95 research outputs found
Validity and reliability of the Structured Clinical Interview for Depersonalization-Derealization Spectrum (SCI-DER).
This study evaluates the validity and reliability of a new instrument developed to assess symptoms of depresonalization: the Structured Clinical Interview for the Depersonalization-Derealization Spectrum (SCI-DER). The instrument is based on a spectrum model that emphasizes soft-signs, sub-threshold syndromes as well as clinical and subsyndromal manifestations. Items of the interview include, in addition to DSM-IV criteria for depersonalization, a number of features derived from clinical experience and from a review of phenomenological descriptions. Study participants included 258 consecutive patients with mood and anxiety disorders, 16.7% bipolar I disorder, 18.6% bipolar II disorder, 32.9% major depression, 22.1% panic disorder, 4.7% obsessive compulsive disorder, and 1.5% generalized anxiety disorder; 2.7% patients were also diagnosed with depersonalization disorder. A comparison group of 42 unselected controls was enrolled at the same site. The SCI-DER showed excellent reliability and good concurrent validity with the Dissociative Experiences Scale. It significantly discriminated subjects with any diagnosis of mood and anxiety disorders from controls and subjects with depersonalization disorder from controls. The hypothesized structure of the instrument was confirmed empirically
Resting energy expenditure assessment in anorexia nervosa: comparison of indirect calorimetry, a multisensor monitor and the Müller equation.
The aim of this study was to compare the estimations provided by three different means of measuring the resting energy expenditure (REE) in anorexia nervosa (AN) patients. REE was measured, after 24 h of refeeding, using a portable multisensor body monitor [SenseWear Pro2 Armband (SWA)], FitMate™ method and the Müller equation for individuals with body mass index < 18.5, the latter being based on dual-energy X-ray absorptiometry assessment of body composition. The mean differences between REE values estimated by SWA and those provided by the Müller equation and the FitMate™ method were significantly different from zero in both cases. In contrast, the mean differences between FitMate™ method and Müller equation were weakly significantly different from zero, and a significant correlation was noted between these two methods. In conclusion, the SWA does not appear to be an alternative to FitMate™ and Müller equation methods for assessing REE in AN patients
Recent advances in psychological therapies for eating disorders
Recent years have seen substantial consolidation and development of the evidence base for psychological therapies for eating disorders. This review summarises the key changes over that time period. Specific forms of cognitive behavioural therapy and family-based treatment have consolidated and extended their positions as treatments of choice despite the development of novel approaches. However, there is still a significant need for further development and testing to improve recovery rates, particularly in anorexia nervosa
Comorbidades físicas e psicológicas antes e depois da cirurgia bariátrica : um estudo longitudinal
Introduction: Morbid obesity has multiple implications for
psychological and physical health. Bariatric surgery has been
selected as the treatment of choice for this chronic disease,
despite the controversial impact of the surgery on psychosocial
health. The objective of this study was to describe candidates
for bariatric surgery and analyze changes in weight, psychopathology,
personality, and health problems and complaints at
6- and 12- month follow-up assessments.
Methods: Thirty obese patients (20 women and 10 men) with a
mean age of 39.17±8.81 years were evaluated in different dimensions
before surgery and 6 and 12 months after the procedure.
Results: Six and 12 months after bariatric surgery, patients
reported significant weight loss and a significant reduction in
the number of health problems and complaints. The rates of
self-reported psychopathology were low before surgery, and
there were no statistically significant changes over time. The
conscientiousness, extraversion, and agreeableness dimensions
increased, but neuroticism and openness remained unchanged.
All changes had a medium effect size.
Conclusions: Our results suggest that patients experience
significant health improvements and some positive personality
changes after bariatric surgery. Even though these findings
underscore the role of bariatric surgery as a relevant treatment
for morbid obesity, more in-depth longitudinal studies
are needed to elucidate the evolution of patients after the
procedure.Introdução: A obesidade mórbida tem várias implicações para
a saúde psicológica e física. A cirurgia bariátrica tem sido o
tratamento de escolha para essa doença crônica, apesar da
controvérsia sobre o impacto da cirurgia na saúde psicossocial.
O objetivo deste estudo foi descrever candidatos a cirurgia bariátrica e analisar mudanças no peso, psicopatologia personalidade,
problemas e queixas de saúde desses pacientes em avaliações
realizadas 6 e 12 meses após a cirurgia.
Métodos: Trinta pacientes obesos (20 mulheres e 10 homens)
com idade média de 39,17±8,81 anos foram avaliados em diferentes
dimensões antes da cirurgia e 6 e 12 meses após.
Resultados: Aos 6 e 12 meses após a cirurgia bariátrica, os
pacientes relataram significativa perda de peso e significativa
redução no número de problemas e queixas de saúde. As taxas
de psicopatologia autorrelatada foram baixas antes da cirurgia e
não sofreram mudanças significativas com o tempo. As dimensões
conscienciosidade, extroversão e agradabilidade aumentaram,
mas o neuroticismo e a abertura permaneceram inalteradas.
Todas as mudanças apresentaram um tamanho de efeito médio.
Conclusões: Os nossos resultados sugerem que os pacientes
experimentam melhoras significativas em saúde e algumas mudanças
positivas de personalidade após a cirurgia bariátrica.
Embora esses achados reforcem o papel da cirurgia bariátrica
como um tratamento relevante para a obesidade mórbida, mais
estudos longitudinais e aprofundados são necessários para elucidar
a evolução dos pacientes após a realização do procedimento.(undefined
Specialized inpatient treatment of adult anorexia nervosa: effectiveness and clinical significance of changes
Background: Previous studies have predominantly evaluated the effectiveness of inpatient treatment for anorexia nervosa at the group level. The aim of this study was to evaluate treatment outcomes at an individual level based on the clinical significance of improvement. Patients' treatment outcomes were classified into four groups: deteriorated, unchanged, reliably improved and clinically significantly improved. Furthermore, the study set out to explore predictors of clinically significant changes in eating disorder psychopathology. Methods: A total of 435 inpatients were assessed at admission and at discharge on the following measures: body-mass-index, eating disorder symptoms, general psychopathology, depression and motivation for change. Results: 20.0-32.0% of patients showed reliable changes and 34.1-55.3% showed clinically significant changes in the various outcome measures. Between 23.0% and 34.5% remained unchanged and between 1.7% and 3.0% deteriorated. Motivation for change and depressive symptoms were identified as positive predictors of clinically significant changes in eating disorder psychopathology, whereas body dissatisfaction, impulse regulation, social insecurity and education were negative predictors. Conclusions: Despite high rates of reliable and clinically significant changes following intensive inpatient treatment, about one third of anorexia nervosa patients showed no significant response to treatment. Future studies should focus on the identification of non-responders as well as on the development of treatment strategies for these patients
Umbilical cord blood: The role of apoptosis in the control of CD34+ cell counts
Background and Objective: Cord blood obtained at delivery can be used for hematopoietic precursor cells (HPC) transplantation. The major limit for its success is represented by the low cellular yield of the stem cell population. The objective of this study was to determine the role played by apoptosis in the numerical control of CD34+ cell counts. Design and Methods: Umbilical Cord blood samples were collected from 15 women at the time of the delivery and cord blood units processed. Cells, collected following 24 h and 48 h of incubation, were analysed by flow cytometry using the gating strategy. Results: Remarkable levels of apoptosis were detected in the stem cell population and a significant difference between apoptosis mean values at 24 h and 48 h within CD34+ cells were found. The difference between the percentage of apoptosis in CD34+ cells and that in the remaining population was significant both at 24 h and at 48 h. Conclusions: CD34+ cells have a higher likelihood to undergo apoptosis in comparison to the remaining ones present in umbilical cord blood. This process of cellular death plays a major role in the control of CD34+ cell counts in placental blood and influence, for this reason, the possibility of success of a cord blood transplantation. © 2002 Elsevier Science Ltd. All rights reserved
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