Psychiatric Comorbidity and Other Psychological Factors in Patients with “Chroni

[Guest guest]

comorbidy factors,now thats almost pysyhcotic

 

On Sun, Sep 20, 2009 at 10:57 PM, <Angls4Hope wrote:

 

>

> American Journal of Medicine

> Official Journal of the Association of Professors of Medicine

>

>

> There is no evidence of current or previous Borrelia burgdorferi infection

> in most patients evaluated at university-based Lyme disease referral

> centers. Instead, psychological factors likely exacerbate the persistent

> diffuse

> symptoms or “Chronic Multisymptom Illness” (CMI) incorrectly ascribed to

> an ongoing chronic infection with B. burgdorferi. The objective of this

> study was to assess the medical and psychiatric status of such patients

> and

> compare these findings to those from patients without CMI.

>

> Methods

> There were 240 consecutive patients who underwent medical evaluation and

> were screened for clinical disorders (eg, depression and anxiety) with

> diagnoses confirmed by structured clinical interviews at an academic Lyme

> disease referral center in New Jersey. Personality disorders,

> catastrophizing,

> and negative and positive affect also were evaluated, and all factors were

> compared between groups and with functional outcomes.

>

> Results

> Of our sample, 60.4% had symptoms that could not be explained by current

> Lyme disease or another medical condition other than CMI. After adjusting

> for age and sex, clinical disorders were more common in CMI than in the

> comparison group (P <.001, odds ratio 3.54, 95% confidence interval,

> 1.97-6.55),

> but personality disorders were not significantly more common. CMI patients

> had higher negative affect, lower positive affect, and a greater tendency

> to catastrophize pain (P <.001) than did the comparison group. Except for

> personality disorders, all psychological factors were related to worse

> functioning. Our explanatory model based on these factors was confirmed.

>

> Conclusions

> Psychiatric comorbidity and other psychological factors are prominent in

> the presentation and outcome of some patients who inaccurately ascribe

> longstanding symptoms to “chronic Lyme disease.”

> _a_

> (

> http://www.amjmed.com/article/PIIS0002934309003428/abstract?rss=yes#back-aff1)

> Division of Rheumatology and Connective Tissue Research,

> University of Medicine and Dentistry of New Jersey-Robert Wood Johnson

> Medical

> School, New Brunswick, NJ

> _b_

> (

> http://www.amjmed.com/article/PIIS0002934309003428/abstract?rss=yes#back-aff2)

> Department of Medicine, University of Medicine and Dentistry of

> New Jersey-Robert Wood Johnson Medical School, New Brunswick, NJ

> _c_

> (

> http://www.amjmed.com/article/PIIS0002934309003428/abstract?rss=yes#back-aff3)

> Department of Statistics, Rutgers University, Piscataway, NJ

> _d_

> (

> http://www.amjmed.com/article/PIIS0002934309003428/abstract?rss=yes#back-aff4)

> Lyme Disease Center, University of Medicine and Dentistry of New

> Jersey-Robert Wood Johnson Medical School, New Brunswick, NJ

> _e_

> (

> http://www.amjmed.com/article/PIIS0002934309003428/abstract?rss=yes#back-aff5)

> Department of Molecular Genetics & Microbiology, University of

> Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School,

> New

> Brunswick, NJ

> _f_

> (

> http://www.amjmed.com/article/PIIS0002934309003428/abstract?rss=yes#back-aff6)

> Pharmaceutical Research Institute, Bristol-Myers Squibb,

> Princeton, NJ

> Requests for reprints should be addressed to Afton L. Hassett, PsyD,

> UMDNJ-Robert Wood Johnson Medical School, 1 R W Johnson Place MEB-484, New

> Brunswick, NJ 08903-0019

>

> Funding: The National Institute of Mental Health grant number 1

> K08MH65360-01.

>

> Conflict of Interest: Afton L. Hassett, PsyD, Principal Investigator and

> corresponding author: Dr. Hassett does not have any conflicts of interest

> associated with this study. For full disclosure, Dr. Hassett has other

> research funded by Bristol-Myers Squibb (BMS) and is a consultant to BMS

> and

> Forest Laboratories; however, this study was not funded by either. There

> is no

> foreseeable way for her to gain financially by the results reported

> herein.

>

> Diane C. Radvanski, MS, Senior Research Assistant: No conflicts of

> interest to report. Steven Buyske, PhD, Statistician: Dr. Buyske has no

> conflicts

> of interest to report. He does have subcontracts to analyze data related

> to

> Dr. Hassett's other research funded by BMS.

>

> Shantal V. Savage, BA, Research Assistant: No conflicts of interest to

> report.

>

> Leonard H. Sigal, MD, Senior Author: Dr. Sigal is the Director of the

> Pharmaceutical Research Institute at Bristol-Myers Squibb (BMS); however,

> this

> study was not funded by BMS, and Dr. Sigal does not stand to gain

> financially by the results reported herein.

>

> Authorship: All authors had access to the data and a meaningful role in

> writing this manuscript.

> PII: S0002-9343(09)00342-8

> doi:10.1016/j.amjmed.2009.02.022

> © 2009 Elsevier Inc. All rights reserved.

>

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