Predictors of readmission and health related quality of life in patients with chronic heart failure: a comparison of different psychosocial aspects

Psychological distress is common in patients with chronic heart failure. The impact of different psychological variables on prognosis has been shown but the comparative effects of these variables remain unclear. This study examines the impact of depression, anxiety, vital exhaustion, Type D personality, and social support on prognosis in chronic heart failure patients. One hundred eleven patients (mean age 57 �� 14 years) having participated in an exercise based ambulatory cardiac rehabilitation program were enrolled in a prospective cohort study. Psychological baseline data were assessed at program entry. Mortality, readmission, and health-related quality of life were assessed at follow up (mean 2.8 �� 1.1 years). After controlling for disease severity none of the psychological variables were associated with mortality, though severe anxiety predicted readmission [HR = 3.21 (95% CI, 1.04-9.93; P = .042)]. Health-related quality of life was independently explained by vital exhaustion, anxiety and either body mass index (physical dimension) or sex (emotional dimension). As psychological variables have a strong impact on health-related quality of life they should be routinely assessed in chronic heart failure patients` treatment.

Cultural and migration aspects in functional abdominal pain

Compared to Europe's mean immigrant contingent of 7.3 to 8.6 % Switzerland holds the highest contingent of foreign population with 23.5 %. Therefore it is of utmost importance that physicians have a knowledge of the specific characteristics of immigrant patients. The influence of personality factors (experience, behavior) is not independent from the influence of culturally-related environmental factors (regional differences in diet, pollutants, meanings, etc.). In addition, different cultural groups rate their quality of life differently. Psychological reasons for recurrent abdominal pain are stress (life events), effects of self-medication (laxatives, cocaine) and sexual abuse but also rare infectious diseases are more common among immigrants (e.g. tuberculosis, histoplasmosis, etc.). Migration-specific characteristics are mainly to find in the semiotics of the symptoms: not every abdominal pain is real pain in the abdomen. Finally, it is crucial to make the distinction between organic, functional and psychological-related pain. This can, however, usually only be accomplished in the context of the entire situation of a patient and, depending on the situation, with the support of a colleague from the appropriate cultural group or an experienced interpreter. In this review we limit ourselves to the presentation of the working population of the migrants, because these represent the largest group of all migrants. The specific situation of asylum seekers will also be refrained to where appropriate.

Psychological Interventions for Infertile Couples: Does Gender Matter?

Purpose: Gender-specific differences exist between male and female infertility patients' mental health, the meaning of infertility in their lives, and the coping strategies used. This systematic review examines whether gender-specific aspects are addressed in psychological intervention studies for infertility and whether infertile women and men benefit equally from such interventions. Methods: Databases were searched to identify relevant articles published between 1978 and 2007 (384 articles). The review included both controlled and uncontrolled psychological intervention studies examining results for infertile women and men separately. Outcome measures (depressive symptoms, anxiety, and mental distress) and gender-specific baseline characteristics (mental distress at pre-assessment, cause of infertility, and medical treatment) were collected. A total of twelve studies were finally included. Results: In 10 of 12 studies, women exhibited higher levels of mental distress than men. Gender-specific aspects were not addressed in the psychological interventions. Examining the efficacy of psychological interventions revealed that women exhibited stronger positive mental health effects in 2 of the 12 studies. Conclusion: Psychological distress before psychological treatment seems more pronounced in women than in men. Therefore psychological interventions for infertile couples should take gender-specific aspects into account. More research is needed to address the gender-specific aspects regarding psychological interventions for infertility.

Cannabis-induced depersonalization disorder in adolescence

We present a case series of 6 patients who developed persistent depersonalization disorder in adolescence after consuming cannabis. In 2 of these cases, the illness course was severely disabling. Within the growing body of literature that investigates the effects of cannabis use on mental health, the association between cannabis and depersonalization disorder is widely neglected. We review the clinical characteristics of this disorder and summarize the neurobiological evidence relating it to cannabis use. This case series extends awareness about the potentially detrimental effect of cannabis use in young individuals beyond its well-documented relationship with psychosis and other psychological sequelae.

Psychological Real Estate: Fractured Female Identity in the Victorian Novel

"Psychological Real Estate: Fractured Female Identity in the Victorian Novel" examines the use of domestic space in three Victorian novels, Charlotte Bronte's Jane Eyre (1847), Mary Elizabeth Braddon's Lady Audley's Secret (1862), and George Eliot's Middlemarch (1871-2). Because Victorian gender identity was conceived of in spatial terms, this thesis explores how the three female authors use complicated domestic environments to engage the problem of conventional Victorian femininity. In the Victorian mindset, a woman's place is confined to the home, or private sphere; however, even the private sphere is intruded upon by public spaces. Expected to conform to the Victorian formulation of femininity in public spaces within the home, women had only their private spaces to cultivate the unique, individualistic aspects of their selves. This thesis explores the ways in which the female protagonists negotiate these gender encoded spaces to argue that because Victorian women had to maintain separate and often disparate identities within domestic space, their identities became problematically fractured. Additionally, in each of these texts, the authors use the failure or loss of the estate, the structure which rigidly upholds the gendered binaries, to expose the harm such fracturing identity formulation caused for Victorian society as a whole. This thesis concludes by examining the final residences of the female characters and arguing that the authors use these final private spaces to assert more feminist re-envisionings of their society's construction of femininity.

Psychosocial aspects on the treatment of HIV-infection

Psychological and social factors have a deep impact on the treatment of HIV-infection, from the readiness to start antiretroviral therapy to treatment adherence over time. Among psychological factors, anxiety may affect HIV-infected persons in all stages of disease, from the disclosure of HIV diagnosis to the decision to start and maintain treatment. This is a lifelong challenge for both patients and doctors. Psychiatric comorbidities (depression, addiction) may enhance negative psychological effects of HIV. Among social factors, stigma and discrimination may occur in families and at work, leading to a loss of social support resulting in isolation and poverty. This may prevent HIV-positive individuals from seeking medical care. These aspects are particularly important in some groups of patients as injecting drug users and migrants. Acknowledgment and consideration of psychosocial factors are therefore essential for the long term success of antiretroviral therapy.

Psychosocial aspects in cardiac rehabilitation: From theory to practice. A position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation of the European Society of Cardiology

A large body of empirical research shows that psychosocial risk factors (PSRFs) such as low socio-economic status, social isolation, stress, type-D personality, depression and anxiety increase the risk of incident coronary heart disease (CHD) and also contribute to poorer health-related quality of life (HRQoL) and prognosis in patients with established CHD. PSRFs may also act as barriers to lifestyle changes and treatment adherence and may moderate the effects of cardiac rehabilitation (CR). Furthermore, there appears to be a bidirectional interaction between PSRFs and the cardiovascular system. Stress, anxiety and depression affect the cardiovascular system through immune, neuroendocrine and behavioural pathways. In turn, CHD and its associated treatments may lead to distress in patients, including anxiety and depression. In clinical practice, PSRFs can be assessed with single-item screening questions, standardised questionnaires, or structured clinical interviews. Psychotherapy and medication can be considered to alleviate any PSRF-related symptoms and to enhance HRQoL, but the evidence for a definite beneficial effect on cardiac endpoints is inconclusive. A multimodal behavioural intervention, integrating counselling for PSRFs and coping with illness should be included within comprehensive CR. Patients with clinically significant symptoms of distress should be referred for psychological counselling or psychologically focused interventions and/or psychopharmacological treatment. To conclude, the success of CR may critically depend on the interdependence of the body and mind and this interaction needs to be reflected through the assessment and management of PSRFs in line with robust scientific evidence, by trained staff, integrated within the core CR team.

The developmental and evolutionary origins of psychological essentialism lie in sortal object individuation

Cimpian & Salomon (C&S) present promising steps towards understanding the cognitive underpinnings of adult essentialism. However, their approach is less convincing regarding ontogenetic and evolutionary aspects. In contrast to C&S's claim, the so-called inherence heuristic, though perhaps vital in adult reasoning, seems an implausible candidate for the developmental and evolutionary foundations of psychological essentialism. A more plausible candidate is kind-based object individuation that already embodies essentialist modes of thinking and that is present in infants and nonhuman primates.

The Psychological Outcome of Religious Coping with Stressful Life Events in a Swiss Sample of Church Attendees

Background: Recent research suggested thatreligious coping, based on dispositional religiousness and spirituality (R/S), is an important modulating factor in the process of dealing with adversity. In contrast to the United States, the effect of R/S on psychological adjustment to stress is a widely unexplored area in Europe. Methods: We examined a Swiss sample of 328 church attendees in the aftermath of stressful life events to explore associations of positive or negative religious coping with the psychological outcome. Applying a cross-sectional design, we used Huber���s Centrality Scale to specify religiousness and Pargament���s measure of religious coping (RCOPE) for the assessment of positive and negative religious coping. Depressive symptoms and anxiety as outcome variables were examined by the Brief Symptom Inventory. The Stress-Related Growth Scale and the Marburg questionnaire for the assessment of well-being were used to assess positive outcome aspects. We conducted Mann-Whitney tests for group comparisons and cumulative logit analysis for the assessmentof associations of religious coping with our outcome variables. Results: Both forms of religious coping were positively associated with stress-related growth (p < 0.01). However, negative religious coping additionally reduced well-being (p = 0.05, �� = 0.52, 95% CI = 0.27���0.99) and increased anxiety (p = 0.02, �� = 1.94, 95% CI = 1.10���3.39) and depressive symptoms (p = 0.01, �� = 2.27, 95% CI = 1.27���4.06). Conclusions: The effects of religious coping on the psychological adjustment to stressful life events seem relevant. These findings should be confirmed in prospective studies.

Intelligence and the psychological refractory period: A lateralized readiness potential study

The psychological refractory period (PRP) refers to a delay of response times (RT) to the second of two stimuli when these stimuli are presented in rapid succession. If this limitation of rapidly processing the second stimulus contributes to the well-known differences in speed of information processing between individuals with higher and lower mental ability, individuals with lower mental ability should exhibit a more pronounced PRP effect than individuals with higher mental ability. Previous studies on this question, however, yielded inconsistent results. In the present study, we assessed mental ability-related differences in the PRP by measuring lateralized readiness potentials (LRPs) to separate premotor and motor aspects of speed of information processing in 95 individuals with higher and 95 individuals with lower mental ability. Although individuals with higher mental ability processed information faster than individuals with lower mental ability as indicated by shorter RTs and shorter premotor LRP latencies, the PRP effect was equally pronounced in both groups. These findings suggest that the processes underlying the PRP effect do not contribute to mental ability-related differences in speed of information processing. Rather, these differences seem to occur at an earlier stage of information processing such as stimulus encoding, stimulus analysis, or stimulus evaluation.

Differential effects of biological sex and relationship status on aspects of sociosexuality

Individuals differ in their orientation toward uncommitted sexual encounters. While previous research has given much emphasis on biological sex as important factor of influence, social determinants, such as relationship status, have been rather ignored. In the present study, the effects of biological sex and relationship status were investigated in a sample of 501 heterosexual adults (mean age: 28.1 years; 71.7 % female). Two-way analyses of variance yielded main effects of biological sex on Sociosexual Attitude and Desire implying men to be more permissive than women with regard to both facets. Relationship status had a main effect on Sociosexual Desire with singles having more permissive motivations than partnered individuals. Concerning Sociosexual Behavior, an interaction between biological sex and relationship status emerged indicating men to be more permissive than women among partnered individuals, but not among singles. Our results complement earlier research by highlighting the differential influence of biological sex and relationship status on aspects of sociosexuality.

Riesgo del consumo de cannabis para la pr��ctica f��sico-deportiva

El consumo de cannabis es uno de los principales problemas de salud p��blica, especialmente entre los j��venes, dadas sus prevalencias de consumo. Esta droga puede provocar alteraciones psicomotrices en el individuo, por ello, el presente trabajo de investigaci��n tiene como objetivo principal comprobar si el consumo de cannabis supone un riesgo a��adido a la pr��ctica f��sico-deportiva. Para alcanzar dicho objetivo, se dividi�� el trabajo en dos estudios interrelacionados entre s��. En el primer estudio o Estudio 1, ���Repercusi��n del consumo de cannabis en las clases de Educaci��n F��sica���, se realiz�� un cuestionario autoadministrado, dirigido al profesorado de Educaci��n F��sica de la Comunidad de Madrid, con el fin de recoger su opini��n sobre la posible presencia de consumidores de cannabis en sus aulas. El segundo estudio o Estudio 2, ���Influencia del cannabis en el equilibrio, la coordinaci��n, el tiempo de respuesta y la percepci��n temporal���, consisti�� en la realizaci��n de una serie de pruebas por parte de un grupo control y un grupo de consumidores de cannabis, para as�� cuantificar y cualificar los efectos de la inhalaci��n de esta droga en la condici��n motriz. La encuesta que se utiliz�� para el Estudio 1, ���El cannabis, los adolescentes y la pr��ctica f��sico-deportiva���, pas�� primero por una fase de elaboraci��n, correcci��n y validaci��n, y despu��s, utiliz��ndose la t��cnica de muestreo aleatorio por conglomerados, fue distribuido por los centros p��blicos de ense��anzas secundarias de la Comunidad de Madrid seleccionados. Se obtuvo respuesta de 93 profesores de Educaci��n F��sica pertenecientes a 76 centros, es decir el 22,35% de los centros de la comunidad. Por ��ltimo, se procedi�� al an��lisis, discusi��n y difusi��n de los resultados. En el Estudio 2, primero se procedi�� al dise��o de la bater��a de pruebas a realizar, compuesta por 7 tests con 16 variables que valoraron el equilibrio, la coordinaci��n, el tiempo de respuesta y la percepci��n temporal de los sujetos. Despu��s se procedi�� a la selecci��n de la muestra, formada por dos grupos de voluntarios de entre 18 y 30 a��os: un grupo control de 52 participantes, y un grupo de consumidores de cannabis, de 28 participantes con un h��bito de consumo diferente. Los sujetos del grupo de consumidores realizaron las pruebas 20 minutos despu��s de la inhalaci��n de cannabis. Tras la realizaci��n de las pruebas por parte de todos los sujetos se procedi�� al an��lisis de los resultados obtenidos, segment��ndolos por sexo y apareando las variables para evitar posibles efectos confundidores. Los resultados del primer estudio indicaron que el 75,27% del profesorado ha pensado alguna vez que sus alumnos consum��an cannabis antes del inicio de su clase, hecho asociado a alteraciones psicol��gicas (90,63%) y cognitivo-conductuales (68,75%); no siendo factores influyentes el sexo o la experiencia docente de los encuestados (p>0,05). El segundo estudio aport�� como principal resultado el empeoramiento de la percepci��n temporal y la conducta motriz de los sujetos que consumieron cannabis, en especial de su equilibrio y su coordinaci��n (p<0,05). Tambi��n indic�� que hubo ligeras diferencias en funci��n del h��bito de consumo de esta droga, si bien los resultados se vieron influenciados por el tama��o de la muestra. Las conclusiones extra��das mostraron que el profesorado de Educaci��n F��sica percibe la presencia de consumidores de cannabis en sus aulas, utiliza el di��logo con el alumnado como herramienta de actuaci��n, y conoce la influencia negativa que tiene el consumo de esta droga en el rendimiento motor. Tambi��n demuestran que el cannabis supone un riesgo a��adido a la pr��ctica f��sico-deportiva, debido al empeoramiento de la conducta motriz, en especial de la coordinaci��n y el equilibrio. Adem��s, las diferencias surgidas en base al h��bito de consumo no son concluyentes pero si apuntan a que el consumo espor��dico puede conllevar un peor rendimiento motor que el consumo habitual. ABSTRACT Cannabis use is one of the most important concerns of public health, particularly among young people, given their use prevalence. This drug can produce psychomotor alterations in the subject; therefore, this research work has as main aim to check if cannabis use is an added risk for physical and sporting practices. In order to achieve the objectives pursued, work was divided in two interrelated studies. First study or Study 1, ���Cannabis use impact in Physical Education lessons���, a self-managed questionnaire addressed to Physical Education teachers in Community of Madrid was carried out, in order to gather the opinion about the possible existence of Cannabis users in their classes. Second Study or Study 2, ���Cannabis influence in balance, coordination, reaction time and temporal perception���, consisted in a series of tests performed by a control group and a cannabis users group, in order to quantify and qualify the effects of inhalation of this drug in the motor skills. The questionnaire used for Study 1, ���Cannabis, teenagers, and physical and sporting practices���, firstly went through an elaboration y correction phase, and then, using cluster sampling technique, was distributed within selected Secondary Education Centres from Community of Madrid. Response from 93 Physical Education teachers from 76 High Schools were obtained, this is 22,35% of total High Schools in Madrid. Finally, analysis, discussion and dissemination of results were held. In Study 2, first of all design of tests to be made was done, consisting on 7 different test with 16 variables that measured balance, coordination, response time and temporal perception in subjects. After that, sample selection was performed, comprised of 2 volunteers groups of ages between 18-30 years: a control group of 52 participants, and a Cannabis Users Group of 28 participants with different consumption habits. Users group subjects carried out tests 20 minutes after cannabis inhalation. After tests were performed by all subjects, results were analyzed and segmented by sex and matching variables in order to avoid confusion effects. First study results brought out that 75,27% of teachers have ever thought that their pupils used cannabis before getting into class, this fact is linked to psychological alterations (90,63%) and cognitive-behavioral (68,75%); not being influencing factors sex or teaching experience of the surveyed (p>0,05). Second study provided as most significant result the worsening of temporal perception and motor tasks behavior in subjects that had used cannabis, especially in regards of their balance and coordination (p<0,05). Also resulted that there were slight differences in consumption habits, although results were influenced by the sample size. Conclusions drawn showed that Physical Education teachers notice the presence of cannabis users in lessons, use dialogue with pupils as an action tool and acknowledge the negative influence this drug has in motor tasks performance. Also, it is shown that cannabis is an additional risk for physical and sporting practices due to deteriorating in motor skills, particularly in coordination and balance. In addition, the differences that may arise depending on the consumption habits are not conclusive, but they suggest that the sporadic drug use may be related to a worse motor performance than usual consumption.

Consequences of adolescent's evening preference on psychological functioning: a review

This review provides an overview of the role of circadian preference in psychological functioning of adolescents taking into account their shift to eveningness during this stage of life. After a brief explanation about morningness/eveningness and other terms related, an overview of the changes that occur on three of the most important areas in the adolescent���s life is presented: school performance, personality styles, and health. Consequences of evening preference on school achievement are considered from the analysis of the relevance of sleep debt and time-of-day in cognition and mood aspects. In general, students who are able to choose activity times coinciding with their preferred times may have a greater opportunity to optimize their performance. The personality styles and health of morning and evening types are also important factors related to school and family adaptation. At last, some recommendations and conclusions in order to promote a healthy psychological functioning are described.