Copyright (c) 2009 Thomas Jefferson University All rights reserved. http://jdc.jefferson.edu/phbfp Recent documents in Department of Psychiatry and Human Behavior Faculty Papers en-us Tue, 10 Nov 2009 23:24:42 PST 3600 http://jdc.jefferson.edu/phbfp/6 http://jdc.jefferson.edu/phbfp/6 Fri, 06 Nov 2009 12:58:53 PST An overview of prescientific medicine, evolution, and individual human development is presented in an attempt to discover the generic factors operating in all interpersonal therapies. We hypothesize that the placebo effect rests on the universal human need for a group and, by symbolic extension, a system. Herbert M. Adler, MD Child Development Evolution Group Processes Humans Medicine, Traditional Parent-Child Relations Philosophy, Medical Physician-Patient Relations Placebos http://jdc.jefferson.edu/phbfp/5 http://jdc.jefferson.edu/phbfp/5 Mon, 23 Mar 2009 11:11:42 PDT BACKGROUND/METHODS: The objective of this study was to determine whether relinquishing cognitive, physical, and social activities is associated with an increased risk of cognitive decline in patients with age-related macular degeneration (AMD). We conducted a 3-year longitudinal study of 206 nondemented patients with AMD. RESULTS: Twenty-three subjects (14.4%) declined cognitively. Age, sex, education, decline in visual acuity, and number of dropped activities were associated with cognitive decline; each additional dropped activity increased the risk by 58%. Subjects who relinquished three activities were 3.87 times (95% confidence interval, 1.95-7.76) more likely to become demented than subjects who relinquished no activities; those who relinquished five activities were 9.54 times (95% confidence interval, 3.05-30.43) more likely. A multivariate model demonstrated that number of dropped activities was a powerful predictor of cognitive decline after controlling for relevant risk factors, particularly for subjects younger than 80 years of age. CONCLUSIONS: Relinquishing valued activities is associated with an increased risk of cognitive decline in older patients with vision loss caused by AMD. These data suggest the importance of promoting optimal cognitive and physical health in patients with AMD and perhaps other chronic diseases. Barry W. Rovner Activities of Daily Living Aged Aged, 80 and over Aging Behavior Therapy Cognition Disorders Comorbidity Dementia Female Humans Incidence Longitudinal Studies Macular Degeneration Male Motor Activity Risk Factors Social Behavior Vision, Low http://jdc.jefferson.edu/phbfp/4 http://jdc.jefferson.edu/phbfp/4 Mon, 29 Sep 2008 13:53:58 PDT The emotional investment required to construct a caring doctor-patient relationship can be justified on humane grounds. Can it also be justified as a direct physiologic intervention? Two lines of evidence point in this direction. People in an empathic relationship exhibit a correlation of indicators of autonomic activity. This occurs between speakers and responsive listeners, members of a coherent group, and bonded pairs of higher social animals. Furthermore, the experience of feeling cared about in a relationship reduces the secretion of stress hormones and shifts the neuroendocrine system toward homeostasis. Because the social engagement of emotions is simultaneously the social engagement of the physiologic substrate of those emotions, the process has been labeled sociophysiology. This process can influence the health of both parties in the doctor-patient relationship, and may be relevant to third parties. Herbert M. Adler http://jdc.jefferson.edu/phbfp/3 http://jdc.jefferson.edu/phbfp/3 Mon, 29 Sep 2008 13:53:57 PDT Herbert M. Adler http://jdc.jefferson.edu/phbfp/2 http://jdc.jefferson.edu/phbfp/2 Mon, 30 Jul 2007 08:56:59 PDT Sleep is a vital, highly organized process regulated by complex systems of neuronal networks and neurotransmitters. Sleep plays an important role in the regulation of central nervous system and body physiologic functions. Sleep architecture changes with age and is easily susceptible to external and internal disruption. Reduction or disruption of sleep can affect numerous functions varying from thermoregulation to learning and memory during the waking state. Dimitri Markov http://jdc.jefferson.edu/phbfp/1 http://jdc.jefferson.edu/phbfp/1 Wed, 16 May 2007 13:44:39 PDT Introducton to the special issue on the sleep-psychiatry interface. Karl Doghramji