Psychosomatics
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"Nonmedical" (i.e., illicit) use of opioid analgesics has skyrocketed among the general population during the past decade, with similar increases observed among pain patients who take opioids by prescription. ⋯ Abuse-disorder patients had a similar physical but worse psychiatric/personality presentation than other chronic-pain patients, which suggests the need for increased psychiatric involvement.
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Many survivors of severe injuries develop significant psychiatric morbidity, especially trauma-related psychiatric disorders, anxiety, and depressive disorders. ⋯ Severely injured accident victims seem to face a major risk of PTSD and impairments in health-related quality of life. For patients with polytrauma, there is a need for a biopsychosocial conceptual framework at the interface of psychiatry and trauma surgery in general hospitals.
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Randomized Controlled Trial
Depression in chronic back pain patients: prediction of pain intensity and pain disability in cognitive-behavioral treatment.
Pain patients with comorbid depression have reduced quality of life and more disturbances than patients without such comorbidity. ⋯ The authors concluded that reducing pain-related depression could be a central therapeutic mechanism in cognitive-behavioral treatment of chronic back pain.
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Comparative Study
Comparison of short-term psychological outcomes of respiratory failure treated by either invasive or non-invasive ventilation.
There is now widespread recognition of the development of symptoms of posttraumatic stress disorder (PTSD) in individuals subjected to treatment in the hospital intensive care unit (ICU). ⋯ Specific traumatic aspects of a patient's treatment, in this case the experience of intubation and mechanical ventilation, may be an additive risk factor for the development of PTSD.
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Utilization studies in inpatient psychosomatic medicine have focused on patterns of consultation requests, timing of consultation requests relative to date of hospital admission, and the association between time to initial psychiatric consultation and length of stay. ⋯ REFLAG is significantly associated with increased LOS. Referring services may need to consider earlier consultation requests.