RESUMO
UNLABELLED: Anorexia nervosa is a common psychiatric condition that most often affects young adults. If left untreated, it can have significant morbidity and mortality. METHODS AND DISCUSSION: In this report, we describe a woman first diagnosed with anorexia nervosa at age 92 and we discuss the relevant diagnostic and treatment-related issues. CONCLUSION: This case underscores the need to heighten diagnostic sensitivity for this and other eating disorders at any age.
Assuntos
Anorexia Nervosa/diagnóstico , Psiquiatria Geriátrica , Idoso , Envelhecimento/psicologia , Anorexia Nervosa/terapia , Diagnóstico Diferencial , Feminino , Humanos , PsicoterapiaRESUMO
Socioeconomic, attitudinal, and psychological factors associated with acceptance or refusal of recommendations for chemotherapy were investigated in 64 consecutive patients with solid tumors or lymphoma who agreed to participate in this study. Patients filled out the Brief Symptom Inventory (BSI) and a questionnaire that investigated selected factors. Patients also were asked if they believed in, used, had used, or planned to use alternative-complementary treatments for their cancer. Eight patients refused chemotherapy against the advice of their oncologist. Frequency, percentage, mean, standard deviation, and range was coded, and differences between the groups of those who accepted and those who rejected recommendations for chemotherapy were analyzed by chi-square, using unpaired t test and the Wilcoxon two-sample test. There was a significant increase in anxiety in the total study population as compared with patients who did not have cancer. In addition, all the BSI scores except those for anxiety were higher in patients who refused chemotherapy, and the difference was statistically significant.
Assuntos
Adaptação Psicológica , Antineoplásicos/uso terapêutico , Serviços de Saúde Comunitária , Neoplasias/tratamento farmacológico , Neoplasias/psicologia , Recusa do Paciente ao Tratamento , Adulto , Idoso , Tomada de Decisões , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/enfermagem , Fatores Socioeconômicos , Inquéritos e QuestionáriosAssuntos
Transtorno Depressivo/tratamento farmacológico , Neoplasias/complicações , Pemolina/uso terapêutico , Adulto , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/classificação , Pemolina/administração & dosagem , Escalas de Graduação PsiquiátricaRESUMO
Medically ill patients who cannot come to the psychotherapist's office on a regular basis frequently are encountered in consultation-liaison settings. For these individuals the telephone becomes the only link to psychological counseling. The two cases presented in this article of successful telephone therapy with cancer patients exemplify and highlight the effect of this mode of interaction on the therapeutic process and relationship. Telephone communication also differs from face-to-face interaction in areas of therapist-patient accessibility, control, formality, and anonymity, which make it an especially effective psychotherapeutic tool for the medically ill patient.