Renate H. Rosenthal

Chronic pelvic pain: psychological features and laparoscopic findings.

One hundred three consecutive patients referred for treatment of chronic pelvic pain underwent MMPI testing, and 60 had diagnostic laparoscopy. A physical cause for the pain was found in 45 (75%) of the 60. However, three fourths (34) of patients with an organic cause for the pain also had evidence of psychopathology on the MMPI. Reassurance and education as to the role of stress in causing or exacerbating pain complaints appeared helpful. Most patients improve without major surgery.

Musculoskeletal factors in chronic pelvic pain

AbstractPhysical therapists were consulted in the evaluation and treatment of 132 chronic pelvic pain (CPP) patients. The majority of the CPP patients reported complete or significant relief of symptoms in response to physical therapy treatment. The physical therapy evaluations revealed a common pattern of faulty posture in the women with CPP. The faulty posture pattern was labeled ‘Typical Pelvic Pain Posture’. Common patterns of muscle imbalance and joint mobility restrictions were noted in association with the faulty posture pattern. Similar lifestyle factors related to faulty posture were also noted in the majority of the cases. These data suggest that patients with CPP, particularly those with normal laparoscopy or persistent pain after definitive gynaecologic surgery, may benefit from careful musculoskeletal evaluation by a physical therapist.

Hospital Violence: Site, Severity, and Nurses' Preventive Training

A sample of 663 nurses was surveyed about exposure to violence at the work site; 243 (37%) had faced violence. Hospitals with low response rates to the questionnaire reported less assault, yet the violence admitted to was described as more deadly. More nurses at public than private hospitals had obtained some training to handle potentially violent situations. Serious assault was negatively related to amount of training. At the public psychiatric hospital, violent acts were most frequent, but the rate of deadly violence (e.g., rape, use of knives or guns, etc.) was lowest. The need to train staffs at general as well as psychiatric hospitals was discussed.

Mental Status Examination

The Mental Status Examination represents the most important step in the clinical evaluation of individuals suffering from or suspected of having mental disorders. The evaluation is based on observations of a patient’s overt and verbal behavior as well as on his or her subjective experiences. Patients’ presenting problems dictate both the types of questions asked and the depth of inquiry necessary for a coherent and complete assessment of the mental status. In general, the more deviant and severely disturbed the patient, the more probing the mental status examination should be.

Diagnosis and management of persistent psychogenic vomiting

Abstract Twenty-four patients who had been diagnosed by a gastroenterologist as psychogenic vomiters were evaluated. Eighteen underwent a comprehensive psychological evaluation consisting of an interview, administration of the MMPI and the Beck Depression Inventory, and follow-up contacts. The majority of the patients did not have serious psychiatric disturbances and were not incapacitated by their illness. The vomiting seemed to be chronic and nondebilitating, with exacerbations in times of stress. The authors conclude that most psychogenic vomiters can be treated effectively by an empathetic primary care physician.

Psychiatric manifestations of hyponatremia

Abstract To ascertain whether hyponatremia produces a characteristic psychiatric syndrome, the authors compared 17 patients with the condition with 18 control patients, all hospitalized. Mental status was assessed with the Cognitive Capacity Screening Examination. Scores showed the hyponatremic patients to have more severe mental deficits than the control subjects. Further, increased severity of hyponatremia correlated with greater cognitive impairment. A large proportion (88%) of the hyponatremic patients had organic brain syndrome. Psychiatric symptoms, such as depression and anxiety, and overt psychosis were absent in both groups. The hyponatremic patients were generally more severely ill than their nonhyponatremic counterparts, and so their clouded mental state cannot be attributed with certainty to their hyponatremia.

Students' self-ratings of stress in medical school: a replication across 20 months

We replicated the essential results of a prior study on the capacity of the BAROMAS scales to reflect stress in medical school as perceived by students. As before, subjective stress was high at the start of medical school, and when facing the exams prerequisite to entry into clinical clerkships. On most measures, stress was lowest when the second year began (i.e. after having passed the first). Once again, most test-retest reliabilities (significant rs ranged from 0.24 to 0.66 for confidence ratings at 12- and 20-months after entry) were moderate.

Assessing chronic pelvic pain: clinical use of the Eysenck Personality Questionnaire

AbstractThe Eysenck Personality Questionnaire (EPQ) was administered to 108 chronic pelvic pain patients and 96 non-pain controls in a public sector ambulatory clinic, and to 58 private gynaecology outpatients without pain. Sharp differences emerged on all four EPQ scales. These data suggest that the evaluation and treatment of chronic pelvic pain in this group of medically indigent women can be made more individualized based upon abnormal EPQ profiles

Vicarious, direct, and imaginal aversion in habit control: Outcomes, heart rates, and subjective perceptions

Direct, modeled, or imaginal shocks administered by therapist or recipient were compared as aversion techniques for 60 women college students with severe nail-biting habits. All methods increased habit control (p <.001)on self-report and objective measures but with no outcome differences among treatments. Providing mental rehearsal guidance for extralaboratory use failed to alter outcome but raised client optimism to ward therapy. Vicarious aversion produced the most rapid heart rates and, typically, the greatest subjective arousal; no data suggested that direct shock was superior. In a second study with unselected student volunteers of both sexes, modeled shock consistently surpassed imaginal shock in ratings of perceived badness, subjective discomfort, and vividness of covert pain (p <.01).Treatment and ethical implications were discussed.

Comparing high school and college students' leisure interests and stress ratings

We compared a large high school area sample with normative data from prior research with college students on the Leisure Interests Checklist (LIC) factor scales, and on the BAROMAS. Whether combined or separated by sex, the college sample displayed far more interest in the LIC activities than the high school students (all P << 0.001). On the BAROMAS, differences were more complex. The teenagers expressed more confidence about dismissing time pressures, sleeping soundly and finding time to do sports, but college students were more confident about falling asleep and sticking to set priorities. The high school data replicated the previous pattern of LIC x BAROMAS relationships, with most scales significantly inter-correlated within inventories, but mainly the sports scales covarying across the two inventories. Numerous differences between the sexes emerged from the high school student sample.