Abstract P108: The Cause and Treatment of Paroxysmal Hypertension

Hypertension ◽  
2020 ◽  
Vol 76 (Suppl_1) ◽  
Author(s):  
Samuel Mann ◽  
Kaushal Solanki
Keyword(s):  
Coping Style ◽  
Past History ◽  
Patient Characteristics ◽  
Response To Treatment ◽  
Repressive Coping ◽  
Paroxysmal Hypertension ◽  
History Of ◽  
Psychosocial History ◽  
History Of Depression ◽  
Repressive Coping Style

Introduction: The cause and treatment of paroxysmal hypertension (PH) (“pseudopheochromocytoma”) in the 98-99% of patients who do not have a pheochromocytoma has long been a mystery. It has been linked to a psychosomatic origin based on the finding in nearly all patients of repression of emotions associated with either a past history of overwhelming stress or trauma or a repressive coping style. The purpose of this study is to convey further experience in understanding and treating PH. Methods: We reviewed the medical records of patients with a diagnosis of PH. Patients were considered to have PH if episodes were sudden in onset, were unprovoked (not precipitated by stress or anxiety) and were symptomatic (e.g., headache, flushing, tachycardia and/or others). Patient characteristics, psychosocial history and response to treatment were assessed. Based on the previous study, the psychosocial characteristics examined most closely were the presence of a past history of trauma or overwhelming stress, the emotional response to that trauma, the presence or absence of a history of depression or anxiety, and the presence or absence of a repressive coping style. Results: Sixty-eight percent of patients (24 of 35) reported a history of trauma with repression of related emotions; a repressive coping style was evident in 26% (9 of 35). Neither characteristic was evident in only 2 patients (6%). Most patients were prescribed clonidine and/or alprazolam for acute management of paroxysms; this intervention was considered sufficient by 10 (28%). Twenty-three of the remaining 25 were offered treatment with an antidepressant. Two refused and two could not tolerate an effective dose. Of the remaining 19, 17 (89%) responded, including 10 (53%) with complete cessation and 7 (37%) with reduction in frequency of paroxysms. The disorder resolved promptly without medication in 2 patients who gained awareness of emotions long held from awareness. Conclusions: The psychosocial history, the marked efficacy of antidepressant agents, and the rapid cure associated with gaining of awareness of previously repressed emotions strongly support the origin of PH in repressed emotions. To date, no other cause or effective treatment has been reported.

PREVALENCE AND RELATED FACTORS OF POSTNATAL DEPRESSION IN HIV INFECTED WOMEN

2014 ◽  
pp. 140-152
Author(s):  
Manh Hoan Nguyen ◽  
Ngoc Thanh Cao
Keyword(s):  
Regression Analysis ◽  
Postpartum Depression ◽  
Hiv Infection ◽  
Postnatal Depression ◽  
Past History ◽  
Depression Scale ◽  
Multivariate Regression Analysis ◽  
Related Factors ◽  
History Of ◽  
History Of Depression

Background and Objective: HIV infection is also a cause of postpartum depression, however, in Vietnam, there has not yet the prevalence of postpartum depression in HIV infected women. The objective is to determine prevalence and related factors of postpartum depression in HIV infected women. Materials and Methods: From November 30th, 2012 to March 30th, 2014, a prospective cohort study is done at Dong Nai and Binh Duong province. The sample includes135 HIV infected women and 405 non infected women (ratio 1/3) who accepted to participate to the research. We used “Edinburgh Postnatal Depression Scale (EPDS) as a screening test when women hospitalized for delivery and 1 week, 6weeks postpartum. Mother who score EPDS ≥ 13 are likely to be suffering from depression. We exclude women who have EPDS ≥ 13 since just hospitalize. Data are collected by a structural questionaire. Results: At 6 weeks postpartum, prevalence of depression in HIV infected women is 61%, in the HIV non infected women is 8.7% (p < 0.001). There are statistical significant differences (p<0.05) between two groups for some factors: education, profession, income, past history of depression, child’s health, breast feeding. Logistical regression analysis determine these factors are related with depression: late diagnosis of HIV infection, child infected of HIV, feeling guilty of HIV infected and feeling guilty with their family. Multivariate regression analysis showed 4 factors are related with depression: HIV infection, living in the province, child’s health, past history of depression. Conclusion: Prevalence of postpartum depression in HIV infected women is 61.2%; risk of depression of postnatal HIV infected women is 6.4 times the risk of postnatal HIV non infected women, RR=6.4 (95% CI:4.3 – 9.4). Domestic women have lower risk than immigrant women from other province, RR=0.72 (95% CI:0.5 – 0.9). Past history of depression is a risk factor with RR=1.7 (95% CI:1.02 – 0.9. Women whose child is weak or die, RR=1.7(95% CI:0.9 – 3.1). Keywords: Postpartum depression, HIV-positive postpartum women

Quality of parenting and vulnerability to depression: results from a family study

1998 ◽  
Vol 28 (1) ◽  
pp. 185-191 ◽  
Author(s):  
C. DUGGAN ◽  
P. SHAM ◽  
C. MINNE ◽  
A. LEE ◽  
R. MURRAY
Keyword(s):  
Mental Illness ◽  
Family Study ◽  
Past History ◽  
Familial Risk ◽  
Self Report ◽  
History Of ◽  
Quality Of Parenting ◽  
Independent Effects ◽  
The Relationship ◽  
History Of Depression

Background. We examined a group of subjects at familial risk of depression and explored the relationship between the perceptions of parents and a history of depression. We also investigated: (a) whether any difference in perceived parenting found between those with and without a past history of depression was an artefact of the depression; and (b) whether the relationship between parenting and depression was explained by neuroticism.Method. We took a sample of first-degree relatives selected from a family study in depression and subdivided them by their history of mental illness on the SADS-L, into those: (a) without a history of mental illness (N=43); and (b) those who had fully recovered from an episode of RDC major depression (N=34). We compared the perceptions of parenting, as measured by the Parental Bonding Instrument (PBI), in these two groups having adjusted for the effect of neuroticism and subsyndromal depressive symptoms. We also had informants report on parenting of their siblings, the latter being subdivided into those with and without a past history of depression.Results. Relatives with a past history of depression showed lower care scores for both mother and father combined compared with the never ill relatives. The presence of a history of depression was associated with a non-significant reduction in the self-report care scores compared to the siblings report. Vulnerable personality (as measured by high neuroticism) and low perceived care were both found to exert independent effects in discriminating between the scores of relatives with and without a history of depression and there was no interaction between them.Conclusion. This study confirmed that low perceived parental care was associated with a past history of depression, that it was not entirely an artefact of having been depressed, and suggested that this association was partially independent of neuroticism.

Suicide in Chronic Schizophrenia

1982 ◽  
Vol 141 (2) ◽  
pp. 171-177 ◽  
Author(s):  
Alec Roy
Keyword(s):  
Suicidal Ideation ◽  
Patient Care ◽  
Past History ◽  
Chronic Schizophrenia ◽  
Controlled Study ◽  
Chronic Schizophrenic ◽  
Duration Of Illness ◽  
History Of ◽  
History Of Depression

SummaryA matched controlled study of 30 chronic schizophrenic suicides is presented. Eighty per cent were male and committed suicide at a mean age of 25.8 years after a mean duration of illness of 4.8 years. Significantly more of the suicides had a chronic relapsing schizophrenic illness; 23.3 per cent committed suicide while in-patients, and 50 per cent of the out-patients committed suicide within three months of discharge from in-patient care. Significantly more of the suicides had a past history of depression (56.6 per cent), were depressed in the last episode of contact (53.3 per cent), had their last admission for depression or suicidal ideation (55.2 per cent) and were unemployed (80 per cent).

Repressive coping style and anxiety in stressful dental surgery

1989 ◽  
Vol 62 (4) ◽  
pp. 371-380 ◽  
Author(s):  
Elaine Fox ◽  
Ciaran O'Boyle ◽  
Hugh Barry ◽  
Chris McCreary
Keyword(s):  
Coping Style ◽  
Repressive Coping ◽  
Dental Surgery ◽  
Repressive Coping Style

The assessment of dysfunctional attitudes and their role in the onset, persistence and recurrence of clinical depression

1995 ◽  
Vol 9 (5) ◽  
pp. 379-400 ◽  
Author(s):  
P. Francis C. Charlton ◽  
Mick J. Power
Keyword(s):  
Information Processing ◽  
Prospective Studies ◽  
Past History ◽  
Cognitive Model ◽  
Risk Groups ◽  
Dysfunctional Attitudes ◽  
Self Report ◽  
Clinical Samples ◽  
History Of ◽  
History Of Depression

Dysfunctional attitudes have been proposed as an important vulnerability factor in the cognitive model of depression. Yet it has often proved difficult to demonstrate their existence in non‐symptomatic populations. We examine the ways in which dysfunctional attitudes have been conceptualized and assessed, from self‐report methods to information‐processing tasks. A s dysfunctional attitudes are typically viewed as latent in non‐symptomatic groups, the importance of priming or activating such variables is emphasized, together with recommendations as to how this may best be achieved. Comparative studies of depressed, control, and at‐risk groups are then considered, together with longitudinal studies that have directly testedpredictions of the cognitive model. Prospective studies of non‐depressed, non‐clinical samples have so far had mixed results in demonstrating that dysfunctional attitudes precede depression or that specific attitudes interact with congruent events in the way the model predicts, although more consistent results emerge from clinical samples with a past history of depression. Possible reasons for the variability in findings are presented, together with suggestions for further research and a revised cognitive model of depression.

Personality Traits in Former Depressed Patients and in Healthy Subjects without Past History of Depression

1984 ◽  
Vol 17 (4) ◽  
pp. 178-186 ◽  
Author(s):  
Carlo Perris ◽  
Martin Eisemann ◽  
Lars von Knorring ◽  
Hjördis Perris
Keyword(s):  
Personality Traits ◽  
Healthy Subjects ◽  
Past History ◽  
Depressed Patients ◽  
History Of ◽  
History Of Depression
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