Postgraduate medical journal
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The enduring and contentious hypothesis that sleepwalking and night terrors are symptomatic of a protective dissociative mechanism is examined. This is mobilised when intolerable impulses, feelings and memories escape, within sleep, the diminished control of mental defence mechanisms. They then erupt but in a limited motoric or affective form with restricted awareness and subsequent amnesia for the event. ⋯ However, the symptoms express themselves within the form of the sleepwalking/night terror syndrome rather than as rapid eye movement sleep related nightmares. The main group of subjects with the syndrome and with no history of major psychological trauma show no clinical or DIS-Q evidence of dissociation during wakefulness. The proposition that, within the character structure of this group, the mechanism still operates but exclusively within sleep remains a possibility.
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Aortitis is the inflammation of the wall of the aorta and can occur from an infection or autoimmune disease. Myelodysplastic syndrome (MDS) is characterised by abnormal haematopoiesis and a dysfunctional immune system. ⋯ All possible aetiologies were ruled out. The patient's symptoms resolved after she received steroids.
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Work related stress and anxiety may have a profound effect on an individual's wellbeing. In the case of doctors this may also affect patient care. This study measured stress, anxiety, and job satisfaction and the influence of personality factors on these in a group of preregistration house officers in the north east of England. ⋯ There were significant negative correlations between stress and job satisfaction scores (r = -0.508; p<0.0001) and between anxiety and job satisfaction scores (r = -0.421; p<0.0001), and significant positive associations between anxiety and stress scores (r = 0.593; p<0.0001). Stress, anxiety, and depression scores were significantly correlated with neuroticism scores in both men and women. The personality characteristic of neuroticism was a predisposing factor for stress and anxiety in the junior doctors which may be taken into consideration when offering support and counselling.