1
|
Das Gupta D, Wong DWS. Age-Dependent Differences in Frequent Mental Distress (FMD) of US Older Adults Living in Multigenerational Families versus Living Alone. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3747. [PMID: 36834440 PMCID: PMC9964232 DOI: 10.3390/ijerph20043747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 02/10/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
Frequent mental distress (FMD) is prevalent among older Americans, but less is known about disparities in FMD of older adults living in multigenerational families versus living alone. We pooled cross-sectional data (unweighted, n = 126,144) from the Behavioral Risk Factor Surveillance System (BRFSS) between 2016 and 2020 and compared FMD (≥14 poor mental health days in the past 30 days = 1; 0 otherwise) of older adults (≥65 years) living in multigenerational families versus living alone in 36 states. After controlling for covariates, findings indicate 23% lower odds of FMD among older adults living in multigenerational households compared to counterparts living alone (adjusted odds ratio (AOR): 0.77; 95% confidence interval (CI): 0.60, 0.99). Findings also show that the reduction in the odds of FMD with each 5 year increase in age was larger among older adults living in multigenerational families by 18% (AOR: 0.56; 95% CI: 0.46, 0.70) compared to older adults living alone (AOR: 0.74; 95% CI: 0.71, 0.77), and this difference was significant at the 5% significance level. Multigenerational living may have a protective association with FMD among older adults. Further research is needed to identify multigenerational family and non-kin factors that translate into mental health advantages for older adults.
Collapse
Affiliation(s)
- Debasree Das Gupta
- Department of Kinesiology and Health Science, Emma Eccles Jones College of Education and Human Services, Utah State University, Logan, UT 84322, USA
| | - David W. S. Wong
- Department of Geography and Geoinformation Science, George Mason University, Fairfax, VA 22030, USA
| |
Collapse
|
2
|
Kempton CL, Michaels Stout M, Barry V, Figueroa J, Buckner TW, Gillespie S, Ellen Lynch M, Mattis S, Whitten S, McCracken C. Validation of a new instrument to measure disease-related distress among patients with haemophilia. Haemophilia 2020; 27:60-68. [PMID: 33141984 DOI: 10.1111/hae.14187] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 10/13/2020] [Accepted: 10/15/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION In patients with haemophilia, general psychological distress as measured by the National Comprehensive Cancer Network (NCCN) distress thermometer has been associated with pain, disability and increased healthcare utilization. AIMS To develop and validate a measure of haemophilia-related distress. METHODS After qualitative interviews, the Hemophilia-Related Distress Questionnaire (HRDq) was developed. To validate the HRDq, adults (≥18 years) with haemophilia were enrolled, reported demographic and clinical information, and completed the HRDq and other questionnaires that measured similar constructs. Analysis included factor analysis and assessment of internal consistency using Cronbach's α, convergent validity using Pearson's correlation coefficient, and discriminant validity by comparing subgroups of patients. Test-retest reliability was assessed using an intraclass correlation coefficient (ICC). RESULTS Among 130 enrolled participants, 126 (median age=32.7 years) completed the 24 item HRDq in a median time of 5.4 minutes with overall HRDq scores ranging from 2 to 83 (median score=31.5; higher scores indicating higher distress). Assessment of convergent validity demonstrated a strong correlation (ρ>.60) of the HRDq total score with the NCCN Distress Thermometer, Haem-A-QoL total Score, and PROMIS-29 Profile social role domain and a mild to moderate correlation with all other questionnaire domains (.3-.59, p < .05). Distress was higher among those who had less education, were not employed, and were disabled and was not significantly different among those with severe compared with non-severe disease. Assessment of test-retest reliability demonstrated an ICC value of .84 (95% CI .71-.91) for the total score. CONCLUSIONS The HRDq demonstrates good internal consistency, construct and discriminant validity, and retest reliability with a low responder burden.
Collapse
Affiliation(s)
- Christine L Kempton
- Department of Hematology and Medical Oncology and Hemophilia of Georgia Center for Bleeding & Clotting Disorders of Emory, Emory School of Medicine, Emory University, Atlanta, GA, USA
| | - Mary Michaels Stout
- Department of Medicine, Emory University School of Medicine, Emory University, Atlanta, GA, USA
| | - Vaughn Barry
- Department of Hematology and Medical Oncology and Hemophilia of Georgia Center for Bleeding & Clotting Disorders of Emory, Emory School of Medicine, Emory University, Atlanta, GA, USA
| | - Janet Figueroa
- Pediatric Biostatistics Core, Department of Pediatrics, Emory University School of Medicine, Emory University, Atlanta, GA, USA
| | | | - Scott Gillespie
- Pediatric Biostatistics Core, Department of Pediatrics, Emory University School of Medicine, Emory University, Atlanta, GA, USA
| | - Mary Ellen Lynch
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Shanna Mattis
- Department of Hematology and Medical Oncology and Hemophilia of Georgia Center for Bleeding & Clotting Disorders of Emory, Emory School of Medicine, Emory University, Atlanta, GA, USA
| | - Stephanie Whitten
- Department of Hematology and Medical Oncology and Hemophilia of Georgia Center for Bleeding & Clotting Disorders of Emory, Emory School of Medicine, Emory University, Atlanta, GA, USA
| | - Courtney McCracken
- Pediatric Biostatistics Core, Department of Pediatrics, Emory University School of Medicine, Emory University, Atlanta, GA, USA
| |
Collapse
|
3
|
Sciamanna CN, Smyth JM, Doerksen SE, Richard BR, Kraschnewski JL, Mowen AJ, Hickerson BD, Rovniak LS, Lehman EB, Yang C. Physical Activity Mode and Mental Distress in Adulthood. Am J Prev Med 2017; 52:85-93. [PMID: 27838116 DOI: 10.1016/j.amepre.2016.09.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 08/18/2016] [Accepted: 09/12/2016] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Nearly one fifth of American adults suffer from mental health issues, yet many treatments have side effects and stigma attached. Physical activity can be an effective treatment for mental health disorders, but most promotion efforts fail. One understudied aspect of physical activity is the specific mode, including if it engages others, and how this may relate to mental health. This study examined the potential relationship between different modes of physical activity and the frequency of mental distress. METHODS Data from the 2000 Behavioral Risk Factor Surveillance System were analyzed in 2015 to determine the relationship between participation in different modes of physical activity and frequent mental distress. RESULTS Data were obtained on physical activity and frequent mental distress from 183,341 adults (aged 18-99 years, 51.9% female, 57.4% overweight/obese, 9.5% frequent mental distress). Prevalence of mental distress for those reporting activities was contrasted against walking alone. People who participated in tennis had 46% lower odds (95% CI=0.35, 0.84) of frequent mental distress. Approaching significance, non-team play sports were associated with 18% lower odds (95% CI=0.66, 1.01) of frequent mental distress, compared with walking alone. CONCLUSIONS Activity modes are associated with mental health outcomes above and beyond the frequency and duration of activity. Given the social and play nature of the activities, this may reflect the relational aspect, enjoyment, or a combination of both. These results suggest that adding social or affective components to physical activity may enhance engagement and retention in activity promotion efforts and their benefits on mental health.
Collapse
Affiliation(s)
- Christopher N Sciamanna
- Department of Medicine, Penn State Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, Pennsylvania; Department of Public Health Sciences, Penn State College of Medicine; Pennsylvania State University, State College, Pennsylvania.
| | - Joshua M Smyth
- Department of Biobehavioral Health, Pennsylvania State University, University Park, Pennsylvania
| | | | - Barrett R Richard
- Department of Medicine, Penn State Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, Pennsylvania
| | - Jennifer L Kraschnewski
- Department of Medicine, Penn State Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, Pennsylvania; Department of Public Health Sciences, Penn State College of Medicine; Pennsylvania State University, State College, Pennsylvania
| | - Andrew J Mowen
- Department of Recreation, Park and Tourism Management, Pennsylvania State University, University Park, Pennsylvania
| | - Benjamin D Hickerson
- Department of Community and Therapeutic Recreation, University of North Carolina at Greensboro, Greensboro, North Carolina
| | - Liza S Rovniak
- Department of Medicine, Penn State Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, Pennsylvania; Department of Public Health Sciences, Penn State College of Medicine; Pennsylvania State University, State College, Pennsylvania
| | - Erik B Lehman
- Department of Public Health Sciences, Penn State College of Medicine; Pennsylvania State University, State College, Pennsylvania
| | - Chengwu Yang
- Department of Public Health Sciences, Penn State College of Medicine; Pennsylvania State University, State College, Pennsylvania; Office for Scholarship in Learning and Education Research, Penn State College of Medicine, Hershey, Pennsylvania
| |
Collapse
|
4
|
O'Donnell S, Rusu C, Hawker GA, Bernatsky S, McRae L, Canizares M, MacKay C, Badley EM. Arthritis has an impact on the daily lives of Canadians young and old: results from a population-based survey. BMC Musculoskelet Disord 2015; 16:230. [PMID: 26319735 PMCID: PMC4553213 DOI: 10.1186/s12891-015-0691-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 08/20/2015] [Indexed: 11/30/2022] Open
Abstract
Background There is a perception that the impacts of arthritis are greatest among older adults. However, the effect of age on health-related outcomes in individuals with arthritis has not been explicitly studied. This study examined whether the physical and mental health impacts of arthritis are greater in older (75+ years) versus younger (20–44, 45–64 and 65–74 years) Canadian adults. Methods Data were from the arthritis component of the 2009 Survey on Living with Chronic Diseases in Canada. The responses were weighted to be representative of Canadians (≥20 years) with arthritis. Associations between age and the prevalence of severe/frequent joint pain, severe/frequent fatigue, sleep limitations, instrumental activities of daily living (IADLs) limitations, high levels of stress, suboptimal general and suboptimal mental health, were examined descriptively prior to conducting multivariate log-binomial regression analyses. Results A total of 4565 respondents completed the survey (78 % response rate). Individuals with arthritis were mostly female (63 %), of working age (57 %) and overweight or obese (67 %). Upon adjusting for covariates, younger (20–44 years) and/or middle aged (45–64 years) adults were more likely than those older (75+ years) to report severe/frequent joint pain, sleep limitations, high levels of stress and suboptimal mental health. After adjusting for covariates, age was not associated with IADL limitations, severe/frequent fatigue or suboptimal general health. Conclusions Contrary to the belief that older adults with arthritis experience more severe physical and mental health outcomes, we found that older adults were less likely to report worse outcomes than younger adults. In light of these findings, public health messaging should stress that arthritis does not just affect the elderly and emphasize the importance of timely diagnosis and management at all ages in order to prevent or, minimize arthritis-related impairment.
Collapse
Affiliation(s)
- Siobhan O'Donnell
- Centre for Chronic Disease Prevention, Public Health Agency of Canada, Ottawa, ON, Canada.
| | - Corneliu Rusu
- Centre for Chronic Disease Prevention, Public Health Agency of Canada, Ottawa, ON, Canada.
| | - Gillian A Hawker
- Department of Medicine, University of Toronto School of Medicine, Toronto, ON, Canada. .,Department of Medicine, Women's College Hospital, Toronto, ON, Canada.
| | - Sasha Bernatsky
- Division of Rheumatology and Clinical Epidemiology, McGill University Health Centre, Montreal, QC, Canada. .,Division of Clinical Epidemiology, Research Institute of the McGill University Health Centre, Montreal, QC, Canada.
| | - Louise McRae
- Centre for Chronic Disease Prevention, Public Health Agency of Canada, Ottawa, ON, Canada.
| | - Mayilee Canizares
- Arthritis Community Research and Evaluation Unit, Division of Health Care and Outcomes Research, Toronto Western Research Institute, Toronto, ON, Canada.
| | - Crystal MacKay
- Arthritis Community Research and Evaluation Unit, Division of Health Care and Outcomes Research, Toronto Western Research Institute, Toronto, ON, Canada.
| | - Elizabeth M Badley
- Arthritis Community Research and Evaluation Unit, Division of Health Care and Outcomes Research, Toronto Western Research Institute, Toronto, ON, Canada. .,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
| |
Collapse
|
5
|
Barry V, Lynch ME, Tran DQ, Antun A, Cohen HG, DeBalsi A, Hicks D, Mattis S, Ribeiro MJA, Stein SF, Truss CL, Tyson K, Kempton CL. Distress in patients with bleeding disorders: a single institutional cross-sectional study. Haemophilia 2015; 21:e456-64. [DOI: 10.1111/hae.12748] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2015] [Indexed: 11/26/2022]
Affiliation(s)
- V. Barry
- Division of Hematology/Oncology; Department of Pediatrics; Emory University School of Medicine; Atlanta Georgia USA
- Aflac Cancer and Blood Disorders Center; Children's Healthcare of Atlanta; Atlanta Georgia USA
| | - M. E. Lynch
- Department of Psychiatry and Behavioral Services; Emory University School of Medicine; Atlanta Georgia USA
| | - D. Q. Tran
- Department of Hematology and Medical Oncology; Emory University School of Medicine; Atlanta Georgia USA
| | - A. Antun
- Department of Hematology and Medical Oncology; Emory University School of Medicine; Atlanta Georgia USA
| | - H. G. Cohen
- Winship Cancer Institute of Emory University; Atlanta Georgia USA
| | - A. DeBalsi
- Division of Hematology/Oncology; Department of Pediatrics; Emory University School of Medicine; Atlanta Georgia USA
- Aflac Cancer and Blood Disorders Center; Children's Healthcare of Atlanta; Atlanta Georgia USA
| | - D. Hicks
- Division of Hematology/Oncology; Department of Pediatrics; Emory University School of Medicine; Atlanta Georgia USA
- Aflac Cancer and Blood Disorders Center; Children's Healthcare of Atlanta; Atlanta Georgia USA
| | - S. Mattis
- Division of Hematology/Oncology; Department of Pediatrics; Emory University School of Medicine; Atlanta Georgia USA
- Aflac Cancer and Blood Disorders Center; Children's Healthcare of Atlanta; Atlanta Georgia USA
| | - M. J. A. Ribeiro
- Department of Hematology and Medical Oncology; Emory University School of Medicine; Atlanta Georgia USA
| | - S. F. Stein
- Department of Hematology and Medical Oncology; Emory University School of Medicine; Atlanta Georgia USA
| | - C. L. Truss
- Division of Hematology/Oncology; Department of Pediatrics; Emory University School of Medicine; Atlanta Georgia USA
- Aflac Cancer and Blood Disorders Center; Children's Healthcare of Atlanta; Atlanta Georgia USA
| | - K. Tyson
- Aflac Cancer and Blood Disorders Center; Children's Healthcare of Atlanta; Atlanta Georgia USA
| | - C. L. Kempton
- Division of Hematology/Oncology; Department of Pediatrics; Emory University School of Medicine; Atlanta Georgia USA
- Aflac Cancer and Blood Disorders Center; Children's Healthcare of Atlanta; Atlanta Georgia USA
- Department of Hematology and Medical Oncology; Emory University School of Medicine; Atlanta Georgia USA
| |
Collapse
|
6
|
Marino P, DePasquale A, Sirey JA. Cognitive Behavior Therapy With Mindfulness and Acceptance Skills for the Treatment of Older Adults. Clin Case Stud 2015. [DOI: 10.1177/1534650114556147] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Cognitive behavior therapy (CBT) is a psychotherapy approach for the treatment of depression in older adult populations. This article discusses an extension of CBT to include mindfulness and acceptance skills for the treatment of depression in older adults with comorbid medical illness. Findings support that a brief intervention of 12 weeks was effective in producing a clinically significant change in depression and quality of life at the completion of therapy and at follow-up. This suggests that mindfulness and acceptance skills in addition to CBT skills may be an effective intervention for the treatment of depression of older adults with chronic medical illnesses.
Collapse
Affiliation(s)
| | | | - Jo Anne Sirey
- Weill Cornell Medical College, White Plains, NY, USA
| |
Collapse
|
7
|
Iakhno NN, Smulevich AB, Terluin B, Reĭkhart DV, Zakharova EK, Andriushchenko AV, Parfenov VA, Zamergrad MV, Arnautov VS. [The primary screening of patients with autonomic disorders in outpatient clinics in Russia (START1) using the Russian version of The Four-Dimensional Symptom Questionnaire (4DSQ)]. Zh Nevrol Psikhiatr Im S S Korsakova 2015; 114:112-122. [PMID: 25726790 DOI: 10.17116/jnevro2014114121112-122] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To develop an effective diagnostic algorithm for detection of a mental component in the state of patients diagnosed with autonomic nervous system disorder. MATERIAL AND METHODS In the frames of START1 epidemiological study, we examined 6633 patients with autonomic nervous system disorders (ICD-10 G.90.8 and G90.9) and somatoform disorders (F45) including 18,8% patients who got a referral to a psychiatrist. A linguistically validated Russian version of The Dutch Four-Dimensional Symptoms Questionnaire (4DSQ) was tested in domain subpopulations. RESULTS In subpopulations of anxiety and depression, more than 26% of the patients got a referral to a psychiatrist that indirectly supported the assumption on the conformity of 4DSQ to the purposes of primary screening of four-dimensional disorders in the general population of patients with autonomic nervous system disorders. CONCLUSION The linguistically validated Russian version of 4DSQ enabled to formalize the description of clinical profile of these patients. Cluster analysis of the results allowed to single out two superdomains by the pairwise combination somatization with distress (SDis) and anxiety with depression (ADep). The detection of superdomain SDis appears to be a population specific characteristic of autonomic nervous system disorders in the Russian Federation.
Collapse
Affiliation(s)
- N N Iakhno
- GBOU VPO Pervyĭ Moskovskiĭ gosudarstvennyĭ meditsinskiĭ universitet im. I.M. Sechenova Minzdrava Rossii, Moskva
| | - A B Smulevich
- GBOU VPO Pervyĭ Moskovskiĭ gosudarstvennyĭ meditsinskiĭ universitet im. I.M. Sechenova Minzdrava Rossii, Moskva
| | - B Terluin
- Department of General Practice, EMGO-Institute, VU University Medical Centre, Amsterdam, The Netherlands
| | - D V Reĭkhart
- GBOU VPO Pervyĭ Moskovskiĭ gosudarstvennyĭ meditsinskiĭ universitet im. I.M. Sechenova Minzdrava Rossii, Moskva
| | | | - A V Andriushchenko
- GBOU VPO Pervyĭ Moskovskiĭ gosudarstvennyĭ meditsinskiĭ universitet im. I.M. Sechenova Minzdrava Rossii, Moskva
| | - V A Parfenov
- GBOU VPO Pervyĭ Moskovskiĭ gosudarstvennyĭ meditsinskiĭ universitet im. I.M. Sechenova Minzdrava Rossii, Moskva
| | - M V Zamergrad
- GBOU VPO Pervyĭ Moskovskiĭ gosudarstvennyĭ meditsinskiĭ universitet im. I.M. Sechenova Minzdrava Rossii, Moskva
| | | |
Collapse
|
8
|
Primary Care Medical Provider Attitudes Regarding Mental Health and Behavioral Medicine in Integrated and Non-integrated Primary Care Practice Settings. J Clin Psychol Med Settings 2012; 19:364-75. [DOI: 10.1007/s10880-011-9283-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
9
|
Hootman JM, Helmick CG, Brady TJ. A public health approach to addressing arthritis in older adults: the most common cause of disability. Am J Public Health 2012; 102:426-33. [PMID: 22390506 PMCID: PMC3487631 DOI: 10.2105/ajph.2011.300423] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2011] [Indexed: 11/04/2022]
Abstract
Arthritis is highly prevalent and is the leading cause of disability among older adults in the United States owing to the aging of the population and increases in the prevalence of risk factors (e.g., obesity). Arthritis will play a large role in the health-related quality of life, functional independence, and disability of older adults in the upcoming decades. We have emphasized the role of the public health system in reducing the impact of this large and growing public health problem, and we have presented priority public health actions.
Collapse
Affiliation(s)
- Jennifer M Hootman
- Arthritis Program, Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
| | | | | |
Collapse
|
10
|
Theis KA, Furner SE. Shut-In? Impact of Chronic Conditions on Community Participation Restriction among Older Adults. J Aging Res 2011; 2011:759158. [PMID: 21837277 PMCID: PMC3151523 DOI: 10.4061/2011/759158] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2011] [Accepted: 04/28/2011] [Indexed: 11/20/2022] Open
Abstract
Community participation may be especially important for older adults, who are often at risk for unwanted declines in participation. We estimated the prevalence of community participation restriction (PR) due to perceived environmental barriers among older adults (≥50 years) and compared the impact among those with selected chronic conditions. Individuals with low-prevalence conditions reported high community PR (9.1–20.4%), while those with highly prevalent conditions (e.g., arthritis) had relatively low community PR (5.1–10.0%) but represented the greatest absolute numbers of condition-associated burden (>1 million). Across all conditions, more than half of those with community PR reported being restricted “always or often.” Community PR most often resulted from modifiable environmental barriers. Promising targets to reduce community PR among adults ≥50 years with chronic conditions, particularly arthritis, include building design, sidewalks/curbs, crowd control, and interventions that improve the built environment.
Collapse
Affiliation(s)
- Kristina A Theis
- Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | | |
Collapse
|
11
|
Activity Limitations and Healthcare Access as Correlates of Frequent Mental Distress in Adults 65 Years and Older. J Prim Care Community Health 2011; 3:17-22. [DOI: 10.1177/2150131911412380] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objectives: Poor mental health is a major source of distress, disability, and social burden in older adults. The objective of this study was to determine if activity limitation and healthcare access are associated with frequent mental distress (FMD) in adults 65 years and older. Methods: Of the 123 427 study participants aged 65 years or older, 120 445 participants responded to the Behavioral Risk Factors Surveillance System (BRFSS) survey question on number of mentally unhealthy days. Participants who reported having 14 or more mentally unhealthy days during the past 30 days were considered as having FMD. Activity limitation, avoidance of medical care due to cost, and availability of personal doctor were examined for their association with FMD in multivariable logistic regression analysis. Age, sex, race/ethnicity, marital and employment status, emotional support, and life satisfaction were included as potential confounders. Results: The prevalence of FMD in this study population was 6.5% (95% CI = 6.3-6.8) with estimates significantly greater among women (7.2%, 95% CI = 6.9-7.6) as compared to men (5.5%, 95% CI = 5.1-6.0). The odds of FMD were more than 2-fold elevated for those who reported activity limitations due to physical, mental, or emotional problems (adjusted OR = 2.59, 95% CI = 2.33-2.87), and among those who reported health care cost as a barrier to see a doctor (adjusted OR = 2.14, 95% CI = 1.75-2.61). There was no significant relationship between availability of personal doctor and FMD observed in the study. Conclusions: The findings of this study showed that activity limitation and cost of medical care are associated with FMD in the US elderly population.
Collapse
|
12
|
Development and validation of a 6-day standard for the identification of frequent mental distress. Soc Psychiatry Psychiatr Epidemiol 2011; 46:403-11. [PMID: 20401465 DOI: 10.1007/s00127-010-0204-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2009] [Accepted: 02/23/2010] [Indexed: 10/19/2022]
Abstract
PURPOSE The goals of the current study were to assess the concurrent validity of a single-item measure of general mental distress with established, multi-item mental health measures used in population-level surveillance and to establish the optimal cutpoint for determining psychological distress (previously identified as frequent mental distress) using recently available data from the Behavioral Risk Factor Surveillance System survey. METHODS Data for this study were obtained from the core questionnaire and two optional modules available as part of the 2006 and 2007 Behavioral Risk Factor Surveillance System (BRFSS) surveys. Frequent mental distress (FMD) was identified by the number of days of self-reported poor mental health during the last 30 days. Comparisons of the number of days with poor mental health and positive scores for measures of depression and serious mental illness were calculated to identify the most efficient cutpoint for establishing FMD. RESULTS Comparisons of results obtained from ROC analyses using the PHQ-8 and K6 reported 0.867 (95% CI 0.861-0.872) and 0.840 (95% CI 0.836-0.845) of the area under the curve, respectively, suggesting good accuracy. Using the Youden index, 6 days of poor mental health in the past 30 days, rather than the existing 14-day standard, was identified as the point at which the sum of the sensitivity and specificity was greatest. CONCLUSION Results from this study suggest that a 6-day standard (FMD-6) can be used as a valid and reliable indicator of generalized mental distress with strong associations to both diagnosable depressive symptomology and serious mental illness.
Collapse
|
13
|
Ade J, Rohrer JE, Merchant M. Immigration, Drinking, and Frequent Mental Distress. J Prim Care Community Health 2010; 1:164-7. [DOI: 10.1177/2150131910379248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective: The objective of this study was to investigate the importance of immigration as a risk factor for self-reported frequent mental distress (FMD) among black respondents to an Internet survey. Method: Snowball sampling was used to obtain Internet survey responses from immigrant and non-immigrant black adults in the United States. Multiple logistic regression analysis was used to control for the effects of personal characteristics ( N = 301). Results: In this sample of black adults, 13.3% had FMD. Being an immigrant was not associated with FMD in this sample (adjusted odds ratio [OR] = 0.75, P = .53). However, more drinking days was an independent risk factor (OR = 1.07, P < .01). Conclusions: Being an immigrant was not an independent risk factor for FMD in this sample of black adults. However, drinking more days per month was a significant risk factor. Primary care providers should be alert for FMD and alcohol consumption in this population. Directing health education about hazardous drinking toward high-risk individuals should be considered.
Collapse
|
14
|
Holden L, Scuffham P, Hilton M, Vecchio N, Whiteford H. Psychological distress is associated with a range of high-priority health conditions affecting working Australians. Aust N Z J Public Health 2010; 34:304-10. [PMID: 20618274 DOI: 10.1111/j.1753-6405.2010.00531.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Psychological distress is growing in prevalence in Australia. Comorbid psychological distress and/or depressive symptoms are often associated with poorer health, higher healthcare utilisation and decreased adherence to medical treatments. METHODS The Australian Work Outcomes Research Cost-benefit (WORC) study cross-sectional screening dataset was used to explore the association between psychological distress and a range of health conditions in a sample of approximately 78,000 working Australians. The study uses the World Health Organization Health and Productivity Questionnaire (HPQ), to identify self-reported health status. Within the HPQ is the Kessler 6 (K6), a six-item scale of psychological distress which strongly discriminates between those with and without a mental disorder. Potential confounders of age, sex, marital status, number of children, education level and annual income were included in multivariate logistic regression models. RESULTS Psychological distress was significantly associated with all investigated health conditions in both crude and adjusted estimates. The conditions with the strongest adjusted association were, in order from highest: drug and alcohol problems, fatigue, migraine, CVD, COPD, injury and obesity. CONCLUSIONS Psychological distress is strongly associated with all 14 health conditions or risk factors investigated in this study. Comorbid psychological distress is a growing public health issue affecting Australian workers.
Collapse
Affiliation(s)
- Libby Holden
- School of Medicine, Griffith University, University Drive, Meadowbrook, QLD 4131.
| | | | | | | | | |
Collapse
|
15
|
SCHIEIR ORIT, THOMBS BRETTD, HUDSON MARIE, TAILLEFER SUZANNE, STEELE RUSSELL, BERKSON LAEORA, BERTRAND CAROLE, COUTURE FRANCOIS, FITZCHARLES MARYANN, GAGNÉ MICHEL, GARFIELD BRUCE, GUTKOWSKI ANDRZEJ, KANG HARB, KAPUSTA MORTON, LIGIER SOPHIE, MATHIEU JEANPIERRE, MÉNARD HENRI, MERCILLE SUZANNE, STARR MICHAEL, STEIN MICHAEL, ZUMMER MICHEL, BARON MURRAY. Symptoms of Depression Predict the Trajectory of Pain Among Patients with Early Inflammatory Arthritis: A Path Analysis Approach to Assessing Change. J Rheumatol 2009; 36:231-9. [DOI: 10.3899/jrheum.080147] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objective.To assess the longitudinal relationships, including directionality, among chronic pain, symptoms of depression, and disease activity in patients with early inflammatory arthritis (EIA).Methods.One hundred eighty patients with EIA completed an examination, including swollen joint count, and were administered the Center for Epidemiological Studies Depression Scale (CES-D) and the McGill Pain Questionnaire (MPQ) at 2 timepoints 6 months apart. Cross-lagged panel path analysis was used to simultaneously assess concurrent and longitudinal relationships among pain, symptoms of depression, and number of swollen joints.Results.Pain, symptoms of depression, and number of swollen joints decreased over time (p < 0.001) and were prospectively linked to pain, symptoms of depression, and number of swollen joints, respectively, at 6 months. Symptoms of depression and pain were correlated with each other at baseline (0.47) and at 6-month followup assessments (0.28). Baseline symptoms of depression significantly predicted pain symptoms at 6 months (standardized regression coefficient = 0.28, p = 0.001), whereas pain and disease activity did not predict the course of any other variable after controlling for baseline values.Conclusion.Symptoms of depression predicted the trajectory of pain from baseline to 6 months. In addition, there were reciprocal/bidirectional associations between pain and symptoms of depression over time. More research is needed to better understand the relationship between pain and depressive symptoms and how to best manage patients with EIA who have high levels of both.
Collapse
|
16
|
Gajre SS, Singh U, Saxena RK, Anand S. Electrical impedance signal analysis in assessing the possibility of non-invasive diagnosis of knee osteoarthritis. J Med Eng Technol 2007; 31:288-99. [PMID: 17566932 DOI: 10.1080/03091900600863745] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Knee osteoarthritis (OA) is a degenerating disorder that leads to pain, disability and dependence. Although significant numbers of elderly people are affected by this irreversible damage, not many non-invasive methods have been found that can detect onset of OA. The traditional x-ray has the disadvantage of detecting a problem only after many changes have taken place. Others, such as MRI and ultrasound, are either expensive or unsuitable for mass screening and repeated use. In this paper, an attempt has been made to study the usefulness of electrical impedance plethysmography (EIP) in non-invasive diagnosis of knee OA. In two experiments on 10 OA knees and eight control knees in groups aged 45 - 65 years (OA group: 62.40 +/- 3.47 years, controls: 53.38 +/- 8.55 years), knee swing (active flexion and extension of leg in sitting position, KS) and normal walking (WN) electrical impedance changes (DeltaZ) around the knee were analysed. The results indicate that there is significant difference in amplitudes of signals. Difference in mean of variances of two groups was significant (p < 0.05) for KS and WN. The difference in the mean rms values was also significant (p < 0.05) for KS and WN. Impedance changes suggest that EIP signal around the knee have the potential for non-invasive diagnosis of knee OA.
Collapse
Affiliation(s)
- S S Gajre
- Centre for Biomedical Engineering, Indian Institute of Technology, Hauz Khas, New Delhi, India.
| | | | | | | |
Collapse
|
17
|
McGuire LC, Strine TW, Okoro CA, Ahluwalia IB, Ford ES. Modifiable characteristics of a healthy lifestyle in U.S. older adults with or without frequent mental distress: 2003 Behavioral Risk Factor Surveillance System. Am J Geriatr Psychiatry 2007; 15:754-61. [PMID: 17804829 DOI: 10.1097/jgp.0b013e3180986125] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine the associations between frequent mental distress (FMD; 14 or more mentally unhealthy days during the previous 30 days), health behaviors, body weight, and use of preventive services among adults >or=65 years using the 2003 Behavioral Risk Factor Surveillance System (BRFSS). METHODS Participants (N = 52,600) were asked how many days during the past 30 days that their mental health was not good. Having a healthy weight (body mass index 18.5-24.9 kg/m(2)), not smoking, consuming <or=1 alcoholic beverage per day, consuming of at least five fruits or vegetables daily, participating in moderate-to-vigorous physical activity during the average week, receiving an annual influenza immunization, and ever receiving a pneumococcal immunization were examined in addition to combinations of these behaviors. RESULTS People with FMD were less likely than those without FMD to be nonsmokers (adjusted odds ratio [AOR] = 0.67, confidence interval [CI] = 0.53-0.85), to consume at least five fruits or vegetables daily (AOR = 0.80, CI = 0.70-0.91), and to participate in moderate-to-vigorous physical activity during the average week (AOR = 0.82, CI = 0.68-0.99). However, there was no difference between those with and without FMD in the consumption of <or=1 alcoholic beverage per day, having a healthy weight, receiving an annual influenza immunization, and ever receiving a pneumococcal immunization. CONCLUSIONS Older adults with FMD are less likely to engage in many health behaviors and to use preventive services than those without FMD.
Collapse
Affiliation(s)
- Lisa C McGuire
- Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341-3724, USA.
| | | | | | | | | |
Collapse
|
18
|
Fortin M, Hudon C, Bayliss EA, Soubhi H, Lapointe L. Caring for body and soul: the importance of recognizing and managing psychological distress in persons with multimorbidity. Int J Psychiatry Med 2007; 37:1-9. [PMID: 17645193 DOI: 10.2190/41x8-42qw-2571-h20g] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Primary care providers routinely encounter patients with interacting physical and psychological conditions that present as undifferentiated symptoms and feelings. Caring for the whole patient requires a good understanding of the interconnection between physical, psychological and social dimensions that may affect patients' well-being. In this article, we review the relationship between psychological distress and multimorbidity through the presentation of clinical vignettes from the real world of primary care, and discuss a team-based approach to managing care for this complex patient population.
Collapse
|
19
|
Rohrer J, Rohland B, Denison A, Pierce JR, Rasmussen NH. Family history of mental illness and frequent mental distress in community clinic patients. J Eval Clin Pract 2007; 13:435-9. [PMID: 17518811 DOI: 10.1111/j.1365-2753.2006.00737.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The objective of this study was to investigate the importance of family history of mental illness as a risk factor for self-reported frequent mental distress among patients who use community-based clinics. DESIGN A cross-sectional survey was distributed to a convenience sample in three community clinics serving largely low-income patients. Forms were completed by 793 clinic patients. Multiple logistic regression analysis was to control for the effects of demographic variables. RESULTS In this sample of primary care patients, 27.1% had frequent mental distress. Having a family history of mental illness or substance abuse was found to be associated with frequent mental distress in this population [adjusted odds ratio (OR) = 2.24, P = 0.000]. Also associated with increased odds of frequent mental distress were avoiding medical care owing to cost (OR = 1.86, P = 0.003) and obesity (OR = 1.73, P = 0.006). CONCLUSIONS Having a family history of mental illness or substance abuse is independently associated with increased odds of frequent mental distress among primary care patients seen in community clinics. Three strategies are suggested for using this information to prevent frequent mental distress: health education via mass communication to the general population of primary care patients being followed in a clinic, health education to at-risk patients, and targeted screening of clinic patients who have the risk factor.
Collapse
Affiliation(s)
- James Rohrer
- Department of Family Medicine, Mayo Clinic, Rochester, MN 55944, USA.
| | | | | | | | | |
Collapse
|
20
|
Shih M, Hootman JM, Strine TW, Chapman DP, Brady TJ. Serious psychological distress in U.S. adults with arthritis. J Gen Intern Med 2006; 21:1160-6. [PMID: 16879706 PMCID: PMC1831669 DOI: 10.1111/j.1525-1497.2006.00573.x] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2005] [Revised: 11/11/2005] [Accepted: 06/07/2006] [Indexed: 11/27/2022]
Abstract
BACKGROUND Arthritis and mental health disorders are leading causes of disability commonly seen by health care providers. Several studies demonstrate a higher prevalence of anxiety and depression in persons with arthritis versus those without arthritis. OBJECTIVES Determine the national prevalence of serious psychological distress (SPD) and frequent anxiety or depression (FAD) in adults with arthritis, and in adults with arthritis, identify risk factors associated with SPD. METHODS Cross-sectional data from the 2002 National Health Interview Survey, an in-person household interview survey, were used to estimate the prevalence of SPD and FAD in adults with (n=6,829) and without (n=20,676) arthritis. In adults with arthritis, the association between SPD and sociodemographic, clinical, and functional factors was evaluated using multivariable logistic regression. RESULTS The prevalence of SPD and FAD in adults with arthritis is significantly higher than in adults without arthritis (5.6% vs 1.8% and 26.2% vs 10.7%, P<.001, respectively). In adults with arthritis, SPD was significantly associated with younger age, lower socioeconomic status, divorce/separation, recurrent pain, physical inactivity, having functional or social limitations, and having comorbid medical conditions. Adults aged 18 to 44 years were 6.5 times more likely to report SPD than those 65 years or older, and adults with recurrent pain were 3 times more likely to report SPD than those without recurrent pain. CONCLUSIONS Serious psychological distress and FAD affect persons with arthritis and should be addressed in their treatment. Younger adults with arthritis, and those with recurrent pain or either functional or social limitations, may be at higher risk for SPD.
Collapse
Affiliation(s)
- Margaret Shih
- Office of Health Assessment and Epidemiology, Los Angeles County Department of Public Health, Los Angeles, CA 90012, USA.
| | | | | | | | | |
Collapse
|
21
|
Fortin M, Bravo G, Hudon C, Lapointe L, Dubois MF, Almirall J. Psychological distress and multimorbidity in primary care. Ann Fam Med 2006; 4:417-22. [PMID: 17003141 PMCID: PMC1578652 DOI: 10.1370/afm.528] [Citation(s) in RCA: 185] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Psychological distress may decrease adherence to medical treatments and lead to poorer health outcomes of chronic diseases. The aim of this study was to evaluate the relationship between psychological distress and multimorbidity among patients seen in family practice after controlling for potential confounding variables and taking into account the severity of diseases. METHODS We evaluated 238 patients to construct quintiles of increasing multimorbidity based on the Cumulative Illness Rating Scale (CIRS), which is a comprehensive multimorbidity index that takes into account disease severity. Patients completed a psychiatric symptom questionnaire as a measurement of their psychological distress. In the first model of logistic regression analyses, we used the counted number of chronic diseases as the independent variable. In subsequent models, we used the quintiles of CIRS. RESULTS After adjusting for confounding factors, multimorbidity measured by a simple count of chronic diseases was not related to psychological distress (OR, 1.12; 95% CI, 0.97-1.29; P = .188), whereas multimorbidity measured by the CIRS remained significantly associated (OR, 1.67; 95% CI, 1.19-2.37; P = .002). The estimate risk of psychological distress by quintile of CIRS was as follows: Q1/2 = 1.0; Q3 = OR, 1.72; 95% CI, 0.53-5.86; Q4 = OR, 2.99; 95% CI, 1.01-9.74; Q5 = OR, 4.67; 95% CI, 1.61-15.16. CONCLUSIONS Psychological distress increased with multimorbidity when we accounted for disease severity. Clinicians should be aware of the possible presence of psychological distress, which can further complicate the comprehensive management of these complex patients.
Collapse
Affiliation(s)
- Martin Fortin
- Department of Family Medicine, Sherbrooke University, Québec, Canada.
| | | | | | | | | | | |
Collapse
|