Insomnia can predict anxiety disorders Dr. Dag Neckelmann of the Haukeland Hospital in Norway reports the results of an eleven year prospective study which showed that insomnia is a predictive risk factor for developing anxiety or an anxiety disorder but not for depression. Dr. Neckelman looked at two health surveys carried out between 1984 to 1986 and one from 1997 and 1997, and found that compared to subjects
without chronic insomnia, those
with chronic insomnia had a significantly increased risk in developing a DSM anxiety disorder eleven years later. Dr. Neckelmann partly concludes, “individuals reporting difficulties initiating or maintaining sleep (DIMS), in addition to receiving adequate treatment for their sleep disturbance, should be carefully examined for the presence of anxiety disorder as well as depression."
Sleep 2007, 30, 873-880
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Gastrointestinal cancer surgery survival improved with counseling Dr. Thomas Kuchler and colleagues from the Universitatskliniken Schleswig-Holstein in Kiel, Germany, found that supportive psychotherapy is associated with improved survival in surgical patients with gastrointestinal cancer. The results are from a 10 year randomized study of 271 gastrointestinal cancer patients who either received usual hospital care or who received formal counseling by a psychotherapist. Dr. Kuchler reports that the psychotherapy group had significantly better survival than the controls. with a result that 29 of the 136 psychotherapy subjects survived versus 13 of the 136 control subjects. Dr. Kuchler concludes that, “An individualized psycho-oncological approach delivered within an interdisciplinary surgical team that intervenes as early as possible preoperatively has a significant impact on long-term survival of patients with gastrointestinal cancer.”
Journal of Clinical Oncology 2007, 25, 2702-2708
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Poorer outcomes for 'Type-D' chronic heart failure patients? Dr. Angelique Schiffer and colleagues from Tilburg University in the Netherlands report that cardiac patients who suffer from chronic heart failure (CHF) who demonstrate a Type-D Personality,’ (defined as internalizing a broad range of negative feelings with fear of rejection) are more likely to have poor outcomes to their treatment than those CHF patients without these personality characteristics – especially as they apply to patient self-care. Dr. Schiffer reports that after studying 178 CHF patients below 80 year of age, those who had the Type D personality profile experienced more heart-related symptoms, higher stress and were 2.7 times LESS likely to seek medical assistance than those CHF patients without the Type-D profile. Dr. Schiffer concludes, “The results of our study indicate that type D personality is a risk factor for the delay to consult a doctor or nurse, despite clinically evident symptoms of CHF and associated high levels of health worry.”
Heart 2007, 93, 814-818
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U.S. adults with alcohol disorders go largely untreated? Dr. Deborah Hasin and colleagues from New York’s Columbia University report the results of data analysis of the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (which included face to face interviews with 43,093 respondents over the age of 18). This report showed that nearly one-third of American adults report having alcohol abuse or dependence disorders but few seek treatment. The study showed that on the average, alcohol abuse developed at age 22.5 years and dependence at 21.9 years but there was an eight to ten year delay before these individuals sought any kind of treatment. Dr. Hasin concludes, “A call to action appears indicated to educate and update the public and policy makers about alcohol-use disorders, to destigmatize the disorders, and to encourage help-seeking among those who cannot stop drinking despite considerable harm to themselves and others.”
Archives of General Psychiatry 2007, 64, 830-842
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Pregnancy depression fueled by social conflict Dr. Claire Westdahl of Emory University’s School of Medicine reports that low social support and high social conflict contribute to prenatal depression in pregnant women. Dr. Westdahl and colleagues conducted a prospective study involving structured interviews of 1,047 low-income, minority pregnant women from early pregnancy to one year after giving birth and report that the subjects reported high levels of social support and moderate levels of social conflict, with 33% reporting depressive symptoms. Social conflict was the stronger predictor. Dr. Westdahl concludes, “…we have learned from this research that social conflict predicts prenatal depression more than lack of social support and that social support doesn't protect pregnant women from prenatal depression.”
Obstetrics and Gynecology (2007, 110: 134-140
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Cinnamon extract and Type 2 diabetes Dr. David Pham from the Kings County Hospital in Brooklyn, New York, along with his colleagues at other centers from around the country, conducted a meta-analysis on cinnamon extract in the treatment of Type 2 diabetes. They report that two prospective randomized, double-blind, placebo-controlled studies involving a total of 164 Type-2 diabetic patients showed moderate improvements in lowering blood glucose levels with the administering of cinnamon supplements, which were over-all well tolerated (although one trial in one of the studies showed no difference between cinnamon and placebo). Dr. Pham and his colleagues partly conclude, “These data suggest that cinnamon has a possible modest effect in lowering plasma glucose levels in patients with poorly controlled type 2 diabetes. However, clinicians are strongly urged to refrain from recommending cinnamon supplementation in place of the proven standard of care, which includes lifestyle modifications, oral antidiabetic agents, and insulin therapy.”
Pharmacotherapy 2007, 27, 595-599
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Families often find hospice is too late to help Dr. Joan Teno and colleagues from Brown University in Providence, Rhode Island surveyed 106,514 bereaved family members of hospice patients served by 631 hospice programs. They found that 11 percent said their family member/relative received hospice referrals and care too late. They also report that their family members received inadequate pain control while continuing to have difficulty breathing and coping emotionally with end of life issues. Among the 11 percent who thought that the physician referral to hospice was too late, 19 percent cited lack of emotional support, and 41 percent cited being uninformed as to what to expect, as the most common unmet family needs. Dr. Teno concludes, “Ultimately, we need to educate the public about the benefits of early hospice referral so they can get the full benefit of hospice services and not just an intense intervention in the last days of life.”
Journal of Pain and Symptom Management, June 21, 2007 on-line version
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