1
|
Rutten S, Hulscher M, Boeschoten RE, Keuning I, van Eck van der Sluijs JF, Rikkers M, den Boer C, Maarseveen J, Olde Hartman T, Tak LM. [Hardnekkige aanhoudende lichamelijke klachten in de huisartsenpraktijk]. Tijdschr Psychiatr 2024; 66:195-201. [PMID: 38650528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
BACKGROUND In the care of patients with persevering (‘treatment-resistant’) persistant physical symptoms (PPS), problems are common. With this study, we want to identify starting points for improvement of care, including suggestions for the role of mental health care. AIM Using the profile for persevering PPS we will estimate the prevalence, describe characteristics of this patient group and map problems encountered in their care. METHOD Online survey in general practitioners (GPs). RESULTS The response rate to the survey was 12.8%. The mean estimated prevalence of persevering PPS in general practice was 0.7% (corresponding to an estimated 122,500 patients throughout the Netherlands). Many patients encountered iatrogenic harm, experience societal problems and limitations in mobility and ADL independence. Although there was a general increased use of health care in these patients, some also avoided care or were under-treated. In the persistence of symptoms, patient-related factors played a role (like insisting on further somatic diagnostic tests, lack of motivation for PPS-specific treatment), but health-care related factors, like rejection for care or a lack of regional treatment options for patients with PPS, also had a causal role. CONCLUSION Almost every GP experiences problems in the care for patients with persevering PPS. Mental health care professionals can support the GP better, by optimizing options for consultation and referral.
Collapse
|
2
|
Canjels LPW, Ghossein-Doha C, Alers RJ, Rutten S, van den Kerkhof M, Schiffer VMMM, Mulder E, Gerretsen SC, Aldenkamp AP, Hurks PPM, van de Ven V, Spaanderman MEA, Jansen JFA, Backes WH. Functional connectivity of limbic system and prefrontal cortex years after pre-eclampsia: 7-Tesla functional magnetic resonance imaging study. Ultrasound Obstet Gynecol 2022; 60:532-540. [PMID: 35502135 DOI: 10.1002/uog.24928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 04/08/2022] [Accepted: 04/19/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Pre-eclampsia is a vascular complication of pregnancy, associated with a long-term risk of cerebrovascular and mental disorders. We explored whether formerly pre-eclamptic women exhibit differences in functional brain organization, especially in regions that may explain the commonly reported emotional symptoms and cognitive complaints even years after the pregnancy. METHODS Formerly pre-eclamptic women and control women with a history of normotensive pregnancy underwent structural and functional 7-Tesla magnetic resonance imaging scans. Using graph theoretical analysis, the efficiency and clustering coefficient of the functional brain network were investigated. The study included local analysis focusing on particular brain structures, such as the limbic system and the prefrontal cortex, and global analysis of the whole cerebrum. Univariable and multivariable linear regression was used to investigate the relationship between brain network-related graph measures and the group (formerly pre-eclamptic or control). RESULTS A total of 17 control parous women and 55 women with a history of pre-eclampsia were recruited. The time intervals between the index pregnancy and recruitment were 8.0 and 5.6 years for the two groups, respectively. Compared with control women, formerly pre-eclamptic women had higher local efficiency in the prefrontal cortex (P = 0.048) and anterior cingulate cortex (P = 0.03) but lower local efficiency and local clustering coefficient in the amygdala (P = 0.004 and P = 0.02, respectively) and parahippocampal cortex (P = 0.007 and P = 0.008, respectively). No differences were found in the global functional brain organization. CONCLUSIONS Compared to controls with a history of normotensive pregnancy, formerly pre-eclamptic women displayed a different local functional brain organization. These differences in functional connectivity, especially in the limbic regions and the prefrontal cortex, are in line with the psychological and cognitive complaints reported commonly by women with a history of pre-eclampsia. © 2022 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
Collapse
Affiliation(s)
- L P W Canjels
- Department of Radiology & Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
- MHeNs, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - C Ghossein-Doha
- Department of Cardiology, Maastricht University Medical Center, Maastricht, The Netherlands
- GROW, School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
- CARIM, School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
| | - R J Alers
- GROW, School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Gynaecology and Obstetrics, Maastricht University Medical Center, Maastricht, The Netherlands
| | - S Rutten
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Scannexus Ultra-High Field MRI Center, Maastricht, The Netherlands
| | - M van den Kerkhof
- Department of Radiology & Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
- MHeNs, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - V M M M Schiffer
- GROW, School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Gynaecology and Obstetrics, Maastricht University Medical Center, Maastricht, The Netherlands
| | - E Mulder
- GROW, School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Gynaecology and Obstetrics, Maastricht University Medical Center, Maastricht, The Netherlands
| | - S C Gerretsen
- Department of Radiology & Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | - A P Aldenkamp
- MHeNs, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Academic Center for Epileptology Kempenhaeghe/Maastricht UMC+, Heeze and Maastricht, The Netherlands
- Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - P P M Hurks
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - V van de Ven
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - M E A Spaanderman
- GROW, School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Gynaecology and Obstetrics, Maastricht University Medical Center, Maastricht, The Netherlands
| | - J F A Jansen
- Department of Radiology & Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
- MHeNs, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - W H Backes
- Department of Radiology & Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
- MHeNs, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
- CARIM, School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
| |
Collapse
|
3
|
Rutten S, Vriend C, Berendse HW, Van der Werf YD, van den Heuvel OA. [Anxiety, depression and sleep disorders in Parkinson's disease: a complex interaction between body and mind]. Tijdschr Psychiatr 2020; 62:62-72. [PMID: 31994713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Anxiety and depression in Parkinson's disease (PD) are often unrecognized, partially due to a complex relationship with sleep disorders and other PD-related symptoms. <br/> AIM: To gain more insight in anxiety, depression and sleep disorders in PD, their reciprocal interaction and relationship with other (non)motor symptoms. <br/> METHOD: With three epidemiological studies in this thesis article we describe: the symptom dimensions of anxiety, motor symptoms and autonomic failure; predictors of the course of anxiety; and the temporal relationship between anxiety, depression and insomnia in PD.<br/> RESULTS: Anxiety in PD has one affective and various somatic symptom dimensions. There is a symptomatic overlap between anxiety and symptoms of motor and autonomic dysfunctions. Anxiety, depression and impulsive-compulsive behaviors in de novo PD show a parallel course. Cognitive dysfunctions and REM-sleep behaviour disorder are risk factors for anxiety in PD patients. The relationship between insomnia and anxiety and depression is bi-directional.<br/> CONCLUSION: There is an overlap, co-morbidity and interaction between anxiety, depression, sleep disorders and (non)motor symptoms, which warrants a multi-disciplinary approach to PD. Sleep disorders and cognitive dysfunctions may provide starting points for treatment and preventions of anxiety in PD.
Collapse
|
5
|
Kunst MJJ, Rutten S, Knijf E. Satisfaction with the initial police response and development of posttraumatic stress disorder symptoms in victims of domestic burglary. J Trauma Stress 2013; 26:111-8. [PMID: 23335201 DOI: 10.1002/jts.21774] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2012] [Revised: 07/10/2012] [Accepted: 09/06/2012] [Indexed: 11/08/2022]
Abstract
The current study used a prospective design to investigate the association between early symptoms, satisfaction with the initial police response, and development of posttraumatic stress disorder (PTSD) symptomatology in victims of domestic burglary (n = 95). Early symptoms and satisfaction with the initial police response were assessed through telephone interviews conducted within the first month after the burglary and PTSD symptoms 4 to 6 weeks after baseline. Separate regression models were tested for satisfaction with performance and satisfaction with procedure. Results suggested that early symptoms were a risk factor for PTSD symptomatology (β = .50, p < .001 and β = .48, p < .001) above and beyond levels of peritraumatic distress (β = .21, p < .05 and β = .22, p < .05) and irrespective of level of satisfaction (β = -.02, ns and β = -.10, ns). Victims with high levels of early symptoms, however, were clearly at an increased risk of PTSD symptomatology if they scored low on satisfaction at baseline. Results were discussed in light of the framework of therapeutic jurisprudence.
Collapse
Affiliation(s)
- M J J Kunst
- Leiden University, Faculty of Law, Institute for Criminal Law and Criminology, Leiden, The Netherlands.
| | | | | |
Collapse
|
6
|
Rutten S, Jenner J, Beuckens J, Boonstra N, Sytema S. Positive and Useful Auditory Vocal Hallucinations: Prevalence, Characteristics, Attributions and Implications for Treatment. Eur Psychiatry 2009. [DOI: 10.1016/s0924-9338(09)71423-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective:Patients who seek treatment often suffer from negative auditory vocal hallucinations (‘voices’). However, some of these patients also report positive or useful voices, that they wish to preserve. When this wish is neglected by their therapist, this may lead to rejection of therapy or low compliance. This study describes prevalence, characteristics, course of and attributions to these voices in psychotic and non-psychotic patients.Method:One hundred and thirty one patients of a Voices Clinic and 65 members of the Dutch Resonance Foundation were assessed with the Positive and Useful Voices Inquiry. Data were analyzed using Pearson's chi-square, one-way ANOVA, Student's T-test and Crohnbach's alpha statistics.Results:First voices are most often reported as negative. the lifetime prevalence of positive voices ranged from 50 to 75%, useful voices were reported by 40 to 60% of respondents, with higher prevalences among the members of the Resonance Foundation. Positive voices occur more among non-psychotic patients. No significant association was found between voice characteristics and diagnosis. Attributions of protective power to positive voices has the strongest association with positive experience. Useful voices that are advising are experienced as most useful. Over 30% of respondents want to keep their positive and/or useful hallucinations. This wish is significantly associated with perceived control over the voices.Conclusions:The prevalence of positive and useful voices is considerable and therefore clinically relevant. A substantial part of patients want to preserve these voices.
Collapse
|
7
|
Jenner JA, Rutten S, Beuckens J, Boonstra N, Sytema S. Positive and useful auditory vocal hallucinations: prevalence, characteristics, attributions, and implications for treatment. Acta Psychiatr Scand 2008; 118:238-45. [PMID: 18636994 DOI: 10.1111/j.1600-0447.2008.01226.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Auditory hallucinations that are viewed by patients as positive and useful may be barriers to treatment-seeking. The aim was to assess prevalence, impact, and course of, and attributions to, these voices in psychotic and non-psychotic patients. METHOD One hundred thirty-one patients of a Voices Clinic and 65 members of the Dutch Resonance Foundation were assessed with the Positive and Useful Voices Inquiry. Data were analyzed using Pearson's chi-square, one-way anova, and Crohnbach's alpha statistics. RESULTS First voices are most often reported as negative. Positive voices occur more among non-psychotic subjects, but the specific characteristics and diagnosis are not significantly associated. Lifetime prevalence of positive and useful voices ranged between 40% and 60%, with varied prevalence rates over time. Positive voices are experienced by subjects as direct addresses in the third person. Perceived control of voices is significantly associated with the wish to preserve them. Attribution of protective power to positive voices has the strongest association with positive experience. CONCLUSION Many patients express a desire to preserve these voices. Voice characteristics do not allow for validly discriminating psychotic from non-psychotic disorders.
Collapse
Affiliation(s)
- J A Jenner
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
| | | | | | | | | |
Collapse
|
8
|
Rutten S, Beuckens J, Boonstra N, Jenner JA. [Positive and negative auditory vocal hallucinations]. Tijdschr Psychiatr 2007; 49:803-812. [PMID: 17994500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
BACKGROUND Modern psychiatry emphasises the negative aspects of hearing voices. However, experience shows that some patients find these voices positive or useful. AIM To describe the life-time prevalence of hearing voices in a group of patients and the course of this phenomenon and to find out whether these patients find the hearing of voices positive and/or useful. METHOD The study population consisted of patients and former patients of the Voices Outpatient Department of the Groningen University Medical Centre. For this study the Positive and Useful Voices Inquiry, a self-report questionnaire was developed. RESULTS The life-time prevalence of positive voices was 52%, whereas the life-time prevalence of useful voices was 40%. In the majority of patients the number of positive voices decreased and the number of useful remained the same. Positive voices provided protection, reassurance or companionship. Useful voices gave advice, assist with daily activities or decision-making. Thirty two percent of the patients wished to continue hearing positive voices, 40% wished to continue hearing useful voices. These wishes were correlated to patients feeling that they have control over these voices. CONCLUSION The prevalence of positive and useful voices is quite considerable and is therefore therapeutically relevant. A substantial proportion of the patients wishes to continue hearing these types of voices.
Collapse
Affiliation(s)
- S Rutten
- Stemmenpolikliniek van het UMC Groningen
| | | | | | | |
Collapse
|
9
|
Raven EEJ, Kerkhoffs GMMJ, Rutten S, Marsman AJW, Marti RK, Albers GHR. Long term results of surgical intervention for osteoarthritis of the trapeziometacarpal joint : comparison of resection arthroplasty, trapeziectomy with tendon interposition and trapezio-metacarpal arthrodesis. Int Orthop 2006; 31:547-54. [PMID: 17021835 PMCID: PMC2267630 DOI: 10.1007/s00264-006-0217-5] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2005] [Accepted: 06/09/2006] [Indexed: 01/27/2023]
Abstract
Trapeziometacarpal osteoarthritis is a common entity, often bilateral and predominantly affecting postmenopausal women. In the case of failure of conservative treatment, surgery is a good option. The aim of this study was to compare three surgical procedures. 63 patients (74 thumbs) with osteoarthritis of the trapezio-metacarpal joint were surgically treated; 54 patients were seen for follow-up, 7 had died and 2 were lost to follow-up. The patients were stratified according to treatment; resection arthroplasty (the joint surface's of the metacarpal and the trapezium are resected) (18 thumbs), trapeziectomy with tendon interposition (17 thumbs) or trapezio-metacarpal arthrodesis (28 thumbs). Baseline characteristics were comparable in the three groups for mean age at operation, Eaton classification, left right distribution and dominant hands operated. The average follow-up was 13 years for the resection group, 8 years for the trapeziectomy group and 9 years for the arthrodesis group. No statistically significant difference between the three groups was found for the visual analogue pain and satisfaction scale, pain frequency nor DASH score. Patients in the trapeziectomy group had significantly less pain compared to the arthrodesis group (p=0.025). Statistically, radial abduction was significantly better after trapeziectomy compared to resection arthroplasty (p<0.01) or arthrodesis (p=0.01). There was no difference among the three groups in grip and tip pinch strength nor in pain on palpation. None of the patients in the trapeziectomy group needed a re-operation, one patient in the resection arthroplasty group had a re-operation, and 22 patients in the arthrodesis group had one or more re-operations for hardware removal or because of a complication. This study shows that the resection arthroplasty has equally good long term results compared to trapeziectomy combined with tendon interposition or arthrodesis. Resection arthroplasty is performed through a single incision and is technically simple. In our clinic resection arthroplasty is therefore the preferred technique for the treatment of osteoarthritis of the trapeziometacarpal joint.
Collapse
Affiliation(s)
- E E J Raven
- Department of Orthopaedics and Traumatology, Gelre Ziekenhuizen Apeldoorn, P.O. Box 9014, 7300 DS Apeldoorn, The Netherlands.
| | | | | | | | | | | |
Collapse
|