Behavioural Treatment of Compulsive Polydipsia: Two Case Studies

1987 ◽  
Vol 4 (4) ◽  
pp. 23-29 ◽  
Author(s):  
Brian Oldenburg

Two case studies are described where behavioural strategies, including response prevention and controlled drinking, were used to successfully treat chronic compulsive polydipsia where traditional medical management had failed. The improvement during treatment and at the 3-month follow-up was reflected not only in reduced fluid intake but also in the reduction of associated thirst symptoms and psychological distress. The implications of these results for treatment of polydipsia and non-compliance with fluid restrictions, particularly among dialysis patients, are discussed.

1993 ◽  
Vol 21 (4) ◽  
pp. 335-346 ◽  
Author(s):  
Gillian Haddock ◽  
Richard P. Bentall ◽  
Peter D. Slade

Two cases involving the cognitive-behavioural treatment of hallucinations are described. In both cases, a focusing strategy was used with a view to enabling patients to reattribute the nature and meaning of their experiences. One patient showed a marked reduction in the frequency and content of his voices. The second patient showed little change. The implications of observations made during therapy for the future development of cognitive-behavioural strategies for use with psychotic patients are discussed.


Author(s):  
Tanja Laukkala ◽  
Jaana Suvisaari ◽  
Tom Rosenström ◽  
Eero Pukkala ◽  
Kristiina Junttila ◽  
...  

The COVID-19 pandemic has caused an unequally distributed extra workload to hospital personnel and first reports have indicated that especially front-line health care personnel are psychologically challenged. A majority of the Finnish COVID-19 patients are cared for in the Helsinki University Hospital district. The psychological distress of the Helsinki University Hospital personnel has been followed via an electronic survey monthly since June 2020. We report six-month follow-up results of a prospective 18-month cohort study. Individual variation explained much more of the total variance in psychological distress (68.5%, 95% CI 65.2–71.9%) and negative changes in sleep (75.6%, 95% CI 72.2–79.2%) than the study survey wave (1.6%, CI 0.5–5.5%; and 0.3%, CI 0.1–1.2%). Regional COVID-19 incidence rates correlated with the personnel’s psychological distress. In adjusted multilevel generalized linear multiple regression models, potentially traumatic COVID-19 pandemic-related events (OR 6.54, 95% CI 5.00–8.56) and front-line COVID-19 work (OR 1.81, 95% CI 1.37–2.39) was associated with personnel psychological distress but age and gender was not. While vaccinations have been initiated, creating hope, continuous follow-up and psychosocial support is still needed for all hospital personnel.


Open Heart ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e001440
Author(s):  
Shameer Khubber ◽  
Rajdeep Chana ◽  
Chandramohan Meenakshisundaram ◽  
Kamal Dhaliwal ◽  
Mohomed Gad ◽  
...  

BackgroundCoronary artery aneurysms (CAAs) are increasingly diagnosed on coronary angiography; however, controversies persist regarding their optimal management. In the present study, we analysed the long-term outcomes of patients with CAAs following three different management strategies.MethodsWe performed a retrospective review of patient records with documented CAA diagnosis between 2000 and 2005. Patients were divided into three groups: medical management versus percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG). We analysed the rate of major cardiovascular and cerebrovascular events (MACCEs) over a period of 10 years.ResultsWe identified 458 patients with CAAs (mean age 78±10.5 years, 74.5% men) who received medical therapy (N=230) or underwent PCI (N=52) or CABG (N=176). The incidence of CAAs was 0.7% of the total catheterisation reports. The left anterior descending was the most common coronary artery involved (38%). The median follow-up time was 62 months. The total number of MACCE during follow-up was 155 (33.8%); 91 (39.6%) in the medical management group vs 46 (26.1%) in the CABG group vs 18 (34.6%) in the PCI group (p=0.02). Kaplan-Meier survival analysis showed that CABG was associated with better MACCE-free survival (p log-rank=0.03) than medical management. These results were confirmed on univariate Cox regression, but not multivariate regression (OR 0.773 (0.526 to 1.136); p=0.19). Both Kaplan-Meier survival and regression analyses showed that dual antiplatelet therapy (DAPT) and anticoagulation were not associated with significant improvement in MACCE rates.ConclusionOur analysis showed similar long-term MACCE risks in patients with CAA undergoing medical, percutaneous and surgical management. Further, DAPT and anticoagulation were not associated with significant benefits in terms of MACCE rates. These results should be interpreted with caution considering the small size and potential for selection bias and should be confirmed in large, randomised trials.


2021 ◽  
Vol 10 (2) ◽  
pp. e000839
Author(s):  
Heather Cassie ◽  
Vinay Mistry ◽  
Laura Beaton ◽  
Irene Black ◽  
Janet E Clarkson ◽  
...  

ObjectivesEnsuring that healthcare is patient-centred, safe and harm free is the cornerstone of the NHS. The Scottish Patient Safety Programme (SPSP) is a national initiative to support the provision of safe, high-quality care. SPSP promotes a coordinated approach to quality improvement (QI) in primary care by providing evidence-based methods, such as the Institute for Healthcare Improvement’s Breakthrough Series Collaborative methodology. These methods are relatively untested within dentistry. The aim of this study was to evaluate the impact to inform the development and implementation of improvement collaboratives as a means for QI in primary care dentistry.DesignA multimethod study underpinned by the Theoretical Domains Framework and the Kirkpatrick model. Quantitative data were collected using baseline and follow-up questionnaires, designed to explore beliefs and behaviours towards improving quality in practice. Qualitative data were gathered using interviews with dental team members and practice-based case studies.ResultsOne hundred and eleven dental team members completed the baseline questionnaire. Follow-up questionnaires were returned by 79 team members. Twelve practices, including two case studies, participated in evaluation interviews. Findings identified positive beliefs and increased knowledge and skills towards QI, as well as increased confidence about using QI methodologies in practice. Barriers included time, poor patient and team engagement, communication and leadership. Facilitators included team working, clear roles, strong leadership, training, peer support and visible benefits. Participants’ knowledge and skills were identified as an area for improvement.ConclusionsFindings demonstrate increased knowledge, skills and confidence in relation to QI methodology and highlight areas for improvement. This is an example of partnership working between the Scottish Government and NHSScotland towards a shared ambition to provide safe care to every patient. More work is required to evaluate the sustainability and transferability of improvement collaboratives as a means for QI in dentistry and wider primary care.


2021 ◽  
pp. 000313482110111
Author(s):  
Kevin J. Gale ◽  
Santana Sanchez ◽  
Thomas J. Sorenson ◽  
Todd D. Elftmann

Complications following fundoplication surgery for hiatal hernias are rare. Herein, we present the case of a 61-year-old woman who underwent a Nissen fundoplication, complicated by dysphagia, and a revision modified Toupet fundoplication for a hiatal hernia, after which she began to experience severe prandial referred left shoulder pain that was refractory to medical management. We hypothesized that a diaphragmatic suture placed during the revision fundoplication could be the source of the pain, and we elected to remove the suture, resulting in resolution of the pain. This pain remained resolved at the most recent follow-up on postoperative week six, and the patient had no further concerns.


Author(s):  
Andrés Losada-Baltar ◽  
José Ángel Martínez-Huertas ◽  
Lucía Jiménez-Gonzalo ◽  
María del Sequeros Pedroso-Chaparro ◽  
Laura Gallego-Alberto ◽  
...  

Abstract Objectives To longitudinally analyze the correlates of loneliness and psychological distress in people exposed to the coronavirus disease 2019 (COVID-19) lockdown, exploring the effects of age and self-perceptions of aging (SPA). Methods A longitudinal follow-up of 1,549 participants was carried out at four different time points during the lockdown in Spain. Questions about the risk of COVID-19, age, SPA, family and personal resources, loneliness, and psychological distress were measured. Results Changes in loneliness showed a linear longitudinal trajectory through time, but changes in psychological distress showed a U-shaped relationship with time. Age was a relevant predictor of differences in distress, with older people reporting less psychological distress. Change in both dependent variables was related to change in different predictors like family and personal variables and also to negative SPA. Discussion In a stressful situation such as the COVID-19 pandemic, older adults may be more resilient to adverse mental health outcomes by using more adaptive resources that strengthen their resilience. Support is provided for the importance of stereotyped views of the aging process that, independently of chronological age, may put people at risk of suffering adverse mental health outcomes such as loneliness and psychological distress in times of crisis.


1989 ◽  
Vol 33 (4) ◽  
pp. 441-448 ◽  
Author(s):  
Colin A. Espie ◽  
Eric Freedlander ◽  
Linda M. Campsie ◽  
David S. Soutar ◽  
A.G. Robertson

2007 ◽  
Vol 29 (2) ◽  
pp. 416-419 ◽  
Author(s):  
J. R. Sharma ◽  
S. Sathanandam ◽  
S. P. Rao ◽  
S. Acharya ◽  
V. Flood

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