No abstract

SYNOPSISThe main aim of this study was to construct logistic models of emotional distress (defined as a GHQ-30 score of 6 or greater) in a community sample of 226 men and 225 women. The independent variables included were: sociodemographic characteristics, physical health status, social problems and undesirable life events. Univariate comparisons showed that in both sexes undesirable life events and social problems were associated with emotional distress; in men the presence of physical symptoms and widowed, separated or divorced status also showed such an association. Separate logistic regression models for men and women confirmed the importance of undesirable life events and social problems as predictors for emotional distress. In women there was also a significant interaction effect between the two variables on emotional distress. Sociodemographic characteristics and physical health status did not exert a statistically significant effect in these models.

The associations between marital relationships, as measured by the Ryle Marital Patterns Test, and symptoms of anxiety and depression as measured by the Interval General Health Questionnaire (I-GHQ), were assessed in 98 married couples in the community. Logistic regression analyses showed that symptoms of anxiety and depression in wives were best predicted by low ratings of affection exchange. Occupational class interacted with husbands' affection ratings, suggesting that in the nonmanual class only lower affection ratings were significantly associated with more symptoms. Anxiety in men was best predicted by low affection ratings while depression was best predicted by unemployment, by an affection discrepancy score indicating that more affection is given than received, and by a marriage which was rated as relatively more wife-dominated by wives and as relatively more husband-dominated by husbands.

Thirty women admitted to hospital for cholecystectomy were compared with a healthy community control group. Univariate comparisons showed that patients had significantly more social problems, manifested greater psychological distress and reported poorer social support. Logistic multiple regression analysis indicated that patient status was best predicted by manual occupational class and the interaction between employment and presence/absence of young children. The findings are discussed within the framework of illness behaviour.

The authors examine the problem of dementia from a theoreticalpractical point of view with special reference to psychiatric rehabilitation and to the contributions by the health and social systems. A case of presenile dementia is presented and the basic principles of intervention are described, which consist in 1) early diagnosis which allows the immediate realization of a specific rehabilitation program aiming at the patient's reintegration into his or her environment and at the maximal utilization of his or her residual capacity; and 2) the involvement of the families in the program and the psychological and social help necessary to sustain them in their effort. The authors discuss then to what extent this type of intervention is feasible in the context of a community psychiatric service as prescribed by the Italian psychiatric reform known as Law 180.