The stress of caring for people with obsessive compulsive disorders.

This paper presents a survey of stress of key carers of 46 consecutive cases of chronic obsessive-compulsive disorders who were receiving combined drug and cognitive-behavioral therapy in an out-patient clinic. A reliable semi-structured interview was used to estimate the overall stresses in various aspects of life. The effects of the disorder were most commonly expressed by carers in their marital relationship and in home management. Twenty-eight percent were severely burdened by their carer role, and 35% were extremely distressed at the prospect of ongoing care provision. Caregivers require support, and may be considered to be consumers of mental health services themselves.

What happens to women with preeclampsia? Microalbuminuria and hypertension following preeclampsia.

There is little published data on the incidence of remote hypertension, microalbuminuria (a possible marker of remote cardiovascular events) and diabetes following preeclampsia. This is of particular importance in Pacific Island populations as they have a high rate of preeclampsia, non-insulin dependent diabetes and cardiovascular related deaths. The aim of this study was to compare the rate of microalbuminuria and hypertension in 50 Samoan women with past preeclampsia (cases) with 50 Samoan women who did not have past preeclampsia (controls). Forty per cent of cases were hypertensive at follow-up compared to 2% in the control group (p < 0.0001). Microalbuminuria or proteinuria occurred in 40% of women with past preeclampsia and 18% of controls (p < 0.02). Half of the cases with microalbuminuria were hypertensive. No case or control had an elevated fructosamine, suggesting that current diabetes was an unlikely explanation for the microalbuminuria. We conclude that Samoan women with past preeclampsia are at increased risk of developing chronic hypertension and microalbuminuria. The significance of the microalbuminuria after preeclampsia is not known, but it may be a marker of either remote cardiovascular morbidity or non-insulin dependent diabetes. This study raises longterm health implications for women with preeclampsia.