1
|
Nkyi AK, Baaba B. Coping, health anxiety, and stress among health professionals during Covid-19, Cape Coast, Ghana. PLoS One 2024; 19:e0296720. [PMID: 38285712 PMCID: PMC10824413 DOI: 10.1371/journal.pone.0296720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 12/15/2023] [Indexed: 01/31/2024] Open
Abstract
The aim of this study is to investigate coping strategies, health anxiety and stress among healthcare professionals in selected hospitals in the Cape Coast Metropolis during the Covid 19 pandemic. This study adopted the Descriptive survey design. The Multistage sampling technique was used to select 322 health professionals. The health professionals included Medical Officers, Physician Assistants and Nurses. Data were gathered using the Health Anxiety Inventory (HAI-SF), Perceived Stress Scale (PSS), and the Brief-COPE Inventory. Analyses were conducted using mean and standard deviation, ANOVA as well as Independent Samples t-test. Results indicate that Health professionals adopted diverse coping strategies ranging from positive to negative coping style to overcome the negative impact of the COVID-19 pandemic. Results also indicate that coping strategies significantly influenced health anxiety levels of health professionals, and that Active Coping is a significant determinant of stress among health professionals. Male health professionals had significantly more health anxiety than females. However, gender was not a significant factor in the experiences of stress. Lastly, age of health professionals does not determine the type of coping strategy they adopted during the pandemic.
Collapse
Affiliation(s)
- Anthony K. Nkyi
- Department of Guidance and Counselling, College of Education Studies, University of Cape Coast, Cape Coast, Ghana
| | - Bridgette Baaba
- Counselling Center, College of Education Studies, University of Cape Coast, Cape Coast, Ghana
| |
Collapse
|
2
|
Jayalakshmi S, Telugu R, Vooturi S, Patil A, Sirisha S, Somayajula S. Anxiety, depression, and psychosocial adjustment in people with epilepsy. J Neurosci Rural Pract 2023; 14:111-118. [PMID: 36891095 PMCID: PMC9945281 DOI: 10.25259/jnrp-2022-6-40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 08/09/2022] [Indexed: 01/28/2023] Open
Abstract
Objective Effect of psychological disorders on social functioning in people with epilepsy (PWE) is not extensively reported. We evaluate psychosocial functioning in PWE attending an outpatient clinic and aim to understand the differences in psychosocial functioning between anxiety, depression, and coexisting anxiety and depression in PWE. Materials and Methods A prospective evaluation of psychosocial functioning of 324 consecutive adult PWE attending outpatient epilepsy clinic was done using self-reported Washington Psychosocial Seizure Inventory. The study population was divided in four groups - without psychological disorders, anxiety, depression, and both anxiety and depression. Results The mean age of study population was 25.90 ± 6.22 years. Anxiety was noted in 73 (22.5%), depression in 60 (18.5%), and both anxiety and depression were seen in 70 (21.6%) and the rest had normal psychosocial function. There were no significant differences across all the four sub-groups for sociodemographics. Psychosocial functioning did not differ significantly between PWE with normal psychosocial function and PWE with anxiety alone. However, psychosocial functioning scores were worse in PWE with depression and PWE with both anxiety and depression when compared to PWE with normal psychosocial function. Conclusion In the present study of PWE attending an outpatient epilepsy clinic, one-fifth of PWE had both anxiety and depression. Psychosocial functioning in PWE with anxiety was similar to otherwise healthy/normal PWE, whereas PWE with depression showed poor psychosocial functioning. Role of psychological interventions on psychosocial aspects of epilepsy should be studied extensively in future.
Collapse
Affiliation(s)
- Sita Jayalakshmi
- Department of Neurology, Krishna Institute of Medical Sciences, Secunderabad, Telangana, India
| | - Ramakrishna Telugu
- Department of Neurology, Krishna Institute of Medical Sciences, Secunderabad, Telangana, India
| | - Sudhindra Vooturi
- Department of Neurology, Krishna Institute of Medical Sciences, Secunderabad, Telangana, India
| | - Anuja Patil
- Department of Neurology, Krishna Institute of Medical Sciences, Secunderabad, Telangana, India
| | - Sai Sirisha
- Department of Neurology, Krishna Institute of Medical Sciences, Secunderabad, Telangana, India
| | - Shanmukhi Somayajula
- Department of Neurology, Krishna Institute of Medical Sciences, Secunderabad, Telangana, India
| |
Collapse
|
3
|
Tu H, Gong G, Zhang S, Fu Y, Wang T, Chu Q, Hu S, Wang K, Zhu C, Fan Y. The association between illness perception and quality of life among Chinese adults with epilepsy: The mediating role of coping style. Epilepsy Behav 2022; 130:108677. [PMID: 35398723 DOI: 10.1016/j.yebeh.2022.108677] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 03/13/2022] [Accepted: 03/19/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To evaluate the associations between illness perception, quality of life (QOL), and coping style among patients with epilepsy (PWE), and to establish the behavior of coping style as a mediator of the interplay between illness perception and QOL. METHODS A cross-sectional study of 135 adult Chinese PWE was performed. All patients completed clinical and demographic questionnaires, the Chinese version of the Revised Illness Perception Questionnaire (CIPQ-R), the quality of life in epilepsy-31 inventory (QOLIE-31), and the Simplified Coping Style Questionnaire (SCSQ). Collected data were assessed through correlation analyses, structural equation modeling (SEM), and multiple stepwise linear regression assessments. RESULTS These patients exhibited a mean QOLIE-31 total score of 46.9 points, consistent with moderately low QOL. Under model III (F = 9.447, p < 0.01, R2 = 0.486), all included variables were found to explain 48.6% of the observed variation in QOL, with illness perception and coping style, respectively, explaining 27.3% and 7% of such variation. SEM findings illustrated that the total influence value of illness perception on QOL was 77.5% (β = -0.775, p < 0.001). Moreover, the illness perception was found to have a direct impact on QOL (β = -0.620, p = 0.001), negative coping (β = 0.309, p < 0.001), and positive coping (β = -0.265, p = 0.014), with negative coping (β = -0.256, p = 0.003), and positive coping (β = 0.288, p = 0.006) also having a direct impact on such QOL. Positive and negative coping styles also served as mediators of an indirect relationship between illness perception and QOL (β = -0.27*0.29 + 0.31* - 0.26 = -0.159, p = 0.001), with coping style thus serving as a significant mediator of the association between QOL and illness perception. The mediating impact of coping style on QOL accounted for 20.5% (-0.159/-0.775) of the total influence. CONCLUSION Both coping style and illness perception were detected to be significantly correlated with the QOL of Chinese adult PWE, with coping style serving as a mediator of the association between QOL and illness perception in this patient population. As such, when seeking to control seizures, medical workers should assess illness perceptions and coping styles among PWE as quickly as possible in order to select the optimal interventions most likely to improve the QOL of these patients.
Collapse
Affiliation(s)
- Houmian Tu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University. 81 Meishan Road, Hefei, Anhui Province 230032, PR China; Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province 230032, PR China
| | - Guiping Gong
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province 230032, PR China
| | - Sichen Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University. 81 Meishan Road, Hefei, Anhui Province 230032, PR China
| | - Yuansheng Fu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University. 81 Meishan Road, Hefei, Anhui Province 230032, PR China
| | - Ting Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University. 81 Meishan Road, Hefei, Anhui Province 230032, PR China
| | - Qinshu Chu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University. 81 Meishan Road, Hefei, Anhui Province 230032, PR China
| | - Shaohua Hu
- Nursing Department, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province 230032, PR China
| | - Kai Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province 230032, PR China
| | - Chunyan Zhu
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230032, PR China.
| | - Yinguang Fan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University. 81 Meishan Road, Hefei, Anhui Province 230032, PR China.
| |
Collapse
|
4
|
Wang S, Zhou Y, Li L, Kent S. Benefit finding: understanding the impact and public health factors among COVID-19 patients in China. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2022; 31:222-228. [PMID: 35220753 DOI: 10.12968/bjon.2022.31.4.222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND This study aimed to determine the level of benefit finding among COVID-19 patients in a hospital in mainland China, and to identify its associated impact and public health factors. METHODS Using a cross-sectional design, a total of 288 COVID-19 patients were recruited in Huoshenshan Hospital in Wuhan, China to complete a survey on benefit finding. The level of benefit finding evaluated by the Benefit Finding Scale (BFS), mental resilience evaluated by the Connor-Davidson Resilience Scale (CD-RISC), social support evaluated by the Multidimensional Scale of Perceived Social Support (MSPSS), medical coping modes evaluated by the Medical Coping Modes Questionnaire (MCMQ), and general information was collected by self-designed questionnaires. T-test and chi-square test were used for single-factor analyses. For multiple factor analyses, multivariate regression analyses were performed. RESULT The mean BFS score of 288 participants was 61.26±10.25. Multivariate regression analysis showed that the factors associated with the level of benefit finding among COVID-19 patients in China included education level, having experienced major event, social support, optimism, confrontive coping and resigned coping mode. CONCLUSIONS In general, the patients with COVID-19 in this study had a middle level of benefit finding. Health professionals should take measures to identify the influencing factors on the quality of the life and take targeted intervention measures.
Collapse
Affiliation(s)
- Sitong Wang
- Nurse Researcher, Department of Nursing, Third Affiliated Hospital of the Naval Military Medical University, Shanghai, China
| | - Yanan Zhou
- Nurse Researcher, Department of Nursing, Third Affiliated Hospital of the Naval Military Medical University, Shanghai, China
| | - Li Li
- Director of Nursing, Department of Nursing, Third Affiliated Hospital of the Naval Military Medical University, Shanghai, China
| | - Susan Kent
- Professor Associate, School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| |
Collapse
|
5
|
Huiberts AJ, Vermeeren YM, van Bemmel T, Wieberdink RG, van Jaarsveld CHM, Zomer TP. Coping strategies and quality of life in patients with chronic symptoms visiting a Lyme Center in a Dutch teaching hospital. Qual Life Res 2022; 31:2423-2434. [PMID: 35122610 DOI: 10.1007/s11136-022-03094-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2022] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Little is known on coping strategies in patients with chronic symptoms suspected of Lyme borreliosis (LB). Different coping strategies might influence quality of life (QoL). We assessed coping strategies and QoL in patients with chronic symptoms suspected of LB. METHODS Adult patients referred to the Lyme Center Apeldoorn were included (November 2019-April 2021). Participants completed the RAND-36 to assess QoL and the Utrecht Coping List to assess coping strategies. Patient data were extracted from medical records. Patients were categorized based on clinical LB and serology. Linear regression analyses were conducted to examine an association between coping strategies and QoL subscales. RESULTS Included were 201 patients. Patients suspected of LB had a different coping profile and lower QoL compared to the reference population. Patients with negative serology and no clinical LB scored lowest on all QoL subscales. In multivariate analyses, correcting for age, gender, comorbidity, and patient category, a negative association was found between passive coping and the QoL subscales physical functioning (β(SE) = - 1.1(0.5)), social functioning (β(SE) = - 3.3(0.5)), role limitations (emotional) (β(SE) = - 5.5(0.8)), mental health (β(SE) = - 3.7(0.3)), vitality (β(SE) = - 2.3(0.3)), pain (β(SE) = - 2.3(0.5)), and general health (β(SE) = - 2.7(0.3)). A negative association was also found between palliative coping and the QoL subscale role limitations (physical) (β(SE) = - 1.8(0.6)) and between expressing emotions and mental health (β(SE) = - 1.3(0.6)). A positive association was found between active coping and the QoL subscales mental health (β(SE) = 1.0(0.3)) and role limitations (emotional) (β(SE) = 1.9(0.8)). CONCLUSION In patients suspected of LB, dysfunctional coping strategies were associated with worse quality of life. There is a need for interventions that can guide patients with chronic symptoms suspected of LB towards more active coping and increase QoL.
Collapse
Affiliation(s)
- Anne J Huiberts
- Lyme Center Apeldoorn, Gelre Hospital, P.O. Box 9014, 7300 DS, Apeldoorn, The Netherlands
| | - Yolande M Vermeeren
- Lyme Center Apeldoorn, Gelre Hospital, P.O. Box 9014, 7300 DS, Apeldoorn, The Netherlands.,Department of Internal Medicine, Gelre Hospital, Apeldoorn, The Netherlands
| | - Thomas van Bemmel
- Lyme Center Apeldoorn, Gelre Hospital, P.O. Box 9014, 7300 DS, Apeldoorn, The Netherlands.,Department of Internal Medicine, Gelre Hospital, Apeldoorn, The Netherlands
| | - Renske G Wieberdink
- Lyme Center Apeldoorn, Gelre Hospital, P.O. Box 9014, 7300 DS, Apeldoorn, The Netherlands.,Department of Neurology, Gelre Hospital, Apeldoorn, The Netherlands
| | - Cornelia H M van Jaarsveld
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Tizza P Zomer
- Lyme Center Apeldoorn, Gelre Hospital, P.O. Box 9014, 7300 DS, Apeldoorn, The Netherlands.
| |
Collapse
|
6
|
Elkayal MM, Shahin MAH, Hussien RM. Psychological distress related to the emerging COVID-19 pandemic and coping strategies among general population in Egypt. J Egypt Public Health Assoc 2022; 97:3. [PMID: 35022868 PMCID: PMC8754360 DOI: 10.1186/s42506-021-00100-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 12/11/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Psychological distress is considered a threat to the mental health of human beings. This research was conducted at the beginning of the emerging COVID-19 pandemic, when most people had limited knowledge about coronavirus, mode of transmission, associated manifestations, with uncertainty about treatment, vaccine, future life, and coping capacity. This study examined the nature of the psychological distress related to the emergence of the coronavirus disease 2019 (COVID-19) pandemic and coping strategies adopted among the general population in Egypt. METHODS This was a descriptive, cross-sectional study assessing a convenience sample consisting of 312 participants from the general population in Egypt. Data were gathered as online responses to a questionnaire which incorporated a sociodemographic datasheet, psychological distress scale, and ways of coping scale. RESULTS Forty-two percent of the participants showed severe psychological distress and 26% showed mild to moderate psychological distress. There was a strong positive correlation between the distress score and the overall coping score-that is, the higher the distress, the more ways of coping were adopted (p < 0.001). This study also showed that the methods of adaptation used by most of the population were based on emotional coping strategy. The most adaptive people were those who work in the health field and the residents in the cities with a monthly income sufficient enough to meet their needs; better adaptation methods were also seen among both divorced and highly educated people. We also found a significant relationship between sociodemographic characteristics except for sex and overall coping methods (p < 0.001). Further, significant relationships between sociodemographic characteristics and psychological distress were observed (p < 0.001). CONCLUSION Most of the study population as a sample of the general population in Egypt reported suffering from varying degrees of psychological distress during the COVID-19 crisis. However, the more severe an individual's level of psychological distress, the greater their adaptation ability was. This study focuses light on the importance to provide appropriate interventions against COVID-19-related stresses and equipping people with suitable strategies for coping with the COVID-19 pandemic.
Collapse
Affiliation(s)
- Manal Mohamed Elkayal
- grid.31451.320000 0001 2158 2757Department of Psychiatric and Mental Health Nursing, Faculty of Nursing, Zagazig University, Zagazig, Egypt
| | | | - Rasha Mohammed Hussien
- grid.31451.320000 0001 2158 2757Department of Psychiatric and Mental Health Nursing, Faculty of Nursing, Zagazig University, Zagazig, Egypt ,Department of Psychiatric and Mental Health and Community Health Nursing, College of Nursing, Qasim University, Buraydah, Saudi Arabia
| |
Collapse
|
7
|
Aldosary WS, Heena H, El-Bakri NK. Psychological self-security and self-concept among Saudi epilepsy patients at a tertiary care center in KSA. J Family Med Prim Care 2021; 10:3888-3891. [PMID: 34934697 PMCID: PMC8653478 DOI: 10.4103/jfmpc.jfmpc_261_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 09/15/2018] [Accepted: 06/04/2021] [Indexed: 11/24/2022] Open
Abstract
Objective: While psychological issues in epilepsy patients have been studied extensively, the phenomena of self-concept and self-security have not been adequately addressed in such patients. Therefore, the aim of the current study is to assess the levels of psychological self-security and self-concept among Saudi epilepsy patients. Methods: A case-control study was conducted on adult patients with epilepsy from the Epilepsy Monitoring Unit at King Fahad Medical City in Riyadh, Saudi Arabia. Healthy controls were obtained from the community. Demographic data including age, gender and education level were collected. Self-concept and self-security were assessed using validated scales. Descriptive statistics were obtained, and inferential testing was conducted. Results: Data from 145 subjects was entered in the final analysis, including 100 patients with epilepsy and 45 controls (females = 32%). A significantly higher level of psychological insecurity was found in PWE (people with epilepsy) compared to controls. No significant difference was noticed on self-concept level between PWE versus controls. Education level was significantly lower in PWE than in controls. Those with higher education levels scored lower on psychological insecurity, although this effect disappeared when the data were split by health status. Conclusion: Level of psychological self-security was higher in PWE than controls, while no difference in self-concept was observed. This study highlights the areas of focus needed in epilepsy-related social services in order to improve the psychological wellbeing of patients with epilepsy.
Collapse
Affiliation(s)
- Wardah S Aldosary
- Department of Mental Health, National Neurosciences Institutes, King Fahad Medical City, Riyadh, KSA
| | | | - Nahid K El-Bakri
- Department of Mental Health, National Neurosciences Institutes, King Fahad Medical City, Riyadh, KSA
| |
Collapse
|
8
|
Advances in Hereditary Angioedema: The Prevention of Angioedema Attacks With Subcutaneous C1-Inhibitor Replacement Therapy. JOURNAL OF INFUSION NURSING 2021; 43:134-145. [PMID: 32287168 PMCID: PMC7328861 DOI: 10.1097/nan.0000000000000365] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Supplemental Digital Content is Available in the Text. Hereditary angioedema (HAE) is a debilitating condition caused by a functional C1-inhibitor (C1-INH) deficiency and characterized clinically by episodes of subcutaneous or submucosal swelling. C1-INH replacement is highly effective for preventing HAE attacks and can improve health-related quality of life. Once available only for intravenous use, C1-INH is now available as a subcutaneous formulation for self-administration, shown to provide sustained plasma levels of C1-INH and reducing the monthly median HAE attack rate by 95% versus placebo in the phase 3 COMPACT study. Subcutaneously administered C1-INH satisfies multiple unmet needs in the management of patients with HAE.
Collapse
|
9
|
Kluger BM, Drees C, Wodushek TR, Frey L, Strom L, Brown MG, Bainbridge JL, Fischer SN, Shrestha A, Spitz M. Would people living with epilepsy benefit from palliative care? Epilepsy Behav 2021; 114:107618. [PMID: 33246892 PMCID: PMC9326903 DOI: 10.1016/j.yebeh.2020.107618] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 10/30/2020] [Accepted: 10/30/2020] [Indexed: 12/30/2022]
Abstract
Palliative care (PC) is an approach to the care of persons living with serious illness and their families that focuses on improving quality of life and reducing suffering by addressing complex medical symptoms, psychosocial needs, spiritual well-being, and advance care planning. While PC has traditionally been associated with hospice care for persons with cancer, there is now recognition that PC is relevant to many noncancer diagnoses, including neurologic illness, and at multiple points along the illness journey, not just end of life. Despite the recent growth of the field of neuropalliative care there has been scant attention paid to the relevance of PC principles in epilepsy or the potential for PC approaches to improve outcomes for persons living with epilepsy and their families. We believe this has been a significant oversight and that PC may provide a useful framework for addressing the many sources of suffering facing persons living with epilepsy, for engaging patients and families in challenging conversations, and to focus efforts to improve models of care for this population. In this manuscript we review areas of significant unmet needs where a PC approach may improve patient and family-centered outcomes, including complex symptom management, goals of care, advance care planning, psychosocial support for patient and family and spiritual well-being. When relevant we highlight areas where epilepsy patients may have unique PC needs compared to other patient populations and conclude with suggestions for future research, clinical, and educational efforts.
Collapse
Affiliation(s)
- Benzi M Kluger
- Departments of Neurology and Medicine, University of Rochester Medical Center, Rochester, NY, USA.
| | - Cornelia Drees
- Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Thomas R Wodushek
- Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Lauren Frey
- Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Laura Strom
- Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Mesha-Gay Brown
- Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Jacquelyn L Bainbridge
- Department of Clinical Pharmacy, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Sarah N Fischer
- Department of Clinical Pharmacy, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Archana Shrestha
- Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Mark Spitz
- Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| |
Collapse
|
10
|
Yang X, Xiong Z, Li Z, Li X, Xiang W, Yuan Y, Li Z. Perceived psychological stress and associated factors in the early stages of the coronavirus disease 2019 (COVID-19) epidemic: Evidence from the general Chinese population. PLoS One 2020; 15:e0243605. [PMID: 33275635 PMCID: PMC7717525 DOI: 10.1371/journal.pone.0243605] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 11/20/2020] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Coronavirus disease 2019 (COVID-19) is an acute respiratory infection caused by novel coronavirus 2019. Many individuals suffered psychological symptoms in the early stage when the epidemic was uncertain. We explored the perceived psychological stress and associated factors in the early stage of COVID-19 epidemic. METHOD The Perceived Stress Scale, Simplified Coping Style Questionnaire, Social Support Rating Scale and a general information questionnaire were integrated in an on-line survey conducted from February 1, 2020 until February 4, 2020. Multiple linear regression analysis was performed to explore whether coping style, social support or other factors contributed to psychological stress. RESULTS A total of 1638 participants were included, of whom 44.3% showed moderate psychological stress. Individuals who were younger, female, unmarried, spent more time on the disease, felt more concern about it, reported lower social support (Subjective Social support; Objective social support; Utilization social support), or showed a negative coping style were more likely to suffer higher psychological stress in the early stages of the COVID-19 epidemic. CONCLUSION Psychological interventions may be targeted to individuals with the risk characteristics identified in this study. It may be helpful to promote social support and positive coping style in the early stage of infectious disease epidemics. This initial evidence from the general Chinese population may be relevant to interventions in other countries for dealing with the COVID-19 and other epidemics.
Collapse
Affiliation(s)
- Xiao Yang
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- West China Brain Research Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhenzhen Xiong
- School of Nursing, Chengdu Medical College, Chengdu, Sichuan, China
| | - Zhixiong Li
- The Third Department of Clinical Psychology, Karamay Municipal People's Hospital, Karamay, Xinjiang, China
| | - Xiao Li
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Weiyi Xiang
- The West China College of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Yiwen Yuan
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhe Li
- The Mental Health Center and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- * E-mail:
| |
Collapse
|
11
|
Wang H, Xia Q, Xiong Z, Li Z, Xiang W, Yuan Y, Liu Y, Li Z. The psychological distress and coping styles in the early stages of the 2019 coronavirus disease (COVID-19) epidemic in the general mainland Chinese population: A web-based survey. PLoS One 2020; 15:e0233410. [PMID: 32407409 PMCID: PMC7224553 DOI: 10.1371/journal.pone.0233410] [Citation(s) in RCA: 160] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 05/05/2020] [Indexed: 02/05/2023] Open
Abstract
As the epidemic outbreak of 2019 coronavirus disease (COVID-19), general population may experience psychological distress. Evidence has suggested that negative coping styles may be related to subsequent mental illness. Therefore, we investigate the general population's psychological distress and coping styles in the early stages of the COVID-19 outbreak. A cross-sectional battery of surveys was conducted from February 1-4, 2020. The Kessler 6 psychological distress scale, the simplified coping style questionnaire and a general information questionnaire were administered on-line to a convenience sample of 1599 in China. A multiple linear regression analysis was performed to identify the influence factors of psychological distress. General population's psychological distress were significant differences based on age, marriage, epidemic contact characteristics, concern with media reports, and perceived impacts of the epidemic outbreak (all p <0.001) except gender (p = 0.316). The population with younger age (F = 102.04), unmarried (t = 15.28), with history of visiting Wuhan in the past month (t = -40.86), with history of epidemics occurring in the community (t = -10.25), more concern with media reports (F = 21.84), perceived more impacts of the epidemic outbreak (changes over living situations, F = 331.71; emotional control, F = 1863.07; epidemic-related dreams, F = 1642.78) and negative coping style (t = 37.41) had higher level of psychological distress. Multivariate analysis found that marriage, epidemic contact characteristics, perceived impacts of the epidemic and coping style were the influence factors of psychological distress (all p <0.001). Epidemic of COVID-19 caused high level of psychological distress. The general mainland Chinese population with unmarried, history of visiting Wuhan in the past month, perceived more impacts of the epidemic and negative coping style had higher level of psychological distress in the early stages of COVID-19 epidemic. Psychological interventions should be implemented early, especially for those general population with such characteristics.
Collapse
Affiliation(s)
- Huiyao Wang
- The Mental Health Center and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qian Xia
- The Mental Health Center and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhenzhen Xiong
- School of Nursing, Chengdu Medical College, Chengdu, Sichuan, China
| | - Zhixiong Li
- The Third Department of Clinical Psychology, Karamay Municipal People’s Hospital, Karamay, Xinjiang, China
| | - Weiyi Xiang
- The West China College of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Yiwen Yuan
- The Mental Health Center and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yaya Liu
- The Mental Health Center and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Zun Yi Psychiatric Hospital, Zunyi, Guizhou, China
| | - Zhe Li
- The Mental Health Center and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- * E-mail:
| |
Collapse
|
12
|
Ridsdale L, McKinlay A, Wojewodka G, Robinson EJ, Mosweu I, Feehan SJ, Noble AJ, Morgan M, Taylor SJ, McCrone P, Landau S, Richardson M, Baker G, Goldstein LH. Self-Management education for adults with poorly controlled epILEpsy [SMILE (UK)]: a randomised controlled trial. Health Technol Assess 2019; 22:1-142. [PMID: 29717699 DOI: 10.3310/hta22210] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Epilepsy is a common neurological condition resulting in recurrent seizures. Research evidence in long-term conditions suggests that patients benefit from self-management education and that this may improve quality of life (QoL). Epilepsy self-management education has yet to be tested in a UK setting. OBJECTIVES To determine the effectiveness and cost-effectiveness of Self-Management education for people with poorly controlled epILEpsy [SMILE (UK)]. DESIGN A parallel pragmatic randomised controlled trial. SETTING Participants were recruited from eight hospitals in London and south-east England. PARTICIPANTS Adults aged ≥ 16 years with epilepsy and two or more epileptic seizures in the past year, who were currently being prescribed antiepileptic drugs. INTERVENTION A 2-day group self-management course alongside treatment as usual (TAU). The control group received TAU. MAIN OUTCOME MEASURES The primary outcome is QoL in people with epilepsy at 12-month follow-up using the Quality Of Life In Epilepsy 31-P (QOLIE-31-P) scale. Other outcomes were seizure control, impact of epilepsy, medication adverse effects, psychological distress, perceived stigma, self-mastery and medication adherence. Cost-effectiveness analyses and a process evaluation were undertaken. RANDOMISATION A 1 : 1 ratio between trial arms using fixed block sizes of two. BLINDING Participants were not blinded to their group allocation because of the nature of the study. Researchers involved in data collection and analysis remained blinded throughout. RESULTS The trial completed successfully. A total of 404 participants were enrolled in the study [SMILE (UK), n = 205; TAU, n = 199] with 331 completing the final follow-up at 12 months [SMILE (UK), n = 163; TAU, n = 168]. In the intervention group, 61.5% completed all sessions of the course. No adverse events were found to be related to the intervention. At baseline, participants had a mean age of 41.7 years [standard deviation (SD) 14.1 years], and had epilepsy for a median of 18 years. The mean QOLIE-31-P score for the whole group at baseline was 66.0 out of 100.0 (SD 14.2). Clinically relevant levels of anxiety symptoms were reported in 53.6% of the group and depression symptoms in 28.0%. The results following an intention-to-treat analysis showed no change in any measures at the 12-month follow-up [QOLIE-31-P: SMILE (UK) mean: 67.4, SD 13.5; TAU mean: 69.5, SD 14.8]. The cost-effectiveness study showed that SMILE (UK) was possibly cost-effective but was also associated with lower QoL. The process evaluation with 20 participants revealed that a group course increased confidence by sharing with others and improved self-management behaviours. CONCLUSIONS For people with epilepsy and persistent seizures, a 2-day self-management education course is cost-saving, but does not improve QoL after 12-months or reduce anxiety or depression symptoms. A psychological intervention may help with anxiety and depression. Interviewed participants reported attending a group course increased their confidence and helped them improve their self-management. FUTURE WORK More research is needed on self-management courses, with psychological components and integration with routine monitoring. TRIAL REGISTRATION Current Controlled Trials ISRCTN57937389. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 22, No. 21. See the NIHR Journals Library website for further project information.
Collapse
Affiliation(s)
- Leone Ridsdale
- Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Alison McKinlay
- Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Gabriella Wojewodka
- Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Emily J Robinson
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Iris Mosweu
- King's Health Economics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Sarah J Feehan
- Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Adam J Noble
- Department of Psychological Sciences, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - Myfanwy Morgan
- Institute of Pharmaceutical Science, King's College London, London, UK
| | - Stephanie Jc Taylor
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Centre for Primary Care and Public Health, London, UK
| | - Paul McCrone
- King's Health Economics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Sabine Landau
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Mark Richardson
- Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Gus Baker
- Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, UK
| | - Laura H Goldstein
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| |
Collapse
|
13
|
Wijnen BFM, Schat SL, de Kinderen RJA, Colon AJ, Ossenblok PPW, Evers SMAA. Burden of disease of people with epilepsy during an optimized diagnostic trajectory: costs and quality of life. Epilepsy Res 2018; 146:87-93. [PMID: 30086483 DOI: 10.1016/j.eplepsyres.2018.07.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 07/10/2018] [Accepted: 07/30/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND Diagnosing epilepsy can be lengthy and stressful, potentially leading to increased use of healthcare resources and a reduction in quality of life. AIM This study aims to determine cost and quality of life before and after an optimized diagnostic procedure for people suspected of having epilepsy from a societal perspective with a follow-up of 12 months. In addition, this study aims to differentiate between people diagnosed with epilepsy during the follow-up of the study and the people who are diagnosed as not having epilepsy or for whom diagnosis is still uncertain. METHODS A questionnaire regarding the use of healthcare resources was used accompanied by the EQ-5D-3 L. Multiple imputations by chained equations with predictive mean matching was used to account for missing data. To investigate the uncertainty of the results, non-parametric bootstrapped (1000 times) was used. RESULTS In total, 116 people were included in the study. Total average costs per patient made in the previous 3 months had decreased from €4594 before the optimized diagnostic trajectory to €2609 in the 12 months after the optimized diagnostic trajectory. Healthcare costs were the largest expense group (52-66%) and had decreased significantly from baseline measurement to 12 months after baseline (€2395 vs €1581). Productivity costs had decreased from €1367 to €442 per 3 months. Total annual costs were similar between people diagnosed with epilepsy during the follow-up of the study and the people who are diagnosed as not having epilepsy or for whom diagnosis is still uncertain. Quality of Life had significantly increased over the course of 12 months from 0.80 to 0.84 (Dutch tariff). DISCUSSION This study indicates that an optimized diagnostic trajectory has positively influenced the use of healthcare resources and the quality of life in people with epilepsy. As chronic care patients make diverse costs, future research should identify the long-term costs after an optimized diagnostic trajectory for patients with epilepsy, possibly identifying patients who are at high risk of becoming high-cost users in the future for early intervention.
Collapse
Affiliation(s)
- Ben F M Wijnen
- Trimbos Institute, Centre for Economic Evaluations, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands; Department of Health Services Research, Maastricht University, Maastricht, The Netherlands in collaboration with CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands; Department of Biomedical Engineering, Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands.
| | - Scarlett L Schat
- Department of Health Services Research, Maastricht University, Maastricht, The Netherlands in collaboration with CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands; Department of Biomedical Engineering, Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands.
| | - Reina J A de Kinderen
- Trimbos Institute, Centre for Economic Evaluations, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands; Department of Biomedical Engineering, Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands.
| | - Albert J Colon
- Department of Research & Development, Epilepsy Centre Kempenhaeghe, Heeze, The Netherlands; Department of Biomedical Engineering, Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands.
| | - Pauly P W Ossenblok
- Department of Clinical Neurophysiology, Academic Center for Epileptology Kempenhaeghe/MUMC, Heeze, The Netherlands; Department of Clinical Physics, Epilepsy center Kempenhaeghe, Heeze, The Netherlands; Department of Biomedical Engineering, Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands.
| | - Silvia M A A Evers
- Trimbos Institute, Centre for Economic Evaluations, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands; Department of Health Services Research, Maastricht University, Maastricht, The Netherlands in collaboration with CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands; Department of Biomedical Engineering, Eindhoven University of Technology, Den Dolech 2, 5612 AZ Eindhoven, The Netherlands.
| |
Collapse
|
14
|
Lagae L, Brambilla I, Mingorance A, Gibson E, Battersby A. Quality of life and comorbidities associated with Dravet syndrome severity: a multinational cohort survey. Dev Med Child Neurol 2018; 60:63-72. [PMID: 28984349 DOI: 10.1111/dmcn.13591] [Citation(s) in RCA: 112] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/06/2017] [Indexed: 11/26/2022]
Abstract
AIM To test the hypothesis that higher seizure burden in Dravet syndrome is associated with increased comorbidities and lower quality of life (QoL) in a large cohort of patients with Dravet syndrome and their caregivers in Europe. METHOD An extensive survey of caregivers of patients with Dravet syndrome on experiences of diagnosis, seizure burden, management, social and financial impact, and health services use was administered online in 10 languages. RESULTS The survey received 584 unique responses from caregivers of paediatric (83%) and adult (17%) patients with Dravet syndrome (aged <1-48y). Despite broadly following current treatment guidance, less than 10% of patients were seizure free in the previous 3 months. Nearly all (99.6%) patients aged 5 years or older experienced at least one or more motor, speech, learning, or behavioural impairment. High seizure frequency was related to more reports of emergency treatment, comorbidities, and a lower QoL (as measured by the standardized instrument EQ-5D-5L). If not diagnosed at the first instance, the majority (83%) of adults, but less than 20% of 6- to 11-year-olds were diagnosed after 4 or more years. INTERPRETATION Patients with Dravet syndrome with the highest current seizure frequency suffer from more comorbidities and have a lower QoL. Therefore, more effective antiepileptic treatments are needed. WHAT THIS PAPER ADDS The survey captured about 15% of all patients with Dravet syndrome in Europe. Less than 10% of patients had current seizure freedom. Patients with a high current seizure burden have more comorbidities and lower quality of life.
Collapse
Affiliation(s)
- Lieven Lagae
- Department of Development and Regeneration, University Hospitals KU Leuven, Leuven, Belgium
| | | | | | | | | |
Collapse
|
15
|
Lee SA, No SK, Park H, Kim OJ, Kwon JH, Ryu JY, Lee SM, Jo KD. Predictors of disclosure management behavior at the end of 1-year follow-up in Korean adults with newly diagnosed epilepsy. Epilepsy Behav 2017; 74:94-98. [PMID: 28732261 DOI: 10.1016/j.yebeh.2017.06.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 06/16/2017] [Accepted: 06/16/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE Epilepsy is a concealable stigmatizing condition. We investigated the factors predicting disclosure management behavior in Korean adults with newly diagnosed epilepsy. METHODS This longitudinal multicenter study included Korean adults with newly diagnosed epilepsy. Using statistical analyses, we determined at the end of a 1-year follow-up whether Disclosure Management Scale (DMS) scores were predicted by demographic, clinical, and psychosocial variables, including felt stigma, stress coping style, personality traits, social support, and experienced discrimination from society. RESULTS Of a total of 121 participants, 69% reported that they often or sometimes kept their diagnosis a secret from others and rarely or never talked to others about their epilepsy. The average DMS score was 5.8 (SD=2.9, range 0-11). In univariate analyses, DMS scores were significantly associated with an emotion-focused coping style (r=0.320, p<0.001), social support (r=-0.185, p<0.05), and experienced discrimination (p<0.05). Emotion-focused coping was the only independent predictor of a higher DMS score. Felt stigma, personality traits, and seizure freedom were not related to the DMS score. CONCLUSIONS Two-thirds of Korean adults with newly diagnosed epilepsy often or sometimes keep their epilepsy a secret. Emotion-focused coping is the most important predictor of concealment of epilepsy diagnosis at the end of a 1-year follow-up, although social support and episodes of experienced discrimination are also associated with disclosure management strategies.
Collapse
Affiliation(s)
- Sang-Ahm Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - Soon-Kee No
- Department of Neurology, Bong-Seng Memorial Hospital, Pusan, Republic of Korea
| | - Hyungkook Park
- Department of Neurology, SoonChunHyang University College of Medicine, Cheonan, Republic of Korea
| | - Ok-Joon Kim
- Department of Neurology, CHA University, Seongnam, Republic of Korea
| | - Jee-Hyun Kwon
- Department of Neurology, Ulsan College Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Ji-Yeon Ryu
- Department of Neurology, Kepco Medical Center, Seoul, Republic of Korea
| | - Sang-Moo Lee
- Department of Neurology, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Kwang-Deog Jo
- Department of Neurology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea
| |
Collapse
|
16
|
Kotwas I, McGonigal A, Bastien-Toniazzo M, Bartolomei F, Micoulaud-Franchi JA. Stress regulation in drug-resistant epilepsy. Epilepsy Behav 2017; 71:39-50. [PMID: 28494323 DOI: 10.1016/j.yebeh.2017.01.025] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 12/29/2016] [Accepted: 01/25/2017] [Indexed: 12/17/2022]
Abstract
The prevalence of psychological distress, especially depressive and anxiety disorders, is higher in epilepsy than in other chronic health conditions. These comorbid conditions contribute even more than epileptic seizures themselves to impaired quality of life in patients with epilepsy (PWE). The link between these comorbidities and epilepsy appears to have a neurobiological basis, which is at least partly mediated by stress through psychological and pathophysiological pathways. The impact of stress in PWE is also particularly important because it is the most frequently reported seizure trigger. It is therefore crucial for clinicians to take stress-related conditions and psychiatric comorbidities into account when managing PWE and to propose clinical support to enhance self-control of stress. Screening tools have been specially designed and validated in PWE for depressive disorders and anxiety disorders (e.g. NDDI-E, GAD-7). Other instruments are useful for measuring stress-related variables (e.g. SRRS, PSS, SCS, MHLCS, DSR-15, ERP-R, QOLIE-31) in order to help characterize the individual "stress profile" and thus orientate patients towards the most appropriate treatment. Management includes both pharmacological treatment and nonpharmacological methods for enhancing self-management of stress (e.g. mindfulness-based therapies, yoga, cognitive-behavioral therapies, biofeedback), which may not only protect against psychiatric comorbidities but also reduce seizure frequency.
Collapse
Affiliation(s)
- Iliana Kotwas
- Laboratoire Parole et Langage UMR 7309, Aix-Marseille Université, Marseille, France.
| | - Aileen McGonigal
- Service de Neurophysiologie Clinique, Centre Hospitalo Universitaire de la Timone, 264, rue Saint-Pierre, 13005 Marseille, France; Unité mixte INSERM Epilepsie et Cognition UMR 751, 27 Bd Jean Moulin, 13385 Marseille Cedex 05, France
| | | | - Fabrice Bartolomei
- Service de Neurophysiologie Clinique, Centre Hospitalo Universitaire de la Timone, 264, rue Saint-Pierre, 13005 Marseille, France; Unité mixte INSERM Epilepsie et Cognition UMR 751, 27 Bd Jean Moulin, 13385 Marseille Cedex 05, France
| | - Jean-Arthur Micoulaud-Franchi
- Service d'explorations fonctionnelles du système nerveux, Clinique du sommeil, CHU de, Bordeaux, Place Amélie Raba-Léon, 33076 Bordeaux, France; USR CNRS 3413 SANPSY, CHU Pellegrin, Université de Bordeaux, France
| |
Collapse
|
17
|
Carnevali L, Rivara S, Nalivaiko E, Thayer JF, Vacondio F, Mor M, Sgoifo A. Pharmacological inhibition of FAAH activity in rodents: A promising pharmacological approach for psychological—cardiac comorbidity? Neurosci Biobehav Rev 2017; 74:444-452. [DOI: 10.1016/j.neubiorev.2016.04.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 04/19/2016] [Accepted: 04/20/2016] [Indexed: 01/09/2023]
|
18
|
Central lobe epilepsy surgery - (functional) results and how to evaluate them. Epilepsy Res 2017; 130:37-46. [PMID: 28126646 DOI: 10.1016/j.eplepsyres.2017.01.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 12/22/2016] [Accepted: 01/14/2017] [Indexed: 11/22/2022]
Abstract
OBJECT To evaluate whether central lobe epilepsy (CLE) surgery in the pericentral area implies inevitable function loss and to determine how postsurgical functional outcomes are perceived by the patient. METHODS We included all 22 people with epilepsy (PWE) who received central lobe epilepsy (CLE) surgery in the pre- and postcentral gyri between 1995 and 2015 in the University Medical Center Utrecht. We determined function loss and followed-up on quality of life (AQoL-8D), mobility (Rivermead Mobility Index RMI) and self-evaluation of the surgery. To compare this with the literature, a systematic review was conducted, with specific regard for studies that included functional outcome. RESULTS Our own cohort showed newly developed functional loss in 54.4% postoperatively. Follow-up questionnaires were returned by 11/19 PWE (the other 3 could not be contacted). The mean AQoL-8d score was 0.74 (SD 0.16) and the mean RMI score was 13.7 (SD 3.0). This mean AQoL-8d was slightly lower than the Western mean population scores (0.86 and 0.87 respectively). RMI scores and postoperative functional deficits were both significantly related to how well PWE scored on the AQoL-8d. 72.7% of the PWE became seizure free after surgery (Engel class 1A). All PWE were happy with the CLE surgery and would recommend this type of surgery to other PWE. Becoming seizure-free, gaining better functioning and having more energy were reported as the most important reasons. The literature provided 475 unique papers, of which 25 were selected for critical appraisal. Six studies were of adequate quality and provided sufficient information to extract results. Prevalence of postoperative neurological deficit varied between 0 and 50%. No information is given on patient's perceptions. CONCLUSIONS About half of central lobe resections do not result in new neurological deficits. The patient's perspective is important in CLE surgery, but neglected in the literature. PWE may report being satisfied with the results of surgery despite new deficits and impact on quality of life. Counseling in CLE surgery should take these findings into account. Neurologists and neurosurgeons should not by default refrain from CLE surgery and think a PWE will not accept a deficit.
Collapse
|
19
|
Vorobyova OV, Stadniuk YI. An influence of interictal anxiety on coping and self-control strategies for epileptic seizures in patients with temporal lobe epilepsy. Zh Nevrol Psikhiatr Im S S Korsakova 2017; 117:44-49. [DOI: 10.17116/jnevro20171179244-49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
20
|
Ji H, Zhang L, Li L, Gong G, Cao Z, Zhang J, Zhou N, Wang Y, Tu H, Wang K. Illness perception in Chinese adults with epilepsy. Epilepsy Res 2016; 128:94-101. [DOI: 10.1016/j.eplepsyres.2016.10.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 10/10/2016] [Accepted: 10/25/2016] [Indexed: 01/08/2023]
|
21
|
Stadnyuk YI, Vorob'eva OV. [The strategies for psychological self-control of seizures in patients with focal epilepsy]. Zh Nevrol Psikhiatr Im S S Korsakova 2016; 116:12-16. [PMID: 27500870 DOI: 10.17116/jnevro20161167112-16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM To investigate self-control strategies for epileptic seizures and their relationship to the individual coping-style in patients with focal epilepsy. MATERIAL AND METHODS Twenty one adult patients with focal epilepsy were examined. Strategies for seizure control and coping-style were estimated with the CBES-SC and the Brief COPE scale, respectively. The control group consisted of 20 healthy individuals. RESULTS 86% of patients tried to control their seizures. Most of the patients (33%) preferred to use behavioral self-management strategies, which reduced the consequences of seizure. Patients with the high self-control activity more often had adaptive problem-focused coping-style in comparison to the patients with the low self-control (p<0.01). CONCLUSION The psychological coping-style modifying support can motivate patient to the wider use of strategies for seizure control and improve a psychosocial adjustment of the patient.
Collapse
Affiliation(s)
- Yu I Stadnyuk
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - O V Vorob'eva
- Sechenov First Moscow State Medical University, Moscow, Russia
| |
Collapse
|
22
|
Wassenaar M, Leijten FSS, Sander JW, Uijl SG, Egberts ACG. Anti-epileptic drug changes and quality of life in the community. Acta Neurol Scand 2016; 133:421-6. [PMID: 26370534 DOI: 10.1111/ane.12478] [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] [Accepted: 08/17/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Changes in anti-epileptic drug (AED) regimens may indicate unsatisfactory treatment results such as insufficient seizure control or adverse effects. This inference underlies epilepsy management and research, yet current studies often do not account for AED changes. We assessed AED change patterns and their association with quality of life (QoL), as main outcome measure, in a community-based setting. METHODS We assessed a cohort of 248 people with epilepsy identified from community pharmacy records from whom we retrieved AED dispensing history. We assessed all changes in AED use during the 2 years prior to the index date and current QoL using the validated Dutch QOLIE-31 questionnaire. RESULTS Thirty-one per cent had at least one AED change during the study period, either in drug type or dose. People who changed showed significantly lower QoL (QOLIE score 73 vs 79), especially those who intensified their treatment. Each additional change was associated with a further reduction of 4.9 points in QoL score. CONCLUSIONS AED changes are common practice, even in people with long-standing epilepsy. Frequent changes, as objective measure of epilepsy severity, are associated with a progressively lower QoL. Changes, even in dose, should be monitored in daily clinical practice and used as a red flag that may require adjustments in epilepsy management. This may include earlier referral to a specialized centre for a more thorough evaluation or counselling. AED changes can also be used as an outcome marker in epilepsy research as a proxy of QoL for better translation of drug-efficacy results to general practice.
Collapse
Affiliation(s)
- M. Wassenaar
- Stichting Epilepsie Instellingen Nederland (SEIN) Heemstede; Heemstede Netherlands
- Department of Neurology and Neurosurgery; Brain Center Rudolf Magnus; University Medical Center Utrecht; Utrecht Netherlands
| | - F. S. S. Leijten
- Department of Neurology and Neurosurgery; Brain Center Rudolf Magnus; University Medical Center Utrecht; Utrecht Netherlands
| | - J. W. Sander
- Stichting Epilepsie Instellingen Nederland (SEIN) Heemstede; Heemstede Netherlands
- Biomedical Research Centre; UCL Institute of Neurology; NIHR University College London Hospitals; London UK
- Epilepsy Society; Chalfont St Peter UK
| | - S. G. Uijl
- Julius Center for Health Sciences and Primary Care; University Medical Center Utrecht; Utrecht Netherlands
| | - A. C. G. Egberts
- Department of Pharmacoepidemiology and Clinical Pharmacology; Utrecht Institute for Pharmaceutical Sciences; Utrecht University; Utrecht Netherlands
- Department of Clinical Pharmacy; University Medical Center Utrecht; Utrecht Netherlands
| | | |
Collapse
|
23
|
Aliczki M, Barna I, Till I, Baranyi M, Sperlagh B, Goldberg SR, Haller J. The effects anandamide signaling in the prelimbic cortex and basolateral amygdala on coping with environmental stimuli in rats. Psychopharmacology (Berl) 2016; 233:1889-99. [PMID: 26809457 DOI: 10.1007/s00213-016-4219-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 01/18/2016] [Indexed: 01/25/2023]
Abstract
RATIONALE Several lines of recent evidence suggest that endocannabinoids affect behavior by influencing the general patterns of challenge responding. OBJECTIVES Here, we investigated the brain mechanisms underlying this phenomenon in rats. METHODS The anandamide hydrolysis inhibitor URB597 was condensed into the tip of stainless steel cannulae, which were chronically implanted slightly above the prelimbic cortex (PRL) or the basolateral amygdala (BLA), two important regions of coping and endocannabinoid action. Thereafter, we investigated behavioral responsiveness to ambient light level in the elevated plus-maze and conditioned fear tests. RESULTS URB597 concentration was ~30 μg/mg protein in target areas; local brain anandamide levels increased threefold, without significant changes in 2-arachidonoylglycerol. High levels of illumination halved the time spent by controls in the open arms of the plus-maze. No similar decrease was observed in rats with URB597 implants in the PRL. High light decreased conditioned fear by 30 % in controls, but not in rats with prelimbic URB597 implants. Unresponsiveness to environmental challenges was not attributable to the anxiolytic effects of anandamide enhancement, as implants induced paradoxical anxiogenic-like effects under low light, which could be explained by effects on stimulus responsiveness rather than by effects on anxiety. URB597 implants targeting the BLA did not affect stimulus responsiveness. CONCLUSIONS Our findings show that elevated prelimbic anandamide signaling leads to less environment-dependent (more autonomous) behavioral responses to challenges, which is an attribute of active coping styles. These findings are discussed in light of two emerging concepts of endocannabinoid roles, particularly "emotional homeostasis" and "active coping."
Collapse
Affiliation(s)
- Mano Aliczki
- Department of Behavioural Neurobiology, Institute of Experimental Medicine, Hungarian Academy of Sciences, 1450, Budapest, P.O. Box 67, Hungary
| | - Istvan Barna
- Department of Behavioural Neurobiology, Institute of Experimental Medicine, Hungarian Academy of Sciences, 1450, Budapest, P.O. Box 67, Hungary
| | - Ibolya Till
- Department of Behavioural Neurobiology, Institute of Experimental Medicine, Hungarian Academy of Sciences, 1450, Budapest, P.O. Box 67, Hungary
| | - Maria Baranyi
- Department of Pharmacology, Institute of Experimental Medicine, Hungarian Academy of Sciences, Budapest, Hungary
| | - Beata Sperlagh
- Department of Pharmacology, Institute of Experimental Medicine, Hungarian Academy of Sciences, Budapest, Hungary
| | - Steven R Goldberg
- Preclinical Pharmacology Section, Behavioral Neuroscience Research Branch, Intramural Research Program, Department of Health and Human Services, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA
| | - Jozsef Haller
- Department of Behavioural Neurobiology, Institute of Experimental Medicine, Hungarian Academy of Sciences, 1450, Budapest, P.O. Box 67, Hungary.
| |
Collapse
|
24
|
Ring A, Jacoby A, Baker GA, Marson A, Whitehead MM. Does the concept of resilience contribute to understanding good quality of life in the context of epilepsy? Epilepsy Behav 2016; 56:153-64. [PMID: 26895477 DOI: 10.1016/j.yebeh.2016.01.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 12/31/2015] [Accepted: 01/02/2016] [Indexed: 12/15/2022]
Abstract
A significant body of research highlights negative impacts of epilepsy for individual quality of life (QOL). Poor seizure control is frequently associated with reporting of poor QOL and good seizure control with good QOL; however, this is not a universal finding. Evidence suggests that some people enjoy good QOL despite ongoing seizures while others report poor QOL despite good seizure control. Understanding the factors that influence QOL for people with epilepsy and the processes via which such factors exert their influence is central to the development of interventions to support people with epilepsy to experience the best possible QOL. We present findings of a qualitative investigation exploring influences and processes on QOL for people with epilepsy. We describe the clinical, psychological, and social factors contributing to QOL. In particular, we focus on the value of the concept of resilience for understanding quality of life in epilepsy. Based on our analysis, we propose a model of resilience wherein four key component sets of factors interact to determine QOL. This model reflects the fluid nature of resilience that, we suggest, is subject to change based on shifts within the individual components and the interactions between them. The model offers a representation of the complex influences that act and interact to either mitigate or further compound the negative impacts of epilepsy on individual QOL.
Collapse
Affiliation(s)
- Adele Ring
- Department of Public Health & Policy, University of Liverpool, Liverpool, UK
| | - Ann Jacoby
- Department of Public Health & Policy, University of Liverpool, Liverpool, UK.
| | - Gus A Baker
- Department of Molecular & Clinical Pharmacology, University of Liverpool, UK
| | - Anthony Marson
- Department of Molecular & Clinical Pharmacology, University of Liverpool, UK
| | | |
Collapse
|
25
|
Facteurs d’insertion professionnelle des personnes souffrant d’épilepsie : revue de la littérature. ARCH MAL PROF ENVIRO 2016. [DOI: 10.1016/j.admp.2015.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
26
|
Aygören-Pürsün E, Bygum A, Beusterien K, Hautamaki E, Sisic Z, Boysen HB, Caballero T. Estimation of EuroQol 5-Dimensions health status utility values in hereditary angioedema. Patient Prefer Adherence 2016; 10:1699-707. [PMID: 27660419 PMCID: PMC5019462 DOI: 10.2147/ppa.s100383] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To estimate health status utility (preference) weights for hereditary angioedema (HAE) during an attack and between attacks using data from the Hereditary Angioedema Burden of Illness Study in Europe (HAE-BOIS-Europe) survey. Utility measures quantitatively describe the net impact of a condition on a patient's life; a score of 0.0 reflects death and 1.0 reflects full health. STUDY DESIGN AND METHODS The HAE-BOIS-Europe was a cross-sectional survey conducted in Spain, Germany, and Denmark to assess the real-world experience of HAE from the patient perspective. Survey items that overlapped conceptually with the EuroQol 5-Dimensions (EQ-5D) domains (pain/discomfort, mobility, self-care, usual activities, and anxiety/depression) were manually crosswalked to the corresponding UK population-based EQ-5D utility weights. EQ-5D utilities were computed for each respondent in the HAE-BOIS-Europe survey for acute attacks and between attacks. RESULTS Overall, a total of 111 HAE-BOIS-Europe participants completed all selected survey items and thus allowed for computation of EQ-5D-based utilities. The mean utilities for an HAE attack and between attacks were 0.44 and 0.72, respectively. Utilities for an acute attack were dependent on the severity of pain of the last attack (0.61 for no pain or mild pain, 0.47 for moderate pain, and 0.08 for severe pain). There were no significant differences across countries. Mean utilities derived from the study approach compare sensibly with other disease states for both acute attacks and between attacks. CONCLUSION The impacts of HAE translate into substantial health status disutilities associated with acute attacks as well as between attacks, documenting that the detrimental effects of HAE are meaningful from the patient perspective. Results were consistent across countries with regard to pain severity and in comparison to similar disease states. The results can be used to raise awareness of HAE as a serious disease with wide-ranging personal and social impacts.
Collapse
Affiliation(s)
- Emel Aygören-Pürsün
- Angioedema Centre, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
- Correspondence: Emel Aygören-Pürsün, Angioedema Centre, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Theodor-Stern-Kai 7, 60596 Frankfurt, Germany, Tel +49 69 63016312, Fax +49 69 63016491, Email
| | - Anette Bygum
- Hereditary Angioedema Centre Denmark, Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark
| | | | - Emily Hautamaki
- Patient Reported Outcomes, Oxford Outcomes Inc., an ICON plc company, Bethesda, MD, USA
| | - Zlatko Sisic
- ViroPharma Incorporated, Chatsworth House, Maidenhead, UK
| | - Henrik B Boysen
- HAEi – Hereditary Angioedema International Patient Organization for C1 Inhibitor Deficiencies, Skanderborg, Denmark
| | - Teresa Caballero
- Allergy Department, Hospital La Paz Institute for Health Research (IdiPaz), Biomedical Research Network on Rare Diseases U754 (CIBERER), University Hospital La Paz, Madrid, Spain
| |
Collapse
|
27
|
Elumelu TN, Asuzu CC, Akin-Odanye EO. Impact of active coping, religion and acceptance on quality of life of patients with breast cancer in the department of radiotherapy, UCH, Ibadan. BMJ Support Palliat Care 2014; 5:175-80. [DOI: 10.1136/bmjspcare-2012-000409] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 05/25/2014] [Indexed: 11/03/2022]
|
28
|
Choi H, Hamberger MJ, Munger Clary H, Loeb R, Onchiri FM, Baker G, Hauser WA, Wong JB. Seizure frequency and patient-centered outcome assessment in epilepsy. Epilepsia 2014; 55:1205-12. [DOI: 10.1111/epi.12672] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2014] [Indexed: 01/27/2023]
Affiliation(s)
- Hyunmi Choi
- Department of Neurology; Columbia University; New York New York U.S.A
| | | | - Heidi Munger Clary
- Department of Neurology; Wake Forest University School of Medicine; Winston-Salem North Carolina U.S.A
| | - Rebecca Loeb
- Department of Psychiatry and Behavioral Sciences; Memorial Sloan-Kettering Cancer Center; New York New York U.S.A
| | | | - Gus Baker
- Department of Neurosciences; University of Liverpool; Liverpool United Kingdom
| | - W. Allen Hauser
- Department of Neurology; Columbia University; New York New York U.S.A
| | - John B. Wong
- Department of Medicine; Division of Clinical Decision Making; Tufts University School of Medicine; Boston Massachusetts U.S.A
| |
Collapse
|
29
|
Haller J, Aliczki M, Pelczer KG, Spitzer K, Balogh Z, Kantor S. Effects of the fatty acid amide hydrolase inhibitor URB597 on coping behavior under challenging conditions in mice. Psychopharmacology (Berl) 2014; 231:593-601. [PMID: 24037493 DOI: 10.1007/s00213-013-3273-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Accepted: 08/27/2013] [Indexed: 12/15/2022]
Abstract
RATIONALE Recent evidence suggests that in addition to controlling emotional behavior in general, endocannabinoid signaling is engaged in shaping behavioral responses to challenges. This important function of endocannabinoids is still poorly understood. OBJECTIVES Here we investigated the impact of blockade of fatty acid amide hydrolase (FAAH), the degrading enzyme of anandamide on behavioral responses induced by challenges of different intensity. METHODS Mice treated with FAAH inhibitor URB597 were either manually restrained on their backs (back test) or received foot-shocks. RESULTS The behavior of mice showed bimodal distribution in the back test: they either predominantly showed escape attempts or equally distributed time between passivity and escape. URB597 increased escapes in animals with low escape scores. No effects were noticed in mice showing high escape scores, which is likely due to a ceiling effect. We hypothesized that stronger stressors would wash out individual differences in coping; therefore, we exposed mice to foot-shocks that decreased locomotion and increased freezing in all mice. URB597 ameliorated both responses. The re-exposure of mice to the shock cage 14 days later without delivering shocks or treatment was followed by reduced and fragmented sleep as shown by electrophysiological recordings. Surprisingly, sleep was more disturbed after the reminder than after shocks in rats receiving vehicle before foot-shocks. These reminder-induced disturbances were abolished by URB597 administered before shocks. CONCLUSIONS These findings suggest that FAAH blockade has an important role in the selection of behavioral responses under challenging conditions and-judging from its long-term effects-that it influences the cognitive appraisal of the challenge.
Collapse
Affiliation(s)
- Jozsef Haller
- Department of Behavioural Neurobiology, Institute of Experimental Medicine, Hungarian Academy of Sciences, P.O. Box 67, 1450, Budapest, Hungary,
| | | | | | | | | | | |
Collapse
|
30
|
The importance of the experiences of initial diagnosis and treatment failure when switching antiepileptic drugs. Epilepsy Behav 2013; 29:492-6. [PMID: 24094841 DOI: 10.1016/j.yebeh.2013.08.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Revised: 07/16/2013] [Accepted: 08/23/2013] [Indexed: 11/21/2022]
Abstract
We sought to understand the issues that lead from the need to change antiepileptic drugs (AEDs) and how this may influence someone's feelings regarding swapping to another drug. We conducted semistructured interviews with 14 people with epilepsy, four months after changing from AED monotherapy. Interviews were digitally recorded, transcripts were coded independently, and thematic analysis was undertaken through group work. There were seven major themes: failure, the reason behind the failure, and the experience itself; expectations; previous experience; personality and life events; side effects; impact of diagnosis; and outcome. Clinical outcome and patients' ideas of outcome were often discordant. Each drug change arises from a position of failure that elicits strong feelings of loss of control and vulnerability in participants. Recognizing the need for counseling of targeted individuals undergoing AED change is key. Unresolved emotional issues surrounding biographical disruption following diagnosis were potent modifiers of the change process.
Collapse
|
31
|
The coping styles and health-related quality of life of South African patients with psychogenic nonepileptic seizures. Epilepsy Behav 2013; 29:581-4. [PMID: 24169204 DOI: 10.1016/j.yebeh.2013.09.045] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Revised: 09/17/2013] [Accepted: 09/29/2013] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The primary aim of this study was to explore a possible association between the coping styles and the health-related quality of life (HRQOL) of patients with psychogenic nonepileptic seizures (PNES) in the South African context. METHODS Twenty-two patients with PNESs with confirmatory video-EEG were matched by age and gender with a healthy control group. Participants had to complete self-reported measures of HRQOL and coping strategies. Data analysis consisted of performing Pearson correlations, analysis of variances, and regression analysis. RESULTS The results indicated that the HRQOL scores of the group with PNESs were significantly lower than the HRQOL scores of the healthy control group. The participants with PNESs utilized significantly more escape-avoidance and distancing coping strategies in comparison to the healthy control group. The results also indicated that the avoidance coping strategies utilized by participants with PNESs had a significant negative effect on their HRQOL. CONCLUSIONS The findings of this study provided greater insight into the coping strategies utilized by participants with PNESs, which have been identified as risk factors in PNESs. This is the first study of this nature of people with PNESs in South Africa.
Collapse
|
32
|
Haller J, Goldberg SR, Pelczer KG, Aliczki M, Panlilio LV. The effects of anandamide signaling enhanced by the FAAH inhibitor URB597 on coping styles in rats. Psychopharmacology (Berl) 2013; 230:353-62. [PMID: 23743650 PMCID: PMC3830591 DOI: 10.1007/s00213-013-3161-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Accepted: 05/20/2013] [Indexed: 12/15/2022]
Abstract
RATIONALE Coping styles are fundamental characteristics of behavior that affect susceptibility to, and resilience during, mental and physical illness. Shifts from passive to active coping are considered therapeutic goals in many stress-related disorders, but the neural control of coping is poorly understood. Based on earlier findings, we hypothesized that coping styles are influenced by endocannabinoids. OBJECTIVES Here, we tested whether FAAH inhibition by URB597 affects behaviors aimed at controlling a critical situation and the degree to which environmental stimuli influence behavior i.e., we studied the impact of URB597 on the two main attributes of coping styles. METHODS Rats were tested in the tail-pinch test of coping and in the elevated plus-maze test that was performed under highly divergent conditions. RESULTS Under the effects of URB597, rats focused their behavior more on the discomfort-inducing clamp in the tail-pinch test, i.e., they coped with the challenge more actively. In the elevated plus-maze, URB597-treated rats demonstrated an autonomous behavioral control by reducing both "wariness" induced by aversive conditions and "carelessness" resulting from favorable conditions. CONCLUSIONS URB597 treatment-induced behavioral changes indicated a shift towards active coping with challenges. This behavioral change appears compatible with the previously suggested role of endocannabinoids in emotional homeostasis. Albeit further studies are required to characterize the role of endocannabinoids in coping, these findings suggest that the enhancement of endocannabinoid signaling may become a therapeutic option in emotional disorders characterized by passive coping (e.g., anxiety and depression) and in physical diseases where active coping is therapeutically desirable.
Collapse
Affiliation(s)
- Jozsef Haller
- Department of Behavioral Neurobiology, Institute of Experimental Medicine, Budapest, Hungary,
| | | | | | | | | |
Collapse
|
33
|
Wassenaar M, Heijl I, Leijten FSS, Linden P, Uijl SG, Egberts ACG, Carpay JA. Treatment of epilepsy in daily clinical practice: have outcomes improved over the past 10 years? J Neurol 2013; 260:2736-43. [DOI: 10.1007/s00415-013-7058-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Revised: 07/03/2013] [Accepted: 07/18/2013] [Indexed: 12/31/2022]
|
34
|
Mikula P, Nagyova I, Krokavcova M, Vitkova M, Rosenberger J, Szilasiova J, Gdovinova Z, Groothoff JW, van Dijk JP. Coping and its importance for quality of life in patients with multiple sclerosis. Disabil Rehabil 2013; 36:732-6. [DOI: 10.3109/09638288.2013.808274] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
35
|
Determining the coping strategies of individuals with epilepsy. Epilepsy Behav 2013; 27:286-91. [PMID: 23507304 DOI: 10.1016/j.yebeh.2013.01.029] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Revised: 01/11/2013] [Accepted: 01/31/2013] [Indexed: 11/23/2022]
Abstract
PURPOSE The purpose of the present study was to determine whether the coping styles of patients with epilepsy are associated with certain demographic, clinical, and psychosocial variables. METHODS A survey of 200 patients using several tests including the Brief-COPE was conducted. RESULTS Nine subscales of the Brief-COPE achieved acceptable internal consistency and were employed in study analysis. Using principal component analysis, six subscales correlated well with one another, representing engagement-type coping strategies. The other three also correlated well, representing disengagement-type strategies. As a group, our patients favored engagement-type strategies. On univariate analysis, increased age, being African-American, receiving disability benefits, and work status were associated with the use of engagement-type strategies, while on multiple linear regression, only age and race were independently associated. Low BMQ-S scores, low income level, and not driving were associated with the use of disengagement-type strategies both on univariate and multivariate analyses. CONCLUSION Among patients with epilepsy, certain demographic and psychosocial variables are associated with particular coping styles.
Collapse
|
36
|
Epilepsy surgery can help many more adult patients with intractable seizures. Epilepsy Res 2012; 101:210-6. [DOI: 10.1016/j.eplepsyres.2012.04.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2012] [Revised: 03/26/2012] [Accepted: 04/01/2012] [Indexed: 11/22/2022]
|
37
|
Winter Y, Epifanova-Bertschi N, Sankowski R, Zhukova TV, Oertel WH, Dodel R, Korchounov A. Health-related quality of life and its determinants in the urban Russian population with major depressive disorder: a cross-sectional study. Int J Psychiatry Med 2012; 43:35-49. [PMID: 22641929 DOI: 10.2190/pm.43.1.c] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Depressive disorders pose a major challenge to healthcare in the countries of the former Soviet Union. The objective of the current study was to evaluate health-related quality of life (HrQoL) and its determinants in outpatients with major depressive disorder in an urban Russian population. METHODS We consecutively recruited 100 urban Russian outpatients with major depression and 100 non-depressed controls who were matched for age and sex. The severity of their depression was assessed using the Hamilton Depression Rating Scale (HDRS). HrQoL was evaluated using the EuroQol (the EQ-5D and the visual analogue scale, EQ VAS). Independent determinants of HrQoL were identified using multiple regression analysis. RESULTS The mean EQ VAS score was 43.0 +/- 27.4 in patients with depression compared to 81.4 +/- 14.7 in the controls (p < 0.01). Out of the domains of the EQ-5D, "anxiety/depression," "usual activities," and "self-care" were the most impaired. Independent determinants of reduced HrQoL were: severity of depression according to the HDRS; violent suicide attempts; suicide attempts in the past; and drug addiction. CONCLUSIONS HrQoL is considerably reduced in Russians with major depression. The disease-specific patterns of HrQoL impairment and the independent determinants of HrQoL identified in our study could be addressed in focused healthcare programs and clinical trials. Comorbid drug addiction as a determinant of HrQoL should receive greater attention in the management of depressive disorders in urban Russian populations.
Collapse
|
38
|
Current world literature. Curr Opin Pediatr 2011; 23:700-7. [PMID: 22068136 DOI: 10.1097/mop.0b013e32834dda34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
39
|
van Andel J, Westerhuis W, Zijlmans M, Fischer K, Leijten FSS. Coping style and health-related quality of life in caregivers of epilepsy patients. J Neurol 2011; 258:1788-94. [PMID: 21445601 PMCID: PMC3184224 DOI: 10.1007/s00415-011-6013-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2010] [Revised: 03/11/2011] [Accepted: 03/14/2011] [Indexed: 12/03/2022]
Abstract
Epilepsy has a significant impact on health-related quality of life (HRQOL) of patients and personal coping style is an important determinant. Less is known about home caregivers. This study investigates HRQOL and coping style of both patients and caregivers and their interaction. Epilepsy patients attending the outpatient clinic of the University Medical Centre in Utrecht and their caregivers were sent EQ5D and RAND-36 questionnaires. The Utrecht Coping List was used to chart personal coping styles. HRQOL scores of patients and caregivers were compared to the general Dutch population. The association between patient and caregiver HRQOL scores was calculated. A stepwise backward multivariate linear regression analysis was used to explain variances in caregiver HRQOL. Eighty-six couples (49%) returned all questionnaires. Caregiver HRQOL scores were comparable to the general Dutch population (EQ5D: 0.88-0.88; p = 0.90, RAND-36 MCS: -2 points; p = 0.16), while patients HRQOL scores were lower (EQ5D: 0.79; p < 0.01, RAND-36 MCS -10 points; p < 0.01). However, on several specific domains, associations between patient and caregiver HRQOL scores within couples were found. Passive coping style explained 50% of variation in HRQOL scores of caregivers. As a group, caregivers of epilepsy patients have normal HRQOL, but there are significant associations between patient and caregiver HRQOL scores. Improving caregiver HRQOL through interventions on coping style might benefit patients as well. Recognizing personal coping styles of both patient and caregiver should be part of a patient-oriented approach in treatment.
Collapse
Affiliation(s)
- Judith van Andel
- Department of Neurology and Clinical Neurophysiology, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Willemien Westerhuis
- Department of Neurology and Clinical Neurophysiology, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Maeike Zijlmans
- Department of Neurology and Clinical Neurophysiology, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
- Department of Clinical Neurophysiology, F02.201, University Medical Centre Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands
| | - Kathelijn Fischer
- Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands
| | - Frans S. S. Leijten
- Department of Neurology and Clinical Neurophysiology, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| |
Collapse
|
40
|
Motamedi M, Sahraian MA, Moshirzadeh S. Perceived impact of epilepsy in teaching hospitals of Tehran University. IRANIAN JOURNAL OF NEUROLOGY 2011; 10:43-5. [PMID: 24250845 PMCID: PMC3829224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/23/2011] [Accepted: 05/18/2011] [Indexed: 11/13/2022]
Abstract
BACKGROUND Epileptic seizures would result in embarrassment in society and have some negative impact on the patients' social activities. The aim of this study was to show the perceived impact of epilepsy by patients on different aspect of their social activities including occupation, marriage and education. METHODS We studied 179 epileptic patients aged 16 years and over using face to face interview. Nine domains including relation to spouses, relation to family members, social life, general health, interpersonal communications and friendships, feelings about success, hope for future, ordinary life and cope with others were considered. RESULTS One hundred and seven men and 72 women were studied. Nearly 78% of the patients had generalized tonic-clonic seizures. More than half of the patients believed that epilepsy had affected their social life and activities. General health was negatively affected by this disease more than any other item. This may be due to uncontrolled attacks or taking medications. About 15.5% of married and 39% of the single patients considered epilepsy as an obstacle to marry with their ideal spouses and more than half of the employed persons considered epilepsy as an obstacle for their job promotions. CONCLUSION Epilepsy frequently impacts on several aspects of life. The disease negatively affects social life and activities, overall health, feelings about self, ability to work in paid employments, relationship with spouses, friends, and other family members, future plans, standards of living and ambitions of epileptic patients. Decreasing such impacts should be considered as an important part of treatment and proper management can certainly increase various aspects of life in these patients.
Collapse
Affiliation(s)
- Mahmoud Motamedi
- Department of Neurology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran,Iranian Center for Neurological Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Sahraian
- Department of Neurology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran,Iranian Center for Neurological Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Sasan Moshirzadeh
- Iranian Center for Neurological Research, Tehran University of Medical Sciences, Tehran, Iran,Department of Neurology, Loghman Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|