Understanding the "worried well".

The burden of giving a diagnosis to patients who have no discernible clinical findings is often frustrating and anxiety provoking for the primary care clinician. This frustration is magnified when that patient returns on a frequent basis. These patients have been called the worried well, but there is no good CPT code for this diagnosis. Smith et al (1) have taken a novel approach to evaluating patients who are frequent users of primary care services.

Read more

Peritraumatic dissociation and physiological response to trauma-relevant stimuli in Vietnam combat veterans with posttraumatic stress disorder

Abstract

A recent study found that female rape victims with acute posttraumatic stress disorder (PTSD) who received a high score on the Peritraumatic Dissociative Experiences Questionnaire exhibited suppression of physiological responses during exposure to trauma-related stimuli. The goal of our present study was to test whether the same relationship holds true for male Vietnam combat veterans with chronic PTSD, using secondary analyses applied to data derived from a Veteran's Affairs Cooperative Study.

Read more

Medically unexplained symptoms and the problem of power in the primary care consultation : a qualitative study.

Abstract

BACKGROUND:

Patients presenting in primary care frequently exhibit physical symptoms that may be unrelated to organic pathology. Such symptoms are commonly regarded as products of psychological or emotional problems, and their legitimacy as 'medical' matters is often called into question.

OBJECTIVES:

Our aim was to explore GPs' attitudes to the management of patients that present with medically unexplained symptoms in primary care.

METHODS:

Read more

Impact of Event Scale : psychometric properties.

Abstract

BACKGROUND:

For more than 20 years, the Impact of Event Scale (IES) has been widely used as a measure of stress reactions after traumatic events.

AIMS:

To review studies that evaluated the IES's psychometric properties.

METHOD:

Literature review.

RESULTS:

Read more

Evaluation of diagnostic procedures

This is the first of a series of five articles

Read more

Long-term assessment of personality after burn trauma in adults.

Several studies have shown that burn victims display higher rates of premorbid
psychopathology, such as depression, substance abuse, and personality disorders, than the
general population (Patterson et al., 1993).

Read more

Predicting medically unexplained physical symptoms and health care utilization : A symptom-perception approach.

Abstract

OBJECTIVES:

The present study investigated the contribution of demographic characteristics (age, gender, socioeconomic status [SES]) and symptom-perception variables to unexplained physical symptoms and health care utilization. In addition, the consequences of the use of four frequently applied symptom-detection methods for relations among study variables were examined.

METHOD:

Read more

The genetic aetiology of somatic distress.

Abstract

BACKGROUND:

Somatoform disorders such as neurasthenia and chronic fatigue syndrome are characterized by a combination of prolonged mental and physical fatigue. This study aimed to investigate the heritability of somatic distress and determine whether this dimension is aetiologically distinct from measures of depression and anxiety.

METHOD:

Read more

Health Problems Among Latin-American and Middle-Eastern Refugees in the Netherlands: Relations With Violence Exposure and Ongoing Sociopsychological Strain

In two studies (n = 480; n = 156), the health problems (somatic, psychological, and migration-related complaints) of refugees were examined, in relation to violence, demographic, and asylum variables (ongoing sociopsychological strain). High frequencies for torture events and a substantial number of medical complaints were reported, but few cases ofdiagnosable Posttraumatic Stress Disorder (PTSD) were identified (Study I: 6%; Study II: 11%). Not only reported violence, but also the current social situation contributed to the experiencing of ongoing health complaints.

Read more

Nocturnal Re-Experiencing More Than Forty Years After War Trauma

The aim of this study was the examination of Posttraumatic Nightmares (PTNM) and Posttraumatic Anxiety Dreams (PTAD) in Dutch combat veterans and World War II victims. Participants (outpatients; n = 223) were administered a standardized psychiatric interview, the Impact of Event Scale, the SCL-90, the Clinician Administered PTSD Scale, and an interview on posttraumatic nocturnal re-experiencing. Prevalence of PTNM was 56%. Patients with PTNM, even those who were not diagnosed with PTSD, had significantly more psychiatric complaints than patients with no PTNM.

Read more

Pages