Journal of psychosomatic research
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Assessing the effect of interventions on quality of life in cardiac patients lacks sensitivity because there is no specifically validated scale for measuring depression in cardiac patients. A questionnaire of 35 items (selected for face validity) was given to 246 cardiac outpatients (age 59.3 +/- 14.1 years, 159 male, 87 female). The Beck Depression Scale was then administered, followed by blinded clinical rating of depression. ⋯ The final scale consisted of 26 items (alpha reliability coefficient 0.90) in 2 robust dimensions and 7 subscales. The scale correlated well with clinical rating and with the Beck Depression Scale, but without the marked skewness of the latter. The behavior of the new Cardiac Depression Scale suggests that it will be an excellent measure for studies of outcome in cardiac patients.
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In order to determine the occurrence of psychological disturbances the authors studied 47 women who fulfilled the American College of Rheumatology Criteria for the classification of fibromyalgia and 25 random selected control patients without chronic muscle pain, all of whom live in Sorocaba, SP, Brazil. Personality disturbances were observable in 63.8% of the patients and 8.0% of the control group (p < 0.05); depression in 80.0% of the fibromyalgia group and 12.0% of the controls (p < 0.05) and anxiety in 63.8% of the patients and 16.0% of the controls (p < 0.05). The Hamilton test mean scores showed higher values for depression and anxiety among the fibromyalgia patients when compared to the control group. A significant association between fibromyalgia and depression, anxiety and personality disturbances was studied and recorded.
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One hundred and five consecutive patients attending an ENT out-patients' clinic with a diagnosis of globus pharyngis completed a 10-item questionnaire concerning common throat symptoms. Principal components analysis of the questionnaire revealed a general throat pathology factor, and three orthogonal rotated factors which were related to dysphagia, globus sensation, and pain/swelling in the throat. ⋯ The clear factor structure and the satisfactory internal consistency of the Glasgow-Edinburgh Throat Scale (GETS) suggest that it offers a clinically useful instrument for assessing and monitoring the severity of some common throat ailments. The degree of distress caused by throat symptoms was predicted independently by the intensity of the globus sensation and by anxiety level.
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Adolescent cigarette smoking is an increasing health risk behaviour in many societies. The reasons why adolescents commence smoking are patently complex, though it has been suggested that young people take up this behaviour as a means of stress reduction during the difficult and challenging time of adolescence. ⋯ Moreover, though the personality attribute of neuroticism is independently associated with this decision, it does not mediate the association between stress and smoking onset. The implications of these data for adolescent smoking prevention programs are discussed.
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Randomized Controlled Trial Clinical Trial
Post-operative fatigue following coronary artery bypass surgery: relationship to emotional state and to the catecholamine response to surgery.
Post-operative fatigue is an important subjective problem for surgical patients, but its basis is unknown, and the possibility of a psychological component has been neglected. To investigate its putative physiological and psychological bases, 74 patients undergoing coronary artery bypass graft surgery were studied. Circulating catecholamine levels were measured at intervals perioperatively and questionnaires were used to measure fatigue, depression and anxiety up to 30 days post-operatively. ⋯ Fatigue at 30 days was greatest in patients whose noradrenaline levels were greatest perioperatively. Independently of this relationship, fatigue at 30 days correlated with concurrent levels of depression and anxiety. Post-operative fatigue has both physiological and psychological correlates.