International journal of psychiatry in medicine
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Using a modified version of the Hackett-Cassem denial scale we measured preoperative denial in 121 patients scheduled for CABG surgery. A significant inverse relationship was found between the denial scale and Hamilton Anxiety measures four days postoperatively (p less than .02). Longitudinal assessments were carried out using the Spielberger State Anxiety Inventory (SSAI), the Zung Self-Rating Depression Scale (Zung SDS) and the Psychosocial Adjustment to Illness Scale (PAIS). ⋯ Our findings suggest that denial serves as an adaptive mechanism, especially in the immediate postoperative period. Furthermore, higher levels of denial may be predictive of improved psychologic outcome for up to six months following surgery. Subsequently, however, other events, unrelated to the surgery, may be of greater importance than preoperative denial in determining psychological outcome from CABG surgery.
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Int J Psychiatry Med · Jan 1988
Screening emergency room patients with atypical chest pain for depression and panic disorder.
In response to recent reports relating atypical chest pain to normal coronary arteries and to various types of psychopathology, we developed a pilot study to investigate 1) the prevalence of depression and panic disorder among patients presenting to an emergency room with atypical chest pain, and 2) what the likelihood is of an emergency room physician recognizing the psychosocial factor. Of forty-nine subjects screened, 39 percent scored positively for depressive syndrome on the Center for Epidemiological Studies-Depression rating scale, 43 percent met criteria for panic attack and 16 percent met criteria for panic disorder by DSM-III. Although thirty subjects (61%) screened positively for depression or panic attack, only one received a psychiatric diagnosis of any kind. This pilot study suggests: 1) that the relationship between chest pain and psychopathology in emergency room patients deserves further rigorous study; 2) that depression and panic attacks in association with atypical chest pain may be underdiagnosed by the emergency room physician; and 3) that self-report screening measures as an aid to diagnosis in this population need to be more closely investigated.
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Int J Psychiatry Med · Jan 1988
The influence of problems with concentration and memory on emotional distress and daily activities in chronic pain patients.
This study examined concentration and memory problems in chronic pain patients as they related to emotional distress and interference with daily activity. Three hundred and sixty-three chronic pain patients were divided into two groups based on how much they expressed difficulty in concentrating and remembering things. ⋯ The results showed that problems in concentration and memory were related to emotional distress, poor family support, and interference with daily activities. It is suggested that techniques to improve concentration and memory should be incorporated as part of a multidisciplinary pain program.