Abstract：
OBJECTIVE:Demoralization, a state of lowered morale and poor coping, has a prevalence of 13-18% among patients with advanced cancer. We surveyed clinicians' perspectives of the utility of "with demoralization" as a diagnostic specifier for adjustment and depressive disorders. METHOD:Using comparative clinical vignettes in a field survey, clinicians from a range of disciplines were asked their perception of the utility of diagnosis and treatment options. Response frequencies were compared using Cochran's Q and McNemar's tests, with sensitivity and specificity rated against expert rankings of diagnosis. Analysis of variance and paired t-tests examined significant differences in ratings of utility. RESULTS:Vignettes were assessed by 280 clinicians; 77% supported utility of the category 'adjustment disorder with demoralization' compared to 33% supporting 'adjustment disorder with anxiety' (McNemar test, p<0.001), while 83% supported the utility of 'with demoralization' for major depressive episode, matching 83% perceiving utility for 'with melancholia.' Sensitivity and specificity ratings were 77% and 94% for adjustment disorder with demoralization and 83% and 91% for major depression with demoralization. CONCLUSION:Clinicians perceived the specifier 'with demoralization' to deepen diagnostic understanding, treatment choice, and ability to communicate with clinicians and patients, particularly for the category of adjustment disorder with demoralization.
journal_name
Gen Hosp Psychiatryjournal_title
General hospital psychiatryauthors
Kissane DW,Bobevski I,Gaitanis P,Brooker J,Michael N,Lethborg C,Richardson G,Webster P,Hempton Cdoi
10.1016/j.genhosppsych.2017.01.007subject
Has Abstractpub_date
2017-05-01 00:00:00pages
20-24eissn
0163-8343issn
1873-7714pii
S0163-8343(16)30406-6journal_volume
46pub_type
杂志文章abstract：:Children (N = 110) hospitalized on a child psychiatric unit improved significantly in psychological functioning at discharge and 1- and 6-months follow-up relative to their functioning at admission. Children who were more impaired at admission made more progress during admission but were more impaired at follow-up tha...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/s0163-8343(01)00153-0
更新日期：2001-09-01 00:00:00
abstract：:The ventral striatum has been assigned a major role in addictive behavior. In addition, clinical lesion studies have described involvement of the insula and globus pallidus. To the best of our knowledge, this is the first report of alleviation of alcohol and nicotine addiction after a cerebrovascular incident in the d...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2012.01.008
更新日期：2012-11-01 00:00:00
abstract：OBJECTIVE:The objective was to assess the association between asthma and depressive symptoms (DS) and to evaluate the relationship between DS and risk factors [smoking, physical inactivity, body mass index (BMI) and sleep duration] in asthmatic individuals. METHODS:We analyzed data from the Israeli National Health Int...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2011.09.007
更新日期：2012-01-01 00:00:00
abstract：:Bone marrow transplantation offers new hope for cure in a variety of leukemias, aplastic anemia, and other immunodeficiency and hematologic disorders. But the psychologic circumstances accompanying this procedure are often profoundly stressful. The evolution of consultation--liaison services on a bone marrow transplan...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(88)90006-0
更新日期：1988-09-01 00:00:00
abstract：:There is still a striking lack of homogeneity in the terminology and classifications used in the registration of psychiatric consultation-liaison (C-L) data. Nowadays, the need for standardization of C-L data is greater than ever. Each registration consists of two components: the items and their categories. The presen...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(88)90064-3
更新日期：1988-11-01 00:00:00
abstract：:To test the hypothesis that depression is often inaccurately detected in medical settings, we examined the psychiatric consultations performed at two medical-surgical teaching hospitals. All records for the 4396 consultations seen in a 3-year period were retrospectively reviewed. Consultations were categorized by the ...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(95)00089-5
更新日期：1996-01-01 00:00:00
abstract：:Efforts to improve the care of depression in primary care patients have largely ignored the potential of obstetrics/gynecology (OB/GYN) practices. We describe feasibility studies of a depression screening and care management intervention in three diverse OB/GYN practices. Patients were screened using the Patient Healt...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/s0163-8343(03)00006-9
更新日期：2003-03-01 00:00:00
abstract：OBJECTIVE:Missed appointments are associated with poorer health outcomes. We predicted that compared to secure attachment style, fearful and dismissing attachment styles would be associated with greater number of missed primary care visits in patients with diabetes. METHODS:In patients with diabetes from nine health m...
journal_title：General hospital psychiatry
pub_type： 杂志文章,多中心研究
doi：10.1016/j.genhosppsych.2005.07.004
更新日期：2006-01-01 00:00:00
abstract：:Family systems theory provides the physician with a comprehensive paradigm to investigate the social and interpersonal context of physical illness. All physical illnesses, particularly life-threatening and chronic ones, profoundly affect the family life of the patient, and the changed family circumstances in turn have...
journal_title：General hospital psychiatry
pub_type： 杂志文章,评审
doi：10.1016/0163-8343(90)90003-u
更新日期：1990-11-01 00:00:00
abstract：OBJECTIVE:Every year, millions of Americans become informal caregivers to loved ones admitted to Neuroscience Intensive Care Units (Neuro-ICU), and face challenges to Quality of Life (QoL). This study sought to identify associations between resiliency, distress, and caregiver QoL at time of Neuro-ICU admission. METHOD...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2018.02.012
更新日期：2018-01-01 00:00:00
abstract：:A common problem facing the psychiatric consultant and the medical practitioner is evaluating depression in patients with concurrent medical illnesses. Depression is difficult to recognize in the medically ill, often presenting with "masked" symptoms and organized into unique syndromes. A primary concern of the clinic...
journal_title：General hospital psychiatry
pub_type： 杂志文章,评审
doi：10.1016/0163-8343(92)90024-5
更新日期：1992-01-01 00:00:00
abstract：OBJECTIVE:Patients with factitious disorder (FD) fabricate illness, injury or impairment for psychological reasons and, as a result, misapply medical resources. The demographic and clinical profile of these patients has yet to be described in a sufficiently large sample, which has prevented clinicians from adopting an ...
journal_title：General hospital psychiatry
pub_type： 杂志文章,评审
doi：10.1016/j.genhosppsych.2016.05.002
更新日期：2016-07-01 00:00:00
abstract：OBJECTIVE:Tinnitus is known to have an association with depression and other psychiatric disorders. As part of a larger epidemiological survey, we evaluated the associations among tinnitus, depression and alexithymia in a group of elderly people. METHODS:A survey of hearing loss, audiological rehabilitation and associ...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2007.05.002
更新日期：2007-09-01 00:00:00
abstract：:The psychosocial skills of 24 PGY I medical residents receiving psychiatric training every other week during the internship year were evaluated and compared to a control group of 13 PGY I residents. After the internship year, the psychiatrically trained residents showed an increase in their ability to recognize emotio...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(86)90088-5
更新日期：1986-03-01 00:00:00
abstract：:Both electroconvulsive therapy (ECT) and paliperidone (PLP) can induce, though infrequently, severe cardiac side-effects. Thus far, no studies are available on the cardiac safety of their co-administration. We report on the cardiac safety of the ECT-PLP combination in nine female inpatients who underwent this treatmen...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2010.09.012
更新日期：2011-01-01 00:00:00
abstract：BACKGROUND:Oral loading with the delayed release formulation of divalproex sodium is widely used for the treatment of patients with acute mania and produces rapid attainment of therapeutic serum levels. Recently, an extended release formulation of divalproex sodium (divalproex ER) was approved for treatment of migraine...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2005.02.001
更新日期：2005-05-01 00:00:00
abstract：:This paper reviews the purposes and methodologic requirements of conclusion-oriented research for evaluating outcomes of consultation-liaison (C-L) teaching in psychiatry. Requirements for replicating educational methods and outcomes, and for demonstrating cause-effect relationships between program inputs and program ...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(79)90008-2
更新日期：1979-12-01 00:00:00
abstract：:Cultural competence, as a tool to overcome disparities in mental healthcare to ethnic minorities, is facing unprecedented challenges. Providers are turning to cultural competence as one of the few resources available for badly needed information and strategies for improving clinical care. This essay provides backgroun...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2005.06.007
更新日期：2005-11-01 00:00:00
abstract：:This report describes the rates of recovery and remission from minor depression or dysthymia in primary care patients three months after completing a randomized controlled treatment trial. The subjects were primary care patients who received > or =4 treatment sessions with Problem-Solving Treatment, paroxetine, or pla...
journal_title：General hospital psychiatry
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/s0163-8343(01)00166-9
更新日期：2001-11-01 00:00:00
abstract：:Depression is a common disorder in the primary care setting; it is associated with considerable distress and dysfunction. The management of depressed primary care patients can be complicated by the fact that these patients may lack insight into the cause of their symptoms and report only the somatic manifestations of ...
journal_title：General hospital psychiatry
pub_type： 杂志文章,评审
doi：10.1016/0163-8343(94)00093-s
更新日期：1995-03-01 00:00:00
abstract：:Among the most important adverse effects of antipsychotics is abnormal glucose metabolism, which includes not only hyperglycemia but hyperinsulinemia and hypoglycemia. We have previously described five patients who experienced hypoglycemia during treatment with antipsychotics. Thus, an anamnesis of gastric surgery, wh...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2015.03.012
更新日期：2015-07-01 00:00:00
abstract：OBJECTIVE:Over the last decade, charcoal burning has become a common method of suicide in Taiwan; however, the underlying psychiatric diagnoses and gender differences have yet to be examined. METHODS:We conducted a retrospective chart review on inpatients after suicide attempt by charcoal burning during 2000-2010. The...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2012.03.015
更新日期：2012-09-01 00:00:00
abstract：OBJECTIVE:To assess the performance of the Japanese version of the Patient Health Questionnaire-9 (J-PHQ-9) for depression in primary care. METHODS:Participants in both phases completed the J-PHQ-9, while patients in the second phase also completed the SF-8 (the short form for the health-related QOL scale SF-36). Subj...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2018.03.007
更新日期：2018-01-01 00:00:00
abstract：BACKGROUND:Post-traumatic stress disorder (PTSD) is one of the most prevalent long-term psychiatric diagnoses among survivors of severe acute respiratory syndrome (SARS). OBJECTIVES:The objective of this study was to identify the predictors of chronic PTSD in SARS survivors. DESIGN:PTSD at 30 months after the SARS ou...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2010.07.007
更新日期：2010-11-01 00:00:00
abstract：OBJECTIVE:The prevalence of depression in multiple sclerosis (MS) is known to be elevated, but nearly all available studies have estimated period prevalence. The objective of this study was to estimate the point prevalence of depression in a representative community sample using the Patient Health Questionnaire, Brief ...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2013.12.011
更新日期：2014-05-01 00:00:00
abstract：:Bupropion, a dual norepinephrine and dopamine reuptake inhibitor, has been approved by the United States Food and Drug Administration for the treatment of major depressive disorder. The most common treatment-emergent adverse events reported with bupropion were headache, dry mouth, nausea and agitation. The following i...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2011.01.010
更新日期：2011-07-01 00:00:00
abstract：:The Ras-Raf-mitogen-activated protein kinase/extracellular signal-regulated kinase (ERK) kinase (MEK)-ERK cascade is important in the intra-cellular transduction of neurotransmitters, such as dopamine and glutamate. Sorafenib (Nexavar), a multi-kinase inhibitor targeting Raf kinase, vascular endothelial growth factor ...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2012.03.001
更新日期：2014-07-01 00:00:00
abstract：:The validity and clinical use of a recently developed instrument to assess health care needs of patients with a physical illness, called INTERMED, is investigated. The INTERMED combines data reflecting patients' biological, psychological, and social characteristics with information on health care utilization character...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/s0163-8343(98)00061-9
更新日期：1999-01-01 00:00:00
abstract：:A 32-year-old female with a seven year history of multiple sclerosis was hospitalized due to an exacerbation of symptoms, and complained of a high frequency of urination and occasional urinary incontinence. A urologic consult was obtained and the patient was diagnosed as having neurogenic (spastic) bladder, resulting ...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(82)90022-6
更新日期：1982-04-01 00:00:00
abstract：:Alcohol use disorders (AUDs) are common among inpatients in general hospitals and often cause excess mortality. This study investigates the prevalence of AUDs among nonpsychiatric inpatients in one general hospital and evaluates the ability of medical staff to identify such morbidity. A two-phase case-identification s...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2004.01.001
更新日期：2004-05-01 00:00:00
