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Trajectory of illness

Baptiste Brossard, Normand Carpentier
Contemporary research into health and mental health treats diagnosis as a central step in understanding illness management and trajectory; consequently, in the last two decades, sociology of diagnosis has attained increasing influence within medical sociology. Deeply embedded in social constructionism, the set of research divides between those who focus on the social and historical construction of diagnoses as categories, and those who see diagnosis as a process. Regarding the latter, this approach explores the constitution of the medical production, highlighting how it constitutes a starting point for entering a 'sick role', for being labelled, for naming one's problem and by extension, for framing one's illness narrative...
October 22, 2016: Sociology of Health & Illness
Jan-Marie Kozicky, Alexander McGirr, David J Bond, Marjorie Gonzalez, Leonardo E Silveira, Kamyar Keramatian, Ivan J Torres, Raymond W Lam, Lakshmi N Yatham
OBJECTIVES: Bipolar I disorder (BD-I) is associated with gray matter volume (GMV) alterations in neural regions important for emotional regulation. Reductions found in patients with multiple episodes are not seen at illness onset, suggesting that changes occur with illness progression, although no prospective studies to date have examined this. In the present study, we assessed GMV at baseline and one year following a first manic episode, examining the impact of episode recurrence on the trajectory of change...
September 2016: Bipolar Disorders
Wanjie Tang, Jingdong Zhao, Yi Lu, Tingting Yan, Lijuan Wang, Jun Zhang, Jiuping Xu
OBJECTIVE: Millions of children were exposed to major earthquake in China, with serious psychological and developmental consequences. To obtain accurate rate of post-disaster related disorder and identify predictors may help inform post-disaster rescue and rehabilitation efforts. The present longitudinal study explored correlations of demographic and socioeconomic characteristics of juvenile survivors of the Ya'an and Wenchuan earthquakes in China with their trajectories of post-disaster related disorder...
September 13, 2016: Comprehensive Psychiatry
Cali F Bartholomeusz, Vanessa L Cropley, Cassandra Wannan, Maria Di Biase, Patrick D McGorry, Christos Pantelis
OBJECTIVE: This review critically examines the structural neuroimaging evidence in psychotic illness, with a focus on longitudinal imaging across the first-episode psychosis and ultra-high-risk of psychosis illness stages. METHODS: A thorough search of the literature involving specifically longitudinal neuroimaging in early illness stages of psychosis was conducted. The evidence supporting abnormalities in brain morphology and altered neurodevelopmental trajectories is discussed in the context of a clinical staging model...
October 12, 2016: Australian and New Zealand Journal of Psychiatry
Susan Enguidanos, Jennifer Ailshire
CONTEXT: Given recent Medicare rules reimbursing clinicians for engaging in advance care planning, there is heightened need to understand factors associated with the timing of advance directive (AD) completion before death and how the timing impacts care decisions. OBJECTIVE: The purpose of this study is to investigate patterns in timing of AD completion and the relationship between timing and documented care preferences. We hypothesize that ADs completed late in the course of illness or very early in the disease trajectory will reflect higher preferences for aggressive care...
October 5, 2016: Journal of Pain and Symptom Management
Meredith Greene, Amy C Justice, Kenneth E Covinsky
: As the number of older adults living with HIV continues to increase, understanding how to incorporate geriatric assessments within HIV care will be critical. Assessment of geriatric syndromes and physical function can be useful tools for HIV clinicians and researchers to help identify the most vulnerable older adults and to better understand the aging process in PLWH. This review focuses on the assessment of falls, frailty and physical function, first in the general population of older adults and includes a specific focus on use of these assessments in older adults living with HIV...
October 7, 2016: Virulence
M Charlesworth, M Mort, A F Smith
Previous studies of critical care admissions have largely compared patients that have been granted or declined admission. To better understand the decision process itself, our ethnographic approach combined observation of and interviews with critical care physicians in a large English hospital. We observed 30 critical care doctors managing 71 referrals and conducted ten interviews with senior decision-makers to explore the themes raised by our observations. We analysed data using the constant comparative method...
October 7, 2016: Anaesthesia
Biing-Jiun Shen, Jen-Tzer Gau
PURPOSE: Although hostility and depression have been linked to higher cardiac risk and poor prognosis of patients with coronary heart disease (CHD), there is a lack of research that studies how they may influence the short-term outcomes among patients participating in cardiac rehabilitation (CR). This study aimed to investigate the influence of hostility and depression on patients' exercise tolerance and improvement trajectory in a CR program over 6 weeks. METHOD: Participants were 142 patients with CHD, with a mean age of 62 years...
October 4, 2016: International Journal of Behavioral Medicine
Alvina A Acquaye, Elizabeth Vera, Mark R Gilbert, Terri S Armstrong
BACKGROUND: Outcomes projects can be a catalyst for determining disease- and treatment-related consequences for patients with rare tumors. The Adult Ependymoma Outcomes (AEO) survey uses self-reported experience to evaluate how this tumor affects patient groups throughout the illness trajectory. METHODS: Patients completed the AEO survey via a Web-based portal. The survey included questions on treatment, tumor recurrence, and current health status; the MD Anderson Symptom Inventory Brain Tumor and Spine Tumor modules; and the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36)...
September 28, 2016: Cancer
Natália S Kapczinski, Benson Mwangi, Ryan M Cassidy, Diego Librenza-Garcia, Mariane Bagatin Bermudez, Márcia Kauer-Sant'anna, Flávio Kapczinski, Ives Cavalcante Passos
The longitudinal course of bipolar disorder is highly variable, and a subset of patients seems to present a progressive course associated with brain changes and functional impairment. Areas covered: We discuss the theory of neuroprogression in bipolar disorder. This concept considers the systemic stress response that occurs within mood episodes and late-stage deficits in functioning and cognition as well as neuroanatomic changes. We also discuss treatment refractoriness that may take place in some cases of bipolar disorder...
October 3, 2016: Expert Review of Neurotherapeutics
Maren Falch Lindberg, Christine Miaskowski, Tone RustøEn, Leiv Arne Rosseland, Bruce A Cooper, Anners Lerdal
Background and purpose - Functional limitations after total knee arthroplasty (TKA) are common. In this longitudinal study, we wanted to identify subgroups of patients with distinct trajectories of pain-related interference with walking during the first year after TKA and to determine which demographic, clinical, symptom-related, and psychological characteristics were associated with being part of this subgroup. Patients and methods - Patients scheduled for primary TKA for osteoarthritis (n = 202) completed questionnaires that evaluated perception of pain, fatigue, anxiety, depression, and illness on the day before surgery...
September 23, 2016: Acta Orthopaedica
Christine Grady
Nursing and bioethics have a lot in common because they share concerns about life and death, illness and health, the rights of individuals and communities, ethical patient care, health care delivery, and public health. Nurses and bioethicists contribute to ethical practice, ethics scholarship, and health policy-making in a variety of ways. Some nurses have bioethics education or experience, some bioethicists study or collaborate closely with nurses, and some of us proudly identify as both bioethicists and as nurses...
September 2016: Hastings Center Report
J Amblàs-Novellas, S A Murray, J Espaulella, J C Martori, R Oller, M Martinez-Muñoz, N Molist, C Blay, X Gómez-Batiste
OBJECTIVES: 2 innovative concepts have lately been developed to radically improve the care of patients with advanced chronic conditions (PACC): early identification of palliative care (PC) needs and the 3 end-of-life trajectories in chronic illnesses (acute, intermittent and gradual dwindling). It is not clear (1) what indicators work best for this early identification and (2) if specific clinical indicators exist for each of these trajectories. The objectives of this study are to explore these 2 issues...
September 19, 2016: BMJ Open
Martin H Teicher, Jacqueline A Samson, Carl M Anderson, Kyoko Ohashi
Maltreatment-related childhood adversity is the leading preventable risk factor for mental illness and substance abuse. Although the association between maltreatment and psychopathology is compelling, there is a pressing need to understand how maltreatment increases the risk of psychiatric disorders. Emerging evidence suggests that maltreatment alters trajectories of brain development to affect sensory systems, network architecture and circuits involved in threat detection, emotional regulation and reward anticipation...
September 19, 2016: Nature Reviews. Neuroscience
Regine Zopf, Erika Contini, Chris Fowler, Naresh Mondraty, Mark A Williams
Body size and shape distortion is a core feature of Anorexia Nervosa (AN) - patients experience their body as fat while objectively being very thin. The cause of this distortion is unclear and disturbances in body perception could be involved. Body perception comprises estimating shape and location of one's body and requires integrating multisensory signals. We investigated if and how body location perception is changed and tested 23 AN patients and 23 healthy controls (HC) in a Rubber Hand Illusion (RHI) reaching paradigm...
November 30, 2016: Psychiatry Research
Nina L Papalia, Stefan Luebbers, James Rp Ogloff, Margaret Cutajar, Paul E Mullen
OBJECTIVES: There is a growing body of research investigating the relationship between child sexual abuse and a range of adverse outcomes. However, very little is known about the long-term co-occurrence of psychiatric disorders and behavioral problems among this vulnerable population, or the interaction between characteristics of the abuse, such as the nature and timing of the child sexual abuse, and the extent of subsequent adversities. This study aimed to determine the rate and co-occurrence of mental health morbidity, criminal justice system contact, and fatal self-harm among medically confirmed victims of child sexual abuse, and to identify abuse variables associated with a greater likelihood of cumulative adverse experiences...
September 14, 2016: Australian and New Zealand Journal of Psychiatry
Kershena Liao, Jennifer Blumenthal-Barby, Andrew G Sikora
OBJECTIVE: The factors influencing head and neck surgical oncologists' goals of care and decisions to initiate conversations about transitioning to palliative-intent treatment for patients with limited curative treatment options are incompletely understood. Lack of guidance for physicians on this topic can lead to inconsistent utilization of palliative services, as well as confusing, upsetting experiences for patients and families. We review the literature investigating the clinical factors, inter- and intrapersonal factors, and financial and health care system considerations that head and neck cancer physicians weigh during this decision-making process...
September 13, 2016: Otolaryngology—Head and Neck Surgery
Pamela Rakhshan, Holger Sørensen, Jordan DeVylder, Vijay Mittal, Erik L Mortensen, Niels M Michelsen, Morten Ekstrøm, Steven C Pitts, Sarnoff A Mednick, Jason Schiffman
Motor abnormalities have been established as a core aspect of psychosis-spectrum disorders, with numerous studies identifying deficits prior to clinical symptom presentation. Additional research is needed to pinpoint standardized motor assessments associated with psychosis-spectrum disorders prior to illness onset to enhance prediction and understanding of etiology. With a long history of findings among people with diagnosable psychosis-spectrum disorders, but little research conducted during the premorbid phase, pegboard tasks are a viable and understudied measure of premorbid for psychosis motor functioning...
September 9, 2016: Schizophrenia Research
Tom A Hummer, Michael M Francis, Jenifer L Vohs, Emily Liffick, Nicole F Mehdiyoun, Alan Breier
AIM: White matter abnormalities have been reported in schizophrenia and may indicate altered cortical network integrity and structural connectivity, which have been hypothesized as key pathophysiological components of this illness. In this study, we aimed to further characterize the nature and progression of white matter alterations during the early stages of the disorder. METHODS: We employed diffusion tensor imaging (DTI) approaches to investigate fractional anisotropy (FA), radial diffusivity (RD) and axial diffusivity (AD) in 40 patients with schizophrenia and related psychotic disorders (aged 18-30 years) who were within 5 years of illness, along with an age-, sex- and race-matched sample of 21 healthy controls...
September 13, 2016: Early Intervention in Psychiatry
Patrick J Brown, Bret R Rutherford, Kristine Yaffe, Jane M Tandler, Justina Laurence Ray, Emily Pott, Sarah Chung, Steven P Roose
Depression in later life is a severe public health problem, associated with higher rates of mortality, suicide, and dementia. Effectiveness of treatment is limited by the failure to deconstruct the heterogeneity of the illness and because diagnostic criteria, pathophysiological models, and treatment algorithms for depression are primarily based on studies of younger adults even though symptoms of the illness and physiology of the patient change with age. Thus, understanding how aging interacts with depressive illness may elucidate endophenotypes of late-life depression with different clinical manifestations and underlying mechanisms that can then be targeted with more personalized approaches to treatment...
November 2016: American Journal of Geriatric Psychiatry
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