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Marshall C, Hoshi R, Gregory J. Parental Expressed Emotion and Behavioural Outcomes in Autistic Children and Adolescents: A Systematic Review. Child Psychiatry Hum Dev 2024:10.1007/s10578-023-01660-4. [PMID: 38319471 DOI: 10.1007/s10578-023-01660-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/16/2023] [Indexed: 02/07/2024]
Abstract
Growing interest in the links between parent-child relationships and child behavioural presentations in families of autistic children has led to an increased use of the Five Minute Speech Sample (FMSS) measure of parental expressed emotion (EE) in autism research. This review focuses on studies exploring the relationships between parental EE and behavioural outcomes in autistic children. Electronic searches of six databases and grey literature wielded eight studies that met eligibility criteria. Study designs were a mixture of cross-sectional and longitudinal and quality of studies was variable. Parental criticism was largely positively related to, and showed some predictive value for, child behaviour problems. Warmth was mostly negatively related to, and showed some predictive value for, child behaviour problems. Preliminary evidence from one study showed paternal warmth to be significantly related to child behaviours, whilst child behaviours were also significantly related to paternal warmth, suggesting a bidirectional relationship. Analysis of additional EE components produced variable results, however parental stress and depressive symptoms were consistently related to child behaviour, and preliminary evidence suggests a possible role of maternal education level and family cohesion. Outcomes were variable across FMSS coding systems and greater consistency in their application is needed in future research. The current findings suggest that parental EE has an important relationship with child behaviour and future intervention efforts may benefit from aiming to reduced EE in order to improve child outcomes.
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Affiliation(s)
- Corinne Marshall
- South Wales Doctoral Programme in Clinical Psychology, Cardiff University, Cardiff, UK.
- Cardiff University, 70 Park Place, Tower Building, 11th Floor, Cardiff, CF10 3AT, UK.
| | - Rosa Hoshi
- South Wales Doctoral Programme in Clinical Psychology, Cardiff University, Cardiff, UK
| | - James Gregory
- South Wales Doctoral Programme in Clinical Psychology, Cardiff University, Cardiff, UK
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Doss J. Psychogenic non-epileptic seizures in youth: Individual and family psychiatric characteristics. Front Psychiatry 2022; 13:1068439. [PMID: 36590633 PMCID: PMC9798111 DOI: 10.3389/fpsyt.2022.1068439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 11/24/2022] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Youth with psychogenic non-epileptic seizures (PNES) are an understudied group associated with significant medical and psychiatric morbidity. Several studies have examined characteristics associated with youth's development of this disorder, though the exploration of family factors including psychiatric illness, has been lacking. This study sought to establish the need for a more comprehensive future study. METHODS A retrospective chart review was conducted on patients who had been admitted and diagnosed with PNES at the epilepsy monitoring unit at Children's Hospitals and Clinics of Minnesota. A total of 62 patients were included. All patients were evaluated by an epileptologist and psychologist during their diagnostic admission. "Spells" in question were captured via video EEG monitoring. PNES youth and family risk factors were assessed. RESULTS Mean age of PNES symptom onset was 13.9 years. Patients (73%) were diagnosed within 6 months of onset of symptoms. Histories of other impairing somatic complaints were present in the youth (54%), with 67% having prior psychiatric diagnoses. Experiencing suicidal ideation or thoughts of self-harm occurred in 47% of this sample. Family members were unaware of the history of these symptoms with 12% of the parent's reporting awareness. Family history of psychiatric disorders (first-degree relatives of patient) was present in 54% of the sample, with anxiety, depression and conversion disorder being the most commonly endorsed diagnoses. CONCLUSIONS Youth with PNES present with comorbid psychiatric disorders, though prior assessment and treatment for these disorders was not common. Youth with PNES have history of suicidal ideation and thoughts of self-harm, though parental awareness of these co-occurring symptoms is limited. Family risk factors, such as history of psychiatric disorder in first degree relatives, was high. The impact of these family risk factors is understudied and should be further evaluated to better understand the impact on development and maintenance of this disorder in youth.
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Affiliation(s)
- Julia Doss
- Julia Doss Clinic of Health Psychology, LLC, Minneapolis, MN, United States.,Children's Hospitals and Clinics of Minnesota, Saint Paul, MN, United States
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Deli A, Kinariwalla N, Calvello C, Capelli V, Neale M, Henderson R, Tristram M, Sen A. An evaluation of the psychosocial impact of epilepsy on marriage in the United Kingdom. Epilepsy Behav 2019; 94:204-208. [PMID: 30974348 DOI: 10.1016/j.yebeh.2019.03.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 03/10/2019] [Accepted: 03/11/2019] [Indexed: 12/30/2022]
Abstract
OBJECTIVES The primary objective of this study was to measure the psychosocial burden for persons with epilepsy (PWEs) and for their spouses and to compare and correlate this with the clinical burden of seizures. A secondary objective was to examine the presence of gender-specific differences in the perception of psychosocial burdens by both PWE and their spouses, as well as in the factors that may influence this perception. We also sought to delineate differences in perceived stigmatization if the onset of epilepsy was within matrimony or if seizure onset was prior to marriage. METHODS A questionnaire was constructed from previously validated instruments to measure stigma and was administered to 50 PWE-spouse pairs. A copy was applied to the PWE, and another was administered separately to the spouse. The medical notes were scrutinized by a Consultant Neurologist to enable an assessment of seizure severity for each type of seizure that the PWE experienced. Pearson correlation significance was examined at 95% level of significance. RESULTS Higher seizure severity over the month prior to data collection correlated with smaller reporting differences in psychosocial outcome between spouses and the PWE (p = 0.005), an effect that maintained significance when the period over which seizure severity was evaluated was extended to one year (p = 0.021). Regarding gender-specific differences, low mood over the month prior to administration of the questionnaire was associated with worse psychosocial scores in females only (p = 0.001). Significant impairment in driving was correlated with worse outcomes in males only (p = 0.008). Male spouses' judgment on the 'overall health' of their wife correlated to seizure severity (p = 0.003). However, the psychosocial scores reported by male spouses were inversely correlated to those of the PWE (p = 0.042). Finally, in PWE with seizure onset within marriage, a high degree of perceived stigmatization (p = 0.025) and low mood (p = 0.004) was correlated to worse psychosocial functioning. This group also tended to be more anxious when the PWE was experiencing severe seizures (p = 0.013). CONCLUSION Although severe seizures in this sample of couples were correlated with a smaller discrepancy in perceived seizure burden, gender-specific differences in perception of epilepsy-related psychosocial burden exist. This is true for both PWE and their spouses. Irrespective of gender, onset of epilepsy within matrimony was correlated with higher levels of anxiety and stigma. These factors need to be considered during efforts to reduce epilepsy-related stigmatization, as well as in tailoring therapies that aim to support the spouse as well as the PWE.
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Affiliation(s)
- Alceste Deli
- Oxford Epilepsy Research Group, NIHR Biomedical Research Centre, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK; Nuffield Department of Surgical Sciences, University of Oxford, UK
| | - Neha Kinariwalla
- Oxford Epilepsy Research Group, NIHR Biomedical Research Centre, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK; Columbia College of Physicians and Surgeons, New York, USA
| | - Carmen Calvello
- Oxford Epilepsy Research Group, NIHR Biomedical Research Centre, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK; Clinica Neurologica, Dipartimento di Medicina, Università degli studi di Perugia, Ospedale S. Maria della Misericordia, 06156 Perugia, Italy
| | - Valentina Capelli
- Oxford Epilepsy Research Group, NIHR Biomedical Research Centre, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK
| | - Marcus Neale
- Oxford Epilepsy Research Group, NIHR Biomedical Research Centre, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK
| | - Russett Henderson
- Oxford Epilepsy Research Group, NIHR Biomedical Research Centre, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK
| | - Maggie Tristram
- Oxford Epilepsy Research Group, NIHR Biomedical Research Centre, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK
| | - Arjune Sen
- Oxford Epilepsy Research Group, NIHR Biomedical Research Centre, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK.
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Abstract
BACKGROUND Expressed emotion (EE) is detrimental to patients with schizophrenia, mood disorders, eating disorders and many other psychiatric and neurological disorders. However, majority of the EE literature is generated from the west, and the results of those studies may have limited application in Indian setting. Hence, we conducted this review with the main aim of understanding EE research in India and its potential role in the course and outcome of psychiatric disorders and other chronic illnesses. METHODS Using keywords, we performed searches of electronic databases (PubMed, IndMed, PsychInfo, Science-Direct and Google Scholar) and internet sources and a manual search in the bibliography of the retrieved articles to identify potential original research articles on EE in India. RESULTS As per the selection criteria, 19 reports of 16 studies were included and reviewed. The sample size of the EE studies ranged from 20 to 200, and majority of the studies were conducted in psychosis/schizophrenia, followed by obsessive compulsive disorder and epilepsy. Although high EE was found in most of the studies, the impact of EE on illness outcome is not well explored and only two studies examined the relationship between EE and relapse. DISCUSSION AND CONCLUSION There is a dearth of studies on EE, especially its relationship with relapse or clinical outcomes in the Indian context. We recommend more studies in these areas which may be helpful for clinical decisions and advancement of context knowledge in EE.
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Affiliation(s)
- Anvar Sadath
- Department of Psychiatric Social Work, Institute of Mental Health and Neurosciences, Kozhikode, Kerala, India
| | - Ram Kumar
- Department of Psychiatry, Government Medical College, Kollam, Kerala, India
| | - Magnus Karlsson
- Department of Social Work, Linneaus University, Vaxjo, Sweden
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Mameniškienė R, Guk J, Jatužis D. Family and sexual life in people with epilepsy. Epilepsy Behav 2017; 66:39-44. [PMID: 28025177 DOI: 10.1016/j.yebeh.2016.10.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 10/13/2016] [Accepted: 10/14/2016] [Indexed: 11/18/2022]
Abstract
Having epilepsy is much more than having seizures. Epilepsy can have a severe negative effect on quality of life, affecting social relationships, academic achievement, housing, employment, and the ability to live and function independently. We undertook a cross-sectional study in a tertiary epilepsy center in Lithuania, aiming to assess the influence of epilepsy and aspects relating to epilepsy (employment, stigma, anxiety) on patients and their families, and to estimate their quality of family life and sexual functioning. We asked patients to complete a questionnaire about their socio-demographic situation, their seizure types and antiepileptic medications, and their quality of family and sexual life. Our results confirmed that epilepsy seriously influences family life. One third of our patients are lonely and half are childless. Epilepsy leads to difficulty in finding a job, especially for men, and unemployment affects their status in the family. People with epilepsy are uncomfortable interacting with those of the opposite sex and tend to conceal their medical condition from their partner. One third have sexual dysfunction, yet only a quarter of them seek professional help. There is a clear need to improve self-confidence and to reduce social stigma in people with epilepsy, and to encourage them to discuss their problems with specialists.
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Affiliation(s)
- Rūta Mameniškienė
- Vilnius University, Department of Neurology and Neurosurgery, Center for Neurology, Vilnius, Lithuania.
| | - Jevgenija Guk
- Department of Neurology, Vilnius University Hospital "Santariškių klinikos", Vilnius, Lithuania
| | - Dalius Jatužis
- Vilnius University, Department of Neurology and Neurosurgery, Center for Neurology, Vilnius, Lithuania
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Alway Y, Ponsford J, McKay A. The relationship between family expressed emotion, perceived criticism and criticism sensitivity and psychiatric outcomes following traumatic brain injury. Psychiatry Res 2016; 246:827-832. [PMID: 27817907 DOI: 10.1016/j.psychres.2016.10.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 08/08/2016] [Accepted: 10/16/2016] [Indexed: 11/29/2022]
Abstract
Family expressed emotion (EE) is a strong predictor of outcome in a range of psychiatric and medical conditions. This study aimed to examine the relationship between family EE-criticism, patient perceived criticism and criticism sensitivity and psychiatric disorders following moderate to severe traumatic brain injury (TBI). Participants were 60 patients with TBI and their family members. Patients were assessed for psychiatric disorders using the Structured Clinical Interview for DSM-IV (SCID-I) and completed the Perceived Criticism Measure (PCM) to determine levels of perceived criticism and criticism sensitivity. Family members completed the Family Questionnaire (FQ) to assess patient directed EE-criticism. Patients were reassessed approximately 12-months post-baseline. After controlling for diagnostic status at baseline, high criticism sensitivity at baseline was associated with greater probability of psychiatric diagnosis at follow-up (odds ratio=3.99, 95% CI=1.15-13.71). Family EE-criticism and perceived criticism were not predictive of patient diagnostic status at follow-up, but patients with high EE-family members were more likely to have a concurrent psychiatric diagnosis at baseline. Findings suggest that sensitivity to interpersonal criticism may have a role in the development and course of psychiatric disorders following TBI.
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Affiliation(s)
- Yvette Alway
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Australia; Monash-Epworth Rehabilitation Research Centre, Epworth Hospital, Melbourne, Australia.
| | - Jennie Ponsford
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Australia; Monash-Epworth Rehabilitation Research Centre, Epworth Hospital, Melbourne, Australia; National Trauma Research Institute, Melbourne, Australia
| | - Adam McKay
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Australia; Monash-Epworth Rehabilitation Research Centre, Epworth Hospital, Melbourne, Australia
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Conversation analysis in the differentiation of psychogenic nonepileptic and epileptic seizures in pediatric and adolescent settings. Epilepsy Behav 2016; 62:231-8. [PMID: 27494360 DOI: 10.1016/j.yebeh.2016.07.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 07/01/2016] [Accepted: 07/02/2016] [Indexed: 11/20/2022]
Abstract
The differential diagnosis of epileptic seizures (ES) and psychogenic nonepileptic seizures (PNES) is often difficult, especially in pediatric and adolescent settings. Conversation analysis (CA) can be a worthwhile diagnostic tool in adults. The aim of this study was to assess the diagnostic value of CA in Italian children and adolescents. Ten patients (seven females and three males), diagnosed using video-EEG as having either ES or PNES, underwent a video-recorded interview by a physician from outside the center specifically trained for this purpose. An external linguistic rater then examined the video recordings and transcripts using CA. Diagnoses formulated on the basis of interactional and linguistic features of the patients' speech were compared with diagnoses made by seizure experts on the basis of all available clinical information including the video-EEG findings. Conversation analysis diagnoses corresponded to the video-EEG diagnoses in 8 out of 10 cases. In conclusion, while some conversational adaptation is necessary to enable children and adolescents to share their seizure experiences with an adult health professional, this study indicates the differential diagnostic potential of a CA approach in these young people with PNES or epilepsy. Larger samples are obviously needed to confirm these findings.
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Walker ER, Barmon C, McGee RE, Engelhard G, Sterk CE, DiIorio C, Thompson NJ. A dyadic model of living with epilepsy based on the perspectives of adults with epilepsy and their support persons. Epilepsy Behav 2015; 53:1-9. [PMID: 26515151 PMCID: PMC4674340 DOI: 10.1016/j.yebeh.2015.09.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 08/25/2015] [Accepted: 09/12/2015] [Indexed: 11/30/2022]
Abstract
Epilepsy is a chronic condition that significantly affects the lives of individuals with epilepsy and their support persons, though few studies have examined the experiences of both. To examine these experiences and explore the interpersonal relationships between dyad members, we conducted in-depth interviews with 22 persons with epilepsy and 16 support persons. Data analysis was guided by a grounded theory perspective. We developed a model that shows how epilepsy impacts the lives of both persons with epilepsy and their support persons and how the experiences of persons with epilepsy and supporters influence one another. The core model elements were seizure and treatment factors, relationship characteristics, self-management, seizure control, support provided, illness intrusiveness, and quality of life. Persons with epilepsy moved through the model in five trajectories depending on seizure control, relationship type, and gender. Support providers followed four trajectories based on seizure control, perception of burden, and support for themselves. Persons with epilepsy and their primary support providers have varied experiences in how epilepsy affects their lives. This model could serve as a basis for future research and intervention efforts focused on ways to reduce illness intrusiveness and improve quality of life for persons with epilepsy and their supporters.
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Affiliation(s)
| | | | - Robin E. McGee
- Rollins School of Public Health, Department of Behavioral Sciences and Health Education, Emory University
| | - George Engelhard
- Division of Educational Studies, Emory University; Present address: Department of Educational Psychology, University of Georgia
| | - Claire E. Sterk
- Rollins School of Public Health, Department of Behavioral Sciences and Health Education, Emory University
| | - Colleen DiIorio
- Rollins School of Public Health, Department of Behavioral Sciences and Health Education, Emory University
| | - Nancy J. Thompson
- Rollins School of Public Health, Department of Behavioral Sciences and Health Education, Emory University
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Beghi M, Cornaggia I, Magaudda A, Perin C, Peroni F, Cornaggia CM. Childhood trauma and psychogenic nonepileptic seizures: A review of findings with speculations on the underlying mechanisms. Epilepsy Behav 2015; 52:169-73. [PMID: 26432009 DOI: 10.1016/j.yebeh.2015.09.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Revised: 08/31/2015] [Accepted: 09/04/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The objective of this review was to examine the possible link between psychological trauma in a patient's medical history and the onset of psychogenic nonepileptic seizures (PNES). METHODOLOGY An electronic search of published reports was made using the search engines PubMed-MedLine, EBSCO, PsycINFO, SFX, and Embase and the keywords "PNES", "psychogenic seizures", "sexual abuse", and "trauma". RESULTS A correlation emerged between history of childhood trauma and the presence of PNES. Antecedent trauma was more frequent in females than in males and in patients exhibiting psychiatric disorders but was inversely correlated with cognitive impairment. CONCLUSIONS In the presence of PNES, it is important to accurately investigate the patient's medical history in search of psychological trauma, particularly in women and in patients with psychiatric disorders.
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Affiliation(s)
- Massimiliano Beghi
- Department of Mental Health, "Salvini" Hospital, Garbagnate Milanese, Milan, Italy.
| | - Isotta Cornaggia
- Department of Surgery and Translational Medicine, University of Milano Bicocca, Monza, Italy
| | - Adriana Magaudda
- Epilepsy Center, Department of Neurosciences, University of Messina, Messina, Italy
| | - Cecilia Perin
- Department of Surgery and Translational Medicine, University of Milano Bicocca, Monza, Italy
| | - Federica Peroni
- Department of Surgery and Translational Medicine, University of Milano Bicocca, Monza, Italy
| | - Cesare Maria Cornaggia
- Department of Surgery and Translational Medicine, University of Milano Bicocca, Monza, Italy
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Walker ER, Barmon C, McGee RE, Engelhard G, Sterk CE, DiIorio C, Thompson NJ. Perspectives of adults with epilepsy and their support persons on self-management support. QUALITATIVE HEALTH RESEARCH 2014; 24:1553-66. [PMID: 25192759 PMCID: PMC4623566 DOI: 10.1177/1049732314548880] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Social support is an important mechanism for improving self-management, although little is known about its role in epilepsy self-management. We examined the type of support provided to people with epilepsy and its influence on self-management. We conducted in-depth interviews with 22 people with epilepsy and 16 support persons, representing 14 pairs and 10 unpaired individuals. We analyzed the data using principles of grounded theory. Supporters, who were mainly parents and spouses, aided people with epilepsy in every dimension of self-management. Support for self-management occurred along a continuum from person with epilepsy-led management to support person-led management. Where the pairs fell on the continuum depended on developmental stage, relationship type, and relationship dynamics. Seizure control shaped individuals' experiences with self-management and support within each group. The self-management continuum provides a new aspect that can be integrated into existing models of self- and family management.
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Abstract
PRIMARY OBJECTIVES This study examined the role of expressed emotion (EE) in post-stroke depression (PSD) and the extent to which partner/spouse EE interacted with lesion laterality in PSD. The relationship between (i) lesion location and levels of PSD and (ii) levels of EE and levels of PSD were investigated. The role of perceived EE in PSD was also explored. DESIGN Cross-sectional, between-subjects design. METHODS Measures applied to stroke survivors included Extended Activities of Daily Living Scale (EADL), Post-Stroke Depression Rating Scale (PSDRS) and Level of Expressed Emotion Scale (LEE); spouses/partners completed the LEE. RESULTS The interaction between lesion laterality and levels of partner/spouse EE on PSD was not statistically significant (p = 0.63, F = 0.24, df = 1,56). However, a clear relationship was found between lesion laterality and PSD (p = 0.028). As levels of spouse/partner LEE scores increased, levels of PSD also increased (p = 0.039). Perceived EE scores illustrated a significant interaction between lesion laterality and levels of EE on PSD (p = 0.005, F = 8.591, df = 1,56). CONCLUSION Whilst spouse/partner EE scores showed no interaction with lesion laterality to determine levels of PSD, a significant interaction was found when compared with stroke survivor perceived EE scores. Furthermore, left hemisphere (LHS) stroke survivors reported higher levels of depression than right hemisphere (RHS) stroke survivors. As levels of EE increased, PSD also increased, with LHS being greater than RHS.
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Affiliation(s)
- Naheed Rashid
- Department of Clinical Psychology and Psychological Therapies, The University of Hull, Hull, UK.
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Hatfield JP, Hirsch JK, Lyness JM. Functional impairment, illness burden, and depressive symptoms in older adults: does type of social relationship matter? Int J Geriatr Psychiatry 2013; 28:190-8. [PMID: 22495689 PMCID: PMC3417080 DOI: 10.1002/gps.3808] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2011] [Accepted: 03/09/2012] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The nature of interpersonal relationships, whether supportive or critical, may affect the association between health status and mental health outcomes. We examined the potential moderating effects of social support, as a buffer, and family criticism, as an exacerbating factor, on the association between illness burden, functional impairment and depressive symptoms. METHODS Our sample of 735 older adults, 65 years and older, was recruited from internal and family medicine primary care offices. Trained interviewers administered the Hamilton Rating Scale for Depression, Duke Social Support Inventory, and Family Emotional Involvement and Criticism Scale. Physician-rated assessments of health, including the Karnofsky Performance Status Scale and Cumulative Illness Rating Scale, were also completed. RESULTS Linear multivariable hierarchical regression results indicate that social interaction was a significant buffer, weakening the association between illness burden and depressive symptoms, whereas perceived social support buffered the relationship between functional impairment and depressive symptoms. Family criticism and instrumental social support were not significant moderators. CONCLUSIONS Type of medical dysfunction, whether illness or impairment, may require different therapeutic and supportive approaches. Enhancement of perceived social support, for those who are impaired, and encouragement of social interactions, for those who are ill, may be important intervention targets for treatment of depressive symptoms in older adult primary care patients.
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Mahrer-Imhof R, Jaggi S, Bonomo A, Hediger H, Eggenschwiler P, Krämer G, Oberholzer E. Quality of life in adult patients with epilepsy and their family members. Seizure 2012; 22:128-35. [PMID: 23273809 DOI: 10.1016/j.seizure.2012.11.012] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2012] [Revised: 11/26/2012] [Accepted: 11/28/2012] [Indexed: 10/27/2022] Open
Abstract
PURPOSE Epilepsy is not only a neurological disorder but may also have negative psychosocial consequences on people with epilepsy (PWE) and their relatives. Epilepsy has a major impact on quality of life (QoL) in PWE and family members. However, less is known about the impact of family support and family functioning on quality of life for PWE and family members and their interaction. Therefore, the study aimed to investigate factors that influence QoL in hospitalized adult patients with epilepsy and their relatives. METHOD An explorative cross-sectional study has been conducted in a tertiary clinic in Switzerland. Hospitalized adult patients with epilepsy and their relatives were enrolled in the study. Subjective QoL as well as family support and family functioning were measured with patients and family members. Patients and their relatives assessed the patients' support need and their satisfaction with the care provided. In addition, patients were administered a disease-related HRQoL measure (QoLIED-36, Version 2). Backward stepwise multivariate linear regression analysis was used to explain variances in patients and relatives' subjective QoL. RESULTS One hundred and four dyads of patient and family member participated. Subjective QoL in patients and family members differed significantly, as did satisfaction with care delivery. In both groups family support contributed significantly to QoL. In the models 40% of the variance in QoL in patients and relatives could be explained. While the quality of life of the family members was affected by the patients' knowledge about the disease and the reason for their current hospitalization, patient QoL scores had no influence on the QoL of family members. The patients' QoL, however, depended significantly on the QoL of the family members. CONCLUSION Interventions should address both PWE and family members and focus on the self-care improvement of PWE and the well-being and coping of family members. A patient-centred approach needs to include both the PWE and the relatives and address family support in order to alleviate stress in the patients and relatives alike.
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Affiliation(s)
- Romy Mahrer-Imhof
- Zurich University of Applied Sciences, Institute of Nursing, Winterthur, Switzerland.
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Alway Y, McKay A, Ponsford J, Schönberger M. Expressed emotion and its relationship to anxiety and depression after traumatic brain injury. Neuropsychol Rehabil 2012; 22:374-90. [DOI: 10.1080/09602011.2011.648757] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Grimaldi I, Dubuc M, Kahane P, Bougerol T, Vercueil L. Anxiety and depression in psychogenic movement disorder and non-epileptic seizures: a prospective comparative study. Rev Neurol (Paris) 2010; 166:515-22. [PMID: 20056263 DOI: 10.1016/j.neurol.2009.10.016] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2009] [Revised: 08/25/2009] [Accepted: 10/27/2009] [Indexed: 11/19/2022]
Abstract
OBJECTIVE This study compared anxiety and depression in patients presenting with psychogenic non-epileptic seizures (PNES) with those suffering from psychogenic movement disorders (PMD) to assess the link between these psychiatric pathologies and neurological symptoms. METHODS This clinically descriptive, prospective study involved consecutive patients who fulfilled the clinical and video-EEG criteria for PNES and PMD, and who were recruited over an 18-month period. Semi-structured (according to DSM-IV criteria) psychiatric interviews and self-evaluation using the Beck Depression Inventory and Spielberger State-Trait Anxiety Inventory were carried out. Clinical follow-up was conducted 8-12 months after the first evaluation. RESULTS A total of 17 patients were recruited: nine presented with PNES; and eight had PMD. Both patient groups had similar demographic and clinical data as well as depression and personality disorders. Although not statistically significant, there was a trend towards an increased prevalence of a familial medical history of epilepsy and a higher incidence of anxiety disorders among patients with PNES. CONCLUSION The data from this prospective study underscore the clinical and psychiatric similarity between PNES and PMD patients. Further studies involving a larger number of subjects should confirm, from a statistical point of view, the differences suggested in the present investigation and, in particular, the greater incidence of anxiety disorders in PNES patients and the presence of an epileptic parent as a risk factor for PNES.
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Affiliation(s)
- I Grimaldi
- Clinique psychiatrique, CHU de Grenoble, pavillon Dominique-Villars, Grenoble, France.
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Bressi C, Porcellana M, Pedrinazzi C, Manoussakis C, Marinaccio P, Magri L, Inama G. Expressed emotion in wives of myocardial infarction patients: an exploratory feasibility study. J Cardiovasc Med (Hagerstown) 2009; 10:752-7. [DOI: 10.2459/jcm.0b013e32832cae71] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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