Diagnosis Of Physical Illness Research Articles

Conductometric Flexible CuO-Based Sweat-Loss Monitoring Sensor for Future Wearable Technology in Healthcare.

Healthcare tracking supports early diagnosis of illnesses, real-time tracking of the impacts of therapy and treatment, and tracking of cases of human health. Based on this, real-time tracking of sweat loss provides an easy, convenient, and noninvasive approach to the early diagnosis of physical illness in individuals. To date, copper oxide (CuO) as a nanostructured semiconductor metal-oxide is regarded as a hopefully p-type sensing material. The corresponding sweat rate monitoring systems were fabricated using a repeatable and cost-effective SILAR system using a cellulose acetate-based organic substrate. To provide a practical application, we investigated the working efficiency of Al:CuO under room conditions since most clinical and healthcare industries operate under ambient temperature. Fabricated flexible devices immediately respond to the implementation of the sweat solution and reach a steady-state value in a short time. It can be obtained from experimental results that the sweat-loss monitoring performances of CuO-based devices can be enhanced by employing Al-doping. The increment in the sensing efficacy was interpreted in terms of structural and morphological characterization and electrical data. Our designed flexible thin film-based system can be used in conjunction with a customized wearable, healthcare industry integrated, low-cost fabrication source.

Influence of comorbid depression and diagnostic workup on diagnosis of physical illness: arandomized experiment.

Patients with mental illness are less likely to receive the same physical healthcare as those without mental illness and are less likely to be treated in accordance with established guidelines. This study employed a randomized experiment to investigate the influence of comorbid depression on diagnostic accuracy. Physicians were presented with an interactive vignette describing a patient with a complex presentation of pernicious anemia. They were randomized to diagnose either a patient with or without (control) comorbid depression and related behaviors. All other clinical information was identical. Physicians recorded a differential diagnosis, ordered tests, and rated patient likeability. Fifty-nine physicians completed the study. The patient with comorbid depression was less likeable than the control patient (p=0.03, 95% CI [0.09, 1.53]). Diagnostic accuracy was lower in the depression compared to control condition (59.4% vs. 40.7%), however this difference was not statistically significant χ2(1)=2.035, p=0.15. Exploratory analyses revealed that patient condition (depression vs. control) interacted with the number of diagnostic tests ordered to predict diagnostic accuracy (OR=2.401, p=0.038). Accuracy was lower in the depression condition (vs. control) when physicians ordered fewer tests (1 SD below mean; OR=0.103, p=0.028), but there was no difference for physicians who ordered more tests (1 SD above mean; OR=2.042, p=0.396). Comorbid depression and related behaviors lowered diagnostic accuracy when physicians ordered fewer tests- a time when more possibilities should have been considered. These findings underscore the critical need to develop interventions to reduce diagnostic error when treating vulnerable populations such as those with depression.

Accessing acute medical care to protect health: the utility of community treatment orders

BackgroundThe conclusion that people with severe mental illness require involuntary care to protect their health (including threats due to physical—non-psychiatric—illness) is challenged by findings indicating that they often lack access...

Simple, Skin-Attachable, and Multifunctional Colorimetric Sweat Sensor.

In situ analysis of sweat provides a simple, convenient, cost-effective, and noninvasive approach for the early diagnosis of physical illness in humans and is particularly useful in family care. In this study, a flexible and skin-attachable colorimetric sweat sensor for multiplexed analysis is developed using a simple, cost-effective, and convenient method. The obtained sweat sensor can be used to simultaneously detect glucose, lactate, urea, and pH value in sweat, as well as sweat loss and skin temperature. Only 2.5 μL of sweat is enough for the whole test, and the sweat loss and chemical-sensing results can be read out conveniently by naked eyes or a smartphone. In addition, body temperature can also be detected with an additional electrical circuit. Our sweat sensor provides a new, cost-effective, and convenient approach for in vitro diagnosis of multiple components in sweat, and the easy fabrication and cost-effectiveness make our sensor commercializable in the near future.

Pattern, clinical and demographic profile of inpatient psychiatry referrals in a tertiary care teaching hospital: a descriptive study

BackgroundConsultation liaison psychiatry (CLP) as a subspecialty is defined as the area of clinical psychiatry that encompasses clinical understanding, teaching and research activities of psychiatrists and allied health professionals in...

Mental and physical comorbidity in an Arab primary health care setting

BackgroundThere are no published studies on the comorbidity of common mental conditions (anxiety, depression, and somatization) and physical illnesses in the Arab world. Our aim was to estimate the prevalence of common mental conditions comorbid with physical illnesses among primary care attenders in Kuwait, and the sociodemographic characteristics associated with this comorbidity.MethodsThe Patient Health Questionnaires for somatization, anxiety and depression (PHQ-SAD) were administered to a representative sample of 1046 attenders (M: F = 429: 617; mean age 37.6, SD 12.7) seen in primary care clinics in Kuwait. Based on well-established cut-off scores, the presence and severity of three mental conditions –depression, anxiety, and somatization—was ascertained; physical diagnoses were ascertained by the attending physicians.ResultsOf 1046 respondents, 442 (42.3%) had at least one mental condition and 670 (64.1%) had a physical illness diagnosis, viz.: diabetes mellitus (248/670 = 37.0%), hypertension (229/670 = 34.2%), asthma (82/670 = 12.2%), non-chronic physical illnesses (63/670 = 9.4%), or heart disease (48/670 = 7.2%), with 34.4% (360/1046) having mental-physical comorbidity. Male: female ratio for the 670 subjects was 287: 383. The unadjusted odds ratio (OR) for having a mental condition in those with a physical illness vs. those without a physical illness was 4.16 (95% C.I. = 3.12, 5.55). Comorbidity was associated with older age, being divorced or widowed, a lower level of education, and poorer living conditions. Regardless of the physical illness, the most frequent comorbid mental disorder was somatization. The prevalence and severity of mental conditions were associated with the number of physical illnesses.ConclusionAs has been reported in other parts of the world, somatization, anxiety, and depression are highly prevalent among primary care attenders in Kuwait and they are typically comorbid with physical illness. Strategies for their prevention and treatment need to take into consideration their association with physical illness and social disadvantage.

The utility of outpatient commitment: acute medical care access and protecting health.

This study considers whether, in an easy access single-payer health care system, patients placed on outpatient commitment-community treatment orders (CTOs) in Victoria Australia-are more likely to access acute medical care addressing physical illness than voluntary patients with and without severe mental illness. For years 2000 to 2010, the study compared acute medical care access of 27,585 severely mentally ill psychiatrically hospitalized patients (11,424 with and 16,161 without CTO exposure) and 12,229 never psychiatrically hospitalized outpatients (individuals with less morbidity risk as they were not considered to have severe mental illness). Logistic regression was used to determine the influence of the CTO on the likelihood of receiving a diagnosis of physical illness requiring acute care. Validating their shared and elevated morbidity risk, 53% of each hospitalized cohort accessed acute care compared to 32% of outpatients during the decade. While not under mental health system supervision, however, the likelihood that a CTO patient would receive a physical illness diagnosis was 31% lower than for non-CTO patients, and no different from lower morbidity-risk outpatients without severe mental illness. While, under mental health system supervision, the likelihood that CTO patients would receive a physical illness diagnosis was 40% greater than non-CTO patients and 5.02 times more likely than outpatients were. Each CTO episode was associated with a 4.6% increase in the likelihood of a member of the CTO group receiving a diagnosis. Mental health system involvement and CTO supervision appeared to facilitate access to physical health care in acute care settings for patients with severe mental illness, a group that has, in the past, been subject to excess morbidity and mortality.

Variation in narrative identity is associated with trajectories of mental health over several years.

This article presents 2 longitudinal studies designed to assess the relationship between variability in narrative identity and trajectories of mental health over several years. In Study 1, core scenes from 89 late-mid-life adults' life stories were assessed for several narrative themes. Participants' mental health and physical health were assessed concurrently with the narratives and annually for the subsequent 4 years. Concurrent analyses indicated that the themes of agency, redemption, and contamination were significantly associated with mental health. Longitudinal analyses indicated that these same 3 themes were significantly associated with participants' trajectories of mental health over the course of 4 years. Exploratory analyses indicated that narratives of challenging experiences may be central to this pattern of results. In Study 2, similar longitudinal analyses were conducted on a sample of 27 late-mid-life adults who received a major physical illness diagnosis between the baseline assessment and 6 months later and a matched sample of 27 control participants who remained healthy throughout the study. Participants' mental health and physical health were assessed every 6 months for 2 years. In this study, the themes of agency, communion, redemption, and contamination in participants' life narratives collected at baseline (before any participant became sick) were significantly associated with mental health in the group of participants who went on to receive a medical diagnosis, but not in the control group. Taken together, the results of these 2 studies indicate that the way an individual constructs personal narratives may impact his or her trajectory of mental health over time.

Improving the diagnosis of physical illness in patients with mental illness who present in Emergency Departments: Consensus study

ObjectiveThe aim of this study was to establish consensus among clinicians in order to produce recommendations to optimise the diagnosis of physical illness in patients with mental illness who present in Emergency Departments (EDs). MethodA list of recommendations was derived from qualitative interviews conducted with 39 doctors and nurses working in EDs in four general hospitals in England. Using a modified nominal group technique, we then asked a selected group of 15 doctors and nurses to take part in a group discussion with two voting rounds in order to decide which recommendations are most beneficial and feasible. ResultsFive recommendations met the a priori criteria to be considered ‘strongly supported’. These included: having a psychiatric liaison team staff available 24hours a day in the vicinity of the ED; developing detailed guidelines regarding intoxicated patients and regarding parallel assessment of patients by both ED and psychiatric staff; and having regular meetings between representatives of both departments. ConclusionIn addition to suggesting specific recommendations, the study stresses the advantages in increasing the accessibility of psychiatric staff in the ED but also identifies challenges regarding joint work and division of responsibilities between them and the ED acute team.

The interface of physical and mental health

The interaction between physical and mental health is complex. In this paper we aim to provide an overview of the main components of this relationship and to identify how care could be improved for people with co-morbidities. We performed a literature search of MedLine, Ovid and Psycinfo and identified studies that examined the association between mental illness and physical illness. We also examined the key policy documents and guidelines in this area. People with mental health conditions are at higher risk of developing physical illness, have those conditions diagnosed later and have much higher mortality rates. Conversely, people with a diagnosis of physical illness, especially cardiovascular disease, diabetes and cancer have a greater chance of developing a mental health problem. When both mental and physical illnesses conditions are present together, there are higher overall rates of morbidity, healthcare utilisation, and poorer quality of life. Physicians and psychiatrists need to be aware of the co-occurrence of mental and physical health problems and the challenges posed for both general and mental health services. There is a need to screen appropriately in both settings to ensure timely diagnosis and treatment. Liaison psychiatry provides psychological assessment and treatment for people with physical illness, but there is a gap in the provision of physical healthcare for people with severe mental illness. There is a need for public policy to drive this forward to overcome the institutional barriers to equitable access to healthcare and for educators to reverse the tendency to teach mind and body as separate systems.

P03-70 Differences in personality traits evaluated by TCI according to physical illness

Aim:To identify differences in personality traits (temperament and character) using Cloninger's typology according to the presence of physical illness (WONCA criteria).Method:404 subjects, without psychiatric pathology, from Asturias (Northern Spain) were included in the study [50% men; mean age (SD)= 40.5 (11.3)]. Assessments were made using an ad hoc interview (socio-demographic and clinical data), and the Spanish versions of the MINI International Neuropsychiatric Interview (DSM-IV criteria) (Sheehan et al., 1997), and the Temperament and Character Inventory (TCI) (Cloninger et al., 1994).Results:154 (38.1%) subjects have at least one diagnosis of physical illness. Subjects with physical illness scored significantly higher in: i) temperament scales: harm avoindance (HA) (17.02 vs 15.76, t= -1.968; p= 0.050); fatigability and asthenia (HA4) (3.56 vs 2.82, t= -3.652; p< 0.000), ii) character scales: transpersonal (ST2) (3.91 vs 3.26, t= -2.900; p= 0.004). However, they scored significantly lower in: i) temperament scales: attachment (RD3) (5.18 vs 5.70, t= 2.346; p= 0.019), ii) character scales: responsibility (SD1) (5.57 vs 5.96, t= 1.984; p=0.048); purposeful (SD2) (5.43 vs 5.84, t= 2.092; p= 0.037); cooperativeness (C) (31.52 vs 33.26, t= 3.166; p< 0.000); social acceptance (C1) (6.50 vs 6.89, t= 2.536; p= 0.012); empathy (C2) (4.81 vs 5.18, t= 2.484; p= 0.013); compassion (C4) (7.44 vs 7.94, t= 2.190; p= 0.019); pure-hearted (C5) (6.55 vs 7.06, t= 3.225; p= 0.001). No other significant differences were found between the groups.Conclusions:Our data suggest that physical illness might influence personality traits in non-psychiatric population.

Correction

Back to table of contents Previous article Next article ArticleNo AccessCorrectionPublished Online:1 Apr 2006https://doi.org/10.1176/ps.42.5.539-aAboutSectionsView articleAbstractPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail View articleAbstractThe address given for Ann D'Ercole, Ph. D., on page 395 of the April issue was incorrect. The correct address is Manhattan Bowery Corporation, 275 7th Avenue, 5th Floor, New York, New York 10001. Dr. D'Ercole is the corresponding author of the Paper entitled "Diagnosis of Physical Illness in Psychiatric Patients Using Axis III and a Standardized Medical History." Access content To read the fulltext, please use one of the options below to sign in or purchase access. Personal login Institutional Login Sign in via OpenAthens Purchase Save for later Item saved, go to cart PPV Articles - Psychiatric Services $35.00 Add to cart PPV Articles - Psychiatric Services Checkout Please login/register if you wish to pair your device and check access availability. Not a subscriber? Subscribe Now / Learn More PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development. Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.). FiguresReferencesCited byDetailsCited ByNone Volume 42Issue 5 May 1991Pages 539-a-539 Metrics PDF download History Published online 1 April 2006 Published in print 1 May 1991

Diagnosis of Physical Illness in Psychiatric Patients Using Axis III and a Standardized Medical History

Psychiatrists' axis III diagnoses of physical illnesses in 357 psychiatric patients were compared with diagnoses by a physician's assistant using a standardized medical history form. The physician's assistant detected nearly three times as many physical illnesses as the psychiatrists. The psychiatrists were significantly more likely to miss diagnoses among older patients and women. Patients who met criteria for depressive disorders appeared to be at greatest risk for undetected illnesses, followed by patients with bipolar disorders and schizophrenia. Patients with a secondary diagnosis of substance abuse had significantly more undetected illness than those who did not abuse substances. The authors suggest that current axis III guidelines are inadequate and that a systematic review of physical health problems should be part of the psychiatric diagnostic assessment.

Multiaxial characterization of depressive patients.

A review of the literature on the comprehensive description of depressive patients revealed prominent concern with syndromic subtypes, course of illness, and personality factors, followed by severity, concomitant physical disorders, psychosocial stressors, and adaptive functioning. The descriptive value of multiaxial approaches for depression was illustrated through the application of an extended DSM-III formulation to all 3455 depressive (bipolar depression, major depression, dysthymic disorder, and atypical depression) and 7837 nondepressive patients of all ages and sexes presenting for evaluation and care at the Psychiatric Institute of the University of Pittsburgh during a period of 53 months. Twenty-six percent of the depressive patients received an additional diagnosis in axis I, the most frequent of which were substance use disorder, anxiety disorder, and condition not attributable to a mental disorder. In axis II, depressive patients presented a differentially higher frequency of dependent personality disorder and the "anxious/fearful" cluster of personality disorders. In axis III, 47% of the depressive vs. 40% of the nondepressive patients had a positive diagnosis of physical illness, with a significantly higher frequency among depressive patients attained by acquired hypothyroidism, migraine, essential hypertension, unspecified abdominal hernia, and unspecified arthropathies. Specific stressors differentially more frequent among depressive patients were those of conjugal, parenting, and occupational types and those reflecting the impact of physical illness. Overall stressor severity was at severe, extreme, or catastrophic levels for 42% of the depressive and 31% of the nondepressive patients. The highest level of adaptive functioning in the past year was good, very good, or superior for 44% of the depressive and 29% of the nondepressive patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Symptoms and personality in the diagnosis of physical illness.

Symptoms and personality in the diagnosis of physical illness.

Psychophysiologic Gastrointestinal Reactions: Therapeutic Observations

The two principal factors in precipitation of functional disturbance are quality of individual and quantity of trauma.An erroneous diagnosis of physical illness followed by medical or surgical treatment tends to fix the neurotic state, but the greatest harm occurs when a patient with a conversion reaction dies with an untreated malignant disease.Successful management of functional gastrointestinal disturbance encompasses dietetic therapy, pharmacologic aids, creation of insight, correction of rigid states, reeducation, and adjunctive measures.The comparative effectiveness of various tranquilizers and antidepressants is reviewed, and experience with the nonbarbiturate sedative thalidomide is presented.