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Emotional processing deficits and happiness : assessing the measurement, correlates, and well-being of people with alexithymia
\"This briefs reviews the literature on alexithymia with a particular focus on the relation between positive well-being and alexithymia. It starts by exploring the definition, history and etiology of the construct. The briefs then discusses the importance of research and presents new research which sheds light on why alexithymia is characterized by poor well-being. The research strongly suggests that people who score high in alexithymia are low in aspects of positive well-being such as happiness, life satisfaction, and positive affect, and high in aspects of negative well-being, such as depression and negative affect. Next, the book examines the correlates of alexithymia and the latter's relation with personality and subjective well-being. Although there has been an increased interest in human flourishing, and even though research in positive psychology has included personality, there has been little application of positive psychology to people with deficits in emotional processing including people with alexithymia. This briefs fills that gap\"-- From publisher's website.
Book
B3 agonists or anticholinergics in the treatment of the lower urinary tract dysfunction in patients with multiple sclerosis?—A randomized study
Introduction and objectiveMultiple sclerosis (MS) is the most frequent autoimmune demyelinating disease of the central nervous system. MS patients usually present with lower urinary tract dysfunction (LUTD). Objective of this study is to evaluate and compare the efficacy and safety of treating MS patients with LUTD with either a b3 agonist (mirabegron) or anticholinergics. The study’s primary outcome is the LUTD symptom improvement. Material and MethodsThis is a multi-center, single-blinded, comparative study including 91 MS patients with LUTD. At baseline, patients underwent thorough clinical examination, urine cultivation and abdominal ultrasound and completed urination diaries and specific, validated questionnaires (NBSS, MusiQoL). At second visit, patients were administered either mirabegron or anticholinergics. Treatment was always carried out alongside with MS treatment. Reevaluation was performed 3 months after first visit. Patients underwent the same clinical and imaging tests that were carried out at first visit.ResultsWe compared several clinical and imaging parameters between the two groups at first visit and month 3 after treatment. Νo statistical difference was noted between the mirabegron group and the anticholinergic group in terms of LUTD improvement. In both groups, improvement from baseline regarding LUTD was recorded. Statistical analysis was performed using the paired and unpaired t test method. No patient discontinued either medication due to side effects.ConclusionsMS patients receiving either mirabegron or anticholinergic therapy for LUTD showed improvement. Nevertheless, no statistical difference was noted between the two cohorts at 3 months in terms of drug efficacy in all the statistically significant parameters.
Journal Article
Vomit!
\"This book looks at the how and why of vomit, taking readers through the reasons people spew and what to do when it feels like they need to hurl\"--Amazon.com.
Book
Efficacy of Pennebaker’s expressive writing intervention in reducing psychiatric symptoms among patients with first-time cancer diagnosis: a randomized clinical trial
PurposeThe aim of this randomized clinical trial was to examine the efficacy of Pennebaker’s expressive writing intervention (EWI) in improving the perceived quality of life (QoL) and in reducing psychiatric symptoms among patients who received a cancer diagnosis.MethodsSeventy-one consecutively recruited patients who received a cancer diagnosis for the first time in their life were randomized into two groups: an EWI group (EWG: n = 35) and a control group (CG n = 36). At the baseline, anamnestic information was collected for all patients, and the patients completed a series of self-reported measures assessing psychiatric symptoms, alexithymia, and health-related QoL. A modified Pennebaker’s EWI adapted to cancer diagnosis was also administered to the EWG. Six months later, 32 patients (EWG: n = 17, CG: n = 15) participated in the follow-up and filled out the same questionnaires.ResultsThe Pennebaker’s EWI was effective in decreasing global psychopathology (d = -.55). Small but significant effects were also observed for alexithymia levels and health-related QoL, with the EWG showing a reduction in alexithymia levels (d = -.31) and an increase in the mental component of QoL (d = .31) compared to the CG.ConclusionsOur findings indicate that the Pennebaker’s EWI is effective in reducing the negative impact of cancer diagnosis on patients’ mental health.
Journal Article
Transurethral Resection of the Prostate (TURP) Versus Original and PErFecTED Prostate Artery Embolization (PAE) Due to Benign Prostatic Hyperplasia (BPH): Preliminary Results of a Single Center, Prospective, Urodynamic-Controlled Analysis
Purpose
To compare clinical and urodynamic results of transurethral resection of the prostate (TURP) to original and PErFecTED prostate artery embolization (PAE) methods for benign prostatic hyperplasia.
Methods
We prospectively randomized 30 patients to receive TURP or original PAE (oPAE) and compared them to a cohort of patients treated by PErFecTED PAE, with a minimum of 1-year follow-up. Patients were assessed for urodynamic parameters, prostate volume, international prostate symptom score (IPSS), and quality of life (QoL).
Results
All groups were comparable for all pre-treatment parameters except bladder contractility and peak urine flow rate (
Q
max
), both of which were significantly better in the TURP group, and IIEF score, which was significantly higher among PErFecTED PAE patients than TURP patients. All groups experienced significant improvement in IPSS, QoL, prostate volume, and
Q
max
. TURP and PErFecTED PAE both resulted in significantly lower IPSS than oPAE but were not significantly different from one another. TURP resulted in significantly higher
Q
max
and significantly smaller prostate volume than either original or PErFecTED PAE but required spinal anesthesia and hospitalization. Two patients in the oPAE group with hypocontractile bladders experienced recurrence of symptoms and were treated with TURP. In the TURP group, urinary incontinence occurred in 4/15 patients (26.7 %), rupture of the prostatic capsule in 1/15 (6.7 %), retrograde ejaculation in all patients (100 %), and one patient was readmitted for temporary bladder irrigation due to hematuria.
Conclusions
TURP and PAE are both safe and effective treatments. TURP and PErFecTED PAE yield similar symptom improvement, but TURP is associated with both better urodynamic results and more adverse events.
Journal Article
Longitudinal symptomatic interactions in long-standing schizophrenia: a novel five-point analysis based on directed acyclic graphs
Recent network models propose that mutual interaction between symptoms has an important bearing on the onset of schizophrenic disorder. In particular, cross-sectional studies suggest that affective symptoms may influence the emergence of psychotic symptoms. However, longitudinal analysis offers a more compelling test for causation: the European Schizophrenia Cohort (EuroSC) provides data suitable for this purpose. We predicted that the persistence of psychotic symptoms would be driven by the continuing presence of affective disturbance.
EuroSC included 1208 patients randomly sampled from outpatient services in France, Germany and the UK. Initial measures of psychotic and affective symptoms were repeated four times at 6-month intervals, thereby furnishing five time-points. To examine interactions between symptoms both within and between time-slices, we adopted a novel technique for modelling longitudinal data in psychiatry. This was a form of Bayesian network analysis that involved learning dynamic directed acyclic graphs (DAGs).
Our DAG analysis suggests that the main drivers of symptoms in this long-term sample were delusions and paranoid thinking. These led to affective disturbance, not vice versa as we initially predicted. The enduring relationship between symptoms was unaffected by whether patients were receiving first- or second-generation antipsychotic medication.
In this cohort of people with chronic schizophrenia treated with medication, symptoms were essentially stable over long periods. However, affective symptoms appeared driven by the persistence of delusions and persecutory thinking, a finding not previously reported. Although our findings as ever remain hostage to unmeasured confounders, these enduring psychotic symptoms might nevertheless be appropriate candidates for directly targeted psychological interventions.
Journal Article
Randomised controlled trial to investigate the effectiveness of the symptom management after radiotherapy (SMaRT) group intervention to ameliorate lower urinary tract symptoms in men treated for prostate cancer
Purpose
To evaluate the effectiveness of the symptom management after radiotherapy (SMaRT) group intervention to improve urinary symptoms in men with prostate cancer.
Methods
The randomised controlled trial (RCT) recruited men from one radiotherapy centre in the UK after curative radiotherapy or brachytherapy and with moderate to severe urinary symptoms defined as scores ≥ 8 on the International Prostate Symptom Score (IPSS) questionnaire. Sixty-three men were randomised either; to SMaRT, a 10-week symptom-management intervention including group support, education, pelvic floor muscle exercises, or a care-as-usual group. The primary outcome was the IPSS at 6 months from baseline assessment. Secondary outcomes were IPSS at 3 months, and International Continence Society Male Short Form (ICS), European Organisation for Research and Treatment of Cancer Quality of Life prostate scale (EORTC QLQ-PR25), EORTC QLQ-30 and Self-Efficacy for Symptom Control Inventory (SESCI) at 3 and 6 months from baseline. Analysis of covariance (ANCOVA) was used to analyse the effect of the intervention.
Results
SMaRT group intervention did not improve urinary symptoms as measured by IPSS at 6-months. The adjusted difference was − 2.5 [95%CI − 5.0 to 0.0],
p
= 0.054. Significant differences were detected at 3 months in ICS voiding symptoms (− 1.1 [− 2.0 to − 0.2],
p
= 0.017), ICS urinary incontinence (− 1.0 [− 1.8 to − 0.1],
p
= 0.029) and SESCI managing symptoms domain (13.5 [2.5 to 24.4],
p
= 0.017). No differences were observed at 6 months.
Conclusions
SMaRT group intervention provided short-term benefit in urinary voiding and continence and helped men manage symptoms but was not effective long term.
Journal Article