Psychosomatics
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Multicenter Study
The association of comorbid depression with intensive care unit admission in patients with diabetes: a prospective cohort study.
It is unknown if comorbid depression in patients with diabetes mellitus increases the risk of intensive care unit (ICU) admission. ⋯ Patients with diabetes and comorbid depression have a greater risk of ICU admission. Improving depression treatment in patients with diabetes could potentially prevent hospitalizations for critical illnesses and lower healthcare costs.
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Delirium is a common, yet frequently under-recognized medical/psychiatric complication for hospitalized patients, associated with substantial morbidity and mortality. While easy-to-use delirium screening tools exist for ventilated patients, their use in non-critically ill, hospitalized patients has not been validated. ⋯ This study suggests that in non-critically ill hospitalized patients, the CAM-ICU and ICDSC intensive care delirium screening tools are not adequately sensitive for use in routine clinical practice. Further work is needed to develop more sensitive, efficient tools in this population.
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The objective of this study was to determine how age and psychological characteristics assessed prior to diagnosis could predict psychological distress in outpatients immediately after disclosure of their diagnosis. ⋯ In both groups, trait anxiety assessed prior to diagnosis was the significant predictor of psychological distress after diagnosis, and might have prospects as a screening method for psychologically vulnerable women.
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Fibromyalgia, as defined by the American College of Rheumatology, is characterized by widespread pain lasting for at least 3 months, with pain in at least 11 out of 18 tender points when palpated with digital pressure. ⋯ Response to treatment of pain in the pregabalin trials did not depend on baseline levels of anxiety or depressive symptoms, and pregabalin improved pain in fibromyalgia patients with or without depressive or anxiety symptoms. Changes in the level of anxiety or depression had a low-to-moderate impact on pain reduction. Pain reduction with pregabalin treatment appeared to result mostly from a direct treatment effect, rather than an indirect effect mediated through improvement in anxiety or depressive symptoms.
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Randomized Controlled Trial
Administration of olanzapine to prevent postoperative delirium in elderly joint-replacement patients: a randomized, controlled trial.
Delirium is a serious postoperative condition for which few pharmacologic prevention trials have been conducted. ⋯ Administration of 10 mg of oral olanzapine perioperatively, versus placebo, was associated with a significantly lower incidence of delirium. These findings suggest that olanzapine prophylaxis of postoperative delirium may be an effective strategy.