Higher Levels Of Psychological Symptoms Research Articles

Psychopathology in boys with Tourette syndrome: Effects of age on the relationship between psychological and physical symptoms

AbstractTourette syndrome (TS), a neuropsychiatric disorder that presents in childhood and is characterized by recurrent tics, is often associated with a variety of psychological problems. Most studies of concomitant problems have focused on psychiatric comorbidity, with less attention paid to nonsyndrome-specific or subsyndromal emotional and behavioral difficulties. Moreover, little is known about the factors that influence the specificity or severity of psychological problems. We hypothesized that level and type of psychological problem would be influenced by both severity of illness and developmental period. Children with severe tics were predicted to show increased levels of externalizing (undercontrolled) behavior, whereas adolescents with severe tics were predicted to show increased levels of internalizing (overcontrolled) behavior. Forty-one boys with TS were rated by their parents for tic severity (simple and complex motor tics) and psychological symptoms (Connors Parent Symptom Questionnaire and the Child Behavior Checklist). Results partially confirmed the hypothesis, indicating that greater illness severity was associated with greater psychological disturbance, but only in the younger subjects. Among the adolescents, even those with mild tics demonstrated relatively high levels of psychological symptoms. However, there was no indication that developmental period was related to the specific type of problem manifested. Regardless of age, patients with severe tics domonstrated high levels of externalizing behavior, and relatively high levels of internalizing behavior were also seen. Results are discussed in terms of the developmental factors that might influence the relationship between psychological and physical symptoms in children with TS.

Effects on Care-Givers of Special Day Care Programmes for Dementia Sufferers

Two groups of care-givers to dementia sufferers were interviewed to assess their psychological symptoms and the behaviour problems of the dementia sufferers. The first group were using special dementia day care while the second group were about to begin using it. The second group were re-interviewed three months later. Therefore two comparisons could be made; a with/without day care comparison and a before/after admission to day care comparison. Care-givers had a high level of psychological symptoms which were not significantly reduced by using day care. Full-time institutional care did reduce distress. Day centre clients continued to deteriorate as would be expected with a degenerative condition. While special dementia day care centres appear to play a useful role for many care-givers, they may provide too few hours relief per week to markedly reduce the care-givers' psychological symptoms. Family care-givers currently take the major role in caring for dementia sufferers in the community and the burden of care needs to be shared more equitably.

Perceived family support as a moderator psychological well-being in end-stage renal disease.

End-stage renal disease (ESRD) is associated with an increased incidence of psychological distress. The present research examined the salutary effects of a supportive family environment on the psychological well-being of ESRD patients receiving renal transplants. Patients (N = 57) completed a measure of perceived family support and an assessment of the physical impact of their illness. Psychological well-being was assessed utilizing two measures of depression and two measures of anxiety. One group of patients was classified as experiencing high illness-related physical dysfunction. In this group, patients perceiving a less supportive family environment displayed significantly higher levels of psychological symptoms of depression and anxiety than patients with a more supportive family environment. A second group of patients was classified as experiencing low illness-related physical dysfunction. In this group, the perceived level of family support was not significantly related to their relatively lower reported levels of depression and anxiety.

Evaluation of a Special Nursing Home Unit for Dementia Sufferers: A Randomised Controlled Comparison with Community Care

Applicants for a newly opened special unit for dementia sufferers were randomly allocated to full-time care in the unit or placed on a waiting list and offered periodic respite care in the meantime. All applicants were living in the community at the time of random assignment. Both groups were followed up for three months to assess the effects on the dementia sufferers and on their family care-givers. Care-givers initially had a high level of psychological symptoms, which was greatly reduced after admission of the dementia sufferer to full-time care. By contrast, the care-givers of the community care group of sufferers continued to have a high level of symptoms. Dementia sufferers continued to deteriorate with both forms of care, with little difference between the two groups. Admission of dementia sufferers to full-time care in a special unit appears to be of great benefit to the psychological health of their care-givers and has no adverse effects on the dementia sufferers themselves.

Perceived job stress, job satisfaction, and psychological symptoms in critical care nursing.

This study tested the relationships among perceived job stress, job satisfaction, and psychological symptoms of critical care nurses. A self-administered questionnaire was sent to a sample of 180 critical care nurses from eight hospitals. The results supported the hypotheses that higher levels of perceived job stress are related to lower levels of job satisfaction (r = -.24, p = .001) and to higher levels of psychological symptoms (r = .33, p = .000). These effects remained even when years of experience in nursing and shift were controlled. Item analysis, however, showed that four of the five top-ranking stressors were not related to the outcome measures. A distinction between positive and negative stressors is proposed to explain the pattern of results.

Success and Failure at Outpatient Opioid Detoxification

Two controlled trials have suggested that clonidine can be used on an outpatient basis to assist in opioid withdrawal, but that rates of successful detoxification do not exceed those obtained with gradual methadone reduction. This study examines the process of clonidine-and methadone-assisted detoxification to provide information about the timing and severity of withdrawal symptoms and side effects associated with each of the two methods. Derived from a double-blind clinical trial with randomized treatment assignment, data are presented which might guide the clinician in the choice of detoxification methods. In this study, subjects in either treatment condition had a success rate of approximately 40% and most subjects experienced at least moderate withdrawal discomfort in the areas of difficulty sleeping, feeling "blah," and craving. In both treatment groups the best predictor of detoxification failure was a high level of psychological symptoms at the onset of the study. Compared with gradual methadone reduction, clonidine treatment resulted in higher levels of withdrawal symptoms and side effects, earlier onset of withdrawal discomfort, earlier attrition, earlier termination of withdrawal discomfort, and a posttreatment course of drug use that was more consistent with success status during the study treatment.