients hesitate to use ICS for a long time because of corticophobia. There is no study evaluating corticophobia via Likert-type appendix among the asthmatic patients. Aim: In this study, it was aimed to evaluate the fears and beliefs about ICS in asthmatic patients. Subjects and Methods: Between December 2017 and January 2018, 150 stable asthmatic patients were included in the study. Demographic data (age, education, smoking history, etc.) and asthma-related data (pulmonary function test, drug use) were recorded. The appendix of TOPICOP study applied to the patients with asthma which was composed of 10 questions (five questions about fear of ICS and five questions about beliefs of ICS). Results: The rate of ICS maintain in stable asthmatic patients was found to be 66.6%. According to the survey results, 68% of the patients believed that ICS may lead to weight gain, 52% believed that ICS may lead to infection, 73% believed that ICS may pass into bloodstream, and 67.3% believed that ICS may damage the lungs. It was also found that 90.7% needed to be informed about ICS and 67.3% wanted to cut the ICS drug as soon as possible. Conclusion: We found that treatment adherence may increase, if physicians allocate more time to asthma patients to inform about ICS beneficial effects at the initiating of ICS treatment and control visits.


Assuntos
Corticosteroides/uso terapêutico , Antiasmáticos/uso terapêutico , Asma/tratamento farmacológico , Medo , Conhecimentos, Atitudes e Prática em Saúde , Adesão à Medicação/psicologia , Transtornos Fóbicos/psicologia , Administração por Inalação , Corticosteroides/efeitos adversos , Adulto , Antiasmáticos/efeitos adversos , Asma/psicologia , Feminino , Humanos , Masculino , Adesão à Medicação/estatística & dados numéricos , Pessoa de Meia-Idade , Transtornos Fóbicos/epidemiologia , Transtornos Fóbicos/etiologia , Inquéritos e Questionários
2.
Top Magn Reson Imaging ; 29(3): 125-130, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32568974

RESUMO

Claustrophobia, other anxiety reactions, excessive motion, and other unanticipated patient events in magnetic resonance imaging (MRI) not only delay or preclude diagnostic-quality imaging but can also negatively affect the patient experience. In addition, by impeding MRI workflow, they may affect the finances of an imaging practice. This review article offers an overview of the various types of patient-related unanticipated events that occur in MRI, along with estimates of their frequency of occurrence as documented in the available literature. In addition, the financial implications of these events are discussed from a microeconomic perspective, primarily from the point of view of a radiology practice or hospital, although associated limitations and other economic viewpoints are also included. Efforts to minimize these unanticipated patient events can potentially improve not only patient satisfaction and comfort but also an imaging practice's operational efficiency and diagnostic capabilities.


Assuntos
Ansiedade/psicologia , Imagem por Ressonância Magnética/psicologia , Transtornos Fóbicos/psicologia , Ansiedade/epidemiologia , Humanos , Imagem por Ressonância Magnética/economia , Imagem por Ressonância Magnética/estatística & dados numéricos , Movimento , Transtornos Fóbicos/epidemiologia , Prevalência , Recusa do Paciente ao Tratamento/psicologia
3.
Infect Dis Poverty ; 9(1): 58, 2020 May 29.
Artigo em Inglês | MEDLINE | ID: covidwho-427304

RESUMO

BACKGROUND: A cluster of pneumonia cases were reported by Wuhan Municipal Health Commission, China in December 2019. A novel coronavirus was eventually identified, and became the COVID-19 epidemic that affected public health and life. We investigated the psychological status and behavior changes of the general public in China from January 30 to February 3, 2020. METHODS: Respondents were recruited via social media (WeChat) and completed an online questionnaire. We used the State-Trait Anxiety Inventory, Self-rating Depression Scale, and Symptom Checklist-90 to evaluate psychological status. We also investigated respondents' behavior changes. Quantitative data were analyzed by t-tests or analysis of variance, and classified data were analyzed with chi-square tests. RESULTS: In total, 608 valid questionnaires were obtained. More respondents had state anxiety than trait anxiety (15.8% vs 4.0%). Depression was found among 27.1% of respondents and 7.7% had psychological abnormalities. About 10.1% of respondents suffered from phobia. Our analysis of the relationship between subgroup characteristics and psychological status showed that age, gender, knowledge about COVID-19, degree of worry about epidemiological infection, and confidence about overcoming the outbreak significantly influenced psychological status. Around 93.3% of respondents avoided going to public places and almost all respondents reduced Spring Festival-related activities. At least 70.9% of respondents chose to take three or more preventive measures to avoid infection. The three most commonly used prevention measures were making fewer trips outside and avoiding contact (98.0%), wearing a mask (83.7%), and hand hygiene (82.4%). CONCLUSIONS: We need to pay more attention to public psychological stress, especially among young people, as they are likely to experience anxiety, depression, and psychological abnormalities. Different psychological interventions could be formulated according to the psychological characteristics of different gender and age groups. The majority of respondents followed specific behaviors required by the authorities, but it will take time to observe the effects of these behaviors on the epidemic.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia , Adolescente , Adulto , Idoso , Betacoronavirus , China/epidemiologia , Infecções por Coronavirus/prevenção & controle , Estudos Transversais , Depressão/epidemiologia , Depressão/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Transtornos Fóbicos/epidemiologia , Transtornos Fóbicos/psicologia , Pneumonia Viral/prevenção & controle , Inquéritos e Questionários , Adulto Jovem
4.
Infect Dis Poverty ; 9(1): 58, 2020 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-32471513

RESUMO

BACKGROUND: A cluster of pneumonia cases were reported by Wuhan Municipal Health Commission, China in December 2019. A novel coronavirus was eventually identified, and became the COVID-19 epidemic that affected public health and life. We investigated the psychological status and behavior changes of the general public in China from January 30 to February 3, 2020. METHODS: Respondents were recruited via social media (WeChat) and completed an online questionnaire. We used the State-Trait Anxiety Inventory, Self-rating Depression Scale, and Symptom Checklist-90 to evaluate psychological status. We also investigated respondents' behavior changes. Quantitative data were analyzed by t-tests or analysis of variance, and classified data were analyzed with chi-square tests. RESULTS: In total, 608 valid questionnaires were obtained. More respondents had state anxiety than trait anxiety (15.8% vs 4.0%). Depression was found among 27.1% of respondents and 7.7% had psychological abnormalities. About 10.1% of respondents suffered from phobia. Our analysis of the relationship between subgroup characteristics and psychological status showed that age, gender, knowledge about COVID-19, degree of worry about epidemiological infection, and confidence about overcoming the outbreak significantly influenced psychological status. Around 93.3% of respondents avoided going to public places and almost all respondents reduced Spring Festival-related activities. At least 70.9% of respondents chose to take three or more preventive measures to avoid infection. The three most commonly used prevention measures were making fewer trips outside and avoiding contact (98.0%), wearing a mask (83.7%), and hand hygiene (82.4%). CONCLUSIONS: We need to pay more attention to public psychological stress, especially among young people, as they are likely to experience anxiety, depression, and psychological abnormalities. Different psychological interventions could be formulated according to the psychological characteristics of different gender and age groups. The majority of respondents followed specific behaviors required by the authorities, but it will take time to observe the effects of these behaviors on the epidemic.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia , Adolescente , Adulto , Idoso , Betacoronavirus , China/epidemiologia , Infecções por Coronavirus/prevenção & controle , Estudos Transversais , Depressão/epidemiologia , Depressão/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Transtornos Fóbicos/epidemiologia , Transtornos Fóbicos/psicologia , Pneumonia Viral/prevenção & controle , Inquéritos e Questionários , Adulto Jovem
5.
Artigo em Inglês | MEDLINE | ID: mdl-32183487

RESUMO

The prevalence of anxiety disorders over the last year among seniors ranged from 3.6% to 17.2%. The most prevalent disorders are specific phobias. Data are needed concerning the consequences of specific phobia disorder on the level of functioning and quality of life of older people, the age of onset of specific phobia disorder, and the duration of episodes. In total, 555 community-dwelling people aged between 65 and 84 years who lived in Madrid (Spain) were assessed (Composite International Diagnostic Interview for people over 65 years (CIDI65+), WHO Disability Assessment Schedule (WHODAS II), Health of the Nation Outcome Scales for Older Adults (HoNOS65+), World Health Organization Quality of Life Brief (WHOQOL-BREF). Prevalence rates and odds ratio, t-tests, binary logistic regression, and point-biserial correlations were calculated. A total of 12.07% of the sample suffered a specific phobia disorder over the last year. The average age at onset of the specific phobia was 38.78 (sd = 21.61) years. The mean duration of the phobia was approximately 20 (sd = 20) years. A significant effect of the specific phobia was found for the current levels of functioning and quality of life: WHOQOL-BREF total score (p < 0.05), WHODAS II overall score (p < 0.01), and HoNOS65+ total score (p < 0.001). Having specific phobia disorder decreased the level of functioning and negatively affected the quality of life. These data suggest the need for primary healthcare professionals to include the detection of specific phobia disorders in their protocols because people do not receive treatment for this problem, and they might carry it throughout their lives.


Assuntos
Transtornos Fóbicos , Qualidade de Vida , Idoso , Idoso de 80 Anos ou mais , Transtornos de Ansiedade , Feminino , Humanos , Masculino , Transtornos Fóbicos/epidemiologia , Prevalência , Espanha/epidemiologia
6.
Arch Dis Child ; 105(7): 684-689, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-31974300

RESUMO

OBJECTIVE: To investigate the mental health of children and adolescents admitted to neonatal intensive/special care units (NICUs) in infancy. METHODS: This cross-sectional study used a provincially representative cohort from the 2014 Ontario Child Health Study. Parents provided data on psychiatric disorders using the MINI International Neuropsychiatric Interview for Children and Adolescents in 3141 children aged 4-11 years (NICU n=389; control n=2752) and in 2379 children aged 12-17 years (NICU n=298; control n=2081). Additionally, 2235 adolescents aged 12-17 years completed the interview themselves (NICU n=285; control n=1950). Odds of psychiatric disorder were compared in those admitted and controls. RESULTS: Based on parent reports, NICU graduates aged 4-11 years had increased adjusted ORs (95% CI) of 1.78 (1.39 to 2.28) for any psychiatric disorder, with a marginal prevalence of 32.4% in NICU participants and 27.6% in controls. At this age, NICU graduates also had increased ORs of 1.74 (1.25 to 2.40) for psychiatric comorbidity, 1.48 (1.04 to 2.11) for oppositional defiant disorder, 1.61 (1.19 to 2.19) for attention-deficit hyperactivity disorder, 4.11 (2.33 to 7.25) for separation anxiety disorder and 2.13 (1.37 to 3.31) for specific phobia. At 12-17 years, 40.5% and 30.5% of NICU graduates and 30.6% and 17.9% of controls had any psychiatric disorder as reported by parents and self-report, respectively. Parents and adolescents, respectively, reported increased adjusted ORs (95% CI) of 1.63 (1.18 to 2.26) and 1.55 (1.13 to 2.11) for any disorder, 1.64 (1.06 to 2.54) and 1.74 (1.11 to 2.73) for psychiatric comorbidity, and 1.89 (1.22 to 2.93) and 3.17 (2.03 to 4.95) for oppositional defiant disorder. CONCLUSIONS: NICU graduates are at increased risk for psychiatric disorders during childhood and adolescence.


Assuntos
Ansiedade de Separação/epidemiologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/epidemiologia , Unidades de Terapia Intensiva Neonatal/estatística & dados numéricos , Transtornos Fóbicos/epidemiologia , Adolescente , Fatores Etários , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Criança , Pré-Escolar , Comorbidade , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Lactente , Recém-Nascido , Masculino , Saúde Mental , Ontário/epidemiologia , Prevalência
7.
Cancer ; 126(1): 211-218, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31539169

RESUMO

BACKGROUND: Fear of cancer recurrence (FCR) has a profound negative impact on quality of life (QOL) for many cancer survivors. Breast cancer survivors (BCS) are particularly vulnerable, with up to 70% reporting clinically significant FCR. To the authors' knowledge, evidence-based interventions for managing FCR are limited. Acceptance and commitment therapy (ACT) promotes psychological flexibility in managing life's stressors. The current study examined the feasibility and preliminary efficacy of group-based ACT for FCR in BCS. METHODS: Post-treatment BCS (91 patients with stage I-III disease) with clinical FCR randomly were assigned to ACT (6 weekly 2-hour group sessions), survivorship education (SE; 6 weekly 2-hour group sessions), or enhanced usual care (EUC; one 30-minute group coaching session with survivorship readings). FCR severity (primary outcome) and avoidant coping, anxiety, post-traumatic stress, depression, QOL, and other FCR-related variables (secondary outcomes) were assessed at baseline (T1), after the intervention (T2), 1 month after the intervention (T3), and 6 months after the intervention (T4) using intent-to-treat analysis. RESULTS: Satisfactory recruitment (43.8%) and retention (94.5%) rates demonstrated feasibility. Although each arm demonstrated within-group reductions in FCR severity over time, only ACT produced significant reductions at each time point compared with baseline, with between-group differences at T4 substantially favoring ACT over SE (Cohen d for effect sizes, 0.80; P < .001) and EUC (Cohen d, 0.61; P < .01). For 10 of 12 secondary outcomes, only ACT produced significant within-group reductions across all time points. By T4, significant moderate to large between-group comparisons favored ACT over SE and EUC with regard to avoidant coping, anxiety, depression, QOL, and FCR-related psychological distress. CONCLUSIONS: Group-based ACT is a feasible and promising treatment for FCR and associated outcomes in BCS that warrants testing in larger, fully powered trials.


Assuntos
Neoplasias da Mama/psicologia , Sobreviventes de Câncer , Medo/psicologia , Recidiva Local de Neoplasia/psicologia , Adulto , Idoso , Ansiedade/tratamento farmacológico , Ansiedade/epidemiologia , Ansiedade/patologia , Mama/patologia , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/patologia , Depressão/tratamento farmacológico , Depressão/epidemiologia , Depressão/patologia , Feminino , Humanos , Internação Involuntária , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/tratamento farmacológico , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/prevenção & controle , Estadiamento de Neoplasias , Transtornos Fóbicos/tratamento farmacológico , Transtornos Fóbicos/epidemiologia , Transtornos Fóbicos/patologia , Qualidade de Vida , Transtornos de Estresse Pós-Traumáticos/complicações , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/patologia , Transtornos de Estresse Pós-Traumáticos/psicologia
8.
Midwifery ; 82: 102590, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31864080

RESUMO

OBJECTIVE: The primary objective was to estimate the population prevalence of specific phobias (including pregnancy related specific phobias) and associated mental disorders. The secondary objective was to investigate the effectiveness of routinely collected screening tools (depression and anxiety screens, Whooley and GAD-2 respectively) in identifying specific phobias. Specific phobias are the most common anxiety disorder to occur during pregnancy, but studies on prevalence and clinical correlates of specific phobias, including pregnancy related specific phobias are lacking. DESIGN: Cross-sectional survey using a two-phase sampling design stratified according to being positive or negative on the Whooley questions routinely asked by midwives. Approaching all whooley positive women and drawing a random sample of Whooley negative women. Sampling weights were used to account for the bias induced by the stratified sampling. PARTICIPANTS: 545 pregnant women attending their first antenatal appointment. Language interpreters were used where required. SETTING: Inner-city maternity service, London, UK. MEASUREMENTS: The Structured Clinical Interview for DSM-IV Axis I Mental Disorders were administered to assess mental disorders and 544 women responded to the anxiety module on specific phobias. RESULTS: The maternity population prevalence estimate for specific phobias was 8.4% (95%CI: 5.8-12.1%) and for pregnancy related phobias was 1.5% (95%CI: 0.6-3.7%), most of which were needle phobias. The prevalence estimate of tokophobia was 0.032% (95%CI: 0.0044-0.23%). Over half (52.4%) the women with specific phobias had comorbid mental disorders. Routinely administered screening tools (Whooley and GAD-2) were not helpful in identifying phobias. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Phobias in pregnancy are common but pregnancy related phobias are rare, particularly tokophobia. As routinely administered screening tools were not helpful in identifying phobias, other indicators could be considered, such as avoidance of blood tests and requests for caesarean sections.


Assuntos
Transtornos Fóbicos/psicologia , Gestantes/psicologia , Prevalência , Adolescente , Adulto , Criança , Estudos Transversais , Feminino , Humanos , Londres/epidemiologia , Programas de Rastreamento/métodos , Programas de Rastreamento/estatística & dados numéricos , Pessoa de Meia-Idade , Transtornos Fóbicos/epidemiologia , Gravidez , Escalas de Graduação Psiquiátrica , Psicometria/instrumentação , Psicometria/métodos , Inquéritos e Questionários
9.
Pan Afr Med J ; 33: 47, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31448010

RESUMO

Introduction: Hypogonadism refers to a syndrome that results from failure of gonads to function properly. The main concern is considerable rise in morbidity, as shown by increased cardiovascular risk, infertility, osteoporosis and above all, the psychological impact on the life of the patients with hypogonadism. Judicious steroid replacement and culturally-sensitive psychological support before and during steroid therapy remains the key tool in the management of this condition. The present study aimed at filling the knowledge gap on hypogonadism in Cameroon. Methods: We conducted a cross-sectional study over a period of 12 months, in 3 reference hospitals of Cameroon. We included males and females diagnosed with hypogonadism, aged 16 to 50 years and 16 to 45 years respectively. After a complete clinical examination, patients were invited to fill the modified middlesex hospital questionnaire for psychoneurotic evaluation. Results: We recruited 59 patients with a sex ratio of 1:1. The mean age of the females and males were 27.7 ± 9.1years and 30.8 ± 11.7 years respectively. Normosmic Idiopathic Hypogonadotropic Hypogonadism (NIHH) was the most common presentation. Compulsive obsessive traits, phobic anxiety and hysterical trait, were most pronounced in these patients. Testosterone titers significantly correlated positively with testicular size and negatively with body mass index (BMI). A significant positive correlation was found between the testicular volumes measured with ultrasound (US) and with the orchidometer. Conclusion: Normosmic idiopathic hypogonadotropic hypogonadism is the most common presentation of hypogonadism in the study population. There is a significant psychosocial impact requiring further investigation and attention.


Assuntos
Hipogonadismo/fisiopatologia , Testículo/diagnóstico por imagem , Testosterona/sangue , Adolescente , Adulto , Índice de Massa Corporal , Camarões , Estudos Transversais , Feminino , Humanos , Hipogonadismo/epidemiologia , Hipogonadismo/psicologia , Histeria/epidemiologia , Masculino , Pessoa de Meia-Idade , Transtorno Obsessivo-Compulsivo/epidemiologia , Transtornos Fóbicos/epidemiologia , Ultrassonografia , Adulto Jovem
10.
J Pak Med Assoc ; 69(6): 823-827, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31189289

RESUMO

OBJECTIVE: To investigate the relationships of pain beliefs with clinical/functional status and kinesiophobia in patients with knee osteoarthritis. Methods: The descriptive cross-sectional study was conducted at the Department of Physical Therapy and Rehabilitation, Acibadem Hospitals Group, Istanbul, Turkey, between May 2015 and April 2016, and comprised chronic patients who were either overweight or obese. Patients were evaluated using visual analogue scale, Western Ontario and McMaster University Osteoarthritis Index, Lequesne Index (LI), Tampa Scale for Kinesiophobia and the Pain Beliefs Questionnaire. Statistical analysis was done using SPSS 15. . RESULTS: Of the 78 patients, there were 10(13%) males, 68(87%) females with an overall mean age of 56.09}11.79 years and mean body mass index of 29.3}4.91. There were moderate positive correlations among kinesiophobia, pain and functional scores, while organic pain beliefs had a moderate positive correlation with body mass index scores and positive weak correlations with clinical/functional status scores and kinesiophobia (p<0.05 each). There were no associations between the organic subscale and psychological subscale of the Pain Beliefs Questionnaire (p>0.05).. CONCLUSIONS: Possible fear of movement and pain belief should be taken into consideration in the management of patients with knee osteoarthritis.


Assuntos
Artralgia , Osteoartrite do Joelho , Transtornos Fóbicos , Adulto , Idoso , Artralgia/complicações , Artralgia/epidemiologia , Artralgia/fisiopatologia , Artralgia/psicologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/complicações , Osteoartrite do Joelho/epidemiologia , Osteoartrite do Joelho/fisiopatologia , Osteoartrite do Joelho/psicologia , Transtornos Fóbicos/complicações , Transtornos Fóbicos/epidemiologia , Turquia/epidemiologia
11.
Artigo em Inglês | MEDLINE | ID: mdl-31152643

RESUMO

BACKGROUND: Fearful and anxious behaviour is especially common in children, when they come across new situations and experiences. The difference between normal worry and an anxiety disorder is in the severity and in the interference with everyday life and normal developmental steps. Many longitudinal studies in children suggest that anxiety disorders are relatively stable over time and predict anxiety and depressive disorders in adolescence and adulthood. For this reason, the early diagnostic and treatment are needed. Researchers supposed that anxiety is a result of repeated stress. Additionally, some genetic, neurobiological, developmental factors are also involved in the aetiology. METHODS AND SUBJECTS: The aim of this article is to summarize and to present our own results obtained with the assessment and treatment of different forms of anxiety disorders in children and adolescents such as: Posttraumatic Stress Disorder (PTSD), Obsessive Compulsive Disorder (OCD), Dental anxiety, General Anxiety Disorder (GAD), and Anxious-phobic syndrome. Some results are published separately in different journals. a) Post Traumatic Stress Disorder (PTSD) in 10 young children aged 9 ± 2, 05 y. is evaluated and discussed concerning the attachment quality. b) The group with OCD comprises 20 patients, mean age 14,5 ± 2,2 years, evaluated with Eysenck Personality Questionnaire (EPQ), Child behaviour Checklist (CBCL), K-SADS (Schedule for Affective Disorders and Schizophrenia for School age children), Beck Depression Inventory (BDI), SCWT (Stroop Colour Word task), WCST (Wisconsin Card Scoring test). c) Dental stress is evaluated in a group of 50 patients; mean age for girls 11,4 ± 2,4 years; for boys 10,7 ± 2,6 years, evaluated with (General Anxiety Scale (GASC), and Eysenck Personality Questionnaire (EPQ). d) Minnesota Multiphasic Personality Inventory (MMPI) profiles obtained for General Anxiety Disorder in 20 young females and 15 males aged 25,7± 5,35 years, and a group with Panic attack syndrome N=15 aged 19,3±4,9 years are presented and discussed by comparison of the results for healthy people. e) Heart Rate Variability (HRV) was applied for assessment and treatment in 15 anxious-phobic patients, mean age 12, 5±2,25 years and results are compared with other groups of mental disorder. RESULTS: Children with PTSD showed a high level of anxiety and stress, somatization and behavioural problems (aggression, impulsivity, non-obedience and nightmares), complemented by hypersensitive and depressed mothers and misattachment in the early period of infancy. Consequently, the explanation of the early predisposition to PTSD was related to be the non-developed Right Orbital Cortex. The later resulted from insecure attachment confirmed in all examined children. The obtained neuropsychological profile of children with OCD confirmed a clear presence of obsessions and compulsions, average intellectual capacities, but the absence of depressive symptoms. Executive functions were investigated through Event Related Potentials on Go/NoGo tasks. Results showed that no significant clinical manifestations of cognitive dysfunction among children with OCD in the early stage of the disorder are present, but it could be expected to be appearing in the later stage of the disorder if it is no treated. In a study of 50 children randomly selected, two psychometric instruments were applied for measuring general anxiety and personal characteristics. It was confirmed that there was presence of significant anxiety level (evaluated with GASC) among children undergoing dental intervention. The difference in anxiety scores between girls and boys was also confirmed (girls having higher scores for anxiety). Results obtained with EPQ showed low psychopathological traits, moderate extraversion and neuroticism, but accentuated insincerity (L scale). L scales are lower by increasing of age, but P scores rise with age, which can be related to puberty. No correlation was found between personality traits and anxiety except for neuroticism, which is positively correlated with the level of anxiety. The obtained profiles for MMPI-201 in a group of patients with general anxiety are presented as a figure. Females showed only Hy peak, but in the normal range. However, statistics confirmed significant difference between scores in anxiety group and control (t= 2, 25164; p= 0, 038749). Males showed Hs-Hy-Pt peaks with higher (pathological) scores, related to hypersensitivity of the autonomic nervous system, as well as with manifested anxiety. Calculation confirmed significant difference between control and anxiety in men (t= 15.13, p=0.000). Additionally, MMPI profiles for patients with attack panic syndrome are also presented as a figure. Control scales for females showed typical V form (scales 1 and 3) related to conversing tendencies. In addition, females showed peaks on Pt-Sc scales, but in normal ranges. Pathological profile is obtained in males, with Hy-Sc peaks; this profile corresponds to persons with regressive characteristics, emotionally instable and with accentuated social withdraw. Heart rate variability (HRV) is a measure of the beat to beat variability in heart rate, related to the work of autonomic nervous system. It may serve as a psychophysiological indicator for arousal, emotional state and stress level. We used HRV in both, the assessment and biofeedback training, in a group of anxious-phobic and obsessive-compulsive school children. Results obtained with Eysenck Personality Questionnaire showed significantly higher psychopathological traits, higher neuroticism and lower lie scores. After 15 session HRV training very satisfying results for diminishing stress and anxiety were obtained.


Assuntos
Transtornos de Ansiedade/psicologia , Transtorno Depressivo/psicologia , Medo/psicologia , Adolescente , Adulto , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/terapia , Criança , Ansiedade ao Tratamento Odontológico/epidemiologia , Ansiedade ao Tratamento Odontológico/psicologia , Ansiedade ao Tratamento Odontológico/terapia , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/terapia , Epilepsia Pós-Traumática/epidemiologia , Epilepsia Pós-Traumática/psicologia , Epilepsia Pós-Traumática/terapia , Feminino , Humanos , Masculino , Neuroticismo , Transtorno Obsessivo-Compulsivo/epidemiologia , Transtorno Obsessivo-Compulsivo/psicologia , Transtorno Obsessivo-Compulsivo/terapia , Transtornos Fóbicos/epidemiologia , Transtornos Fóbicos/psicologia , Transtornos Fóbicos/terapia , Escalas de Graduação Psiquiátrica , Psicometria , Adulto Jovem
12.
Asian J Psychiatr ; 43: 137-142, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31146170

RESUMO

INTRODUCTION: There is scarce data available on community based prevalence of Anxiety Disorders (ADs) amongst adolescents in north Indian settings. OBJECTIVE: To determine the prevalence of anxiety disorders, and associated factors amongst adolescents in a rural community of Ballabgarh block, district Faridabad, Haryana. METHODS: Participants (10-19 years) were enrolled through simple random sequence from a sampling frame of adolescents residing in 28 villages of Ballabgarh block using household survey technique. They were screened using Screen for Childhood Anxiety Related Emotional Disorders (SCARED) tool and then subjected to confirmatory diagnosis using Mini-International Neuropsychiatric Interview for Children/Adolescent (MINI KID). All adolescents with ADs were assessed for co-psychiatric morbidities using MINI-KID and functional impairment using Children Global Assessment Scale (CGAS). Prevalence and 95% Confidence intervals are reported. Additionally, socio-demographic factors were elicited using a semi-structured interview schedule and associations were determined using multivariable logistic regression analysis. RESULTS: A total of 678 adolescents participated in this study with mean age (SD) as 14.2 (2.5) years. The age adjusted prevalence of anxiety disorders was found to be 16.6% (95% CI: 16.0-17.2). The most prevalent anxiety disorder among participants was social anxiety disorders followed by specific phobias. Female sex and low socio-economic status were associated with anxiety disorders. Two third of adolescents with ADs had no functional impairment and almost one third were found to have one or more co-existing psychiatric co-morbidity. CONCLUSION: We found a high prevalence of ADs in rural north Indian community settings warranting adequate health system response at primary care level.


Assuntos
Transtornos de Ansiedade/epidemiologia , População Rural/estatística & dados numéricos , Classe Social , Adolescente , Criança , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Índia/epidemiologia , Masculino , Fobia Social/epidemiologia , Transtornos Fóbicos/epidemiologia , Prevalência , Fatores Sexuais
13.
BMC Med ; 17(1): 101, 2019 05 24.
Artigo em Inglês | MEDLINE | ID: mdl-31122269

RESUMO

BACKGROUND: Specific phobia (SP) is a relatively common disorder associated with high levels of psychiatric comorbidity. Because of its early onset, SP may be a useful early marker of internalizing psychopathology, especially if generalized to multiple situations. This study aimed to evaluate the association of childhood generalized SP with comorbid internalizing disorders. METHODS: We conducted retrospective analyses of the cross-sectional population-based World Mental Health Surveys using the Composite International Diagnostic Interview. Outcomes were lifetime prevalence, age of onset, and persistence of internalizing disorders; past-month disability; lifetime suicidality; and 12-month serious mental illness. Logistic and linear regressions were used to assess the association of these outcomes with the number of subtypes of childhood-onset (< 13 years) SP. RESULTS: Among 123,628 respondents from 25 countries, retrospectively reported prevalence of childhood SP was 5.9%, 56% of whom reported one, 25% two, 10% three, and 8% four or more subtypes. Lifetime prevalence of internalizing disorders increased from 18.2% among those without childhood SP to 46.3% among those with one and 75.6% those with 4+ subtypes (OR = 2.4, 95% CI 2.3-2.5, p < 0.001). Twelve-month persistence of lifetime internalizing comorbidity at interview increased from 47.9% among those without childhood SP to 59.0% and 79.1% among those with 1 and 4+ subtypes (OR = 1.4, 95% CI 1.4-1.5, p < 0.001). Respondents with 4+ subtypes also reported significantly more disability (3.5 days out of role in the past month) than those without childhood SP (1.1 days) or with only 1 subtype (1.8 days) (B = 0.56, SE 0.06, p < 0.001) and a much higher rate of lifetime suicide attempts (16.8%) than those without childhood SP (2.0%) or with only 1 subtype (6.5%) (OR = 1.7, 95% CI 1.7-1.8, p < 0.001). CONCLUSIONS: This large international study shows that childhood-onset generalized SP is related to adverse outcomes in the internalizing domain throughout the life course. Comorbidity, persistence, and severity of internalizing disorders all increased with the number of childhood SP subtypes. Although our study cannot establish whether SP is causally associated with these poor outcomes or whether other factors, such as a shared underlying vulnerability, explain the association, our findings clearly show that childhood generalized SP identifies an important target group for early intervention.


Assuntos
Transtornos Mentais/epidemiologia , Transtornos Fóbicos/diagnóstico , Transtornos Fóbicos/epidemiologia , Adolescente , Adulto , Idade de Início , Idoso , Envelhecimento/psicologia , Biomarcadores/análise , Criança , Estudos Transversais , Diagnóstico Precoce , Feminino , Saúde Global/estatística & dados numéricos , Inquéritos Epidemiológicos , Humanos , Longevidade , Masculino , Transtornos Mentais/diagnóstico , Saúde Mental , Pessoa de Meia-Idade , Prevalência , Psicopatologia , Estudos Retrospectivos , Adulto Jovem
14.
Obes Surg ; 29(7): 2078-2086, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30838534

RESUMO

BACKGROUND: Obesity is a rising social and economic burden. Patients with obesity often suffer from stigmatization and discrimination. Underrecognition of obesity as a disease could be a contributing factor. The present study aimed to compare attitudes towards obesity with other chronic diseases and to evaluate the recognition of need of professional treatment. METHODS: Nine hundred and forty-nine participants (subgroups: general population, patients with obesity, nurses in training, nurses, medical students, physicians) were randomized to video teaching on obesity and control. Questionnaires on the burden and influence of obesity on daily life compared to other chronic diseases and the fat phobia scale (FPS) were answered. RESULTS: Burden of obesity was rated low (4.2 ± 1.3; rank 9 of 11) compared to other diseases. Bowel cancer (5.5 ± 0.9) had the highest and caries the lowest (2.7 ± 1.4) estimated impact. Females (p = 0.011) and older people (p < 0.001) rated burden of obesity high whereas general population (p < 0.001) and control (p < 0.001) rated it low. Females (p = 0.001) and people with higher BMI (p = 0.004) rated the influence of obesity on daily life high; the general population (p < 0.001; reference physicians) and the control group (p < 0.001) rated it low. FPS was lowest in patients with obesity (3.2 ± 0.7) and highest in the general population (3.6 ± 0.4) and medical students (3.6 ± 0.5; p < 0.001; compared to physicians). CONCLUSIONS: Obesity is underestimated as a disease compared to other chronic diseases and attitudes towards obesity are rather negative in comparison. Video teaching showed positive effects so a focus in medical education and public campaigns should aim to improve prevention and treatment of obesity.


Assuntos
Atitude do Pessoal de Saúde , Recursos Audiovisuais , Educação Médica/métodos , Educação em Enfermagem/métodos , Obesidade/psicologia , Gravação em Vídeo , Preconceito de Peso/prevenção & controle , Adulto , Doença Crônica/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/psicologia , Transtornos Fóbicos/epidemiologia , Transtornos Fóbicos/prevenção & controle , Médicos/psicologia , Médicos/estatística & dados numéricos , Relações Profissional-Paciente , Estereotipagem , Estudantes de Medicina/psicologia , Estudantes de Medicina/estatística & dados numéricos , Inquéritos e Questionários , Preconceito de Peso/psicologia , Preconceito de Peso/estatística & dados numéricos , Adulto Jovem
15.
Curr Psychiatry Rep ; 21(4): 27, 2019 03 12.
Artigo em Inglês | MEDLINE | ID: mdl-30868272

RESUMO

PURPOSE OF REVIEW: This paper seeks to identify the risk factors of fear of childbirth (FOC) and posttraumatic stress disorder (PTSD) related to birth and reviews the efficacy of their respective screening tools and therapeutic interventions. RECENT FINDINGS: Biofeedback, hypnosis, internet-based cognitive behavioral therapy, and antenatal education are promising treatments for FOC. Training midwives to address traumatic birth experiences could help in preventing PTSD. A shorter more pragmatic screening tool for FOC than the Wijma Delivery Expectancy/Experience Questionnaire (WDEQ) is needed. Women with PTSD attributed a mismatch between the expected mode of delivery (MOD) and the actual MOD as the cause of their trauma. A history of mental health disorders, lack of social support, previous negative birth experiences, and MOD are correlated to FOC and postpartum PTSD. Psycho-education and CBT-based treatments have been found to reduce levels of FOC and PTSD.


Assuntos
Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/terapia , Medo/psicologia , Parto/psicologia , Transtornos Fóbicos/epidemiologia , Transtornos Fóbicos/terapia , Período Pós-Parto/psicologia , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/psicologia , Terapia Cognitivo-Comportamental , Feminino , Humanos , Transtornos Fóbicos/diagnóstico , Transtornos Fóbicos/psicologia , Gravidez , Apoio Social , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/etiologia , Transtornos de Estresse Pós-Traumáticos/terapia , Inquéritos e Questionários
16.
Aerosp Med Hum Perform ; 90(4): 384-388, 2019 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-30922426

RESUMO

BACKGROUND: Fear of flying is one of the most common phobias. It hinders people in performing their work and hampers family relations. Even though flight traffic has increased, there are new fears. Valid studies are needed to answer whether there have been changes in the prevalence of flight anxiety, are there sex differences in relation to fear of flying, use of alcohol, and tranquilizers, which situations cause the most flight anxiety, and whether the above factors have changed compared to a similar study from 1986.METHODS: A questionnaire was distributed to a representative random sample of the Norwegian population (N = 5500), where 36% answered. To assess flight anxiety across the time period, we used similar instruments to those we used in 1986.RESULTS: The prevalence of an assumed flight phobia decreased from 8% in 1986 to 3% in 2015. The percentage of those reported to never fly had decreased from 5% in 1986 to 0.5% in 2015. There were 11.0% who always used alcohol in 1986 and 7.5% in 2015 and 3% and 2%, respectively, always used tranquillizers. More women reported being afraid of both flying and other situations compared to men. Turbulence, unknown sounds, and fear of terror attacks caused the most anxiety.DISCUSSION: Flight anxiety still affects a considerable proportion of the Norwegian population and more women than men report that they are afraid of flying. However, in spite of methodology, people are significantly less afraid of flying than in 1986.Grimholt TK, Bonsaksen T, Schou-Bredal I, Heir T, Lerdal A, Skogstad L, Ekeberg Ø. Flight anxiety reported from 1986 to 2015. Aerosp Med Hum Perform. 2019; 90(4):384-388.


Assuntos
Medicina Aeroespacial/estatística & dados numéricos , Ansiedade/epidemiologia , Transtornos Fóbicos/epidemiologia , Autorrelato/estatística & dados numéricos , Adulto , Medicina Aeroespacial/tendências , Idoso , Idoso de 80 Anos ou mais , Ansiedade/psicologia , Aviação/estatística & dados numéricos , Medo/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Noruega/epidemiologia , Transtornos Fóbicos/psicologia , Prevalência , Fatores Sexuais , Adulto Jovem
17.
Psychosom Med ; 81(5): 398-407, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30920464

RESUMO

Illness anxiety disorder is a primary disorder of anxiety about having or developing a serious illness. The core feature is the cycle of worry and reassurance seeking regarding health, as opposed to a focus on relief of distress caused by somatic symptoms (as in Somatic Symptom Disorder). Clinically significant health anxiety is common, with estimates ranging up to 13% in the general adult population. There are evidence-based treatments, including psychopharmacology and cognitive behavioral therapy, that can significantly alleviate symptoms. An understanding of the core psychopathology and clinical features of illness anxiety disorder is essential to fostering a working alliance with patients with health anxiety, as is the maintenance of an empathic, curious, and nonjudgmental stance toward their anxiety. Collaboration between medical providers is essential to avoid the pitfalls of excess testing and medical treatment.


Assuntos
Atitude Frente a Saúde , Terapia Cognitivo-Comportamental , Transtornos Fóbicos/fisiopatologia , Transtornos Fóbicos/terapia , Inibidores de Captação de Serotonina/uso terapêutico , Adulto , Feminino , Humanos , Transtorno de Pânico/diagnóstico , Transtorno de Pânico/fisiopatologia , Transtorno de Pânico/terapia , Transtornos Fóbicos/diagnóstico , Transtornos Fóbicos/epidemiologia
18.
Pediatr Dermatol ; 36(3): 311-316, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30882946

RESUMO

BACKGROUND/OBJECTIVES: The TOPICOP scale is an easy-to-use scale for assessing topical corticosteroid (TCS) phobia in atopic dermatitis (AD) patients and their caretakers. TCS phobia is a common problem among AD patients and their caretakers. The aim of this study was to examine the relationship between TCS phobia in caretakers of children with AD and the characteristics of patients using the TOPICOP scale. METHODS: Caretakers of AD patients who visited the allergy clinic at the National Center for Child Health and Development in Tokyo between February 2014 and May 2014 were recruited. Caretakers of patients in follow-up had already attended an education session on treatment at the institution. All participants completed an anonymous questionnaire on the characteristics of the respondents and patients using the Patient-Oriented Eczema Measure (POEM) and the Japanese version of TOPICOP. RESULTS: In total, 243 participants (88.9% female) completed the survey. The average TOPICOP score was 40.3 and the median POEM score was 4. The TOPICOP score was significantly higher for patients younger than 12 months old with moderate to very severe AD (POEM ≥ 8) whose caretaker had not attended an educational session (P < 0.01, respectively). There was no significant difference in the family history of AD, age, or gender of the respondents. In multivariable analysis, preattendance at an education session was the only significant factor accounting for a higher TOPICOP score (P < 0.001). CONCLUSIONS: Regardless of their background, caretakers of AD patients can be affected from TCS phobia. Attending an educational session might ease their anxiety.


Assuntos
Cuidadores/psicologia , Dermatite Atópica/tratamento farmacológico , Glucocorticoides/uso terapêutico , Conhecimentos, Atitudes e Prática em Saúde , Pais/psicologia , Transtornos Fóbicos/epidemiologia , Administração Cutânea , Adolescente , Adulto , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Japão , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
20.
Int J Geriatr Psychiatry ; 34(3): 397-407, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30444008

RESUMO

OBJECTIVES: To provide an estimate of 12-month and lifetime prevalence of Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) anxiety disorders in older adults based on published studies on this topic and to identify the impact of gender and age. METHODS/DESIGN: A systematic review and meta-analysis was performed. Six databases were searched, and manual searches through reference lists of selected articles and reviews were performed. When the information was available, summary effects were calculated for the prevalence of each anxiety disorder and for every age and gender subgroups. Summary odd ratios (OR) were calculated to compare the prevalence of an anxiety disorder according to age and gender. RESULTS: A total of 6464 studies were identified, and 16 studies were included in the meta-analyses. Prevalence was significantly higher in women than men for generalized anxiety disorder (12 month OR = 6.10, P = 0.001; lifetime OR = 1.96, P = 0.001), 12-month social anxiety disorder (OR = 2.07, P = 0.01), and lifetime post-traumatic stress disorder (OR = 1.93, P = 0.002). The prevalence of specific phobia was significantly lower in both the 75 to 84 and 85 years and above age groups when compared with the 65 to 74 years age group (OR = 0.70, P = 0.004 and OR = 0.63, P = 0.01, respectively). CONCLUSIONS: Our results suggest that the tendency for women to experience a greater prevalence of anxiety disorders remains present in older adults. Specific phobia was the only disorder to be less frequent with advancing age. This is likely to change with the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria because this new DSM version now indicates that fear of falling is a possible type of specific phobia and fear of falling is generally more frequent in the oldest age groups.


Assuntos
Transtornos de Ansiedade/epidemiologia , Fatores Etários , Idoso , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Masculino , Razão de Chances , Transtornos Fóbicos/epidemiologia , Prevalência , Fatores Sexuais , Transtornos de Estresse Pós-Traumáticos/epidemiologia
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