[Comparative study of the frequency and features of emotional disturbances in patients in primary care clinics].

Background: Psychological problems are a frequent cause of consultation in primary care outpatient clinics.

Aim: To report the results for Santiago de Chile of the World Health Organisation multicentric collaborative study on Psychological Symptoms in General Health Care.

Patients And Methods: The results of 1453 patients that attended three primary care clinics in East Metropolitan Santiago were compared with those of patients studied in 15 other centers throughout the world.

Posttraumatic stress disorder following an air disaster: a prospective study.

Objective: The purpose of this study was to determine predictors of posttraumatic stress disorder (PTSD) in health care workers exposed to a disaster, in order to facilitate early case identification and prevention of subsequent morbidity.

Method: Following an air disaster, 355 military medical health care workers were studied over an 18-month follow-up period. Measures included assessment of peritraumatic reactions associated with the disaster, the frequency of other stressful events after the disaster, and standard PTSD rating scales at 6, 12, and 18 months.

Measurement of cell proliferation by labeling of DNA with stable isotope-labeled glucose: studies in vitro, in animals, and in humans.

A method for measuring DNA synthesis and, thus, cell proliferation, in vivo is presented. The technique consists of administering [6,6-2H2]Glc or [U-13C]Glc, isolating genomic DNA, hydrolyzing enzymatically to free deoxyribonucleosides, and derivatizing for GC-MS analysis of dA or dG isotopic enrichments, or both. Comparison of dA or dG to extracellular Glc enrichment (with a correction for intracellular dilution) reveals the fraction of newly synthesized DNA, by application of the precursor-product relationship.

The threat of biological weapons. Prophylaxis and mitigation of psychological and social consequences.

The microbial world is mysterious, threatening, and frightening to most people. The stressors associated with a biological terrorist attack could create high numbers of acute and potentially chronic psychiatric casualties who must be recognized, diagnosed, and treated to facilitate triage and medical care. Media communications, planning for quarantine and decontamination, and the role of community leaders are important to the mitigation of psychological consequences.

Acute and chronic distress and posttraumatic stress disorder as a function of responsibility for serious motor vehicle accidents.

In this study on the effects of attributions of responsibility for traumatic events, stress, coping, and symptoms of posttraumatic stress disorder (PTSD) were measured, including intrusive thoughts among 130 victims of serious motor vehicle accidents (MVAs) 14-21 days and 3, 6, and 12 months after their accident. MVA victims and 43 control participants were categorized by accident and attribution of responsibility for their accidents (self-responsible, other-responsible, and control). Although initially all MVA victims reported higher levels of intrusive thoughts and were more likely to meet criteria for PTSD diagnoses, only other-responsible participants continued to demonstrate increased distress 6 and 12 months postaccident.

Psychiatric morbidity in medical and surgical patients evacuated from the Persian Gulf War.

Acute treatment records of all medical and surgical patients evacuated to Walter Reed Army Medical Center in Washington, D.C., from the Persian Gulf theater (N = 161) were examined to better understand the relationship of injury to psychiatric symptoms.

Posttraumatic stress symptoms following forensic dental identification: Mt. Carmel, Waco, Texas.

Objective: This study was conducted to determine risk factors for posttraumatic stress in medical care professionals who perform postmortem identifications.

Method: Thirty-one dentists (29 men and two women) who had identified the dead from the fire at the Branch Davidian compound in April 1993 were compared to 47 dentists (45 men and two women) who lived in the area but had not identified any of these remains. Posttraumatic symptoms in both groups were measured by using the Impact of Event Scale and the Brief Symptom Inventory.

Acute stress disorder, subsequent posttraumatic stress disorder and depression after a series of typhoons.

From August to November 1992, five typhoons struck the U.S. Pacific island territory of Guam.

Psychiatric dimensions of disaster: patient care, community consultation, and preventive medicine.

The majority of persons exposed to a disaster do well and have only mild, transitory symptoms. However, some individuals develop psychiatric illness postdisaster. Such illnesses include those that are secondary to physical injury and sickenss as well as specific trauma-related psychiatric disorders such as acute stress disorder.

Anticipatory stress of handling human remains from the Persian Gulf War. Predictors of intrusion and avoidance.

High levels of distress were found in military mortuary workers prior to the arrival of the human remains from the Persian Gulf War of 1991. To better understand the stress of anticipating the handling of remains, we performed stepwise multiple regression analyses to identify the best predictors of intrusive thoughts and avoidant thoughts and behavior, two of the primary symptoms of posttraumatic stress disorder. After volunteer status and sex were controlled, fear and discomfort with mutilation and the grotesque, as measured by the Mutilation Questionnaire, and defensiveness or denial, as measured by the Marlowe-Crowne Scale, were significant predictors of intrusion and avoidance in the inexperienced group.

Symptoms of PTSD following recovery of war dead: 13-15-month follow-up.

Objective: The authors explored whether individuals who participated in the recovery of war dead were more likely to experience later symptoms of posttraumatic stress disorder (PTSD) than were individuals who were not involved in the recovery of war dead.

Method: PTSD symptoms were assessed by questionnaire in men and women who had or had not handled human remains during the Persian Gulf War: 116 men and women who had and 118 who had not handled human remains participated in the study 3-5 months after returning from the war; 55 of the subjects who had and 56 of those who had not handled human remains participated in a follow-up assessment 13-15 months after their return.

Results: Subjects who had been involved in the recovery of war dead had significantly higher symptom levels than comparison subjects at both time points.

Gruesomeness, emotional attachment, and personal threat: dimensions of the anticipated stress of body recovery.

Previous research has shown that exposure to grotesque death has been associated with posttraumatic stress disorder and higher levels of stress have been associated with mortuary workers who anticipated handling remains than those who did not. Additional research is presented here to further clarify the nature of the anticipated stress of handling the dead. Anticipated stress of handling human remains was rated for 13 different situations by 479 persons (384 men and 95 women) without such experience, but whose job was likely to require it.

Longitudinal assessment of posttraumatic stress disorder and depression after exposure to traumatic death.

Little is known of the specific effects of exposure to traumatic death, an important dimension of many disasters. This study examined acute and long-term intrusive and avoidant symptoms, depression, and posttraumatic stress disorder (PTSD) in disaster workers exposed to traumatic death after the USS Iowa gun turret explosion. Fifty-four volunteer body handlers were assessed at 1, 4, and 13 months.

Factor analysis of the General Health Questionnaire.

We present the factor structure of the General Health Questionnaire-60 as derived from a population of 2115 Army soldiers. An eight-factor principal components analysis provided the most clinically relevant solution and explained 58.0% of the variance.

Health care delivery in the high-stress environment of chemical and biological warfare.

Understanding health care delivery in high-stress environments, such as the chemical and biological warfare (CBW) environment, is important to developing better procedures for providing health care to individuals and groups exposed to this and other traumas and disasters. Little is known about the behavioral and psychological responses affecting health and performance in the CBW environment. In this paper, we report preliminary observations of the behavioral and psychological responses of a health care delivery exercise occurring over 1 week in a simulated CBW environment.

Symptoms of posttraumatic stress disorder following recovery of war dead.

Persons who handled human remains in Operation Desert Storm (N = 116) were compared with those who did not handle remains (N = 118) on symptoms of posttraumatic stress disorder. Subjects who handled remains reported more intrusive and avoidant symptoms than other subjects. Subjects who were inexperienced at handling remains had more symptoms than those who were experienced.

Anticipation of handling the dead: effects of gender and experience.

In addition to the direct psychological effects of disaster stressors, anticipation of stress can itself be debilitating. We examined the relationship between the anticipated stress of handling the dead and gender and experience. Experienced persons had lower anticipated stress than inexperienced persons.

[Patients cared for at the mental health unit of a primary care office: morbidity study].

Establishing the frequency of mental disorders among patients cared for at the mental health unit of a primary care outpatient clinic of Santiago, Chile, is intended. In this connection, 618 medical records have been screened retrospectively (i.e.

Traumatic stress of a wartime mortuary. Anticipation of exposure to mass death.

Exposure to traumatic death is a risk factor for posttraumatic stress disorder. For some groups, anticipation of such exposure may contribute to traumatic stress. We studied the anticipated stress of working in the Operation Desert Storm mortuary in two groups prior to the arrival of the dead.

Psychological responses of rescue workers: fire fighters and trauma.

The psychological responses of two groups of fire fighters were examined following the performance of rescue work. Four types of responses were reported: identification with the victims, feelings of helplessness and guilt, fear of the unknown, and physiological reactions. Stress was found to be mediated by availability of social support, type of leadership, level of training, and use of rituals.

[Psychiatric patients from general hospitals: pathways followed before consultation].

A survey of all patients who consulted at the Psychiatric Service of a general hospital during a one month period was used to evaluate factors influencing the referral of the patient to the specialist. A preponderance of young females was observed. Patients presenting with somatic symptoms, anxiety or depression were usually referred from another physician, while patients with psychotic disorders and problems related to alcohol abuse were first seen by the specialist.

Behavioral and psychological responses to chemical and biological warfare.

Understanding the behavioral and psychological responses in a chemical environment is critical to individual health and unit functioning. Reports of incidents of acute nerve agent and other organophosphate exposures and of repeated low-dose toxic exposures can provide information about psychiatric symptomatology, performance disruption, and recovery. This paper presents a review of the literature on the longer term consequences of acute and chronic exposure to nerve agents and other organophosphates.