Clinical research on the quality of life and emotion symptoms in patients with permanent peripheral facial paralysis / 中国基层医药

To investigate the quality of life (QoL) and emotion symptoms (anxiety symptom and depressive symptom), and its influencing factors in patients with permanent peripheral facial paralysis ( PPFP). Methods A case-control trial was conducted to evaluate the QoL status and emotion symptoms of 79 PPFP patients (PPFP group,disease course ＞12 months) between January 2017 and January 2018 from the Affiliated Hospital of Yangzhou University,and 42 healthy individuals were selected as control group.The generic questionnaire medical outcomes study short -form 36 items health survey(SF-36),Chinese version of facial clinimetric evaluation (FaCE) scale,self-rating depression scale(SDS) and self-rating anxiety scale (SAS) were evaluated.The correlation among SF-36,SDS,SAS and FaCE was evaluated.SPSS 21.0 software was used to analyze the data.Results By the assessment of SF-36,the score of vitality[(73.23 ±15.04)points],social function[(72.41 ±15.46)points],role-emotion[(72.53 ±15.27) points] and mental health [(73.35 ±14.54) points] in four dimensions of the PPFP group were lower than those of the control group [( 97.56 ±3.76 ) points, (96.51 ±3.32 ) points, (97.09 ± 2.49)points and (96.63 ±2.37) points] (t＝-10.506,-10.144,-10.505,-10.403,all P＜0.001),but the scores of physical function ,role-physica,bodily pain and general health in four domains of the PPFP group were similar with those of the control group (all P＞0.05).By the assessment of FaCE,the total score of the PPFP group was lower than those of the control group [(48.63 ±17.44) points vs.(100.00 ±0.00) points,t＝-19.281,P＜0.05].The score of SDS in the PPFP group was higher than those of the control group [(48.43 ±11.57)points vs. (40.63 ±5.39) points] ( t ＝4.174, P ＜0.001), but the score of SAS had no statistically significant difference between the two groups (P＞0.05).According to the assessment of the correlation among SF -36,SDS,SAS and FaCE,the total scores of FaCE in the PPFP group was related only to SF -36 related mental health dimensions and SDS(r＝-0.848 ～0.908, all P ＜0.001).Multiple linear regression analysis showed that marital status ( t ＝-2.442,P＝0.017),occupation ( t＝-2.377,P＝0.020),and age ( t ＝-5.501,P＝0.000) were negatively correlated with the SDS scores;with／without synkinesis ( t ＝3.604, P ＝0.042), disease course ( t ＝4.152,P ＝0.000),and the level of House-Brackmann grading system(HBGS)(t＝2.116,P＝0.038) were positively associated with the SDS of the PPFP group.However,disease course (t＝-2.616,P＝0.011),HBGS(t＝-6.523,P＝0.000) were negatively correlated with the total scores of FaCE ,and with／without synkinesis (t＝2.767,P＝0.000) was positively associated with the total scores of FaCE.Conclusion The patients with PFPP have a poorer quality of life and experienced greater psychological distress than healthy individuals .The present study suggested that age ,gender, occupation,marital status,disease course,with／without synkinesis ,the sources of PPFP and the level of HBGS are associated with depression increasing and quality of life decreasing in PPFP patients.

Clinical research on the quality of life and emotion symptoms in patients with permanent peripheral facial paralysis / 中国基层医药

Objective@#To investigate the quality of life(QoL) and emotion symptoms(anxiety symptom and depressive symptom), and its influencing factors in patients with permanent peripheral facial paralysis(PPFP).@*Methods@#A case-control trial was conducted to evaluate the QoL status and emotion symptoms of 79 PPFP patients(PPFP group, disease course >12 months) between January 2017 and January 2018 from the Affiliated Hospital of Yangzhou University, and 42 healthy individuals were selected as control group.The generic questionnaire medical outcomes study short-form 36 items health survey(SF-36), Chinese version of facial clinimetric evaluation(FaCE) scale, self-rating depression scale(SDS) and self-rating anxiety scale(SAS) were evaluated.The correlation among SF-36, SDS, SAS and FaCE was evaluated.SPSS 21.0 software was used to analyze the data.@*Results@#By the assessment of SF-36, the score of vitality[(73.23±15.04)points], social function[(72.41±15.46)points], role-emotion[(72.53±15.27)points] and mental health[(73.35±14.54)points] in four dimensions of the PPFP group were lower than those of the control group [(97.56±3.76)points, (96.51±3.32)points, (97.09±2.49)points and (96.63±2.37)points](t=-10.506, -10.144, -10.505, -10.403, all P<0.001), but the scores of physical function, role-physica, bodily pain and general health in four domains of the PPFP group were similar with those of the control group (all P>0.05). By the assessment of FaCE, the total score of the PPFP group was lower than those of the control group [(48.63±17.44)points vs.(100.00±0.00)points, t=-19.281, P<0.05]. The score of SDS in the PPFP group was higher than those of the control group[(48.43±11.57)points vs.(40.63±5.39)points](t=4.174, P<0.001), but the score of SAS had no statistically significant difference between the two groups (P>0.05). According to the assessment of the correlation among SF-36, SDS, SAS and FaCE, the total scores of FaCE in the PPFP group was related only to SF-36 related mental health dimensions and SDS(r=-0.848~0.908, all P<0.001). Multiple linear regression analysis showed that marital status(t=-2.442, P=0.017), occupation(t=-2.377, P=0.020), and age(t=-5.501, P=0.000) were negatively correlated with the SDS scores; with/without synkinesis(t=3.604, P= 0.042), disease course(t=4.152, P=0.000), and the level of House-Brackmann grading system(HBGS)(t=2.116, P=0.038) were positively associated with the SDS of the PPFP group.However, disease course (t=-2.616, P=0.011), HBGS(t=-6.523, P=0.000) were negatively correlated with the total scores of FaCE, and with/without synkinesis(t= 2.767, P=0.000) was positively associated with the total scores of FaCE.@*Conclusion@#The patients with PFPP have a poorer quality of life and experienced greater psychological distress than healthy individuals.The present study suggested that age, gender, occupation, marital status, disease course, with/without synkinesis, the sources of PPFP and the level of HBGS are associated with depression increasing and quality of life decreasing in PPFP patients.

Psychogenic illness following vaccination: exploratory study of mass vaccination against pandemic influenza A (H1N1) in 2009 in South Korea

PURPOSE: Adverse events during mass vaccination campaigns have had a profoundly negative impact on vaccine coverage rates. The objective of the study was to identify the characteristics of reported psychogenic illness cases following mass vaccination that needed further interventions of the national immunization program. MATERIALS AND METHODS: We collected documents that were submitted to the Korea Centers for Disease Control and Prevention for vaccine injury compensation, and analyzed cases of psychogenic illness following pandemic influenza A (H1N1) vaccination in 2009 which were confirmed by the Korean Advisory Committee on Vaccine Injury Compensation. RESULTS: During the 2009-2010 influenza season, 13 million Koreans were vaccinated against pandemic influenza. Of 28 reported psychogenic illness cases following immunization, 25 were vaccinated through school-located mass immunization. Significant numbers of them were female adolescents (68%) or had underlying vulnerable conditions or emotional life stressors (36%). They required lengthy hospitalization (median, 7 days) and high medical costs (median, US $1,582 per case). CONCLUSION: Health authorities and organizers of future mass vaccinations should be well aware of the possible occurrence of psychogenic illness, acknowledge their detailed characteristics, and take its economic burden into account to mitigate the risk of transmission of infectious diseases efficiently.

Adolescência vulnerável: fatores biopsicossociais relacionados ao uso de drogas / Vulnerable adolescence: bio-psychosocial factors related to drug use / Adolescencia vulnerable: factores biopsicosociales relacionados al uso de drogas

As modificações físicas, psíquicas e sociais da adolescência aprofundam a condição de vulnerabilidade e aumentam o risco de início precoce do uso de substâncias psicoativas (SPA). Realizou-se estudo transversal com 229 adolescentes usuários de SPA, em tratamento em centro de atenção psicossocial à infância e adolescência (Capsia), durante o período correspondente aos primeiros dez anos de funcionamento desse serviço, com a finalidade de traçar o perfil biopsicossocial dos usuários e identificar fatores de risco para o início do uso de drogas entre adolescentes. A maioria dos prontuários analisados pertencia a pacientes do sexo masculino, que praticam ou praticaram atos infracionais, estão em evasão escolar e conviveram ou convivem com familiares que utilizam drogas e/ou em situações de agressão familiar. Tais dados revelam um perfil de vulnerabilidade que gera a necessidade de proteção adicional por parte dos diversos serviços de atenção às crianças e adolescentes, em diferentes esferas.

The physical, psychological and social modifications in adolescence deepen the condition of vulnerability and increase the risk of precocious use of psychoactive substances (PAS). This cross-sectional study covered 229 adolescent users of PAS under treatment at a psychosocial center for the care of children and adolescents (CAPSIA), during the first ten years of the service, with the purpose of outlining the bio-socio-psychological of the users and profile of the users and identifying risk factors for beginning drug use among adolescents. Most of the medical records belonging to male patients who practice or had practiced misdemeanors as school dropouts and had lived or live with family members who use drugs, and/or in situations of family aggression. Such data reveal a profile of vulnerability that generates a need for additional protection on the part of the diverse services for child and adolescent care, in different spheres.

Las modificaciones físicas, psíquicas y sociales de la adolescencia profundizan la condición de vulnerabilidad y aumentan el riesgo de un inicio precoz en el uso de sustancias psicoactivas (SPA). Se realizó un estudio transversal con 229 adolescentes usuarios de SPA, en tratamiento en un centro de atención psicosocial a la infancia y adolescencia (CAPSIA), durante el período correspondiente a los primeros diez años de funcionamiento de este servicio, con la finalidad de trazar el perfil biopsicosocial de los usuarios e identificar factores de riesgo para el inicio en el uso de drogas entre adolescentes. La mayoría de los prontuarios analizados pertenecía a pacientes del sexo masculino, que practican o practicaron actos de infracción, están en evasión escolar y convivieron o conviven con familiares que utilizan drogas y/o en situaciones de agresión familiar. Tales datos revelan un perfil de vulnerabilidad que genera la necesidad de protección adicional por parte de los diversos servicios de atención a los niños y adolescentes, en diferentes esferas.

Relación de tipo y ciclo vital familiar con la presencia de problemas psicosomáticos en un consultorio docente de medicina familiar / Association of kind and family life cycle with the presence of psychosomatic problems in an academic family practice outpatient setting

Objetivos: Determinar la relación entre el tipo de familia y el ciclo vital familiar con el desarrollo de problemas psicosomáticos en pacientes que acudieron al consultorio de medicina familiar. Material y métodos: Estudio observacional de corte transversal, en el que se revisaron las historias clínicas de un consultorio docente de medicina familiar y se buscó asociación entre el tipo de familia y ciclo vital familiar con el desarrollo de problemas psicosomáticos. Resultados: Se encontró un mayor porcentaje de familias nucleares según el tipo familiar y en plataforma de despegue según el ciclo vital familiar, se encontró en un 41% del total de la muestra con al menos un problema psicosomático en la historia clínica. No se encontró asociación entre el tipo de familia y el ciclo vital familiar con el desarrollo de problemas psicosomáticos. Conclusiones: El desarrollo de problemas psicosomáticos en un consultorio docente de medicina familiar no está asociado con el tipo de familia ni con el ciclo vital familiar. (AU)

Objectives: Determine an association of kind of family and family life cycle with the presence of psychosomatic problems in an academic family practice outpatient setting. Methods: Cross-sectional study that involved revision of patient´s charts in an outpatient setting. Results: A higher proportion of nuclear families was found, 41% had at least one psychosomatic problem. No association between kind of family and family life cycle with the development of psychomotor problems was found. Conclusions: Psychosomatic problems are not related with kind of families or family life cycle in an academic family practice outpatient setting. (AU)

Prevalencia de enfermedades en trabajadores académicos de una universidad pública según seguro de gastos médicos / Prevalence of disease among academic workers at a Public University in Mexico City: health insurance data

La salud de los trabajadores académicos sin lugar a dudas es uno de los objetivos primordiales de numerosas investigaciones no sólo en nuestro país sino en España, Venezuela, Perú, Costa Rica, por mencionar algunos. En esos países se han estudiado principalmente entidades nosológicas desde el punto de vista médico, las investigaciones publicadas dan cuenta de la problemática y abordan enfermedades generales y estrés. El objetivo de este estudio fue conocer y reportar la prevalencia de enfermedades de los trabajadores académicos de una universidad pública, en la Ciudad de México, según el seguro de gastos médicos mayores y cuyos hallazgos demuestran que en relación al género, los más afectados son del sexo masculino, la edad de mayor presentación de enfermedades fue de 51 años, incrementándose el riesgo al ser casado con hijos menores de 18 años. Asimismo, la población objeto de estudio manifiestó no disponer de tiempo libre para recreación familiar o personal. El grupo más afectado son los profesores con mayor antigüedad laboral y que se desempeñan en las áreas de ciencias biológicas y de la salud. Otro factor observado como predisposición para enfermedad fue la exigencia laboral del propio individuo ya que invierten tiempo de sus días de descanso y vacaciones para mejorar su desempeño académico a fin de incrementar los estímulos que les otorga la universidad, lo cual se traduce en desgaste físico y emocional. Las enfermedades psicosomáticas mayormente encontradas fueron en primer lugar colitis, seguida por gastritis e hipertensión arterial y no existe diferencia estadísticamente significativa para la presentación de estas enfermedades psicosomáticas entre hombres y mujeres, por lo que se concluye que todos los profesores académicos están expuestos a los mismos riesgos para enfermarse

The health of academic workers has been the subject of numerous studies not only in our country, but also in Spain, Venezuela, Peru, Costa Rica, etc. This research has focused mostly on nosologic entities from a medical point of view, with general descriptions of the nature of the problem, diseases encountered, and stress. The objective of this study was to measure disease prevalence of diseases among academic workers at a Public University in Mexico City, using data from the largest health insurance company. Most affected were males, age greater than 51 years, and being married with children under 18 years of age. The study population also reported having little time for personal or family recreation. Also at risk were faculty with greater seniority, and working in the biological and health sciences. Another predisposing factor was self-imposed work demands, including working on weekends and holidays in order to obtain incentives provided by the University, resulting in physical and emotional fatigue. Psychosomatic illnesses included colitis, followed by gastritis and hypertension, without regard to gender, suggesting that all academic workers are exposed to similar health risks in this environment

Sofrimento difuso e transtornos mentais comuns: uma revisão bibliográfica / Diffuse distress and common mental disorders: a bibliographic review

Este artigo tem como objetivo abordar a problemática dasqueixas somáticas inespecíficas, tais como dores no corpo,mal-estar, dores de cabeça, nervosismo, insônia, nemsempre classificáveis nas grandes síndromes psiquiátricas,tampouco na nosologia da clínica médica. Tais queixas seapresentam como uma freqüente demanda de atenção,principalmente nas unidades básicas de saúde. Elas estãorelacionadas com questões psicossociais importantes,como redes de apoio social, relações familiares, laborativas,sociais e econômicas dos usuários dos serviços de saúde.Os autores consideram que o conceito de transtornos mentaiscomuns (TMC), utilizado por pesquisas no campo daepidemiologia psiquiátrica, traz elementos relevantes paraa compreensão de tal problemática. No trabalho que deuorigem a este artigo utilizou-se a metodologia de revisãobibliográfica não exaustiva, por meio de busca nas basesde dados Lilacs, usando como palavra chave common mentaldisorders. Foram selecionados prioritariamente artigosbaseados em pesquisas realizadas no Brasil, mesmo quepublicados em língua inglesa. Foram excluídos os artigosque não enfocavam os TMC como principal questão, ouque os relacionavam apenas com doenças clínicas. Assimforam examinados treze artigos como bibliografia principal.Dois deles não se referem diretamente a pesquisas realizadasno Brasil, mas em países de economia periférica ecom realidades sociais semelhantes. Os resultados apontampara as seguintes questões: alta taxa de prevalência de TMCnas unidades de atenção primária e na comunidade; faltade capacitação adequada para as equipes de saúde lidaremcom formas de sofrimento não classificadas nos manuais diagnósticos; ausência de políticas públicas e metodologiasde cuidado destinadas para essa problemática no campo dasaúde. A reflexão sobre esse tema, assim como a criaçãode espaços de acolhimento e escuta sensível para usuáriose profissionais são de fundamental importância para queessas manifestações de sofrimento recebam o cuidado e aatenção adequados nos serviços de saúde.

This paper addresses medically unexplained symptoms(MUS) such as body pains, uneasiness, headaches, nervousness,insomnia, all conditions difficult to classify bothamong the major psychiatric syndromes or within nosology.Such complaints frequently demand immediate attention,especially in primary care units. They are closely relatedto important psycho-social factors including social supportnetworks and family relations, as well as labor and socioeconomicconditions experienced by those who use suchservices. The authors contend that the concept of commonmental disorders (CMD), applied in psychiatric epidemiologicresearch, provides an important contribution to theunderstanding of this subject. Using the epidemiologicalconcept of CMD as a search term, this study employed anon-exhaustive bibliographic review methodology of theLILACS database. Articles based on research carried outin Brazil were given precedence, including those publishedin English. Those articles that did not focus of CMD astheir main subject, or that related them only to somaticdisorders, were excluded. As a result, a main bibliographyof thirteen articles was identified. Two of the articles donot directly deal with research based in Brazil, but refer toother countries with similar economics and comparablesocial conditions. The results suggest the following mainareas of concern: the high prevalence of CMD in primaryhealth units and in the community; the lack of specificprofessional training for health teams to deal with thiskind of suffering not classified in their diagnostic manuals,and the absence of public policies and methodologiesmeant to specifically address this problem in the of healthcare. Public discussion of this subject, as well as theformation of hospitable opportunities for health serviceusers and professionals to speak and listen, are essentialin order to provide adequate attention and care for thosewho demonstrate this kind of suffering

Confirmación de un modelo explicativo del estrés y de los síntomas psicosomáticos mediante ecuaciones estructurales / Confirmation of a descriptive model of stress and psychosomatic symptoms using structural equations

OBJETIVO: Evaluar mediante ecuaciones estructurales un modelo del estrés que integra la explicación de los síntomas psicosomáticos y la teoría transaccional del estrés. MÉTODOS: Se seleccionó una muestra representativa, aleatoria y estratificada de estudiantes de la Facultad de Psicología de la Universidad Autónoma de Nuevo León, México. Los sujetos se seleccionaron a partir del listado de alumnos proporcionado por la facultad. Se utilizaron cuestionarios de autoevaluación con adecuadas propiedades psicométricas para valorar cada una de las variables incluidas en el modelo. Los resultados se analizaron con el programa AMOS 5.0, empleando el método de máxima verosimilitud. Asimismo, se compararon el modelo estructural con variables observables y un modelo con variables latentes endógenas. RESULTADOS:Los resultados obtenidos confirman parcialmente el modelo presentado y corroboran los efectos del estrés y el cansancio emocional sobre los síntomas psicosomáticos, y de la autoestima, la autoeficacia y el apoyo social sobre el estrés. El modelo con variables observables (c²/gl = 2,87; GFI (índice de bondad del ajuste) = 0,985; AGFI (índice de bondad de ajuste corregido) = 0,946; RMSEA (error de aproximación cuadrático medio) = 0,072; IFI (índice de ajuste incremental) = 0,982) tiene mejor ajuste que el modelo con variables latentes (c²/gl = 3,74; GFI = 0,924; AGFI = 0,876; RMSEA = 0,09, IFI = 0,927). En ambos casos, el ajuste es adecuado. CONCLUSIONES:El modelo presentado constituye el principal aporte de este trabajo. Se trata de un modelo explicativo de síntomas psicosomáticos, con buen ajuste, que explica el 24,3 por ciento de la varianza al utilizar variables observables y el 39,4 por ciento al utilizar variables latentes.

OBJECTIVES:To evaluate a descriptive model of stress that integrates an explanation of psychosomatic symptoms with the transactional theory of stress. METHODS:A random and stratified representative sample was selected from among the students in the School of Psychology at the Autonomous University of Nuevo León, Mexico. The subjects were chosen randomly from a student directory provided by the school. A self-administered questionnaire was used that contained the psychometric properties necessary for accurately quantifying each of the variables included in the model. Results were analyzed using AMOS 5.0, employing the best probability method. Also, the structural model was compared using discrete variables only and endogenous latent variables. RESULTS: The results that were obtained partly confirmed the model and corroborated the impact that stress and emotional exhaustion have on psychosomatic symptoms and that self-esteem, self-efficacy, and social support have on stress. The model with discrete variables [chi square test/degrees of freedom (c²/df) = 2.87; goodness of fit (GFI) = 0.985; adjusted goodness of fit (AGFI) = 0.946; root mean square error of approximation (RMSEA) = 0.072; incremental fit index (IFI) = 0.982] has a better fit than the model with latent variables (c²/df = 3.74; GFI = 0.924; AGFI = 0.876; RMSEA = 0.09, IFI = 0.927). In both cases, the fit is adequate. CONCLUSIONS:The model discussed is the main contribution of this study. It is a descriptive model of psychosomatic symptoms, with a good fit, that describes 24.3 percent of the variance for discrete variables and 39.4 percent when using latent variables.