Rahe Stress Scale Research Articles

Perception of Job Stress among Fighter Controllers in Indian Air Force

The fighter controllers (FC) are an occupational group who deal with a hectic, difficult and highly demanding job. Their occupation entails high levels of responsibility in terms of shouldering the Air Defence operations. These kinds of duties require them to perform optimally at all times and thus impose high grade of an unambiguous occupational stress. In the present study 38 Fighter Controllers of 4 IAF Stations were administered Organisational Role Stress (ORS) scale, Stress Buster Tool Kit and Holmes & Rahe Stress Scale. It was found that 66 per cent of the participants felt Inter Role Distance as a reason for high graded stress, similarly Role Stagnancy (55 %), Role overload (61 %) and Role Isolation (40 %) have severely affected the sample studied. Stress buster tool kit showed that 34 per cent participants perceived severe service related and workplace related stress. Holmes & Rahe questionnaire reported that a total of 31.6 per cent participants were at 90 per cent risk of developing systemic co-morbidities due to stress. This study reports that Fighter Controllers perceive their role to be less important with little opportunities for growth. A significant finding that emerged and that needs attention is the possibility that 1/3rd of the participants are prone to stress induced illnesses. The role of Aerospace Medicine Specialists in this context is paramount in alleviating stress and enhancing self-esteem in Fighter Controllers.

Role of Psychological Stress on Interferon-Gamma (IFN-γ) in Atopic Dermatitis

Atopic dermatitis (AD) is a chronic inflammatory skin disease, with itching predominant symptom, which usually develope in infancy and associated with an increase in serum IgE and history of atopies, such as allergic rhinitis or bronchial asthma. The etiology of AD remains unclear. However, there are many predisposing factors, such as genetic, immunological disorders, infections, foods, irritants, and psychological stress. Many research has conclude that stress is one of the risk factor for AD, but the current understanding for the underlying mechanism remain unclear. Recent research shows that stress can suppress interferon gamma (IFN-γ), which plays an important role in the pathogenesis of AD. This study aims to determine the role of stress and serum levels of IFN-γ to AD. Study design using a case-control study with a sample consisting of 31 cases and 28 controls. Stress indexes were measured using Holmes & Rahe Stress Scale and serum IFN-γ levels were examined. Statistical analysis was performed to determine the differences between the mean stress index and serum IFN-γ level between cases and controls, the magnitude of psychological stress as a risk factor for AD, and the correlation between psychological stress and serum IFN-γ level against the severity of AD. This study concluded that stress is a risk factor for AD with an odds ratio of 5.3, and the stress index is positively correlated with the severity of AD. Serum IFN-γ levels were significantly lower in cases group. There was a strong negative correlation between IFN-γ with the severity of AD (r = -0.905; p <0.05). Current study conclude that psychological stress is a risk factor for AD and stress can suppress serum IFN-γ levels.

Major stressful life events and risk of developing lung cancer.

1575 Background: Lung cancer is the leading cause of cancer-related mortality linked with smoking, though only 6-18% of heavy smokers die of lung cancer. We hypothesized that major stressful life events are a risk factor for developing lung cancer. Methods: In our matched case-control study, cases (CA) were lung cancer patients diagnosed within past 12 months. Controls (CO) were patients without a prior history of malignancy. CA and CO were matched for age, gender and smoking status. Smokers had at least 10 packs/years history of smoking. Data was collected using standardized research questionnaire on 11 major stressful life events using Holmes and Rahe stress scale. The primary endpoint was odds of having a major stressful life event. A sample of 360 patients (120 CA and 240 CO), was needed to achieve 80% power to detect an odds ratio (OR) of 2.00 using Chi-Square test with a P = 0.05 significance. The study was IRB approved at each institution. Results: Between May 2015 and December 2016, 324 patients were enrolled (23 were excluded due to prior cancer history or incomplete information). 301 (CA = 102; CO = 199) were included in the final analysis. The two groups were well matched in median age (CA = 64.4 years; CO = 63.9years), gender (CA-Male = 48%; CO-Male = 49.2%) and smoking status (ever smoker, CA = 86%; CO = 85%). There was no difference in lifetime stressful life event between CA and CO (95% vs 93.9% P = 0.68%). However, CA were significantly more likely to have had a major stressful life event within the past 5 years than controls (CA = 77.4% vs CO = 65.8%, P = 0.03, (OR = 1.78). Serious life-threatening illness of an immediate family member (P = 0.04) and retirement (P = 0.07) within the past 5 years were noticeably more common among CA. Holmes-Rahe stress score in the last 5 years was higher in men (86.3 vs 63.3, P = 0.07) and those > 65 years old (82.4 vs 57.2,P = 0.04) as compared with CO and in those with squamous histology than with adenocarcinoma (115.6 vs 63.4, P = 0.005). Conclusions: Patients with lung cancer (CA) were significantly more likely to have had a major stressful life event within the past 5 years than the matched controls (CO), especially in older men with squamous histology. Major stressful life events should be considered a risk factor for developing lung cancer.

Effects of Maternal Education, Psychosocial Stress, Nutritional Status at Pregnancy, and Family Income, on Birthweight in Nganjuk, East Java

Background : Low birthweight (LBW) is one of the primary causes of infant mortality. It shares 27% of infant mortality rate (IMR). The Indonesian Demographic and Health Survey in 2007 reported that the IMR was 34 deaths per 1,000 live births. As much as 30.3% of this rate was accounted by LBW. As such LBW is an important global public health issue. Countries arround the world have committed to overcome this problem. This study aimed to investigate the effects of maternal education, psychosocial stress, nutritional status at pregnancy, and family income, on birthweight. Subjects and Method : This was an observational analytic study with case control design. The study was conducted in Ngetos community health center, Nganjuk, East Java, from May to June, 2017. A total sample of 120 were selected for this study by fixed disease sampling, compresing 40 infants with low birthweight and 80 infants with normal birthweight. The dependent variable was birthweight. The independent variables were maternal education, psychosocial stress, nutritional status at pregnancy (middle-upper arm circumference, MUAC), maternal anemia, and family income. MUAC was measured by MUAC measuring tape. Hemoglobin concetration was measured by Sahli meter. Psychosocial stress was measured by Holmes and Rahe stress scale. The other variables were measured by a set of questionnaire. Path analysis was used for data analysis. Results : MUAC ≥23.5 cm (b= -0.80, SE= 0.57; p=0.064), hemoglobin concetration ≥11 g/dL (b= -120.16, SE= 45.14, p=0.008), and low psychosocial stress (b= -0.80, SE= 0.57, p=0.164) directly and negatively affected low birthweight. Maternal education ≥Senior High School (b= 1.28, SE = 0.056, p= 0.022), psychosocial stress (b= -0.001, SE<0.001, p=0.097), and family income (b= 0.97, SE= 0.46, p=0.036) positively affected MUAC. MUAC ≥23.5 cm positively affected hemoglobin concentration ≥11 g/dL (b= 0.19, SE = 20.84, p<0.001). Conclusion: MUAC, hemoglobin concetration, and low psychosocial stress directly and negatively affect low birthweight. Keywords : low birthweight, MUAC, maternal anemia, psychosocial stress, family income Correspondence: Dhewi Nurahmawati. Masters Program in Public Health, Sebelas Maret University, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: dhenoura@gmail.com. Mobile: +62813330787826. Journal of Maternal and Child Health (2017), 2(4): 324-334 https://doi.org/10.26911/thejmch.2017.02.04.04

Correlation of functional state of dental system and emotional stress in young adults

The aim of the study was to evaluate correlation of dental system functional status and emotional stress level in young adults. The study involved 164 patients aged 20-25 years. TMJ dysfunction was diagnosed according to M. Ahlers and H. Jakstat criteria (2000). All patients underwent electromyography (EMG) of mastication muscles at rest and by functional test. Emotional stress and anxiety were assessed by Holmes and Rahe stress scale, Jakhin-Mendeleevich clinical questionnaire and State-Trait Anxiety Inventory. The study revealed correlation between EMG activity of masticatory muscles and emotional stress level highlighting the importance of stress assessment in TMJ dysfunction planning.

Biopsychosocial Factors Associated with Mental Retardation in Children Aged 6-17 Years in Tulungagung District, East Java

Background : According to WHO, 15% of the world population, or 785 million people, suffer mental or physical disorders. Mental retardation is a serious problem socially and medically. Mental retardation affects child development in various forms: physical, self-care, communication, social, emotional, and mental. The objective of this study was to determine biopsychosocial factors associated with mental retardation in children aged 6-17 years. Subje cts and Method : This study was observational analytic with case control design. It was conducted at Kauman and Tulungangung community health centers in Tulungangung District, East Java, from April to May, 2017. A sample of 100 parents of children aged 6 to 17 years old were selected for this study by fixed disease sampling. This sample consisted of 25 parents of children with mental retardation and 75 parents of children without mental retardation. Children with mental retardation were identified and sampled at a disability special school in Tulungagung, East Java. The dependent variable was mental retardation. The independent variables were prenatal history, perinatal history, maternal stress during pregnancy, maternal education, and family income. The data were collected by a pre-tested questionnaire. Maternal stress was measured by Holmes and Rahe stress scale. The data was analyzed by path analysis. Results : Mental retardation was directly associated with prenatal history (b= 1.17; 95%­ CI= 0.65 to 2.27; p= 0.038), perinatal history (b=­ 1.41;­ 95% CI= 0.87 to 2.73; p= 0.037), and maternal stress during pregnancy (b= 1.84; 95% CI = 0.59 to 3.09; p= 0.004). Prenatal history was associated with maternal education (b= -1.16; 95% CI= -2.17 to -0.15; p= 0.025) and maternal stress during pregnancy (b= 1.48; 95% CI= 0.43 to 2.54; p= 0.006). maternal stress during pregnancy was associated with maternal education (b= -1.65; 95% CI= 2.62 to -0.69; p=0.001) and family income (b=-1.35; 95% CI= 2.29 to -0.41; p=0.005). Family income was associated with maternal education (b= 1.70; 95% CI=­­ 0.82 to 2.57; p<0.001). Conclusion : Mental retardation is directly associated with prenatal history, perinatal history, and maternal stress during pregnancy. K eywords : mental retardation, biopsychosocial factors, children Correspondence: Yani Ikawati. Masters Program in Public Health, Sebelas Maret University, Jl. Ir. Sutami 36 A, Su­ra­kar­ta, Central Java. Email: yaniikawati@gmail.com. Mobile: +6285655730050. Journal of Epidemiology and Publich Health (2017), 2(2): 119-129 https://doi.org/10.26911/jepublichealth.2017.02.02.03

An exploratory study of immune markers in acute and transient psychosis.

The aim of this study was to look into the balance of pro-inflammatory (TNF-α, IL-6) and anti-inflammatory (TGF-β) cytokines and their association with stress, alterations in HPA axis activity and the disease severity in acute psychosis. Socio-demographic and clinical details were collected from 41 in-patients with a diagnosis of Acute and Transient Psychotic Disorder. Holmes and Rahe Stress Scale for stress in the preceding year, and Brief Psychiatric Rating Scale at baseline and follow up (4-12 weeks) for psychopathology were applied. IL-6, TNF-α (pro-inflammatory), TGF-β (anti-inflammatory) and Cortisol (morning and afternoon values) were measured at baseline and follow up. A total of 30 out of 41 cases recruited had follow up data available. The levels of IL-6 (p<0.001), TNF-α (p<0.001) and TGF-β (p<0.001) at baseline were all found to be significantly elevated compared to 42 age and gender matched healthy controls. There was a significant increase in the levels of TNF-α (p=0.020) and morning levels of cortisol (p=0.009) and a significant decrease in the levels of TGF-β (p=0.004) and afternoon levels of cortisol (p=0.043) from baseline to follow up. This study showed that there was an increased level of both pro and anti-inflammatory cytokines at baseline and a prolonged pro - inflammatory compared to anti - inflammatory response which warrants larger prospective studies and comparative studies to patients with schizophrenia and bipolar disorders.

Psychosocial factors in pregnancy and birthweight: Path analysis.

Birthweight is known to be affected by several factors. In the present study a relationship model of psychological and economic determinants of birthweight was designed and tested. This prospective study involved 400 pregnant women in four districts of Tehran, Iran. The subjects were selected through a multistage sampling method. Seven questionnaires (socioeconomic status; Holmes and Rahe Stress Scale; Perceived Stress Scale; 21-item Depression, Anxiety, and Stress Scale [DASS-21]; perceived social support; pregnancy-related anxiety scale; and domestic violence questionnaire) were used to assess participant psychosocial and economic conditions. In order to collect post-partum information about the mother and the infant, the women were followed up until delivery. Data were analyzed using SPSS-16 and Lisrel-8.8. Based on the obtained path diagram, the greatest adverse effects on birthweight were exerted directly by DASS-21 score (B = -0.14) and indirectly by stressful life events (B = -0.037). Among variables that affected birthweight in both paths, socioeconomic status and perceived stress had the strongest overall effects on birthweight (B = 0.203 and -0.1024, respectively). According to the path analysis model, psychosocial and economic factors can directly/indirectly affect birthweight.

Stress among Unmarried Professional Girls

In psychology stress is a feeling of strain and pressure. The present era is a era of mental work and problems related to mental works are also increasing. Now days, girls are also carrier oriented and they have a tendency to work out of home town and are living without their families. The aim of the present study is to study the difference of the stress level and coping between two groups – unmarried professional girls living with family and unmarried professional girls living without family. The second aim is to find out the positive effect of emotional and social support in both the groups. The Holmes and Rahe stress scale (1967) developed by Holmes and Rahe is used to measure the level of stress. Purposive sample of 60 unmarried professional girls were selected from different professional areas of Jaipur city,,(Rajasthan),with two categories, 30 staying with family and 30 staying alone without family. Means, S.D.s and ‘t’ values were computed to find out the difference between both the groups. The ‘t’ value for this study is 1.66 and this was not found significant means although there is difference on the level of stress perceived by both the groups but this difference is not significant. In follow up study it was found that the sample which was staying alone was not actually alone they developed their own support system around them in the city away from family and this affected the results of this study.

Elevated Brain-Derived Neurotrophic Factor Correlates Negatively with Severity and Duration of Major Depressive Episodes

Major depressive disorder is a neuropsychiatric condition associated with neurochemical changes that alter levels of neurotrophins. We aimed to measure serum levels of brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) in patients experiencing their first episode of major depression and to examine those levels in relation to the severity and duration of the depressive episode. We recruited 85 participants: 44 drug-free patients with major depression (35 women, 9 men) and 41 healthy controls (32 women, 9 men). We used the Hamilton Rating Scale for Depression to assess the severity of the patients' depression. We assessed the controls' mental health according to Diagnostic and Statistical Manual of Mental Disorders, 4th ed, criteria. To assess all participants' stress levels, we used the Holmes and Rahe stress scale. We measured all participants' serum BDNF and NGF levels via enzyme-linked immunosorbent assay. The mean stress score was significantly higher in the patients than the controls (P=0.03). The patients had higher serum BDNF than the controls (P=0.001), but similar NGF levels. BDNF levels correlated negatively with symptom severity (r=-0.33, P=0.03) and duration (r=-0.2, P=0.06). NGF levels did not correlate with stress or with severity or duration of depressive episode. These findings suggest that an elevated serum BDNF level may contribute to the pathophysiology of major depressive disorder. The findings also indicate a possible role for BDNF in altering the clinical course of the condition.

Prenatal stress and newborn telomere length

The developmental origin of the health and disease hypothesis is based on the premise that many chronic diseases have their roots in fetal development. Specifically, maternal stress during pregnancy is associated with altered fetal development and many adverse long-term health outcomes. Although the mechanisms underlying this effect are currently unclear, at the cellular level 1 possible mediator is the regulation of telomere length. Telomere dynamics appear to play a role in disease progression, and an adverse intrauterine environment may contribute in the establishment of short telomeres in newborns. In accordance with this, it was recently reported that prenatal stress is significantly associated with shorter mean newborn telomere length. However, this finding has yet to be replicated, and currently we know nothing about whether different size classes of telomeres within the telomere length distribution are differentially affected by prenatal stress. Examining telomere length frequency distributions is important, because the shortest telomeres in the distribution appear to be the most indicative of telomere dysfunction and thus the best predictors of mortality and morbidity in humans. We investigated the effects of intrauterine exposure to maternal stress over the whole course of gestation on newborn mean telomere length and telomere length frequency distributions. We conducted a prospective cohort study of 24 mother-newborn dyads at an urban teaching hospital. Pregnant women with nonanomalous, uncomplicated pregnancies were recruited and assessed in the third trimester of gestation. Maternal psychosocial stress was quantified using the Holmes and Rahe Stress Scale and categorized as high stress (≥300 points) or low stress (≤299 points) exposure. Newborn telomere length was measured from cord blood at delivery using the Telomere Restriction Fragment assay. We found a significant negative association between maternal stress and newborn telomere length (β=-0.463, P= 0.04). Newborns whose mothers experienced a high level of stress during pregnancy had significantly shorter telomere length (6.98 ± 0.41 kb) compared to newborns of mothers with low stress (8.74 ± 0.24 kb; t=-3.99, P= .003). Moreover, the difference in newborn telomere length between high-stress and low-stress mothers was due to a shift in the telomere length distribution, with the high-stress group showing an underrepresentation of longer telomeres and an over-representation of shorter telomeres. Our findings replicate those of other recent studies and also show, for the first time, that the prenatal stress-associated difference in newborn mean telomere length is due to a shift in the overall telomere distribution.

Factors associated with problematic drug use among psychiatric outpatients.

ABSTRACTObjective:to examine the factors associated with problematic drug use among psychiatric outpatients. Method:a cross-sectional study was carried out in two mental health services. Eligible individuals were patients of these mental health services, who used them within the data collection period. Instruments: standardized questionnaire with sociodemographic, social network, social harm, and clinical information; Alcohol, Smoking and Substance Involvement Screening Test; Barratt Impulsiveness Scale; Holmes and Rahe Stress Scale. Statistical analysis was performed using parametric statistics considering a significance level of p ≤ 0.05. Study participants were 243 patients, with 53.9% of these presenting problematic drug use. Results:the most important independent predictors of problematic drug use were marital status (OR = 0.491), religious practice (OR = 0.449), satisfaction with financial situation (OR = 0.469), having suffered discrimination (OR = 3.821) and practicing sports activities in previous 12 months (OR = 2.25). Conclusion:the variables found to be predictors were those related to the social context of the patient, there, it is recommended that mental health services valorize psychosocial actions, seeking to know the social support network of patients, their modes of socialization, their financial needs, and their experiences of life and suffering.

Is Mania Precipitated by Life Events?

Objectives To describe the prevelance of life events as precipitants of manic episodes in patients with bipolar affective disorder. Methods A descriptive cross sectional study. Fifty three inward patients with mania were selected by simple random sampling method during the study period of one month. The data was obtained through an interviewer administered questionnaire and Holmes and Rahe Stress scale. Results Thirty two (60.3%) of the study subjects were females and the mean age was 35.8 years (range 18-62). Bipolar affective disorder current episode mania with psychotic symptoms was the diagnosis in 52.8% (n=28). Thirty one patients (58.5%) had experienced life events in the month preceding the onset of manic episode. Eight (25.8%) of the life events were above 50 life change units of Holmes and Rahe Stress Scale. The most commonly occurring life events were marital separation (n=5, 16.1%), trouble with in laws (n=5, 16.1%) and change in living conditions (n=4, 12.9%). The other precipitant identified was defaulted treatment which was present in 43.3% (n=23), while 3.7% (n=2) share the combination of treatment default and life events. Conclusions This study reveals that life events have played an important role in precipitating manic episodes in patients with Bipolar Affective disorder.

Psychiatric disorders in the postpartum period

Objective The aim of this study was to determine the incidence, risk factors, clinical presentation, and complications of postpartum psychiatric disorders and the correlation between psychosocial stressors and postpartum psychiatric disorders. Background Postpartum psychiatric disorders are important factors that affect the quality of life - for example, employment rates, interpersonal and interfamilial communications, maternal skills, and many other social-cognitive functions - in different ways. Patients and methods This study was conducted on 250 women in their postpartum period who were recruited from Kfr El-Zayat General Hospital (Gharbia Governorate); of them, 50 patients fulfilled the Diagnostic and statistical manual of mental disorders , 4th ed., (DSM-IV) criteria of postpartum psychiatric disorders. All participants were evaluated by means of clinical evaluation according to DSM-IV criteria and psychometric evaluation using the Holmes and Rahe Stress Scale, the Quality of Life Scale, the Stress Level Assessment Questionnaire, the Edinburgh Postnatal Depression Scale, and the Global Assessment of Functioning Scale. Results In our study, 50/250 (20%) women fulfilled the DSM-IV criteria for postpartum psychiatric disorders and were classified into the following groups: postpartum blues, 68% (34/50); postpartum depression, 20% (10/50); postpartum panic disorder, 8% (4/50); and postpartum generalized anxiety disorder, 4% (2/50). Conclusion The postpartum period is a critical period during which time women are vulnerable to many postpartum psychiatric disorders. The incidence of postpartum psychiatric disorders in new Egyptian mothers is similar to that in many countries. The most frequent postpartum psychiatric disorder is postpartum blues. Marital, social, and economic factors play a major role in the development of the observed postpartum psychiatric disorders.

Psychiatric morbidity among a sample of orphanage children in Cairo

Background Children raised in orphanages have increased rates of psychiatric morbidity. Aims The study aimed to detect psychiatric morbidity and various sociodemographic factors associated with it among children raised in orphanages in Cairo. Participants and methods In all, 100 children were recruited from four orphanages: 25 from Nasr City orphanage for preschool girls; 25 from Heliopolis orphanage primary and preparatory boys; 25 from Maadi orphanage for preschool boys; and 25 from Hadaaek Al Kooba primary and preparatory girls. They were assessed using a General Health Questionnaire, a Child Behavior Checklist, a Childhood Trauma Questionnaire, and the Holmes and Rahe stress scale (nonadults) between June and December 2013. Results The study found the following: (a) sexual and emotional abuse render the child prone to mental illness (General Health Questionnaire). (b) Change of teachers and orphanages render the child prone to emotional neglect and abuse, reactive attachment, oppositional defiance, and nocturnal enuresis. (c) Reactive attachment and oppositional defiance are more in male children. (d) Depression is more in teens. (e) Male teens are prone to sexual abuse. (f) Conduct and substance abuse is more in male teens. (g) Suicide, post-traumatic stress disorder, and substance abuse are strongly associated with sexual abuse. Conclusion This study concluded that there is a high rate of emotional and developmental disorders among orphanage children and are strongly inter-related with sociodemographic characteristics.

Health-Related Quality of Life of Future Physicians at a Medical School in the Philippines

Medical students are trained to maintain the health of patients, but such training may have undesirable effects on medical students’ personal health. This study therefore aimed to assess the health-related quality of life (HRQOL) of medical students and to determine the factors that are associated with the students’ HRQOL. The target population included all students enrolled at the Saint Louis University School of Medicine in Baguio City, Philippines, during school year 2012-2013. The measurements included the 36-Item Short Form Health Survey (SF-36) questionnaire for HRQOL, Beck Depression Inventory, abbreviated Maslach Burnout Inventory, Perceived Stress Scale, Holmes and Rahe Stress Scale, and self-report items for other exposure variables. A total of 527 medical students participated in the study. The mean scores in all of the eight domains of HRQOL ranged from 51.36 to 85.83. The highest mean scores were along the areas of physical functioning (85.83) and bodily pain (69.20), whereas the lowest mean scores were in the areas of vitality (51.72) and role limitations due to emotional problems (51.36). Depression, stress, and burnout were associated with lower scores in most of the domains of HRQOL. Medical students in our school are generally in a satisfactory state of functional health and well-being, but have a lower level of mental health as compared with physical health.

EPA-1196 – Psychometric assessment of mood and anxiety disorders in maxillofacial surgeons’ patients

Taking into account epidemiological data about growing frequency of acute and chronic disorders of maxillofacial area evaluation of psychopathological disorders in this group of patients is of great importance. The purpose was to diagnose symptoms of psychopathological disorders in maxillofacial surgeons’ patients. The study used psychometric method. The validated scales used were SAS, SDS, Holmes and Rahe stress scale, HCL-32-R1. We included all patients who have applied to the clinic of Moscow State Medico-Stomatologic University from January 2010 to March 2013 and who gave Inform Consent. Study sample consists of 408 patients (206 men, 202 women), 18-71 years old. According to somatic status all patients were divided into three groups. First group (n=160) – patients with chronic somatic disease resulted in fixed deformity of maxillofacial area. 41,3% of patients had depressive symptoms, 31,3% had anxiety symptoms and 16,3% had hypomania symptoms. Second group (n=127) - patients with acute posttraumatic face tissue injury. 10,7% of patients had symptoms of depression, 20% of patients had symptoms of anxiety and 32,3% of patients had symptoms of hypomania. Third group (n=121) – patients without evident somatic pathology wishing to perform surgical correction of appearance.51,2% of patients had depressive symptoms, 40,5% of patients had anxiety symptoms and 35,7% of patients had hypomania symptoms. Our data suggest that 10-55% of maxillofacial surgeons’ patients have different symptoms of mental disorders (affective, anxiety). Further investigation needed to determine syndromal characteristics and nosological diagnosis and to elaborate psychopharmacotherapy and psychotherapy approaches.

Psychopatological disorders and personality traits in plastic surgeons’ and cosmetologists’ patients

In the view of growing number of patients consulting plastic surgeons and cosmetologists, evaluation of psychopathological disorders and personality traits of these patients is of great importance. The purpose of this screening study was to evaluate and to compare pathocharacterological and pathopsychological traits of plastic surgeons and cosmetologists’ patients. The study used psychometric method. The validated scales used were Leonhard Personality Inventory, NEO-PI-R, SAS, SDS, HCL-32- R1, Holmes and Rahe stress scale, SAF. We included all patients who have applied to the Institute of Plastic Surgery and Cosmetology from February 2012 to June 2012 and who gave Inform Consent. Study sample consists of 123 patients (103 women), 18-70 years. In the group of cosmetologists’ patients (n=92; 76 women; mean age 44,6+-2,5 years) histrionic and anxiety-phobic personality traits predominated. Constitutionally determined or gained extroversion, expressivity, impulsivity and emotional instability were detected. Anxiety symptoms were detected in 32,4% of patients; depressive symptoms were detected in 35,8% of patients. In the group of plastic surgeons’ patients (n=31; 27 women; mean age 36,7+-1,8 years) pedantic, sticking and disthymic personality traits predominated. Introversion, high level of self-control and detachment were detected. Anxiety symptoms were detected in 22,9% of patients; depressive symptoms were detected in 21,7% of patients. Our data give evidence of statistically significant differences in pathocharacterological and pathopsychological traits of plastic surgeons and cosmetologists’ patients. About one-third of these patients report about symptoms of depression, anxiety and hypomania. Complex diagnostic examination needed in order to determine nosological diagnosis and treatment strategies.

Improvement of burn pain management through routine pain monitoring and pain management protocol

IntroductionPain management is an important aspect of burn management. We developed a routine pain monitoring system and pain management protocol for burn patients. The purpose of this study is to evaluate the effectiveness of our new pain management system. MethodsFrom May 2011 to November 2011, the prospective study was performed with 107 burn patients. We performed control group (n=58) data analysis and then developed the pain management protocol and monitoring system. Next, we applied our protocol to patients and performed protocol group (n=49) data analysis, and compared this to control group data. Data analysis was performed using the Numeric Rating Scale (NRS) of background pain and procedural pain, Clinician-Administered PTSD Scale (CAPS), Hamilton Depression Rating Scale (HDRS), State-Trait Anxiety Inventory Scale (STAIS), and Holmes and Rahe Stress Scale (HRSS). ResultsThe NRS of background pain for the protocol group was significantly decreased compared to the control group (2.8±2.0 versus 3.9±1.9), and the NRS of procedural pain of the protocol group was significantly decreased compared to the control group (4.8±2.8 versus 3.7±2.5). CAPS and HDRS were decreased in the protocol group, but did not have statistical significance. STAIS and HRSS were decreased in the protocol group, but only the STAIS had statistical significance. ConclusionOur new pain management system was effective in burn pain management. However, adequate pain management can only be accomplished by a continuous and thorough effort. Therefore, pain control protocol and pain monitoring systems need to be under constant revision and improvement using creative ideas and approaches.

Effect of stressful life events on the initiation of graves’ disease

Objective. The aim of this study was to investigate the relationship between stressful life events (LESs) and its effect on the initiation of Graves’ disease (GD) and toxic nodular goitre (TNG). Patients and method. Forty-five patients with GD, 24 patients with TNG and 36 healthy control (CG) were included to the study. Graves and TNG patients had diagnosed within the last 12 months, with clinical and biochemical confirmation in Endocrinology Metabolism Outpatient Clinic of Cerrahpasa Medical School. The Holmes–Rahe Stress Scale and the Life Experience Survey (LES) was the psychological evaluation instrument used in this study. Results. There was no significant difference according to Holmes–Rahe scale (Graves & TNG P = 0.329, Graves & Control P = 0.115, TNG and control P = 0.571). According to LES scale when negative event number, positive event number, neutral events and their effects are considered, between Graves and TNG groups no statistically difference was observed (P = 0.139, P = 0.083, P = 0.167, P = 0.162, P = 0.861). The number and impact of negative SLEs were significantly higher in GD compared to CG (P = 0.015, P < 0.001). Conclusion. According to LES scale GD patients has significant difference with respect to CG when negative event number and impact are considered.