Translating the Intention to Seek Treatment into Action: Does Symptom Monitoring Make a Difference? Results from a Randomized Controlled Trial.

BACKGROUND: Most people with common mental health problems do not seek evidence-based psychological interventions. AIMS: The aim of this study was to investigate whether monitoring symptoms of depression and anxiety using an app increased treatment-seeking. METHOD: Three hundred and six people with significant levels of anxiety and depression, none of whom were currently receiving treatment, were randomly allocated to receive either (a) information about local psychological services only, (b) information plus regular symptom monitoring (every 6 days), or (c) information plus open symptom monitoring (monitoring when they felt like it). An app was used to provide information and monitor mood. RESULTS: The proportion of participants who reported receiving treatment after starting the study was 7.2% (10/138) in the information only group, 8.1% (9/111) in the information plus regular monitoring group and 15.8% (9/57) in the information plus open monitoring group. There was a trend for participants who were able to monitor whenever they wished to be more likely to report receiving treatment than people who were only given information about their local treatment services. The impact of the intervention was greatest among participants who intended to seek treatment before taking part. Limitations were that only a small minority of those who downloaded the app completed the study and that the study relied on self-reported measures of treatment-seeking. CONCLUSIONS: Symptom monitoring can increase actual treatment-seeking in those with an intention to seek treatment.

UK patients with primary Sjögren's syndrome are at increased risk from clinical depression.

OBJECTIVE: This study was undertaken to assess the presence and degree of anxiety and depression in a group of UK patients with primary Sjögren's syndrome (1 degrees SS). DESIGN: Cross-sectional. SETTING: Department of Oral Medicine, Liverpool University Dental Hospital. SUBJECTS: Eighty adult patients; 40 diagnosed with 1 degrees SS according to the revised European Criteria and 40 age/gender-matched controls with no history of chronic illness. INTERVENTION: Hospital Anxiety and Depression Scale (HADS), a self-administered questionnaire designed to evaluate the presence and degree of anxiety and depression in a clinical setting. MAIN OUTCOME MEASURES: Age, gender, Hospital Anxiety and Depression Scale (HADS). RESULTS: Forty patients with 1degrees SS and 40/age/gender-matched controls completed the HADS. Scores for anxiety in both the 1 degrees SS and control groups showed no statistically significant difference. Patients with 1 degrees SS had statistically significant higher, mean HADS scores for depression than the controls. There was an increased prevalence of 'definite' clinical depression in the 1 degrees SS group. CONCLUSION: Patients with 1 degrees SS appear to be at increased risk from clinical depression. Early recognition and appropriate intervention is therefore essential to reduce the negative impact of depression on the patient's quality of life and outcome of their disease.

Burning mouth syndrome and vulvodynia coexisting in the same patient: a case report.

The 'dynias' are a group of chronic focal pain syndromes with a predilection for the orocervical and urogenital regions. This is a case report of stomatodynia (burning mouth syndrome) and vulvodynia coexisting in a middle-aged woman. The dynias are an enigma in terms of aetiology, which is multifactorial, making clinical investigations difficult and often requiring liaison with other specialties.

Oral signs and symptoms as predictors of salivary gland hypofunction in general dental practice.

OBJECTIVE: To evaluate the signs and symptoms of oral dryness as predictors of salivary gland hypofunction (SGH) in general dental practice. DESIGN AND SETTING: Prospective study recruiting adult patients attending five general dental practices in Merseyside in 1999. MATERIALS AND METHOD: Patients were screened for subjective symptoms of oral dysfunction and clinical signs of oral dryness. Patients with oral symptoms or signs of SGH were invited to undergo sialometry. Results were analysed using multiple logistic regression. RESULTS: 1103 patients were screened for signs and symptoms of oral dryness, 115 reported continuous xerostomia, of these 65 were also clinically (subjectively) assessed as having a dry oral mucosa. One hundred and one patients attended for sialometry and 73% of these had objective evidence of SGH. Neither the patients' complaints of oral dryness or the assessment of dryness of the oral mucosa were significant predictors of SGH. CONCLUSIONS: Symptoms of oral dysfunction and clinical signs of oral dryness were not significant predictors of SGH in dental practice.

Age and medication are significant risk factors for xerostomia in an English population, attending general dental practice.

OBJECTIVE: To study the prevalence of xerostomia in an English population, attending general dental practice and relate it to age, medication and gender. DESIGN STUDY: Cross-sectional. SETTING: Five General Dental Practices in Merseyside, North of England. SUBJECTS: 1,103 adult patients attending for routine dental care. INTERVENTION: Questionnaire administered by dentists. MAIN OUTCOME MEASURES: Age, gender, systemic medication, reported oral dryness. RESULTS: 1,103 patients (654 females) were recruited, of whom 427 (39%) were aged 60 years or older. 26% of patients reported taking medication. The overall prevalence of xerostomia was 12.7% (males--10.3%, females 14.4%). Age, medication and female gender were found to be significant risk factors for xerostomia, using logistic regression analysis. CONCLUSIONS: The prevalence of xerostomia (12.7%) in an English population was lower than reported in previous North American and Swedish studies. Medication was a significant risk factor for xerostomia and a better predictor of risk status, than either age or gender.

Parental age, parity and sex ratio in births in England and Wales, 1968-77.

PIP: Variations in sex ratio with maternal age, paternal age, parity, and time are examined in data on all legitimate births in England and Wales, 1968-1977. Significant linear declines in sex ratio with both increasing parity and increasing paternal age, and a curvilinear relationship with maternal age are found. Results show that 1) before 1955 it seems likely that the sex ratio declined with an increase in maternal age, 2) between 1955 and 1968 there was an unexplained decline in the sex ratio of births to women aged 20-24 and an increase in that of births to women aged 30-34, and 3) there was no significant secular trend in sex ratio during the period 1968-1977. Using data provided by the Registrar General of England and Wales, a weighted multiple regression analysis is applied. Some possible explanations for the changes in sex ratios of births during the years studied are: 1) racial heterogeneity, 2) artificial insemination, 3) the pill, and 4) ovulation induction. Overall, some artifact or combination of artifacts has transformed the regression of sex ratio on maternal age from a monotonic decline to a cubic, or this hypothesis stands in need of modification.^ieng

On the computation of inbreeding coefficients.

A method of calculating inbreeding coefficients is described using a recursive algorithm. This has been programmed in ALGOL 68 and in SNOBOL 4. Advantages and disadvantages of this method are discussed, and several examples are given.

Multivariate studies on the genetics of dermal ridges.

In order to investigate the inheritance of the series of ten ridgecounts, factor analysis was used to reduce the dimensionability to two. These two factors are inherited more or less independently and the heritability of the first is 0.97.

Sex and lateral asymmetry of the finger ridge-count.

In a sample 719 individuals, the bimanual difference in ridge-count (right minus left) differed only slightly between the two sexes, the mean difference being 0-621 (females minus males). This is not statistically significant, but further evidence suggests that this difference may be real.