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Prevalence, psychiatric comorbidity and risk factor profile of generalized anxiety disorder patients with coronary artery disease
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Poster abstracts / Journal of Psychosomatic Research 55 (2003) 147–178
Results: Japanese sleeping time was significantly later than China. Average sleeping hours were 6.8 h in males and 6.7 h in females in Japan, on the other hand these were 7.3 h in males and 7.2 h in females in China. Thus Japanese sleeping hours were short compared with Chinese. However, the percentage of the students who could not obtain a feeling of a deep sleep was 10.2% in Japan, though it was 23.0% in China. In Japan, the most popular type of sleep disorder is difficulty getting to sleep. In China, there were much students who had difficulty remaining asleep and early morning awakening than in Japan. Lifestyles were differed between Japan and China, but correlation between a lifestyle and sleep was not significant.
Sense of coherence: relationships with distress, quality of life, and medication use in lung cancer patients Floyd A, Ghate S, Weissbecker I, Banis P, Studts J, Salmon P, Sephton S Lung cancer is the most common cause of cancer-related death in the United States and patients generally report high emotional distress. Quality of life has been found to be a predictor of lung cancer mortality. Sense of coherence (SOC) is a personality disposition to experience life as meaningful and manageable. Research suggests that SOC is related to psychological well-being among subjects with chronic illness. We hypothesized that SOC would be associated with psychological adjustment to lung cancer. Twenty-nine patients with lung cancer (59% females, 41% males, mean age = 66) were recruited. Assessments included SOC, symptom distress, quality of life, cancer-specific and general anxiety, depression, and current medication use. Two-tailed Pearson correlations were employed to examine the relationships of interest. Results showed that patients with greater SOC reported less symptom distress, had greater quality of life and fewer depressive symptoms. SOC was marginally associated with lower cancer-specific and general anxiety. Patients with higher SOC reported using fewer medications for the treatment of mood disorders and pain. These data support the notion that SOC is a protective factor in psychological adjustment to serious illness.
Duloxetine reduces painful physical symptoms associated with depression Goldstein DJ, Lu Y, Iyengar S, Detke M Objective: To examine the efficacy and safety of duloxetine, a balanced dual re-uptake inhibitor of serotonin (5HT) and norepinephrine (NE) (Bymaster et al., 2001) in the treatment of pain associated with diabetic neuropathy. Both 5-HT and NE are thought to inhibit pain via spinal chord pathways (Basbaum and Fields, 1984; Clark and Proudtit, 1993). Methods: In a 12-week multicenter double-blind study, 457 patients with diabetic neuropathy were randomly assigned to treatment with duloxetine 60 mg BID, 60 mg QD, 20 mg QD, or placebo. The primary efficacy measure was the weekly mean score of the 24-Hour Average Pain Severity on the 11-point Likert scale. Results: Duloxetine 60 mg QD and BID demonstrated statistically significant improvement compared to placebo on the 24-Hour Average Pain Severity score, beginning 1 week after randomization and continuing through the acute phase. Duloxetine also separated from placebo on nearly all of the secondary measures. Safety and tolerability were very good with less than 20% discontinuation due to adverse events. Conclusion: This study provides definitive evidence that duloxetine at 60 mg QD and 60 mg BID was safe and effective in the treatment of pain associated with diabetic neuropathy. Funding Source: Eli Lilly and Company.
Prevalence, psychiatric comorbidity and risk factor profile of generalized anxiety disorder patients with coronary artery disease Laurin C, Lavoie KL, Fleet R, Arsenault A, Burelle D
Anxiety has been linked to coronary artery disease (CAD) morbidity and mortality. Studies have documented a high rate of Panic Disorder (PD) among CAD patients (pts), but less is known about the prevalence of other common anxiety disorders among CAD pts, e.g., generalized anxiety disorder (GAD). GAD is characterized by persistent, uncontrollable worries and chronic anxiety, which may be prevalent among cardiac pts who may worry about potentially fatal cardiac events. This study evaluated the prevalence of GAD, psychiatric comorbidity, and risk factor profile of 658 CAD pts on the day of their exercise stress tests. Pts underwent a psychiatric screening (PRIME-MD) and medical history interview and completed a battery of psychological questionnaires (e.g., anxiety sensitivity index, ASI). Fifty-eight pts (9%) met diagnostic criteria for GAD (mean age = 55 years; 74% men). Comorbid diagnoses included: Major Depression (59%; n = 34); Minor Depression (47%; n = 27); Dysthymia (37%; n = 21); PD (19%; n = 19). More GAD than non-GAD pts reported having chest pain in the last month ( P < .05), but pts did not differ on risk factors, exercise ischemia, or cardiac medication. GAD pts scored higher on all questionnaires ( Ps < .001) and reported having more worries about having a heart attack on the ASI ( P < .0001). Results suggest that GAD is common among CAD pts and associated with significant psychiatric comorbidity, psychological distress, reported chest pain, and worries about having a heart attack.
Effect of surgery type on sexuality, body image, self-esteem and marital adjustment in breast cancer: a controlled trial ¨ nen Serto¨z O ¨ , Elbi Mete H, Noyan A O Introduction: Most of the investigators reported that the surgeries resulted with breast loss or deformation had negative impact on body image, sexuality, and quality of life in women with breast cancer. Our objective is to evaluate the effect of surgery type on sexuality, body image, self-esteem, and marital adjustment in women with breast cancer. Patients and methods: Fifty menstruating women who had total mastectomy (Group 1), 25 menstruating women who had breast reconstruction after total mastectomy (Group 2) and 50 aged matched healthy women (Group 3) eligible for the current study were given the Golombok Rust Inventory of Sexual Satisfaction (GRISS), the Rosenberg Scale (only first 10 items), the Body Catechism Scale (BCS), and the Dyadic Adjustment Scale (DAS) after having been applied SCID-NP. To test purpose of the study one way analysis of variance was used. Results: The mean age of three groups was similar. Group 1 had the lowest educational and wealth level. The mean scores taken from GRISS, DAS, and BCS were similar, but the mean score of the Rosenberg Scale and the 23rd item of BCS (asks about breast perception) showed significant difference between three groups ( P = .002 and P < 0.01, respectively). Conclusions: Total mastectomy surgery has negative effect on body image and self-esteem. Sexual satisfaction and marital adjustment were not effected by surgery type. Both education and economic status influence preference surgery type.
Total mastectomy and breast reconstruction: a comparison of their effect on body image and self-esteem ¨ nen Serto¨z O ¨ , Elbi Mete H, Noyan A O Object: To evaluate the effect of surgery type on body image and self-esteem in women with breast cancer. Patients and methods: Seventy-five breast cancer survivors, 50 of them underwent total mastectomy, 25 of them underwent breast reconstruction surgery after total mastectomy eligible for the current study recruited from surgery and plastic surgery departments of two university hospitals ˙ zmir. To evaluate the effects of surgery type on body image and in Y self-esteem, the patients were given Rosenberg Scale, Body Catechism
Poster abstracts / Journal of Psychosomatic Research 55 (2003) 147–178
Results: Japanese sleeping time was significantly later than China. Average sleeping hours were 6.8 h in males and 6.7 h in females in Japan, on the other hand these were 7.3 h in males and 7.2 h in females in China. Thus Japanese sleeping hours were short compared with Chinese. However, the percentage of the students who could not obtain a feeling of a deep sleep was 10.2% in Japan, though it was 23.0% in China. In Japan, the most popular type of sleep disorder is difficulty getting to sleep. In China, there were much students who had difficulty remaining asleep and early morning awakening than in Japan. Lifestyles were differed between Japan and China, but correlation between a lifestyle and sleep was not significant.
Sense of coherence: relationships with distress, quality of life, and medication use in lung cancer patients Floyd A, Ghate S, Weissbecker I, Banis P, Studts J, Salmon P, Sephton S Lung cancer is the most common cause of cancer-related death in the United States and patients generally report high emotional distress. Quality of life has been found to be a predictor of lung cancer mortality. Sense of coherence (SOC) is a personality disposition to experience life as meaningful and manageable. Research suggests that SOC is related to psychological well-being among subjects with chronic illness. We hypothesized that SOC would be associated with psychological adjustment to lung cancer. Twenty-nine patients with lung cancer (59% females, 41% males, mean age = 66) were recruited. Assessments included SOC, symptom distress, quality of life, cancer-specific and general anxiety, depression, and current medication use. Two-tailed Pearson correlations were employed to examine the relationships of interest. Results showed that patients with greater SOC reported less symptom distress, had greater quality of life and fewer depressive symptoms. SOC was marginally associated with lower cancer-specific and general anxiety. Patients with higher SOC reported using fewer medications for the treatment of mood disorders and pain. These data support the notion that SOC is a protective factor in psychological adjustment to serious illness.
Duloxetine reduces painful physical symptoms associated with depression Goldstein DJ, Lu Y, Iyengar S, Detke M Objective: To examine the efficacy and safety of duloxetine, a balanced dual re-uptake inhibitor of serotonin (5HT) and norepinephrine (NE) (Bymaster et al., 2001) in the treatment of pain associated with diabetic neuropathy. Both 5-HT and NE are thought to inhibit pain via spinal chord pathways (Basbaum and Fields, 1984; Clark and Proudtit, 1993). Methods: In a 12-week multicenter double-blind study, 457 patients with diabetic neuropathy were randomly assigned to treatment with duloxetine 60 mg BID, 60 mg QD, 20 mg QD, or placebo. The primary efficacy measure was the weekly mean score of the 24-Hour Average Pain Severity on the 11-point Likert scale. Results: Duloxetine 60 mg QD and BID demonstrated statistically significant improvement compared to placebo on the 24-Hour Average Pain Severity score, beginning 1 week after randomization and continuing through the acute phase. Duloxetine also separated from placebo on nearly all of the secondary measures. Safety and tolerability were very good with less than 20% discontinuation due to adverse events. Conclusion: This study provides definitive evidence that duloxetine at 60 mg QD and 60 mg BID was safe and effective in the treatment of pain associated with diabetic neuropathy. Funding Source: Eli Lilly and Company.
Prevalence, psychiatric comorbidity and risk factor profile of generalized anxiety disorder patients with coronary artery disease Laurin C, Lavoie KL, Fleet R, Arsenault A, Burelle D
Anxiety has been linked to coronary artery disease (CAD) morbidity and mortality. Studies have documented a high rate of Panic Disorder (PD) among CAD patients (pts), but less is known about the prevalence of other common anxiety disorders among CAD pts, e.g., generalized anxiety disorder (GAD). GAD is characterized by persistent, uncontrollable worries and chronic anxiety, which may be prevalent among cardiac pts who may worry about potentially fatal cardiac events. This study evaluated the prevalence of GAD, psychiatric comorbidity, and risk factor profile of 658 CAD pts on the day of their exercise stress tests. Pts underwent a psychiatric screening (PRIME-MD) and medical history interview and completed a battery of psychological questionnaires (e.g., anxiety sensitivity index, ASI). Fifty-eight pts (9%) met diagnostic criteria for GAD (mean age = 55 years; 74% men). Comorbid diagnoses included: Major Depression (59%; n = 34); Minor Depression (47%; n = 27); Dysthymia (37%; n = 21); PD (19%; n = 19). More GAD than non-GAD pts reported having chest pain in the last month ( P < .05), but pts did not differ on risk factors, exercise ischemia, or cardiac medication. GAD pts scored higher on all questionnaires ( Ps < .001) and reported having more worries about having a heart attack on the ASI ( P < .0001). Results suggest that GAD is common among CAD pts and associated with significant psychiatric comorbidity, psychological distress, reported chest pain, and worries about having a heart attack.
Effect of surgery type on sexuality, body image, self-esteem and marital adjustment in breast cancer: a controlled trial ¨ nen Serto¨z O ¨ , Elbi Mete H, Noyan A O Introduction: Most of the investigators reported that the surgeries resulted with breast loss or deformation had negative impact on body image, sexuality, and quality of life in women with breast cancer. Our objective is to evaluate the effect of surgery type on sexuality, body image, self-esteem, and marital adjustment in women with breast cancer. Patients and methods: Fifty menstruating women who had total mastectomy (Group 1), 25 menstruating women who had breast reconstruction after total mastectomy (Group 2) and 50 aged matched healthy women (Group 3) eligible for the current study were given the Golombok Rust Inventory of Sexual Satisfaction (GRISS), the Rosenberg Scale (only first 10 items), the Body Catechism Scale (BCS), and the Dyadic Adjustment Scale (DAS) after having been applied SCID-NP. To test purpose of the study one way analysis of variance was used. Results: The mean age of three groups was similar. Group 1 had the lowest educational and wealth level. The mean scores taken from GRISS, DAS, and BCS were similar, but the mean score of the Rosenberg Scale and the 23rd item of BCS (asks about breast perception) showed significant difference between three groups ( P = .002 and P < 0.01, respectively). Conclusions: Total mastectomy surgery has negative effect on body image and self-esteem. Sexual satisfaction and marital adjustment were not effected by surgery type. Both education and economic status influence preference surgery type.
Total mastectomy and breast reconstruction: a comparison of their effect on body image and self-esteem ¨ nen Serto¨z O ¨ , Elbi Mete H, Noyan A O Object: To evaluate the effect of surgery type on body image and self-esteem in women with breast cancer. Patients and methods: Seventy-five breast cancer survivors, 50 of them underwent total mastectomy, 25 of them underwent breast reconstruction surgery after total mastectomy eligible for the current study recruited from surgery and plastic surgery departments of two university hospitals ˙ zmir. To evaluate the effects of surgery type on body image and in Y self-esteem, the patients were given Rosenberg Scale, Body Catechism