Psychosomatic medicine
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Psychosomatic medicine · Jul 2004
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialPsychosocial treatment within sex by ethnicity subgroups in the Enhancing Recovery in Coronary Heart Disease clinical trial.
Intervening in depression and/or low perceived social support within 28 days after myocardial infarction (MI) in the Enhancing Recovery in Coronary Heart Disease (ENRICHD) clinical trial did not increase event-free survival. The purpose of the present investigation was to conduct post hoc analyses on sex and ethnic minority subgroups to assess whether any treatment subgroup is at reduced or increased risk of greater morbidity/mortality. ⋯ White men, but not other subgroups, may have benefited from the ENRICHD intervention, suggesting that future studies need to attend to issues of treatment design and delivery that may have prevented benefit among sex and ethnic subgroups other than white men.
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Psychosomatic medicine · Jul 2004
Comparative Study Clinical TrialPosttraumatic stress, nonadherence, and adverse outcome in survivors of a myocardial infarction.
Posttraumatic stress disorder (PTSD) symptoms have been reported in patients with coronary vascular disease, after the trauma of a myocardial infarction (MI). The effect of these symptoms on post-MI disease control has not been elucidated. We conducted a study that sought to determine whether PTSD symptoms post-MI are associated with increased likelihood of cardiovascular readmission and with nonadherence to treatment recommendations. ⋯ PTSD symptoms predicted poor disease control in this cohort of MI survivors. The data suggest that screening MI survivors for symptoms of PTSD may be beneficial if this high-risk population is to be targeted for interventions.
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Psychosomatic medicine · May 2004
Comparative StudyDepression and abdominal pain in IBS patients: the mediating role of catastrophizing.
Depression has been linked to irritable bowel syndrome (IBS), but the mechanism underlying this relationship is unknown. This cross-sectional study explores the possibility that negatively skewed beliefs patients hold regarding abdominal pain (ie, catastrophizing) mediate the relationship between depression and pain severity. ⋯ The relation between depression and pain is not, as psychogenic models predict, strictly a direct and linear one but works partly through patients' beliefs regarding their pain in general and pain catastrophizing in specific. Implications of the findings for understanding and investigating the depression-IBS link from a biopsychosocial perspective are discussed.
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Psychosomatic medicine · Mar 2004
Randomized Controlled Trial Comparative Study Clinical TrialFor whom does it work? Moderators of the effects of written emotional disclosure in a randomized trial among women with chronic pelvic pain.
Although written emotional disclosure has potential as a stress management intervention for people with health problems, the main (group) effects of disclosure in medical populations are limited. This study sought to identify individual difference moderators of the effects of written disclosure among women with chronic pelvic pain. ⋯ Although the main effects of writing about the stress of pelvic pain are limited, women with higher baseline ambivalence about emotional expression or negative affect appear to respond more positively to this intervention.
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Psychosomatic medicine · Mar 2004
Clinical Trial Controlled Clinical TrialSex differences in pain and hypothalamic-pituitary-adrenocortical responses to opioid blockade.
Sex differences in pain sensitivity and stress reactivity have been well documented. Little is known about the role of the endogenous opioid system in these differences. This study was conducted to compare adrenocortical, pain sensitivity, and blood pressure responses to opioid blockade using naltrexone in men and women. ⋯ Although men and women exhibited similar hormonal responses to opioid receptor blockade, women reported less pain and showed smaller blood pressure responses during CPT. Results suggest differential effects of the endogenous opioid system on pain perception and blood pressure in men and women.