Middlesex Hospital Questionnaire Research Articles

Prospective Examination of Anxiety Persistence and Its Relationship to Cardiac Symptoms and Recurrent Cardiac Events

Background: The current study builds on previous research demonstrating a link between anxiety and inhospital recurrent ischemic and arrhythmic events, by examining the effects of persistent anxiety on recurrent events 1 year later. Methods: 913 patients with unstable angina (UA) and myocardial infarction (MI) from 12 coronary care units were recruited, and follow-up data were collected at 6 and 12 months after the event. Measures included cardiac symptomatology, healthcare utilization, the anxiety subscale of the Primary Care Evaluation of Mental Disorders , the phobic anxiety subscale of the Middlesex Hospital Questionnaire, and the Beck Depression Inventory. Results: Over one third of participants with UA and MI experienced elevated anxiety at the time of the ischemic event, and these symptoms persisted for 1 year in 50% of anxious participants. Although participants with anxiety reported more atypical cardiac symptomatology, the prevalence of typical cardiac symptoms such as chest pain did not differ based on anxiety. After controlling for the severity of the coronary event, family income, sex, diabetes, and smoking, the following variables were significantly predictive of self-reported recurrent cardiac events at 6 months or 1 year: older age, family history of cardiovascular disease, greater depressive symptomatology at baseline, and anxiety at 6 months. Only 38% of anxious patients were asked about such symptoms, indicating underutilization of effective psychotherapeutic treatment. Conclusions: Over and above the effects of depressive symptomatology (among other confounding variables), nonphobic anxiety appears to have a negative effect on self-reported outcome following an ischemic coronary event. Anxiety symptomatology is underrecognized and undertreated, and examination of effects of treatment on secondary prevention must be pursued.

Posters

The relation between sexual and cardiovascular health in women is not well defined. Clitoral color Doppler ultrasound (CDU) with assessment of the pulsatility index (PI), reflecting resistance to blood flow, has been proposed as an objective measurement of sexual functioning.To investigate associations between clitoral PI and cardiometabolic risk factors, sexual and intrapsychic parameters, and self-perception of body image.Seventy-one adult heterosexual women in a stable relationship attending our clinic for sexual dysfunction were consecutively recruited.Patients underwent physical, laboratory, and clitoral color Doppler ultrasound examinations and completed the Female Sexual Function Index, the Middlesex Hospital Questionnaire, and the Body Uneasiness Test (BUT).Clitoral PI was positively correlated with body mass index (r = 0.441, P < .0001), waist circumference (r = 0.474, P < .0001), glycemia (r = 0.300, P = .029), insulin (r = 0.628, P = .002), homeostatic model assessment index (r = 0.605, P = .005), triglycerides (r = 0.340, P = .011), total cholesterol (r = 0.346, P = .010), and low-density lipoprotein cholesterol (r = 0.334, P = .016). All relations, with the exception of glycemia, retained statistical significance after adjusting for age, smoking habit, and years since menopause (P < .0001 for body mass index, waist circumference, and triglycerides; P < .05 for all other associations). Analysis of covariance, after adjusting for confounders, showed that women with obesity or metabolic syndrome (MetS) showed significantly higher PI values (obesity: F = 17.79, P = .001; MetS: F = 7.37, P = .019). In particular, a stepwise increase of PI was found as a function of increasing MetS components (β = 0.434, P = .007). Clitoral PI was negatively associated with Female Sexual Function Index arousal (β = −0.321, P = .014) and satisfaction (β = −0.289, P = .026) scores and positively associated with Middlesex Hospital Questionnaire somatized anxiety symptoms, even after adjusting for age, smoking habit, years since menopause, and current use of psychiatric medication (β = 0.354, P = .011). A positive association also was observed between PI and the BUT positive symptom distress index (β = 0.322, P = .039) and BUT for dislike of the womb, genitals, and breast (β = 0.538, P < .0001; β = 0.642, P < .0001; β = 0.549, P < .0001, respectively). After introducing waist circumference as another covariate, the associations between clitoral PI and the BUT positive symptom distress index and BUT dislike of the womb, genitals, and breast retained statistical significance (P = .038 for positive symptom distress index; P < .0001 for dislike of womb, genitals, and breast).Clitoral vascular resistance is positively associated with MetS (in particular insulin resistance), decreased sexual arousal, body image concerns, and increased somatized anxiety symptoms. Further studies are needed to establish whether treatment of metabolic abnormalities might improve clitoral color Doppler ultrasound indices and sexual outcomes.

Psychiatric disorders in opioid dependants.

Psychiatric disorders are common among substance dependants. The objectives of this study were to assess the rate of neurotic disorders among opioid addicts, and reassess the rate of those neurotic disorders two weeks after complete detoxification of the patients. Data were gathered from 500 (496 men and 4 women) opioid dependants, using DSM-IV criteria. The Middlesex Hospital Questionnaire (MHQ) was used to measure free-floating anxiety, depression, phobia, obsession, hysteria and somatization. Four hundred and ninety-six (99.2%) of the subjects were men of whom the majority (65.2%) were married, 26.4% single and the others were divorced or separated. Three hundred and thirty-four (66.8%) were in age range of 20 to 39 years. Of the subjects 154 (30.8) were self-employed, 116 (23.2%) were factory workers, 100 (20%) unemployed, 64 (12.8%) employees and 32 (6.4%) retailers. The majority, 322 (64.4%), reported elementary and high school as their level of education and only 20 (4%) were illiterate. The means for neurotic disorders (using the MHQ) before and two weeks after detoxification were 10.12 and 9.98 for anxiety, 7.54 and 7.41 for phobia, 10.10 and 9.76 for depression, 11.11 and 11.05 for obsession, 8.47 and 8.49 for hysteria and 9.82 and 9.46 for somatization, respectively. The mean difference was significant only for depression. Present findings indicated that the rate of neurotic disorders in opioid dependants is high and (except for depression) was not significantly different before detoxification and two weeks after detoxification. Opium was found to be the most prevalent form of opioid used. Also it can be concluded that during the last years some demographic characteristics of Iranian opioid addicts in this sample have changed. Cultural attitudes toward substance use quite likely affect the pattern of substance use. These findings can be considered when planning preventive and therapeutic programs.

Psychiatric Disorders in Opioid Dependents

Abstract Aims: Psychiatric disorders are common among substance dependents. The objectives of this study were to assess the rate of neurotic disorders among opioid addicts, and re-assess the rate of those neurotic disorders after complete detoxification of the patients. Measurements: Data were gathered from 500 opioid dependents, using DSM-IV criteria. The Middlesex Hospital Questionnaire (MHQ) was used to measure free floating anxiety, depression, phobia, obsession, hysteria and somatization. Results: The subjects were 99.2% men of whom 65.2% were married and 26.4% single. About 67% were in age range of 20 to 39 years. Of the subjects 28.8% were workers, 20% unemployed, 12.8% employees, and 6.4% retailers. The majority (64.4%) reported elementary or high school as their level of education and only 4% were illiterate. The means for neurotic disorders (using the MHQ) before and after detoxification were, respectively, 10.12 and 9.98 for anxiety, 7.54 and 7.41 for phobia, 10.10 and 9.76 for depression, 11.1...

SELF-EFFICACY AND DEPRESSION AMONG IRANIAN COLLEGE STUDENTS

The present study examined the correlations of depression and self-efficacy among college students. Responses of 200 college students to the Self-efficacy Scale and Middlesex Hospital Questionnaire showed that there is a negative correlation between the two sets of scores.

Morning and evening types: stress-related personality aspects

A group of 232 adult subjects was administered the Morningness-Eveningness Questionnaire to assess their individual circadian typology and a battery of questionnaires of personality and psychological and psychosomatic disorders (Beck Depression Inventory; Bortner Type A Scale; Eysenck Personality Questionnaire; Jenkins Activity Survey; Middlesex Hospital Questionnaire; Strelau Temperament Inventory). Significant correlations between circadian typology scores and data relative to personality, psychosomatic disorders, and stress-prone behaviour were found. Evening types reported psychological and psychosomatic disturbances more frequently and intensively than morning types, and showed more problems in coping with environmental and social demands. The relevance of the morningness-eveningness dimension for research on stress and cardiovascular diseases is discussed.

A Study on Neurosis According to Experience of Sexual Abuse among Female High School Students in Taegu

This study was intended to identify the neurotic traits related to sexual abuse in female high school students. The Neurosis Scale of Middlesex Hospital Questionnaire was conducted to 320 female high school students in Taegu, Korea from July 10 to July 17, 1994. The results were as follows: 1) The sexual abuse victim group showed significantly higher neurotic traits of Free floating anxiety (p

The role of psychological distress and personality in the incidence of sciatic pain among working men.

The role of personality characteristics and psychological distress in the incidence of sciatic pain was investigated in a 3-year prospective study. The study population consisted of 1149 Finnish men aged 25 through 49 years (387 machine operators, 336 carpenters, and 426 office workers) with no history of sciatic pain at the beginning of follow-up. The psychological distress and personality characteristics were assessed by the Middlesex Hospital Questionnaire and the Maudsley Personality Inventory. The 3-year cumulative incidence rate for sciatic pain was 22% among the machine operators, 24% among the carpenters, and 14% among the office workers. The multivariate analysis of psychological factors, taking into account individual and occupational factors, showed that only hysteria was significantly associated with the incidence of sciatic pain among the blue-collar workers. Among the white-collar workers, none of the psychological dimensions were associated with sciatic pain. These results are in accordance with previous relationships found between hysteria and low-back disorders. Further follow-up investigations are needed to elucidate the role of psychological factors in the occurrence of back problems.

Cognitive failure during pregnancy

Abstract Many women report an increased incidence of cognitive failure in pregnancy. Psychological literature on cognitive failure suggests that it occurs more frequently at times of stress, when task demands are high and when people undergo a disruption in routine, all of which could apply to pregnancy. This study investigates links between women's reported cognitive failure during pregnancy and psychological and social factors. Thirty-one pregnant women were interviewed and asked to complete the Cognitive Failure Questionnaire and Middlesex Hospital Questionnaire at 4-weekly intervals during their pregnancy. The results suggest that women's cognitive failure scores in pregnancy are not significantly higher than the general female population, though some of the women studied did report very frequent cognitive failures. Levels of reported cognitive failure were related to maternal occupation, psychological and physical health prior to pregnancy. Differences in reported cognitive failure during pregnancy w...

Effect of Spiritual Healing on Chronic Idiopathic Pain

To study over a period of one and a half years the effect of spiritual healing on patients with idiopathic pain syndrome using several psychological and medical parameters. Randomized clinical trial. Outpatient pain clinic. Twenty-four patients with idiopathic chronic pain who had passed a pretreatment psychological interview were allocated randomly to receive spiritual healing or no active treatment. Medical interview (Visual Analog Scale and Pain Clinic Investigation Formula); International Association for the Study of Pain (IASP) Data Base Outline; psychological interview (Hopkin's Symptom Checklist, Middlesex Hospital Questionnaire, Beck's Depression Inventory, Coping Strategy Questionnaire, Health Locus of Control scale). Patients were evaluated at baseline and at 2 weeks posttreatment. Final assessment at 1 year posttreatment was done with a modified form of IASP Data Base Outline. There was a minor decrease in analgesic drug intake and an improvement in sleep patterns in patients treated by the healer. Generally, clinical variables remained unchanged. Attitudes toward spiritual healing improved. There was a decrease in the feeling of hopelessness (p < 0.05) and an increased acceptance of psychological factors as reasons for pain (p < 0.05). Other scores of the psychological tests were unaffected by the healing. However, half (n = 6) of the treated patients felt that spiritual healing gave them some relief. Spiritual healing appears harmless and was subjectively helpful to some patients suffering from idiopathic chronic pain syndrome.

Longitudinal study on the role of personality characteristics and psychological distress in neck trouble among working men

The role of personality characteristics and psychological distress in the occurrence of severe neck trouble was investigated in a 3-year follow-up study conducted from 1984 to 1987 among 1015 men (age: 25–49 years old) employed as machine operators, carpenters and office workers. The subjects had reported in a questionnaire in 1984 that they had experienced no more than 7 days with neck trouble during the past 12 months. Based on a similar questionnaire in 1987, severe neck trouble was defined as trouble having lasted more than 30 days. Psychological distress and personality characteristics were assessed in 1984 by the Middlesex Hospital Questionnaire (MHQ) and the Maudsley Personality Inventory (MPI) respectively. Severe neck trouble occurred in 11% of the subjects, who were considered as cases; those with 0–7 days with neck trouble were considered as controls. When individual and occupational factors were adjusted for no powerful predictors were found. However, after performing a backward stepping analysis, somatic symptoms and hysteria were significantly associated with severe neck trouble. In occupation-specific analyses, somatic symptoms and neuroticism were significantly associated with the occurrence of severe neck trouble among the machine operators, as were somatic symptoms, depression and hysteria among the office workers. Neither the personality characteristics nor psychological distress predicted the occurrence of severe neck trouble among the carpenters. We conclude that the associations between psychological factors and neck trouble are complex and may depend on the psychosocial environment.

Effects of discontinuation of individual antiepileptic drugs on mood

AbstractForty‐four patients undergoing withdrawal of phenytoin, carbamazepine or sodium valproate and 21 patients on stable medication were assessed using standardised, objective ratings of mood, notably the Mood Adjective Checklist and the Middlesex Hospital Questionnaire. The study followed a prospective, double‐blind, placebo‐controlled design. Patients' mood was assessed before and after drug withdrawal with an additional assessment being made four weeks after the completion of withdrawal. The number of seizures, serum anticonvulsant levels and EEGs were assessed at the same time as the mood assessments. In addition, the potential influence of life events on mood was monitored.Anxiety, as measured by the Middlesex Hospital Questionnaire, increased on withdrawal of carbamazepine. This change was not related to seizure rate. Withdrawal of phenytoin or sodium valproate did not appear to have an impact on mood. Concomitant changes in serial EEGs are discussed in relation to the changes in mood.

Crown-Crisp Experiential Index, a useful tool for measuring neurotic psychopathology

The Crown-Crisp Experiential Index (CCEI), earlier called the Middlesex Hospital Questionnaire, has been widely used for measuring six different kinds of neurotic traits and symptoms. It has been validated in different studies. It has not, however, been used so often in Finland. The aim of the present study was, first, to test how the Finnish-language version functions and, second, to examine the concordance between the CCEI and another even more widely used questionnaire for assessing psychologic problems, the General Health Questionnaire (GHQ-36). The material consisted of 52 students at a nursing college. They were all healthy and did not have any noteworthy somatic diseases or psychic disturbances. They filled in both the inventories during a normal class. The scores for the six subscales of the CCEI were quite highly comparable with the scores obtained for three earlier English“normal samples”. The concordance between the GHQ scores and the CCEI total scores was comparatively high. These results show...

Histrionic Disorder among Iranian High School and College Students

This study was designed to explore the sex and group differences in histrionic personalities of high school and university students, and also to explore the results of this study with those of Crown and Crisp from 1966 in England. A sample of 160 high school students (80 girls and 80 boys) were selected randomly from four high schools in Shiraz and Shiraz University. The mean ages for high school girls and boys were 15.3 and 17.3 yr., for university women and men were 20.6 and 23.2 yr., respectively. The hysteria (H) scale of the Middlesex Hospital Questionnaire was used. The questions of this scale refer to histrionic personality according to DSM-III and DSM-III--R. Analysis showed significant effects of group (high school, college) for histrionic personality disorder. It was concluded that more histrionic personality disorders were reported among British college students than among their Iranian peers.

HISTRIONIC DISORDER AMONG IRANIAN HIGH SCHOOL AND COLLEGE STUDENTS

This study was designed to explore the sex and group differences in histrionic personalities of high school and university students, and also to explore the results of this study with those of Crown and Crisp from 1966 in England. A sample of 160 high school students (80 girls and 80 boys) were selected randomly from four high schools in Shiraz and Shiraz University. The mean ages for high school girls and boys were 15.3 and 17.3 yr., for university women and men were 20.6 and 23.2 yr., respectively. The hysteria (H) scale of the Middlesex Hospital Questionnaire was used. The questions of this scale refer to histrionic personality according to DSM-III and DSM-III—R. Analysis showed significant effects of group (high school, college) for histrionic personality disorder. It was concluded that more histrionic personality disorders were reported among British college students than among their Iranian peers.

Mental Health of Iranian High School and College Students

The objectives of this study were to investigate the mental health of Iranian high school and college students with regard to sex differences and to compare the results with those from other countries. The sample included 159 high school students (79 boys, 80 girls) and 160 college students (80 boys, 80 girls). The Middlesex Hospital Questionnaire was used to measure free floating anxiety, depression, phobia, obsession, and somatization. Significant effects of group and sex were noted for phobia, but for depression only the main effect of group was significant. For other scales neither the main effects of group and sex nor their interactions were significant. Iranian college students showed more anxiety than their British peers.

Patient-Handling Skill, Back Injuries, and Back Pain

The aim of this intervention was to evaluate the effect of training on patient-handling skills and prospectively to assess the effect of skill on subsequent back pain and back injuries in nursing. Of a total of 255 nurses, 199 were assessed for their skill in patient-handling. One-half (control group) received traditional training in patient-handling, and the other half (trained group) received a curriculum of instruction totaling 40 hours. The skills of both groups were assessed on graduation. The control group was rated as less competent in patient-handling. Nurses in both groups were questioned about the prevalence of back pain and incidence of back injuries in the first year after graduation. In multiple regression analysis, the major risk indicators for back injuries were poor patient-handling skill, low numbers of repetitions in the sit-up test, and high work-load scores. High score on the hysteria scale of Middlesex Hospital Questionnaire was a risk indicator for all kinds of back pain. Though back pain was independent of patient-handling skill, those rated as "bad" or "poor" had more back injuries (24%) than those who had been rated as "good" or "excellent" (2%) (P less than 0.001), but the difference between the trained and control groups was not statistically significant. It was concluded that back injuries may be prevented by the teaching of patient-handling skills.

Alexithymia and breast cancer. Survey of 200 women undergoing mammography.

The Schalling Sifneos Personality Scale (SSPS) and the Middlesex Hospital Questionnaire (MHQ) have been used in 381 women just before mammography at the Breast Center of the Radiology Institute, University of Bari (Italy). Of the 200 women who accepted to complete the questionnaires 13 were found positive for cancer. Student's t test comparison of the mean SSPS and MHQ scores of the positive for cancer with the negative showed that women with breast cancer have more pronounced alexithymic but not neurotic traits. Our findings suggest that patients with cancer may have something in common with those suffering from so-called psychosomatic pathologies who have a constrained imagination and fantasy and difficulty in verbalizing their emotions. Thus, this study indicates a relationship between alexithymia and cancer.

Standardisation of the Kannada version of the Crown-Crisp Experiential Index (CCEI).

The Crown-Crisp Experiential Index (CCEI), formerly called the Middlesex Hospital Questionnaire (MHQ) was standardised in Kannada. The Kannada version showed adequate reliability and yielded normative data comparable to the original version. The CCEI scores distinguished the normal group from another group of neurotic patients.

The relationship between cognitive failures, psychoneurotic symptoms and sex.

As Broadbent et al's (1) original analysis of the relationship between the Cognitive Failures Questionnaire (CFQ) and the Middlesex Hospital Questionnaire (MHQ) was conducted on an altered version of the MHQ, the present study undertook this same analysis using the full MHQ. In addition, the relationship was examined to see if it was mediated by the differences in the scoring of males and females on each questionnaire. Our results support and strengthen Broadbent et al's conclusion that high rates of cognitive failure are associated with psychoneurotic symptoms. The sex difference on the CFQ is discussed in terms of vulnerability to stress to account for the higher incidence of psychoneurotic symptoms in females.