The Journal of nervous and mental disease
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J. Nerv. Ment. Dis. · Apr 2015
The complex role of personality in cancer treatment: impact of dependency-detachment on health status, distress, and physician-patient relationship.
Personality traits have been associated with positive and negative adjustment to a cancer diagnosis. No studies have assessed trait dependency and detachment and their relationship to health, distress, and the doctor-patient relationship in patients undergoing radiation treatment for cancer. ⋯ Detachment scores were positively and significantly correlated with pain, somatization, depression, and anxiety and marginally associated with lower health-related quality of life. These preliminary findings support the construct validity and clinical utility of trait dependency and detachment testing with oncology patients and suggest that detachment is associated with poorer quality of life and higher psychological distress, whereas dependency is associated with poorer doctor-patient relationships after a cancer diagnosis.
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There is controversy about the use of antidepressant medication during pregnancy. Decisions about their use are affected by understanding the risks of these medications causing pregnancy loss, congenital malformations, neonatal adaptation syndrome, persistent pulmonary hypertension of the newborn, autism spectrum disorder, or long-term neurocognitive deficits. ⋯ Untreated depression during pregnancy can also cause harm from poor diet, substance abuse, suicidal behavior, or prematurity. Decisions about the use of antidepressants during pregnancy must be based on a risk-benefit analysis based on the best evidence of the risks of treating or not treating maternal depression.
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J. Nerv. Ment. Dis. · Feb 2015
Randomized Controlled TrialNonverbal communication of patients with borderline personality disorder during clinical interviews: a double-blind placebo-controlled study using intranasal oxytocin.
Interpersonal dysfunction is central to borderline personality disorder (BPD). Recent research has focused on the role of oxytocin (OT) in BPD, with mixed results regarding the processing of social information. Fifteen BPD patients and 15 controls participated in two clinical interviews, one under OT and one under placebo, which were randomly conducted 1 week apart in a double-blind fashion. ⋯ OT was also associated with less flight behavior in both groups when given at T1 compared with placebo. OT responses were unrelated to the patients' history of childhood trauma. The present findings are informative with respect to patients' nonverbal prosocial behavior in clinical settings.
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J. Nerv. Ment. Dis. · Oct 2014
The relationship of life stressors, mood disorder, and health care utilization in primary care patients referred for integrated behavioral health services.
Exposure to stressful life events, mood disorder, and health care utilization were evaluated in 102 low-income, primarily minority patients receiving behavioral health and medical services at a safety-net primary care clinic. Exposure to major stressors was far higher in this sample than in the general population, with older patients having lower stress scores. ⋯ Contrary to expectation, anxiety, depression, or stress exposure was not related to service utilization. Latter findings are discussed in terms of the influence of the provision of behavioral health services, the highly skewed distribution of major stressor scores, and the likely greater influence of individual differences in minor stressor exposure on utilization in this population.
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J. Nerv. Ment. Dis. · Oct 2014
Short-term cognitive effects after recovery from a delirium in a hospitalized elderly sample.
The aim of this study was to examine early cognitive performance after a delirium in elderly general hospital patients. Patients were divided into a delirium (n = 47) and a control (n = 25) group. ⋯ Adjusting for group differences in baseline variables, the delirium group performed significantly worse than the control group on CAMCOG-R; its subdomains language, praxis, and executive functioning; and on Mini Mental State Examination derived from CAMCOG-R. The occurrence of delirium in hospital thus detrimentally affects early cognitive performance.