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Liu BP, Wang XT, Jia CX. Suicide attempters with high and low suicide intent: Different populations in rural China. Psychiatry Res 2017; 251:176-181. [PMID: 28213187 DOI: 10.1016/j.psychres.2017.01.096] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 11/16/2016] [Accepted: 01/08/2017] [Indexed: 11/16/2022]
Abstract
This paired case-control study aimed to compare characteristics between suicide attempters with high and low suicide intent in rural China. We evaluated 409 suicide attempters and their paired controls who were matched with the same gender, age (a difference of no more than 3 years), and similar residence. Compared to paired control, suicide attempt with high and low suicide intent shared the 3 common risk factors of negative life event, high depression score, and low social support score. In addition, mental disorder was an independent risk factor of suicide attempt with high intent. Having a low education level and occupation as a farmer were risk factors of suicide attempt with low intent. Mental disorder and depression were associated with a significantly increased risk of suicide attempt with high intent compared to low intent. Depression was found to be related to suicide attempt with high intent compared to low intent in the subgroups of male or female aged 35-54 or 55-70 years. Distinct characteristics were found in the suicide attempters with different intent. These findings are important and the aim is to transform them into concrete ideas for the prevention of suicide attempt in rural China.
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Affiliation(s)
- Bao-Peng Liu
- Department of Epidemiology, Shandong University School of Public Health, Jinan 250012, China
| | - Xin-Ting Wang
- Department of Epidemiology, Shandong University School of Public Health, Jinan 250012, China
| | - Cun-Xian Jia
- Department of Epidemiology, Shandong University School of Public Health, Jinan 250012, China.
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Abstract
OBJECTIVE The study compared distress levels among two groups of older adults who had been newly prescribed an antidepressant by their primary care physician, those with major depressive disorder (MDD) and those without MDD. METHODS This analysis used a convenience sample of participants (N=231) who had been newly prescribed an antidepressant in a randomized controlled trial of a program to improve antidepressant adherence and depression outcomes among older adults (≥55). After determining the proportion of participants with and without MDD (using the Structured Clinical Interview for DSM-IV), the authors compared groups on demographic, clinical, and psychosocial characteristics, including the 12-Item Short-Form Health Survey physical and mental component summary scores (PCS and MCS). Logistic regression was used to test the association of these characteristics with antidepressant use in the absence of MDD. RESULTS Most (57%) participants did not have MDD. This group was older (69.4 versus 64.7, p<.001), had a larger proportion of white participants (82% versus 56%, p<.001), and reported better physical (PCS, 43.4 versus 39.9, p=.03) and emotional (MCS, 40.2 versus 30.5, p<.001) well-being compared with the group with MDD. In the final regression model, white race (adjusted odds ratio [AOR]=3.11, p=.03) and better emotional well-being (AOR=1.16, p<.001) were associated with antidepressant use in the absence of MDD. CONCLUSIONS Older adults prescribed antidepressants in the absence of MDD did not report similar distress levels compared with their counterparts with MDD. Given the continued emphasis on screening for depression in primary care, it is important to consider the potential for overtreatment.
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Affiliation(s)
- Donovan T Maust
- Dr. Maust and Dr. Kales are with the Department of Psychiatry, University of Michigan, and the U.S. Department of Veterans Affairs (VA) Center for Clinical Management Research, VA Ann Arbor Healthcare System, both in Ann Arbor (e-mail: ). Dr. Sirey is with the Department of Psychiatry, Weill Cornell Medical College, White Plains, New York
| | - Jo Anne Sirey
- Dr. Maust and Dr. Kales are with the Department of Psychiatry, University of Michigan, and the U.S. Department of Veterans Affairs (VA) Center for Clinical Management Research, VA Ann Arbor Healthcare System, both in Ann Arbor (e-mail: ). Dr. Sirey is with the Department of Psychiatry, Weill Cornell Medical College, White Plains, New York
| | - Helen C Kales
- Dr. Maust and Dr. Kales are with the Department of Psychiatry, University of Michigan, and the U.S. Department of Veterans Affairs (VA) Center for Clinical Management Research, VA Ann Arbor Healthcare System, both in Ann Arbor (e-mail: ). Dr. Sirey is with the Department of Psychiatry, Weill Cornell Medical College, White Plains, New York
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153
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Sleath B, Sayner R, Vitko M, Carpenter DM, Blalock SJ, Muir KW, Giangiacomo AL, Hartnett ME, Robin AL. Glaucoma patient-provider communication about vision quality-of-life. PATIENT EDUCATION AND COUNSELING 2017; 100:703-709. [PMID: 27916461 PMCID: PMC5385288 DOI: 10.1016/j.pec.2016.11.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 11/18/2016] [Accepted: 11/21/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE The purpose of this study was to: (a) describe the extent to which ophthalmologists and glaucoma patients discuss vision quality-of-life during office visits, and (b) examine the association between patient and ophthalmologist characteristics and provider-patient communication about vision quality-of-life. METHODS Patients with glaucoma who were newly prescribed or on glaucoma medications were recruited at six ophthalmology clinics. Patients' visits were video-tape recorded and quality-of-life communication variables were coded. Generalized estimating equations were used to analyze the data. RESULTS Two hundred and seventy-nine patients participated. Specific glaucoma quality-of-life domains were discussed during only 13% of visits. Older patients were significantly more likely to discuss one or more vision quality-of-life domains than younger patients. African American patients were significantly less likely to make statements about their vision quality-of-life and providers were less likely to ask them one or more vision quality-of-life questions than non-African American patients. CONCLUSION Eye care providers and patients infrequently discussed the patient's vision quality-of-life during glaucoma visits. African American patients were less likely to communicate about vision quality-of-life than non-African American patients. PRACTICE IMPLICATIONS Eye care providers should make sure to discuss vision quality-of-life with glaucoma patients.
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Affiliation(s)
- Betsy Sleath
- Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, CB# 7573, Chapel Hill, NC 27599-7573, USA; Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, CB # 7590, Chapel Hill, NC 27599-7590, USA.
| | - Robyn Sayner
- Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, CB# 7573, Chapel Hill, NC 27599-7573, USA.
| | - Michelle Vitko
- Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, CB# 7573, Chapel Hill, NC 27599-7573, USA.
| | - Delesha M Carpenter
- Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, CB# 7573, Chapel Hill, NC 27599-7573, USA.
| | - Susan J Blalock
- Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, CB# 7573, Chapel Hill, NC 27599-7573, USA.
| | - Kelly W Muir
- Department of Ophthalmology, School of Medicine, Duke University and Durham VA Medical Center, Health Services Research and Development, 2351 Erwin Rd #3802, Durham, NC 27705, USA.
| | - Annette L Giangiacomo
- Ophthalmology, Emory University School of Medicine, 1365B Clifton Rd, Atlanta, GA 30322, USA.
| | - Mary Elizabeth Hartnett
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center University of Utah, 65 N Mario Capecchi, Salt Lake City, UT 84132, USA.
| | - Alan L Robin
- Ophthalmology and International Health, Johns Hopkins School of Medicine, 600 N Wolfe St, Baltimore, MD 21287, USA; Department of Ophthalmology, University of Maryland, 419 West Redwood St., Suite 420, Baltimore, MD 21201, USA; Department of Ophthalmology, University of Michigan, 1000 Wall St., Ann Arbor, MI 48105, USA.
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154
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Wariso BA, Guerrieri GM, Thompson K, Koziol DE, Haq N, Martinez PE, Rubinow DR, Schmidt PJ. Depression during the menopause transition: impact on quality of life, social adjustment, and disability. Arch Womens Ment Health 2017; 20:273-282. [PMID: 28000061 PMCID: PMC6309889 DOI: 10.1007/s00737-016-0701-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 12/05/2016] [Indexed: 11/29/2022]
Abstract
The impact of depression on quality of life (QOL) and social support has neither been well characterized in clinical samples of women with perimenopausal depression (PMD) nor have the relative contributions of depression and other menopausal symptoms (e.g., hot flushes) to declining QOL been clarified. In this study, we compared QOL measures, social support, and functional disability in PMD and non-depressed perimenopausal women. We evaluated women aged 40-60 years who presented with menstrual cycle irregularity, elevated plasma FSH levels, and met criteria for perimenopause. A structured clinical interview was administered to determine the presence or absence of major and minor depression. Outcome measures included the Quality of Life Enjoyment Scale Questionnaire, the Sheehan Disability Scale, the Global Assessment of Functioning, the Social Adjustment Scale, and the Duke Social Support Index. Kruskal-Wallis tests and ANOVAs were used to compare outcome measures. Ninety women with PMD and 51 control women participated in this study. Women with PMD reported significantly decreased QOL, social support, and adjustment and increased disability compared with non-depressed perimenopausal women. Neither perimenopausal reproductive status alone nor the presence of hot flushes had a significant negative impact on QOL measures. PMD is accompanied by significant reductions in QOL, social support, and disability similar to depression in women at other stages of life. PMD may also contribute to decreased QOL in community- or clinic-based samples of perimenopausal women. It remains unclear whether the clinical characteristics we identified reflect pre-existing risk factors for depression during the perimenopause or the effects of a current depression. Future clinical and treatment studies in perimenopausal women should distinguish depressed women when outcome measures include QOL.
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Affiliation(s)
- Bathsheba A Wariso
- Section on Behavioral Endocrinology, National Institute of Mental Health, NIMH, Bldg. 10CRC, Room 25330, 10 Center Drive MSC 1277, Bethesda, MD, 20892-1277, USA
| | - Gioia M Guerrieri
- Section on Behavioral Endocrinology, National Institute of Mental Health, NIMH, Bldg. 10CRC, Room 25330, 10 Center Drive MSC 1277, Bethesda, MD, 20892-1277, USA
| | - Karla Thompson
- Section on Behavioral Endocrinology, National Institute of Mental Health, NIMH, Bldg. 10CRC, Room 25330, 10 Center Drive MSC 1277, Bethesda, MD, 20892-1277, USA
| | - Deloris E Koziol
- Biostatistics and Clinical Epidemiology Service, Clinical Center, National Institutes of Health, Bethesda, MD, 20892-1871, USA
| | - Nazli Haq
- Section on Behavioral Endocrinology, National Institute of Mental Health, NIMH, Bldg. 10CRC, Room 25330, 10 Center Drive MSC 1277, Bethesda, MD, 20892-1277, USA
| | - Pedro E Martinez
- Section on Behavioral Endocrinology, National Institute of Mental Health, NIMH, Bldg. 10CRC, Room 25330, 10 Center Drive MSC 1277, Bethesda, MD, 20892-1277, USA
| | - David R Rubinow
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Peter J Schmidt
- Section on Behavioral Endocrinology, National Institute of Mental Health, NIMH, Bldg. 10CRC, Room 25330, 10 Center Drive MSC 1277, Bethesda, MD, 20892-1277, USA.
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155
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Korda RJ, Du W, Day C, Page K, Macdonald PS, Banks E. Variation in readmission and mortality following hospitalisation with a diagnosis of heart failure: prospective cohort study using linked data. BMC Health Serv Res 2017; 17:220. [PMID: 28320381 PMCID: PMC5359909 DOI: 10.1186/s12913-017-2152-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 03/10/2017] [Indexed: 11/24/2022] Open
Abstract
Background Hospitalisation for heart failure is common and post-discharge outcomes, including readmission and mortality, are often poor and are poorly understood. The purpose of this study was to examine patient- and hospital-level variation in the risk of 30-day unplanned readmission and mortality following discharge from hospital with a diagnosis of heart failure. Methods Prospective cohort study using data from the Sax Institute’s 45 and Up Study, linking baseline survey (Jan 2006-April 2009) to hospital and mortality data (to Dec 2011). Primary outcomes in those admitted to hospital with heart failure included unplanned readmission, mortality and combined unplanned readmission/mortality, within 30 days of discharge. Multilevel models quantified the variation in outcomes between hospitals and examined associations with patient- and hospital-level characteristics. Results There were 5074 participants with a heart failure admission discharged from 251 hospitals; 1052 (21%) had unplanned readmissions, 186 (3.7%) died, and 1146 (23%) had either/both outcomes within 30 days of discharge. Crude outcomes varied across hospitals, but between-hospital variation explained little of the total variation in outcomes (intraclass correlation coefficients (ICC) after inclusion of patient factors: 30-day unplanned readmission ICC = 0.0125 (p = 0.24); death ICC = 0.0000 (p > 0.99); unplanned readmission/death ICC = 0.0266 (p = 0.07)). Patient characteristics associated with a higher risk of unplanned readmission included: being male (male vs female, adjusted odds ratio (aOR) = 1.18, 95% CI: 1.00–1.37); prior hospitalisation for cardiovascular disease (aOR = 1.44, 1.08–1.91) and for anemia (aOR = 1.36, 1.14–1.63); comorbidities at admission (severe vs none: aOR = 1.26, 1.03–1.54); lower body-mass-index (obese vs normal weight: aOR = 0.77, 0.63–0.94); and lower social interaction scores. Similarly, risk of 30-day mortality was associated with patient- rather than hospital-level factors, in particular age (≥85y vs 45–< 75y: aOR = 3.23, 1.93–5.41) and comorbidity (severe vs none: aOR = 2.68, 1.82–3.94). Conclusions The issue of high readmission and mortality rates in people with heart failure appear to be system-wide, with the variation in these outcomes essentially attributable to variation between patients rather than hospitals. The findings suggest that there are limitations in using these outcomes as hospital performance measures in this patient population and support the need for patient-centred strategies to optimise heart failure management and outcomes. Electronic supplementary material The online version of this article (doi:10.1186/s12913-017-2152-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Rosemary J Korda
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australia.
| | - Wei Du
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australia
| | - Cathy Day
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australia
| | - Karen Page
- Deakin University, School of Nursing and Midwifery, Melbourne, Australia
| | - Peter S Macdonald
- St Vincent's Clinical School, Faculty of Medicine, University of New South Wales, Kensington, Australia
| | - Emily Banks
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australia.,The Sax Institute, Sydney, Australia
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156
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Gallione C, Dal Molin A, Cristina FVB, Ferns H, Mattioli M, Suardi B. Screening tools for identification of elder abuse: a systematic review. J Clin Nurs 2017; 26:2154-2176. [PMID: 28042891 DOI: 10.1111/jocn.13721] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2016] [Indexed: 01/17/2023]
Abstract
AIMS AND OBJECTIVES To review the efficacy and accuracy of tools administered to older people, intended to detect and measure elder abuse. BACKGROUND The mistreatment of older people represents a widespread problem, with exponential growth risk, especially considering the progressive ageing of the world population. It could have serious consequences for the victim's health if not recognised early, denounced and stopped. Abuse is often undetected by service providers because there is a lack of awareness surrounding the magnitude of the problem. Education and formal training in the signs of abuse are also generally poorly developed, as are reporting procedures which would lead to further investigation. DESIGN Systematic review. METHODS Comprehensive database searches of MEDLINE, Cochrane, EMBASE and Scopus were undertaken. Screening of 695 articles resulted in 11 included. Appraisal and analysis using PRISMA Statement and STROBE checklist were undertaken. RESULTS Eleven screening tools have been presented: H-S/EAST, VASS, EASI, CASE, BASE, E-IOA, EAI, EPAS, CPEABS, OAPAM and OAFEM, all aimed at healthcare professional or, in some cases, expected to be specifically used by nurses. CONCLUSIONS The fundamental function of any assessment instrument is to guide through a standardised screening process and to ensure that signs of abuse are not missed. Several tools have been tested; some have demonstrated a moderate to good internal consistency and some have been validated to allow an early identification. None have been evaluated against measurable violence or health outcomes. RELEVANCE TO CLINICAL PRACTICE Nurses and all healthcare providers should screen patients routinely. However, we are not able to recommend a single tool as the selection and implementation has to be appropriate to the setting. Furthermore, the study population and the possibility of using multiple tools in combination should be taken into consideration, to assess all the aspects of violence.
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Affiliation(s)
- Chiara Gallione
- Department of Translational Medicine, University of Eastern Piedmont, Novara/"Maggiore della Carità" University Hospital, Novara, Italy
| | - Alberto Dal Molin
- Department of Translational Medicine, University of Eastern Piedmont - Coordinator of Nursing School, Biella Hospital, Biella, Italy
| | | | | | | | - Barbara Suardi
- Department of Translational Medicine, University of Eastern Piedmont, Novara/"Maggiore della Carità" University Hospital, Novara, Italy
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157
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Shu CC, Cumming RG, Kendig HL, Blyth FM, Waite LM, Le Couteur DG, Handelsman DJ, Naganathan V. Health status, health behaviours and anxiety symptoms of older male caregivers: Findings from the Concord Health and Ageing in Men Project. Australas J Ageing 2017; 36:151-157. [PMID: 28211188 DOI: 10.1111/ajag.12376] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To explore differences between older male caregivers and non-caregivers on health status, health behaviours and well-being, including symptoms of anxiety. METHODS Data were collected through self-completed questionnaires and face-to-face interviews with 1705 community living men aged ≥70 in the Concord Health and Ageing in Men Project. RESULTS Eleven per cent of older men were caregivers, of whom 81.7% were looking after their wives or partners. Older male caregivers did not have worse physical health or more depressive symptoms than non-caregivers, but being a caregiver was associated with increased likelihood of reporting anxiety symptoms (OR: 2.32, 95% CI: 1.39-3.87). Caregivers had similar levels and frequencies of leisure activities but did more housework activities than non-caregivers. CONCLUSION Higher anxiety levels were the main adverse health condition in older male caregivers. Strategies to assist minimising anxiety for caregivers should be a target of interventions.
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Affiliation(s)
- Chen-Chun Shu
- Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, Sydney, New South Wales, Australia
| | - Robert G Cumming
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Hal L Kendig
- Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, Sydney, New South Wales, Australia.,College of Medicine, Australian National University, Melbourne, Victoria, Australia
| | - Fiona M Blyth
- Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, Sydney, New South Wales, Australia
| | - Louise M Waite
- Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, Sydney, New South Wales, Australia
| | - David G Le Couteur
- Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, Sydney, New South Wales, Australia.,ANZAC Research Institute, Concord Hospital, University of Sydney, Sydney, New South Wales, Australia
| | - David J Handelsman
- ANZAC Research Institute, Concord Hospital, University of Sydney, Sydney, New South Wales, Australia
| | - Vasi Naganathan
- Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, Sydney, New South Wales, Australia
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158
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Feng X, Astell-Burt T. Impact of a type 2 diabetes diagnosis on mental health, quality of life, and social contacts: a longitudinal study. BMJ Open Diabetes Res Care 2017; 5:e000198. [PMID: 28243446 PMCID: PMC5316913 DOI: 10.1136/bmjdrc-2016-000198] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Revised: 12/03/2016] [Accepted: 12/17/2016] [Indexed: 12/03/2022] Open
Abstract
AIMS The aim was to examine whether a type 2 diabetes mellitus (T2DM) diagnosis increases the odds of psychological distress, a worsening in overall quality of life, and a potential reduction in social contacts. METHOD Longitudinal data were obtained from the 45 and Up Study (baseline 2006-2008; 3.4±0.95 years follow-up time). Fixed effects logistic and negative binomial regression models were fitted on a complete case on outcome sample that did not report T2DM at baseline (N=26 344), adjusted for time-varying confounders. The key exposure was doctor-diagnosed T2DM at follow-up. Outcome variables examined included the Kessler Psychological Distress Scale, self-rated quality of life, and four indicators of social contacts. RESULTS A modest increase in the odds of psychological distress associated with T2DM diagnosis (OR=1.30) was not statistically significant (95% CI 0.75 to 2.25). A T2DM diagnosis was associated with a fivefold increase in the odds of a participant reporting that their quality of life had become significantly poorer (OR 5.49, 95% CI 1.26 to 23.88). T2DM diagnosis was also associated with a reduction in times spent with friends and family (RR 0.88, 95% CI 0.82 to 0.95), contacts by telephone (RR 0.95, 95% CI 0.87 to 1.02), attendance at social clubs or religious groups (RR 0.82, 95% CI 0.73 to 0.91), and the number of people nearby but outside the home that participants felt they could rely on (RR 0.92, 95% CI 0.86 to 0.98). CONCLUSIONS A T2DM diagnosis can have important impacts on quality of life and on social contacts, which may have negative impacts on mental health and T2DM management in the longer term.
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Affiliation(s)
- Xiaoqi Feng
- Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
- Early Start Research Institute, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Thomas Astell-Burt
- Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
- Early Start Research Institute, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
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159
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Feng X, Astell-Burt T. What types of social interactions reduce the risk of psychological distress? Fixed effects longitudinal analysis of a cohort of 30,271 middle-to-older aged Australians. J Affect Disord 2016; 204:99-102. [PMID: 27344617 DOI: 10.1016/j.jad.2016.06.041] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 06/12/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Research on the impact of social interactions on psychological distress tends to be limited to particular forms of support, cross-sectional designs and by the spectre of omitted variables bias. METHOD A baseline sample with 3.4±0.95 years follow-up time was extracted from the 45 and Up Study. Change in the risk of psychological distress (Kessler Psychological Distress Scale) was assessed using fixed effects logistic regressions in relation to the number of times in the past week a participant: i) spent time with friends or family they did not live with; ii) talked to friends, relatives or others on the telephone; iii) attended meetings at social clubs or religious groups; and the count of people outside their home, but within one hour travel-time, participants felt close to. Separate models were fitted for men and women, adjusting for age, income, economic and couple status. RESULTS An increase in the number of social interactions was associated with a reduction in the risk of psychological distress, with some gender differences. Interactions with friends or family were important for women (adjusted OR 0.85, 95%CI 0.74, 0.98, p=0.024), whereas telephone calls were effective among men (adjusted OR 0.83, 95%CI 0.72, 0.96, p=0.011). Strong effects for the number of people that can be relied on were observed for men and women, but attendance at clubs and groups was not. No age-specific effects were observed. LIMITATIONS No indicator of positive mental health. CONCLUSIONS Policies targeting greater social interactions in middle-to-older age may help protect mental health.
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Affiliation(s)
- Xiaoqi Feng
- School of Health and Society, University of Wollongong, Wollongong, NSW 2522, Australia; Early Start Research Institute (ESRI), University of Wollongong, Wollongong, NSW 2522, Australia; Illawarra Health and Medical Research Institute (IHMRI), Wollongong, NSW 2522, Australia.
| | - Thomas Astell-Burt
- School of Health and Society, University of Wollongong, Wollongong, NSW 2522, Australia; Early Start Research Institute (ESRI), University of Wollongong, Wollongong, NSW 2522, Australia; Illawarra Health and Medical Research Institute (IHMRI), Wollongong, NSW 2522, Australia
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160
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Koenig HG, Pearce MJ, Nelson B, Erkanli A. Effects on Daily Spiritual Experiences of Religious Versus Conventional Cognitive Behavioral Therapy for Depression. JOURNAL OF RELIGION AND HEALTH 2016; 55:1763-77. [PMID: 27305903 DOI: 10.1007/s10943-016-0270-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
We compared religiously integrated cognitive behavioral therapy (RCBT) versus conventional CBT (CCBT) on increasing daily spiritual experiences (DSE) in major depressive disorder and chronic medical illness. A total of 132 participants aged 18-85 were randomized to either RCBT (n = 65) or CCBT (n = 67). Participants received ten 50-min sessions (primarily by telephone) over 12 weeks. DSE was assessed using the Daily Spiritual Experiences Scale (DSES). Mixed-effects growth curve models compared the effects of treatment group on trajectory of change in DSE. Baseline DSE and changes in DSE were examined as predictors of change in depressive symptoms. DSE increased significantly in both groups. RCBT tended to be more effective than CCBT with regard to increasing DSE (group by time interaction B = -1.80, SE = 1.32, t = -1.36, p = 0.18), especially in those with low religiosity (B = -4.26, SE = 2.27, t = -1.88, p = 0.07). Higher baseline DSE predicted a decrease in depressive symptoms (B = -0.09, SE = 0.04, t = -2.25, p = 0.025), independent of treatment group, and an increase in DSE with treatment correlated with a decrease in depressive symptoms (r = 0.29, p = 0.004). RCBT tends to be more effective than CCBT in increasing DSE, especially in persons with low religiosity. Higher baseline DSE and increases in DSE over time predict a faster resolution of depressive symptoms. Efforts to increase DSE, assessed by a measure such as the DSES, may help with the treatment of depression in the medically ill.
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Affiliation(s)
- Harold G Koenig
- Duke University Medical Center, Box 3400, Durham, NC, 27710, USA.
- King Abdulaziz University, Jeddah, Saudi Arabia.
- School of Public Health, Ningxia Medical University, Yinchuan, People's Republic of China.
| | - Michelle J Pearce
- Department of Family and Community Medicine, Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Bruce Nelson
- Department of Research, Glendale Adventist Medical Center, Glendale, CA, USA
| | - Alaattin Erkanli
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA
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Chandler MJ, Parks AC, Marsiske M, Rotblatt LJ, Smith GE. Everyday Impact of Cognitive Interventions in Mild Cognitive Impairment: a Systematic Review and Meta-Analysis. Neuropsychol Rev 2016; 26:225-251. [PMID: 27632385 PMCID: PMC5048589 DOI: 10.1007/s11065-016-9330-4] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 08/22/2016] [Indexed: 01/13/2023]
Abstract
Cognitive interventions in Mild Cognitive Impairment (MCI) seek to ameliorate cognitive symptoms in the condition. Cognitive interventions may or may not generalize beyond cognitive outcomes to everyday life. This systematic review and meta-analysis sought to assess the effect of cognitive interventions compared to a control group in MCI on generalizability outcome measures [activities of daily living (ADLs), mood, quality of life (QOL), and metacognition] rather than cognitive outcomes alone. PRISMA guidelines were followed. MEDLINE and PsychInfo were utilized as data sources to locate references related to cognitive interventions in individuals with MCI. The cognitive intervention study was required to have a control or alternative treatment comparison group to be included. Thirty articles met criteria, including six computerized cognitive interventions, 14 therapist-based interventions, and 10 multimodal (i.e., cognitive intervention plus an additional intervention) studies. Small, but significant overall median effects were seen for ADLs (d = 0.23), mood (d = 0.16), and metacognitive outcomes (d = 0.30), but not for QOL (d = 0.10). Computerized studies appeared to benefit mood (depression, anxiety, and apathy) compared to controls, while therapist-based interventions and multimodal interventions had more impact on ADLs and metacognitive outcomes than control conditions. The results are encouraging that cognitive interventions in MCI may impact everyday life, but considerably more research is needed. The current review and meta-analysis is limited by our use of only PsychInfo and MEDLINE databases, our inability to read full text non-English articles, and our reliance on only published data to complete effect sizes.
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Affiliation(s)
- M J Chandler
- Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA.
| | - A C Parks
- Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - M Marsiske
- University of Florida, Gainesville, FL, USA
| | | | - G E Smith
- University of Florida, Gainesville, FL, USA
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162
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Abstract
BACKGROUND Driving cessation in later life is associated with depression. This study examines if social support can buffer the negative effects of driving cessation on older women's mental health. METHODS Participants were drawn from the 1921-1926 cohort of the Australian Longitudinal Study on Women's Health (ALSWH) and included 4,075 older women (aged 76-87 years) who drove at baseline, following them for three years to assess driving cessation. The outcome variable was mental health, measured by the mental health index (MHI) of the SF-36. The explanatory variables were social support factors, including social interaction, whether the women were living alone or with others, and engagement in social activities. Control variables included age, country of birth, area of residence, ability to manage on income, marital status, and general health. RESULTS Main effect results showed that poor mental health was predicted by driving cessation, low levels of social interaction, and non-engagement in social activities. There was a significant interaction effect of driving status by social activities engagement on mental health. Women who remained active in their engagement of social activities were able to maintain a good level of mental health despite driving cessation. CONCLUSION Engagement and participation in social activities can help older women who stopped driving maintain a good level of mental health.
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163
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Dyck DG, Weeks DL, Gross S, Lederhos Smith C, Lott HA, Wallace AJ, Wood SM. Comparison of two psycho-educational family group interventions for improving psycho-social outcomes in persons with spinal cord injury and their caregivers: a randomized-controlled trial of multi-family group intervention versus an active education control condition. BMC Psychol 2016; 4:40. [PMID: 27457478 PMCID: PMC4960711 DOI: 10.1186/s40359-016-0145-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 07/14/2016] [Indexed: 11/24/2022] Open
Abstract
Background Over 12,000 individuals suffer a spinal cord injury (SCI) annually in the United States, necessitating long-term, complex adjustments and responsibilities for patients and their caregivers. Despite growing evidence that family education and support improves the management of chronic conditions for care recipients as well as caregiver outcomes, few systematic efforts have been made to involve caregivers in psycho-educational interventions for SCI. As a result, a serious gap exists in accumulated knowledge regarding effective, family-based treatment strategies for improving outcomes for individuals with SCI and their caregivers. The proposed research aims to fill this gap by evaluating the efficacy of a structured adaptation of an evidence-based psychosocial group treatment called Multi-Family Group (MFG) intervention. The objective of this study is to test, in a randomized-controlled design, an MFG intervention for the treatment of individuals with SCI and their primary caregivers. Our central hypothesis is that by providing support in an MFG format, we will improve coping skills of persons with SCI and their caregivers as well as supportive strategies employed by caregivers. Methods We will recruit 32 individuals with SCI who have been discharged from inpatient rehabilitation within the previous 3 years and their primary caregivers. Patient/caregiver pairs will be randomized to the MFG intervention or an active SCI education control (SCIEC) condition in a two-armed randomized trial design. Participants will be assessed pre- and post-program and 6 months post-program. Intent to treat analyses will test two a priori hypotheses: (1) MFG-SCI will be superior to SCIEC for SCI patient activation, health status, and emotion regulation, caregiver burden and health status, and relationship functioning, and (2) MFG will be more effective for individuals with SCI and their caregivers when the person with SCI is within 18 months of discharge from inpatient rehabilitation compared to when the person is between 19 and 36 months post discharge. Discussion Support for our hypotheses will indicate that MFG-SCI is superior to specific education for assisting patients and their caregivers in the management of difficult, long-term, life adjustments in the months and years after SCI, with increased efficacy closer in time to the injury. Trial registration ClinicalTrials.gov NCT02161913. Registered 10 June 2014.
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Affiliation(s)
- Dennis G Dyck
- Department of Psychology, Washington State University Spokane, 412 E. Spokane Falls Blvd., Spokane, WA, 99202, USA.
| | - Douglas L Weeks
- St. Luke's Rehabilitation Institute, 711 S. Cowley St., Spokane, WA, 99202, USA.,Department of Biomedical Sciences, Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, 99202, USA
| | - Sarah Gross
- St. Luke's Rehabilitation Institute, 711 S. Cowley St., Spokane, WA, 99202, USA
| | - Crystal Lederhos Smith
- College of Nursing, Washington State University Spokane, 412 E. Spokane Falls Blvd., Spokane, WA 99202, USA
| | - Hilary A Lott
- St. Luke's Rehabilitation Institute, 711 S. Cowley St., Spokane, WA, 99202, USA
| | - Aimee J Wallace
- St. Luke's Rehabilitation Institute, 711 S. Cowley St., Spokane, WA, 99202, USA
| | - Sonya M Wood
- St. Luke's Rehabilitation Institute, 711 S. Cowley St., Spokane, WA, 99202, USA
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Abstract
OBJECTIVE Two small studies have suggested that family carers of people with dementia may be a high-risk group for suicide. The objective of this study was to further explore the rate of suicidal ideation in a large sample of carers and identify psychosocial risk and protective factors. METHOD A cross-sectional survey was conducted with 566 family carers. The survey included measures of suicidality, self-efficacy, physical health, depression, anxiety, hopelessness, optimism, burden, coping strategies, and social support. RESULTS Sixteen percent of carers had contemplated suicide more than once in the previous year. There were univariate differences between suicidal and non-suicidal carers on self-efficacy, social support, coping, burden, depression, anxiety, hopelessness, optimism, reasons for living, and symptoms of dementia, as well as age and income management. In a multivariate model, age, depression, and reasons for living predicted suicidal ideation. In tests for mediation, satisfaction with social support and dysfunctional coping had indirect effects on suicidal ideation via depression. CONCLUSION Family carers of people with dementia have high rates of suicidal ideation, with depression a risk factor and increasing age and reasons for living as protective factors. Depression and reasons for living should be targeted in interventions to reduce suicide risk in dementia carers.
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Affiliation(s)
- Siobhan T O'Dwyer
- a Centre for Health Practice Innovation, Menzies Health Institute Queensland , Griffith University , Brisbane , Australia
| | - Wendy Moyle
- a Centre for Health Practice Innovation, Menzies Health Institute Queensland , Griffith University , Brisbane , Australia
| | | | - Diego De Leo
- c Australian Institute for Suicide Research and Prevention , Griffith University, Mt. Gravatt , Australia
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Heisel MJ, Flett GL. Investigating the psychometric properties of the Geriatric Suicide Ideation Scale (GSIS) among community-residing older adults. Aging Ment Health 2016; 20:208-21. [PMID: 26286664 DOI: 10.1080/13607863.2015.1072798] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To investigate the psychometric properties of the Geriatric Suicide Ideation Scale (GSIS) among community-residing older adults. METHOD We recruited 173 voluntary participants, 65 years and older, into a 2+ year longitudinal study of the onset or exacerbation of depressive symptoms and suicide ideation. We assessed the internal consistency of the GSIS and its four component subscales, and its shorter and longer duration test-retest reliability, convergent (depression, social hopelessness, and loneliness), divergent (psychological well-being, life satisfaction, perceived social support, and self-rated health), discriminant (basic and instrumental activities of daily living and social desirability), criterion (history of suicide behavior), and predictive validity (future suicide ideation). RESULTS The GSIS demonstrated strong test-retest reliability and internal consistency. Baseline GSIS scores were significantly positively associated with suicide risk factors, negatively associated with potential resiliency factors, and not associated with functional impairment or social desirability. GSIS scores significantly differentiated between participants with as compared to those without a history of suicide behavior. Baseline GSIS scores significantly predicted suicide ideation at a 2+ year follow-up assessment. CONCLUSION Findings suggest strong measurement characteristics for the GSIS with community-residing older adults, including impressive consistency over time. These results are consistent with research attesting to the empirical and pragmatic strengths of this measure. These findings have implications for the monitoring of suicide risk when aiming to enhance mental health and well-being and prevent suicide in later life.
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Affiliation(s)
- Marnin J Heisel
- a Department of Psychiatry, Schulich School of Medicine and Dentistry , The University of Western Ontario , London , Canada.,b Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry , The University of Western Ontario , London , Canada.,c Lawson Health Research Institute , London , Canada.,d Center for the Study and Prevention of Suicide, Department of Psychiatry , University of Rochester Medical Center , Rochester , NY , USA
| | - Gordon L Flett
- e Department of Psychology , York University , Toronto , Canada
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166
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Van Orden KA, Smith PN, Chen T, Conwell Y. A Case Controlled Examination of the Interpersonal Theory of Suicide in the Second Half of Life. Arch Suicide Res 2016. [PMID: 26219512 PMCID: PMC4899307 DOI: 10.1080/13811118.2015.1025121] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The interpersonal theory of suicide proposes that the most proximal cause of suicide is the combination of thwarted belongingness and perceived burdensomeness coupled with a pre-existing vulnerability of reduced fear of death and increased pain tolerance. This pre-existing vulnerability develops in response to painful and provocative life events. According to the theory, empirically demonstrated risk factors for suicide operate by increasing the likelihood of one or more of the theory's constructs. The current study examined the relations of the major constructs of the interpersonal theory with suicide case status compared to living controls in the second half of life. The current study used a pre-existing psychological autopsy database to compare suicide decedents to living controls 50 years and older. Theory constructs were measured by composite scores of thwarted belongingness, perceived burdensomeness, and painful and provocative experiences using an a priori selection of items comprising each construct. Suicide decedents experienced greater levels of all three of the theory's constructs when examined independently compared to living controls. When examined simultaneously while also controlling for Major Depression, greater perceived burdensomeness and painful and provocative experiences were associated with suicide case status (vs. control). The interpersonal theory is a comprehensive framework that may be useful in understanding risk for death by suicide in the second half of life. Clinical management of suicide risk for adults in the second half of life could include a focus on perceived burdensomeness, as the IPTS proposes that this psychological state is amenable to change via therapeutic intervention.
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167
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Schofield M, Hussain R, Loxton D, Miller Z. Psychosocial and Health Behavioural Covariates of Cosmetic Surgery: Women’s Health Australia Study. J Health Psychol 2016; 7:445-57. [DOI: 10.1177/1359105302007004332] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Current psychosocial and health behavioural covariates of past cosmetic surgery were assessed in a population-based sample ( n = 14,100) aged 45-50 years, from the baseline survey of the Women’s Health Australia study. Seven percent ( n = 982) reported having ever had cosmetic surgery. Multivariate analysis found that self-reported dieting frequency in the past year and body mass index were highly significant covariates of cosmetic surgery; perception about body weight was moderately significant, and satisfaction with body weight was unrelated. A higher likelihood of cosmetic surgery was also found for women who had ever been in a violent relationship, who had been verbally abused recently, smokers, those taking medication for sleep or nerves and those with private hospital insurance. There were moderate associations between cosmetic surgery and state of residence, higher occupational status, alcohol use, higher stress and poorer mental health. Life satisfaction, social support, recent life events, physical health, area of residence, country of birth and marital status, though all significant at the univariate level, were unrelated in multivariate analyses. The psychological and health implications of the findings are discussed.
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Affiliation(s)
- Margot Schofield
- School of Health, University of New England, Australia; Research Centre for Gender and Health, University of Newcastle, Australia
| | - Rafat Hussain
- School of Health, University of New England, Australia,
| | - Debbie Loxton
- School of Health, University of New England, Australia
| | - Zoe Miller
- School of Health, University of New England, Australia
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Miller-Lewis LR, Wade TD, Lee C. Risk factors for pregnancy and childbearing in single young women: Evidence from the Australian Longitudinal Study on Women's Health. INTERNATIONAL JOURNAL OF BEHAVIORAL DEVELOPMENT 2016. [DOI: 10.1177/01650250544000071] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study investigated psychosocial predictors of early pregnancy and childbearing in single young women, consistent with the Eriksonian developmental perspective. Two mail-out surveys assessing reproductive behaviour and sociodemographic, education/competence, psychosocial well-being, and aspiration factors were completed 4 years apart by 2635 young women, aged 18 to 20 when first surveyed. Young women in the “emerging adulthood” developmental period were selected from the Australian Longitudinal Study on Women's Health. Longitudinally, lower investment in education over low-status paid work, experiencing unemployment, greater psychosocial distress, stress and alcohol use, and high family aspirations combined with low vocational aspirations were risk factors for early single pregnancy and childbearing. Several mediational relationships also existed between these predictor variables. It was concluded that psychosocial factors play an important role in understanding early pregnancy and childbearing in single young Australian women, and that the findings provide some support for investigating early pregnancy and childbearing from an Eriksonian developmental perspective.
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169
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Schofield MJ, Reynolds R, Mishra GD, Powers JR, Dobson AJ. Screening for Vulnerability to Abuse Among Older Women: Women's Health Australia Study. J Appl Gerontol 2016. [DOI: 10.1177/0733464802021001002] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The validity of a brief self-report screening measure for elder abuse was examined on a nationally representative sample of more than 12,000 older women in the baseline survey of the Australian Longitudinal Study onWomen's Health. The screening instrument was a modification of the Hwalek-Sengstock Elder Abuse Screening Test. Construct validity was examined using factor analysis and correlation with a wide range of sociodemographic, psychological, and healthrelated variables. Four factors, each of three items, were identified representing the following domains: Vulnerability, Dependence, Dejection, and Coercion. The Vulnerability and Coercion factors had the highest face validity for abuse and demonstrated moderate to good construct validity. The six items comprising these factors may provide a simple screening tool for elder abuse. The identified correlates of abuse indicators have the potential to enhance policy development, screening, intervention, and carer support programs.
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170
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Wang Z, Koenig HG, Ma H, Shohaib SA. Religion, Purpose in Life, Social Support, and Psychological Distress in Chinese University Students. JOURNAL OF RELIGION AND HEALTH 2016; 55:1055-1064. [PMID: 26818682 DOI: 10.1007/s10943-016-0184-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
We examined the relationship between religious involvement and psychological distress and explored the mediating effects of social support and purpose in life in university students in western, mid-western, and eastern China. Cross-sectional survey of a representative sample of 1812 university students was conducted. The Purpose in Life scale, Duke Social Support Index, and Religious Commitment Inventory-10 were administered, along with Kessler's Psychological Distress Scale. Structural equation modeling was used to test two models of the mediation hypothesis, examining direct, indirect, and total effects. Model 1 (with direction of effect hypothesized from religiosity to psychological distress) indicated that religious involvement had a direct effect on increasing psychological distress (β = 0.23, p < .01) with minor mediated effects. However, Model 2 (with direction of effect hypothesized from psychological distress to religiosity) indicated strong indirect protective effects of religiosity on psychological distress through purpose in life and social support (β = -.40, p < .01). The findings are consistent with the hypothesis that psychological distress increases religious involvement, which then increases purpose in life and social support that then lead to lower psychological distress.
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Affiliation(s)
- Zhizhong Wang
- Department of Epidemiology and Statistics, School of Public Health, Ningxia Medical University, Yinchuan, 750004, China
| | - Harold G Koenig
- Department of Epidemiology and Statistics, School of Public Health, Ningxia Medical University, Yinchuan, 750004, China.
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Box 3400, Durham, NC, 27710, USA.
- Department of Medicine, Duke University Medical Center, Durham, NC, 27710, USA.
- Department of Medicine, King Abdulaziz University (KAU), Jeddah, 22254, Saudi Arabia.
| | - Hui Ma
- Department of Epidemiology and Statistics, School of Public Health, Ningxia Medical University, Yinchuan, 750004, China
| | - Saad Al Shohaib
- Department of Medicine, King Abdulaziz University (KAU), Jeddah, 22254, Saudi Arabia
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171
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Choo WY, Hairi NN, Sooryanarayana R, Yunus RM, Hairi FM, Ismail N, Kandiben S, Mohd Ali Z, Ahmad SN, Abdul Razak I, Othman S, Tan MP, Mydin FHM, Peramalah D, Brownell P, Bulgiba A. Elder mistreatment in a community dwelling population: the Malaysian Elder Mistreatment Project (MAESTRO) cohort study protocol. BMJ Open 2016; 6:e011057. [PMID: 27225651 PMCID: PMC4885447 DOI: 10.1136/bmjopen-2016-011057] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Despite being now recognised as a global health concern, there is still an inadequate amount of research into elder mistreatment, especially in low and middle-income regions. The purpose of this paper is to report on the design and methodology of a population-based cohort study on elder mistreatment among the older Malaysian population. The study aims at gathering data and evidence to estimate the prevalence and incidence of elder mistreatment, identify its individual, familial and social determinants, and quantify its health consequences. METHODS AND ANALYSIS This is a community-based prospective cohort study using randomly selected households from the national census. A multistage sampling method was employed to obtain a total of 2496 older adults living in the rural Kuala Pilah district. The study is divided into two phases: cross-sectional study (baseline), and a longitudinal follow-up study at the third and fifth years. Elder mistreatment was measured using instrument derived from the previous literature and modified Conflict Tactic Scales. Outcomes of elder mistreatment include mortality, physical function, mental health, quality of life and health utilisation. Logistic regression models are used to examine the relationship between risk factors and abuse estimates. Cox proportional hazard regression will be used to estimate risk of mortality associated with abuse. Associated annual rate of hospitalisation and health visit frequency, and reporting of abuse, will be estimated using Poisson regression. ETHICS AND DISSEMINATION The study has been approved by the Medical Ethics Committee of the University of Malaya Medical Center (MEC Ref 902.2) and the Malaysian National Medical Research Register (NMRR-12-1444-11726). Written consent was obtained from all respondents prior to baseline assessment and subsequent follow-up. Findings will be disseminated to local stakeholders via forums with community leaders, and health and social welfare departments, and published in appropriate scientific journals and presented at conferences.
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Affiliation(s)
- Wan Yuen Choo
- Department of Social and Preventive Medicine, Faculty of Medicine, Julius Centre University of Malaya, University of Malaya, Kuala Lumpur, Malaysia
| | - Noran Naqiah Hairi
- Department of Social and Preventive Medicine, Faculty of Medicine, Julius Centre University of Malaya, University of Malaya, Kuala Lumpur, Malaysia
| | - Rajini Sooryanarayana
- Department of Social and Preventive Medicine, Faculty of Medicine, Julius Centre University of Malaya, University of Malaya, Kuala Lumpur, Malaysia
| | - Raudah Mohd Yunus
- Department of Social and Preventive Medicine, Faculty of Medicine, Julius Centre University of Malaya, University of Malaya, Kuala Lumpur, Malaysia
| | - Farizah Mohd Hairi
- Department of Social and Preventive Medicine, Faculty of Medicine, Julius Centre University of Malaya, University of Malaya, Kuala Lumpur, Malaysia
| | - Norliana Ismail
- Department of Social and Preventive Medicine, Faculty of Medicine, Julius Centre University of Malaya, University of Malaya, Kuala Lumpur, Malaysia
| | - Shathanapriya Kandiben
- Department of Social and Preventive Medicine, Faculty of Medicine, Julius Centre University of Malaya, University of Malaya, Kuala Lumpur, Malaysia
| | | | | | | | - Sajaratulnisah Othman
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Maw Pin Tan
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Fadzilah Hanum Mohd Mydin
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Devi Peramalah
- Department of Social and Preventive Medicine, Faculty of Medicine, Julius Centre University of Malaya, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Awang Bulgiba
- Department of Social and Preventive Medicine, Faculty of Medicine, Julius Centre University of Malaya, University of Malaya, Kuala Lumpur, Malaysia
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Astell-Burt T, Feng X, Kolt GS. Large-scale investment in green space as an intervention for physical activity, mental and cardiometabolic health: study protocol for a quasi-experimental evaluation of a natural experiment. BMJ Open 2016; 6:e009803. [PMID: 27053266 PMCID: PMC4823445 DOI: 10.1136/bmjopen-2015-009803] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
INTRODUCTION 'Green spaces' such as public parks are regarded as determinants of health, but evidence from tends to be based on cross-sectional designs. This protocol describes a study that will evaluate a large-scale investment in approximately 5280 hectares of green space stretching 27 km north to south in Western Sydney, Australia. METHODS AND ANALYSIS A Geographic Information System was used to identify 7272 participants in the 45 and Up Study baseline data (2006-2008) living within 5 km of the Western Sydney Parklands and some of the features that have been constructed since 2009, such as public access points, advertising billboards, walking and cycle tracks, BBQ stations, and children's playgrounds. These data were linked to information on a range of health and behavioural outcomes, with the second wave of data collection initiated by the Sax Institute in 2012 and expected to be completed by 2015. Multilevel models will be used to analyse potential change in physical activity, weight status, social contacts, mental and cardiometabolic health within a closed sample of residentially stable participants. Comparisons between persons with contrasting proximities to different areas of the Parklands will provide 'treatment' and 'control' groups within a 'quasi-experimental' study design. In line with expectations, baseline results prior to the enhancement of the Western Sydney Parklands indicated virtually no significant differences in the distribution of any of the outcomes with respect to proximity to green space preintervention. ETHICS AND DISSEMINATION Ethical approval was obtained for the 45 and Up Study from the University of New South Wales Human Research Ethics Committee. Ethics approval for this study was obtained from the University of Western Sydney Ethics Committee. Findings will be disseminated through partner organisations (the Western Sydney Parklands and the National Heart Foundation of Australia), as well as to policymakers in parallel with scientific papers and conference presentations.
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Affiliation(s)
- Thomas Astell-Burt
- School of Health and Society, University of Wollongong, Wollongong, NSW, Australia
- Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
- Early Start Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Xiaoqi Feng
- School of Health and Society, University of Wollongong, Wollongong, NSW, Australia
- Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
- Early Start Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Gregory S Kolt
- School of Science and Health, Western Sydney University, Penrith, NSW, Australia
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173
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Aihara Y, Shrestha S, Sharma J. Household water insecurity, depression and quality of life among postnatal women living in urban Nepal. JOURNAL OF WATER AND HEALTH 2016; 14:317-324. [PMID: 27105416 DOI: 10.2166/wh.2015.166] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVES This observational study aimed to assess distress related to the household water supply and to examine the relationship between household water insecurity and psychological health among Nepali postnatal women. METHODS In total, 300 women consented to participate in the study, of which 267 women were able to participate in a follow-up 1 month after discharge. We developed a household water insecurity scale (HWIS; total score range 0-24 points) by adapting the household food insecurity access scale. RESULTS The Cronbach's coefficient alpha for the HWIS was moderately acceptable. Psychological health was assessed in terms of postnatal depression and physical health-related quality of life (HRQOL). The median score of the HWIS was 8, and more than 60% of the participants answered that they sometimes or often worried about not having enough water, used only small amounts of water, had a lack of hygiene, and had insufficient time for childrearing. Multiple regression models showed that women with high levels of stress derived from household water insecurity had greater odds of probable depression and lower physical HRQOL scores than did women with low HWIS scores. CONCLUSION The results suggest that improving water security is necessary to foster maternal psychological health in developing countries.
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Affiliation(s)
- Yoko Aihara
- Kobe City College of Nursing, 3-4 Gakuennishimachi Nishi-ku Kobe-city, Hyogo 651-2103, Japan E-mail:
| | - Salina Shrestha
- Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, 4-3-11 Takeda, Kofu-city, Yamanashi 400-8511, Japan
| | - Jyoti Sharma
- Department of Gynaecology/Obstetric, Institute of Medicine, Tribhuvan University, Maharajgunj 3, Kathmandu, Nepal
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174
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Gardiner PA, Mishra GD, Dobson AJ. The Effect of Socioeconomic Status Across Adulthood on Trajectories of Frailty in Older Women. J Am Med Dir Assoc 2016; 17:372.e1-3. [DOI: 10.1016/j.jamda.2015.12.090] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 12/18/2015] [Indexed: 11/25/2022]
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175
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Wallace GL, Budgett J, Charlton RA. Aging and autism spectrum disorder: Evidence from the broad autism phenotype. Autism Res 2016; 9:1294-1303. [DOI: 10.1002/aur.1620] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 02/05/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Gregory L. Wallace
- Department of Speech and Hearing Sciences; The George Washington University; Washington DC
| | - Jessica Budgett
- Department of Psychology; Goldsmiths University of London; London UK
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Perlick DA, Berk L, Kaczynski R, Gonzalez J, Link B, Dixon L, Grier S, Miklowitz DJ. Caregiver burden as a predictor of depression among family and friends who provide care for persons with bipolar disorder. Bipolar Disord 2016; 18:183-91. [PMID: 27004622 DOI: 10.1111/bdi.12379] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 11/18/2015] [Accepted: 01/12/2016] [Indexed: 01/04/2023]
Abstract
OBJECTIVES Over one-third of caregivers of people with bipolar disorder report clinically significant levels of depressive symptoms. This study examined the causal relationship between depression and caregiver burden in a large sample of caregivers of adult patients with bipolar disorder. METHODS Participants were 500 primary caregivers of persons with bipolar disorder enrolled in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD).This study evaluates the strength and direction of the associations between caregiver burden and depressive symptoms at baseline and at six- and 12-month follow-up using cross-lagged panel analyses, controlling for the clinical status of patients and sociodemographic variables. RESULTS Higher levels of overall caregiver burden at baseline were associated with increased levels of depressive symptoms among caregivers at follow-up (F = 8.70, df = 1,290, p < 0.001), after controlling for baseline caregiver depression, gender, race, age, social support, and patients' clinical status. By contrast, caregiver depression at baseline was not significantly associated with caregiver burden at follow-up (F = 1.65, p = 0.20). CONCLUSIONS Caregiver burden is a stronger predictor of caregiver depressive symptoms over time than the reverse. Interventions that help alleviate caregiver burden may decrease depressive symptoms.
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Affiliation(s)
- Deborah A Perlick
- James J. Peters Department of Veterans Affairs Medical Center and VISN 3 Mental Illness, Research, Education and Clinical Center (MIRECC), Bronx, NY, USA.,Department of Psychiatry, Icahn School of Medicine, Mount Sinai, New York, NY, USA
| | - Lesley Berk
- Mental Health and Wellbeing Research Centre, Faculty of Health, Deakin University, Geelong, VIC, Australia.,Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
| | - Richard Kaczynski
- Veterans Affairs New England Mental Illness Research, Education and Clinical Center, West Haven, CT, USA.,Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Jodi Gonzalez
- Department of Psychiatry, University of Texas Health Science Center, San Antonio, TX, USA
| | - Bruce Link
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Lisa Dixon
- Department of Psychiatry, Columbia University, New York, NY, USA.,Center for Practice Innovations, New York State Psychiatric Institute, New York, NY, USA
| | - Savannah Grier
- James J. Peters Department of Veterans Affairs Medical Center and VISN 3 Mental Illness, Research, Education and Clinical Center (MIRECC), Bronx, NY, USA.,Department of Psychiatry, Icahn School of Medicine, Mount Sinai, New York, NY, USA
| | - David J Miklowitz
- Division of Child and Adolescent Psychiatry, UCLA Semel Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
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177
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Horsfall D, Blignault I, Perry A, Antonopoulos P. Love stories: understanding the caring journeys of aged Greek-Australian carers. HEALTH & SOCIAL CARE IN THE COMMUNITY 2016; 24:194-202. [PMID: 25706511 DOI: 10.1111/hsc.12206] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/08/2014] [Indexed: 06/04/2023]
Abstract
This article documents the findings of a short-term longitudinal study that explored the caring journeys of aged Greek carers providing in-home care for their spouse. Through a deeper understanding of carers' decisions and decision-making and insights from service providers and community leaders, we aimed to inform policy makers, service managers and providers about how to develop and promote culturally appropriate support services, and negotiate them with carers and care recipients in a timely way. Initially, we conducted three focus groups and one follow-up forum with service providers and Greek community leaders. Then, over a 6-month period, we conducted two in-home interviews and two telephone interviews with 12 older Greek carers. We sought to understand factors influencing carers' decision-making regarding service uptake, and we provided information about services as required. Through our thematic analysis, we found that most carers wanted to remain as independent as possible and to avoid forced separation from the one they loved, through institutionalisation. They placed great value on their caring role which, while a struggle at times, gave them a sense of meaning, purpose and belonging. We also found that carers had great resourcefulness, strength and competence. They were all in long-term relationships, had negotiated coming to a foreign country and establishing themselves and were now in the process of negotiating old age and increasing frailty while at the same time providing care and support to family and friends. Our findings suggest that services need to be communicated in ways which support what carers value, not on outdated assumptions about cultural groups, otherwise providers will perpetuate exclusion. We propose an outreach in-home service model with an emphasis on ageing well and staying at home. This model of service provision is a model of care which emphasises relationships and community, and seeks to build social and cultural capital.
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Affiliation(s)
- Debbie Horsfall
- Social Sciences and Psychology, University of Western Sydney, Penrith, New South Wales, Australia
| | - Ilse Blignault
- School of Public and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Astrid Perry
- Multi Cultural Health, South Eastern Sydney Local Health District, Sydney, New South Wales, Australia
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178
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Wagner CA, Dichter ME, Mavandadi S, Klaus J, Oslin DW. Gender Differences in Social Relationships and Mental Health Among Veterans Affairs Patients. ACTA ACUST UNITED AC 2016. [DOI: 10.1080/21635781.2016.1153531] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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179
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Harris ML, Dolja-Gore X, Kendig H, Byles JE. First incident hospitalisation for Australian women aged 70 and beyond: A 10 year examination using competing risks. Arch Gerontol Geriatr 2015; 64:29-37. [PMID: 26952374 DOI: 10.1016/j.archger.2015.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 12/14/2015] [Accepted: 12/18/2015] [Indexed: 11/16/2022]
Abstract
There are increasing concerns regarding high hospital use among older adults and the capacity to manage the economic impact of the ageing population trend on healthcare systems. First hospitalisation in old age may act as a catalyst for ongoing intensification of health problems and acute care use. This study examined factors associated with first incident hospitalisation in women aged over 70, accounting for the health inequalities associated with geographic location. Survey data from 3780 women from the 1921 to 1926 cohort of the Australian Longitudinal Study on Women's Health were matched with the Admitted Patients Data Collection and National Death Index. Days to first event (hospitalisation or death) were modelled using competing risks methods. A total of 3065 (80.3%) women had at least one hospital admission. More than half of the top 15 reasons for first hospitalisation were related to cardiovascular disease, with atrial fibrillation the most common. Proportional subdistribution hazards models showed that first hospital admission was driven by enabling and need factors including asthma/bronchitis diagnosis (HR=1.16; p=0.047), private health insurance (HR=1.16; p=0.004) more than two prescribed medications in previous month (HR=1.31; p=0.001), more than four general practitioner visits in previous year (HR=1.50; p=0.034), lower physical functioning (HR=0.99; p<0.001) and living in an inner regional area (HR=1.17; p=0.003). First overnight hospitalisation was primarily related with potentially preventable and treatable chronic diseases. Primary and secondary strategies aimed at chronic disease generally, and better chronic disease management particularly for cardiovascular and respiratory diseases, may play a vital role in disease prevention or delay in readmissions among this population.
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Affiliation(s)
- Melissa L Harris
- Research Centre for Generational Health and Ageing, Faculty of Health and Medicine, University of Newcastle, Australia.
| | - Xenia Dolja-Gore
- Research Centre for Generational Health and Ageing, Faculty of Health and Medicine, University of Newcastle, Australia
| | - Hal Kendig
- Centre for Research on Ageing, Health and Wellbeing, College of Medicine, Biology and Environment, Australian National University, Australia; ARC Centre of Excellence in Population Ageing Research (CEPAR), Australia
| | - Julie E Byles
- Research Centre for Generational Health and Ageing, Faculty of Health and Medicine, University of Newcastle, Australia; ARC Centre of Excellence in Population Ageing Research (CEPAR), Australia
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180
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Sharpley C, Wark S, Hussain R, McEvoy M, Attia J. The Influence of Social Support on Psychological Distress in Older Persons: An Examination of Interaction Processes in Australia. Psychol Rep 2015; 117:883-96. [DOI: 10.2466/21.10.pr0.117c27z5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | | | - Rafat Hussain
- Australian National University, Canberra, Australia, and University of New England, Armidale
| | - Mark McEvoy
- University of Newcastle, Newcastle, Australia
| | - John Attia
- University of Newcastle, and Hunter Medical Research Institute, Newcastle
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181
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McLoughlin K, Rhatigan J, McGilloway S, Kellehear A, Lucey M, Twomey F, Conroy M, Herrera-Molina E, Kumar S, Furlong M, Callinan J, Watson M, Currow D, Bailey C. INSPIRE (INvestigating Social and PractIcal suppoRts at the End of life): Pilot randomised trial of a community social and practical support intervention for adults with life-limiting illness. BMC Palliat Care 2015; 14:65. [PMID: 26603516 PMCID: PMC4658760 DOI: 10.1186/s12904-015-0060-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 11/09/2015] [Indexed: 11/12/2022] Open
Abstract
Background For most people, home is the preferred place of care and death. Despite the development of specialist palliative care and primary care models of community based service delivery, people who are dying, and their families/carers, can experience isolation, feel excluded from social circles and distanced from their communities. Loneliness and social isolation can have a detrimental impact on both health and quality of life. Internationally, models of social and practical support at the end of life are gaining momentum as a result of the Compassionate Communities movement. These models have not yet been subjected to rigorous evaluation. The aims of the study described in this protocol are: (1) to evaluate the feasibility, acceptability and potential effectiveness of The Good Neighbour Partnership (GNP), a new volunteer-led model of social and practical care/support for community dwelling adults in Ireland who are living with advanced life-limiting illness; and (2) to pilot the method for a Phase III Randomised Controlled Trial (RCT). Design The INSPIRE study will be conducted within the Medical Research Council (MRC) Framework for the Evaluation of Complex Interventions (Phases 0–2) and includes an exploratory two-arm delayed intervention randomised controlled trial. Eighty patients and/or their carers will be randomly allocated to one of two groups: (I) Intervention: GNP in addition to standard care or (II) Control: Standard Care. Recipients of the GNP will be asked for their views on participating in both the study and the intervention. Quantitative and qualitative data will be gathered from both groups over eight weeks through face-to-face interviews which will be conducted before, during and after the intervention. The primary outcome is the effect of the intervention on social and practical need. Secondary outcomes are quality of life, loneliness, social support, social capital, unscheduled health service utilisation, caregiver burden, adverse impacts, and satisfaction with intervention. Volunteers engaged in the GNP will also be assessed in terms of their death anxiety, death self efficacy, self-reported knowledge and confidence with eleven skills considered necessary to be effective GNP volunteers. Discussion The INSPIRE study addresses an important knowledge gap, providing evidence on the efficacy, utility and acceptability of a unique model of social and practical support for people living at home, with advanced life-limiting illness. The findings will be important in informing the development (and evaluation) of similar service models and policy elsewhere both nationally and internationally. Trial registration ISRCTN18400594 18th February 2015.
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Affiliation(s)
- Kathleen McLoughlin
- Department of Psychology, Maynooth University, Maynooth, Co., Kildare, Ireland. .,Milford Care Centre, Limerick, Ireland.
| | | | - Sinead McGilloway
- Department of Psychology, Maynooth University, Maynooth, Co., Kildare, Ireland.
| | - Allan Kellehear
- Faculty of Health Studies, University of Bradford, Bradford, UK.
| | | | | | | | | | - Suresh Kumar
- Institute of Palliative Medicine, Kozhikode, Kerala, India.
| | - Mairead Furlong
- Department of Psychology, Maynooth University, Maynooth, Co., Kildare, Ireland.
| | | | - Max Watson
- Queens University Belfast and Northern Ireland Hospice, Belfast, UK.
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182
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Passey ME, Longman JM, Johnston JJ, Jorm L, Ewald D, Morgan GG, Rolfe M, Chalker B. Diagnosing Potentially Preventable Hospitalisations (DaPPHne): protocol for a mixed-methods data-linkage study. BMJ Open 2015; 5:e009879. [PMID: 26597867 PMCID: PMC4663419 DOI: 10.1136/bmjopen-2015-009879] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION Rates of potentially preventable hospitalisations (PPH) are used as a proxy measure of effectiveness of, or access to community-based health services. The validity of PPH as an indicator in Australia has not been confirmed. Available evidence suggests that patient-related, clinician-related and systems-related factors are associated with PPH, with differences between rural and metropolitan settings. Furthermore, the proportion of PPHs which are actually preventable is unknown. The Diagnosing Potentially Preventable Hospitalisations study will determine the proportion of PPHs for chronic conditions that are deemed preventable and identify potentially modifiable factors driving these, in order to develop effective interventions to reduce admissions and improve measures of health system performance. METHODS AND ANALYSIS This mixed methods data linkage study of approximately 1000 eligible patients with chronic PPH admissions to one metropolitan and two regional hospitals over 12 months will combine data from multiple sources to assess the: extent of preventability of chronic PPH admissions; validity of the Preventability Assessment Tool (PAT) in identifying preventable admissions; factors contributing to chronic PPH admissions. Data collected from patients (quantitative and qualitative methods), their general practitioners, hospital clinicians and hospital records, will be linked with routinely collected New South Wales (NSW) Admitted Patient Data Collection, the NSW Registry of Births, Death and Marriages death registration and Australian Bureau of Statistics mortality data. The validity of the PAT will be assessed by determining concordance between clinician assessment and that of a 'gold standard' panel. Multivariable logistic regression will identify the main predictor variables of admissions deemed preventable, using study-specific and linked data. ETHICS AND DISSEMINATION The NSW Population and Health Services Research Ethics Committee granted ethical approval. Dissemination mechanisms include engagement of policy stakeholders through a project Steering Committee, and the production of summary reports for policy and clinical audiences in addition to peer-review papers.
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Affiliation(s)
- Megan E Passey
- University Centre for Rural Health-North Coast, University of Sydney, Lismore, New South Wales, Australia
| | - Jo M Longman
- University Centre for Rural Health-North Coast, University of Sydney, Lismore, New South Wales, Australia
| | - Jennifer J Johnston
- University Centre for Rural Health-North Coast, University of Sydney, Lismore, New South Wales, Australia
| | - Louisa Jorm
- Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Dan Ewald
- North Coast Primary Health Network, Ballina, New South Wales, Australia
| | - Geoff G Morgan
- University Centre for Rural Health-North Coast, University of Sydney, Lismore, New South Wales, Australia
| | - Margaret Rolfe
- University Centre for Rural Health-North Coast, University of Sydney, Lismore, New South Wales, Australia
| | - Bronwyn Chalker
- Mid North Coast Local Health District, South West Rocks, New South Wales, Australia
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183
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Shaheen Al Ahwal M, Al Zaben F, Sehlo MG, Khalifa DA, Koenig HG. Religious beliefs, practices, and health in colorectal cancer patients in Saudi Arabia. Psychooncology 2015; 25:292-9. [PMID: 25990540 DOI: 10.1002/pon.3845] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 03/03/2015] [Accepted: 04/14/2015] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Colorectal cancer (CRC) patients experience considerable psychological stress because of changes brought on by their illness. Religion may be a resource for such patients. We examined the prevalence of religious beliefs and practices in CRC patients and correlation with demographic, social, psychological, and physical health characteristics. METHODS Seventy CRC patients (all Muslim) in Jeddah, Saudi Arabia, were surveyed using a 13-item Muslim religiosity scale. Standard measures were used to assess depressive symptoms, depressive disorder, and social support; demographic and social factors, psychiatric history, and disease factors were also measured. RESULTS All 70 participants (100%) engaged in group worship and prayer (Fard) five times/day, and 75.7% never skipped or combined two or more obligatory prayers; 71.4% read or recited the Qur'an several times/week or daily; 80.0% gave money to the poor each year (Zakat); 71.4% fasted throughout the month of Ramadan (Sawm) and other times as well; 91.4% said they 'definitely' experienced the presence of Allah; and 74.3% said their entire approach to life was definitely based on their religious beliefs. Overall religiosity was inversely related to depressive symptoms (B = -0.58, SE = 0.30, p = 0.026) and suicidal ideation (B = -0.07, SE = 0.03, p = 0.025), after controlling for financial status and social factors. CONCLUSIONS Religious involvement was widespread in this sample of CRC patients in Saudi Arabia and was related to fewer depressive symptoms and less suicidal ideation. No relationship was found with stage of disease or duration of treatment.
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Affiliation(s)
| | - Faten Al Zaben
- Department of Psychiatry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammad Gamal Sehlo
- Department of Psychiatry, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Psychiatry, Zagazig University, Zagazig, Egypt
| | - Doaa Ahmed Khalifa
- Department of Psychiatry, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Psychiatry, Ain Shams University, Cairo, Egypt
| | - Harold G Koenig
- Department of Psychiatry, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.,School of Public Health, Ningxia Medical University, Yinchuan, China
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184
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Prospective study of depression among dialysis patients in Saudi Arabia. Int Urol Nephrol 2015; 47:1001-10. [DOI: 10.1007/s11255-015-0977-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Accepted: 04/06/2015] [Indexed: 11/26/2022]
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185
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Does psychological resilience mediate the impact of social support on geriatric depression? An exploratory study among Chinese older adults in Singapore. Asian J Psychiatr 2015; 14:22-7. [PMID: 25703041 DOI: 10.1016/j.ajp.2015.01.011] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2014] [Revised: 12/23/2014] [Accepted: 01/27/2015] [Indexed: 11/21/2022]
Abstract
Social support and resilience were considered to be two significant influential factors for depression in late life. The study aims to present a mediation model for understanding the interrelations among social support, resilience, and geriatric depression. A cross-sectional survey study was conducted among 162 community-dwelling Chinese older adults in Singapore. Findings indicated a significant indirect effect of social support on geriatric depression through the mediation of resilience, by controlling demographic variables. Further, an identical influencing pattern between problem-solving resilience and emotion regulation resilience were found in the two individual models, suggesting a similar mediation role in linking social support and geriatric depression. These results extended and integrated earlier findings on the relationship of psychosocial factors and geriatric depression, and pointed out practical implications for future work on depression interventions.
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186
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Al Zaben F, Khalifa DA, Sehlo MG, Al Shohaib S, Binzaqr SA, Badreg AM, Alsaadi RA, Koenig HG. Religious involvement and health in dialysis patients in Saudi Arabia. JOURNAL OF RELIGION AND HEALTH 2015; 54:713-30. [PMID: 25316206 DOI: 10.1007/s10943-014-9962-8] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Patients on hemodialysis experience considerable psychological and physical stress due to the changes brought on by chronic kidney disease. Religion is often turned to in order to cope with illness and may buffer some of these stresses associated with illness. We describe here the religious activities of dialysis patients in Saudi Arabia and determined demographic, psychosocial, and physical health correlates. We administered an in-person questionnaire to 310 dialysis patients (99.4 % Muslim) in Jeddah, Saudi Arabia, that included the Muslim Religiosity Scale, Structured Clinical Interview for Depression, Hamilton Depression Rating Scale, Global Assessment of Functioning scale, and other established measures of psychosocial and physical health. Bivariate and multivariate analyses identified characteristics of patients who were more religiously involved. Religious practices and intrinsic religious beliefs were widespread. Religious involvement was more common among those who were older, better educated, had higher incomes, and were married. Overall psychological functioning was better and social support higher among those who were more religious. The religious also had better physical functioning, better cognitive functioning, and were less likely to smoke, despite having more severe overall illness and being on dialysis for longer than less religious patients. Religious involvement is correlated with better overall psychological functioning, greater social support, better physical and cognitive functioning, better health behavior, and longer duration of dialysis. Whether religion leads to or is a result of better mental and physical health will need to be determined by future longitudinal studies and clinical trials.
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Affiliation(s)
- Faten Al Zaben
- Department of Psychiatry, King Abdulaziz University, Jeddah, Saudi Arabia
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187
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The PACE study: a randomized clinical trial of cognitive activity strategy training for older people with mild cognitive impairment. Am J Geriatr Psychiatry 2015; 23:360-372. [PMID: 24801607 DOI: 10.1016/j.jagp.2014.04.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Revised: 04/01/2014] [Accepted: 04/02/2014] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The role of cognition-focused interventions in reducing cognitive decline in older people remains uncertain. This study aimed to clarify whether a group cognitive activity (CA) strategy-training program would decrease the 2-year rate of cognitive decline of people with mild cognitive impairment (MCI). DESIGN Randomized controlled trial. SETTING One study site. PARTICIPANTS 160 older adults with MCI ≥65 years of age (mean: 75, SD: 5.8). INTERVENTION Five-week CA strategy training or a control nonspecific educational program. The primary outcome measure was change from baseline in the total score on the Cambridge Cognitive Examination-Revised (CAMCOG-R). Secondary outcomes of interest included changes in memory, attention, executive functions, mood, and quality of life. Endpoints were collected 10, 52, and 104 weeks post baseline. RESULTS Intention to treat analysis identified no significant difference in CAMCOG-R scores over time between the two groups (mean difference: -0.36, 95% CI: -1.02,0.29) or across secondary outcome measures. The exceptions were better performance of the CA group on immediate attention (Digit Span Forwards, adjusted mean difference: 0.15, 95% CI: 0.01,0.30) and better quality of life (adjusted mean difference: 0.57, 95% CI: 0.10,1.04) compared with controls. CONCLUSION The devised program of CA did not improve general cognitive performance of older adults with MCI over a period of 2 years. Although favorable, the beneficial effects of the intervention on attention and quality of life were small, and of uncertain significance.
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188
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Hou F, Cerulli C, Wittink MN, Caine ED, Qiu P. Depression, social support and associated factors among women living in rural China: a cross-sectional study. BMC Womens Health 2015; 15:28. [PMID: 25879808 PMCID: PMC4392745 DOI: 10.1186/s12905-015-0180-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 02/13/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Few studies have focused on depression and social support in Eastern populations, especially women in rural China. Our research investigated depression among women in rural China, and studied the relationships between social support and depression. METHODS We recruited women ages 16 years and older from north Sichuan. Participants completed socio-demographic measures, the Center for Epidemiologic Studies Depression Scale, and the Duke Social Support Index. The analysis method included descriptive statistics and logistic regression. RESULTS The final sample included 1,898 participants with a mean age of 48.6 years, and the prevalence of significant depressive symptoms was 12.4%. Results suggest being unemployed, having poorer perceived health/economic status, and lower social support were positively associated with depression. Younger age and greater social support were negatively associated with depression. CONCLUSIONS This study provides insights on the psychological health of women in rural China and potential directions for future research. These issues are especially pertinent during this time of rapid economic transformation and outmigration in rural China.
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Affiliation(s)
- Fengsu Hou
- Department of Epidemiology and Statistics, West China School of Public Health, Sichuan University, No.17, 3 section South Renmin Road, Chengdu, Sichuan, 610041, China.
- Department of Psychiatry, University of Rochester Medical Center, 601 Elmwood Ave, Box PSYCH, Rochester, NY, 14642, USA.
| | - Catherine Cerulli
- Injury Control Research Center for Suicide Prevention, University of Rochester Medical Center, 601 Elmwood Ave, Box PSYCH, Rochester, NY, 14642, USA.
- Department of Psychiatry, University of Rochester Medical Center, 601 Elmwood Ave, Box PSYCH, Rochester, NY, 14642, USA.
| | - Marsha N Wittink
- Department of Psychiatry, University of Rochester Medical Center, 601 Elmwood Ave, Box PSYCH, Rochester, NY, 14642, USA.
| | - Eric D Caine
- Injury Control Research Center for Suicide Prevention, University of Rochester Medical Center, 601 Elmwood Ave, Box PSYCH, Rochester, NY, 14642, USA.
- Department of Psychiatry, University of Rochester Medical Center, 601 Elmwood Ave, Box PSYCH, Rochester, NY, 14642, USA.
| | - Peiyuan Qiu
- Department of Epidemiology and Statistics, West China School of Public Health, Sichuan University, No.17, 3 section South Renmin Road, Chengdu, Sichuan, 610041, China.
- Department of Psychiatry, University of Rochester Medical Center, 601 Elmwood Ave, Box PSYCH, Rochester, NY, 14642, USA.
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189
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Loh DA, Hairi NN, Choo WY, Mohd Hairi F, Peramalah D, Kandiben S, Lee PL, Gani N, Madzlan MF, Abd Hamid MAI, Akram Z, Chu AS, Bulgiba A, Cumming RG. MultiComponent Exercise and theRApeutic lifeStyle (CERgAS) intervention to improve physical performance and maintain independent living among urban poor older people--a cluster randomised controlled trial. BMC Geriatr 2015; 15:8. [PMID: 25887235 PMCID: PMC4334409 DOI: 10.1186/s12877-015-0002-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 01/20/2015] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The ability of older people to function independently is crucial as physical disability and functional limitation have profound impacts on health. Interventions that either delay the onset of frailty or attenuate its severity potentially have cascading benefits for older people, their families and society. This study aims to develop and evaluate the effectiveness of a multiComponent Exercise and theRApeutic lifeStyle (CERgAS) intervention program targeted at improving physical performance and maintaining independent living as compared to general health education among older people in an urban poor setting in Malaysia. METHODS This cluster randomised controlled trial will be a 6-week community-based intervention programme for older people aged 60 years and above from urban poor settings. A minimum of 164 eligible participants will be recruited from 8 clusters (low-cost public subsidised flats) and randomised to the intervention and control arm. This study will be underpinned by the Health Belief Model with an emphasis towards self-efficacy. The intervention will comprise multicomponent group exercise sessions, nutrition education, oral care education and on-going support and counselling. These will be complemented with a kit containing practical tips on exercise, nutrition and oral care after each session. Data will be collected over four time points; at baseline, immediately post-intervention, 3-months and 6-months follow-up. DISCUSSION Findings from this trial will potentially provide valuable evidence to improve physical function and maintain independence among older people from low-resource settings. This will inform health policies and identify locally acceptable strategies to promote healthy aging, prevent and delay functional decline among older Malaysian adults. TRIAL REGISTRATION ISRCTN22749696.
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Affiliation(s)
- Debbie Ann Loh
- Julius Centre University of Malaya, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Noran Naqiah Hairi
- Julius Centre University of Malaya, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Wan Yuen Choo
- Julius Centre University of Malaya, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Farizah Mohd Hairi
- Centre for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Devi Peramalah
- Julius Centre University of Malaya, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Shathanapriya Kandiben
- Julius Centre University of Malaya, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Pek Ling Lee
- Julius Centre University of Malaya, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Norlissa Gani
- Julius Centre University of Malaya, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Mohamed Faris Madzlan
- Julius Centre University of Malaya, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Mohd Alif Idham Abd Hamid
- Julius Centre University of Malaya, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Zohaib Akram
- Department of Oral Pathology, Oral Medicine and Periodontology, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.
| | - Ai Sean Chu
- Fitness First Malaysia, Menara MBF, Jalan Sultan Ismail, Kuala Lumpur, Malaysia.
| | - Awang Bulgiba
- Julius Centre University of Malaya, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Robert G Cumming
- Centre for Education and Research on Ageing, Concord Hospital, Concord, NSW, Australia. .,Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia.
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190
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Prinsloo S, Wei Q, Scott SM, Tannir N, Jonasc E, Pisters L, Cohen L. Psychological states, serum markers and survival: associations and predictors of survival in patients with renal cell carcinoma. J Behav Med 2015; 38:48-56. [PMID: 24935017 PMCID: PMC4824635 DOI: 10.1007/s10865-014-9578-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Accepted: 05/31/2014] [Indexed: 11/26/2022]
Abstract
This study sought to determine if there was an association between prognostic-based serum biomarkers, survival, and psychosocial factors in patients with metastatic renal cell carcinoma. Associations were found between psychosocial factors and biomarker levels (hemoglobin with depressive symptoms (r = -0.29), positive affect (r = 0.30), social support (r = 0.19), and perceived stress (r = -0.27); albumin with depressive symptoms (r = -0.19), positive affect (r = 0.22), and social support (r = 0.20); alkaline phosphatase with depressive symptoms (r = 0.21), all p values <0.05. After adjustment for disease-related risk factors, only the associations between positive affect and perceived stress with hemoglobin remained significant (p's < 0.05). Positive affect (HR = 0.90; 95% CI = 0.83, 0.97; p = 0.009) and depressive symptom total scores (HR = 1.03; 95% CI = 1.01, 1.06; p = 0.013), and alkaline phosphatase (HR 2.72; 95% CI = 1.41, 5.24; p = 0.003) were associated with survival. This study suggests that measures of positive and negative psychological outlook may contribute differently to health, well-being, and survival.
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Affiliation(s)
- Sarah Prinsloo
- Unit 410, Department of General Oncology and the Integrative Medicine Program, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77230, USA
| | - Qi Wei
- Unit 410, Department of General Oncology and the Integrative Medicine Program, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77230, USA
| | - Shellie M. Scott
- Department of Urology, University of Texas MD Anderson, Cancer Center, Houston, TX, USA
| | - Nizar Tannir
- Department of Genitourinary Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Eric Jonasc
- Department of Genitourinary Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Louis Pisters
- Department of Urology, University of Texas MD Anderson, Cancer Center, Houston, TX, USA
| | - Lorenzo Cohen
- Unit 410, Department of General Oncology and the Integrative Medicine Program, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77230, USA
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191
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Heisel MJ, Talbot NL, King DA, Tu XM, Duberstein PR. Adapting interpersonal psychotherapy for older adults at risk for suicide. Am J Geriatr Psychiatry 2015; 23:87-98. [PMID: 24840611 PMCID: PMC4211998 DOI: 10.1016/j.jagp.2014.03.010] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Revised: 02/28/2014] [Accepted: 03/20/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To pilot a psychological intervention adapted for older adults at risk for suicide. DESIGN A focused, uncontrolled, pre-to-post-treatment psychotherapy trial. All eligible participants were offered the study intervention. SETTING Outpatient mental health care provided in the psychiatry department of an academic medical center in a mid-sized Canadian city. PARTICIPANTS Seventeen English-speaking adults 60 years or older, at risk for suicide by virtue of current suicide ideation, death ideation, and/or recent self-injury. INTERVENTION A 16-session course of Interpersonal Psychotherapy (IPT) adapted for older adults at risk for suicide who were receiving medication and/or other standard psychiatric treatment for underlying mood disorders. MEASUREMENTS Participants completed a demographics form, screens for cognitive impairment and alcohol misuse, a semi-structured diagnostic interview, and measures of primary (suicide ideation and death ideation) and secondary study outcomes (depressive symptom severity, social adjustment and support, psychological well-being), and psychotherapy process measures. RESULTS Participants experienced significant reductions in suicide ideation, death ideation, and depressive symptom severity, and significant improvement in perceived meaning in life, social adjustment, perceived social support, and other psychological well-being variables. CONCLUSIONS Study participants experienced enhanced psychological well-being and reduced symptoms of depression and suicide ideation over the course of IPT adapted for older adults at risk for suicide. Larger, controlled trials are needed to further evaluate the impact of this novel intervention and to test methods for translating and integrating focused interventions into standard clinical care with at-risk older adults.
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Affiliation(s)
- Marnin J. Heisel
- Departments of Psychiatry and of Epidemiology & Biostatistics, Schulich School of Medicine and Dentistry, The University of Western Ontario, Lawson Health Research Institute, Center for the Study and Prevention of Suicide, Department of Psychiatry, University of Rochester School of Medicine and Dentistry,Corresponding author. Department of Psychiatry, The University of Western Ontario, LHSC-Victoria Hospital, 800 Commissioners Road East, Room #A2-515, London, Ontario, N6A-5W9, Canada; phone: (519) 685-8500, ext. 75981; fax: (519) 667-6707;
| | - Nancy L. Talbot
- Center for the Study and Prevention of Suicide, Department of Psychiatry, University of Rochester School of Medicine and Dentistry
| | - Deborah A. King
- Center for the Study and Prevention of Suicide, Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Veterans Health Administration VISN 2 Center of Excellence for Suicide Prevention
| | - Xin M. Tu
- Center for the Study and Prevention of Suicide, Department of Psychiatry, University of Rochester School of Medicine and Dentistry
| | - Paul R. Duberstein
- Center for the Study and Prevention of Suicide, Department of Psychiatry, University of Rochester School of Medicine and Dentistry
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192
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Byles JE, Francis JL, Chojenta CL, Hubbard IJ. Long-term survival of older Australian women with a history of stroke. J Stroke Cerebrovasc Dis 2014; 24:53-60. [PMID: 25440353 DOI: 10.1016/j.jstrokecerebrovasdis.2014.07.040] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 06/06/2014] [Accepted: 07/27/2014] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Although many people survive an initial stroke, little is known about long-term impacts of stroke on survival. METHODS Data from the Australian Longitudinal Study on Women's Health were used to compare 12-year survival rates in older women with prevalent stroke, incident stroke, and no stroke. Cox regression models were fitted to assess the effect of lifestyle and demographic characteristics on the relationship between stroke and all-cause mortality. The "no stroke" group was used as the reference category in all statistical models. RESULTS At baseline, 4% of the women reported a previous stroke (prevalent stroke). At survey 2 in 1999, a further 3% reported having a stroke between 1996 and 1999 (incident stroke). Stroke was significantly associated with reduced long-term survival. Age-adjusted hazards ratios (HRs) were: 1.64 (1.43-1.89) for the "prevalent stroke" group and 2.29 (1.97-2.66) for the "incident stroke" group. Adjusting for comorbidities reduced the HRs, but the risk of death was still significantly higher in the 2 stroke groups. Adjusting for demographic and lifestyle factors did not make any further difference to the relationship between stroke and survival. However, obesity and past smoking were also risk factors for mortality. CONCLUSIONS This study highlights the long-term impacts of stroke on life expectancy and the importance of comorbidities and other lifestyle factors in affecting poststroke survival.
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Affiliation(s)
- Julie E Byles
- Research Centre for Gender, Health and Ageing, Hunter Medical Research Institute, University of Newcastle, Callaghan, New South Wales, Australia.
| | - Jerryl Lynn Francis
- Research Centre for Gender, Health and Ageing, Hunter Medical Research Institute, University of Newcastle, Callaghan, New South Wales, Australia
| | - Catherine L Chojenta
- Research Centre for Gender, Health and Ageing, Hunter Medical Research Institute, University of Newcastle, Callaghan, New South Wales, Australia
| | - Isobel J Hubbard
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia
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193
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Handley TE, Hiles SA, Inder KJ, Kay-Lambkin FJ, Kelly BJ, Lewin TJ, McEvoy M, Peel R, Attia JR. Predictors of suicidal ideation in older people: a decision tree analysis. Am J Geriatr Psychiatry 2014; 22:1325-35. [PMID: 24012228 DOI: 10.1016/j.jagp.2013.05.009] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Revised: 05/24/2013] [Accepted: 05/28/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Suicide among older adults is a major public health issue worldwide. Although studies have identified psychological, physical, and social contributors to suicidal thoughts in older adults, few have explored the specific interactions between these factors. This article used a novel statistical approach to explore predictors of suicidal ideation in a community-based sample of older adults. DESIGN Prospective cohort study. PARTICIPANTS AND SETTING Participants aged 55-85 years were randomly selected from the Hunter Region, a large regional center in New South Wales, Australia. MEASUREMENTS Baseline psychological, physical, and social factors, including psychological distress, physical functioning, and social support, were used to predict suicidal ideation at the 5-year follow-up. Classification and regression tree modeling was used to determine specific risk profiles for participants depending on their individual well-being in each of these key areas. RESULTS Psychological distress was the strongest predictor, with 25% of people with high distress reporting suicidal ideation. Within high psychological distress, lower physical functioning significantly increased the likelihood of suicidal ideation, with high distress and low functioning being associated with ideation in 50% of cases. A substantial subgroup reported suicidal ideation in the absence of psychological distress; dissatisfaction with social support was the most important predictor among this group. The performance of the model was high (area under the curve: 0.81). CONCLUSIONS Decision tree modeling enabled individualized "risk" profiles for suicidal ideation to be determined. Although psychological factors are important for predicting suicidal ideation, both physical and social factors significantly improved the predictive ability of the model. Assessing these factors may enhance identification of older people at risk of suicidal ideation.
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Affiliation(s)
- Tonelle E Handley
- Centre for Translational Neuroscience and Mental Health, University of Newcastle, Callaghan, Australia.
| | - Sarah A Hiles
- Centre for Translational Neuroscience and Mental Health, University of Newcastle, Callaghan, Australia
| | - Kerry J Inder
- Centre for Translational Neuroscience and Mental Health, University of Newcastle, Callaghan, Australia; Hunter Medical Research Institute, Hunter Region Mail Centre, Newcastle, Australia
| | - Frances J Kay-Lambkin
- Centre for Translational Neuroscience and Mental Health, University of Newcastle, Callaghan, Australia; National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Brian J Kelly
- Centre for Translational Neuroscience and Mental Health, University of Newcastle, Callaghan, Australia; Hunter Medical Research Institute, Hunter Region Mail Centre, Newcastle, Australia
| | - Terry J Lewin
- Centre for Translational Neuroscience and Mental Health, University of Newcastle, Callaghan, Australia; Hunter Medical Research Institute, Hunter Region Mail Centre, Newcastle, Australia
| | - Mark McEvoy
- Centre for Clinical Epidemiology and Biostatistics, University of Newcastle, Newcastle, Australia
| | - Roseanne Peel
- Centre for Clinical Epidemiology and Biostatistics, University of Newcastle, Newcastle, Australia
| | - John R Attia
- Hunter Medical Research Institute, Hunter Region Mail Centre, Newcastle, Australia; Centre for Clinical Epidemiology and Biostatistics, University of Newcastle, Newcastle, Australia
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194
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Alexopoulos GS, Kiosses DN, Sirey JA, Kanellopoulos D, Seirup JK, Novitch RS, Ghosh S, Raue PJ, Raue PJ. Untangling therapeutic ingredients of a personalized intervention for patients with depression and severe COPD. Am J Geriatr Psychiatry 2014; 22:1316-24. [PMID: 23954038 PMCID: PMC3923856 DOI: 10.1016/j.jagp.2013.05.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Revised: 05/08/2013] [Accepted: 05/15/2013] [Indexed: 11/16/2022]
Abstract
OBJECTIVE We developed a personalized intervention for depressed patients with COPD (PID-C) aimed to mobilize patients to participate in the care of both conditions. We showed that PID-C reduced depressive symptoms and dyspnea-related disability more than usual care over 28 weeks. This study focused on untangling key therapeutic ingredients of PID-C. DESIGN Randomized controlled trial. SETTING Community. PARTICIPANTS 138 patients who received the diagnoses of COPD and major depression after screening 898 consecutive admissions for acute inpatient pulmonary rehabilitation. INTERVENTION Nine sessions of PID-C compared with usual care over 28 weeks. MEASUREMENTS Primary outcome measures were the 17-item Hamilton Depression Rating Scale and the Pulmonary Functional Status and Dyspnea Questionnaire-Modified. Other measures were adherence to rehabilitation exercise (≥2 hours per week) and adherence to adequate antidepressant prescriptions. RESULTS Low severity of dyspnea-related disability and adherence to antidepressants predicted subsequent improvement of depression. Exercise and low depression severity predicted improvement of dyspnea-related disability. CONCLUSIONS PID-C led to an interacting spiral of improvement in both depression and disability in a gravely medically ill population with a 17% mortality rate over 28 weeks and an expected deterioration in disability. The interrelationship of the course of depression and dyspnea-related disability underscores the need to target adherence to both antidepressants and chronic obstructive pulmonary disease rehabilitation. PID-C may serve as a care management model for depressed persons suffering from medical illnesses with a deteriorating course.
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Affiliation(s)
| | | | - Jo Anne Sirey
- Weill Cornell Medical College Institute for Geriatric Psychiatry
| | | | - Joanna K. Seirup
- Weill Cornell Medical College Institute for Geriatric Psychiatry
| | | | - Samiran Ghosh
- Weill Cornell Medical College Institute for Geriatric Psychiatry
| | - Patrick J. Raue
- Weill Cornell Medical College Institute for Geriatric Psychiatry
| | - Patrick J Raue
- Weill Cornell Medical College, Institute for Geriatric Psychiatry, White Plains, NY
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195
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Shaheen Al Ahwal M, Al Zaben F, Khalifa DA, Sehlo MG, Ahmad RG, Koenig HG. Depression in patients with colorectal cancer in Saudi Arabia. Psychooncology 2014; 24:1043-50. [PMID: 25328130 DOI: 10.1002/pon.3706] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Revised: 09/03/2014] [Accepted: 09/17/2014] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Persons with colon cancer experience considerable psychological stress due to physical and social changes brought on by illness, increasing their risk of depressive disorder (DD). We examine the prevalence of DD and depressive symptoms and determine baseline demographic, social, psychological, and physical health correlates. METHODS A convenience sample of 70 cancer patients in Jeddah, Saudi Arabia, was screened for DD using an abbreviated version of the Structured Clinical Interview for Depression (SCID) and for depressive symptoms using the Hamilton Depression Rating Scale (HDRS). Demographic, psychosocial, psychiatric, and physical health characteristics were also assessed, along with past treatments for colon cancer. Bivariate and multivariate analyses identified predictors of DD and symptoms. RESULTS The 1-month prevalence of DD was 30.0% (12.9% major depression, 5.7% minor depression, and 11.4% for dysthymia) and significant depressive symptoms were present in 57.1% (HDRS 8 or higher), including having persistent suicidal thoughts for 2 weeks or longer wthin the past month (14.3%) . Low social support and having a co-morbid psychiatric illness (particularly anxiety) independently predicted DD based on the SCID. Saudi nationality, poor financial situation, low social support, and co-morbid psychiatric illness independently predicted depressive symptoms on the HDRS. Surprisingly, stage of cancer, duration of cancer, and treatments for cancer were unrelated to DD or depressive symptoms. CONCLUSIONS DD and significant depressive symptoms are common in patients with colon cancer in Saudi Arabia, and are predicted by a distinct set of demographic and psychosocial risk factors that may help with identification. Demographic and psychological risk factors were more likely to be associated with depression than cancer characteristics in this sample.
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Affiliation(s)
| | - Faten Al Zaben
- Department of Psychiatry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Doaa Ahmed Khalifa
- Department of Psychiatry, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Psychiatry, Ain Shams University, Cairo, Egypt
| | - Mohammad Gamal Sehlo
- Department of Psychiatry, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Psychiatry, Zagazig University, Zagazig, Egypt
| | - Rami Ghazi Ahmad
- Resident in Psychiatry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Harold G Koenig
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.,King Abdulaziz University, Jeddah, Saudi Arabia
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196
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Beyer JL, Greenberg RL, Marino P, Bruce ML, Al Jurdi RK, Sajatovic M, Gyulai L, Mulsant BH, Gildengers A, Young RC. Social support in late life mania: GERI-BD. Int J Geriatr Psychiatry 2014; 29:1028-32. [PMID: 24664811 PMCID: PMC4545672 DOI: 10.1002/gps.4093] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Accepted: 01/23/2014] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Using the database of the National Institute of Mental Health-sponsored acute treatment of late life mania study (GERI-BD), we assessed the role of social support in the presentation of late life bipolar mania. METHODS In the first 100 subjects randomized in geriatric BD, we explored the demographic, clinical, and social support characteristics (assessed using the Duke Social Support Index) and aspects of manic presentation. We selected two dependent variables: symptom severity, as determined by the Young Mania Rating Scale (YMRS) at baseline, and duration of episode. We selected nine potential independent variables on the basis of Pearson correlation coefficients. We derived two final models using multiple regression analysis employing an iterative process. RESULTS In our severity model, being married was associated with a higher YMRS score (p = 0.05), whereas higher social interaction scores with non-family members were associated with a lower YMRS score (p = 0.011). In the episode duration model, longer duration was associated with a higher Hamilton Depression Rating Scale score (p = 0.03) and higher social interaction scores with non-family members (p = 0.0003), younger age (p = 0.04), higher number of persons in one's family social network (p = 0.017), and higher instrumental support scores (p = 0.0062). CONCLUSIONS In late life mania, more social interaction with one's community appears to be associated with less severe symptoms at presentation for treatment, however, it can also be associated with slightly longer the duration of episode. Two aspects of the Duke Social Support Index are associated with a shorter episode duration prior to seeking treatment: being part of a larger family network and a having a higher level of instrumental support prior to treatment. The Instrumental Support Subscale measures the degree of assistance that is available for the respondent in performing daily tasks. These findings suggest that in older adults with BD, close social interactions and support are important in limiting the length of the illness episode prior to treatment. Social interactions involving non-family members may be less important in moderating the intensity of the symptoms at presentation.
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Affiliation(s)
| | | | | | | | | | | | | | - Benoit H. Mulsant
- Centre for Addiction and Mental Health, Toronto and University of Toronto, Ontario,University of Pittsburg School of Medicine
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197
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Depression in patients with chronic kidney disease on dialysis in Saudi Arabia. Int Urol Nephrol 2014; 46:2393-402. [PMID: 25164589 DOI: 10.1007/s11255-014-0802-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 07/24/2014] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Patients with chronic kidney disease on hemodialysis experience considerable psychological stress due to physical and social changes brought on by illness, increasing the risk of depressive disorder (DD). We examined the prevalence of DD and depressive symptoms, identified treatments for depression, and determined baseline demographic, social/behavioral, physical, and psychological correlates. METHODS A convenience sample of 310 dialysis patients in Jeddah, Saudi Arabia, was screened for DD using the Structured Clinical Interview for Depression and for depressive symptoms using the Hamilton Depression Rating Scale (HDRS). Established measures of psychosocial and physical health characteristics were administered, along with questions about current and past treatments. Bivariate and multivariate analyses identified independent correlates of DD and symptoms. RESULTS The prevalence of DD was 6.8 % (major depression 3.2 %, minor depression 3.6 %), and significant depressive symptoms were present in 24.2 % (HDRS 8 or higher). No patients with DD were being treated with antidepressant medication, whereas 28.6 % (6 of 21) were receiving counseling. Being a Saudi national, married, in counseling, or having a history of antidepressant were associated with DD in bivariate analyses. Correlates of depressive symptoms HDRS in multivariate analyses were Saudi nationality, marital status, stressful life events, poor physical functioning, cognitive impairment, overall severity of medical illness, and history of family psychiatric problems. CONCLUSIONS The prevalence of DD and depressive symptoms is lower in Saudi dialysis patients than in the rest of the world, largely untreated, and is associated with a distinct set of demographic, psychosocial, and physical health characteristics.
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198
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Langer JK, Weisman JS, Rodebaugh TL, Binder EF, Lenze EJ. Short-term affective recovery from hip fracture prospectively predicts depression and physical functioning. Health Psychol 2014; 34:30-9. [PMID: 25133825 DOI: 10.1037/hea0000111] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The goals of the current study were to determine the average affective experiences in the weeks and months after a hip fracture and assess how these experiences relate to physical and mental health functioning over time. METHOD Positive and negative affect were assessed over time in a sample of older adults recruited after surgery for hip fracture (n = 500) and a comparison sample of older adults without hip fracture (n = 102) for 1 year longitudinally. RESULTS For most of the individuals with a hip fracture, positive affect tended to increase over time and negative affect tended to decrease over time, suggesting that most people had at least some recovery of affect. In addition, individuals who showed a slower decrease in negative affect had higher levels of depression 1 year later, and individuals who showed a sharper increase in positive affect had superior physical function 1 year later. CONCLUSION The current study provides evidence that both positive and negative affect in the first 12 weeks of recovery from hip fracture are potential targets for intervention to maximize psychological and physical recovery in the ensuing year.
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Affiliation(s)
- Julia K Langer
- Department of Psychology, Washington University in St. Louis
| | | | | | - Ellen F Binder
- Internal Medicine/Division of Geriatrics and Nutritional Science, Washington University in St. Louis
| | - Eric J Lenze
- Department of Psychiatry, Washington University in St. Louis
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199
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Koenig HG, Berk LS, Daher NS, Pearce MJ, Bellinger DL, Robins CJ, Nelson B, Shaw SF, Cohen HJ, King MB. Religious involvement is associated with greater purpose, optimism, generosity and gratitude in persons with major depression and chronic medical illness. J Psychosom Res 2014; 77:135-43. [PMID: 25077855 DOI: 10.1016/j.jpsychores.2014.05.002] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 05/06/2014] [Accepted: 05/08/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Religious involvement may help individuals with chronic medical illness cope better with physical disability and other life changes. We examine the relationships between religiosity, depressive symptoms, and positive emotions in persons with major depression and chronic illness. METHODS 129 persons who were at least somewhat religious/spiritual were recruited into a clinical trial to evaluate the effectiveness of religious vs. secular cognitive behavioral therapy. Reported here are the relationships at baseline between religious involvement and depressive symptoms, purpose in life, optimism, generosity, and gratefulness using standard measures. RESULTS Although religiosity was unrelated to depressive symptoms (F=0.96, p=0.43) and did not buffer the disability-depression relationship (B=-1.56, SE 2.90, p=0.59), strong relationships were found between religious indicators and greater purpose, optimism, generosity, and gratefulness (F=7.08, p<0.0001). CONCLUSIONS Although unrelated to depressive symptoms in the setting of major depression and chronic medical illness, higher religious involvement is associated with positive emotions, a finding which may influence the course of depression over time.
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Affiliation(s)
- Harold G Koenig
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, United States; Department of Medicine, King Abdulaziz University (KAU), Jeddah, Saudi Arabia.
| | - Lee S Berk
- School of Allied Health Professions, Department of Pathology and Human Anatomy, School of Medicine, Loma Linda University, Loma Linda, CA, United States
| | - Noha S Daher
- Epidemiology, Biostatistics, and Population Medicine, School of Public Health, Loma Linda University, Loma Linda, CA, United States
| | - Michelle J Pearce
- Center for Integrative Medicine, School of Medicine, University of Maryland, Baltimore, United States
| | - Denise L Bellinger
- Department of Pathology and Human Anatomy, School of Medicine, Loma Linda University, Loma Linda, CA, United States
| | - Clive J Robins
- Department of Psychology and Neuroscience, Duke University Medical Center, Durham, NC, United States
| | - Bruce Nelson
- Department of Research, Glendale Adventist Medical Center, Glendale, CA, United States
| | - Sally F Shaw
- Department of Research, Glendale Adventist Medical Center, Glendale, CA, United States
| | - Harvey Jay Cohen
- Department of Medicine, Center for Aging and Human Development, Duke University Medical Center, Durham, NC, United States
| | - Michael B King
- Division of Psychiatry, Faculty of Brain Sciences, University College, London, United Kingdom
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200
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Jayasinghe N, Rocha LP, Sheeran T, Wyka K, Bruce ML. Anxiety symptoms in older home health care recipients: prevalence and associates. Home Health Care Serv Q 2014; 32:163-77. [PMID: 23937710 DOI: 10.1080/01621424.2013.813885] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This study examined the prevalence and associates of anxiety symptoms in older home health care recipients (N = 249) who completed structured interviews assessing sociodemographic, cognitive, medical and disability, and psychosocial variables--including anxiety (assessed by the Clinical Anxiety Scale). Mild or moderate anxiety was reported by 3.6% of the sample. No anxiety symptoms whatsoever were reported by 63.9%, while the remaining endorsed at least one symptom. Binary logistic regression analysis revealed that the odds of having any anxiety were elevated among participants who had had a recent fall, OR = 2.81, 95% CI [1.46, 5.43]; and those with major depression, OR = 4.78, 95% CI [1.46, 15.68]. These findings point to the importance of conducting studies to clarify whether the mild severity of anxiety found in this sample is best accounted for by protective factors inherent to the home health care setting or assessment factors that diminish the reporting of anxiety symptoms.
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