A 15-year follow-up study after deliberate self-poisoning

The 15-year follow-up of mortality and the factors associated with death from various causes were studied in an unselected group of patients surviving deliberate self-poisoning in 1978. The cohort included 152 females and 101 males. By the end of 1993 a total of 37 (24%) of the females and 33 (33%) of the males admitted in 1978 had died. The total follow-up mortality was 4.5 times greater than expected for the female group (95% confidence interval: 3.1-6.1) and 3.6 times greater than expected (2.5-5.1) for the male group. It was highest in the first 5-year period. With regard to specific causes the mortality ratio was highest for deaths from suicide. For females it was 61.1 (30.5-109.4) and for males: 38.8 (20.4-65.4) times the expected ratio. It was also significantly raised for deaths from cardiovascular diseases in females: SMR = 3.7 (2.0-6.4) and from respiratory diseases in males: SMR = 3.3 (1.2-7.1). Significant predictors for death from all causes were age > or = 30 years: RR = 4.4 (2.3-8.5) and male sex: RR = 2.1 (1.2-3.5). Imprisonment was found to be a protective factor: RR = 0.2 (0.1-0.5). Predictors for death from suicide were age > or = 30: RR = 3.1 (1.2-8.1), male sex: RR = 3.3 (1.4-7.9) and a serious suicidal attempt, as evaluated by a psychiatrist: RR = 3.4 (1.4-7.9). It is concluded that patients who survive parasuicide by deliberate self-poisoning are at increased risk of death. The predictors for death are not very specific and are difficult to apply in clinical work with these patients.     

Cardiovascular outcome in white-coat versus sustained mild hypertension: a 10-year follow-up study

BACKGROUND: The aim of this study was to compare the risk conferred by white-coat versus sustained mild hypertension for the development of cardiovascular disease. METHODS AND RESULTS: Patients (n=479) who underwent 24-hour intra-arterial ambulatory blood pressure monitoring on the basis of a persistently elevated clinic systolic blood pressure of 140 to 180 mm Hg were followed up for the development of subsequent cardiovascular events during a 9.1+/-4. 2-year period. White-coat hypertension, defined as a clinic systolic blood pressure of 140 to 180 mm Hg associated with a 24-hour ambulatory systolic blood pressure <140 mm Hg and diastolic blood pressure <90 mm Hg, was present in 126 patients, and the remainder had sustained mild hypertension. A subgroup of patients without complications underwent follow-up echocardiography and carotid ultrasound. White-coat hypertensives were younger (44+/-12 versus 52+/-10 years, respectively; P<0.001) and had a significantly lower incidence of cardiovascular events (1.32 versus 2.56 events per 100 patient-years, respectively; P<0.001) than sustained hypertensives. Multivariate analysis revealed age (P=0.002), sex (P=0.007), race (P=0.001), smoking (P=0.005), and the presence of white-coat hypertension (hazard ratio, 0.29; 95% CI, 0.09 to 0.90; P=0.04) to be independent predictors of subsequent cardiovascular events. Subgroup analysis in patients without complications revealed a lower incidence of left ventricular hypertrophy and lesser degrees of carotid hypertrophy in the white-coat group. CONCLUSIONS: These findings indicate a relatively benign outcome in white-coat hypertension compared with sustained mild hypertension.     

The Japanese career progress study: A 7-year follow-up.

A longitudinal study of managerial progress, begun by the present 1st author and colleagues (1978, 1980) in 1972 in a Japanese department store chain, monitored the professional and dyadic development of a cohort group of 80 newly recruited male college graduates (mean age 23.6 yrs) over their 1st 3 yrs with the company. Seven waves of data were collected from Ss, their immediate superiors, and company records. After 7 yrs with the company, Ss were promoted to their 1st management positions. The present study examined the preemployment selection test results and measured quality of vertical dyadic exchanges between S and his immediate superior over the 1st 3 yrs and the interaction of these 2 factors in predicting the speed of promotion, annual salary, and size of bonus after 7 yrs. Results show that the 1st 3 yrs were critically important to Ss; the combined effect of exchange and ability produced significant contributions to all 3 career outcomes assessed. (33 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The tinnitus intensive therapy habituation program: A 2-year follow-up pilot study on subjective tinnitus.

Objectives: To explore the effects of a new tinnitus treatment program (tinnitus intensive therapy [TIT]) based on auditory perception principles and neural habituation. Methods: A follow-up study with measurement of treatment effects every third month over a 2-year period in which the cases were their own controls. Participants: There were 25 participants with a mean age 50.1 years (SD = 16.1); 10 women (52.7 years; SD = 16.8) and 15 men (48.3 years; SD = 15.9). The participants were recruited from clinical population admitted to a polyclinic tinnitus treatment program in western Germany. Results: There was a significant reduction of tinnitus in the follow-up period. Mean baseline tinnitus scores (Tinnitus Fragebogen; Goebel & Hiller, 1998) at the start of the treatment were 50.9 (SD = 14.5) and the final scores were 14.2 (SD = 5.9). In total, the clinical improvement over the follow-up period was 72.1%. Conclusion: The TIT program showed a significant clinical treatment effect and should be tested further in a multicenter treatment project. The findings support the Jastreboff habituation model of tinnitus, but social cognitive factors should also be taken into account. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A 35-year follow-up study on burnout among Finnish employees.

This three-wave 35-year prospective study used the Job Demands-Resources model and life course epidemiology to examine how life conditions in adolescence (1961–1963) through achieved educational level and working conditions in early adulthood (1985) may be indirectly related to job burnout 35 years later (1998). We used data (N = 511) from the Finnish Healthy Child study (1961–1963) to investigate the hypothesized relationships by employing structural equation modeling analyses. The results supported the hypothesized model in which both socioeconomic status and cognitive ability in adolescence (1961–1963) were positively associated with educational level (measured in 1985), which in turn was related to working conditions in early adulthood (1985). Furthermore, working conditions (1985) were associated with job burnout (1998) 13 years later. Moreover, adult education (1985) and skill variety (1985) mediated the associations between original socioeconomic status and cognitive ability, and burnout over a 35-year time period. The results suggest that socioeconomic, individual, and work-related resources may accumulate over the life course and may protect employees from job burnout. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Health outcomes for burn survivors: A 2-year follow-up.

Objective: To determine the evolution of health-related function in survivors of burn injuries. Design: Prospective cohort. Measure: Sickness Impact Profile (SIP). Participants: Adults who completed the SIP 1 month (n=237), 1 year (n=183), and 2 years (n=117) after burn injury. Results: Participants reported relatively low sickness impact compared with other medical populations within 1 year of injury. Overall health improved between 1 month and 1 year postinjury, after which it stabilized. Survivors reported worse psychosocial than physical function, regardless of age, gender, burn size, or days hospitalized. Conclusions: Most burn survivors can expect good physical recovery, even after large burn injuries. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relationship between coping and adjustment after spinal cord injury: A 5-year follow-up study.

Investigated the relationship between coping and adjustment (including psychological distress, acceptance of disability, vocational hours, and medical status) 5 to 6 yrs after spinal cord injury. 28 people who had provided coping data during acute rehabilitation (AR) completed various measures including the SCL-90 (Revised). Results indicate that coping strategies during AR were not associated with long-term adjustment. However, at 5-yr follow-up, cognitive restructuring was positively associated and wish-fulfilling fantasy was negatively associated with acceptance of disability. Self-blame was related to psychological distress during AR but not at 5-yr follow-up. These results suggest that the importance of specific coping strategies to adjustment changes over time and support the belief that coping is a dynamic process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stability of intelligence: A 40-year follow-up.

Readministered the Revised Examination "M," a measure of intelligence, to 260 men approximately 40 yrs after they had received this test as World War II army recruits. Their average age and educational level was 64.7 yrs and Grade 8.7, respectively. Three sets of scores were compared: those obtained at the time of army enlistment; current scores obtained within the regular time limits of the test; and current scores obtained within double the test's regular time limits. Results indicate a reliable but minor decline in total score in the regular speeded condition and a reliable improvement over wartime total scores in the double-time conditions. Test–retest correlation coefficients, in general, attested to the long-term stability of individual differences among members of the sample. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pollicisation of the index finger. A 27-year follow-up study

We have reviewed 11 patients with congenital absence of the thumb, treated by pollicisation of the index finger, after follow-up for 20 to 38 years. Seven of the hands also had an associated radial club-hand deformity. Function as assessed by the Percival score was excellent in six, good in three, fair in two and poor in four; three of the poor results were in patients with radial club hand. Ten of the 15 transfers were used as normal thumbs, but in five hands function required trick movements. Of the seven unilateral cases, two transplants were used as the dominant hand, and in another two thumb strength was more than 50% of that on the opposite side. For patients with isolated congenital absence of the thumb, pollicisation of the index finger gives good functional and cosmetic results which are maintained. The results are less reliable for those with radial club hand.     

A 5-year follow-up study of suicide attempts

We reviewed 59 hips in 44 children with slipped capital femoral epiphysis (SCFE), all treated by in situ pinning. The average clinical and radiographic follow-up was 11.4 years. Fifty-three hips (90%) were rated as either excellent or good. Osteonecrosis or chondrolysis developed in five patients. Postoperative remodeling was noted, not only by a process of local resorption and apposition of bone, but also by correction of the disturbed anatomic axes, in proportion to the severity of the slip, together with global thickening of the femoral neck. We believe that the good long-term results after in situ pinning are the consequence of this important remodeling process.     

Motor organization after early middle cerebral artery stroke: a PET study

We analyzed HLA class II genes of Okinawan centenarians using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method to identify primary genetic factors in the major histo-compatibility complex (MHC) region associated with human longevity. Gene frequencies of centenarians were compared with those of normal adults of the same ethnicity who were selected in the same vicinity as the centenarians. The following differences were identified in the HLA-DQB1 and DQA1 genes: the frequencies of DQB1*0503, DQA1*0101 (04) and DQA1*05 were increased in the centenarians, whereas those of DQA1*0102, DQA1*0103 and DQB1*0604 were decreased. Similarly, for the DRB1 gene, the frequencies of DRB1*0101, DRB1*1201 and DRB1*1401 were increased in the centenarians, whereas those of DRB1*0403 and DRB1*1302 were decreased. These data suggest that several alleles of the HLA-DRB1 and/or HLA-DQ genes are involved in human longevity.     

Risk factors of stroke incidence and mortality. A 12-year follow-up of the Oslo Study

BACKGROUND AND PURPOSE: The objective of this study was to determine the risk factors of stroke incidence and mortality. METHODS: Our data are based on a prospective cohort study of men aged 40 to 49 years after 12 years of follow-up. RESULTS: In age-adjusted Cox proportional-hazards regression analysis of 14,403 healthy men, diastolic blood pressure was a stronger predictor for stroke incidence and mortality than systolic blood pressure. Smoking was a stronger predictor of mortality than of incidence. However, there was no dose-response relation among smokers by increased cigarette consumption. Total serum cholesterol was a significant (P < .05) risk factor for stroke mortality and of borderline significance (P = .08) for stroke incidence. Increased physical activity at leisure was associated with reduced stroke incidence but not mortality. The myocardial infarction risk score comprising systolic blood pressure, total serum cholesterol, and daily cigarette smoking was a strong predictor of mortality and incidence. Body mass index, triglycerides, blood glucose, and physical activity at work were not found to be risk factors for stroke. CONCLUSIONS: Reduction of blood pressure, cessation of smoking, lowered cholesterol, and increased physical activity at leisure are individual measures to reduce the risk of stroke.     

Laparoscopic splenectomy for idiopathic thrombocytopenic purpura. A 1-year follow-up study

BACKGROUND: Laparoscopic splenectomy is a novel approach for the treatment of idiopathic thrombocytopenic purpura (ITP) in patients requiring surgical intervention. This technique was used for treatment in 16 consecutive patients. Follow-up was initiated at a median of 13.5 months after surgery to determine whether or not laparoscopic splenectomy is a safe and successful procedure that should be used in all patients requiring splenectomy for ITP. METHODS: Sixteen patients underwent laparoscopic splenectomy for ITP between May 1994 and September 1996. They were evaluated prospectively prior to surgery, immediately following surgery, at discharge, and at 13.5 months following surgery (n = 14) to determine the short- and long-term results of the procedure. RESULTS: Mean operation time was 123.4 +/- 12.1 min, and there were no significant intra- or postoperative complications. Mean intraoperative blood loss was 437.5 +/- 73.5 ml. Autologous blood transfusion was necessary in one patient (6.3%). Mean organ weight was 202.2 +/- 47.3 g. Mean postoperative hospital stay was 4.6 +/- 0. 4 days. Before discharge, mean platelet count rose by 100.7%. At follow-up (13.5 months postoperatively), it was 77.7% above preoperative values. No additional surgery was necessary in any of the patients undergoing laparoscopic splenectomy, and hematologic success was achieved in 12 patients (85.7%). CONCLUSIONS: Our results clearly indicate that laparoscopic splenectomy is a safe and successful procedure in patients suffering from ITP. It offers the well-known advantages of minimal invasive surgery as well as the surgical effectiveness of the open approach. This surgical technique should therefore be considered in all patients requiring splenectomy for the treatment of ITP.     

Familial subtypes of attention deficit hyperactivity disorder: a 4-year follow-up study of children from antisocial-ADHD families

ADHD is a familial disorder with high rates of comorbidity with conduct disorder in childhood and antisocial personality and substance use disorders in adulthood. A growing literature suggests that ADHD with antisocial comorbidity may be nosologically distinct from other forms of ADHD. Previously, we proposed a family-based stratification that defined Antisocial families as those with either conduct disorder or antisocial personality disorder in the probands or relatives. To provide predictive validity for that stratification, we assessed psychopathology in these families 4 years after their initial assessment. Results show that the probands and siblings from Antisocial families had higher rates of psychopathology during the 4-year follow-up period compared with siblings from Non-antisocial and control families. They also had more deviant ratings on the Child Behavior Checklist (especially for anxious/depressed, delinquent, and aggressive behavior). We found fewer group differences in the academic, psychosocial, and intellectual correlates of ADHD. These results confirm and extend previous work indicating that Antisocial ADHD may be a nosologically and clinically meaningful subform of ADHD.     

Prediction of marital distress: A 5-year follow-up.

26 couples (mean age 20.3 yrs) planning marriage participated in the initial stage of the study, and 9 of the 21 couples remaining intact during the study completed data (including the Marital Relationship Inventory) at all 3 follow-up points. A correlation coefficient of .59 was obtained, indicating that the more positively premarital couples had rated their communication, the more satisfied they were with their relationship 5? yrs later. Findings are consistent with the social learning model of marriage hypothesis that communication deficits precede the development of marital distress. (4 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A 2-year follow-up of the effectiveness of traditional child psychotherapy.

This study examined outcomes at a 2-year follow-up assessment for child psychotherapy as it typically is delivered in outpatient settings. The treatment condition (53 children, mean age?=?10.5 years) and control condition (53 children, mean age?=?10.0 years) were compared with regard to rates of linear and curvilinear change for psychopathology, adaptive functioning, and consumer satisfaction. Although both conditions showed curvilinear as well as linear improvement in behavioral and emotional problems, relatively little support was found for the effectiveness of traditional child psychotherapy or for the presence of a psychotherapy "sleeper effect." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effect of piracetam on recovery and rehabilitation after stroke: a double-blind, placebo-controlled study

The nootropic agent piracetam has been shown to improve learning and memory, and it may, by this means, facilitate recovery and rehabilitation after a stroke. We report the results of a pilot study exploring its effects in patients undergoing rehabilitation after acute cerebral infarction in the carotid artery territory. We compared piracetam and placebo, each given for 12 weeks, in a multicenter, double-blind, randomized trial of parallel-group design; testing was performed at baseline (6-9 weeks poststroke), weeks 5 and 12, and, in fewer patients, 12 weeks after termination of treatment. Standardized tests of activities of daily living (Barthel Index, Kuriansky Test), aphasia (Aachen Aphasia Test), and perception (Rivermead Perception Assessment Battery) were the primary efficacy variables. Of 158 patients, 137 (81 males, 56 females) were studied after treatment and 88 at 24-week follow-up. Thirty patients on piracetam (45%) and 37 on placebo (53%) were aphasic on entry. Both groups, including the subgroups with aphasia, were well matched at baseline for demographic data, stroke sequelae, type and severity of aphasia, and prognostic parameters. Multivariate analysis of Aachen Aphasia subtest scores showed a significant overall improvement relative to baseline in favor of piracetam (p = 0.02) at 12 weeks. This was not seen at 24 weeks when, however, fewer patients were available for evaluation so that we could neither confirm nor deny whether improvement was maintained after cessation of piracetam. We were unable to demonstrate an effect on tests of activities of daily living and could neither confirm nor exclude an effect on perceptual deficit. We have shown an improvement in aphasia in patients undergoing rehabilitation after a stroke after 12 weeks' treatment with piracetam that requires confirmation in further studies.     

Sexual function in patients with disseminated sclerosis. A 5-year follow-up study

Sexual dysfunction is known to occur in multiple sclerosis (MS). The purpose of the study is to describe the change in sexual function and symptoms in a five year follow-up study. Forty-nine patients (27 females, 22 males) with definite MS were interviewed and examined. The number of patients with sexual dysfunction increased significantly (p = 0.004) and involved females and males equally. Males usually had one or two symptoms, while females frequently had two or more symptoms. It is concluded that the risk of sexual dysfunction increases over time. Further studies concerning treatment possibilities are needed.     

Neuropsychological functioning among the nonpsychotic relatives of schizophrenic patients: A 4-year follow-up study.

In a prior study of 54 relatives of patients with schizophrenia and 72 control participants, 3 neuropsychological functions met the criteria for risk indicators of the schizophrenia genotype: executive functioning, memory, and auditory attention. In an assessment of the stability of these findings, the sample was reexamined 4 years after the initial assessment. Three test scores were found to differ between groups (Immediate Verbal Memory, Delayed Verbal Memory, and Dichotic Listening Digits Detected) or to show a significant Group?×?Gender interaction (immediate and delayed verbal and visual memories). None of the test scores showed Group?×?Time interactions, suggesting that the discriminating power of the tests was stable over time. Evidence for deficits in working memory and rule learning on the object alternation test was also found. These results support the idea that neuropsychological dysfunction among relatives of patients with schizophrenia is a stable trait caused by the familial predisposition to schizophrenia. (PsycINFO Database Record (c) 2010 APA, all rights reserved)