M Hotopf

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..To identify all literature regarding depression in patients with advanced cancer and among mixed hospice populations, and to summarise the prevalence of depression according to different definitions...

..Concerns have been raised about the mental and physical health of UK military personnel who deployed to the 2003 war in Iraq and subsequent tours of duty in the country...

..This is contrasted with psychiatric inpatients, where the problem is no more frequent, but mainly relates to psychotic illness. The article finishes with some general guidance as to how to assess mental capacity in the general hospital...

..To determine whether experiencing physical symptoms is associated with a denial of psychological distress in individuals with probable psychiatric disorder...

..There is no evidence that severe physical disease in childhood is associated with later unexplained symptoms, but common childhood unexplained symptoms are predictors of symptoms in adulthood...

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..Secondly, to determine whether differences in prevalence between Gulf veterans and controls at follow up can be explained by greater persistence or greater incidence of disorders...

..To test the hypothesis that such ill health is limited to military personnel who received multiple vaccines during deployment and that pesticide use modifies any effect...

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..The objective of this study was to assess the relationships among chest pain, psychiatric disorder, and early experience of ill health...

..PON1 activity is reduced in PGW veterans compared with military control groups. The effect is independent of ill health in PGW veterans...

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..We sought to investigate the associations of regaining capacity to make treatment decisions following approximately 1 month of in-patient psychiatric treatment...

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..War time traumatic events are related to subsequent psychological and physical health, but quantifying the association is problematic. Memory changes over time and is influenced by psychological status...

..We assessed socio-demographic and military factors associated with smoking among males in the UK Armed Forces; made comparisons with the general population; and, tested the hypothesis that smoking has declined in the Armed Forces...

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..Our aim in this review is to highlight the complexity of the area, to stimulate debate and to identify important gaps in knowledge where further research might benefit both patients and wider society...

..The purpose of this study was to test the hypothesis that the prior experience of physical illness in childhood is associated with later experience of medically unexplained symptoms...

..We aimed to test the hypothesis that individuals with self-reported CFS/ME have increased levels of psychiatric disorder prior to the onset of their fatigue symptoms...

..To report the prevalence of self reported chemical sensitivities in three cohorts of United Kingdom service personnel...

..To estimate the prevalence of medically unexplained symptoms in patients who most frequently attend outpatient services...

..There is concern surrounding the psychological health and uptake of treatment services among veterans of the UK Armed Forces...

..CONCLUSIONS: This study suggests that stress symptoms and GHQ-12 cases, are strongly predicted both by experiences during deployment and demographic factors...

..Physical symptoms and psychiatric disorder are associated. We aimed to investigate which comes first...

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..A meta-analysis is needed that uses data from all available cohort studies and investigates possible interactive effects on breast cancer risk...

..Despite having high levels of combat exposure, commando and airborne forces may be at less risk of mental ill-health than other troops...

..We aimed to investigate the association between adolescent- and adult-onset affective symptoms and body mass index (BMI) change from age 15 to 53 years...

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..The combined kappa for the three investigators was 0.76, indicating substantial agreement. This suggests that casenote examination is a reliable method of determining whether a symptom is medically unexplained...

..Because it is a legal concept there is a need to clarify associations with variables that clinicians are more familiar with, especially insight...

..Furthermore, employers currently face a number of practical challenges in attempting to facilitate early identification of depression...

..CONCLUSION: In this group of frequent attenders with medically unexplained symptoms outcome as measured by psychiatric morbidity, service use and functional impairment remained poor after 3 years...

..Obesity is an increasing public health problem. A small number of studies have examined the relationship between obesity and sickness absence, with mixed results, particularly regarding short-term sickness absence...

..CONCLUSIONS: Medically unexplained symptoms are common across general/internal medicine and represent the most common diagnosis in some specialities. Medical behavior, training, and management need to take this into account...

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..The effectiveness of screening tools is limited by a number of factors. The clock-drawing test (CDT) has performed well in other settings but has rarely been studied in the hospice setting...

..Developing flexible and responsive recruitment procedures is vital to retain patient participation as more than one contact might be required to successfully conclude an interview...

..To elucidate the associations between frequent headache and psychosocial factors in childhood and to determine whether such children are at an increased risk of headache, multiple physical symptoms, and psychiatric symptoms in adulthood...

..Psychiatrists need to offer greater support and training for GPs in this area of health care...

..This has implications for the psychological assessment of applicants for voluntary euthanasia under an Assisted Dying Act...

..The psycho-behavioural predictors found in this study are amenable to intervention. Such interventions should be tested in randomized controlled trials...

..Such a common, heritable and variable trait is expected to have beneficial as well as detrimental effects. We tested the hypothesis that trait anxiety in childhood reduces the risk of dying from accidental causes in early adult life...

..The purpose of this paper is to establish whether these 13 different syndromes are discrete entities...

..Altogether,1454 studies were screened for relevance, 26 were included in the qualitative synthesis, 18 were included in the meta-analysis. A random effects meta-analysis method was used to obtain a pooled estimate of effect size...

..However, there is increasing evidence for the effectiveness of cognitive behavioural and graded exercise therapies. Medical retirement should be postponed until a trial of such treatment has been given...

..Benzodiazepines are widely used in palliative care, but few studies have attempted to study their use...

..The purpose of this review was to identify all studies that have assessed interventions for postoperative fatigue and to evaluate these interventions using meta-analytical techniques...

..However, there are no systematic reviews assessing amitriptyline, the reference tricyclic drug, v. other tricyclics and SSRIs directly...

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..To assess the relation between self reported number of vaccinations received and health, and between numbers of vaccinations recorded from individuals' medical records and health...

..This paper presents the rationale for the study, describes its context, and the methods for twin ascertainment and data collection...

..The aim of this study was to compare the burden of mental ill health in deployed medics with all other trades during the Iraq war...

..Liaison psychiatric services can be useful not only in offering a second opinion or clarifying the influence of psychopathology on decision-making ability but also mediating between the patient and the clinical team...

..To review the etiology of chronic fatigue syndrome (CFS) and test hypotheses relating to immune system dysfunction, physical deconditioning, exercise avoidance, and childhood illness experiences, using a large prospective birth cohort...

..Less is known about its prevalence in other surgical subgroups, and about its long-term prognosis. A systematic review of prospective cohort studies was conducted to clarify these issues...

..To study childhood risk factors for chronic fatigue syndrome in adult life...

..Exposure to childhood adversity may explain why only a minority of combatants exposed to trauma develop psychological problems...

..To estimate the prevalence of mental capacity to make decisions on treatment in people from different diagnostic and legal groups admitted to psychiatric hospital...

..This systematic review and meta-analysis aims to review the available evidence and make recommendations for practice and research...

..84). CONCLUSIONS: In combination with a clinical interview, the MacCAT-T can be used to produce highly reliable judgements of capacity...

..With the exception of intrusive thoughts, there is insufficient evidence to suggest predeployment psychological status would be useful in correcting for recall bias in subsequent cross-sectional studies...

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..Nothing was found to suggest that, other than for gender-specific health effects, any special considerations need to be made on health grounds for service women in any future deployments...

..The treatment of depression in patients with advanced disease must, for now, be informed by the larger body of evidence on effective treatments for depression in patients with either no physical illness or less severe medical conditions...

..It is not clear whether the increased mortality associated with depression can be explained by the effects of potential confounding variables...

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..This suggests that MAP patients are unrepresentative of the wider deployment to the Persian Gulf...

..However, further surveillance of veterans of the Balkan's War is required in the light of recent concerns...

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..05) but no changes in other cytokines. These data show that multisymptom illness in Gulf War veterans is characterized by ongoing Th1-type immune activation and a biased generation of memory cells secreting the suppressor cytokine, IL-10...

..To assess whether the fatigue commonly reported by patients following surgery is partly a result of somatization and/or cognitive-behavioral factors...

..Little is known about the patterns of alcohol use in the U.K. Armed Forces or the factors associated with heavy drinking...

..UK armed forces personnel who took part in the 1991 Gulf war experienced an increase in symptomatic ill health, colloquially known as Gulf war syndrome. Speculation about an Iraq war syndrome has already started...

..To assess whether parental psychological and physical factors and child factors measured in the first year of life were associated with recurrent abdominal pain (RAP) in children at age 6(3/4) years...

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..Sociologists, anthropologists, and psychologists agree that grief is a universal phenomenon. Reactions to it are, however, socially constructed and patterned...

..This paper examines responses of personnel to this policy...

..We aimed to estimate the summary placebo response in clinical trials of CFS and to determine whether intervention type influences the placebo response in CFS...

..Because elective surgery is one of the few predictable risk factors for chronic fatigue, in this study, we followed a cohort of surgery patients from before to 6 months after their operation to test these theories...

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..Of the 63 with capacity, 6 (9.5%) were detained. CONCLUSIONS: Lack of treatment-related decisional capacity is a common but by no means inevitable correlate of admission to a psychiatric in-patient unit...

..Little is known about the psychological health or treatment experiences of those who have left the British armed forces...

..To assess the effectiveness of olanzapine for treating schizophrenia and to assess if olanzapine promotes a better quality of life than first-generation antipsychotics (FGAs)...

..INTERPRETATION: Mental incapacity is common in acutely ill medical inpatients, and clinicians tend not to recognise it. Screening methods for cognitive impairment could be useful in detecting those with doubtful capacity to consent...

..To examine patterns of drinking in the UK Armed Forces, how they vary according to gender and other demographics, and to make comparisons with the general population...

..To assess any health consequences of the anthrax vaccination programme in UK Armed Forces deployed to Iraq...

..Mental capacity is central to legal and ethical debates on the use of compulsion in psychiatry...

..To assess the relation between frequency and duration of deployment of UK armed forces personnel on mental health...

..In this study, the authors tested the effectiveness of a brief behaviorally oriented intervention in reducing CRF and improving physical function and associated distress in individuals who were receiving chemotherapy...