BACKGROUND & AIMS: BACKGROUND:Early and late dumping are complications of gastric bypass surgery. Early dumping occurs within an hour after eating, when the emptying of food into the small intestine triggers rapid fluid shifts into the intestinal lumen and the release of gastrointestinal hormones, resulting in gastrointestinal and vasomotor symptoms. Late dumping occurs between 1 and 3 hours after carbohydrate ingestion and is caused by an exaggerated insulin release, resulting in hypoglycemia. Almost no data are currently available on the prevalence of early and late dumping or their impact on health-related quality of life (QoL). OBJECTIVES:To study the prevalence of early and late dumping in a large population of patients having undergone a primary Roux-en-Y gastric bypass (RYGB) and its effect on QoL. SETTING:Cross-sectional study at a single bariatric department in the Medical Center Leeuwarden, The Netherlands between 2008 and 2011. METHODS:In 2013, this descriptive cohort study approached by email or post all patients who underwent a primary RYGB in the setting between 2008 and 2011 in one hospital. These patients were asked to fill in standardized questionnaires measuring their QoL (RAND-36), anxiety and depression (HADS), fatigue (MFI-20) and any disease specific indicators of early and late dumping syndrome. RESULTS:The questionnaire was completed and returned by 351 of 613 patients (57.1%) and 121 nonobese volunteers. Participants were mostly female (80%), aged 42 (40-54 years), with an excess weight loss of 76.8% [IQR 61-95] after RYGB surgery 2.3 [ IQR 1.6-3.4] years earlier. Self-reported complaints of moderate to severe intensity suggestive of early and late dumping were present in 18.8% and 11.7% of patients, respectively. Patients with early and late dumping demonstrated significantly lower scores on the RAND-36 and HADS compared with patients without dumping. No differences were seen in the MFI-20 scores between patients with or without early and late dumping. CONCLUSION:In this descriptive cohort, self-reported complaints suggestive of early and late dumping of moderate-to-severe intensity were, respectively, 18.8% and 11.7% in a cohort after primary gastric bypass surgery. These complaints were associated with markedly reduced health-related QoL.

背景与目标： 背景：早期和晚期倾倒是胃搭桥手术的并发症。进食后一小时内会发生早期倾倒，这是因为食物排入小肠会触发液体快速进入肠腔并释放胃肠激素，从而导致胃肠道和血管舒缩症状。延迟进食发生在摄入碳水化合物后的1至3个小时之间，并且是由于胰岛素释放过大引起的，从而导致低血糖症。当前几乎没有关于早期和晚期倾倒的流行率或其对健康相关生活质量（QoL）的影响的数据。
目的：研究大量初次Roux-en-Y胃搭桥术（RYGB）患者的早期和晚期倾倒的发生率及其对QoL的影响。
地点：2008年至2011年，在荷兰吕伐登医学中心的单个减肥科进行横断面研究。
方法：2013年，该描述性队列研究通过电子邮件或将所有在2008年至2011年之间在某医院接受原发性RYGB治疗的患者纳入研究。这些患者被要求填写标准化问卷，以测量他们的生活质量（RAND-36），焦虑和抑郁（HADS），疲劳（MFI-20）以及早期和晚期倾倒综合征的任何疾病特异性指标。
结果：613例患者中的351例（占57.1％）和121例非肥胖志愿者完成了问卷调查并返回。参与者主要是女性（80％），42岁（40-54岁），在RYGB手术2.3年[IQR 1.6-3.4]之前，体重减轻了76.8％[IQR 61-95]。自我报告的中度至重度暗示早期和晚期倾倒的投诉分别占患者的18.8％和11.7％。与没有倾倒的患者相比，早期和晚期倾倒的患者在RAND-36和HADS上的得分明显较低。在有或没有早期和晚期倾倒的患者之间，MFI-20评分均未见差异。
结论：在这个描述性队列中，自我报告的关于初次胃旁路手术后队列中早期至晚期倾倒中度至重度的抱怨分别为18.8％和11.7％。这些投诉与健康相关的生活质量显着降低有关。

BACKGROUND & AIMS: :A brief 21-item symptom rating scale, the Psychiatric Outpatient Rating Scale (PORS), was developed for use in outpatient clinics. On the basis of its initial use with 86 patients, it was shown to have high internal and interjudge reliability and evidence of concurrent and construct validity. Scores on the PORS correlated significantly with the Global Assessment Scale and with the number of sessions of psychotherapy. For a subsample of 45 patients rated on the PORS at the beginning and termination of psychotherapy, seven symptoms revealed highly significant improvement. The PORS appears to be a potentially useful measure of change in outpatient clinics.

背景与目标： ：开发了一个简短的21个项目的症状评定量表，精神科门诊评定量表（PORS），用于门诊诊所。根据对86位患者的初次使用，它被证明具有很高的内部和法官间可靠性，以及并发和构建有效性的证据。 PORS的分数与全球评估量表以及心理疗法的疗程次数显着相关。对于在心理治疗开始和结束时接受PORS评估的45位患者的子样本，有7种症状显示出高度显着改善。 PORS似乎是门诊诊所变化的潜在有用措施。

BACKGROUND & AIMS: :Although affective disorders have been known to have sex differences in the associated clinical characteristics and quality of life (QOL), sex differences among patients with panic disorder (PD) have remained relatively unexplored in Korea. We examined the sex differences in different types of stressful life events (SLEs), coping styles, symptom severity, and health-related QOL (HRQOL) in patients with PD. Data from 291 female and 254 male participants diagnosed with PD were analyzed using a structured clinical interview following the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition criteria. Females with PD reported more SLEs including separation issues, physical illness or disability, and pregnancy-related problems than males. They also reported lower levels of confrontation and help-seeking coping strategies and higher levels of agoraphobia in symptom severity than males. The HRQOL of females with PD was significantly lower than male in physical functioning of HRQOL. This study suggests that the patient's sex is relevant to the assessment and treatment of PD.

背景与目标： ：尽管已知情感障碍在相关的临床特征和生活质量（QOL）中存在性别差异，但在韩国，恐慌症（PD）患者之间的性别差异仍未得到开发。我们检查了PD患者不同类型的应激性生活事件（SLE），应对方式，症状严重程度和健康相关的QOL（HRQOL）的性别差异。根据《精神障碍诊断和统计手册》第4版标准，使用结构化的临床访谈分析了291名诊断为PD的女性和254名男性参与者的数据。患有PD的女性比男性报告了更多的SLE，包括分离问题，身体疾病或残疾以及与怀孕有关的问题。他们还报告说，与男性相比，对抗和寻求帮助的应对措施水平较低，症状严重程度的恐惧症水平更高。女性的PD的HRQOL在HRQOL的身体机能上明显低于男性。这项研究表明，患者的性别与PD的评估和治疗有关。

BACKGROUND & AIMS: BACKGROUND:Palliative care is rarely being offered to patients with Parkinson's disease. AIM:To assess symptom prevalence, severity and palliative care needs in advanced stages of Parkinsonism. DESIGN:A cross-sectional survey using a palliative care assessment tool, the Palliative Outcome Scale was administered to patients. SETTING/PARTICIPANTS:Eight-two patients with a diagnosis of idiopathic Parkinson's disease, multiple systems atrophy or progressive supranuclear palsy were included in the study. RESULTS:Their mean age and disease stages 3-5 Hoehn and Yahr were 67 years and 4.1, respectively. Patients reported a mean of 10.7 (standard deviation = 3.9) physical symptoms. Over 80% had pain, fatigue, day time somnolence and problems with mobility. Other symptoms in 50%-80% included constipation, loss of bladder control, swallowing difficulties, drooling, breathlessness and sleep problems. Symptoms rated as causing severe problems were pain, fatigue, constipation and drooling. Assessment of mood revealed 70% of the patients felt anxiety and 60% had felt depressed. Eight-five per cent felt their families were anxious or worried about them. Thirty-eight per cent would have liked more information and 42% had practical problems that still needed to be addressed. There was a positive correlation between number of symptoms and disease severity (r = 0.39, p = 0.01). The total mean Palliative Outcome Scale score was 13.6 (standard deviation = 6.1), suggesting moderate palliative care needs. CONCLUSION:This is the first study to describe the care needs of people with Parkinson's disease using the Palliative Outcome Scale tool. The burden of symptoms and concerns was high in advanced stages of disease. It might be appropriate that people severely affected by these conditions should be considered for referral to specialist palliative care services.

背景与目标： 背景：帕金森氏病患者很少接受姑息治疗。
目的：评估帕金森病晚期患者的症状患病率，严重程度和姑息治疗需求。
设计：使用姑息治疗评估工具进行横断面调查，对患者进行“姑息治疗结果量表”。
设置/对象：本研究包括八十二名诊断为特发性帕金森氏病，多系统萎缩或进行性核上性麻痹的患者。
结果：他们的平均年龄和疾病阶段3-5 Hoehn和Yahr分别为67岁和4.1。患者报告的平均身体症状为10.7（标准差= 3.9）。超过80％的人有疼痛，疲劳，白天嗜睡和行动不便的问题。 50％-80％的其他症状包括便秘，失去膀胱控制，吞咽困难，流口水，呼吸困难和睡眠问题。被认为造成严重问题的症状是疼痛，疲劳，便秘和流口水。情绪评估显示70％的患者感到焦虑，60％的患者感到沮丧。百分之八十五的人认为他们的家人感到焦虑或担心。 38％的人希望获得更多信息，而42％的人有实际问题需要解决。症状数量与疾病严重程度之间呈正相关（r = 0.39，p = 0.01）。总体平均姑息治疗量表评分为13.6（标准差= 6.1），表明需要中等程度的姑息治疗。
结论：这是第一项使用姑息结果量表工具描述帕金森氏病患者护理需求的研究。在疾病的晚期阶段，症状和忧虑的负担很高。应当考虑将受这些疾病严重影响的人转介到专门的姑息治疗服务。

BACKGROUND & AIMS: OBJECTIVE:This study examined trajectories of posttraumatic stress disorder symptoms in Hurricane Katrina affected youth. METHOD:A total of 426 youth (51% female; 8-16 years old; mean age=11 years; 75% minorities) completed assessments at 4 time points post-disaster. Measures included Hurricane impact variables (initial loss/disruption and perceived life threat); history of family and community violence exposure, parent and peer social support, and post-disaster posttraumatic stress symptoms. RESULTS:Latent class growth analysis demonstrated that there were three distinct trajectories of posttraumatic stress disorder symptoms identified for this sample of youth (resilient, recovering, and chronic, respectively). Youth trajectories were associated with Hurricane-related initial loss/disruption, community violence, and peer social support. CONCLUSIONS:The results suggest that youth exposed to Hurricane Katrina have variable posttraumatic stress disorder symptom trajectories. Significant risk and protective factors were identified. Specifically, youth Hurricane and community violence exposure increased risk for a more problematic posttraumatic stress disorder symptom trajectory, while peer social support served as a protective factor for these youth. Identification of these factors suggests directions for future research as well as potential target areas for screening and intervention with disaster exposed youth. LIMITATIONS:The convenience sample limits the external validity of the findings to other disaster exposed youth, and the self-report data is susceptible to response bias.

背景与目标： 目的：本研究调查了卡特里娜飓风影响的青少年创伤后应激障碍症状的轨迹。
方法：总共426名青年（51％的女性； 8-16岁；平均年龄= 11岁； 75％的少数民族）在灾后4个时间点完成了评估。措施包括飓风影响变量（初始损失/破坏和感知到的生命威胁）；家庭和社区暴力暴露的历史，父母和同伴的社会支持以及灾难后的创伤后压力症状。
结果：潜伏类增长分析表明，针对该青年样本，确定了三种不同的创伤后应激障碍症状轨迹（分别是复原力，恢复力和慢性）。青年的轨迹与飓风相关的初期损失/混乱，社区暴力和同伴社会支持有关。
结论：研究结果表明，暴露于卡特里娜飓风的青年有创伤后应激障碍症状轨迹的变化。确定了重大的风险和保护因素。具体来说，青年遭受飓风和社区暴力的侵害增加了创伤后应激障碍症状轨迹更具问题性的风险，而同龄人的社会支持是这些青年的保护因素。对这些因素的识别为未来的研究指明了方向，并为受灾青年筛选和干预提供了潜在的目标领域。
局限性：便利性样本将调查结果的外部有效性限制于其他受灾青年，并且自我报告数据容易引起反应偏差。

BACKGROUND & AIMS: :This report describes a case of diabetes insipidus associated with acute myelogenous leukemia. An 11-year-old boy presented with fatigue, polydipsia and polyuria. His evaluation revealed a diagnosis of acute myelogenous leukemia FAB-M2, and a water deprivation test confirmed the diagnosis of central diabetes insipidus. His brain magnetic resonance imaging (MRI) showed a thickened, enhancing pituitary stalk with absence of the normal hyperintense signal in the posterior pituitary. He was treated with systemic chemotherapy, intensive intrathecal therapy, and 1,000 cGy to the pituitary. The patient achieved a remission but continued to need desmopressin therapy to control his diabetes insipidus. Diabetes insipidus is a rare complication of acute myelogenous leukemia that can be caused by leukemic infiltration of the pituitary. The diabetes insipidus is irreversible despite intensive systemic and central nervous system chemotherapy and radiation.

背景与目标： ：本报告描述了与尿崩症相关的一例尿崩症。一个11岁的男孩表现出疲劳，多饮和多尿。他的评估显示出诊断为急性粒细胞性白血病FAB-M2，而缺水测试证实了对中枢性尿崩症的诊断。他的脑磁共振成像（MRI）显示脑垂体增厚，垂体后叶增强，而垂体后叶没有正常的高信号。他接受了全身化学疗法，强化鞘内治疗和垂体1000 cGy的治疗。该患者已缓解，但继续需要去氨加压素治疗以控制其尿崩症。尿崩症是急性髓性白血病的罕见并发症，可能由垂体的白血病浸润引起。尽管进行了强烈的全身和中枢神经系统化学疗法和放射治疗，尿崩症还是不可逆的。

BACKGROUND & AIMS: Aims:To focus asthma care on those patients most in need whilst providing annual audit data. Methods:An observational questionnaire study. Patients on the asthma register received a postal invitation to the asthma clinic plus a questionnaire which enquired about both symptoms and the process of care. Medical records were searched for data on non-responders. Results:Of the 1241 people sent the invitation and questionnaire 682 (57%) returned it and 99 attended the clinic. Follow-up of responders with high morbidity resulted in a further 32 people attending. The 99 attenders had a higher morbidity than non-attenders on the criteria of a course of oral steroids in the last six months(15% v 29%)and a mean symptom score of 3 or more ( 12% v 31%). Conclusions:Whilst the process did focus care on those in need, and resulted in a manageable number of people attending the asthma clinic, many individuals with high morbidity or risk factors did not attend.

背景与目标： 目的：在提供年度审核数据的同时，将哮喘护理重点放在最需要的患者身上。
方法：一项观察性问卷调查研究。哮喘登记册上的患者收到了哮喘诊所的邮寄邀请，以及一份询问症状和护理过程的问卷。在病历中搜索无应答者的数据。
结果：在1241人中发送了邀请，调查表682张（57％）返回了邀请，其中99人参加了诊所。对高发病率应答者的随访导致另外32人参加。根据最近六个月的口服类固醇疗程（99％对29％）和平均症状评分3分或更高（12％对31％），这99名参加者的发病率高于非参加者。
结论：尽管该过程确实将治疗重点放在了有需要的人群上，并导致哮喘病门诊人数可控，但许多发病率高或有危险因素的人却没有参加。

BACKGROUND & AIMS: The objective of this study was to develop an indigenous measure of common mental disorders (CMD) in the Shona language in Zimbabwe. Ethnographic and qualitative studies elicited idioms of distress of mental disorder leading to the preliminary Shona Symptom Questionnaire (SSQ), and items from the Self-Report Questionnaire (SRQ) were added to it. The 56-item Preliminary Shona Symptom Questionnaire (PSSQ) was administered to 302 randomly selected primary care attenders, of whom 100 were classified as cases on the basis of agreement between care provider assessment and a psychiatric interview. Discriminant analysis identified 14 items that were the strongest predictors of mental disorder. The 14-item SSQ has a high level of internal consistency (Cronbach's alpha = 0.85). The items are a mixture of emic and etic phenomena. The total score correlates strongly with patients' self-assessment of the emotional nature of their illness. Satisfactory specificity and sensitivity occurred at a cut-off point of 7/8. The SSQ is the first indigenous measure of mental disorder developed in sub-Saharan Africa to have included idioms or distress of primary care attenders and involved patients consulting traditional medical practitioners. It promises to be a useful instrument for epidemiological and clinical research. The methodology used is an innovative way of combining etic and emic methods in the evaluation of CMD.

背景与目标： 这项研究的目的是开发一种津巴布韦以绍纳语为母语的常见精神障碍（CMD）量度。人种学和定性研究引起了精神障碍困扰的成语，导致了初步的《 Shona症状问卷》（SSQ），并且添加了《自我报告问卷》（SRQ）中的项目。对302名随机选择的初级护理人员进行了56项Shona症状初步问卷调查（PSSQ），根据护理人员评估与精神病学访谈之间的协议，将其中100例归类为病例。判别分析确定了14个最能预测精神障碍的项目。 14项SSQ具有很高的内部一致性（Cronbach's alpha = 0.85）。这些项目是emic和etic现象的混合体。总分与患者对疾病情感性质的自我评估密切相关。在7/8的临界点出现了令人满意的特异性和敏感性。 SSQ是在撒哈拉以南非洲开发的第一种本地化的精神障碍测量方法，其中包括基层医疗服务人员的成语或困扰，并使患者咨询传统医学从业者。它有望成为流行病学和临床研究的有用工具。所使用的方法学是在CMD评估中结合了动机和情感方法的创新方法。

BACKGROUND & AIMS: :Fatigue is a common symptom of patients with chronic kidney disease, but seldom investigated after transplantation. We determined the prevalence, impact and related factors of severe fatigue in kidney transplant recipients (KTRs). Medical records and questionnaires were used to assess kidney function, donor characteristics, fatigue (Checklist Individual Strength), functional impairments (Sickness Impact Profile), work status, body mass index (BMI), pain, depressive symptoms, social support and sleeping problems in 180 participating KTRs. KTRs were compared with sex- and age-matched population-based controls. KTRs were significantly more often severely fatigued (39%) compared to matched controls (22%; P = 0.001). Severely fatigued KTRs had significantly more functional impairments than nonseverely fatigued recipients (effect size ≥ 0.7) P < 0.001, and less often a paid job (27% vs. 48%, P = 0.005). Univariate analysis showed that severely fatigued KTRs received more often a kidney from a deceased donor, had a higher BMI, more pain, discrepancy in social support, depressive symptoms and sleeping problems. In a multivariate analysis (n = 151) the latter two associations remained significant. Severe fatigue is a highly prevalent and disabling symptom in KTRs. Moreover, severe fatigue after kidney transplantation is more strongly related to behavioural and psychosocial factors than specific transplantation-related factors. Findings have implications for fatigue management.

背景与目标： ：疲劳是慢性肾脏疾病患者的常见症状，但很少在移植后进行检查。我们确定了肾移植受者（KTR）中严重疲劳的患病率，影响和相关因素。病历和问卷用于评估肾功能，供体特征，疲劳（清单个人力量），功能障碍（疾病影响概况），工作状态，体重指数（BMI），疼痛，抑郁症状，社会支持和睡眠问题。 180个参与的KTR。将KTR与性别和年龄相匹配的基于人群的对照进行了比较。与匹配的对照组（22％; P = 0.001）相比，KTR严重疲劳（39％）的频率明显更高。严重疲劳的KTR比非严重疲劳的接受者具有更大的功能障碍（效应量≥0.7）P <0.001，而有酬工作的频率更低（27％比48％，P = 0.005）。单因素分析表明，严重疲劳的KTR经常从死者的肾脏获得肾脏，BMI更高，疼痛更多，社会支持差异，抑郁症状和睡眠问题。在多变量分析（n = 151）中，后两个关联仍然显着。严重疲劳是KTR的高度普遍和致残的症状。此外，与特定的移植相关因素相比，肾移植后的严重疲劳与行为和社会心理因素的相关性更高。研究结果对疲劳管理有影响。

BACKGROUND & AIMS: Health surveys, studies on physical symptom reporting, and medical registration of physical complaints find consistent sex differences in symptom reporting, with women having the higher rates. By and large, this female excess of physical symptoms is independent from the symptom measure, response format and time frame used, and the population under study. As most studies concern healthy individuals, the sex difference can not simply be attributed to a greater physical morbidity in women. In this paper we propose a number of explanations for this phenomenon, based on a biopsychosocial perspective on symptom perception. We discuss a symptom perception model that brings together factors and processes from the extant literature which are thought to affect symptom reporting, such as somatic information, selection of information through attention and distraction, attribution of somatic sensations, and the personality factors somatisation and negative affectivity. Finally, we discuss the explanations for sex differences in physical symptoms that arise from the model.

背景与目标： 健康调查，有关身体症状报告的研究以及身体不适的医学登记发现，在症状报告中性别差异始终如一，而女性的发病率更高。总体而言，女性过多的身体症状与症状量度，反应形式和使用的时限以及所研究的人群无关。由于大多数研究都涉及健康个体，因此性别差异不能简单地归因于女性更高的身体发病率。在本文中，我们基于对症状感知的生物心理社会学观点，对该现象提出了多种解释。我们讨论一种症状感知模型，该模型将现有文献中的因素和过程综合在一起，这些因素和过程被认为会影响症状报告，例如躯体信息，通过注意力和注意力分散信息选择，躯体感觉的归因以及个性化因素的躯体化和负面情感。最后，我们讨论由模型引起的生理症状中性别差异的解释。

BACKGROUND & AIMS: BACKGROUND:European studies have shown that itch is a widespread symptom, yet little is known about its frequency in the United States. OBJECTIVE:We sought to describe ambulatory care visits to clinicians in the United States for which itch was coded as a patient symptom. METHODS:This study uses retrospective data from the National Ambulatory Medical Care Survey from 1999 through 2009. RESULTS:Itch was coded as a symptom for an average of 7 million visits per year or approximately 1% of all outpatient visits, which was nearly 40% of the number of visits for the symptom of low back pain. Patients seen in visits for itch were more likely to be black or Asian than other patients (20% vs 14%). They were also more likely than other patients to receive a new medication (68% vs 36%) and were over twice as likely to receive 2 or more new medications (31% vs 14%). LIMITATIONS:Secondary data sets may not optimally capture patient reports and some of the procedures or medications may have been ordered for reasons other than itch. CONCLUSION:Visits to clinicians for itch represent a sizeable proportion of ambulatory care visits in the United States, and research on the epidemiology, treatments, and causes of itch should be a priority.

背景与目标： 背景：欧洲的研究表明，瘙痒是一种普遍的症状，但在美国对它的发生频率知之甚少。
目的：我们试图描述对美国临床医生的门诊治疗，其中瘙痒被编码为患者症状。
方法：本研究使用了1999年至2009年美国国家门诊医疗调查的回顾性数据。
结果：瘙痒被编码为一种症状，每年平均有700万人次就诊，约占所有门诊就诊人数的1％，几乎是下腰痛症状就诊次数的40％。探访瘙痒的患者比其他患者更有可能是黑人或亚裔（20％比14％）。与其他患者相比，他们接受新药的可能性更高（68％比36％），而接受2种或更多新药的可能性是后者的两倍以上（31％对14％）。
局限性：次要数据集可能无法最佳地捕获患者报告，并且某些方法或药物可能是出于瘙痒以外的原因而订购的。
结论：在美国，对临床医生的瘙痒诊治占相当大比例的门诊治疗，对瘙痒的流行病学，治疗方法和原因的研究应作为优先事项。

BACKGROUND & AIMS: :Exploring how PTSD and alcohol misuse relate to women's use of intimate partner violence (IPV) is vital to develop our understanding of why some women may engage in IPV, which can serve to maximize intervention efforts for women. This study examined the extent to which posttraumatic stress disorder (PTSD) symptom clusters are directly and indirectly related to women's use of IPV through pathways involving alcohol misuse while controlling for severity of women's IPV victimization. The sample was comprised of substance-using, low socioeconomic status community women (N = 143) currently experiencing IPV victimization. The majority of the sample was African American (n = 115, 80.42%). This sample had an average annual household income of $14,368.68 (SD = $12,800.68) and the equivalent of a high school education (11.94 years, SD = 1.32). Path analyses indicated that the strongest statistical relationship emerged between women's use of IPV and women's IPV victimization. PTSD reexperiencing and numbing symptom severity was related to women's use of psychological, minor physical, and severe physical IPV; however, these relationships were indirect through alcohol misuse. Findings lend preliminary support for the application of the self-medication hypothesis to the study of PTSD, alcohol misuse, and IPV among women.

背景与目标： ：探讨PTSD和滥用酒精与妇女使用亲密伴侣暴力（IPV）有何关系，对于增进我们对为什么某些妇女可能参与IPV的理解至关重要，这可以最大程度地为妇女提供干预措施。这项研究检查了创伤后应激障碍（PTSD）症状群在多大程度上与通过滥用酒精的途径控制女性IPV受害程度的女性IPV的使用直接和间接相关。样本由目前正在遭受IPV侵害的使用毒品，社会经济地位低的社区妇女（N = 143）组成。样本的大多数是非裔美国人（n = 115，80.42％）。该样本的平均家庭年收入为$ 14,368.68（SD = $ 12,800.68），相当于高中学历（11.94年，SD = 1.32）。路径分析表明，妇女对IPV的使用与妇女对IPV的受害之间存在最强的统计关系。 PTSD的重新体验和麻木症状严重程度与妇女使用心理，轻微身体和严重身体IPV有关；但是，这些关系是由于滥用酒精而间接造成的。研究结果为自我用药假说的应用提供了初步的支持，以研究女性的PTSD，滥用酒精和IPV。

BACKGROUND & AIMS: INTRODUCTION:Cognitive impairment is one of the fundamental features among patients with schizophrenia. The relationship between schizophrenia symptoms, insight and cognitive domains remains controversial. We aimed to study these relations in a sample of Egyptian patients with schizophrenia. METHODS:A total of 109 patients with schizophrenia were assessed using Structured Clinical Interview for DSM-IV (Diagnostic and Statistical Manual of Mental Disorders (4th ed.)) Axis I diagnosis (SCID-I), Positive and Negative Syndrome Scale (PANSS) and Scale to Assess Unawareness of Medical Disorder (SUMD). Cognitive functions were assessed using the Wechsler Adult Intelligence Scale (WAIS), the Wisconsin Card Sorting Test (WCST) and the Wechsler Memory Scale (WMS). The cognitive functions would be distributed to cover six cognitive domains: attention/vigilance speed of processing, verbal learning, visual learning, working memory and reasoning/problem solving. RESULTS:There was a significant correlation between all cognitive domains (except attention) and PANSS subscales. PANSS negative and general psychopathology subscales were significantly correlated with five cognitive domains: speed of processing, verbal learning, visual learning, working memory and reasoning/problem solving. PANSS negative subscale was significantly correlated with verbal learning (verbal paired association 1) and visual learning (visual paired association 1). There was a significant correlation between all cognitive domains and SUMD, except verbal and visual learning domains assessed by verbal and visual paired association 1 subtests, as well as attention assessed by failure to maintain set subtest. Only visual learning (trials administered), working memory (percentage error), and processing speed (perseverative responses, and trials to complete first category) were significantly negatively correlated to SUMD. CONCLUSION:Cognitive impairment in patients with schizophrenia is most likely to underlie negative symptoms, general psychopathology symptoms and poor insight, suggesting that treatment strategies minimizing these symptoms would improve cognitive impairment.

背景与目标： 简介：认知障碍是精神分裂症患者的基本特征之一。精神分裂症症状，洞察力和认知范围之间的关系仍然存在争议。我们旨在研究埃及精神分裂症患者样本中的这些关系。
方法：采用结构性临床访谈对DSM-IV（精神障碍诊断和统计手册（第四版）），轴I诊断（SCID-I），阳性和阴性综合征量表（PANSS）进行评估，对总共109例精神分裂症患者进行了评估。和规模以评估对医学疾病的认识（SUMD）。使用韦氏成人智力量表（WAIS），威斯康星卡片分类测验（WCST）和韦氏记忆量表（WMS）评估认知功能。认知功能将被分布为涵盖六个认知领域：处理的注意/警惕速度，语言学习，视觉学习，工作记忆和推理/问题解决。
结果：所有认知领域（注意力除外）与PANSS分量表之间均存在显着相关性。 PANSS阴性和一般心理病理学次级量表与五个认知领域显着相关：处理速度，言语学习，视觉学习，工作记忆和推理/问题解决。 PANSS负分量表与言语学习（语言配对关联1）和视觉学习（视觉配对关联1）显着相关。除通过言语和视觉配对关联1子测验评估的言语和视觉学习域，以及通过不维持设定子测验评估的注意力外，所有认知领域和SUMD之间都存在显着相关性。只有视觉学习（进行试验），工作记忆（误差百分比）和处理速度（持续反应以及完成第一类试验）与SUMD显着负相关。
结论：精神分裂症患者的认知障碍最有可能是消极症状，一般精神病理学症状和缺乏洞察力的基础，这表明将这些症状降至最低的治疗策略将改善认知障碍。

BACKGROUND & AIMS: OBJECTIVE:To characterize a scale for the measurement of fibromyalgia (FM)-like symptoms; to investigate whether FM is a discrete disorder; to understand the significance of FM-like symptoms; and to investigate causal and noncausal factors in the development of such symptoms. METHODS:We evaluated 25,417 patients with rheumatic disease using the Symptom Intensity (SI) Scale, a self-report scale that combines a count of pain in 19 nonarticular regions with a visual analog scale for fatigue. We studied this scale in relation to demographics, clinical symptoms, and serious outcomes, including serious medical illnesses, hospitalization, work disability, and death. RESULTS:Compared with other rheumatic disease assessments, the SI scale was the best identifier of symptoms associated with FM content, including an increase in general medical symptoms. SI scale elevations were associated with increases in cardiovascular disorders, hospitalization, work disability, and death. Persons with socioeconomic disadvantage by reason of sex, ethnicity, household income, marital status, smoking, and body mass had increased SI scores. For almost all clinical variables studied, the prevalence and/or severity of the variable increased linearly with SI scores. CONCLUSION:We identified a clinical marker for general symptom intensification that applies in all patients and is independent of a diagnosis of FM. We found no clinical basis by which FM may be identified as a separate entity. Higher scores on the SI scale were associated with more severe medical illness, greater mortality, and sociodemographic disadvantage, and these factors appear to play a role in the development of FM-like symptoms and symptom intensification.

背景与目标： 目的：表征测量肌纤维痛（FM）样症状的量表；调查FM是否为离散性疾病；了解类似FM的症状的重要性；并调查导致此类症状发展的因果关系和非因果关系。
方法：我们使用症状强度量表（SI）量表对25,417名风湿病患者进行了评估，该量表是一种自我报告量表，将19个非关节区域的疼痛计数与视觉模拟量表相结合来评估疲劳程度。我们针对人口统计学，临床症状和严重后果（包括严重的医疗疾病，住院，工作残障和死亡）进行了研究。
结果：与其他风湿性疾病评估相比，SI量表是与FM含量相关的症状（包括一般医学症状增加）的最佳识别者。 SI量表的升高与心血管疾病，住院，工作障碍和死亡的增加有关。因性别，种族，家庭收入，婚姻状况，吸烟和体重而有社会经济劣势的人的SI得分增加。对于几乎所有研究的临床变量，该变量的发生率和/或严重程度随SI分数线性增加。
结论：我们确定了适用于所有患者且与FM诊断无关的一般症状加剧的临床标志物。我们没有发现可将FM识别为独立实体的临床依据。 SI评分较高与更严重的内科疾病，更高的死亡率和社会人口统计学方面的劣势有关，这些因素似乎在FM样症状的发展和症状加剧中起作用。