Psychosomatic medicine
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Psychosomatic medicine · Sep 2010
Comparative StudyComorbidity and associated severity of borderline personality disorder and physical health conditions in a nationally representative sample.
To investigate the comorbidity and severity of borderline personality disorder and physical health conditions in a nationally representative sample. Despite the recent trend of examining the relationship between physical and mental health, there has been limited research examining the association of physical health conditions and personality disorders, in particular, borderline personality disorder. ⋯ Careful screening and treatment of physical health conditions among people with borderline personality disorder are warranted.
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Psychosomatic medicine · Jul 2010
Barriers to physical and mental condition integrated service delivery.
To assess pragmatic challenges faced when implementing, delivering, and sustaining models of integrated mental health intervention in primary care settings. Thirty percent of primary care patients with chronic medical conditions and up to 80% of those with health complexity have mental health comorbidity, yet primary care clinics rarely include onsite mental health professionals and only one in eight patients receive evidence-based mental health treatment. Integrating specialty mental health into primary care improves outcomes for patients with common disorders, such as depression. ⋯ Correction of disparate physical and mental health reimbursement practices is an important activity in the development of sustainable integrated physical and mental condition care in primary care settings, such as a medical home. Multiple clinical, administrative, and economic factors contribute to operational success.
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Psychosomatic medicine · Jun 2010
Comparative StudyHeart rate and blood pressure changes during autonomic nervous system challenge in panic disorder patients.
To test the hypothesis that panic disorder (PD) patients have a heightened or deregulated autonomic nervous system at rest and during autonomic challenge compared with healthy controls (HC); and to test a second hypothesis that severity of illness differentiates patients'; sympathovagal balance both at rest and during orthostatic challenge. ⋯ These findings demonstrate a consistently higher or deregulated autonomic arousal in PD patients at rest and during orthostatic challenge compared with HC. These data also reveal a possible association between the level of anxiety illness severity and sympathovagal balance, which may imply greater cardiac risk.
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Psychosomatic medicine · Jun 2010
Comparative StudyAberrances in autonomic cardiovascular regulation in fibromyalgia syndrome and their relevance for clinical pain reports.
To investigate autonomic cardiovascular regulation in fibromyalgia syndrome (FMS). ⋯ The data suggest that autonomic cardiovascular regulation in FMS is impaired in terms of reduced sympathetic and parasympathetic influences, as well as baroreflex malfunctioning. Furthermore, autonomic cardiovascular adjustment to acute stress is blunted. The inverse association between BRS and pain severity reflects the well-documented pain inhibition through the baroreceptor system. On account of this and the reduced baroreflex function in FMS, one may assume deficient ascending pain inhibition arising from the cardiovascular system, which may contribute to hyperalgesia that is characteristic of the disorder.
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Psychosomatic medicine · Jun 2010
Comparative StudyAssociation between posttraumatic stress disorder and primary care provider-diagnosed disease among Iraq and Afghanistan veterans.
To determine if a diagnosis of posttraumatic stress disorder (PTSD) was associated with primary care provider-diagnosed physical disease in the first 5 years post deployment. ⋯ PTSD is associated with increased prevalence and onset of physical disease among OEF/OIF veterans within the early years post military service. Rising rates of PTSD may foreshadow an increase in lifespan morbidity and healthcare utilization in the coming years among OEF/OIF veterans.