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Post-Polio Syndrome & Depression
"Psychiatric Aspects of PPS"
Henry Holland, M.D.

From a Post to the Polio Email List With Permission
PPSC DISCLAIMER

Wed, 21 Jul 1999 18:09:49 EDT
From: Henry Holland <Henry4FDR at AOL.COM>
Subject: Re: PPS and Depression

I have noticed several posts in recent days regarding PPS and depression. In my opinion, depression is often a component of the experience of PPS for two main reason. One is a secondary or reactive depression as a result of the losses suffered by many of us with PPS. As has already been written, many of us have lost self esteem because of loss of career, loss of financial resources, loss of a feeling of usefulness within a family system, and loss of physical and mental function. The other reason for the experience of depression among many PPSers is likely biological. There is the likelihood that some brain neurotransmitters such as serotonin and dopamine may be affected by the brain fatigue of PPS, resulting in some degree of biological depression. This may explain why in many cases a low dose of antidepressant medication is helpful to many of us.

Last year, as a member of the Department of Psychiatry at the Medical College of Virginia, I was involved in a research project taking a look at the psychiatric aspects of PPS. I will paste a summary of that study below. It is a survey, but has some degree of objectivity. I hope you find it interesting. This survey summary has been previously published in my support group's newsletter, The DEJA VIEW.

Henry Holland

Psychiatric Aspects of PPS
by Henry Holland

On April 3, 1998, Dr. Rizwan Ali, chief resident in the Department of Psychiatry at the Medical College of Virginia, made a Psychiatric Grand Rounds presentation on the topic of Psychiatric Aspects of Post-Polio Syndrome. Earlier this year, many of you may recall receiving a survey which you were asked to complete regarding PPS. The survey also included the Beck Anxiety and Depression Inventory. This survey was mailed to members of our PPSG [ The Central Virginia Post-Polio Support Group ] as well as PPSers in other support groups in the USA and to PPSers on the Internet including other countries. Two hundred fifty-six completed surveys were returned. Of this number, 64.5% were females, 63.3% married, 17.6% divorced, 12.9% single, 5.9% widowed, and 93.4% were white. 32.4% were employed and another 29.3% were doing some type of work (mostly part time) out of their home. 52.3% were retired or disabled and 42.2% were receiving disability or retirement benefits.

The mean age was 58.4 years, the average length of stay in the initial polio hospitalization was 256 days, the mean age of maximum recovery was 17 years, average years of education was 15.35 years, current average hours of work per week was 34.6 hours, and the average number of children was 1.93 (almost 2).

New symptoms associated with PPS were as follows: fatigue 89.8%, motor weakness 86.3%, muscle pain 77.3%, joint pain 68.8%, emotional problems 48.8%, sexual difficulties 25%, and alcohol and drug abuse 6.6%. The data with psychiatric relevance is displayed as follows:

Average number of all medications per PPSer 4.57
Average number of psychiatric medications per PPSer 0.59
Number taking no psychiatric medications 161 (62.9%)
Number taking one psychiatric medications 60 (23.4%)
Number taking two psychiatric medications 26 (10.2%)
Number taking three psychiatric medications 8 (3.1%)
Number taking five psychiatric medications 1 (0.4%)

Those reporting significant stress in their lives were 133 (52%) and those involved in psychotherapy or counseling were 131 (51.6%). This finding would indicate that most PPSers experiencing stress are involved in some form of psychotherapy. The breakdown of diagnostic categories is as follows: depression 89 (34.8%), adjustment/family problems 71 (27.7%), anxiety 68 (26.6%), posttraumatic stress disorder 25 (9.8%), psychosis 4 (1.6%), obsessive-compulsive disorder 10 (3.9%), phobia 8 (3.1%), and other 16 (6.3%). Some respondents reported more than one diagnosis.

The analysis of the data revealed four predictors for therapy with an 88% probability. They were:

  1. Older age at the onset of polio,
  2. Need for minimum support at the onset,
  3. Current presence of stress other than polio,
  4. and strangely, exclusion of right leg involvement with polio.

Other correlations for therapy were those PPSers with a higher level of education, older age, elevated Beck depression and anxiety scores, and the number of psychiatric medications. A high percentage of those experiencing fatigue, pain and disability from PPS were involved in psychotherapy or counseling.

I offer this data for your own information and review.

Henry

Dr. Holland is an active member of:
The Central Virginia Post-Polio Support Group

Post-Polio Syndrome Central
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