Journals Watch: Low literacy, asthma and anxiety

No time to read the journals? Let Dr Nicolette Price guide you through the latest findings.

Research of the week

MI and depression

Arch Intern Med 2006;166:2,035–43

This prospective study evaluated the prognostic importance of transient, new, or persistent depression on outcomes at six months after MI.

Depressive symptoms using the Patient Health Questionnaire were measured in 1,873 patients during hospitalisation, and one month after discharge and at six months.

It was found that depression at any stage after MI, including transient depression, is associated with worse outcomes (including lower quality of life, higher morbidity and mortality). The association of depression with such outcomes was found to be higher than with traditional measures of disease severity, such as previous MI.

Reduced lung function at birth and asthma

N Engl J Med 2006; 355: 1,682–9

This Norwegian study assessed whether measurement of lung function shortly after birth is a predictor of asthma at the age of 10 years.

The researchers measured lung function shortly after birth in 802 infants with the use of tidal breathing flow-volume loops, and in 664 infants using passive respiratory mechanics, including respiratory-system compliance.

At 10 years of age, 616 children (77 per cent) were reassessed by measuring lung function, exercise-induced bronchoconstriction, and bronchial hyperresponsiveness. Structured interviews were used to determine the asthma status and history.

From the results it was found that reduced lung function shortly after birth is indeed a significant risk factor for asthma in the first 10 years of life.

Anxiety disorders in children and adolescents

J Am Acad Child Adolesc Psychiatry 2006; 45: 1,179–87

In this study, 128 children and adolescents (mean age was 10.8 years) with anxiety disorders were enrolled to assess somatic symptoms in children and adolescents with anxiety disorder. The effect of treatment with fluvoxamine versus placebo was examined.

Most participants reported more than one somatic symptom, the most common being restlessness (74 per cent), stomach-ache (70 per cent), blushing (51 per cent) and palpitations (48 per cent).

Stomach ache was more frequent in boys. Adolescents described more physical symptoms than younger children.

Those with higher levels of somatic symptoms reported more interference with family relationships, and higher overall anxiety levels.

Significant reductions in somatic symptoms were found in children taking either fluvoxamine or placebo, but more so by fluvoxamine.

Low literacy in family planning clinics attendees

J Fam Plann Reprod Health Care 2006; 32: 235–9

This study assessed the association of low reading age in female attendees at Scottish family planning clinics, with sexual behaviour and knowledge.

A total of 505 female attendees aged between 16 and 35 years were interviewed about their sexual behaviour and knowledge.

The results showed that women with low literacy levels were more likely to have been under 16 at first intercourse, less likely to know the most fertile time of the menstrual cycle, and were less knowledgeable about STIs.

It was concluded that written information should be prepared bearing these findings in mind, and that alternative means of providing family planning education should be considered.

Pelvic muscle training for urinary incontinence

BJU Int 2006; 98: 811–7

In this study, 97 women with symptoms of stress urinary incontinence were recruited during a three-year period from a urogynaecology clinic.

Bladder neck mobility was assessed with ultrasonography before the trial and after the 14-week period of treatment. The intensive and carefully supervised programme involved an individualised pelvic muscle floor training programme, taught and monitored by an expert physiotherapist.

Results confirmed effectivity of the technique: bladder neck position was elevated, and significant improvements in loss of urine and quality of life achieved. I was relieved to read that once the initial intensive treatment is completed, twice-weekly exercise sessions are believed sufficient to maintain muscle strength.

- Dr Price is a medical examiner for the Department for Work and Pensions, a former GP in Hampshire, and a member of our team who regularly reviews the journals

The quick study

  • Reduced lung function at birth linked with asthma in children aged 10 years.
  • Children with somatic symptoms from anxiety are helped by fluvoxamine.
  • Sexual health knowledge is lower in women with poor literary levels.
  • Stress urinary incontinence is relieved by pelvic floor muscle training.

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