This review of the literature describes the psychosocial consequences of all the elements associated with Pelvis Exenterative Surgery (PES): a diagnosis of cancer and/or its recurrence, impact of procedures such as simple or radical hysterectomy, prostatectomy, or colostomy. All studies report a high incidence of anxiety, depression, self-image insult, sexual dysfunction, social isolation, and dysfunction. There are few studies of the consequences of PES itself. Their consensus is that its psychosocial impact is not as catastrophic as one would expect. However, their methodological drawbacks do not yet permit a definitive conclusion. The interaction of the patients with their surgeon and treatment team during the preoperative period is examined with special attention to potential pitfalls. Acute psychiatric syndromes that may occur during the postoperative period (delirium, anxiety, depression, brief reactive psychosis) and their management is discussed. So are sexual dysfunctions. General principles of intervention in preparing patients for invasive procedures and facilitating favorable outcomes are described. J. Surg. Oncol. 2001;76:224-236.
A report is presented on a study of social factors associated with the social breakdown syndrome in a number of chronic disorders. Establishment of these factors can be applied to the correction of forces which delay recovery, and can alert staff to identify potentially chronic cases and to endeavor to meet the patient's individual needs.
Phobic and obsessive-compulsive disorders have long been believed to be infrequent in the general population and among persons in treatment. The most recent large-scale multicentered epidemiological study sponsored by NIMH shows startingly different results. Obsessive-compulsive disorders have a life prevalence of 1.9 to 3 percent and a six-month prevalence rate of 1.3 to 2 percent, rates admittedly low but higher than previously thought. Phobic disorders, however, have a life prevalence rate of 7.8 to 23.3 percent and a prevalence rate of 5.4 to 13.4 percent, placing them as the first leading diagnosis. This article also reviews what is known about risk factors and associated pathology.
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