Measuring Illness Behavior in Patients With Systemic Sclerosis.

Measuring illness behavior in patients with systemic sclerosis.

Filed under: Depression Treatment

Arthritis Care Res (Hoboken). 2012 Oct 24;
Merz EL, Malcarne VL, Roesch SC, Sharif R, Harper BE, Draeger HT, Gonzalez EB, Nair DK, McNearney TA, Assassi S, Mayes MD

OBJECTIVE: Illness behaviors (cognitive, affective, and behavioral reactions) among individuals with systemic sclerosis (SSc) are of clinical concern due to relationships between these behaviors and physical and mental-health quality of life such as pain and symptoms of depression. Self-report measures with good psychometric properties can aid in the accurate assessment of illness behavior. The Illness Behavior Questionnaire (IBQ) was designed to measure abnormal illness behaviors; however, despite its long-standing use, there is disagreement regarding its subscales. The goal of the present study was to evaluate the validity of the IBQ in a cohort of patients with SSc. METHODS: Patients with SSc (N = 278) completed the IBQ at enrollment to the Genetics versus ENvironment In Scleroderma Outcome Study (GENISOS). Structural validity of previously derived factor solutions was investigated using confirmatory factor analysis. Exploratory factor analysis was utilized to derive SSc-specific subscales. RESULTS: None of the previously derived structural models were supported for SSc patients. Exploratory factor analysis supported a SSc-specific factor structure with 5 subscales. Validity analyses suggested that the subscales were generally independent of disease severity, but were correlated with other health outcomes (i.e., fatigue, pain, disability, social support, mental health). CONCLUSION: The proposed subscales are recommended for use in SSc, and can be utilized to capture illness behavior that may be of clinical concern. © 2012 by the American College of Rheumatology.
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Temporary management of diplopia with botulinum toxin in multiple ocular motor cranial neuropathies.

Filed under: Depression Treatment

Eur J Ophthalmol. 2012 Sep 26; 22(6): 1042-1044
Tejedor J, Díez L

Purpose. To report management of diplopia with botulinum toxin injection in traumatic multiple ocular motor cranial neuropathies.?Methods. Alternate prism and cover measurement of deviation in different positions of gaze, examination of ductions, field of binocular single vision, and complete ocular anterior and posterior segment evaluation were carried out. CT and MRI of the orbit were available. ?Results. We describe a case of traumatic VI, IV, and mainly superior III cranial nerve palsies, with left hypotropia of 35 prism diopters and esotropia of 45 prism diopters and incapacitating diplopia, due to fracture of the roof and lateral wall of the orbit, extending to the superior orbital fissure, as demonstrated by CT and MRI of the orbit. Severe limitation of abduction, elevation, and depression of the left eye was found. A single botulinum toxin injection in the medial rectus with diffusion to the inferior rectus was effective as a temporary measure for the treatment of diplopia and attainment of a small field of binocular single vision. The patient remained symptom-free for 5 months after injection.?Conclusions. Botulinum toxin injection may be useful for the temporary management of diplopia in multiple ocular motor cranial neuropathies.
HubMed – depression


Adult separation anxiety during pregnancy and its relationship to depression and anxiety.

Filed under: Depression Treatment

J Perinat Med. 2012 Sep 11;
Eapen V, Johnston D, Apler A, Rees S, Silove DM

Abstract Aims: The current study, the first of its kind, investigated the overlap between adult separation anxiety (ASA) and the symptoms of depression and anxiety in the context of pregnancy. Methods: Women attending an antenatal clinic were screened using the Adult Separation Anxiety Scale (ASA-27). As most perinatal clinics use the Edinburgh Depression Scale (EDS), this study explored the relationship between ASA and the anxiety and depression symptoms by comparing the ASA-27 scores with the scores on the EDS. A subsample including both screen positives and screen negatives on ASA-27 was clinically interviewed using the Mini International Neuropsychiatric Interview (MINI). Results: Women with ASA were significantly more likely to be screened positive for depression (EDS total score) and anxiety (EDS-3A anxiety subscale) than those without ASA. The diagnosis of ASA disorder in this population had only a moderate but significant association with the diagnoses of generalized anxiety disorder [?2(1)=25.9, P=0.000, ?=0.443] and major depression [?2(1)=16, P=0.000, ?=0.348] made using the MINI. Conclusion: Adult separation anxiety warrants independent assessment in order to tailor appropriate interventions for the individual subtypes of anxiety in the perinatal period.
HubMed – depression


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