TO STUDY ASSOCIATION OF POST-MENOPAUSAL SYMPTOMS AND CLINICO-DEMOGRAPHIC PROFILE: A DESCRIPTIVE STUDY

Age at menopause influences the severity of post-menopausal symptoms to determine the symptoms and clinicodemographic links in post menopauseal women in a representative population from eastern Uttar Pradesh. All postmenopausal women presenting with symptoms in the Gynaecological Emergency Department for a period of one year were enrolled. Age and clinicodemographic details, symptoms severity, and reasons for delay in seeking treatment were noted. The data was analysed using Chi-square test. Overall 990/17,927 (5.52%) women visiting the gynaecological OPD presented with post-menopausal complaints. Among menopausal women, the mean age ranged from 40 to 60 years old with a mean age of 46.6012.48 years. Majority were para 3-4 (52.5%), age at menarche were >13 years (58.3%), uneducated (58.8 %) , lower/upper lower SES (57.5%), married (77.3%) and had BMI<18.5kg/m2 (62.1%). Tobacco/smoking addiction was reported in 55 (5.6%) women. A total of 145 (14.6%) were working women. Severity of symptoms was mild, moderate and severe in 57.2%, 28.3% and 14.5% cases. Majority had onset of symptoms for 4- 5 years (56.4%) after menopause. Joint pains and Backache/body ache were the most common presenting complaints (81.8%). A significant association of age at presentation was seen with parity, age at menarche, BMI category and occupational status. Severity of symptoms showed a significant association with age at presentation, parity, age at menarche, BMI category, occupational status and tobacco/smoking use. Most common reasons for delayed treatment were financial problems (22.2%), family problems (18.2%) and commonness of problem (12.6%). Only 2.1% women were aware about HRT. Among the relatively less informed members of our study population, low socioeconomic status, underweight, and menopause age were all influenced by clinicodemographic factors.

Longitudinal study of symptoms during chemotherapy in adults with newly diagnosed acute leukemia / 中国实用护理杂志

Objective:To understand the incidence, severity and the change trajectory of symptoms in adult patients with acute leukemia during treatment, so as to provide a reference for clinical medical staff to conduct specific symptom screening and management.Methods:From March 2017 to August 2018, 69 patients who were newly diagnosed with acute leukemia at the Nanfang Hospital of Southern Medical University were conveniently selected. The Memory Symptom Assessment Scale was used to investigate the patients before chemotherapy (T1), after the first chemotherapy (T2), after the second to third chemotherapy (T3) and after the fourth to fifth chemotherapy (T4).Results:The severity score of psychological symptoms in adult patients with acute leukemia at T1, T2, T3, and T4 were 1.00(0.58, 1.42), 1.00(0.83, 1.67), 0.67(0.33, 1.00) and 0.67(0.33, 1.00). The severity score of physical symptoms at T1, T2, T3, and T4 were 0.50(0.21, 0.83), 1.00(0.54, 1.33), 0.75(0.58, 1.17) and 0.92(0.63, 1.08), respectively. The score difference was statistically significant ( H = 28.34, 27.14, both P<0.01) at different time points. The score of physical symptoms reached a peak at T2. In the psychological dimension, the severity and incidence of energy deficiency were higher in T1-T4. Conclusions:Adult acute leukemia patients have different focal symptoms in different treatment stages. Clinical medical staff should provide effective and personalized nursing intervention for patients in different treatment stages.

The effects of COVID-19 fear and anxiety on symptom severity, sleep quality, and mood in patients with fibromyalgia: a pilot study

Abstract Background: During the COVID-19 pandemic, individuals faced psychological stress caused by fear and anxiety due to the high transmission and mortality rate of the disease, the social isolation, economic problems, and difficulties in reaching health services. Fibromyalgia (FM) is a chronic centralized pain sensitivity disorder. Psychological, physical and/or autoimmune stressors were found to increase FM symptoms. This pilot study aimed to evaluate the COVID-19 fear and anxiety level, and to examine their effect on disease severity, sleep quality, and mood in FM patients compared to control group. Methods: This pilot study conducted as a cross-sectional study, and included 62 participants. Participants were divided into two groups: FM patient group ( n = 31) and control group ( n = 31). Symptom severity, sleep quality, and mood were determined using the Revised Fibromyalgia Impact Questionnaire (FIQR), Pitsburg Sleep Quality Index (PSQI), and Hospital Anxiety Depression Scale (HADS), respectively. In order to evaluate the level of COVID-19 fear and anxiety, the Fear of COVID-19 Scale (FCV-19S) and Coronavirus Anxiety Scale (CAS) were used compared to control group. Results: FIQR, PSQI, HAD-A, HAD-D, FCV-19S and CAS scores were significantly higher in the FM group ( p = 0.01). A positive significant correlation was found between FCV-19S and CAS results and FIQR, PSQI, and HAD-anx results in FM patients ( p < 0.05). Conclusion: This pilot study showed that, the individuals with FM can be more affected by psychological stress, and this situation negatively affects the symptom severity, sleep quality, and mood in FM patients, so these patients should be closely monitored in terms of psychological stressors and their effects during pandemics. More studies with more participants are necessary to describe the challenges lived by fibromyalgia population.

Association between Quality of Life and Symptom Severity in Obsessive-Compulsive Disorder Patients Using EQ-5D

OBJECTIVES: Obsessive-compulsive disorder (OCD) is a disabling psychiatric disorder, and more attention is recently paid on the quality of life (QoL) in OCD patients. The Euro-QoL-5D (EQ-5D) is a widely used self-report to calculate a single score which represents ‘health utilities’. The aim of this study was to assess the health-related QoL for patients with OCD using the EQ-5D and to examine the relationship between health-related QoL and symptom severity. METHODS: Seventy-three patients with a Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnosis of OCD were recruited from the outpatient clinic in Seoul National University Hospital. Symptom severity was assessed using the Yale-Brown Obsessive-Compulsive Scale (YBOCS), and QoL was assessed with the EQ-5D-5L questionnaire. Using Korean valuation study, a single score of QoL was calculated. RESULTS: Most of the OCD patients were relatively young (< 45 years) with the mean YBOCS total score of 19.33. The mean EQ-5D score was 0.71 and significantly correlated with symptom severity (r = -0.483, p < 0.001). 25% of the EQ-5D score was predicted by the YBOCS total score (b = -0.011, p < 0.001) by regression analysis. CONCLUSIONS: OCD patients suffer from lower health-related QoL and QoL significantly decreased as symptom severity increased. The results of the EQ-5D would enable further studies on QoL comparison across medical disease and mental disorders.

Comparison of Early Trauma History between Young/Middle Adulthood Patients and Earlier/Later Older Adulthood Patients with Panic Disorder

OBJECTIVE: To investigate the early trauma history between young/middle adulthood patients and earlier/later older adulthood patients with panic disorder (PD). METHODS: 216 patients with PD and 76 healthy controls (HCs) were included for analysis. Patients with PD were operationally dichotomized into two groups of young/middle adulthood (age below 50 years) and earlier/later older adulthood (age 50 years or over) to compare the early trauma history between two groups. Data of sociodemographic factors, self-reported shortened form of the Early Trauma Inventory (ETI), and the Albany Panic and Phobia Questionnaire (APPQ) were analyzed. RESULTS: Patients with PD showed higher scores of ETI than HCs. Young/middle adulthood PD showed statistically significantly higher levels of general trauma (t=-2.088, p=0.041), physical abuse (t=-2.456, p=0.014), emotional abuse (t=-3.690, p=0.000), and total scores of trauma (t=-3.534, p=0.001) except sexual abuse. In the young/middle adulthood PD group, ETI scores were significantly correlated with APPQ scores while no significant correlation with ETI was found in earlier/later older adulthood PD. CONCLUSION: These results show that PD is statistically associated with early trauma history and that early trauma history is more significantly related with PD in young/middle adulthood than earlier/later older adulthood. These findings suggest that the age factor should be considered in clinical practice for patients with PD.

Cardiovascular Autonomic Dysfunction in Mild and Advanced Parkinson's Disease

OBJECTIVE: The purpose of the present study was to investigate cardiovascular autonomic dysfunction in patients with Parkinson's disease (PD) with mild to severe stages of motor symptoms and to compare cardiovascular autonomic dysfunction between drug-naïve and dopaminergic drug-treated groups. METHODS: This study included 188 PD patients and 25 age-matched healthy controls who underwent head-up tilt-testing, 24-h ambulatory blood pressure (BP) monitoring and 24-h Holter monitoring. Autonomic function test results were evaluated among groups categorized by motor symptom severities (mild vs. moderate vs. severe) and treatment (drug-naïve or dopaminergic drug treatment). RESULTS: Orthostatic hypotension and supine hypertension were more frequent in patients with PD than in healthy controls. The frequencies of orthostatic hypotension, supine hypertension, nocturnal hypertension and non-dipping were not different among groups. Additionally, no significant differences were detected in supine BP, orthostatic BP change, nighttime BP, nocturnal BP dipping, or heart rate variabilities among groups. CONCLUSIONS: Cardiovascular autonomic dysfunction is not confined to moderate to severe PD patients, and starts early in the course of the disease in a high proportion of PD patients. In addition, dopaminergic drug treatments do not affect cardiovascular autonomic function.

Comparison of Clinical Characteristics between Early-Onset and Late-Onset Panic Disorder : A Preliminary Study

OBJECTIVES: The objective of this study is to clarify the clinical characteristics of late-onset panic disorder (PD) compared to early-onset PD in symptoms frequency, severity, and quality of life. METHODS: 516 patients with PD were included in this study. Patients with PD onset at 60 or after were grouped (late-onset), and compared with the group with onset at 20 or earlier (early-onset). The following instruments were applied : Beck Depression Inventory, Beck Anxiety Inventory, Panic Disorder Severity Scale, Albany Panic and Phobia Questionnaire, Anxiety Sensitivity Inventory-Revised, and Medical Outcomes Study 36-item Short-Form Health Survey. SPSS version 21.0 was used for statistical analysis. RESULTS: Late-onset PD was 4.84% of all PD patients, and the mean age was 64.68+/-4.36 years. Late-onset PD exhibited fewer panic symptoms and scored lower on most scales assessing clinical severity. However, the panic-related symptoms severity showed significant negative correlations with scores of quality of life, especially in physical functioning subscale, among the late-onset PD patients. CONCLUSION: These findings suggest that less severe panic symptoms may contribute to underdiagnosing PD in this elderly population. However, the panic-related symptoms severity plays an important role in quality of life among the late-onset PD patients. It suggests to implement specific strategies considering the age at onset in clinical approach among patients with PD.

The Relationship of Eating Habits and Trigger Foods to Symptom Severity of Irritable Bowel Syndrome

PURPOSE: The purpose of this study was to investigate eating habits and the frequency of trigger-food consumption in patients with irritable bowel syndrome (IBS) and to examine the associations of these variables with IBS symptom severity. METHODS: We included 145 ROME III-positive IBS patients (mean age 31.2 years, 73.8% of female). Subjects completed an eating-habits and food- consumption questionnaire, IBS-Symptom Severity Scale (IBS-SSS) and Brief Symptom Inventory-18 (BSI-18) for psychological distress. RESULTS: Subjects with unhealthy eating-habits such as irregular meal times, frequently eating out and overeating tended to show higher IBS symptom severity. The severity of IBS symptoms related to the frequency of the consumption of trigger foods. Subjects who ate trigger-foods (i.e., tofu, beans, almonds, and peanuts) less frequently showed higher IBS symptom severity (p=.045, .042, .016, and .019, respectively). However, subjects who ate spicy foods, instant foods, and noodles more frequently experienced more severe IBS symptoms (p=.018, .011, and .023 respectively). CONCLUSION: This study showed that IBS symptom severity was related to meal intake patterns and frequency of trigger food consumption. These findings could provide a basis for developing an intervention program for IBS patients.

Psychopathology of Sexually Abused Children In Korea / 신경정신의학

OBJECTIVES: This study aimed to identify psychopathologies of sexually abused children and intervening variables of symptom severity. METHODS: Eighty-four school-aged children were identified for sexual abuse from a center for child sexual abuse by psychiatrists, clinical psychologists, and social workers. We analyzed correlations among symptom severity, types of sexual abuse, gender, age, relationship with the abuser, family system, and current and past psychopathologies. RESULTS: The percentage of victims with particular psychiatric disorders (current) were 79.8%. Children without identifiable disorders were 20.2%, but these children had significantly increased scores on self report scales of anxiety (RCMAS), depression (CDI), and withdrawal scores on parental reports of child behavior checklist (K-CBCL). Sixty nine percent of abused children had primary diagnosis related to sexual abuse in DSM-IV diagnositic system. PTSD was 41.7%, depressive disorder was 38.1%, and anxiety disorder was 21.4%. Psychopathologies were more severe if perpetrators were of acquaintance or if victims had previous psychopathologies or parent-child relational problems. Types of primary caregiver and older age were also related to the severity of psychopathologies. CONCLUSION: Present study suggests that most victims of childhood sexual abuse suffer from significant psychological distress. Intervening variables are relationship with the perpetrator, previous mental health status, age of the child, type of the primary care taker, and the quality of parent-child relationship.

Relation Among Parameters Determining the Severity of Bronchial Asthma / 결핵

BACKGROUND: International consensus guidelines have recently been developed to improve the assessment and management of asthma. One of the major recommendations of these guidelines is that asthma severity should be assessed through the recognition of key symptoms, such as nocturnal waking, medication requirements, and objective measurements of lung function. Differential classification of asthma severity would lead to major differences in both long term pharmacological management and the treatment of severe exacerbation. METHODS: This study examined the relationship between the symptom score and measurements of FEV1 and PEF when expressed as a percentage of predicted values in asthmatics(n=107). RESULTS: The correlation of FEV1% with PEFR% was highly significant(r=0.83, p<0.01). However, there was agreement in terms of the classification of asthma severity in 76.6% of the paired measurements of FEV1% and PEFR%. Agreement in the classification of asthma severity was also found in 57.1% of the paired analysis of FEV1% and symptom score. 39% of the patients classified as having moderate asthma on the basis of FEV1% recording would be considered to have severe asthma if symptom score alone were used. Low baseline FEV1 and high bronchial responsiveness were associated with a low degree of perception of airway obstruction. CONCLUSION: The relationships between the symptom score, PEFR and FEV1 were generally poor. When assessing asthma severity, age, duration, PC20, and baseline FEV should be considered.