Emotional Distress In Patients Research Articles

Social inhibition and emotional distress in patients with coronary artery disease: The Type D personality construct.

We examined the validity of the social inhibition component of Type D, its distinctiveness from negative affectivity, and value regarding emotional distress as measured with the DS14 in 173 coronary artery disease patients. In dimensional analysis, social inhibition and negative affectivity emerged as distinct traits. Analysis of continuous negative affectivity and social inhibition measures showed main effects for several emotional and inhibition markers and an interaction effect for social anxiety. Categorical analysis indicated that Type D patients reported more depression, negative mood, social anxiety, and less positive mood. Social inhibition is not a redundant trait, but has additional conceptual value.

Single-Center Experience Providing Palliative Care to Pediatric Patients with End-Stage Renal Disease.

End-stage renal disease (ESRD) affects nearly 1400 new children each year in the United States. Morbidity and mortality rates remain high for pediatric patients with ESRD, including those that have received a renal transplant. To better understand ESRD patients referred to palliative care, including their physical symptoms, topics discussed, and themes emerging during initial palliative care consultation. This study is a retrospective chart review of pediatric ESRD patients who received a palliative care consult. Physical symptoms, core topics, and themes were identified by the interprofessional study team. The study team found 35 patients met inclusion criteria during the study period. The most common standard palliative care metric noted was "complex or time-intensive communication and interdisciplinary social support." Pain was the most common physical symptom addressed with goals of care and communication the most common topics discussed. Themes emerging described the emotional distress of patients and parents as well as prognostic discussions. This study demonstrates one institution's experience with pediatric ESRD patients undergoing consultation with the pediatric palliative care service. More research is necessary in this population to better describe the best focus for palliative care teams.

Associations Between Economic Pressure and Diabetes Efficacy in Couples With Type 2 Diabetes.

The purpose of this study was to explore dyadic associations between economic pressure and diabetes self-efficacy via emotional distress in patients with type 2 diabetes and their partners. Understanding how economic pressure is associated with successful diabetes management is an important area for research, as couples with type 2 diabetes can incur heavy economic pressures that could likely influence diabetes outcomes. Data from 117 married couples were used to test actor-partner associations using moderated mediation analyses in a structural equation modeling framework. Problem-solving communication was tested as a possible moderator of the economic pressure-emotional distress pathway. Results revealed that greater patient economic pressure was associated with lower patient and spouse confidence in the patient's diabetes management ability through higher levels of patient emotional distress. The deleterious association between economic pressure and emotional distress was less pronounced when spouses reported more effective problem-solving communication. These results provide evidence that the economic pressure couples with type 2 diabetes face may reduce the patient and spouse's confidence in the patient's diabetes management ability. This study demonstrates the importance of couple's relationship processes in buffering the impact of economic pressure on diabetes management, providing a clear target for intervention and education efforts.

Neuro emotional technique effects on brain physiology in cancer patients with traumatic stress symptoms: preliminary findings.

The purpose of this study was to characterize the neurophysiological and clinical effects that may result from the neuro emotional technique (NET) in patients with traumatic stress symptoms associated with a cancer-related event. We hypothesized that self-regulatory processing of traumatic memories would be observable as physiological changes in key brain areas after undergoing the NET intervention and that these changes would be associated with improvement of traumatic stress symptoms. We enrolled 23 participants with a prior cancer diagnosis who expressed a distressing cancer-related memory that was associated with traumatic stress symptoms of at least 6months in duration. Participants were randomized to either the NET intervention or a waitlist control condition. To evaluate the primary outcome of neurophysiological effects, all participants received functional magnetic resonance imaging (fMRI) during the auditory presentation of both a neutral stimulus and a description of the specific traumatic event. Pre/post-comparisons were performed between the traumatic and neutral condition, within and between groups. Psychological measures included the Impact of Event Scale (IES), State Trait Anxiety Index (STAI), Brief Symptom Inventory (BSI)-18, and Posttraumatic Cognitions Inventory (PTCI). The initial fMRI scans in both groups showed significant increases in the bilateral parahippocampus and brainstem. After NET, reactivity in the parahippocampus, brainstem, anterior cingulate, and insula was significantly decreased during the traumatic stimulus. Likewise, participants receiving the NET intervention had significant reductions (p<0.05) compared to the control group in distress as measured by the BSI-18 global severity index, anxiety as measured by the STAI, and traumatic stress as measured by the IES and PTCI. This study is an initial step towards understanding mechanistic features of the NET intervention. Specifically, brain regions involved with traumatic memories and distress such as the brainstem, insula, anterior cingulate gyrus, and parahippocampus had significantly reduced activity after the NET intervention and were associated with clinical improvement of symptoms associated with distressing recollections. This preliminary study suggests that the NET intervention may be effective at reducing emotional distress in patients who suffer from traumatic stress symptoms associated with a cancer-related event.

Factors Associated with Emotional Distress in Children and Adolescents during Early Treatment for Cancer.

PurposeChildren and adolescents diagnosed with cancer experience emotional distress, such as sadness, worrying, and irritability. However, there is little information about the psychological well-being of parents at the time of their child's diagnosis. We sought to identify factors that were associated with emotional distress in cancer patients as a basis for developing innovative psychological interventions.Materials and MethodsA retrospective chart review was performed on patients newly diagnosed with cancer at a single center in Korea from 2014 to 2016. Eighty-five patients and their mothers completed psychological inventories. To determine factors associated with emotional distress in patients, we assessed the psychological inventory results using multiple linear regression after performing correlation analysis.ResultsThe maternal Beck Depression Inventory-II (BDI-II) score was positively correlated with total problem scores and externalizing scores in patients aged less than 7 years. In patients aged 7–12 years, there was no significant association between the patient's emotional distress and other variables. In contrast, the maternal BDI-II score was the strongest factor associated with patient depression in adolescents.ConclusionWe suggest that the most important factor affecting emotional distress in children and adolescents with cancer is maternal depression, especially in patients aged 1–6 years and aged 13–17 years. Understanding the factors associated with emotional distress of cancer patients allows us to develop early psychiatric interventions for patients and their parents at the initial psychological crisis.

Desarrollo de un instrumento para la evaluación del malestar emocional para pacientes renales en diálisis

Objetivo: Actualmente no existen herramientas validadas para evaluar el malestar emocional en pacientes con enfermedad renal crónica, pese a su alta prevalencia en todas las etapas de la patología. Este trabajo describe el desarrollo de un instrumento breve semiestructurado para la Evaluación del malestar Emocional de los pacientes renales en Diálisis (EE-D). Método: El EE-D incluye cinco preguntas con distintos formatos de respuesta (dicotómico, Likert y preguntas abiertas) para evaluar tristeza, ansiedad, preocupaciones, recursos para afrontar la enfermedad, signos externos de malestar y observaciones. Los ítems de la primera versión se sometieron a un estudio interjueces (N= 10). Posteriormente se realizó un estudio piloto multicéntrico (N= 25 pacientes en 5 hospitales). Resultados: Tras el estudio interjueces un ítem fue eliminado, y otro añadido. Tras el piloto no hubo modificaciones. La puntuación media (sobre 10) fue 4,16 (DT: 3,41) en tristeza y 3,68 (DT: 3,48) en ansiedad. El 48% refirió preocupaciones familiares, el 44% preocupaciones sobre su estado emocional-psicológico y el 40% sobre su enfermedad/tratamientos. Los principales recursos identificados fueron la esperanza en la posibilidad de trasplante y el apoyo social. A juicio de enfermería el 24% presentan expresión facial de malestar y el 16% otros signos de malestar. Discusión: El EE-D muestra unas garantías psicométricas preliminares. Ha sido distribuido en las Unidades de Diálisis de todo el territorio nacional con el objetivo de su implementación clínica en un marco investigador, lo que permitirá el desarrollo de futuros estudios de validación multicéntricos.

Evidence-Based Treatment of Emotional Distress in Patients with Ischemic Coronary Heart Disease

Replicated gold-standard evidence (ie, randomly assigned, controlled clinical trials) demonstrates that cognitive-behavioral therapy targeting AIAI (aggravation, irritation, anger, and impatience) reduces “hard” event (eg, myocardial infarction, death) rates. Symptoms and costs also improve in patients with ischemic coronary heart disease who are treated for emotional distress. Nevertheless, routine care for these patients generally ignores these cost-effective strategies. Anxiety, and perhaps depression, may also be pathogenic for cardiovascular events and are important for symptom control (eg, ischemic or noncardiac chest pain, palpitations, presyncope, fatigue). The pressure on cardiac care practitioners to document actual clinical benefits to patients for expended health care dollars should induce them to take a new look at emotional distress in patients with ischemic coronary heart disease and the benefits of treatment. [ Psychiatr Ann . 2016;46(12):677–682.]

Predicting changes in quality of life and emotional distress in Chinese patients with lung, gastric, and colon-rectal cancer diagnoses: the role of psychological resilience.

Patients with cancer often experience considerable emotional distress, which decreases their quality of life (QOL). Resilience is defined as the psychological characteristics that promote positive adaptation in the face of stress and adversity; however, the relationships among QOL, resilience, and emotional distress in patients with cancer, especially Chinese patients with cancer, are under-researched in the literature. Quality of Life Questionnaire Core 30 items, Zung Self-Rating Anxiety Scale, and the Zung Self-Rating Depression Scale were applied in this study. Univariate correlated analysis and multivariate logistic regression analysis were used to test the associations among resilience, emotional distress, and QOL with a sample of 276 participants. A Sobel test was conducted to determine whether the indirect effect of resilience was significant. The mean ratings of QOL (59.2), resilience (20.8), anxiety (43.1), and depression (47.7) were reported. The correlations between resilience and QOL in patients with lung cancer were significantly increased compared with patients with gastric or colorectal cancer (Spearman coefficient squares of 0.284, 0.189, and 0.227, respectively). The highest quartile of the resilience level was associated with a 64% (odds ratio=0.36, 95% confidence interval=0.17-0.75, P=.006), 70% (odds ratio=0.30, 95% confidence interval=0.14-0.63), and 90% (odds ratio=0.10, 95% confidence interval=0.04-0.26, P<.001) reduction in the risk of emotional distress compared with the lowest quartile. The Sobel test indicated a buffering effect of resilience that was significant for depression (Sobel value=2.002, P=.045) but not anxiety (Sobel value=1.336, P=.182). The present study suggests that psychological resilience is positively associated with QOL and may comprise a robust buffer between depression and QOL in Chinese patients with cancer.

Coping and quality of life in patients with skin tumors in the follow-up stage: The mediating role of body image and psychological morbidity

ABSTRACTThis study examined the relationships between coping style, body image, psychological morbidity, and quality of life. A total of 58 patients who were diagnosed with skin tumors, had been submitted to surgery, and were in the follow-up phase answered the following instruments: dermatology life quality index (DLQI), hospital anxiety and depression scales (HADS), body image scale (BIS), and the mini mental adjustment to cancer scale (Mini-MAC). The results showed that patients with a higher use of the coping styles of helplessness/hopelessness, anxious preoccupation, and cognitive avoidance reported a worse quality of life. Body image mediated the relationship between the coping styles of anxious preoccupation, helplessness/hopelessness, and quality of life. Psychological morbidity mediated the relationship between helplessness/hopelessness and quality of life. Therefore, even in the follow-up phase, it is important that health professionals are aware of the patient's emotional distress and body image to identify those at a higher risk of having a poorer quality of life.

The wish to hasten death: Reflections from practice and research.

The debate over whether or not to allow physician-assisted suicide (PAS) or euthanasia is one that is periodically reopened in Western society. This debate tends to arise as the result of a specific case, a difficult situation involving a patient whose prognosis leads him or her to regard death as the best way out. The experience of those countries or states that have developed legislation on this matter shows that controversy remains. Furthermore, when addressing this issue, the origin of the problem is often overlooked. After all, the possibility of such a ‘‘way out’’ would not arise were there not people who contemplated hastening their own death. Yet how much do we know about the wish to hasten death (WTHD) in patients with advanced illness? Is it common? What are the motives which may trigger such a complex phenomenon? A recent systematic review highlights the lack of precise terminology for referring to this phenomenon. Any attempt to capture a genuine WTHD needs to distinguish between the following situations: (a) a vague wish to die, (b) a wish to hasten one’s death (whether sporadic or enduring), (c) the explicit expression of the WTHD, and (d) as the final stage on this continuum, planning suicide or requesting an assisted death or euthanasia. In practice, however, many of the clinical articles identified in the abovementioned systematic review used the term WTHD (or similar) in an indistinct way, mixing patients from across the continuum, and even at times including those who merely expressed an acceptance of death. An interpretative synthesis of qualitative studies on the WTHD concluded that the WTHD seems to be a reactive phenomenon, a response to multidimensional suffering, and not merely one aspect of the despair that may accompany this suffering. In these patients, the expression of a wish to die may have multiple meanings, and it does not necessarily imply a genuine WTHD. These different meanings can be grouped into six broad categories: the WTHD in response to physical/psychological/spiritual suffering, loss of self (which would encompass the loss of bodily functions, control, and meaning in life), fear of the dying process, the wish to live but not in this way, the WTHD as a way of ending one’s suffering, and the WTHD as a form of control over one’s life. According to the explanatory model developed in that study, there are various factors that can lead to the emergence of such a wish, including the presence of generalized distress, the loss of selfhood (losses of different kinds brought about by the illness), and the fear of both the dying process and of death itself. A combination of these factors can lead to overwhelming emotional distress in patients,

Associations of Emotional Distress and Perceived Health in Persons With Atrial Fibrillation and Their Partners Using the Actor-Partner Interdependence Model.

Individual behavior affects and is affected by other people. The aim of this study was to examine if emotional distress in patients with atrial fibrillation (AF) and their spouses was associated with their own and their partner's perceived health. Participants included 91 dyads of patients and their spouses. Emotional distress was measured using the Hospital Anxiety and Depression Scale and perceived health was measured with the Short Form 36 Health Survey. The Actor-Partner Interdependence Model was used for dyad-level analyses of associations, using structural equation modeling. Higher levels of anxiety and depression were associated with lower levels of perceived health in patients and spouses. Higher levels of depression in patients were associated with lower levels of vitality in spouses and vice versa. As AF patients and their spouses influence each other, health-care interventions should consider the dyad to address dyadic dynamics. This may benefit the health of the individual patient and of the couple.

A longitudinal study on anxiety, depressive and adjustment disorder, suicide ideation and symptoms of emotional distress in patients with cancer undergoing radiotherapy

BackgroundThe aim of this study is to evaluate the presence of anxiety, depressive and adjustment disorders, suicide ideation, and symptoms of anxiety and depression in patients with cancer before (T1), and after radiotherapy (T2) and at the 1-month follow-up (T3). MethodsA longitudinal study on 103 patients with cancer treated as outpatients undergoing radiotherapy was carried out, evaluating them three times (T1-T2-T3) according to DSM-IV criteria with the Mini-International Neuropsychiatric Interview and the Hospital Anxiety and Depression Scale. ResultsPrevalence of the depressive disorders was: T1=6.8%, T2=3.9% and T3=3.9%; for anxiety disorders: T1=16.5%, T2=18.4% and T3=16.5%; for adjustment disorder: 10.7%, 5.8% and 7.8%; and for suicide ideation: T1=11.7%, T2=7.8% and T3=7.8%. In all, the presence of disorders was: T1=35%, T2=26.2%0.4% and T3=29.1%. At least one mental disorder was diagnosed in 46.6% of patients in one of the three times of the study.In relation to the symptoms, the prevalence of the possible cases of clinical anxiety was: T1=35.9%, T2=18.4% and T3=22.3%; the prevalence of possible cases of clinical depression was 19.4%, 16.5% and 10.7%, respectively; and the prevalence of emotional distress was 27.2%, 17.5% and 18.4%, respectively. All symptoms decreased significantly from T1 to T2 and from T1 to T3, with moderate effect sizes. No changes were observed between the end of the radiotherapy and the follow-up period. ConclusionsHigh prevalence of mental disorders and symptoms of anxiety, depression and distress were observed in the patients with cancer before finishing radiotherapy treatment and during the follow-up. FundingBasurto University Hospital and Basque Foundation for Innovation and Research in Health-BIOEF.

Patterns and the mediating role of avoidant coping style and illness perception on anxiety and depression in patients with chronic heart failure.

Emotional distress in patients with chronic heart failure (CHF) predicts mortality, hospital readmission and quality of life. The patient's avoidant coping style and beliefs about the disease have been linked to emotional distress in CHF. However, the pattern and transmitting effects of these variables are indefinite. This study aimed to examine the links between and the potential mediating role of illness perceptions and avoidant coping style on depression and anxiety in patients with CHF. Self-assessment data from 103 patients with CHF were subjected to path analysis in two hypothesised models. The outcome measures were coping styles, illness perception, anxiety and depression. Avoidant coping had a direct adverse effect on anxiety and depression. The perception of symptom burden and personal control, significantly mediated the effect between avoidant coping and anxiety and depression. Avoidant coping style appears to influence not only emotional distress, but also a malignant symptom perception and low sense of control over the illness.

Alterações de comportamento na encefalite herpética: um caso polimórfico e de difícil manejo

RESUMO A encefalite herpética é uma doença de alta mortalidade que deve ser diagnosticada e tratada rapidamente. Cefaleia, febre e alteração de comportamento compõem a tríade clássica. Há escassos estudos sobre o tema e nenhum a respeito do manejo das manifestações psiquiátricas. O relato de caso se refere a paciente de 35 anos, que manifestou a tríade clássica, sendo diagnosticado e tratado corretamente. Após um mês, apresentou desorganização do comportamento e agitação, sendo reinternado. Foi descartada recidiva e, por sua grave agitação, ele foi transferido à Psiquiatria. Permaneceu internado por 116 dias; nesse período, teve seguidos episódios de agitação e heteroagressividade, sendo restrito ao leito na maior parte do tempo. Apresentou crises epilépticas do tipo parcial complexa, somente realizando eletroencefalograma sob a terapêutica de três anticonvulsivantes, quando pôde colaborar para a realização do exame, com resultado normal. Houve intercorrências infecciosas tratadas, e conseguiu-se estabilização parcial com o uso de seis psicotrópicos em doses elevadas. Na alta, apresentava comportamento desorganizado, déficit de memória, raciocínio fragmentado, construção de conceitos de forma errática, com interpretações delirantes, impulsividade latente, mas sem agressividade. Desafios do caso: internação prolongada pela refratariedade terapêutica, riscos, desgaste físico e emocional para paciente, família e equipe de saúde. O resultado final demonstra a possibilidade de melhora parcial em um caso polimórfico de encefalite herpética.

The last days of life: symptom burden and impact on nutrition and hydration in cancer patients.

To examine the symptom burden in cancer patients during the last days of life, its impact on nutrition and hydration, and the role of artificial nutrition and hydration in the final days. During the last days of life, cancer patients often experience progressive functional decline and worsening symptom burden. Many symptoms such as anorexia-cachexia, dysphagia, and delirium could impair oral intake. These, coupled with refractory cachexia, contribute to persistent weight loss and decreased quality of life. Furthermore, the inability to eat/drink and body image changes can result in emotional distress for patients and caregivers. Clinicians caring for these individuals need to ensure longitudinal communication about goals of care, education about the natural process of dying, optimization of symptom management, and provide appropriate emotional support for patients and caregivers. There is a lack of evidence to support that artificial nutrition and hydration can improve outcomes during the last days of life. Artificial nutrition is not recommended because of its invasive nature, whereas artificial hydration may be considered on a case-by-case basis. This review highlights the need to conduct further research on symptom burden, nutrition, and hydration during the last days of life.

Emotional distress in Angolan patients with several types of tuberculosis.

There is growing evidence that emotional distress expressed in terms of anxiety and depression is very high among tuberculosis (TB) patients. This study aims to determine levels of anxiety, depression and emotional distress in patients with several types of TB and to determine the association between social-demographic and economical factors, clinical variables and anxiety, depression and emotional distress. A cross-sectional study was performed in a sample of 81 TB patients. A social-demographic and economical questionnaire was used, followed by the hospital anxiety and depression scale. 38.3% and 49.4% of our sample presented significant levels of anxiety and depression. 44.4% of patients had significant levels of emotional distress.Married subjects, a diagnosis of extra-pulmonary TB and multidrug resistant TB were related to higher risk for anxiety. Gender, extra-pulmonary and multidrug resistant TB were associated to depression. Female gender and cases of extra-pulmonary TB presented a 1.5 times risk for emotional distress. Our study found high rates of anxiety, depression and emotional distress among TB patients. Marital status, gender, type and treatment of TB were related to higher levels of emotional disorder. Mental health services should be an integral part of programs against tuberculosis.

Limited English proficient Hmong- and Spanish-speaking patients’ perceptions of the quality of interpreter services

BackgroundLanguage barriers are a large and growing problem for patients in the US and around the world. Interpreter services are a standard solution for addressing language barriers and most research has focused on utilization of interpreter services and their effect on health outcomes for patients who do not speak the same language as their healthcare providers including nurses. However, there is limited research on patients’ perceptions of these interpreter services. ObjectiveTo examine Hmong- and Spanish-speaking patients’ perceptions of interpreter service quality in the context of receiving cancer preventive services. MethodsTwenty limited English proficient Hmong (n=10) and Spanish-speaking participants (n=10) ranging in age from 33 to 75 years were interviewed by two bilingual researchers in a Midwestern state. Interviews were audio taped, transcribed verbatim, and translated into English. Analysis was done using conventional content analysis. ResultsThe two groups shared perceptions about the quality of interpreter services as variable along three dimensions. Specifically, both groups evaluated quality of interpreters based on the interpreters’ ability to provide: (a) literal interpretation, (b) cultural interpretation, and (c) emotional interpretation during the health care encounter. The groups differed, however, on how they described the consequences of poor interpretation quality. Hmong participants described how poor quality interpretation could lead to: (a) poor interpersonal relationships among patients, providers, and interpreters, (b) inability of patients to follow through with treatment plans, and (c) emotional distress for patients. ConclusionsOur study highlights the fact that patients are discerning consumers of interpreter services; and could be effective partners in efforts to reform and enhance interpreter services.

Spirituality and Religiosity during the Perioperative Period for Cancer Patients and their Family: An Integrative Systematic Review

Background: Religion and Spirituality (R/S) may influence patient's emotional distress, mental health and healing throughout their diagnosis and treatment. Objective: This systematic review examines studies exploring R/S of patients and their family in the perioperative period. Design: We completed a systematic review of the databases MEDLINE, EMBASE, CINAHL, SCOPUS, the Web of Science, and Cochrane library concerning the terms religion and spiri- tuality and cancer surgery. Inclusion criteria included qualitative or quantitative studies evaluating R/S of patients or their family members within the perioperative period (one month pre- and post-surgery). Exclusion criteria included review articles, grey literature, edito- rials, case studies and studies evaluating R/S of healthcare providers. Results: Seven publications met criteria for analysis. Five studies described cross-sectional surveys, one used a focus-group approach, and one utilized in-person interviews. Studied popu- lations predominantly were female breast patients. There were considerable heterogene- ity in survey instruments, variables, and outcomes. Based on these studies: 1) Faith and religious beliefs were used as coping mechanisms during the perioperative pe- riod; 2) Evangelical Christians tended to differ in religious coping compared to Catholics; 3) R/S correlated with coping styles and distress; 4) There was increased religious coping and religious involvement during the perioperative period; Conclusions: Studies evaluating R/S of patients and their families in the perioperative period are few and heterogeneous in design. Direct comparison is difficult, but data suggests that R/S during the perioperative period may increase as compared to R/S during other stages of diagnosis and treatment.

The use of expressive writing in the course of care for cancer patients to reduce emotional distress: analysis of the literature

The emotional distress represents one of the symptoms most frequently reported in the cancer patient in therapy, increasing the risk of developing a disease depressive. Through the analysis of the literature we want to assess whether the use of expressive writing on cancer patients in their care pathway compared to the use of writing neutral reduces emotional distress. The bibliographic search was conducted using the databases CINAHL, PubMed, Cochrane Library and PsycInfo. The results of research conducted on 7 randomized controlled trials, including 3 pilot studies have shown after expressive writing sessions (experimental group) versus neutral writing (control group) a significant reduction in distress in the experimental group early stages of cancer (p = 0,0183); in patients with a diagnosis of metastatic assigned to the group expressive writing there was a statistically significant relevance in the reduction of mood disorders (p = 0,03).Were determined statistically significant group differences also with respect to some measure on the quality of sleep (p = 0,04). The expressive writing did not produce significant reductions in psychological distress and improvements in physical health (p > 0,20) in patients diagnosed with metastatic disease of long duration and, in the palliative care there have been results of feasibility for poor adherence at follow-up. From the results it is evident that the strategies of expressive writing improves the management of the disease, reduce the physical and psychological symptoms related to the tumor while reducing the emotional distress in patients at an early stage of the disease.

Doctor - Patient Relation a Study of Communication

The patient-physician relationship is the very heart of health care delivery. The Doctor-patient relationship not only gives patients access to health care but also can promote healing. Having good communication skills is essential for doctors to establish good doctor -patient relationship. Good doctor patient communication was shown to have a positive impact on health outcomes. Improvements in doctors' communication skills were shown to be associated with increases in the emotional distress of patients. Better doctor -patient communication was shown to be associated with better control of chronic diseases. Patient-centred visits are associated with more diagnostic tests and referrals in the subsequent months. Low compliance with prescribed medical interventions is associated with reduced medical costs. The doctors' attitudes towards their patients, their ability to elicit and respect the patients' concerns, the demonstration of empathy and the development of patient trust are the key determinants of good compliance with medical interventions. Effective doctor-patient communication is highly associated with increased patient satisfaction. Doctors' satisfaction with their professional life are associated with greater patient trust and confidence. Communication problems are important factors in medical litigation. Adequate research has been done to evaluate doctor-patient relationship and doctor-patient communications. “Doctor -patient relation: A study of communication” is an interdisciplinary research work in medico social communication.