ABSTRACT
Some patients have behaviors that make interactions unpleasant, sometimes contributing to suboptimal outcomes and physician burnout. Understanding common difficult personality types can help doctors plan effective strategies for dealing with each, resulting in more effective communication, less stress, and better health outcomes.
Subject(s)
Passive-Aggressive Personality Disorder/psychology , Patient Compliance/psychology , Physician-Patient Relations , Burnout, Professional/etiology , Burnout, Professional/prevention & control , Burnout, Professional/psychology , HumansABSTRACT
The physician's duty to preserve patient confidentiality is challenged when doing so may endanger third parties. We present the case of a bus driver whose alcohol dependence raised concerns of a risk not only to his own health and safety, but to public safety as well. We first examine the legal and ethical obligations to report his alcohol use to his employer and then stress the importance of weighing the potential harm of violating patient-physician confidentiality against the severity of risk to the general public.
Subject(s)
Alcoholism/epidemiology , Automobile Driving/legislation & jurisprudence , Duty to Warn/ethics , Duty to Warn/legislation & jurisprudence , Ethics, Clinical , Motor Vehicles/legislation & jurisprudence , Alcoholism/psychology , Attitude to Health , Automobile Driving/standards , Confidentiality/legislation & jurisprudence , Criminal Law/standards , Humans , Male , Middle Aged , Motor Vehicles/standards , Physician's Role/psychology , Physician-Patient Relations , Risk Factors , Safety , United StatesABSTRACT
This study examined concerns regarding menopause among women with schizophrenia/schizoaffective disorder (N = 30), women with bipolar disorder (N = 25), and women with major depression (N = 36). The three groups were compared regarding knowledge of menopause, expectations of effect of menopause, and menopause-related quality of life. All women had deficits in fund of knowledge regarding menopause. More than half (53.8%) agreed that they felt more stressed due to menopause or approaching menopause, and 51.6% felt that menopause has had a negative effect on their emotional state. Perceptions of menopause effect on emotional states between the three groups were similar. The top five symptoms experienced by women with serious mental illness were all problems related to psychological issues: feeling depressed (88%, N = 80), feeling anxious (88%, N = 80), feeling tired or worn out (87%, N = 79), feeling a lack of energy (86%, N = 78), and experiencing poor memory (84%, N = 76). Larger-scale studies evaluating the effects of menopause on serious mental illness are needed to clarify how menopause affects illness outcomes in women with serious mental illness.
Subject(s)
Bipolar Disorder/diagnosis , Depressive Disorder, Major/diagnosis , Health Knowledge, Attitudes, Practice , Health Status , Perimenopause/psychology , Postmenopause/psychology , Quality of Life , Schizophrenia/diagnosis , Bipolar Disorder/psychology , Cross-Sectional Studies , Depressive Disorder, Major/psychology , Female , Humans , Middle Aged , Outcome Assessment, Health Care , Psychotic Disorders/diagnosis , Psychotic Disorders/psychology , Schizophrenic Psychology , Stress, Psychological/diagnosis , Stress, Psychological/psychology , Surveys and QuestionnairesABSTRACT
OBJECTIVE: Menopause is an important life event that has not yet been well characterized among women with severe mental illness. Our goal was to evaluate menopause-related quality of life among severely mentally ill women. METHOD: We conducted a cross-sectional assessment of perimenopausal and postmenopausal women, ages 45-55, diagnosed with schizophrenia/schizoaffective disorder, bipolar disorder, or major depression, who were receiving inpatient or outpatient psychiatric care. Women were compared regarding menopausal symptoms and quality of life using the Menopause Specific Quality of Life Scale (MENQOL). RESULTS: Women with severe mental illnesses who were peri- and post-menopausal experienced considerable vasomotor, physical, sexual, and psychosocial symptoms related to menopause. On seven of 29 MENQOL items, women with major depression reported problems significantly more often than women with other serious mental illnesses. CONCLUSIONS: This preliminary study indicates that psychiatrists and other physicians should consider the frequency and overlap of menopausal and psychiatric symptoms among women with serious mental illness in this age group.
