INSPIRE study: does stress management improve the course of inflammatory bowel disease and disease-specific quality of life in distressed patients with ulcerative colitis or Crohn's disease? A randomized controlled trial.

Background: The use of stress management psychotherapy is hypothesized to produce greater improvement in disease course and disease-specific quality of life (IBDQ) compared to usual medical care alone in patients with ulcerative colitis (UC) or Crohn's disease (CD) showing high levels of stress (based on the Perceived Stress Questionnaire [PSQ]).

Methods: Fifty-eight patients with UC and 56 patients with CD who had experienced continuous disease activity or had relapsed over the previous 18 months, with an activity index for UC or CD ≥ 4, a PSQ ≥ 60, and without serious psychiatric disorders or other serious medical conditions were randomized to receive either treatment as usual (TAU) or TAU plus stress management psychotherapy. Psychotherapy consisted of three group sessions (psychoeducation, problem-solving, relaxation) and 6-9 individual sessions based on cognitive behavior therapy-related methods with 1-3 booster sessions at 6 and 12 months follow-up.

Rectal visceral sensitivity in women with irritable bowel syndrome without psychiatric comorbidity compared with healthy volunteers.

Background: Psychiatric comorbidity and visceral hypersensitivity are common in patients with irritable bowel syndrome (IBS), but little is known about visceral sensitivity in IBS patients without psychiatric disorders.

Aim: We wanted to examine rectal visceral sensitivity in IBS patients without comorbid psychiatric disorders, IBS patients with phobic anxiety and healthy volunteers.

Methods: A total of thirty-eight female, non-constipated IBS patients without psychiatric disorders and eleven female IBS patients with phobic anxiety were compared to nine healthy women using a barostat double random staircase method.

The INSPIRE study: do personality traits predict general quality of life (Short form-36) in distressed patients with ulcerative colitis and Crohn's disease?

Objective: To assess the role of personality as a predictor of Short form-36 (SF-36) in distressed patients (perceived stress questionnaire, PSQ) with ulcerative colitis (UC) and Crohn's disease (CD).

Material And Methods: Fifty-four patients with CD and 55 with UC (age 18-60 years) who had relapsed in the previous 18 months, i.e.

The INSPIRE study: are different personality traits related to disease-specific quality of life (IBDQ) in distressed patients with ulcerative colitis and Crohn's disease?

Background: To explore the relationship between personality and disease-specific quality of life [Inflammatory Bowel Disease Questionnaire (IBDQ)] in distressed [Perceived Stress Questionnaire (PSQ)] patients with ulcerative colitis (UC) and Crohn's disease (CD).

Methods: Included in the study were 56 patients with UC and 54 patients with CD ranging in age from 18 to 60 years with a relapse in the previous 18 months, a UC or CD activity index 4, a PSQ 60, and without serious mental or other serious medical condition. The patients completed the Buss-Perry Aggression Questionnaire, the Neuroticism and Lie (social conformity/desirability) scales of the Eysenck Personality Questionnaire, the Multidimensional Health Locus of Control (LOC) Scale [Internal (I), Powerful Other (PO), Chance (C)], the Toronto Alexithymia Scale, and the IBDQ.

Autonomic function at rest and in response to emotional and rectal stimuli in women with irritable bowel syndrome.

Our aim was to study autonomic function in patients with Irritable bowel syndrome (IBS) without constipation and psychiatric comorbidity. Respiratory sinus arrhythmia (RSA) (representing cardiac vagal activity), skin conductance (representing sympathetic activity) and heart rate were measured at baseline and as a response to emotional stress and rectal discomfort in 33 women with IBS and 21 healthy women. Baseline heart rate was higher in the patients than in the healthy volunteers.

Visceral sensitivity in irritable bowel syndrome and healthy volunteers: reproducibility of the rectal barostat.

The reproducibility of rectal visceral sensitivity using the barostat double-random staircase method was evaluated. We tested 15 healthy women and 18 women with irritable bowel syndrome twice. Pressure, volume, and tension were measured at first sensation of gas, stool, and discomfort.

Exposure therapy and sertraline in social phobia: I-year follow-up of a randomised controlled trial.

Background: Maintenance of treatment effect is important for the choice of treatment for social phobia.

Aims: To examine the effect of exposure therapy and sertraline 28 weeks after cessation of medical treatment.

Method: In this study 375 patients with social phobia were randomised to treatment with sertraline or placebo for 24 weeks, with or without the addition of exposure therapy.

[Functional somatic diseases--a review].

Functional somatic illness is a clinical concept used to define medically unexplained somatic symptoms considered to express psychological distress. Functional somatic illness may express underlying psychiatric disorders (e.g.

[Chronic pelvic pain in women].

Background: This paper reviews empirical and clinical evidence of the aetiology and treatment of medically unexplained chronic pelvic pain in women.

Material And Methods: Clinical experience from an ongoing randomised treatment trial supplemented by computer-assisted reviews of studies obtained by a Premedline and Medline search (1996 to February 2002) and data from the Cochrane Database of Systematic Reviews and the EBM database of Abstracts of Reviews of Effectiveness.

Results: The aetiology of medically unexplained chronic pelvic pain is disputed but likely to be multifactorial.

[Irritable bowel syndrome--a multifactorial disease in children and adults].

Irritable bowel syndrome is the most frequent gastrointestinal disorder in Norway. Though there has been huge research activity in the field, no proven single aetiology or effective treatment has emerged. Consensus-based clinical diagnostic criteria have not yet brought diagnostic clarity.

Continued symptomatic improvement three to five years after transmyocardial revascularization with CO(2) laser: a late clinical follow-up of the Norwegian Randomized trial with transmyocardial revascularization.

Objectives: The goals of this study were to assess late clinical outcome and left ventricular ejection fraction (LVEF) after transmyocardial revascularization with CO(2) laser (TMR).

Background: During the 1990s TMR emerged as a treatment option for patients with refractory angina not eligible for conventional revascularization. Few reports exist on clinical effects and LVEF >3 years after TMR.

Psychiatric comorbidity and hostility in patients with psychogenic nonepileptic seizures compared with somatoform disorders and healthy controls.

Purpose: To investigate the prevalence of psychiatric comorbidity and level of anxiety, depression, and aggression in patients with psychogenic nonepileptic seizures compared with those in patients with somatoform disorders and healthy controls.

Methods: Twenty-three patients with psychogenic nonepileptic seizures (PNESs) and 23 age- and sex-matched patients with somatoform disorders (SDs) underwent a clinical and a semistructured psychiatric interview (MINI) and filled in the Hospital Anxiety and Depression scale (HAD) and the Aggression Questionnaire (AQ). Twenty-three sex- and age-matched controls without psychopathology also underwent a clinical interview and completed the HAD and AQ.

Phobic anxiety changes the function of brain-gut axis in irritable bowel syndrome.

Objective: Disease severity in the irritable bowel syndrome (IBS) is highly influenced by psychiatric comorbidity. The mechanism of this influence is generally unknown, even if the brain-gut axis seems to be involved. Recent research has indicated that IBS patients have aberrant perception of visceral stimuli in the CNS.

Randomised controlled general practice trial of sertraline, exposure therapy and combined treatment in generalised social phobia.

Background: No controlled trial of treatment of generalised social phobia has been conducted in general practice.

Aims: To examine the efficacy of sertraline or exposure therapy, administered alone or in combination in this setting.

Method: Study was of a randomised, double-blind design.

Perceptual hyperreactivity to auditory stimuli in patients with irritable bowel syndrome.

Background: Patients with irritable bowel syndrome (IBS) have abnormal perception of visceral stimuli; however, no study has so far investigated the perception of non-visceral stimuli in IBS. In the present study we used event-related potentials (ERP) to study whether IBS patients differed from healthy controls in processing of auditory stimuli and, if so, how this was influenced by emotions.

Methods: We compared ERPs to auditory stimuli in 40 female diarrhoea-predominant IBS patients without current psychiatric illness with those in 20 healthy controls.

Intestinal reactivity to words with emotional content and brain information processing in irritable bowel syndrome.

The intestinal reactivity to emotional experiences is poorly understood. We therefore compared healthy controls with nonpsychiatric irritable bowel syndrome (IBS) patients and IBS patients with comorbid phobic anxiety disorders with respect to rectal wall reactivity during exposure to everyday words with emotional content. We found that 70.

Rectal tone and brain information processing in irritable bowel syndrome.

We studied differences in rectal tone between healthy controls, nonpsychiatric irritable bowel syndrome (IBS) patients, and IBS patients with comorbid phobic anxiety disorders to assess the impact of psychiatric comorbidity on rectal tone. The groups were additionally compared with respect to brain information processing of everyday words with emotional content to see if we could identify an association between perception of emotional material in the brain and rectal tone. We found that both nonpsychiatric IBS patients and IBS patients with phobic anxiety disorder had increased baseline rectal tone compared with healthy controls (F = 9.

The treatment of social phobia in general practice. is exposure therapy feasible?

Background: Exposure therapy is an effective treatment for generalized social phobia. Most patients with social phobia are treated in primary care, but family doctors are not usually trained to perform exposure therapy. We have conducted a study in primary care of the effect of exposure therapy alone or in combination with sertraline on generalized social phobia.

The psychologic effect of attending a screening program for colorectal polyps.

Background: Participation in screening programs for malignant disease may have negative psychologic health effects that could outweigh the beneficial effects of the screening itself. The present study was designed to investigate the psychologic effect of attending a screening program for detection and removal of colorectal adenomas, which are precursors to colorectal cancer.

Method: In 1983 a prospective.

Event-related potentials to stimuli with emotional impact in posttraumatic stress patients.

Background: Psychophysiological research has given conflicting results with respect to whether the abnormal physiologic responses observed in posttraumatic stress disorder (PTSD) reflect a general abnormality or are linked to trauma-related stimuli. We studied differences in the central nervous processing of words with emotional impact in survivors after a ship fire disaster.

Methods: Event-related potentials were studied in 11 survivors with posttraumatic stress pathology, and compared with 9 survivors without such pathology.

[The impact of psychological factors on the treatment of somatic diseases. The situation today, as exemplified by cardiovascular disorders and cancer].

Prospective intervention studies have shown that cognitive-behavioral interventions can improve morbidity and mortality both in cancer and in circulatory disorders. Research in fields like molecular biology, psychoneuroendocrinology and psychoneuroimmunology has identified some of the links between emotions and biological reactions. The paper reviews the situation today and concludes that psychobiologically based interventions may make important contributions to somatic medicine.

[Psychosocial aspects in presymptomatic testing for genetic diseases. Experiences after 2 years of counseling in Huntington disease].

The authors describe their experience from the psychiatric assessment and psychosocial counselling of 28 persons who sought presymptomatic testing for Huntington's chorea. Half of the persons had lived with a disease-affected parent during childhood and early adolescence. Nine of these persons had suffered from a psychiatric disorder at least once.

Can prediction of violence among psychiatric inpatients be improved?

In an effort to improve the prediction of violence among psychiatric inpatients, the authors retrospectively studied 25 patients who were violent and 34 who were not violent after admission to a psychiatric emergency ward in Norway. The only demographic variable that discriminated between the two groups was violence in the family of origin; the violent group had experienced significantly more. The best single predictor of violence was a history of previous violence by the patient, which correctly classified 80 percent of the patients.