Tinnitus in childhood

Oral abstracts / Journal of Psychosomatic Research 55 (2003) 133–145 developed a questionnaire to assess parent’s self-efficacy for managing pain associated with tonsillectomy: the Self-Efficacy for Tonsillectomy Questionnaire-Parent (SEFT-P). Parents completed this questionnaire and a range of other tonsillectomy outcome measures were collected including the tonsillectomy quality of life questionnaire, a pain and medication diary, and information such as how long after the operation children first ate and drank. This research investigates whether parental self-efficacy is a predictor of post-operative tonsillectomy pain, independently from other tonsillectomy outcomes. The results of this research will be presented and the clinical implications for helping parents to better manage their children’s pain following tonsillectomy will be discussed.

Determinants of women’s decision making regarding gestational antidepressant use Sonari LA, Einarson A, Jasper J, Koren G Women of childbearing age frequently suffer from depression; peak prevalence for this disorder is 25 – 44 years. Fifty percent of pregnancies are unplanned, so it is not feasible for antidepressants to be avoided during this period. Maternal depression is associated with unfavorable outcomes including preeclampsia, cleft lip. Studies have documented the safety of SSRIs, yet despite this, women often discontinue medication following pregnancy diagnosis. Discontinuation syndrome, characterized by reemergence of the psychiatric syndrome/suicidal ideation, has been documented in women who abruptly stop SSRIs. Due to these facts there exists a need to evaluate misconceptions about gestational antidepressant use. The objectives of this study are (1) to determine teratogenic risk-perception in women with depression; (2) to determine the efficacy of evidence-based counseling in decreasing anxiety associated with psychotropic drugs in pregnancy; and (3) to identify determinants influencing women in decision making. Motherisk callers seeking antidepressant information, within the 1st trimester of pregnancy/planning, were enrolled. They completed a risk perception questionnaire, before receiving evidence-based counseling on antidepressants in pregnancy. Decisions to continue/discontinue pharmacotherapy, determinants of these decisions, and risk-perception changes, were assessed, compared with controls. Evidence-based information had the ability to encourage rational treatment and lower the perception of risk associated with using SSRIs, although 15% of users still discontinued medication, compared with 4% of controls.

Tinnitus in childhood Holgers K, Svedlund C Introduction: Tinnitus is a common symptom and is often related to an auditory dysfunction and approximately two thirds of the adult sufferers have hearing loss, but the severity of tinnitus is more correlated to general health and psychological factors, than audiometry. Seventy-five percent of consecutive adult tinnitus sufferers have depressive or anxiety disorders. However, the knowledge of tinnitus in childhood is very limited. Objectives: To study the prevalence and the severity of tinnitus in schoolchildren aged 9 – 16 years and screening for depressive and anxiety disorders in children seeking help for tinnitus. Methods: In each class, lectures on hearing function and tinnitus were held in during school hours and all 274 students in school, filled in a questionnaire, regarding noise-induced tinnitus, spontaneous tinnitus, occurrence and annoyance of tinnitus. Results: Every second child had experiences of tinnitus, and 16% perceived tinnitus every day or always. Girls had more often and were more annoyed. Eleven percent and 35% of the tinnitus patients had depressive, respectively, anxiety disorders according to the HAD scale. Discussion/conclusions: Tinnitus may be a stress-related symptom and a marker for anxiety disorders in children. Girls have tinnitus more often and suffer from more anxiety/depressive disorders, but more boys seek help for tinnitus.

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Burnout syndrome is associated with markedly reduced sleep efficiency and SWS Ekstedt M, Soderstrom M, Nilsson J, Kecklund G, Perski A, Akerstedt T Introduction: Burnout is characterised by extreme fatigue and impaired (self-reported) sleep quality — no polysomnographical data are available, however. The present study sought to provide this. Methods: Thirty-two patients, with a diagnosis ( > 3 months) of burnout or stress-related disorder, were recruited from the patient register of an insurance company. A control group of 16 normals (matched on gender and age) were recruited. All subjects were subjected to polysomnographical recording in their home (after habituation), a 24-h ambulatory blood pressure recording, morning blood samples, and repeated saliva samples were obtained the next day. Actigraphy and sleep quality ratings were carried out each day throughout the week of measurement. Results: Analysis with t tests or ANOVAs showed that the patients slept as long as the normals but had a lower sleep efficiency (76 F 4% vs. 90 F 5%; P < .01), a higher number of arousals (17 F 2 vs. 14 F 2 per hour; P < .05) a longer sleep latency (42 F 12 vs. 12 F 3 min; P < .01), less slow wave sleep (stage 3/4: 8 F 3% vs. 18 F 4%; P < .01) and more stage 2 sleep (59 F 3% vs. 45 F 2%; P < .001). Most measures of subjective sleep quality showed more disturbances in the patient group. Conclusions: The results indicate that sleep is severely disturbed in burnout patients, although total sleep time may show relatively normal values.

Ethnic differences in the relation between self-reports of negative affect and blood pressure variability in female Hawaii school teachers Brown DE, Etrata ME, Mills PS, James GD Much research on psychosocial stress relies upon self-report measures, but these may be mediated by cultural factors. Physiological measures may help validate self-report measures. Ambulatory blood pressure (BP) readings were taken every 15 min during waking hours and diary recordings were made after each measurement in which moods were recorded in 91 Japanese American (JA) and 58 Caucasian (C) female school teachers. Analyses accounted for age and body mass index of individuals. Teachers were more likely to report negative affect at work than at home. At work, BP was significantly elevated during times that negative affect was reported among JAs (ANCOVA: systolic: F = 19.8, P < .001; diastolic: F = 14.9, P < .001) but not among Cs. At home, BP was not significantly elevated when negative affect was reported for either ethnic group. The rated intensity of negative affect was not significantly related to BP among JAs at work (multiple regression analyses), but the intensity of reported affect was significantly related to both systolic and diastolic BP in Cs. The relationship between reports of negative affect and BP variability appears to be influenced in a profound way by ethnicity and daily setting in this sample. This study was supported by NIH/MBRS grant SO6-GM08073.

Efficacy of cognitive behaviour therapy in generalized anxiety disorders. Results of a controlled clinical trial (Berlin CBT-GAD Study) Linden M, Linden M, Zubraegel D, Baer T Introduction: A controlled clinical trial was done to evaluate treatment efficacy of cognitive behavior therapy (CBT) in generalized anxiety disorders (GAD). Method: Seventy-two outpatients were randomly assigned to 25 sessions of CBT (TGA) or a contact control group (CCG). Patients in the CCG were later also treated with CBT (TGB). Therapists were professionals who worked full time in outpatient routine care. Results: The reduction in the Hamilton anxiety observer rating scale (HAM-A) was 6.4% (1.5 points) in the CCC, 35.4% (9.5 points) in the TGA and 47.3% (10.3 points) in the TGB. In the self-rating STAI-S a reduction of 2.7% was seen in CCG, 14.6% in TGA, and 11.6% in TGB. According to the Clinical Global Impression rating (CGI) 65.6% of patients