Psychological Assessment Of Patients Research Articles

Psychological assessment of patients on the heart transplant waiting list: A single center experience.

To analyze the data of the psychological assessment, focusing attention on the quality of life and the psychological status of patients who are listed for heart transplant. All heart failure patients listed for heart transplant at the Cardiac Surgery Unit of Bari University, Italy, were evaluated from September to November 2023, by administering the Symptom Checklist-90-R (SCL-90-R) and the Short Form Health Survey 36 (SF-36). Overall, 27 patients were studied. Mean age was 60years, 88% were males. One third of the patients showed a clinically significant overall mental distress. The symptoms leading to domains such as somatization (55.55%), anxiety (40.74%) and depression (33.33%) were frequently observed. The majority of the population studied (96.30%) showed low levels of perceived physical health status, while 59,62% of them presented levels of perceived physical health status below normal ranges. Heart transplant candidates show elements of overall mental distress and low quality of life related to physical health status.

Cognitive and psychological assessment in patients with cerebral amyloid angiopathy

Cognitive and psychological assessment in patients with cerebral amyloid angiopathy

Assessing the Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT) in Risk-Stratifying Multiple Myeloma Patients for Autologous Stem Cell Transplantation

Background: Hematopoietic stem cell transplant (SCT) is a high-intensity treatment that can cause psychological distress. Pre-transplant psychosocial screening is commonly used to assess mental health, social support, compliance, and health behaviors in HCT centers. However, the optimal standardized approach to psychosocial screening is still being defined. Some studies have shown that pre-transplant psychosocial assessments can predict overall survival (OS) after SCT, while others have found associations with non-relapse mortality (NRM) but not with OS. Single-institution reports consistently indicate that pre-HCT psychosocial assessments are associated with the length of SCT hospitalization and readmission rate. The Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT) is an established tool in the solid organ transplant field that can be used to assess and quantify psychosocial risk, that can help in patient selection and pre-transplant preparation. Objective: This study aimed to validate the SIPAT as a standardized psychological assessment in patients with multiple myeloma (MM) undergoing autologous SCT (ASCT). The primary goal was to analyze the impact of psychosocial risk, as measured by the SIPAT score, on the length of hospital stay and readmission rates within 100 days post-discharge. Secondary outcomes included the risk of infections, progression-free survival (PFS), and overall survival (OS). Methods: This retrospective, single-center study included 87 patients with MM who underwent ASCT between 2019 and 2022 at University Hospitals Seidman Cancer Center. Patient and disease characteristics were collected, and SIPAT scores were recorded for all patients. Patients were grouped based on their SIPAT scores as “Excellent” (score ≤ 6) or “Good” (score > 6). Hospitalization duration during transplant, readmissions, and infections within the first 100 days after ASCT were used as indicators of treatment-related toxicity. Results: 30 patients had an “Excellent” SIPAT score (mean score: 3.47, SD 1.81), while 57 had a “Good” score (mean score: 11.81, SD 5.92). Both groups exhibited similar sex and race distribution, BMI, and KPS scores. The “Excellent” SIPAT group had more patients with HCT-CI scores of 0-2. Both groups had comparable ISS staging and high-risk cytogenetics, along with similar prior lines of treatment and disease status at the time of transplant. Patients in the “Good” SIPAT score group had a higher number of CD34+ cells infused per kg. No significant differences were observed between the groups in terms of engraftment time, hospitalization duration, or rates of hospitalizations and infections within the first 100 days after transplant. Univariate analysis of risk of readmissions showed that BMI had a significant effect (HR 1.09, 95% CI 1.02-1.16, p=0.009) for each unit increase and HCT-CI had a significant effect (HR 5.56, 95% CI 1.39-22.24, p=0.015) for HCT-CI score 3+ compared to 0-2. However, in the multivariable model, these effects did not persist. Conclusions: Although the SIPAT tool is widely used for evaluating different organ transplants, including HCT, a high SIPAT score alone may not be sufficient to risk-stratify candidates for ASCT in MM. Further research and evaluation are warranted to better understand the true predictive value of pre-transplant psychosocial assessments.

Spine Surgeon Assessments of Patient Psychological Distress are Inaccurate and Bias Treatment Recommendations.

Prospective cohort study. This study determined (1) the surgeon accuracy of psychological assessment in patients in spine clinic, (2) the impact of psychological distress on surgical recommendation, and (3) the correlation between patient-reported disability and psychological distress. Psychological distress is common among patients presenting for spine surgery. Surgeon estimations of patients' distress may influence treatment recommendations, but little is known as to whether these assessments accurately mirror patient-perceived psychological distress. A sample of new patients was recruited from an academic spine center. Prior to their initial consultation, patients completed the Modified Somatic Perception Questionnaire and Zung Depression Index to assess mental and physical manifestations of distress, which generated a Distress and Risk Assessment Method (DRAM) score of N (normal), R (at risk), or D (distressed). The Oswestry Disability Index and Neck Disability Index scores were also collected. Surgeons provided their estimates of the DRAM score after the visit and indicated their surgery recommendation. Of 296 patients, 40.5% reported some level of psychological distress (DRAM=R) and 15.9% had a high level of distress (DRAM=D). All three surgeons' ability to accurately assess the participant DRAM score was poor, with an overall kappa of 0.13 (0.08-0.18), biased toward underestimating the patient's true level of psychological distress. Patients rated as normal (N) by the surgeon were 3.78 times more likely to be recommended for surgery compared to those assessed as distressed (D) ( P =0.007). Patients with higher DRAM scores had higher Oswestry Disability Index ( P =0.008) and Neck Disability Index ( P =0.005) scores compared to those with lower DRAM scores. Spine surgeons have limited ability to detect psychological profiles in patients, with a tendency to underestimate levels of distress. The finding that these inaccurate assessments influence surgical recommendations underscores the importance of limiting surgeon bias in the decision-making process. Diagnostic Level 2.

A national survey of oral maxillofacial surgeons' and trainees' awareness and practice regarding psychological problems associated with facial trauma.

The psychological problems associated with facial trauma may sometimes pose additional health concerns for the injured patient. Understanding the gaps in the Oral and Maxillofacial surgeons' (OMFS) awareness of patient in need of specialist mental health intervention is important in ensuring holistic care for the trauma patient. To determine the knowledge, practices and self-assessed level of competence of Nigerian Oral maxillofacial surgeons/trainees regarding psychological problems associated with facial trauma and to determine their perceived need for training in assessment of psychological consequences following facial trauma. A cross-sectional study was conducted in which a web-based structured questionnaire was sent to Oral and maxillofacial surgeons and trainees. Majority of respondents (85.2%) had encountered psychological problems in patients who have sustained facial trauma. Half (50.6%) of OMFS / trainees had high level of knowledge regarding psychological problems associated with facial trauma; depression, anxiety, post-traumatic stress disorder, body image disorder and acute stress syndrome were the five most common trauma related psychological problems mentioned. More respondents reported low level of competence in conducting mental state examination when compared to other skill sets. In-unit counselling was reported as the method of intervention by majority (69.1 %), followed by referral to the mental health specialists (17.3%). More than one third (40.7%) of OMFS were extremely interested in undergoing additional training in the psychological assessment of patients who have sustained facial trauma. Nigerian Oral and maxillofacial surgeons frequently encounter psychological problems in patients with traumatic facial injuries. Notwithstanding their perceived self-assessed low level of competence in psychological assessment of trauma patients, objective assessment revealed a relatively high level of knowledge of psychological problems that can affect the facial trauma patient with many indicating a high perceived need for additional training in the psychological assessment of facial trauma patient. There is a need for incorporating psychological assessment into the management to ensure holistic care of trauma patients.

Association of diabetes mellitus with depression, anxiety and quality of life

"Introduction: Many studies demonstrated that psychological factors play an important role in the development and course of diabetes mellitus. Objective: The focus of our research, among the first in a Hungarian sample, was to examine depression and anxiety levels and diabetes-specific quality of life in people with type 2 diabetes, to explore gender differences, and to analyze the relationship of depression and anxiety with diabetes-specific quality of life. Method: 157 people diagnosed with type 2 diabetes (women: 58.6%, men: 40.1%) were assessed for levels of depression Center for Epidemiologic Studies Depression Scale – Hungarian version), anxiety (Spielberger’s Trait Anxiety Questionnaire) and diabetes-specific quality of life (Audit of Diabetes-Dependent Quality of Life – Hungarian version). Results: 65% of subjects did not show depressive symptoms, but 56.1% showed moderate trait anxiety. More severe depressive symptoms (U = 1625, p<0.001) and higher trait anxiety (U = 1556, p<0.001) were significantly more frequent in women compared to men. Depressive symptom severity and trait anxiety were inversely and weakly correlated with diabetes-specific quality of life. Discussion: In summary, the results suggest that the psychological state (depressive symptoms and anxiety) in patients with type 2 diabetes is associated with their diabetes-specific quality of life. Women with diabetes also have higher levels of depression and anxiety compared to men with diabetes. Conclusion: Psychological assessment of patients’ depressive and anxiety symptoms and quality of life is recommended in the care of diabetic patients, and appropriate treatment is recommended as needed. This may improve patients’ quality of life, therapeutic cooperation and disease prognosis."

Related factors to the coping style of patients with sudden sensorineural hearing loss.

Coping style can affect the patient's physical and mental health management. Therefore this study aimed to identify factors related to the coping style of young and middle-aged sudden sensorineural hearing loss (SSNHL) patients to provide reference for clinical nursing practice. A cross-sectional study was conducted on young and middle-aged SSNHL patients hospitalized in the otolaryngology departments of four hospitals in Suzhou City, China. A paper-based self-administered questionnaire investigated the patient's coping style and related factors. Multiple linear stepwise regression analysed the effective related factors in patients' coping styles. Among 872 patients, 866 completed the survey, with an average age of 37.27y. Factors related to the coping style of these patients included gender, chronic diseases, history of trauma, social support and type D personality (p<0.05). Female patients adopt more negative coping styles than male patients. Patients with chronic diseases or a history of trauma had more positive coping styles. Higher social support scores were related to improvements in coping style. Patients with type D personality were more likely to adopt negative coping styles. This study suggests that psychological assessment of patients, chronic diseases, history of trauma, social support and type D personality may benefit the understanding of these patients' coping styles and, as a consequence, may improve their stress management.

Clinical and psychological assessment of patients with rheumatoid arthritis and fibromyalgia: a real-world study.

To assess the clinical features and functional and psychological status of patients with rheumatoid arthritis (RA) and those with fibromyalgia (FM) in a real-world setting. Between December 2018 and April 2019, 202 inpatients with RA were enrolled from the Rheumatology and Immunology Department at Peking University People's Hospital and assessed for the presence of FM using the 1990 American College of Rheumatology's classification criteria for FM. Disease activity and functional and psychological status were assessed using the Disease Activity Score in 28 joints (DAS-28), Short-Form 36 (SF-36), Health Assessment Questionnaire (HAQ), Hospital Anxiety and Depression Scale, and Visual Analog Scale. Among the patients with RA, 42 (20.8%) had concurrent FM. Compared with patients without FM, patients with FM had higher DAS-28 (6.0 vs. 4.4, P = 0.011) and notably higher tender joint counts (16.5 vs. 4.5, P < 0.001). Patients with RA and FM had worse HAQ scores (1.24 vs. 0.66, P < 0.001) and lower SF-36 scores (28.6 vs. 58.2, P < 0.001). Patients with RA and FM experienced more fatigue (88.1% vs. 50.6%, P < 0.001) and had higher anxiety (10 vs. 4, P < 0.001) and depression scores (12 vs. 6, P < 0.001). No significant differences in erythrocyte sedimentation rate, C-reactive protein concentration, morning stiffness period, or swollen joint counts were found between the groups. Patients with RA and FM had higher disease activity, a worse functional and psychological status, and poorer quality of life. The DAS-28 may have been overestimated in these patients. When patients with RA do not reach remission, FM should be considered. Key Points • Patients with rheumatoid arthritis and fibromyalgia had a worse functional and psychological status compared with those with rheumatoid arthritis alone. • When patients with rheumatoid arthritis do not reach remission, fibromyalgia should be considered. • Physicians should avoid overtreatment and enable these patients to receive the treatment, such as non-drug interventions, that they need.

Assessment of Patients' Needs Pre and Post Open Heart surgery

Background: Assessment of Bio-psychosocial needs of patient pre and post open heart surgery are very important aspect of patient centered care. Aim: was to assess patients' needs pre and post Open Heart Surgery. Design: -A descriptive exploratory design was utilized in this study. Settings: This study was conducted at Cardio-Thoracic Intensive Care Unit of Educational Tanta University Hospital. Subjects: A convenience sample of (100) open heart surgery patients that had been admitted to Cardio-Thoracic Intensive Care unit and meeting the inclusion criteria. Tools of the study: Two tools was used in this study for data collection: Tool I:A structured Interview Schedule Tool II:Bio psychosocial Needs Interview Questionnaire which included three parts; part (1): Physical Needs for Patients undergoing Open Heart Surgery, part(2): Psychological Assessment for Patients with Open Heart Surgery and part (3) Social Dysfunction Rating Scale for Patients with Open Heart Surgery. Results: There was highly significant positive correlation between total Social Dysfunction of the studied patients and their total score of pain score and total score of psychological needs at (P= < 0.01). In addition, there were significant positive correlation between total score of pain score of the studied patients and their total score of psychological needs and total score of Social Dysfunction at (P= < 0.01). Conclusion: The study concluded that, three-quarters of the studied patient had unsatisfactory level of total knowledge about heart surgeries. Also, there was a marked increase in total patients’ dependency in Activities of Daily Living level at post heart surgery. Recommendations: Routine pre and postoperative assessment of patients who are undergoing open heart surgery is recommended to identify the different patient's biopsychosocial needs and consequently any risk factor and reduced the post-operative complications.

Psychological assessment of the attitude to oral diseases of patients of older age groups who have applied for dental care

Aim. Determination of the psychological type of attitude to the patient's illness, depending on gender and age group, which will further improve communication between the patient and the dentist.Materials and methods. This article provides a psychological assessment of patients in relation to diseases of the oral cavity at a dental appointment using the adapted TOBOL technique. This technique is based on typing patients according to certain cognitive characteristics described in the article. For this study, 65 people of older age groups were interviewed.Results. The frst group of attitudes towards the disease included 27 patients (41.5%), the second – 24 (37%), the third – 14 (21.5%). 11 (45.8%) men were assigned to the frst group, 8 (33.3%) men – to the second and 5 (20.9%) – to the third group. Women showed a distribution: 16 (39%) women belonged to the frst group, 16 (39%) – to the second and 9 (22%) – to the third group, respectively. Negative attitude towards dental diseases, reluctance to treat them sharply increases in centenarians.Conclusions. With increasing age, there is a growing tendency towards pessimization and aggression. Sensitized attitudes toward illness, depression, refusal of treatment, or blame-shifting complicate diagnosis and subsequent treatment. To prevent unwanted emotions and improve the quality of communication, the dentist should be guided by an individual approach to these patients, which should be based on the basic principles of ethics and deontology. Only then will dental treatment be effective and complete.

Predictive variables of prescription opioid misuse in patients with chronic noncancer pain. Development of a risk detection scale: A registered report protocol.

Opioid therapy is utilized for a broad range of chronic pain conditions. Several studies have highlighted the adverse effects of opioid medication due to the misuse of these drugs. The gradual increase in the use of opioids has become a global phenomenon and is generating social concern. Several treatment guidelines have strongly recommended assessing the risks and benefits of pharmacological treatment with opioids. These guidelines also recommend the psychological assessment of patients with chronic noncancer pain in order to make informed decisions on the advisability of intervention with opioids. Some authors have emphasized the relevance of assessing the risk of opioid misuse in patients with noncancer chronic pain before initiating treatment. Two studies will be conducted, each with a different primary objective. The primary objective of the first study (Study 1) will be to conduct a comprehensive investigation to identify the factors most closely associated with subsequent opioid misuse; and based on the results of Study 1, the primary objective of the second study (Study 2) will be to develop a brief, reliable, valid, and useful instrument that would enable health care providers to make decisions on opioid prescription and on the required level of monitoring and follow-up. These decisions would have positive consequences for patient wellbeing. Study 1 will include a logistic regression analysis to test the hypothetical model. Study 2 will have a longitudinal design and include three assessment sessions in order to develop a measure to assess the risk of prescribed opioid misuse and to analyse its reliability and validity. Participants will be individuals with chronic noncancer pain attending three Pain Units. These individuals will either be undergoing pharmacological treatment that includes opioid analgesics (Study 1, N = 400) or are going to commence such treatment (Study 2, N = 250).

Validation of the Hospital Anxiety and Depression Scale and the Perceived Stress Scale and psychological features in patients with periodontitis.

To investigate the psychometric properties of the Hospital Anxiety and Depression Scale (HADS) and 10-item Perceived Stress Scale (PSS-10) in patients with periodontitis and to evaluate the psychological features of patients with periodontitis. Overall, 460 individuals with periodontitis were enrolled. The HADS and the PSS-10 were administered to all patients. Methodology testing included the exploratory factor analysis, the confirmatory factor analysis (CFA), test-retest reliability, as well as internal consistency. Regarding the CFA results of the HADS, as well as the PSS-10, a bifactor model fitted the data best. The Cronbach alpha value, as well as the intra-class correlation coefficients value of the two measures were all >0.70. The anxiety, depression, distress manifestations, and moderate-to-high perceived stress prevalence were 35.2%, 18.2%, 24.6%, and 43.9%, respectively. Severity of periodontitis, age, smoking, and disease comorbidities were identified as independent prognosticators of the presence of psychological manifestations in periodontitis. The HADS and the PSS-10 can be used as general measures for psychological assessment in patients with periodontitis.

Quality of life and psychological assessment in patients with Fibromyalgia Syndrome during COVID-19 pandemic in Italy: prospective observational study

Introduction: Chronic pain patients who undergo to stressful events may experience worsening in pain, sleep, and quality of life (QoL). The primary objective of this observational study was to compare QoL and sleep parameters before and after the COVID-19 lockdown in patients with Fibromyalgia Syndrome (FMS). The psychological impact of lockdown was also assessed, as well as the emotional impact of the pandemic and its correlations with patient socio-demographics. Methods: Patients aged ≥18 years with FMS diagnosed according to ACR (American College of Rheumatology) 2016 Criteria with at least one pre-pandemic QoL and sleep evaluation were included. QoL and sleep disturbances were analyzed by comparing scores on the Fibromyalgia Impact Questionnaire-Revised (FIQ-R), the 12-item Short Form Survey (SF-12), and the Pittsburgh Sleep Quality Index (PSQI) before and after the first lockdown in Italy (March to May 2020). Psychological impact was investigated via a 52-item survey of daily life changes in FMS management during the lockdown and emotional impact with the Impact Event Scale-Revised (IES-R) tool during the onset period after the lockdown. Questionnaire responses were correlated with patients’ socio-demographics. Results: Questionnaires were submitted via email to 54 patients; 37/54 patients (63.7%) returned them. QoL and sleep disturbances showed no statistically significant worsening. However, the psychological impact survey revealed that 3 out of 5 patients feared very much for their family members’ lives during lockdown. The emotional impact survey disclosed 72.7% of patients with psychological distress. Conclusions: While questionnaire responses showed no significant changes in QoL and sleep after the COVID-19 lockdown in this sample of FMS patients, the emotional investigation revealed moderate/severe psychological distress not detected by commonly used QoL tests in FMS.

Erectile Dysfunction and Correlates Among Diabetic Men at Dessie Referral Hospital: North Central Ethiopia, 2020.

BackgroundErectile dysfunction is currently one of the most common sexual dysfunctions worldwide affecting the quality of life of men of all ages, but it is usually underestimated because it is not a life threatening condition.PurposeThis study aims to determine the prevalence of erectile dysfunction and the possible correlates among diabetic men in Dessie Referral Hospital, North Central Ethiopia.MethodsAn institution-based cross-sectional study was conducted among diabetic men aged greater than 18 years, at Dessie Referral Hospital. Systematic random sampling technique was used to select study participants. A pre-tested and structured questionnaire was used to collect the data. Data were entered in Epi Info version 7 and analyzed using SPSS version 21. Logistic regression was applied to identify association between explanatory variables and the outcome variable. An adjusted odds ratio with 95% confidence interval and p-value less than 0.05 was computed to determine the level of significance.ResultsOverall, the prevalence of erectile dysfunction (ED) in this study was 58.5% at 95% CI (0.548–0.622), and specifically 10.5%, 40.9%, 6.8% respondents had mild, moderate and severe erectile dysfunction, respectively. Age, duration of diabetes diagnosis, types of medication, types of complication and body mass index were significant unadjusted factors associated with erectile dysfunction, but following adjustment only age [AOR=5.5 (95% CI 2.06–14.744), duration of diabetes [AOR=20,(95% CI 5.663–75.0096) and types of medication [AOR=2.106 (95% CI 1.112–3.988) have independently statistically significant association with erectile dysfunction.ConclusionThis study showed that ED is high. Age, duration of diabetes mellitus and type of medication are independently associated with erectile dysfunction. Health policymakers need to consider including the training of health personnel to consider the relevant risk factors during the physical, social and psychological assessment of patients, and clinicians should pay attention to the sexual history of their client.

Serological and psychological assessment of patients with oral lichen planus using serum cortisol levels and hads questionnaire—a case control study

Oral lichen planus (OLP) is a T cell-mediated chronic autoimmune disorder directed against antigens secreted by the basal cell layer, with an incidence of 0.02-0.22% in Indian population and showing female predilection. Stress is considered one of the etiological factors in the causation, progression, and recurrence of this disease. To evaluate the levels of serum cortisol, anxiety, and depression in patients with symptomatic OLP and to correlate the levels of serum cortisol with anxiety and depression. Sixty subjects were categorized into two groups. Group A: 30 adults with no history of OLP and no psychological history of anxiety and depression. Group B: 30 patients with clinically and histopathologically diagnosed symptomatic OLP. The subjects in both groups were evaluated for anxiety and depression levels using the Hospital Anxiety and Depression Scale (HADS) questionnaire and serum cortisol levels (8-9 am sample) using the chemiluminiscence method. Higher depression and anxiety levels were significantly associated with group B with significant P values (P < 0.0001 and <0.0002 respectively) when compared with group A; higher mean serum cortisol levels were seen in group B compared with group A, with P < 0.0001. In group A, a positive correlation was found between depression, anxiety, and serum cortisol levels with non-significant P-value. In group B, a positive correlation was found between depression, anxiety, and serum cortisol levels with a significant P value (P < 0.0001). Increased levels of depression and anxiety with increased serum cortisol levels were observed in subjects with OLP.

Optimization of long-term prognosis of patients with alcoholic liver disease

Aim: to prove the effectiveness of combined physical and psychological assessment in improving the long-term outcome of patients with alcoholic liver disease (ALD).Materials and methods: the active outpatient follow-up (AOF) group included 29 patients with ALD consisted of active liver function and motivation assessment, motivational interviewing, liver panel lab tests with the rate once at 3 months. The AOF program consisted of dynamic monitoring of liver function at least 1 time in 3 months and psychological support provided by the hepatologist using brief interventional approach. The control of abstinence was provided by using self-reports and indirect biomarkers of alcohol consumption. The control group included 36 patients with ALD and history of two-years follow-up after first alcoholinduced liver injury who received comprehensive therapy and a simple advice to avoid alcohol.Results: the adherence to abstinence were significantly higher in AOF group compared with control group. The proportion of patients with decompensated cirrhosis was significantly lower in AOF group compared with control group at 12 and 24 months after enrollment. The long-term survival in AOF-group was significantly higher than in control group. The only parameter independently associated with long-term survival was the presence of AOF program.Conclusion: the combined physical and psychological assessment of patients with ALD, provided by internists improves adherence to abstinence, reduces the risk of decompensation of liver function, severity of ALD and improves patients survival in the long term period.

The impact of skin involvement on the psychological well-being of patients with sarcoidosis.

Physicians frequently face challenges when screening and managing mental health impairment caused by different diseases, particularly those involving the skin. We aim to identify the major aspects of mental health impairment related to secondary skin involvement occurring in sarcoidosis patients. A total of 718 patients with a biopsy-confirmed diagnosis of sarcoidosis were included from the A Case Control Etiologic Study of Sarcoidosis (ACCESS) study. Sample was divided into two groups depending on presence or absence of skin involvement. Each recruited patient underwent mental health assessment using two measures: depression and mood scales. Demographic data of participants was obtained. A total of 143 sarcoidosis patients had secondary skin involvement, and 575 had no skin involvement. Sarcoidosis patients with skin involvement had lost their appetite more frequently, experienced low mood more frequently, and had frequently encountered a significant loss of acceptance compared to patients without skin involvement. A multidisciplinary approach including a focused psychological assessment for patients with sarcoidosis; particularly those with skin involvement, is encouraged.

Psychological assessment of patients with bronchial asthma: focus on some predictors of abnormalities

BackgroundBronchial asthma is a common chronic respiratory illness. Psychiatric comorbidity is a neglected zone in the care and management of such important physical disorders as bronchial asthma.ObjectiveThe present study targeted a population sample of out-patient asthmatics, aiming at detailed psychocognitive evaluation. Predictors of depression, anxiety, and cognitive impairment were searched for by detailed assessment of patient sociodemographic and disease-related criteria.Patients and methodsA total of 50 patients with confirmed asthma diagnosis were recruited and subjected to detailed respiratory and psychiatric evaluation using Mini-Mental State Examination, Beck Depression Inventory-II, and Taylor manifest anxiety scale tests.ResultsMild, moderate, and severe depression were diagnosed in 26, 28, and 14% of patients, respectively, whereas mild, moderate, and severe anxiety were revealed in 32, 34, and 20%, respectively. Overall, 54% of the patients showed cognitive impairment. Asthmatic female patients were more common to have depression (P=0.022). The present analysis showed that predictors of cognitive impairment were older age, increasing frequency of hospital admission for asthma in the past year, improper adherence to treatment, and uncontrolled asthma. Meanwhile better education level proved to be protective from abnormal cognitive function.ConclusionThere was high prevalence of depression, anxiety, and cognitive dysfunction among asthmatic patients in Sohag University. Improving patient education, patient adherence to treatment, and asthma level control may lessen the chance of cognitive abnormality.

Personality, depression and anxiety in primary Sjogren's syndrome - Association with sociodemographic factors and comorbidity.

ObjectivePatients with primary Sjögren’s Syndrome (pSS) have diminished health quality and fatigue, arthralgia along with dryness of the mouth and eyes have major impact on their psychological and social aspects of life. The purpose of this study was to determine psychological features of patients with pSS. We analyzed personality, depression and anxiety of patients with primary Sjögren’s Syndrome (pSS) in comparison with patients with rheumatoid arthritis (RA) and healthy controls (HC) and assessed their association with sociodemographic factors and comorbidity.MethodsIn 105 pSS patients (mean age 51.34 years, mean disease duration 5.98 years), 52 RA patients (mean age 51.37 years, mean disease duration 8.10 years) and 54 HC (mean age 51.35 years) clinical and sociodemographic characteristics were determined and results analyzed. At enrollment patients and controls completed the Revisited NEO Personality Inventory Five-Factor model (NEO-PI-R), the Zung Self-Rating Depression Scale and the Zung Self-Rating Anxiety Scale. Statistical analyses were performed using SPSS [Version 16.0]. The relative size of the effect was assessed based on standardized estimates of effect size (d).ResultsPatients with pSS, similarly to RA patients had higher scores of Neuroticism (d = 0.46, p = 0.007) and lower scores of Extraversion (d = 0.51, p = 0.001) and Openness for experience (d = 0.65, p = 0.013) compared to HC. There was no significant differences between pSS group and HC in the depression (d = 0.171, p>0.05). However, patients with pSS had higher anxiety in comparison to HC (p<0.0001). In multivariate models, education and satisfaction with family relationships were significant predictors for psychological characteristics of patients, independently of clinical diagnosis.ConclusionsOur study is the first to show that patients with pSS scored high on neuroticism and anxiety and low on sociability. Education and satisfaction with family relationships predisposed to their psychological profile. Psychological assessment of patients with pSS may improve understanding and treatment of this clinical condition.

Estimation of salivary cortisol level and psychological assessment in patients with oral lichen planus

Introduction: Oral lichen planus (OLP) is a relatively prevalent chronic inflammatory disease, which affects the skin and mucous membrane. The etiology of OLP is unknown and there is controversy over the role of stress as an etiologic factor of OLP. Aim: To assess the salivary cortisol levels and psychological factors in OLP patients. Material and Methods: This study investigated the salivary cortisol level in 30 clinically and histopathologically proven OLP patient and 30 healthy individual. Salivary cortisol levels were analyzed by enzyme-linked immunosorbent assay methods. The psychological factors of study and control groups were assessed by DASS 21questionnaire (depression anxiety stress scale). Salivary cortisol levels and psychological factors were compared by using student's t-test. Results: The mean salivary cortisol level among study group was 9.90 ± 3.09 ng/dL as compared to the 6.92 ± 2.21 ng/dL of the control group with P