Evidence Of Psychological Distress Research Articles

Self-reported anterograde memory loss in older persons that is not validated on neuropsychological assessment: Considerations for a dissociative diagnosis

The past decade has witnessed amplified public awareness of age-related dementias. This has resulted in a dramatic rise in the number of older persons referred to memory clinics with a primary complaint of self-reported memory loss without an antecedent neurological event (e.g., stroke) who produce neuropsychological test profiles that lack evidence of such impairment. Since the latter part of the 19th century, a confusing array of changing terminology, criteria, and perceived causation have been ascribed to patients with unverified medical symptoms to implicate psychological causation. Such terms are often misperceived by laypersons as reflecting character flaws or malingering. Of import for clinical neuropsychologists, the 11th edition of the International Classification of Diseases added cognitive to symptoms eligible for a diagnosis of the modern formulation, dissociative neurological symptom disorder. One dissociative option for referrals with self-reported neurocognitive symptoms not validated on neuropsychological testing is functional memory disorder, conceived as a psychological disorder where emotional distress is plausibly related to the perceived memory loss but is of less severity than would warrant a major depressive or anxiety diagnosis. If evidence of psychological distress or behavioral impairment is not present the referral likely reflects the increased public awareness of age-related dementias interacting with the high base rate of self-perceived memory loss in the general population. In such cases, a dissociative diagnosis should be avoided as there is evidence of neither a medical nor a psychological disorder. A summary statement of not dementia or similar is likely sufficient to help the patient.

Does routine clinical assessment of older adults with gastroesophageal cancer tell the whole story?

297 Background: Geriatric Assessment (GA) can help oncologists determine fitness of their older patients (pt) for anti-cancer therapy. Our objective was to compare routine provider assessment (PA) and GA of older adults with gastroesophageal cancer (GEC). Methods: Patients ≥65 with any stage of GEC completed a GA. The pt’s provider completed a PA and abnormalities detected by both assessments were centrally reviewed and compared. GA and PA assessed functional status, nutrition, comorbidities, psychological distress, cognition, social support, and chemotherapy toxicity risk. Validated assessment tools were used for the GA. Data collected 3 months post-enrollment included hospitalization, ≥ grade 3 toxicities, and treatment delays. We compared the proportions detected/not detected abnormalities by PA vs GA using McNemar’s test for paired data, and we measured agreement using Kappa statistics (1=full, 0=no, -1=disagreement). Results: 82 pts were enrolled, majority male (74%), median age 73 (65-91), stage III/IV (82%) disease on first line therapy (79%). Cancer sites included gastric (32%), esophageal (43%), GEJ (26%). Pts’ demographic and clinical characteristics did not predict for the identification of GA abnormalities. GA detected 196 abnormalities and PA detected 86. Majority of pts (84%) had ≥ 1 unidentified abnormality by PA. Providers identified more pts with clinically significant comorbidities as compared to GA. However, the GA identified more abnormalities compared to PA in all other evaluated domains (Table). Low agreement was found between PA and GA in any of the domains. Pts scoring high on the CARG chemotherapy toxicity prediction tool (p=0.004) and pts with evidence of psychological distress (p=0.049) had more ≥ grade 3 toxicity. Pts with abnormalities in functional status, nutrition, psychological distress, and a high CARG score were more likely to be hospitalized during therapy. Conclusions: Clinical characteristics of older pts with GEC are not predictive of GA abnormalities. While providers were better at identifying comorbidities, the GA resulted in a comprehensive evaluation of all domains and identified significant abnormalities that affect treatment outcomes in this population. [Table: see text]

Symposium

Symposium

Comparison of physical and psychological health outcomes for motorcyclists and other road users after land transport crashes: an inception cohort study

BackgroundSerious injuries and fatalities among vulnerable road users on two wheeled motorised vehicles have increased across Australia and internationally in the past decade yet fallen for motor vehicle occupants. Almost half of all reported motorcycle injury crashes cause serious injury or death, nearly double that of motor vehicle police-reported crashes. This study explores associations with sociodemographic and pre-injury health characteristics and health outcomes after a road traffic injury; aiming to compare motorcyclists with other road users and inform recovery care.MethodsAn inception cohort study recruited 1854 individuals aged > 17 years, injured following land-transport crashes in New South Wales, Australia (July 2013–November 2016). Interviews conducted at baseline, 6-and 12-months post-injury elicited demographic, socioeconomic, and self-reported health conditions.ResultsPrimary analysis involved 1854 participants who were recruited at baseline as three distinct road user groups; 628 (33.9%) motorcyclists, 927 (50%) vehicle occupants and 299 (16.1%) bicyclists. At baseline, injury patterns differed significantly between road user groups; motorcyclists were more than twice as likely to sustain lower extremity injury (p < 0.001); to have more severe injury severity scores (p < 0.001) and longer hospital stays versus vs vehicle occupants and bicyclists (< 0.001) across these measures. Injured motorcyclists were predominantly male (88.1%, p < 0.001), were younger on average (38 years) than bicyclists (41.5 years), had lower income and education levels, and poorer pre-injury physical health than other road user groups. Despite these differences, at 12 months post-injury motorcyclists had better physical health (SF12-PCS 2.07 (0.77, 3.36), p = 0.002) and reported lower pain scores (− 0.51 (− 0.83, − 0.2), p < 0.001) than vehicle occupants. Motorcyclists displayed less evidence of psychological distress than vehicle occupants, but more than bicyclists across several measures used.ConclusionsRoad user types differ in important characteristics, including pre-injury health status and recovery after injury. As vulnerable road users experiencing transport crash and considering their higher initial injury severity, the degree of recovery among motorcyclists compared with other user types is remarkable and unexplained. Health and recovery outcomes after land-transport crashes is least favourable among vehicle occupants despite their higher levels of protection in a crash. This information is valuable for targeting early intervention strategies by road user type during the post-crash care phase, to improve long-term recovery.

Psychological Distress Among General Adult Population Of Kathmandu Valley

Introduction: A large proportion of the population in the community with psychological distress goes unnoticed. This study was done to assess the psychological distress among adult population of urban area of the Kathmandu Valley.&#x0D; Material And Method: The study was conducted among 280 individuals of age 18 years and above. Samples were conveniently selected from passersby in front of Mental Hospital, Lagankhel on World Mental health day 2018. The Nepali translated version of the General Health Questionnaire-12 (GHQ-12) was used to assess the psychological distress among the study participants.&#x0D; Results: Majority of the participants had low psychological distress (62.86%) followed by typical (12.86%), more than typical (9.29%), evidence of psychological distress (5.71%) &amp; severe distress (8.93%). 23.93% of the participants had psychological distress which needed attention.&#x0D; Conclusion: The psychological distress is a major public health concern in our study population. Focused interventions to improve the mental health of population are required to decrease the level of psychological distress among the general population.

Psychological Outcomes in Fathers of Critically Ill Children in the Pediatric Intensive Care Unit: A Systematic Review.

Systematically review evidence of psychological distress in fathers of children admitted to the pediatric intensive care unit (PICU). Two reviewers independently reviewed 24 published articles that studied fathers during and closely following a PICU admission. Results are presented for psychological outcomes of stress, PTSD, anxiety and depression, family functioning, and other forms of distress. Potential moderators of distress are also presented. Although methodological variance and inconsistent findings make it difficult to draw definitive conclusions, mothers and fathers appear to experience similar levels of distress and psychiatric symptoms during and after a PICU admission. Fathers' distress may be characterized by feelings of helplessness and often manifests after discharge, later than for mothers. More research is needed to understand gender differences in the expression of parental distress during and after a PICU admission as this will serve to inform interventions designed to improve family functioning.

Family adjustment to COVID-19 lockdown in Italy: Parental stress, coparenting, and child externalizing behavior.

Evidence of psychological distress in families during COVID‐19 outbreak are arising. However, the perceived changes in psychological adjustment during home confinement with respect to the period before the pandemic have not been addressed yet. Moreover, little is known about the role of coparenting and specific COVID‐19 contextual variables on parental stress and children's behavioral difficulties in the Italian context. Using a cross‐sectional survey, we collected data on 841 Italian parents of children aged 3–11 years with typical development during the home confinement (20th April–18th May). We analyzed levels of parental stress, coparenting, and child externalizing behaviors before and during the home confinement. Additionally, hierarchical regressions were performed to investigate predictors of parental stress and child externalizing behaviors during the lockdown. Results showed that parental stress (especially in mothers) and child externalizing behaviors increased during the lockdown period. Coparenting was a strong predictor of parental stress, together with being a mother, younger child age, less time dedicated to the child, and scarce feasibility of remote working. Besides, child externalizing behaviors were predicted by male gender, less parental time dedicated to the child, higher parental stress, and child distance learning workload. Our findings indicate a negative impact of COVID‐19 lockdown in both parents and children, suggesting that positive coparenting and time dedicated to children may help to reduce the detrimental effect of pandemic restrictions on family adjustment.

The responsibility of knowledge: Identifying and reporting students with evidence of psychological distress in large-scale school-based studies

The use of psychometric tools to investigate the impact of school-based wellbeing programs raises a number of ethical issues around students’ rights, confidentiality and protection. Researchers have explicit ethical obligations to protect participants from potential psychological harms, but guidance is needed for effectively navigating disclosure of identifiable confidential information that indicates signs of psychological distress. Drawing on a large-scale study examining student, school, and system-based factors that impact the implementation of a school-based social and emotional learning program, we describe patterns of distress attained from quantitative and qualitative questions and describe the process that we evolved to monitor and disclose sensitive mental health information, providing one example of how researchers might effectively address the responsibilities that emerge when collecting sensitive information from students within an education system. The patterns and processes that emerged illustrate that the inclusion of mental distress information can elicit important insights, but also brings responsibilities for minimising risks and maximising benefits.

Psychological distress among adult urban population of Puducherry

Background: A large proportion of population in the community with psychological distress goes unnoticed. This study was done to assess the psychological distress among adult population of an urban area of Puducherry.Methods: The study was conducted among 569 individuals of age 18 years and above. Systematic random sampling method was used to select the households in the study area and from each household one adult was randomly selected. The General Health Questionnaire-12 (GHQ-12) was used to assess the psychological distress among the study participants.Results: Majority of the participants had low psychological distress (60.5%) followed by typical (19.3%), more than typical (10%), evidence of psychological distress (6.2%) &amp; severe distress (4%). One-fifth (20.2%) of the participants had psychological distress which needs attention. The mental health status of the participants was significantly associated with the age, sex, marital status, religion and education (p&lt;0.05).Conclusions: The psychological distress is a major public health problem in the study population. Focused interventions to improve the mental health of population are required to decrease the mental distress in the community.

A subjective assessment of mental health of selected population of older persons in Delhi

A cross sectional survey was conducted among 60 subjects aged 60 years and above. The subjects in group was the geriatric population visiting Geriatric OPD, AIIMS, New Delhi. The convenient sampling technique was followed. General health questionnaire 12 administered to the subjects to detect those likely to have or be at risk of developing psychiatric disorders, domains of depression, anxiety, somatic symptoms, and social withdrawal. Study Result shows that 26.7% of elderly patients had evidence of psychological distress. It was found that the prevalence of psychological distress was 20% among elderly and illness and disability are related to psychological distress in old age with the feeling of loneliness is the single most important predictor of psychological distress. An immediate attention and remedial actions are to be taken for them so that they will be able to adapt healthy life style to improve the mental health status of older persons.

Features of residency training and psychological distress among residents in a Nigerian teaching hospital

&lt;p&gt;&lt;strong&gt;Background.&lt;/strong&gt; Resident doctors at University College Hospital (UCH), Ibadan, Nigeria, made a series of complaints about inadequate con­sultant supervision, lack of structure in the training programme and excessive workload. These complaints led to an evaluation of residency training. &lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective. &lt;/strong&gt;To investigate perceptions of the residency training programme and levels of psychological distress among residents.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods.&lt;/strong&gt; All 250 resident doctors at UCH were invited to complete questionnaires about their residency training and general health as part of a cross-sectional study. Data were analysed using SPSS 16. &lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results.&lt;/strong&gt; A total of 128 residents (51.2%) responded to the questionnaire. Of the respondents, 72% rated their consultant supervision as good and 82.6% rated support from nurses as good; 61.8% had &amp;lt;5 hours of formal educational activities and 65.1% had &amp;lt;5 hours of research or private study per week. There was evidence of psychological distress in 48.4% of the respondents, and there was a significant association between psychological distress and the intensity of work (&lt;em&gt;p&lt;/em&gt;&amp;lt;0.01). &lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion.&lt;/strong&gt; The residency training programme at UCH appears to prioritise service provision over research and education activities. Residents who report high workloads also have high levels of psychological distress. Tackling these issues could improve overall satisfaction with residency training and reduce complaints. &lt;/p&gt;&lt;div&gt; &lt;/div&gt;

Features of residency training and psychological distress among residents in a Nigerian teaching hospital

Background. Resident doctors at University College Hospital (UCH), Ibadan, Nigeria, made a series of complaints about inadequate con­sultant supervision, lack of structure in the training programme and excessive workload. These complaints led to an evaluation of residency training. Objective. To investigate perceptions of the residency training programme and levels of psychological distress among residents. Methods. All 250 resident doctors at UCH were invited to complete questionnaires about their residency training and general health as part of a cross-sectional study. Data were analysed using SPSS 16. Results. A total of 128 residents (51.2%) responded to the questionnaire. Of the respondents, 72% rated their consultant supervision as good and 82.6% rated support from nurses as good; 61.8% had <5 hours of formal educational activities and 65.1% had <5 hours of research or private study per week. There was evidence of psychological distress in 48.4% of the respondents, and there was a significant association between psychological distress and the intensity of work ( p <0.01). Conclusion. The residency training programme at UCH appears to prioritise service provision over research and education activities. Residents who report high workloads also have high levels of psychological distress. Tackling these issues could improve overall satisfaction with residency training and reduce complaints.

Stress and psychological well being status among health care professionals

Stress is a condition or feeling experienced when a person perceives that “demands exceed the personal and social resources the individual is able to mobilize” (Lazarus)1. It could be debatable whether stress is inevitable, but most professionals report stress at work place and in general. A common perception prevails regarding high stress level amongst professionals in particular industries like the information technology, professionals with fieldwork (medical representatives, insurance agents) that is also backed by study findings. However, stress among health care professionals is less explored. The present study aims to explore and assess psychological well being and stress levels among health care professionals. 50 health professionals, including doctors, paramedical and nursing staffs from different multi-specialty hospitals in Kolkata were assessed on the General Health Questionnaire (GHQ 12) and the Professional Life Stress scale, and Medico Psychological Questionnaire. Majority of the subjects had evidence of psychological distress. Stress level was present in varying degree among all professionals, while nurses and technicians had stress level at severe level. DOI: http://dx.doi.org/10.3126/ijosh.v3i1.9099 International Journal of Occupational Safety and Health, Vol 3 No 1 (2013) 32-35

Diabetes and ageing in the Melbourne Collaborative Cohort Study (MCCS)

AimsTo examine the association between diabetes, and ageing 12 years later. MethodsSubjects reporting angina, cancer, heart attack or stroke at baseline (1990–1994) were excluded. Diabetes at baseline was identified by self-report or elevated plasma glucose (≥7.0mmol/l fasting or ≥11.1mmol/l non-fasting). 6431 eligible men and women had survived to age 70 years at follow-up (2003–2007), and 5704 with complete data were included in these analyses. Those without ischemic heart disease, stroke, and cancer, no perceived major difficulty with physical functioning, and no evidence of psychological distress were considered to have aged successfully, irrespective of diabetes at follow-up (n=1271). Logistic regression was used to examine the independent association between baseline diabetes and successful ageing. ResultsAt baseline 216 eligible people were identified with diabetes. This was inversely associated with successful ageing at follow-up independent of smoking, physical activity, alcohol use and obesity (OR 0.65, 95% 0.42–0.99), Of the people with diabetes at follow-up, only 12.5% did not have another condition characteristic of usual ageing, compared with 22.7% of people who did not have diabetes. ConclusionsDiabetes is strongly associated with factors characterising less successful ageing, suggesting that the impact of diabetes may be larger than currently estimated.

Medication Use in US Youth With Mental Disorders

To evaluate the prevalence, demographic and clinical correlates, and specificity of classes of psychotropic medications indicated for mental disorders. Cross-sectional survey. Direct household interviews of combined household and school samples representative of the general population of adolescents in the United States. Ten thousand one hundred twenty-three adolescents aged 13 to 18 years who participated in the National Comorbidity Survey Adolescent Supplement. Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) (DSM-IV) mental disorders and neurodevelopmental disorders. Psychotropic medication use in the past 12 months. Among youth with any DSM-IV mental disorder, 14.2% reported that they had been treated with a psychotropic medication in the past 12 months. Strong associations emerged between specific disorders and classes of medications with evidence for efficacy. Antidepressants were most frequently used among those with primary mood disorders (14.1%); stimulant use was most common among those with attention-deficit/hyperactivity disorder (20.4%); and antipsychotic use was infrequent and mostly seen among those with serious developmental disorders. Less than 2.5% of adolescents without a 12-month mental disorder had been prescribed psychotropic medications, and most had evidence of psychological distress or impairment reflected in a previous mental disorder, subthreshold condition, or developmental disorder. Appropriate medication use was significantly more frequent among those in treatment in the mental health specialty sector than general medicine or other settings. These findings challenge recent concerns over widespread overmedication and misuse of psychotropic medications in US youth. In fact, these data highlight the need for greater recognition and appropriate treatment of youth with mental health disorders.

Psychological distress among patients with organophosphorus or paraquat poisoning

Introduction: Recognition of psychological distress following intentional self poisoning is important. The most widely used screening test for psychological distress is the Goldberg's General Health Questionnaire (GHQ). It is available in versions as short as 12 items (GHQ-12) and as long as 60 (GHQ-60). Objective: The aim of the study was to determine the prevalence of psychological distress among patients with self poisoning with organophosphorus (OP) or paraquat (PQ) pesticides admitted to the General Hospital, Matara and the Teaching Hospital, Galle. Method: A case control study was conducted with matched controls. A self-administered validated Sinhala translation of the 12-item Goldberg's General Health Questionnaire (GHQ-12) was used as a general screening test to identify psychological distress. A score >15 indicates evidence of psychological distress and a score >20 is suggestive of severe psychological problems and distress. A score >15 is also considered as positive GHQ-12. : Results: GHQ-12 was administered to 143 (99 OP, 44 PQ) patients and 70 controls. Mean (SD) ages of the test and control group were 34 (14) and 33 (12) is respectively. The prevalence of psychological distress among the patients and the controls were 51% (73/143) and 10% (7/70), respectively. The median (inter-quartile range) of GHQ-12 scores among patients and controls were 16 (11 23) and 8 (5 11), respectively (P Conclusions: This study indicates the high prevalence of psychological distress among patients with self poisoning with OP or PQ and emphasizes the need of assessment, support and if required treatment in needy cases. DOI: http://dx.doi.org/10.4038/gmj.v17i1.4358 Galle Medical Journal , Vol 17: No. 1, March 2012 32-36

Diabetes and mental health; the problem of co‐morbidity

Diabetes and mental health; the problem of co‐morbidity

Experiences of families when a relative is diagnosed brain stem dead: understanding of death, observation of brain stem death testing and attitudes to organ donation

Brain stem death may be a difficult concept for relatives to understand. Our ITU practice follows published recommendations that the use of explanatory leaflets showing CT scans and observing brain stem death testing in some cases may help relatives to understand that death has occurred. Using this strategy, we interviewed 27 relatives 12 months after bereavement following certification by brain stem testing, investigating their understanding of brain stem death, subsequent attitudes to organ donation, grief reactions and attitudes of those who had observed the tests. Most relatives understood that the brain stem death tests indicated that survival was not possible, although three relatives had not fully understood this and valued the opportunity to discuss it again. Only five relatives observed the tests, all were pleased that they had done so as this had confirmed their understanding that death had occurred; however, these relatives had more evidence of psychological distress. No relatives who agreed to organ donation regretted this but three who did not allow donation subsequently expressed regret. Several relatives thought that observing the tests would have helped them to understand that death had occurred, making easier the decision to allow organ donation.

Stressors and counseling needs of undergraduate nursing students in Ibadan, Nigeria.

Existing evidence suggests that nursing students have high levels of stress and that counseling and other support services should be made available to them. However, the stressors and counseling needs of undergraduate nursing students in Nigeria have yet to be explored. This study used a questionnaire to investigate the stressors, counseling needs, and desired counseling facilities of undergraduate nursing students at the University of Ibadan. Common stressors included excessive schoolwork, financial problems, inadequate recreational facilities, and overcrowded accommodations. There was an association between reporting inconsiderate, insensitive lecturers as stressors and evidence of psychological distress. Nearly 60% of the respondents felt counseling would help them, and most desired counseling for academics, finances, and relationships. Most (78%) of the respondents preferred an independent facility with trained counselors. Desired characteristics for the services included accessibility, affordability, confidentiality, and a friendly atmosphere. Educators and administrators should use this information to design counseling facilities for students.

A preliminary investigation of psychological distress following surgical management of early pregnancy loss detected at initial ultrasound scanning: A trauma perspective

Recent research has focused on the occurrence of anxiety symptoms after miscarriage and has suggested that early pregnancy loss (EPL) should be conceptualised from the perspective of a trauma experience. We hypothesised that women who have perceived warning signs of an EPL will be less psychologically distressed in a 3-week period after this pregnancy loss than women with no prior perceived warning signs. The prevalence of Acute Stress Disorder (ASD), post traumatic stress symptoms, anxiety and depression was assessed in 40 women, who had experienced an EPL approximately 3 weeks beforehand and, with the exception of ASD, this was also investigated at 3-month follow-up. Evidence of psychological distress was expected to decrease over time in all women regardless of whether they had perceived warning signs or not. It was found that the presence of perceived warning signs did not determine levels of psychological distress. We ascertained that the experience of EPL itself increased post traumatic stress symptoms and anxiety, regardless of perceived warning signs of a pregnancy complication. Psychological distress subsided over time with the exception of anxiety, which remained high. The present study supported the conceptualisation of EPL as a trauma experience and, at a more practical level, highlighted a need for routine follow-up care.