ABSTRACT
In the frame of current treatment options for multiple sclerosis (MS) and recommendations for early intervention, we investigated the practice and attitudes of neurologists towards MS-diagnosis communication in Greece. We constructed and sent out a 22-item questionnaire to neurologists practising in different employment settings and geographic regions in Greece. Overall, 217 (37.41 %) of 580 neurologists replied. The vast majority (94.9 %) informs the patient of a definite MS diagnosis, and 73.6 % do so immediately, but only 41.7 % use the term multiple sclerosis. Furthermore, neurologists strongly agreed that timing of diagnosis communication depends to a large extent on the individual patient's personality (62.5 %) and mental state (52.3 %). Most neurologists (78.7 %) inform relatives about the diagnosis, but only in the presence of the patient. In cases where disclosure was delayed, 59.5 % noted that they did not observe any changes as regards the trust or confidence of their patients towards them. Most neurologists also noted that education level (72 %) and mental state (51.9 %), at the time of disclosure influenced patients who did not fully understand the meaning of their diagnosis. This survey provided some useful new findings with respect to MS diagnosis communication; however, the questions of how and possibly how much to communicate warrant further cross-cultural investigation.
Subject(s)
Communication , Data Collection/methods , Multiple Sclerosis/diagnosis , Neurology/methods , Physicians , Adult , Aged , Cross-Cultural Comparison , Female , Greece , Humans , Male , Middle Aged , Multiple Sclerosis/psychology , Physician-Patient Relations , Physicians/psychology , Reproducibility of ResultsABSTRACT
SUMMARY: Under normal conditions, motor evoked potentials (MEPs) elicited by transcranial magnetic stimulation increase in amplitude if the subject exercises the examined muscle immediately before recording. The authors examined the effect of nonfatiguing exercise on the amplitude of MEPs on 42 psychiatric, medicated inpatients (14 with depression, 14 with schizophrenia, and 14 with mania) compared with 14 healthy control subjects. For each subject, a total of 50 baseline and 50 postexercise MEPs were recorded. The mean (+/- standard deviation) postexercise MEP facilitation, expressed as a percentage of mean baseline values, was significantly lower (p