Estrogen improves psychological function in asymptomatic postmenopausal women.

Estrogen treatment of postmenopausal women has been suggested to improve mood and psychological function. However, this remains controversial because previous studies involved heterogeneous groups, were not double blind, and included women who were also experiencing somatic symptoms that were relieved by estrogen. A randomized double-blind study was carried out comparing the effects of placebo and conjugated equine estrogens (0.625 and 1.25 mg) on psychological function over 3 months in 36 asymptomatic women, aged 45-60. The tests included the Minnesota Multiphasic Personality Inventory-168, the Profile of Adaptation to Life, and the Beck Depression Inventory. Memory was assessed directly by the Wechsler Adult Intelligence Scales, measuring both digit span and digit symbol. All women were well-adjusted psychologically. The income management scale of the Profile of Adaptation to Life improved (P less than .05) with estrogen, as did the Beck Depression Inventory (P less than .05), but these results were not dose-related. Memory assessed prospectively by the Wechsler Adult Intelligence Scales was not affected significantly. These results suggest that estrogen use may improve the overall quality of life in postmenopausal women.

Psychometric studies and clinical interviews with cochlear implant patients.

Selection of suitable candidates for an implant was a central issue in planning clinical trials. Psychological techniques were included, the purpose being to screen out individuals who, on an a priori basis, we considered cognitively and/or emotionally inappropriate. Psychological measures were further used to assess the effect of the implant on those candidates who did undergo the surgical procedure. The present paper describes the preimplant and postimplant interviews and psychometric assessment. Based on the data developed from the interviews, we concluded that the recipients of implants are in almost unanimous agreement that the implant is a very positive contribution to their lives. Tests of cognitive functioning conducted over time indicate that the implant does not impair cognitive or neuropsychological functions. Personality tests were also administered, and no significant changes in these dimensions were found.

Psychological effects of cochlear implant: patient and "index relative" perceptions.

The ultimate judge of the value of a technological advance is the patient. The patient's evaluation of the cochlear implant is one way of judging its effects. A second method is from observations of the patient made by an individual in close relationship, ie, an "index relative." In order to determine implant effects as experienced by both patient and observer, we devised preimplant and postimplant questionnaires. We found that patients feel the implant gives them a greater sense of safety; self-sufficiency is considerably enhanced: emotionally negative episodes are significantly reduced; the feeling of being a burden to others is diminished; communication with others is much smoother; and, while engaging in group activities is still difficult, participation is less threatening than before the implant. The index relatives agree with these perceptions. They also are emotionally relieved because they feel the patients have a device which extends their range of mastery. In turn, the index relatives feel burdened and responsible.

The inter-relationship of vertigo and stress.

Our research indicates that Meniere's disease is not caused by psychologic disorders. In a 1977 study it was demonstrated that the patient with Meniere's disease is in a stressful situation. The psychologic profile is not significantly different in Meniere's and non-Meniere's vertiginous patients. The patient should be treated for his physical disease and be given support for the emotional effects of the vertigo and other symptoms. Meniere's disease causes emotional problems. Emotional problems do not appear to cause Meniere's disease.

The abnormally patent eustachian tube. Alterations in psychological status resulting from polytef paste injections.

Several authors have noted that patients with an abnormally patent Eustachian tube (APET) seem to be psychologically disturbed. We investigated the psychological status of these patients before and after treatment with polytef paste (Teflon) injections. Twelve women were evaluated by a series of tests designed to catalog the nature and intensity of the symptoms, the degree to which symptoms affected the patient, psychopathological trends, and an assessment by the patients of improvement. Results prior to treatment indicated that the patients' symptoms were quite disturbing and were moderately disabling; such symptoms affected concentration, and a marked decrease in the enjoyment of life was noted. After treatment, a notable decrease in APET symptoms was reported, with a parallel decline in emotional disturbances. Patients felt less depressed, anxious, and angry, and they reported that the quality of life was much improved. These findings indicate that physical symptoms can have profound effects on emotional status. In such cases, the most effective psychological treatment is control of physical symptoms rather than psychiatric referral.

Ménière disease and cerebral impairment.

A recent series of findings based on psychological test patterns suggests that the behavioral disturbance seen in Ménière disease is, in many instances, predicated on organic cerebral impairment. If this proves to be the case, an important source would have been uncovered that could account for some of the behavioral difficulties associated with Ménière disease. The present study challenges the previous reports, suggesting that these findings emerged because of imprecise methodologic procedures. The results based on our psychological test patterns reject prior conclusions that there is demonstrable evidence for organic cerebral impairment in patients with Ménière disease.