The primary care companion for CNS disorders
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Prim Care Companion CNS Disord · Jan 2014
Impact of invalidation and trust in physicians on health outcomes in fibromyalgia patients.
Patients with fibromyalgia have reported experiencing discouragement, rejection, suspicion, and stigma during their encounters with health care professionals. The impact of these experiences on health outcomes has not been extensively examined. The aim of this study was to assess fibromyalgia patients' self-reported quality of life (QoL) and pain based on the following: perceptions of physician attitudes, trust in physicians, perceptions of medical professionals, type of treatment, and various demographic variables. ⋯ Invalidation, trust in physician, and use of complementary medicine can have significant impact on QoL and pain in fibromyalgia. Further research in more representative fibromyalgia samples may help confirm findings.
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Prim Care Companion CNS Disord · Jan 2014
Impact of pretreatment with antidepressants on the efficacy of duloxetine in terms of mood symptoms and functioning: an analysis of 15 pooled major depressive disorder studies.
This post hoc analysis aimed to determine whether patients with major depressive disorder (MDD) in duloxetine trials who were antidepressant naive or who were previously exposed to antidepressants exhibited differences in efficacy and functioning. ⋯ Duloxetine was generally superior to placebo on response and remission rates and in mean change on efficacy measures. Response and remission rates were numerically greater for first-episode versus multiple-episode and drug-treated patients. Mean change differences on efficacy measures among the 4 subgroups were inconsistent. Duloxetine showed a similar therapeutic effect independent of episode frequency and antidepressant pretreatment.
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Prim Care Companion CNS Disord · Jan 2013
Educational impact of a psychiatric liaison in the medical intensive care unit: effects on attitudes and beliefs of trainees and nurses regarding delirium.
Despite high rates and increased risk of mortality, delirium remains underdiagnosed and a minimal focus of formal medical education. This is the first study to examine the educational impact of a psychiatric liaison on beliefs and knowledge about delirium among both nurses and residents. ⋯ Though introduction of a psychiatric liaison was very well received by clinical staff, we did not meaningfully affect the attitudes and beliefs of trainees and nurses regarding delirium. Robust and lasting changes in attitudes regarding delirium may require more intensive efforts involving longer intervention periods, greater rounding frequency, or additional didactic teaching.
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Prim Care Companion CNS Disord · Jan 2013
Pain and pain catastrophizing among internal medicine outpatients with borderline personality symptomatology: a cross-sectional self-report survey.
The extant literature indicates that individuals with borderline personality disorder generally report higher levels of pain than individuals without this disorder. This study examined relationships between borderline personality symptomatology, pain, and pain catastrophizing (a related aspect of the pain experience). ⋯ Regardless of the measure used, individuals with borderline personality disorder symptomatology consistently demonstrated higher pain scores at all time points, as well as higher levels of pain catastrophizing.