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Sariyildiz A, Coskun Benlidayi I, Olmez Engizek S, Deniz V. The relation of psychological status and type D personality with central sensitization in knee osteoarthritis: everything is in your mind! Rheumatol Int 2023; 43:2261-2269. [PMID: 37776500 DOI: 10.1007/s00296-023-05471-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 09/12/2023] [Indexed: 10/02/2023]
Abstract
To evaluate the relation of psychosocial parameters and type D personality with central sensitization in knee osteoarthritis (OA). The study included 126 patients with knee OA according to the American College of Rheumatology criteria. Sociodemographic variables (age, gender, education, marital status, annual income), alcohol consumption/smoking, body mass index, comorbidities, and duration of symptoms were noted. Radiographic evaluation was performed according to the Kellgren-Lawrence grading system. The Western Ontario and McMaster Universities Osteoarthritis Index was used for clinical evaluation. Type D personality, negative affectivity, and social inhibition were evaluated using the type D Scale-14 (DS14). Central sensitization was assessed by the central sensitization inventory (CSI), while psychological status, quality of life, and sleep were assessed by the Hospital Anxiety and Depression Scale (HADS), an abbreviated version of the World Health Organization Quality of Life Instrument (WHOQOL-BREF), and the Jenkins Sleep Evaluation Scale (JSS), respectively. The effect of type D personality on study parameters including central sensitization, as well as the risk factors for the development of central sensitization were assessed by regression analyses. Patients with type D personality had higher CSI, HADS scores and lower WHOQOL-BREF scores for psychological health, social relationship, environment and general quality of life. Linear regression analysis showed that the DS14 total score has a significant positive relation with CSI (β = 0.4, p < 0.05), HADS-depression (β = 0.4, p < 0.05), HADS-anxiety (β = 0.5, p < 0.05), and HADS-total scores (β = 0.5, p < 0.05). It also had a significant negative effect on all domains of WHOQOL-BREF (p < 0.05 for all). Logistic regression analysis revealed that JSS [Odds ratio (OR) 0.83, 95% CI 0.73-0.94; p = 0.003] and negative affectivity (OR 0.78, 95% CI 0.65-0.94; p = 0.008) were independent risk factors for the development of central sensitization in knee OA. Type D personality has an impact on quality of life, central sensitization, and psychological health, with negative affectivity and sleep impairment serving as independent risk factors for central sensitization. While managing patients with knee OA, these intimate relationships should be taken into consideration.
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Affiliation(s)
- Aylin Sariyildiz
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Ilke Coskun Benlidayi
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Cukurova University, Adana, Turkey.
| | - Sıla Olmez Engizek
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Volkan Deniz
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Tarsus University, Mersin, Turkey
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The Big Five personality traits and regularity of lifetime dental visit attendance: evidence of the Survey of Health, Ageing, and Retirement in Europe (SHARE). Aging Clin Exp Res 2022; 34:1439-1445. [PMID: 34964080 PMCID: PMC9151578 DOI: 10.1007/s40520-021-02051-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 12/07/2021] [Indexed: 01/22/2023]
Abstract
Background Regular dental visits are essential for the prevention, early detection and treatment of worldwide highly prevalent oral diseases. Personality traits were previously associated with treatment compliance, medication adherence and regular doctor visits, however, the link between personality traits and regular dental visit attendance remains largely unexplored. Thus, the objective of this study is to clarify this link. Methods Data (wave 7) of the Survey of Health, Ageing and Retirement in Europe (SHARE) were used, focusing on Germany (n = 2822). Personality was assessed using the 10-item Big Five Inventory (BFI-10). Regular dental visits were assessed. Multiple logistic regressions were used, adjusting for various covariates. Results Majority of the participants (84%) reported to attend regular dental visits during lifetime. Regularity of lifetime dental visit attendance was positively and significantly associated with increased extraversion [OR 1.13, 95% CI (1.01–1.26)], increased conscientiousness [OR 1.26, 95% CI (1.10–1.44)], and increased openness to experience [OR 1.12, 95% CI (1.01–1.26)]. However, there was a lack of association with agreeableness and neuroticism. Moreover, the outcome measure was positively associated with younger age, being female, born in Germany, being married, higher education, being retired (compared to being homemaker), whereas it was not associated with obesity or chronic diseases. Conclusions Identification of personality traits that are associated with regular dental visits can support prevention, screening and clinical management of oral diseases. Further research in this field may facilitate the development and increase the incorporation of individualized concepts to enhance patient compliance and attendance, and thus the provision of oral and dental care services. Supplementary Information The online version contains supplementary material available at 10.1007/s40520-021-02051-2.
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Mengelkoch S, Gassen J, Corrigan EK, Hill SE. Exploring the Links between Personality and Immune Function. PERSONALITY AND INDIVIDUAL DIFFERENCES 2022; 184:111179. [PMID: 34737485 PMCID: PMC8562652 DOI: 10.1016/j.paid.2021.111179] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Decades of research finds associations between personality traits and health. In recent years, it has become clear that the activities of the immune system play a key role in linking these variables. In the current work, we add to this research by exploring the relationship between Big Five personality traits and (Study 1) polymorphisms known to impact cytokine release and (Study 2) immunological parameters measured in vivo (differential white blood cell counts, plasma proinflammatory cytokine levels) and in vitro (proinflammatory cytokine release by peripheral blood mononuclear cells, Staphylococcus aureus growth in plasma). Results provide insights into potential mechanistic drivers of the link between personality and immune function and the possibility that, in some cases, relationships between personality and immune function may be sex differentiated.
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Affiliation(s)
- Summer Mengelkoch
- Department of Psychology, Texas Christian University, Fort Worth, TX, United States
| | - Jeff Gassen
- Department of Psychology, Texas Christian University, Fort Worth, TX, United States
| | - Emily K. Corrigan
- Department of Psychology, Texas Christian University, Fort Worth, TX, United States
| | - Sarah E. Hill
- Department of Psychology, Texas Christian University, Fort Worth, TX, United States
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Holzer KJ, Vaughn MG, Loux TM, Mancini MA, Fearn NE, Wallace CL. Prevalence and correlates of antisocial personality disorder in older adults. Aging Ment Health 2022; 26:169-178. [PMID: 33107330 DOI: 10.1080/13607863.2020.1839867] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES There is a paucity of research on antisocial personality disorder (ASPD) in the geriatric population and the majority of knowledge on the disorder is drawn from young adult samples. Researchers posit that the prevalence of ASPD as well as other personality disorders (PDs) is underestimated among older adults. Using a nationally representative sample, the present study examines the prevalence and correlates of ASPD in adults ages 50 and older. METHODS We analyzed data from the National Epidemiologic Survey on Alcohol and Related Conditions Waves I and III. Multivariate logistic regression analyses were employed to investigate associations between ASPD and sociodemographic characteristics. A series of logistic regression analyses were also conducted to study associations between ASPD and medical conditions (liver and cardiovascular disease, arthritis, and stomach ulcer), major psychiatric disorders (lifetime major depressive disorder, mania, and generalized anxiety disorder), and substance use disorders (lifetime alcohol, marijuana, cocaine, heroin, and nicotine use disorders). RESULTS Findings indicated that the prevalence of ASPD increases through early adulthood, with a peak at 3.91% in younger adults and decline to 0.78% in adults ages ≥65. Older adults with ASPD are more likely to be diagnosed with a substance use disorder, major depression, mania, and generalized anxiety disorder as well as each medical condition. CONCLUSION Older adults with ASPD experience increased rates of medical and psychiatric comorbidities. These conditions exacerbate the existing challenges associated with diagnosing and treating this population and may have serious consequences for the patient, their caregivers and society.
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Affiliation(s)
- Katherine J Holzer
- Division of Clinical and Translational Research, Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA.,School of Social Work, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, USA
| | - Michael G Vaughn
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, USA.,Graduate School of Social Welfare, Yonsei University, Seoul, Republic of Korea
| | - Travis M Loux
- Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, USA
| | - Michael A Mancini
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, USA
| | - Noelle E Fearn
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, USA
| | - Cara L Wallace
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, USA
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Mucke J, Brinks R, Dimitriou A, Richter JG, Schneider M. Treatment expectations as a possible prognostic factor for DMARD response in rheumatoid arthritis: a prospective cohort study. Ther Adv Musculoskelet Dis 2021; 13:1759720X211015829. [PMID: 34093746 PMCID: PMC8142018 DOI: 10.1177/1759720x211015829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 04/19/2021] [Indexed: 12/24/2022] Open
Abstract
Background: The prediction of the individual’s response to disease modifying antirheumatic drugs (DMARDs) in rheumatoid arthritis (RA) is challenging and often limited. Here we evaluated the influence of patients’ expectations towards a change in treatment with DMARD on clinical outcome in RA. Methods: One hundred patients (74 female) with RA (2010 ACR/EULAR classification criteria) and an upcoming change in DMARD treatment due to non-response or adverse effects were included. Patients’ treatment beliefs, health-related quality of life and treatment expectations were measured using the Beliefs about Medicines Questionnaire (BMQ), the Short Form 36, and self-designed questions about expectations before treatment initiation (T0), and DAS28-CRP was calculated at T0 and after 4 months (T4). Associations between patients’ beliefs and expectations and changes in DAS28-CRP (T0 to T4, ΔDAS28-CRP) were explored by regression analyses after multiple imputation. Results: A total of 99 patients were included, of whom 84 completed all questionnaires. Thirty-six percent of all variability in treatment response (ΔDAS28-CRP) was explained by expectations assessed with the questionnaires and the C-reactive protein (CRP)-value at T0. Among these, the expected improvement rate, with 10.5%, as well as the CRP-value at T0, with 10.6%, had the greatest positive effect whereas the fear of adverse effects, with 11.4%, and the BMQ.concern scale, with 9.0%, had the greatest negative impact on ΔDAS28. Conclusion: Patients’ expectations towards newly induced DMARD therapies influence clinical response and may serve as possible explanatory factors for treatment response affecting subjective and objective outcome parameters. Clinical trial registration number: DRKS00017005
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Affiliation(s)
- Johanna Mucke
- Policlinic and Hiller Research Unit for Rheumatology, Heinrich-Heine-University, Moorenstrasse 5, Duesseldorf, 40225, Germany
| | - Ralph Brinks
- Policlinic and Hiller Research Unit for Rheumatology, Heinrich-Heine-University Duesseldorf, Germany
| | - Argyri Dimitriou
- Policlinic and Hiller Research Unit for Rheumatology, Heinrich-Heine-University Duesseldorf, Germany
| | - Jutta G Richter
- Policlinic and Hiller Research Unit for Rheumatology, Heinrich-Heine-University Duesseldorf, Germany
| | - Matthias Schneider
- Policlinic and Hiller Research Unit for Rheumatology, Heinrich-Heine-University Duesseldorf, Germany
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Zaharia OP, Pesta DH, Bobrov P, Kupriyanova Y, Herder C, Karusheva Y, Bódis K, Bönhof GJ, Knitza J, Simon D, Kleyer A, Hwang JH, Müssig K, Ziegler D, Burkart V, Schett G, Roden M, Szendroedi J. Reduced Muscle Strength Is Associated With Insulin Resistance in Type 2 Diabetes Patients With Osteoarthritis. J Clin Endocrinol Metab 2021; 106:1062-1073. [PMID: 33382877 PMCID: PMC7993587 DOI: 10.1210/clinem/dgaa912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Indexed: 12/19/2022]
Abstract
CONTEXT Type 2 diabetes is associated with a greater risk for musculoskeletal disorders, yet its impact on joint function remains unclear. OBJECTIVE We hypothesized that patients with type 2 diabetes and osteoarthritis would exhibit musculoskeletal impairment, which would associate with insulin resistance and distinct microRNA profiles. METHODS Participants of the German Diabetes Study with type 2 diabetes (T2D, n = 39) or normal glucose tolerance (CON, n = 27), both with (+OA) or without osteoarthritis (-OA) underwent intravenous glucose tolerance and hyperinsulinemic-euglycemic clamp tests. Musculoskeletal function was assessed by isometric knee extension strength (KES), grip strength, range of motion (ROM), and balance skills, while neural function was measured by nerve conductance velocity (NCV). Arthritis-related symptoms were quantified using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire, serum arthritis-related microRNA using quantitative polymerase chain reaction. RESULTS Insulin sensitivity was lower in T2D+OA vs T2D-OA (4.4 ± 2.0 vs 5.7 ± 3.0 mg* kg-1*min-1) and in CON+OA vs CON-OA (8.1 ± 2.0 vs 12.0 ± 2.6 mg*kg-1,*min-1, both P < .05). In T2D+OA, KES and ROM were 60% and 22% lower than in CON+OA, respectively (both P < .05). Insulin sensitivity correlated positively with KES (r = 0.41, P < .05) among T2D, and negatively with symptom severity in CON and T2D (r = -0.60 and r = -0.46, respectively, P < .05). CON+OA and T2D+OA had inferior balance skills than CON-OA, whereas NCV was comparable in T2D+OA and T2D-OA. Expression of arthritis-related microRNAs was upregulated in T2D compared to CON, but downregulated in CON+OA compared to CON-OA (P < .05), and did not differ between T2D+OA and T2D-OA. CONCLUSION Musculoskeletal impairment and osteoarthritis-related symptoms are associated with insulin resistance. Type 2 diabetes can mask changes in arthritis-related microRNA profiles.
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Affiliation(s)
- Oana Patricia Zaharia
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Division of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Dominik Hans Pesta
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Pavel Bobrov
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany
| | - Yuliya Kupriyanova
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Christian Herder
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Division of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Yanislava Karusheva
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Kálmán Bódis
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Division of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Gidon Josia Bönhof
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Division of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Johannes Knitza
- Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany; Universitätsklinikum Erlangen, Erlangen, Germany
| | - David Simon
- Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany; Universitätsklinikum Erlangen, Erlangen, Germany
| | - Arnd Kleyer
- Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany; Universitätsklinikum Erlangen, Erlangen, Germany
| | - Jong-Hee Hwang
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Karsten Müssig
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany
| | - Dan Ziegler
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Division of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Volker Burkart
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Georg Schett
- Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany; Universitätsklinikum Erlangen, Erlangen, Germany
| | - Michael Roden
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Division of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Julia Szendroedi
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Division of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
- Correspondence: Julia Szendroedi, MD, PhD, German Diabetes Center, Clinical Research Center, c/o Auf`m Hennekamp 65, D-40225 Düsseldorf, Germany.
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des Bordes JKA, Foreman J, Westrich-Robertson T, Lopez-Olivo MA, Peterson SK, Hofstetter C, Lyddiatt A, Willcockson I, Leong A, Suarez-Almazor ME. Interactions and perceptions of patients with rheumatoid arthritis participating in an online support group. Clin Rheumatol 2020; 39:1775-1782. [PMID: 32006180 DOI: 10.1007/s10067-020-04967-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 01/17/2020] [Accepted: 01/27/2020] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Peer support is important for psychosocial well-being in patients with rheumatoid arthritis (RA). Our objective was to assess the interactions, engagement, and perceptions of participants in an online support group for patients with RA. METHODS Participants were 18 years or older, diagnosed with RA within 10 years, and residing in the USA or Canada. All participated in a closed Facebook online support group. Membership was by invitation only, and discussions were visible only to members, moderators, and two research staff. Each week, participants discussed a topic posted by a moderator. They also shared other disease-relevant information beside the topics posted. We assessed participants' engagement and qualitatively analyzed the content of their postings in the first 5 weeks of participation. RESULTS The group had 90 participants: 94% were female and 83% white. Median age was 54 (24-84) years. Mean number of contributors per week was 50 (range, 42-62); 10% of participants never contributed to the discussions. Participation in discussions declined over time. Over three-quarters of participant posting were about information sharing. Participants shared information on disease experiences, medications, social lives (including pictures of themselves, families, and pets), online resources on RA, frustrations, messages of encouragement, and satirical depictions of their disease experience. Many expressed gratitude for the social support provided. CONCLUSION Participants were generally enthusiastic and shared disease-related information and personal experiences. Social media groups may provide alternative means of providing education and peer support often lacking in traditional models of care.Key Points• The study examines how patients with rheumatoid arthritis engage in an online support group and the nature of their interactions.• This study reveals that social media platforms could provide viable options or complements to the traditional face-to-face small group patient support system.• It may be necessary to pay special attention to how to ensure a sustained participant interest in online social support group among patients with rheumatoid arthritis.
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Affiliation(s)
- Jude K A des Bordes
- Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 437, Houston, TX, 77030, USA
| | - Jessica Foreman
- Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 437, Houston, TX, 77030, USA
| | | | - Maria A Lopez-Olivo
- Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 437, Houston, TX, 77030, USA
| | - Susan K Peterson
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Anne Lyddiatt
- Patient Partners in Arthritis, Toronto, Ontario, Canada
| | - Irmgard Willcockson
- School of Biomedical Informatics, University of Texas Health Science Center, Houston, TX, USA
| | - Amye Leong
- Healthy Motivation and the Global Alliance for Musculoskeletal Health of the Bone and Joint Decade, Santa Barbara, CA, USA
| | - Maria E Suarez-Almazor
- Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 437, Houston, TX, 77030, USA.
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Larice S, Ghiggia A, Di Tella M, Romeo A, Gasparetto E, Fusaro E, Castelli L, Tesio V. Pain appraisal and quality of life in 108 outpatients with rheumatoid arthritis. Scand J Psychol 2019; 61:271-280. [PMID: 31674683 DOI: 10.1111/sjop.12592] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 09/16/2019] [Indexed: 12/22/2022]
Abstract
Individual differences in emotional functioning, pain appraisal processing, and perceived social support may play a relevant role in the subjective experience of pain. Due to the paucity of data regarding individuals with Rheumatoid Arthritis (RA), the present study aimed to examine pain intensity, emotional functioning (psychological distress and alexithymia), pain appraisal (pain beliefs, pain catastrophizing, and pain-related coping strategies) and social support, and their relationships with the health-related quality of life (HRQoL) in patients with RA. Data were collected from 108 female patients diagnosed with RA. Clinically relevant levels of depressive and anxiety symptoms assessed by the HADS subscales were present in 34% and 41% of the patients, respectively, and about 24% of them exhibited the presence of alexithymia. The results of hierarchical multiple regression analyses showed that pain intensity, alexithymia, the maladaptive beliefs regarding the stability of pain and the coping strategy of guarding explained 54% of the variance in the physical component of HRQoL (p < 0.001). Depression subscale of the HADS, alexithymia, the coping strategy of resting, and the rumination factor of pain catastrophizing significantly explained 40% of the variance in the mental component of HRQoL (p < 0.001). The present findings provide evidence regarding the importance of emotional functioning and pain appraisal in the negative impact of RA on patients' quality of life. These findings provide additional evidence for the biopsychosocial model of chronic pain, further supporting the complex interaction between emotional, cognitive, and behavioral processes in patients with chronic pain.
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Affiliation(s)
- Sara Larice
- Department of Psychology, University of Turin, Turin, Italy
| | - Ada Ghiggia
- Clinical Psychology Unit, A.O.U. Città della Salute e della Scienza, Turin, Italy
| | | | - Annunziata Romeo
- Clinical Psychology Unit, A.O.U. Città della Salute e della Scienza, Turin, Italy
| | - Eleonora Gasparetto
- Clinical Psychology Unit, A.O.U. Città della Salute e della Scienza, Turin, Italy
| | - Enrico Fusaro
- Rheumatology Unit, A.O.U. Città della Salute e della Scienza, Turin, Italy
| | - Lorys Castelli
- Department of Psychology, University of Turin, Turin, Italy
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Nossent JC, Sagen-Johnsen S, Bakland G. Disease Activity and Patient-Reported Health Measures in Relation to Cytokine Levels in Ankylosing Spondylitis. Rheumatol Ther 2019; 6:369-378. [PMID: 31147969 PMCID: PMC6702619 DOI: 10.1007/s40744-019-0161-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Indexed: 01/20/2023] Open
Abstract
INTRODUCTION Ankylosing spondylitis (AS) is a lifelong condition where spinal inflammation causes chronic back pain and restriction of spinal function. While proinflammatory cytokines participate in the disease process, their relation with disease activity, spinal function, and quality of life is less well understood. METHODS Cross-sectional study of serum levels of four inflammatory cytokines (IL-6, TNF, IL-23, and IL-17A) in AS patients not on biologics. Disease characteristics and simultaneous spinal function tests and patient-reported health measures (Bath Functional Index (BASFI), Dougados Functional Index (DFI), Modified Health Assessment Questionnaire (MHAQ), and routine laboratory parameters were recorded. The composite ASDAS-CRP score was used to classify disease activity as absent, low, or high. RESULTS In 164 AS patients (age 46 years, 70.1% males, 90.9% HLAB27 positive, ASDAS-CRP 1.8), disease activity was classified as inactive in 14%, low in 54%, and high in 31%. ASDAS-CRP correlated well with MHAQ, DFI, BASFI, and spinal mobility across patients with low and high disease activity (all p < 0.05). Cytokine levels did not correlate with ASDAS-CRP, ESR, BASFI, or spinal mobility scores and were comparable between patients with no, low, or high disease activity regardless of gender or disease duration (all p > 0.2). CONCLUSIONS A large proportion of AS not on biologics have active disease far into the disease course. This impacts negatively on quality of life, work ability, and spinal mobility. Serum cytokine levels are poor markers for these central disease features in AS management. FUNDING Abbott Norway AS and Arthritis Foundation of Western Australia.
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Affiliation(s)
- Johannes C Nossent
- University of Western Australia, Perth, Australia.
- Sir Charles Gairdner Hospital, Perth, Australia.
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Haalen FM, Dijk EH, Andela CD, Dijkman G, Biermasz NR, Pereira AM, Boon CJ. Maladaptive personality traits, psychological morbidity and coping strategies in chronic central serous chorioretinopathy. Acta Ophthalmol 2019; 97:e572-e579. [PMID: 30378259 DOI: 10.1111/aos.13952] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 09/26/2018] [Indexed: 11/26/2022]
Abstract
PURPOSE 'Type A' behavioural characteristics and psychosocial stress have traditionally been associated with chronic central serous chorioretinopathy (cCSC). However, a characteristical personality profile could not be identified in these patients and the presumed association with stress is subject to controversy, due to a lack of convincing studies using validated measuring instruments. In this study, we aimed to assess maladaptive personality traits, psychological morbidity and coping strategies in patients with cCSC, in order to identify potentially modifiable psychosocial aspects which could be used in support to current standard treatment. METHODS A cross-sectional study in a cohort of 86 patients with cCSC using validated questionnaires. Findings were compared to both Dutch population reference data and reference data from patients treated for Cushing's disease. RESULTS Maladaptive personality traits were not more prevalent in patients with cCSC than in the general population, and psychological morbidity was not increased. Patients with cCSC were shown to make more use of passive coping, active coping and seeking social support. Interestingly, personality, psychological morbidity and coping characteristics of patients with cCSC were more comparable to features of patients treated for Cushing's disease than to population-based data. CONCLUSION Maladaptive personality traits such as type A behavioural characteristics are not more prevalent in patients with cCSC. Patients with cCSC make more use of certain coping strategies, which could be addressed by psychosocial care to improve self-management. Further research is needed establish whether the course of disease can be improved by altering coping and reducing 'stress'.
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Affiliation(s)
- Femke M. Haalen
- Department of Medicine Division of Endocrinology and Center for Endocrine Tumors Leiden University Medical Center Leiden the Netherlands
| | - Elon H.C. Dijk
- Department of Ophthalmology Leiden University Medical Center Leiden the Netherlands
| | - Cornelie D. Andela
- Department of Medicine Division of Endocrinology and Center for Endocrine Tumors Leiden University Medical Center Leiden the Netherlands
| | - Greet Dijkman
- Department of Ophthalmology Leiden University Medical Center Leiden the Netherlands
| | - Nienke R. Biermasz
- Department of Medicine Division of Endocrinology and Center for Endocrine Tumors Leiden University Medical Center Leiden the Netherlands
| | - Alberto M. Pereira
- Department of Medicine Division of Endocrinology and Center for Endocrine Tumors Leiden University Medical Center Leiden the Netherlands
| | - Camiel J.F. Boon
- Department of Ophthalmology Leiden University Medical Center Leiden the Netherlands
- Department of Ophthalmology Amsterdam University Medical Center University of Amsterdam Amsterdam the Netherlands
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Negative Affect, Type D Personality, Quality of Life, and Dysfunctional Outcomes of Total Knee Arthroplasty. Pain Res Manag 2019; 2019:6393101. [PMID: 30719200 PMCID: PMC6335857 DOI: 10.1155/2019/6393101] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 12/12/2018] [Indexed: 11/17/2022]
Abstract
Background Type D personality (TDP) is a sign of tapered stress and compromises treatment outcomes including those of hip arthroplasty. The common dissatisfaction with total knee arthroplasty (TKA) is predicted by fear avoidance, pain catastrophizing and emotional lability, with poor quality of life (QoL) reflecting these strains. This study is the first to investigate the influence of TDP on TKA assuming (1) negative affect (NA) to be linked to fear avoidance and to increased dissatisfaction with TKA and (2) the expression of NA and social inhibition (SI) to not be stable over time. Method We studied 79 participants using the brief symptom inventory-18, the pain-catastrophizing scale, the Tampa scale of kinesiophobia, the SF-36, and the WOMAC preoperatively and 12 months postoperatively. T-test and regression were used to compare the variables of interest between groups built based upon outcome severity. Result NA at follow-up predicted knee pain (p=0.02) and knee function (p < 0.01) at follow-up. Contrarily, increased expressions of NA/SI at follow-up were predicted by NA (p=0.04) and rumination (p=0.05) at the baseline. Conclusion The present results suggest the postoperative increase of NA to be linked to dysfunctional outcomes of TKA due to an interaction with pain catastrophizing. Baseline self-rated physical health did not connect to the dissatisfaction with TKA 1-year postoperatively.
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Kadłubowska M, Bąk E, Marcisz C, Kózka M, Michalik A, Kolonko J, Krawczyk B, Dobrzyń-Matusiak D, Kapusta-Nowak Z. Perception vs pain and beliefs about pain control and Type A behavior pattern in patients with chronic ischemia of lower extremities or with rheumatoid arthritis. J Pain Res 2018; 11:3051-3059. [PMID: 30568486 PMCID: PMC6276602 DOI: 10.2147/jpr.s182703] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Objective The study aimed at determining the experience of pain taking into consideration beliefs about pain control, Type A behavior pattern and sociodemographic factors in patients with chronic ischemia of the lower extremities or with rheumatoid arthritis (RA). Methods The study enrolled 100 patients with peripheral arterial disease (PAD) and 100 patients with RA. The subjective sensation of pain was assessed using the Visual Analog Scale (VAS); beliefs about pain control were analyzed using the Beliefs about Pain Control Questionnaire (BPCQ), taking into consideration internal factors, the influence of physicians and accidental events (chance); and Type A behavior features (haste and competition) were analyzed using the Framingham Type A Scale. The multiple regression model was used to assess associations between the experienced pain and the BPCQ value, the Framingham Type A Scale and sociodemographic factors. Results The pain intensity degree was found to be comparable in patients with PAD and with RA. The median determined using the VAS was 5.75 in both of the studied groups. In patients with PAD, lower VAS values were associated with the BPCQ – internal factors (P<0.05) whereas a higher VAS value was related to the BPCQ – physicians’ influence (P<0.001). In patients with RA, a higher VAS value was associated with BPCQ – physicians’ influence (P<0.05), disease duration (P<0.05) and smoking cigarettes (P<0.05). Conclusion Experiencing pain by patients with chronic ischemia of the lower extremities occurs at a moderate level and is beneficially connected with the internal factors and adversely connected with the external factors of beliefs about pain control. Patients with RA reported pain ailments of a moderate level in connection with the adverse influence of the external factors of beliefs about pain control, the duration of the disease and smoking cigarettes. Experiencing pain by patients with chronic ischemia of the lower extremities and RA does not seem to be related to Type A behavior.
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Affiliation(s)
- Monika Kadłubowska
- University of Bielsko-Biała, Department of Nursing, Faculty of Health Sciences, Bielsko-Biała, Poland,
| | - Ewelina Bąk
- University of Bielsko-Biała, Department of Nursing, Faculty of Health Sciences, Bielsko-Biała, Poland,
| | - Czesław Marcisz
- Medical University of Silesia, Department of Gerontology and Geriatric Nursing, School of Health Sciences, Katowice, Poland
| | - Maria Kózka
- Jagiellonian University Medical College, Department of Clinical Nursing, Institute of Nursing and Midwifery, Faculty of Health Sciences, Cracow, Poland
| | - Anna Michalik
- University of Bielsko-Biała, Department of Nursing, Faculty of Health Sciences, Bielsko-Biała, Poland,
| | - Jolanta Kolonko
- University of Bielsko-Biała, Department of Nursing, Faculty of Health Sciences, Bielsko-Biała, Poland,
| | - Bożena Krawczyk
- University of Bielsko-Biała, Department of Nursing, Faculty of Health Sciences, Bielsko-Biała, Poland,
| | - Dorota Dobrzyń-Matusiak
- Medical University of Silesia, Department of Nursing Propaedeutics, School of Health Sciences, Katowice, Poland
| | - Zofia Kapusta-Nowak
- Medical University of Silesia, Department of Health Promotion and Community Nursing, School of Health Sciences, Katowice, Poland
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