Psychological distress and coping in women married to men with a diagnosis of solvent-induced chronic toxic encephalopathy.

BACKGROUND: Solvent-induced chronic toxic encephalopathy (TE) is a slowly developing brain disorder associated with both a direct effect on the nervous system and as indirect experienced psychological distress. It can presumably also imply negative influence on the subject's social surroundings. METHODS: Seventeen women married to men diagnosed with TE (WTE) and 51 referent women of the same age married to healthy husbands were examined. Symptoms, social network and coping style were measured by questionnaires. RESULTS: The WTE reported slightly more psychological distress and fewer social contacts than did the referents. The WTE did not report affected stress management. Retired women in the WTE group accounted for most of the deviances from the referents. CONCLUSIONS: The conclusion is that becoming a WTE does not necessarily imply more psychological distress, social isolation or poorer stress management capability if they continue with their work and social activities.

Stress management in men with solvent-induced chronic toxic encephalopathy.

Stress management was studied in male patients with solvent-induced chronic toxic encephalopathy (TE) of types 2A (TE 2A, n = 31) and 2B (TE 2B, n = 26). The patients were compared with a healthy reference group (n = 57). Self-reported symptoms (90-item Symptoms Checklist [SCL-90]), sense of coherence, coping strategies, and level of mastery were measured. As expected, both TE groups reported highly deviating symptoms on most SCL-90 scales. The TE 2B patients, who had objectified cognitive dysfunction, reported more use of passive, less situationally adequate coping strategies; a weaker sense of coherence; and a lower degree of mastery. In contrast, the TE 2A cases showed only minor deviations from the reference group in these respects. The results suggest that having a strong sense of coherence, a sense of mastery, and flexible resources for stress management could be dependent on intact brain functions.

Long-term follow-up of psychological distress, social functioning, and coping style in treated and untreated patients with solvent-induced chronic toxic encephalopathy.

Patients with organic solvent-induced toxic encephalopathy (TE) (n = 13) were followed up seven years after the application of an intervention program. They were also compared with untreated TE patients diagnosed at the same time (n = 26) and with unexposed referents (n = 39). Psychological distress, social function, and coping ability and style were measured with the Symptom Checklist-90, Interview Schedule of Social Interaction, and Sense of Coherence and Strategies to Handle Stress questionnaires. Both TE groups had unchanged function in neuropsychological tests. Members of the treated group had improved their social functioning and reduced their mental stress but were not any better than the untreated patients. Compared with referents, the TE patients continued to live with increased psychological distress and used predominantly emotionally focused strategies to cope with their problems. This can be a cause for concern in family life and can also make gainful work impossible.

Chronic toxic encephalopathy: social consequences and experiences from a rehabilitation program.

This study evaluates a rehabilitation program designed to address the social function issues of patients with solvent-induced chronic toxic encephalopathy (TE) and their families. Fourteen newly diagnosed men and their spouses participated in group sessions. The patients were given cognitive training, and crisis intervention measures were implemented. Their spouses were given information about the disease and had an opportunity to talk about their emotions and the disease's impact on the family's functioning. Interviews after the program showed that patients and their spouses were experiencing less psychological distress and increased social activity and had begun reestablishing contacts with friends. Their psychiatric symptoms, measured during a structured interview by a nurse, decreased significantly immediately after the treatment period but increased again after 6 months. Only a long-term follow-up study comparing the experiences of these patients with those of untreated TE patients can determine whether improvement can be sustained over the long term.

[A pilot study: neuropsychological rehabilitation of patients with solvent-induced toxic encephalopathy]. / En pilotundersökning: Neuropsykologisk rehabilitering av patienter med lösningsmedelsbetingad toxisk encefalopati.

Fourteen patients with chronic toxic encephalopathy underwent a neuropsychological intervention comprising crisis therapy, information about the disease, and cognitive training. Evaluation showed the patients to have experienced substantial improvement in their daily life and family relations as a result of the intervention. Their affective symptoms decreased and their verbal memory improved. Regional cerebral blood flow (rCBF) measurements showed training-dependent changes of functional activity related to change in memory strategy. This rCBF change had disappeared six months later, however, suggesting that the duration of intervention needs to be extended in order for use of the learned memory techniques to become automatic. We conclude that neuropsychological rehabilitation is effective and should be made available to patients with chronic toxic encephalopathy.