Dissociative symptoms in relation to childhood physical and sexual abuse

Article Abstract:

There is a clearly demonstrated relationship between psychiatric disorders and early trauma, specifically, physical and sexual abuse in childhood. Furthermore, the development of dissociative disorders has been associated with prior trauma. The dissociative defense develops as a psychological escape and later often gives rise to a constellation of other symptoms. It is proposed that there is a greater prevalence of dissociative symptoms among adult female psychiatric inpatients who were abused in childhood than among similar patients who were not abused. Ninety-eight women between the ages of 18 and 60 years old who were admitted to a psychiatric unit were evaluated. The women were predominantly middle-class and white. Self-report instruments were used which focused on history of trauma, dissociative symptoms, and other previous psychiatric problems. A majority of the group, 63 percent, reported either physical and/or sexual abuse in childhood. Twenty-three patients reported both physical and sexual abuse; 27 reported physical abuse only; and 12 reported sexual abuse only. Dissociative symptom scores which exceeded the average for normal adults were found in 83 percent of the subjects. Twenty-four percent of the subjects also had scores which exceeded the average score of patients with post-traumatic stress disorder. These results confirm previous studies that have associated childhood physical and sexual abuse with the development of psychiatric disorders, which constitutes a major public health problem. It is concluded that the prevalence of dissociative symptoms has been underestimated, and more attention should be focused upon screening for these symptoms. As many times these episodes of childhood abuse are denied or concealed, the therapist must explore the possibility of this type of history in patients with appropriate symptoms. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Causes of, Dissociation (Psychology), Dissociative disorders, Adult child abuse victims, Adult child sexual abuse victims

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Effects of doxepin on withdrawal symptoms in smoking cessation

Article Abstract:

The efficacy of doxepin, a tricyclic antidepressant, for the relief of nicotine withdrawal symptoms in individuals who have stopped smoking was evaluated. Fifteen smokers who were considered healthy, were over 18, had previously been unsuccessful in stopping smoking, and who did not have psychiatric symptoms, participated in the study. Each subject made a $135 deposit that was refundable if they kept the scheduled appointments and stopped smoking for a week. The participants were randomly assigned to take doxepin or a placebo for a period of 21 days, while continuing to smoke. After this baseline period, on day 22, the subjects were instructed to stop smoking for one week. During this period, self-reports of 10 withdrawal symptoms were obtained. The medication regimen of either doxepin or placebo was continued throughout the two time periods. When data were analyzed, during the cessation period, the subjects who received doxepin reported significantly less craving for cigarettes than the placebo group. Prior to the cessation period, the subjects receiving doxepin reported more symptoms of increased appetite. Over the entire study period, the most significantly increased symptom was elevated levels of anxiety, which occurred in both groups. The small size of the study group is noted, and the authors recommend replication with larger samples. However, these results indicate that doxepin may be useful in alleviating the withdrawal symptoms associated with smoking cessation. The data also supports previous studies that have indicated that antidepressants reduce symptoms during withdrawal from addictive substances. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Prevention, Smokers, Smoking, Tobacco, Drug withdrawal symptoms, Substance withdrawal syndrome, Doxepin

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Symptoms and treatment responses of generalized anxiety disorder patients with high versus low levels of cardiovascular complaints

Article Abstract:

Patients who were diagnosed with general anxiety disorder and who also complained of cardiovascular symptoms were divided into two groups, one with 28 patients indicating high levels of cardiovascular complaint and another with 32 individuals reporting low levels of cardiovascular complaint. Prior research suggesting that a wide range of symptoms occurs in patients with generalized anxiety disorder was corroborated. Manifestations of persistent anxieties may be classified as psychic (mental) or somatic (physical). Measurements showed no significant difference between the two groups on the psychic rating, but the groups did exhibit some differences when measured somatically. A correlation was observed between the patients who reported higher levels of cardiac symptoms and higher degrees of actual cardiac instability. This group also required a higher dosages of alprazolam, a commonly prescribed tranquilizer, suggesting that within a given population of patients suffering from generalized anxiety disorder with comparable psychic anxiety levels, a range of physical symptoms may be experienced. Further study of generalized anxiety disorder was recommended to improve the understanding of the diversity of and the possible relationships between the wide range of mental and physical statuses of these patients.

Anxiety, Chest pain, Symptomatology, Signs and symptoms

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