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High prevalence of chronic gastrointestinal symptoms in Holocaust survivors
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Poster abstracts / Journal of Psychosomatic Research 55 (2003) 147–178
Methods: The study sample included 55 patients and their relatives 12 and 24 months after discharge from a neurological rehabilitation. Outcomes of patients were evaluated by the Barthel index (BI) and SF-36. Outcomes of relatives were rated by SF-36 and caregiver strain index. Results: The functional outcome shows a limited improvement but there is a difference between subjective and objective assessment. Even the average BI score was quite well, 77% of the patients still reported about physical problems. There was no correlation found between physical problems and self-assessment of quality of life. By way of comparison, the SF-36 between patients and relatives, the mean of the patients outcomes are lower than the mean of the relatives, except that scale of bodily pain shows a lower outcome for the relatives. At study time average, 60% of relatives were experiencing considerable strain.
High prevalence of chronic gastrointestinal symptoms in Holocaust survivors Dumitrascu DL, Dumitrascu DM, Ghisa A, Hriscu C, Neufeld G Aim: A higher prevalence of functional gastrointestinal (GI) symptoms has been reported in Holocaust survivors. We looked for this matter in an area where the subjects have survived after Holocaust, to a totalitarian (communist) regime. Methods: All Jews who survived Holocaust living in Cluj, Romania, were questioned in a telephone survey about life conditions during the World War II (WWII) and on 13 GI symptoms (presence, intensity, frequency). This investigation was carried out in 1995 and repeated in 2000. Subjects were divided in two groups: A1: who lived in extermination campuses; A2: who lived in forced labour campuses. Control group B: age and sex matched subjects not deported during WWII. Results: Following GI symptoms were significantly overrepresented in group A1 vs. group B: anorexia, nausea, emesis, heartburn, bloating and diarrhea. In A2 only constipation had a higher prevalence than in B. After 5 years only 8 persons were available, so the study could not be repeated. Conclusion: The number of self-reported chronic GI symptoms is higher in Holocaust survivors than in matched controls. These findings remain significant even when stress caused by living under a totalitarian regime is interfering.
Emotional repression — premorbid trait or coping response to a diagnosis of breast cancer? Zachariae R, Pedersen C, Jorgensen MM, Jensen AB, Christensen S, Lassesen B, Lehbrink M Introduction: It unclear whether emotional repression is a premorbid trait of cancer patients or a coping response to cancer diagnosis. Methods: Of 646 women referred to examination for breast cancer, 71 women were diagnosed with primary breast cancer. Repressive coping was defined as a combination of high defensiveness (Marlowe – Crowne Social Desirability Scale) and low anxiety (Taylor Manifest Anxiety Scale) and was measured before, 4 weeks after, and 12 weeks after diagnosis. Results: Four weeks after diagnosis, increased repression ( P < .01) was found in women diagnosed with breast cancer but not in women without cancer. The women were unaware of their disease status before the examination, and there were no group differences in defensiveness, anxiety, or repression before and 12 weeks after diagnosis. When controlling for repressive coping prior to diagnosis, perceived risk of having breast cancer, age and other demographic factors with a multiple, logistic regression, only cancer diagnosis (Odds ratio: 2.39; P < .05) and having biological children (Odds ratio: 2.83; P < .02) emerged as significant predictors of repressive coping four weeks after diagnosis. Conclusion: The results support previous findings suggesting that repression is a coping response to the cancer diagnosis, rather than a premorbid personality trait.
Stress-related sleep arousals in nonpatients is related to changes in metabolic parameters Ekstedt M, Soderstrom M, Axelsson J, Nilsson J, Akerstedt T Objective: Major sleep disturbances seem to be associated with metabolic changes of potential long term impact on health. The present study sought to investigate such changes in a nonclinical group with a high number of arousals during sleep. Method: 24 individuals (12 males), in an IT company were recruited based on high ( > 2.75) and low mean scores ( < 1.5) on a revised Melamed Burnout Questionnaire (min = 1, max = 4). The subjects were recorded for a 2-week period using daily ratings of sleep quality, actigraphy, polysomnography (EEG) at home, ambulatory blood pressure recordings (24 h), and repeated saliva samples (for analysis of cortisol), and a morning blood sample. Based on the EEG the participants were divided at the median into groups with many (>8/h) and few (< 8/h) arousals, American Sleep Disorders Association norms. The results were analysed using a one-factor ANOVA. Results: The group with more arousals showed an increased: diastolic blood pressure (82 F 1 vs. 73 F 3 mm Hg: P < .05), heart rate (82 F 3 vs. 70 F 2 beats/min P < .05) LDL; (3.3 F .2 vs. 2.6 F .3 nmol/l; P < .05) and cortisol levels in blood (573 F 25 vs. 395 F 19 mmol/l: P < .01) and saliva (17.1 F 2 vs. 10.0 F .1 nmol/l; P < .01). The best predictor of arousals (multiple regression) was tension (42% of variance explained), whereas burnout, fatigue or depression did not enter the regression. Conclusions: Subtle sleep disturbances are associated with elevated metabolic markers and may be an early sign of stress-related disorders.
Disordered eating attitudes and behaviors among Chinese adolescent boys in Hong Kong Leung FY, Mak T The present study examined disordered eating attitudes and behaviors among Chinese adolescent boys in Hong Kong. Participants, 2190 high school boys, of age between 11 and 20, completed questionnaires assessing body concerns, disordered eating attitudes and pathogenic weight loss behaviors. Results indicated that 43% of these boys wanted to lose weight, 12.6% wanted to maintain the same weight, and 44.4% want to gain weight. Boys who wanted to lose weight reported a significantly higher BMI (21.78) than those who wanted to maintain the same weight (19.13) and those who wanted to gain weight (17.91). Boys who wanted to lose weight (the LW group) also reported significantly higher scores than those who wanted to maintain weight (the MW group) and who wanted to gain weight (the GW group) on the drive for thinness and body dissatisfaction subscales of the Eating Disorder Inventory. Boys from both the LW and the GW group also reported significantly lower self-esteem than the MW group. The LW group reported significantly higher percentages of pathogenic weight loss behaviors such as dieting, excessive exercise, self-induced vomiting, and laxative abuse than the MW group and the GW group. These findings indicate that Chinese adolescent boys who feel overweight are also at risk for disordered eating attitudes and behaviors.
The quality of life and the care burden of family caregivers Iida N, Kohashi N, Okamura T, Nagao K, Jamshidi J, Terashima S, Hidaka N, Miyata T Objective: We intend to evaluate the quality of life (QOL) and the burden of 82 family caregivers and the relationships between the two. Methods: A QOL questionnaire included satisfaction, health and good luck. The care burden was measured using a newly developed assessment (ABC-16) which consisted of 16 items and was designed to cover 4 dimensions. The results of examinations performed in July 2002 were cross sectionally analyzed. ` = 0.869. (2) The Results: (1) The internal consistency of the ABC-16 was ƒA mean and standard deviation of the total scores of the ABC-16 was
Poster abstracts / Journal of Psychosomatic Research 55 (2003) 147–178
Methods: The study sample included 55 patients and their relatives 12 and 24 months after discharge from a neurological rehabilitation. Outcomes of patients were evaluated by the Barthel index (BI) and SF-36. Outcomes of relatives were rated by SF-36 and caregiver strain index. Results: The functional outcome shows a limited improvement but there is a difference between subjective and objective assessment. Even the average BI score was quite well, 77% of the patients still reported about physical problems. There was no correlation found between physical problems and self-assessment of quality of life. By way of comparison, the SF-36 between patients and relatives, the mean of the patients outcomes are lower than the mean of the relatives, except that scale of bodily pain shows a lower outcome for the relatives. At study time average, 60% of relatives were experiencing considerable strain.
High prevalence of chronic gastrointestinal symptoms in Holocaust survivors Dumitrascu DL, Dumitrascu DM, Ghisa A, Hriscu C, Neufeld G Aim: A higher prevalence of functional gastrointestinal (GI) symptoms has been reported in Holocaust survivors. We looked for this matter in an area where the subjects have survived after Holocaust, to a totalitarian (communist) regime. Methods: All Jews who survived Holocaust living in Cluj, Romania, were questioned in a telephone survey about life conditions during the World War II (WWII) and on 13 GI symptoms (presence, intensity, frequency). This investigation was carried out in 1995 and repeated in 2000. Subjects were divided in two groups: A1: who lived in extermination campuses; A2: who lived in forced labour campuses. Control group B: age and sex matched subjects not deported during WWII. Results: Following GI symptoms were significantly overrepresented in group A1 vs. group B: anorexia, nausea, emesis, heartburn, bloating and diarrhea. In A2 only constipation had a higher prevalence than in B. After 5 years only 8 persons were available, so the study could not be repeated. Conclusion: The number of self-reported chronic GI symptoms is higher in Holocaust survivors than in matched controls. These findings remain significant even when stress caused by living under a totalitarian regime is interfering.
Emotional repression — premorbid trait or coping response to a diagnosis of breast cancer? Zachariae R, Pedersen C, Jorgensen MM, Jensen AB, Christensen S, Lassesen B, Lehbrink M Introduction: It unclear whether emotional repression is a premorbid trait of cancer patients or a coping response to cancer diagnosis. Methods: Of 646 women referred to examination for breast cancer, 71 women were diagnosed with primary breast cancer. Repressive coping was defined as a combination of high defensiveness (Marlowe – Crowne Social Desirability Scale) and low anxiety (Taylor Manifest Anxiety Scale) and was measured before, 4 weeks after, and 12 weeks after diagnosis. Results: Four weeks after diagnosis, increased repression ( P < .01) was found in women diagnosed with breast cancer but not in women without cancer. The women were unaware of their disease status before the examination, and there were no group differences in defensiveness, anxiety, or repression before and 12 weeks after diagnosis. When controlling for repressive coping prior to diagnosis, perceived risk of having breast cancer, age and other demographic factors with a multiple, logistic regression, only cancer diagnosis (Odds ratio: 2.39; P < .05) and having biological children (Odds ratio: 2.83; P < .02) emerged as significant predictors of repressive coping four weeks after diagnosis. Conclusion: The results support previous findings suggesting that repression is a coping response to the cancer diagnosis, rather than a premorbid personality trait.
Stress-related sleep arousals in nonpatients is related to changes in metabolic parameters Ekstedt M, Soderstrom M, Axelsson J, Nilsson J, Akerstedt T Objective: Major sleep disturbances seem to be associated with metabolic changes of potential long term impact on health. The present study sought to investigate such changes in a nonclinical group with a high number of arousals during sleep. Method: 24 individuals (12 males), in an IT company were recruited based on high ( > 2.75) and low mean scores ( < 1.5) on a revised Melamed Burnout Questionnaire (min = 1, max = 4). The subjects were recorded for a 2-week period using daily ratings of sleep quality, actigraphy, polysomnography (EEG) at home, ambulatory blood pressure recordings (24 h), and repeated saliva samples (for analysis of cortisol), and a morning blood sample. Based on the EEG the participants were divided at the median into groups with many (>8/h) and few (< 8/h) arousals, American Sleep Disorders Association norms. The results were analysed using a one-factor ANOVA. Results: The group with more arousals showed an increased: diastolic blood pressure (82 F 1 vs. 73 F 3 mm Hg: P < .05), heart rate (82 F 3 vs. 70 F 2 beats/min P < .05) LDL; (3.3 F .2 vs. 2.6 F .3 nmol/l; P < .05) and cortisol levels in blood (573 F 25 vs. 395 F 19 mmol/l: P < .01) and saliva (17.1 F 2 vs. 10.0 F .1 nmol/l; P < .01). The best predictor of arousals (multiple regression) was tension (42% of variance explained), whereas burnout, fatigue or depression did not enter the regression. Conclusions: Subtle sleep disturbances are associated with elevated metabolic markers and may be an early sign of stress-related disorders.
Disordered eating attitudes and behaviors among Chinese adolescent boys in Hong Kong Leung FY, Mak T The present study examined disordered eating attitudes and behaviors among Chinese adolescent boys in Hong Kong. Participants, 2190 high school boys, of age between 11 and 20, completed questionnaires assessing body concerns, disordered eating attitudes and pathogenic weight loss behaviors. Results indicated that 43% of these boys wanted to lose weight, 12.6% wanted to maintain the same weight, and 44.4% want to gain weight. Boys who wanted to lose weight reported a significantly higher BMI (21.78) than those who wanted to maintain the same weight (19.13) and those who wanted to gain weight (17.91). Boys who wanted to lose weight (the LW group) also reported significantly higher scores than those who wanted to maintain weight (the MW group) and who wanted to gain weight (the GW group) on the drive for thinness and body dissatisfaction subscales of the Eating Disorder Inventory. Boys from both the LW and the GW group also reported significantly lower self-esteem than the MW group. The LW group reported significantly higher percentages of pathogenic weight loss behaviors such as dieting, excessive exercise, self-induced vomiting, and laxative abuse than the MW group and the GW group. These findings indicate that Chinese adolescent boys who feel overweight are also at risk for disordered eating attitudes and behaviors.
The quality of life and the care burden of family caregivers Iida N, Kohashi N, Okamura T, Nagao K, Jamshidi J, Terashima S, Hidaka N, Miyata T Objective: We intend to evaluate the quality of life (QOL) and the burden of 82 family caregivers and the relationships between the two. Methods: A QOL questionnaire included satisfaction, health and good luck. The care burden was measured using a newly developed assessment (ABC-16) which consisted of 16 items and was designed to cover 4 dimensions. The results of examinations performed in July 2002 were cross sectionally analyzed. ` = 0.869. (2) The Results: (1) The internal consistency of the ABC-16 was ƒA mean and standard deviation of the total scores of the ABC-16 was