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Solá VP, Montes JM, Calvo ET, Gasull V, Campayo JG, Diez JMO, Berrocoso E, Mico JA, Agüera L. Consensus on the detection and management of patients with depression and pain as an associated somatic symptom. SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH 2023:S2950-2853(23)00055-8. [PMID: 37952640 DOI: 10.1016/j.sjpmh.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 09/13/2023] [Accepted: 10/16/2023] [Indexed: 11/14/2023]
Abstract
INTRODUCTION Globally, depression is the most common psychiatric disorder and is frequently associated with somatic symptom disorders, including pain as a physical symptom. There is a current need to improve the detection and management of the individuals in which depression and pain coexist. Hence, the aim of this document is to provide recommendations in the diagnosis and management of patients with major depressive disorder (MDD) who have pain as a physical symptom (PPS), in order to reduce the variability of clinical practice. MATERIAL AND METHODS The methodology used is based on the internationally recognized RAND/UCLA consensus method. The scientific committee, consisted of a group of eight multidisciplinary experts, defined 12 clinically relevant questions. After the systematic review of the literature, the scientific committee assessed the evidence and developed recommendations. The panel group with 15 participants validated these recommendations using a single Delphi round. To conclude, there was a final consensus meeting held to redefine with minor modifications the final recommendations. RESULTS The scientific committee developed a total of 19 recommendations on the diagnosis and detection, impact of PPS in MDD, treatment of MDD with associated PPS, use of healthcare resources, additional recommendations, and care coordination of these patients. Globally, a substantial level of agreement (≥80%) was reached on all items during the Delphi round. All the 19 achieved consensus, seven of them (37%) were agreed with unanimity during the Delphi round. The recommendations with higher consensus were in relation to diagnosis, impact of PPS in MDD, treatment and use of healthcare resources. CONCLUSIONS Currently, the evidence base for patients with MDD and PPS is still being developed and this consensus statement aims to bridge that gap by providing practical recommendations.
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Affiliation(s)
- Víctor Pérez Solá
- Institut de Neuropsiquiatria i Addiccions, Parc de salut mar, Barcelona, Spain; CIBERSAM, Madrid, Spain; Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; Department of Medicine and Life Sciences (MELIS), Universitat Pompeu Fabra, Barcelona, Spain.
| | - José Manuel Montes
- Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain; Universidad de Alcalá, Alcala de Henares, CIBERSAM, Spain
| | - Eva Trillo Calvo
- Medicina de Familia, Centro de Salud Campo de Belchite, Belchite, Zaragoza, Spain
| | - Vicente Gasull
- Medicina de Familia, Centro de Salud Torrent II, Valencia, Spain
| | | | - Jose Manuel Olivares Diez
- Servicio de Psiquiatría del Area Sanitaria de Vigo, Director del Area de Neurociencias, Instituto de Investigación Sanitaria Galicia Sur (IISGS, Cibersam), Spain
| | - Esther Berrocoso
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Psychology, University of Cadiz, Spain; Biomedical Research and Innovation Institute of Cádiz (INiBICA), Spain
| | - Juan Antonio Mico
- Departamento de Neurociencias, Farmacología y Psiquiatría, Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III (CIBERSAM), Universidad de Cádiz, Cádiz, Spain
| | - Luis Agüera
- Servicio de Psiquiatría del Hospital Universitario 12 de Octubre, Madrid, Spain; Associate Professor of the Faculty of Medicine, Universidad Complutense, Madrid, Spain
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Ogliari G, Ryg J, Andersen-Ranberg K, Scheel-Hincke LL, Collins JT, Cowley A, Di Lorito C, Booth V, Smit RAJ, Akyea RK, Qureshi N, Walsh DA, Harwood RH, Masud T. Association between pain intensity and depressive symptoms in community-dwelling adults: longitudinal findings from the Survey of Health, Ageing and Retirement in Europe (SHARE). Eur Geriatr Med 2023; 14:1111-1124. [PMID: 37450107 PMCID: PMC10587243 DOI: 10.1007/s41999-023-00835-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 07/04/2023] [Indexed: 07/18/2023]
Abstract
PURPOSE To investigate the longitudinal associations between pain and depressive symptoms in adults. METHODS Prospective cohort study on data from 28,515 community-dwelling adults ≥ 50 years, free from depression at baseline (Wave 5), with follow-up in Wave 6 of the Survey of Health, Ageing and Retirement in Europe (SHARE). Significant depressive symptoms were defined by a EURO-D score ≥ 4. The longitudinal association between baseline pain intensity and significant depressive symptoms at follow-up was analysed using logistic regression models; odds ratios (ORs) and confidence intervals (CI) were calculated, adjusting for socio-demographic and clinical factors, physical inactivity, loneliness, mobility and functional impairments. RESULTS Mean age was 65.4 years (standard deviation 9.0, range 50-99); 14,360 (50.4%) participants were women. Mean follow-up was 23.4 (standard deviation 3.4) months. At baseline, 2803 (9.8%) participants reported mild pain, 5253 (18.4%) moderate pain and 1431 (5.0%) severe pain. At follow-up, 3868 (13.6%) participants-1451 (10.3%) men and 2417 (16.8%) women-reported significant depressive symptoms. After adjustment, mild, moderate and severe baseline pain, versus no pain, were associated with an increased likelihood of significant depressive symptoms at follow-up: ORs (95% CI) were 1.20 (1.06-1.35), 1.32 (1.20-1.46) and 1.39 (1.19-1.63), respectively. These associations were more pronounced in men compared to women, and consistent in participants aged 50-64 years, those without mobility or functional impairment, and those without loneliness at baseline. CONCLUSION Higher baseline pain intensity was longitudinally associated with a greater risk of significant depressive symptoms at 2-year follow-up, in community-dwelling adults without baseline depression.
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Affiliation(s)
- Giulia Ogliari
- Department of Health Care of Older People (HCOP), Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, Nottinghamshire, NG7 2UH, UK
| | - Jesper Ryg
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
- Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Karen Andersen-Ranberg
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
- Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Unit for Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, 5000, Odense, Denmark
| | - Lasse Lybecker Scheel-Hincke
- Unit for Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, 5000, Odense, Denmark
| | - Jemima T Collins
- Department of Health Care of Older People (HCOP), Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, Nottinghamshire, NG7 2UH, UK
- University of Nottingham, Nottingham, UK
| | - Alison Cowley
- University of Nottingham, Nottingham, UK
- Research & Innovation, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Claudio Di Lorito
- Division of Primary Care and Population Health, University College London, London, UK
| | - Vicky Booth
- University of Nottingham, Nottingham, UK
- Research & Innovation, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Roelof A J Smit
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Building 7 (Maersk Tower), 2200, Copenhagen, Denmark
| | - Ralph K Akyea
- Primary Care Stratified Medicine, School of Medicine, University of Nottingham, Nottingham, UK
| | - Nadeem Qureshi
- Primary Care Stratified Medicine, School of Medicine, University of Nottingham, Nottingham, UK
| | - David A Walsh
- Pain Centre Versus Arthritis, University of Nottingham, Nottingham, UK
- Sherwood Forest Hospitals NHS Foundation Trust, Sutton-in-Ashfield, UK
| | - Rowan H Harwood
- Department of Health Care of Older People (HCOP), Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, Nottinghamshire, NG7 2UH, UK.
- University of Nottingham, Nottingham, UK.
- NIHR Applied Research Collaboration-East Midlands, Nottingham, UK.
| | - Tahir Masud
- Department of Health Care of Older People (HCOP), Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, Nottinghamshire, NG7 2UH, UK
- NIHR Applied Research Collaboration-East Midlands, Nottingham, UK
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Zhang N, Wang C, Li Y, Chen F, Yan P. Hypothetical interventions on risk factors for depression among middle-aged and older community-dwellers in China: An application of the parametric g-formula in a longitudinal study. J Affect Disord 2023; 327:355-361. [PMID: 36754095 DOI: 10.1016/j.jad.2023.01.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 01/22/2023] [Accepted: 01/30/2023] [Indexed: 02/09/2023]
Abstract
BACKGROUND Sleep disturbances, frailty, and body pain are widespread in middle-aged and older adults with depression, and have been identified as depression risk factors. However, there is a scarcity of research on the benefits of sleep improvement, frailty amelioration, and pain management on incident depression. METHODS A total of 8895 respondents aged above 45 years were derived from the China Health and Retirement Longitudinal Study (CHARLS) between 2011 and 2018. The parametric g-formula was used to estimate the 7-year risks of depression under independent hypothetical interventions on nighttime sleep duration (NSD), daytime napping duration (DND), perceived sleep quality (PSQ), frailty, and pain, as well as their various combinations. RESULTS The observed depression risk was 41.77 %. The independent intervention on frailty was the most effective in lowering incident depression, with a risk ratio (RR) of 0.61 (95 % CI: 0.57-0.64), followed by PSQ (RR: 0.75, 95 % CI: 0.73-0.78), pain (RR: 0.90, 95 % CI: 0.87-0.91), and NSD (RR: 0.96, 95 % CI: 0.93-0.98). In subgroup analysis, intervention on NSD was more effective in men, PSQ was more effective in middle-aged individuals, and frailty and pain were more effective in older persons. The combined intervention of NSD, PSQ, frailty, and pain lowered the risk the greatest (RR: 0.35, 95 % CI: 0.32-0.37). LIMITATIONS Generalizing our results to other populations should be possible if they have the same distribution of effect modifiers and interference patterns because of the calculation principle of the parametric g-formula. CONCLUSIONS Interventions for sleep disturbances, frailty, and body pain can minimize the risk of depression.
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Affiliation(s)
- Nan Zhang
- School of Nursing, Xinjiang Medical University, Urumqi, China
| | - Cui Wang
- School of Nursing, Peking University, Beijing, China
| | - Yuli Li
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Fenghui Chen
- School of Nursing, Xinjiang Medical University, Urumqi, China
| | - Ping Yan
- School of Nursing, Xinjiang Medical University, Urumqi, China.
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Adhikari P, McLaren S. Functional Impairment and Depressive Symptoms among Older Adults of Rural Nepal: The Moderating Role of Three Sources of Social Support. Clin Gerontol 2023; 46:832-843. [PMID: 36880604 DOI: 10.1080/07317115.2023.2187732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
OBJECTIVES This study aimed to determine whether social support from family, friends, and significant others moderated the relationship between functional impairment and depressive symptoms among Nepali older adults living in rural areas. METHODS The participants were 147 women (Mage = 66.71, SDage = 5.97) and 153 men (Mage = 67.41, SDage = 6.47) aged 60 years and older who lived in the rural mid-hills of Nepal. They completed the Karnofsky Performance Status Scale, the Multidimensional Scale of Perceived Social Support, and the Geriatric Depression Scale-Short Form. RESULTS Only 6.3% participants experienced some degree of functional impairment. Almost half (44.33%) of participants had depressive symptoms. Social support from family and friends, but not significant others, moderated the relationship between functional impairment and depressive symptoms. Social support from family was protective for older adults with moderate to high levels of functional impairment. Social support from friends was protective at no to low levels of functional impairment. CONCLUSIONS Interventions aimed at increasing social support from family among Nepali older adults living in rural hilly areas may reduce depressive symptoms, particularly among those with high levels of functional impairment. CLINICAL IMPLICATIONS Family support is important to alleviate depressive symptoms among functionally impaired older adults.
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Affiliation(s)
- Pralhad Adhikari
- Department of Psychology and Philosophy, TriChandra Multiple College, Kathmandu, Nepal
| | - Suzanne McLaren
- School of Psychology, Charles Sturt University, Port Macquarie, NSW, Australia
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Fasakin OW, Oboh G, Ademosun AO, Lawal AO. The modulatory effects of alkaloid extracts of Cannabis sativa, Datura stramonium, Nicotiana tabacum and male Carica papaya on neurotransmitter, neurotrophic and neuroinflammatory systems linked to anxiety and depression. Inflammopharmacology 2022; 30:2447-2476. [PMID: 35665872 DOI: 10.1007/s10787-022-01006-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 05/08/2022] [Indexed: 01/03/2023]
Abstract
This study investigated the modulatory effects of alkaloid extracts of Cannabis sativa (CSAE), Datura stramonium (DSAE), Nicotiana tabacum (NTAE) and male Carica papaya (CMAE) on neurotransmitter, neurotrophic and neuro-inflammatory systems linked to anxiety and depression. Male Wistar rats were orally administered the alkaloid extracts in doses of 5, 50, 500, and 2000 mg/kg for 90 days. On day 91, neurobehavioural studies were evaluated, rats were sacrificed, brain hippocampus removed and tissue homogenate prepared. Biochemical, cytokine and neurotransmitter metabolisms were estimated in the hippocampus. Expressions of genes linked to anxiety and depression were evaluated by RT-qPCR. Results showed CSAE, NTAE and CMAE act as anxiolytic and antidepressant agents by depleting TNF-α, IL-1β and reactive oxygen species concentrations, and monoamine oxidase, angiotensin 1-converting enzyme and acetylcholinesterase activities while elevating IL-10 and dopamine concentrations and glutamate dehydrogenase activity at doses of 5, 50 and 500. Same doses of CSAE, NTAE and CMAE also depleted the gene expressions of GSK3β, JNK, NF-ĸB, and Nesfatin-1 while increasing expressions of CREB, BDNF, serotonin and Nrf2. However, administration of DSAE and 2000 mg/kg CSAE, NTAE and CMAE had adverse modulatory effects on the neurochemical concentrations and activities as well as the gene expressions of the evaluated neurotransmitter, neurotrophic and inflammatory systems. In conclusion, the study established the sub-chronic instrumentalization potential of CSAE, CMAE, and NTAE for anxiolytic and anti-depressive moods, though their use may be associated with dependence and addiction, which may result in more detrimental effects than any therapeutic potential they may proffer.
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Affiliation(s)
- Olamide Wilson Fasakin
- Department of Biochemistry, School of Life Sciences, Federal University of Technology, P.M.B. 704, Akure, 340001, Nigeria
| | - Ganiyu Oboh
- Department of Biochemistry, School of Life Sciences, Federal University of Technology, P.M.B. 704, Akure, 340001, Nigeria.
| | - Ayokunle Olubode Ademosun
- Department of Biochemistry, School of Life Sciences, Federal University of Technology, P.M.B. 704, Akure, 340001, Nigeria
| | - Akeem O Lawal
- Department of Biochemistry, School of Life Sciences, Federal University of Technology, P.M.B. 704, Akure, 340001, Nigeria
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Gutierrez S, Wong R, Milani SA. The pain and depressive symptoms cascade: A bidirectional analysis of the Mexican Health and Aging Study 2012-2015. Int J Geriatr Psychiatry 2022; 37:10.1002/gps.5812. [PMID: 36150063 PMCID: PMC9725745 DOI: 10.1002/gps.5812] [Citation(s) in RCA: 2] [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: 06/06/2022] [Accepted: 09/13/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVES The association of pain and depression has not been evaluated in low- and middle-income countries, which have a disproportionate burden of pain compared to high-income countries. METHODS Using data from the Mexican Health and Aging Study (baseline, 2012; follow-up, 2015), we examined the bidirectional relationship between pain and depressive symptoms and identified shared predictors among community-dwelling participants ≥60 years (n = 7237). Multivariable logistic regressions models evaluated the association between (1) baseline pain and incident elevated depressive symptoms and (2) baseline depressive symptoms and incident pain, adjusting for demographic, socioeconomic, and health-related factors. Models included inverse probability weights and evaluated interactions by gender. RESULTS Participants (55.0% women) were on average 69.1 years old. Over half reported no pain (60.7%) and low/no depressive symptoms (67.9%) in 2012, of which, 20.2% reported elevated depressive symptoms and 25.3% self-reported pain in 2015. Baseline pain was associated with higher odds of incident elevated depressive symptoms (aOR 1.65; 95% CI, 1.41-1.93). Baseline elevated depressive symptoms were associated with higher odds of developing pain (aOR 1.57; 95% CI, 1.32-1.87). Age, gender, self-rated health, and activity of daily living limitations were shared risk factors for pain and elevated depressive symptomatology onset. Although the incidence of elevated depressive symptoms and pain was higher in women, there were no statistically significant interactions. CONCLUSIONS Older adults with pain or depression may be at risk for developing the other. These shared predictors could help identify patients in clinical settings, where pain and depression are often overlooked, reducing the cascading risk of this comorbidity.
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Affiliation(s)
- Sirena Gutierrez
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Rebeca Wong
- Department of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, Texas, USA
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, Texas, USA
| | - Sadaf Arefi Milani
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, Texas, USA
- Division of Geriatrics and Palliative Medicine, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, USA
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Association between quality of life and mental stress-induced myocardial ischaemia in high-risk patients after coronary revascularization. Health Qual Life Outcomes 2022; 20:69. [PMID: 35473557 PMCID: PMC9044723 DOI: 10.1186/s12955-022-01976-0] [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: 01/27/2022] [Accepted: 04/14/2022] [Indexed: 11/13/2022] Open
Abstract
Objective We sought to determine the association between mental stress-induced myocardial ischaemia (MSIMI) and quality of life (QoL) in patients with coronary artery disease (CAD) after coronary revascularization.
Methods This cohort study involved patients with high-risk MSIMI who received coronary revascularization between Dec 2018 and Dec 2019. Patients who screened positive for depression/anxiety were enrolled in this study. Mental stress was induced by the Stroop Colour and Word Test 1 month after coronary revascularization. All participants underwent single photon emission computed tomography (SPECT) scans at rest and under mental stress. MSIMI was defined as the presence of four abnormal SPECT phenomena. QoL was assessed using the Seattle Angina Questionnaire (SAQ) prior to treatment and 1 month after coronary revascularization. Results Of the 1845 consecutive patients who received coronary revascularization, 590 (31.9%) had depression/anxiety, and 205 agreed to accept the mental stress test. During the average observation period of 33 days, 105 (51.2%) patients exhibited MSIMI. All SAQ subscales showed significant improvement, except for QoL, in the MSIMI group. The QoL score was lower (− 0.2 ± 32.7 vs. 13.1 ± 29.9, P = 0.005), and the proportion of deterioration in QoL was higher (50.5% vs. 31.9%, P = 0.010) in the MSIMI group than in the non-MSIMI group. Those with a deterioration in QoL had approximately twice the rate of MSIMI than those with an improvement in QoL (unadjusted OR: 2.019, 95% CI 1.122–3.634, P = 0.026; adjusted OR: 1.968, 95% CI 1.083–3.578, P = 0.017). Conclusion Among patients with CAD who received coronary revascularization and had depression/anxiety, deterioration in QoL increased the likelihood of MSIMI. Hence, our results indicate that deterioration in QoL is a predictor of MSIMI. Trail Registration ChiCTR2200055792, retrospectively registered, 2022.1.20, www.medresman.org.cn
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Mu C, Jester DJ, Cawthon PM, Stone KL, Lee S. Subjective social status moderates back pain and mental health in older men. Aging Ment Health 2022; 26:810-817. [PMID: 33733930 PMCID: PMC8919683 DOI: 10.1080/13607863.2021.1899133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Back pain and poor mental health are interrelated issues in older men. Evidence suggests that socioeconomic status moderates this relationship, but less is known about the role of subjective social status (SSS). This study examined if the association between back pain and mental health is moderated by SSS. METHOD We used a sample of community-dwelling older men (≥65 years) from the Osteoporotic Fractures in Men Study (N = 5994). Participants self-reported their back pain severity and frequency over the past 12 months. SSS was assessed with the MacArthur Scale of SSS. Mental health was assessed with the SF-12 Mental Component Summary (MCS). RESULTS Severe back pain was associated with lower SF-12 MCS scores (p = .03). Back pain frequency was not associated with SF-12 MCS scores. SSS moderated the back pain and mental health relationship. Among men with higher national or community SSS, the association between back pain severity and SF-12 MCS scores was not significant. However, among men with lower national or community SSS, more severe back pain was associated with lower SF-12 MCS scores (p's < .001). Among those with lower national or community SSS, greater back pain frequency was also associated with lower SF-12 MCS scores (p's < .05). CONCLUSION Where one ranks oneself within their nation or community matters for the back pain and mental health relationship. Higher SSS may be a psychosocial resource that buffers the negative associations of severe and frequent back pain on mental health in older men.
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Affiliation(s)
- Christina Mu
- School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - Dylan J. Jester
- School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - Peggy M. Cawthon
- California Pacific Medical Center Research Institute, San Francisco, CA, USA;,Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Katie L. Stone
- California Pacific Medical Center Research Institute, San Francisco, CA, USA;,Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Soomi Lee
- School of Aging Studies, University of South Florida, Tampa, FL, USA
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Yona T, Weisman A, Gottlieb U, Masharawi Y. High Levels of Self-Reported Depressive Symptoms Among Physical Therapists and Physical Therapist Students Are Associated With Musculoskeletal Pain: A Cross-Sectional Study. Phys Ther 2022; 102:6492045. [PMID: 35023552 DOI: 10.1093/ptj/pzab278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 08/12/2021] [Accepted: 12/14/2021] [Indexed: 11/14/2022]
Abstract
OBJECTIVE Depressive symptoms and musculoskeletal (MSK) pain are 2 of the most common health conditions. Their relationship, however, remains unclear. As depressive symptoms in physical therapists have not been well assessed, the purpose of this work was to assess self-reported depressive symptoms and MSK pain prevalence-and their possible association-in physical therapists and physical therapist students. METHODS An online cross-sectional survey was used to gather data from 707 physical therapists and 116 physical therapist students from Israel. The Patient Health Questionnaire-9 was used to assess depressive symptoms, and the Extended Nordic Musculoskeletal Questionnaire was used to evaluate the prevalence and characteristics of MSK pain. RESULTS Overall, 108 participants (13.1%) scored in the moderate to severe depressive symptoms category (Patient Health Questionnaire-9 score >10), and 261 participants (31.7%) scored in the mild depressive symptoms category. In total, 84 physical therapists (11.9%) and 24 physical therapist students (20.7%) reported moderate to severe depressive symptoms during the last 2 weeks. Neck and back pain had the highest point prevalence (26.7%-35.3%) and lifetime prevalence (75.9%-78.5%), respectively. Mild depressive symptoms were associated with current pain (adjusted odds ratio [OR] = 1.58) and smoking (adjusted OR = 1.79-1.84). Current pain was also associated with severe depressive symptoms (adjusted OR = 2.76-3.07). Physical therapists with higher salaries were less likely to report severe depressive symptoms (adjusted OR = 0.11-0.36). CONCLUSION The prevalence estimates generated from this study sample imply that 11.9% of physical therapists and 20.7% of physical therapist students in Israel experienced moderate to severe depressive symptoms. Neck and back pain had the highest point and lifetime prevalence. IMPACT The prevalence of self-reported depressive symptoms in this sample places physical therapists and physical therapist students alongside physicians, nurses, and medical profession students who have been previously reported to have elevated depressive symptoms. Future studies should further explore the nature of the association between pain and depressive symptoms in these populations.
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Affiliation(s)
- Tomer Yona
- The Israeli Physiotherapy Society, Tel-Aviv, Israel.,Department of Biomedical Engineering, Technion, Israel Institute of Technology, Haifa, Israel
| | - Asaf Weisman
- Spinal Research Laboratory, Department of Physical Therapy, Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Uri Gottlieb
- Neuromuscular and Human Performance Laboratory, Department of Physiotherapy, Ariel University, Israel
| | - Youssef Masharawi
- Spinal Research Laboratory, Department of Physical Therapy, Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Israel
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Perelman J, Xavier M, Barros PP. How do European Mature Adults and Elderly Perceive SARS-COV-2 and Associated Control Measures? A Cross-Country Analysis of Mental Health Symptoms in June and July 2020. Int J Public Health 2022; 67:1604218. [PMID: 35283718 PMCID: PMC8906259 DOI: 10.3389/ijph.2022.1604218] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 01/21/2022] [Indexed: 11/21/2022] Open
Abstract
Objectives: Recent literature points out that elderly people are psychologically resilient to COVID-19, but the studies were performed in specific contexts. We measured the link between the worsening of mental health symptoms, the epidemiologic situation, and control measures among European people aged 50 or older. Methods: We used data from the 2020 wave of SHARE, merged with Oxford COVID-19 Government Response Tracker data (n = 38,358). We modeled the risk of worsening of depression, anxiety, sleeping trouble, and loneliness symptoms’ self-perception, as functions of control measures and 7-days death incidence, using logistic regressions. Results: The worsening of anxiety and depression perception were more common (16.2 and 23.1%, respectively), compared to that of sleeping troubles and loneliness (8.1 and 11.5%, respectively). The worsening of depression and anxiety perception was negatively related to the rigor of control measures. The seven-days death incidence was positively linked to all symptoms except sleeping troubles. Conclusion: Older people were the most exposed to death risk and were affected psychologically by the COVID-19 epidemiological situation; yet control measures were protective (or neutral) to their mental health condition.
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Affiliation(s)
- Julian Perelman
- Center for Research in Public Health, National School of Public Health, New University of Lisbon, Lisbon, Portugal
- Comprehensive Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
- *Correspondence: Julian Perelman,
| | - Miguel Xavier
- Comprehensive Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
- NOVA Medical School, Faculty of Medical Sciences of Lisbon, New University of Lisbon, Lisbon, Portugal
- National Mental Health Program, General-Directorate for Health, Lisbon, Portugal
| | - Pedro Pita Barros
- School of Business and Economics, New University of Lisbon, Lisbon, Portugal
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Abstract
AIMS Retirement is a major life transition that may improve or worsen mental health, including depression. Existing studies provide contradictory results. We conducted a systematic review with meta-analysis to quantitatively pool available evidence on the association of retirement and depressive symptoms. METHODS We applied PRISMA guidelines to conduct a systematic review and meta-analysis to retrieve, quantitatively pool and critically evaluate the association between retirement and both incident and prevalent depression and to understand better the potential role of individual and contextual-level determinants. Relevant original studies were identified by searching PubMed, Embase, PsycINFO and the Cochrane Library, through 4 March 2021. Subgroup and sensitivity meta-analyses were conducted by gender, study design (longitudinal v. cross-sectional studies), study quality score (QS) and considering studies using validated scales to diagnose depression. Heterogeneity between studies was evaluated with I2 statistics. RESULTS Forty-one original studies met our a priori defined inclusion criteria. Meta-analysis on more than half a million subjects (n = 557 111) from 60 datasets suggested a protective effect of retirement on the risk of depression [effect size (ES) = 0.83, 95% confidence interval (CI) = 0.74-0.93], although with high statistical heterogeneity between risk estimates (χ2 = 895.19, df = 59, I2 = 93.41%, p-value < 0.0001). Funnel plot asymmetry and trim and fill method suggested a minor potential publication bias. Results were consistent, confirm their robustness and suggest stronger protective effects when progressively restricting the included studies based on quality criteria: (i) studies with the highest QS [55 datasets, 407 086 subjects, ES = 0.81, 95% CI = 0.71-0.91], (ii) studies with a high QS and using validated assessment tools to diagnose depression (44 datasets, 239 453 subjects, ES = 0.76, 95% CI = 0.65-0.88) and (iii) studies of high quality, using a validated tool and with a longitudinal design (24 datasets, 162 004 subjects, ES = 0.76, 95% CI = 0.64-0.90). We observed a progressive reduction in funnel plot asymmetry. About gender, no statistically significant difference was found (females ES = 0.79, 95% CI = 0.61-1.02 v. men ES = 0.87, 95% CI = 0.68-1.11). CONCLUSIONS Pooled data suggested that retirement reduces by nearly 20% the risk of depression; such estimates got stronger when limiting the analysis to longitudinal and high-quality studies, even if results are affected by high heterogeneity.As retirement seems to have an independent and protective effect on mental health and depressive symptoms, greater flexibility in retirement timing should be granted to older workers to reduce their mental burden and avoid the development of severe depression. Retirement may also be identified as a target moment for preventive interventions, particularly primary and secondary prevention, to promote health and wellbeing in older ages, boosting the observed impact.
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12
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Hodgetts J, McLaren S, Bice B, Trezise A. The relationships between self-compassion, rumination, and depressive symptoms among older adults: the moderating role of gender. Aging Ment Health 2021; 25:2337-2346. [PMID: 32969298 DOI: 10.1080/13607863.2020.1824207] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Depression is a significant mental health issue for older adults. Rumination is a key risk factor for depressive symptoms, and self-compassion is a protective factor. The aim of the current study was to test the processes by which self-compassion might act as a protective factor among older adults by investigating a mediation model, and whether the model is conditional on gender. It was hypothesised that self-compassion and its six components (self-kindness, common humanity, mindfulness, self-judgement, isolation, and over-identification) would be indirectly associated with depressive symptoms via rumination. METHOD A sample of 135 older Australian women and 106 older Australian men aged between 65 and 89 years completed the Centre for Epidemiologic Studies Depression Scale, the Ruminative Thought Style Questionnaire, and the Self-Compassion Scale. RESULTS Results supported the mediation models for self-compassion for both men and women, however, support for the models involving the individual components of self-compassion varied according to gender. The mediation effects were stronger for women than men. CONCLUSION Interventions aimed at increasing self-compassion might have benefits for older adults. Future research investigating whether tailoring interventions according to gender of participants is efficacious is needed.
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Affiliation(s)
- Jessica Hodgetts
- School of Health and Life Sciences, Federation University, Australia
| | - Suzanne McLaren
- School of Health and Life Sciences, Federation University, Australia.,School of Psychology, Charles Sturt University, Port Macquarie, New South Wales, Australia
| | - Bridget Bice
- School of Health and Life Sciences, Federation University, Australia
| | - Alexandra Trezise
- School of Health and Life Sciences, Federation University, Australia
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13
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Morrissey AM, O’Neill A, O’Sullivan K, Robinson K. Complementary and alternative medicine use among older adults with musculoskeletal pain: findings from the European Social Survey (2014) special module on the social determinants of health. Br J Pain 2021; 16:109-118. [PMID: 35111319 PMCID: PMC8801684 DOI: 10.1177/20494637211023293] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background: This study describes the use of complementary and alternative medicine (CAM) among older adults who report being hampered in daily activities due to musculoskeletal pain. The characteristics of older adults with debilitating musculoskeletal pain who report CAM use is also examined. Methods: Cross-sectional European Social Survey Round 7 data from 21 countries were examined for participants aged 55 years and older, who reported musculoskeletal pain that hampered daily activities in the past 12 months. Results: Of the 4950 older adult participants reporting musculoskeletal pain that hampered daily activities, the majority (63.5%) were from the West of Europe, reported secondary education or less (78.2%), and reported at least one other health-related problem (74.6%). In total, 1657 (33.5%) reported using at least one CAM treatment in the previous year. Manual body-based therapies (MBBTs) were most used, including massage therapy (17.9%) and osteopathy (7.0%). Alternative medicinal systems (AMSs) were also popular with 6.5% using homoeopathy and 5.3% reporting herbal treatments. A general trend of higher CAM use in younger participants was noted. CAM use was associated with physiotherapy use, female gender, higher levels of education, being in employment and living in West Europe. Those reporting multiple health problems were more likely to use all CAM treatments, except MBBT. Conclusion: A third of older Europeans with musculoskeletal pain report CAM use in the previous 12 months. Certain subgroups with higher rates of CAM use could be identified. Clinicians should comprehensively and routinely assess CAM use among older adults with musculoskeletal pain.
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Affiliation(s)
- Ann-Marie Morrissey
- School of Allied Health, Health Research Institute, Ageing Research Centre, University of Limerick, Limerick, Ireland
| | - Aoife O’Neill
- School of Allied Health, Health Research Institute, Ageing Research Centre, University of Limerick, Limerick, Ireland
| | - Kieran O’Sullivan
- School of Allied Health, Health Research Institute, Ageing Research Centre, University of Limerick, Limerick, Ireland
| | - Katie Robinson
- School of Allied Health, Health Research Institute, Ageing Research Centre, University of Limerick, Limerick, Ireland
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14
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Huang DL, Bardhan I, Shin J, Karp JF, Park M. Chronic Pain and Mood Disorders in Asian Americans. Asian Pac Isl Nurs J 2021; 5:217-226. [PMID: 33791409 PMCID: PMC7993888 DOI: 10.31372/20200504.1115] [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] [Indexed: 11/30/2022] Open
Abstract
Purpose: Pain and mood disorder frequently coexist. Yet, for Asian Americans (AAs), scant information about pain and mood disorder is available. Our aims were to compare (1) the rates of pain and mood disorders and (2) the magnitude of associations between pain and mood disorders between AAs and European Americans (EAs), and across different Asian subgroups. Methods: An analytical data was constructed from the Collaborative Psychiatric Epidemiology Studies (CPES), a representative sample of community-residing U.S. adults (n = 9,871). Pain morbidity was assessed by self-report. Mood disorders, including major depression and anxiety disorders, were assessed using the diagnostic interview. Analysis included descriptive statistics and multivariate logistic regression modeling. All analyses were weighted to approximate the U.S. populations, and controlled for sociodemographic and immigration characteristics. Results: Greater proportion of EAs, compared to AAs, endorsed lifetime pain (56.8% vs. 35.8%). Having life pain disorders elevated the likelihood of lifetime mood disorder by more than 2-folds (weight adjusted odds ratio (WAOR): 2.12, 95% CI: 1.77, 2.55). Having pain disorders over the past 12 months elevated the likelihood of mood disorder in the same time period by more than 3-folds (WAOR: 3.29, 95% CI: 2.02, 5.37) among AAs. The magnitude of the association between pain and psychiatric morbidity were greater in Vietnamese Americans compared to other AAs and EAs. Discussion: The conventional belief that rates of pain and mood disorders are greater in AAs than EAs may need to be further examined. Vietnamese Americans may be particularly vulnerable for experience of comorbid pain and mood disorders.
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Affiliation(s)
- Deborah L Huang
- University of Washington, Seattle, Washington, United States
| | - Indraneil Bardhan
- University of California, San Francisco, San Francisco, California, United States
| | - Joohyun Shin
- University of California, San Francisco, San Francisco, California, United States
| | - Jordan F Karp
- University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Mijung Park
- University of California, San Francisco, San Francisco, California, United States
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15
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Gillsjö C, Nässén K, Berglund M. Suffering in silence: a qualitative study of older adults' experiences of living with long-term musculoskeletal pain at home. Eur J Ageing 2021; 18:55-63. [PMID: 33746681 PMCID: PMC7925717 DOI: 10.1007/s10433-020-00566-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Long-term musculoskeletal pain is a major, disabling, and often undertreated health problem among the increasing number of older adults worldwide. However, there is limited knowledge of community-dwelling older adults' experiences of living with this type of pain. The aim of the study was to deepen the understanding of the phenomenon: how older adults experience living with long-term musculoskeletal pain at home. The study design was an inductive qualitative Reflective Lifeworld Research approach grounded in phenomenological epistemology. Data were obtained from 20 community-dwelling older adults, aged 72-97 years. Data were collected through open-ended interviews and analyzed to understand the meanings of the phenomenon. The essence of the phenomenon entailed suffering in silence and encompassed the following constituents: loneliness and restrictions in daily living; ways to endure and distract from pain; not being taken seriously; fear of the future; and valuing joy and meaning in life. Living with long-term musculoskeletal pain restricts access to the world and leads to a suffering in silence. Finding ways to endure and distract from pain and to focus on issues that give joy and meaning in life is predominant in efforts to balance restraints from pain in life. Suffering is reinforced by loneliness, a sense of not being taken seriously by health care providers and fear of an uncertain future. It is necessary to foster increased attentiveness and sensitivity in meeting the needs of each older adult and provide a care that alleviates suffering and preserves and promotes health and well-being.
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Affiliation(s)
- Catharina Gillsjö
- School of Health Sciences, University of Skövde, P.O. Box 408, 541 28 Skövde, Sweden
- College of Nursing, University of Rhode Island, Kingston, USA
| | - Kristina Nässén
- Academy of Care, Working Life and Social Welfare, University of Borås, Borås, Sweden
| | - Mia Berglund
- School of Health Sciences, University of Skövde, P.O. Box 408, 541 28 Skövde, Sweden
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16
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Marques A, Bordado J, Peralta M, Gouveia ER, Tesler R, Demetriou Y, Gomez Baya D. Cross-sectional and prospective relationship between physical activity and depression symptoms. Sci Rep 2020; 10:16114. [PMID: 32999306 PMCID: PMC7527477 DOI: 10.1038/s41598-020-72987-4] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 06/18/2020] [Indexed: 01/27/2023] Open
Abstract
This study aimed to analyse the cross-sectional and prospective relationship between moderate and vigorous physical activity (PA) and depression symptoms. This study analysed 32,392 European late middle-aged to older adults, from 14 European countries across a 4-year follow-up. Data was collected in the fourth (in 2011) and sixth (in 2015) wave, from the Survey of Health, Ageing and Retirement in Europe (SHARE). For the present analysis, participants were considered who responded to the EURO-D 12-item scale of depression symptoms and reported the intensity and frequency of PA. ANCOVAs were conducted to assess the cross-sectional and prospective associations. For both men and women, engaging in moderate or vigorous PA in 2011 was associated with a lower score of depression in 2011 and 2015. From the prospective analysis, moderate and vigorous PA in 2011 was inversely associated with the score of depression. This association remains significant in the fully adjusted for self-rated health, sociodemographic characteristics, and the presence of chronic diseases. Moderate and vigorous PA at least once a week is negatively related to the score of depression, both in men and women. PA is negatively associated with depression symptoms, and from prospective analysis PA predicts lower depression scores 4 years later.
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Affiliation(s)
- Adilson Marques
- CIPER, Faculdade de Motricidade Humana, Univerisdade de Lisboa, Estrada da Costa, Cruz Quebrada, 1499-002, Lisboa, Portugal. .,ISAMB, Faculdade de Medicina, Univerisdade de Lisboa, Lisboa, Portugal. .,University of Huelva, Huelva, Spain.
| | - Joana Bordado
- Faculdade de Motricidade Humana, Univerisidade de Lisboa, Lisboa, Portugal
| | - Miguel Peralta
- CIPER, Faculdade de Motricidade Humana, Univerisdade de Lisboa, Estrada da Costa, Cruz Quebrada, 1499-002, Lisboa, Portugal.,ISAMB, Faculdade de Medicina, Univerisdade de Lisboa, Lisboa, Portugal
| | - Elvio R Gouveia
- Interactive Technologies Institute, LARSyS, Funchal, Portugal
| | - Riki Tesler
- Department of Health Systems Management, Faculty of Health Sciences, Ariel University, Ariel, Israel
| | - Yolanda Demetriou
- Faculty of Sport and Health Sciences, Technical University of Munich, Munich, Germany
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17
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Rahman J, Tareq AM, Hossain MM, Sakib SA, Islam MN, Ali MH, Uddin ABMN, Hoque M, Nasrin MS, Emran TB, Capasso R, Reza ASMA, Simal-Gandara J. Biological Evaluation, DFT Calculations and Molecular Docking Studies on the Antidepressant and Cytotoxicity Activities of Cycas pectinata Buch.-Ham. Compounds. Pharmaceuticals (Basel) 2020; 13:E232. [PMID: 32899148 PMCID: PMC7557754 DOI: 10.3390/ph13090232] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 08/29/2020] [Accepted: 08/31/2020] [Indexed: 12/11/2022] Open
Abstract
Cycas pectinata Buch.-Ham. is commonly used in folk medicine against various disorders. The present study investigated the antidepressant and cytotoxicity activity of methanol extract of C. pectinata (MECP) along with quantitative phytochemical analysis by GC-MS method. Here, the GC-MS study of MECP presented 41 compounds, among which most were fatty acids, esters, terpenoids and oximes. The antidepressant activity was assessed by the forced swimming test (FST) and tail suspension test (TST) models. In contrast, MECP (200 and 400 mg/kg) exhibited a significant and dose-dependent manner reduction in immobility comparable with fluoxetine (10 mg/kg) and phenelzine (20 mg/kg). MECP showed a weak toxicity level in the brine shrimp lethality bioassay (ED50: 358.65 µg/mL) comparable to the standard drug vincristine sulfate (ED50: 2.39 µg/mL). Three compounds from the GC-MS study were subjected to density functional theory (DFT) calculations, where only cyclopentadecanone oxime showed positive and negative active binding sites. Cyclopentadecanone oxime also showed a good binding interaction in suppressing depression disorders by blocking monoamine oxidase and serotonin receptors with better pharmacokinetic and toxicological properties. Overall, the MECP exhibited a significant antidepressant activity with moderate toxicity, which required further advance studies to identify the mechanism.
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Affiliation(s)
- Jinnat Rahman
- Department of Pharmacy, International Islamic University Chittagong, Kumira, Chittagong 4318, Bangladesh; (J.R.); (A.M.T.); (M.M.H.); (M.N.I.); (M.H.A.); (A.B.M.N.U.); (M.H.); (M.S.N.)
| | - Abu Montakim Tareq
- Department of Pharmacy, International Islamic University Chittagong, Kumira, Chittagong 4318, Bangladesh; (J.R.); (A.M.T.); (M.M.H.); (M.N.I.); (M.H.A.); (A.B.M.N.U.); (M.H.); (M.S.N.)
| | - Md. Mohotasin Hossain
- Department of Pharmacy, International Islamic University Chittagong, Kumira, Chittagong 4318, Bangladesh; (J.R.); (A.M.T.); (M.M.H.); (M.N.I.); (M.H.A.); (A.B.M.N.U.); (M.H.); (M.S.N.)
| | - Shahenur Alam Sakib
- Department of Theoretical and Computational Chemistry, University of Dhaka, Dhaka 1000, Bangladesh;
| | - Mohammad Nazmul Islam
- Department of Pharmacy, International Islamic University Chittagong, Kumira, Chittagong 4318, Bangladesh; (J.R.); (A.M.T.); (M.M.H.); (M.N.I.); (M.H.A.); (A.B.M.N.U.); (M.H.); (M.S.N.)
| | - Md. Hazrat Ali
- Department of Pharmacy, International Islamic University Chittagong, Kumira, Chittagong 4318, Bangladesh; (J.R.); (A.M.T.); (M.M.H.); (M.N.I.); (M.H.A.); (A.B.M.N.U.); (M.H.); (M.S.N.)
| | - A. B. M. Neshar Uddin
- Department of Pharmacy, International Islamic University Chittagong, Kumira, Chittagong 4318, Bangladesh; (J.R.); (A.M.T.); (M.M.H.); (M.N.I.); (M.H.A.); (A.B.M.N.U.); (M.H.); (M.S.N.)
| | - Muminul Hoque
- Department of Pharmacy, International Islamic University Chittagong, Kumira, Chittagong 4318, Bangladesh; (J.R.); (A.M.T.); (M.M.H.); (M.N.I.); (M.H.A.); (A.B.M.N.U.); (M.H.); (M.S.N.)
| | - Mst. Samima Nasrin
- Department of Pharmacy, International Islamic University Chittagong, Kumira, Chittagong 4318, Bangladesh; (J.R.); (A.M.T.); (M.M.H.); (M.N.I.); (M.H.A.); (A.B.M.N.U.); (M.H.); (M.S.N.)
| | - Talha Bin Emran
- Department of Pharmacy, BGC Trust University Bangladesh, Chittagong 4381, Bangladesh;
| | - Raffaele Capasso
- Department of Agricultural Sciences, University of Naples Federico II, 80055 Portici, Italy
| | - A. S. M. Ali Reza
- Department of Pharmacy, International Islamic University Chittagong, Kumira, Chittagong 4318, Bangladesh; (J.R.); (A.M.T.); (M.M.H.); (M.N.I.); (M.H.A.); (A.B.M.N.U.); (M.H.); (M.S.N.)
- Department of Biochemistry and Molecular Biology, University of Chittagong, Chittagong 4331, Bangladesh
| | - Jesus Simal-Gandara
- Nutrition and Bromatology Group, Department of Analytical and Food Chemistry, Faculty of Food Science and Technology, University of Vigo—Ourense Campus, E32004 Ourense, Spain
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18
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McCloy K, Peck C. Common factors in the presentation and management of chronic temporomandibular disorders and chronic overlapping pain disorders. J Oral Pathol Med 2020; 49:454-460. [DOI: 10.1111/jop.13079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 06/11/2020] [Indexed: 11/30/2022]
Affiliation(s)
| | - Christopher Peck
- Westmead Initiative The University of Sydney Sydney NSW Australia
- Pain Management Research Institute Royal North Shore HospitalSt Leonards NSW Australia
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Danielsson L, Kvarstein G, Bergvik S. Mediators of Pain and Physical Function in Female and Male Patients with Chronic Pain. J Pain Res 2020; 13:1059-1071. [PMID: 32547171 PMCID: PMC7245456 DOI: 10.2147/jpr.s233501] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Accepted: 02/19/2020] [Indexed: 12/19/2022] Open
Abstract
Purpose Chronic pain is often multifactorial and accompanied by psychological distress, catastrophizing thoughts, reduced physical function, and socio-economic worries. In this explorative study, we investigated potential mediators in the relationships of psychological and demographic variables with chronic pain and physical function in women and men. Patients and Methods The study included 301 patients admitted to a multidisciplinary pain clinic. Prior to their first consultation, patients completed a questionnaire including items on demographics (age, education, occupational and financial situation), catastrophizing thoughts, psychological distress, pain intensity, and physical function. Hierarchical multiple regression analyses examined demographic and psychological factors associated with pain intensity and physical function. Mediation and reversed mediation models were tested and developed based on calculated relations in the regression analyses between demographic, psychological, pain intensity and physical function variables. Results Fifty-eight percent were females and mean age 43.8 and 46.0 years for women and men, respectively. In the regression analyses, psychological factors accounted better for pain intensity than demographic variables, while physical function was best accounted for by demographic variables. Among women, catastrophizing thoughts mediated significantly the relationships between education and pain intensity, and between education and physical function. Psychological distress mediated significantly the relationships between financial situation and pain intensity, and between financial situation and physical function in women. In men, the only significant mediation model was psychological distress mediating the relationship between financial situation and pain intensity. Some of the reversed models revealed indirect effects, indicating bidirectionality. Conclusion The results indicate that there might be gender-specific mediators in how demographic variables are associated with pain intensity and physical function. This suggests an awareness among clinicians of potential gender-specific factors mediating pain problems, and the need for a gender-specific, multidisciplinary approach in the treatment of chronic pain.
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Affiliation(s)
- Lena Danielsson
- Pain Clinic, Division Surgical Medicine and Intensive Care, University Hospital of North Norway, Tromsø, Norway.,Department of Clinical Medicine, UiT - the Arctic University of Norway, Tromsø, Norway
| | - Gunnvald Kvarstein
- Pain Clinic, Division Surgical Medicine and Intensive Care, University Hospital of North Norway, Tromsø, Norway.,Department of Clinical Medicine, UiT - the Arctic University of Norway, Tromsø, Norway
| | - Svein Bergvik
- Department of Psychology, UiT the Arctic University of Norway, Tromsø, Norway
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Rifas-Shiman SL, Cardenas A, Hivert MF, Tiemeier H, Bertoldi AD, Oken E. Associations of acetaminophen use during pregnancy and the first year of life with neurodevelopment in early childhood. Paediatr Perinat Epidemiol 2020; 34:267-277. [PMID: 31965601 PMCID: PMC7192774 DOI: 10.1111/ppe.12632] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 10/30/2019] [Accepted: 12/04/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Over-the-counter analgesic use during pregnancy, particularly acetaminophen, may be associated with negative developmental outcomes in children. OBJECTIVE Estimate associations of prenatal and early-life exposure to acetaminophen in early childhood with cognitive, motor, and language skills in two birth cohorts. METHODS The American Project Viva cohort (1217 mother-child pairs enrolled 1999-2002) assessed cognition at approximately 3 years using the Peabody Picture Vocabulary Test and the Wide Range Achievement of Visual Motor Abilities (WRAVMA). The Brazilian 2015 Pelotas Birth Cohort (3818 mother-child pairs) assessed cognition at 2 years using the INTERGROWTH-21st Neurodevelopment Assessment. We used linear regression to estimate associations of acetaminophen use during pregnancy (Project Viva and Pelotas) and infancy (Project Viva) with children's cognitive scores adjusted for maternal age, pre-pregnancy body mass index, education, parity, race/ethnicity, smoking and alcohol use during pregnancy, depression during pregnancy, antibiotic and ibuprofen use during pregnancy, household income, and child's sex. RESULTS In Project Viva, exposure to acetaminophen in both the 1st and 2nd trimester of pregnancy was associated with lower WRAVMA drawing scores (β -1.51, 95% CI -2.92, -0.10). However, in Pelotas, exposure to acetaminophen in both the 1st and 2nd trimester of pregnancy was not associated with INTER-NDA motor scores (β 0.02; 95% CI -0.05, 0.09) and was associated with higher INTER-NDA total scores (β 0.08, 95% CI 0.01, 0.16). Other comparisons did not show evidence for any associations. CONCLUSIONS Inconsistencies and lack of specificity of the findings did not clarify the research question considering that we still have a large variability and uncertainty to define the risk or safety in the use of acetaminophen related to cognition in early childhood. More studies using better exposure assessment and better confounding variables are needed to clarify these associations.
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Affiliation(s)
- Sheryl L. Rifas-Shiman
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Andres Cardenas
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA, USA
| | - Marie-France Hivert
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Henning Tiemeier
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Child and Adolescent Psychiatry, Erasmus University Medical Center-Sophia Children’s Hospital, Rotterdam, Netherlands
| | - Andrea D. Bertoldi
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Emily Oken
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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21
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Rifas-Shiman SL, Cardenas A, Hivert MF, Tiemeier H, Bertoldi AD, Oken E. Associations of prenatal or infant exposure to acetaminophen or ibuprofen with mid-childhood executive function and behaviour. Paediatr Perinat Epidemiol 2020; 34:287-298. [PMID: 31637744 PMCID: PMC7170759 DOI: 10.1111/ppe.12596] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 08/02/2019] [Accepted: 08/28/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Over-the-counter analgesics during pregnancy or infancy may be related to neurobehavioural problems in children, but little is known about effects of different analgesic types, dosage, and timing. OBJECTIVES Examine associations of acetaminophen and ibuprofen use during pregnancy and infancy with executive function and behaviour problems in children. METHODS We included 1225 mother-child pairs from Project Viva, a pre-birth cohort study. We assessed prenatal acetaminophen and ibuprofen use in early and mid-pregnancy and infant use in the first year of life using questionnaires. Parents and classroom teachers assessed child behaviours in mid-childhood (median 8 years), using the Behavior Rating Inventory of Executive Function (BRIEF) and the Strengths and Difficulties Questionnaire (SDQ), with higher scores indicating worse functioning for both. We examined associations of acetaminophen and ibuprofen use during pregnancy and infancy with mid-childhood neurobehavioural outcomes using linear regression models adjusted for potential confounders. RESULTS During pregnancy, 46.1% of mothers used acetaminophen ≥10 times and 18.4% used any ibuprofen. In the first year, 65.3% and 39.6% of infants received acetaminophen and ibuprofen ≥6 times, respectively. Higher (≥10 vs <10 times) prenatal acetaminophen (β 1.64 points; 95% confidence interval [CI] 0.59, 2.68) and any ibuprofen (β 1.56, 95% CI 0.19, 2.92) were associated with higher parent-rated BRIEF global scores. Patterns of association were linear across categories and were similar for other parent- and teacher-rated outcomes. Infancy exposure (≥6 vs <6 times) to acetaminophen (β 1.69, 95% CI 0.51, 2.87) and ibuprofen (β 1.40, 95% CI 0.25, 2.55) were associated with higher parent-rated BRIEF GEC scores but associations with teacher-rated scores were weaker. CONCLUSIONS Prenatal and early-life exposure to acetaminophen and ibuprofen were associated with poorer executive function and behaviour in childhood. These findings highlight the need for further research on the mechanisms through which analgesics may act on fetal and child brain development.
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Affiliation(s)
- Sheryl L. Rifas-Shiman
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Andres Cardenas
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA, USA
| | - Marie-France Hivert
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Henning Tiemeier
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA,Department of Child and Adolescent Psychiatry, Erasmus University Medical Center-Sophia Children’s Hospital, Rotterdam, Netherlands
| | - Andrea D. Bertoldi
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Emily Oken
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Kouvatsou K, Iliadou M, Kalatzi P, Evanthia S, Christos P, Maria K, Tziaferi S. Depression Among Elderly Users of Open and Closed Care Facilities in a Rural Region of Greece: an Important Public Health Issue. Mater Sociomed 2020; 32:35-40. [PMID: 32410889 PMCID: PMC7219719 DOI: 10.5455/msm.2020.32.35-40] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Introduction: It is estimated that 5.7% of the total Greek population suffers from depressive disorders. Elderly may be particularly prone to depression compared to younger people. In Greece, there is a paucity of literature regarding the correlation between the existence of chronic diseases, sociodemographic features, participation in open/ closed structures, and the presence of depression or depressive symptoms, among seniors. The purpose of this study was to explore potential correlations between the above- mentioned variables, as a whole. Methods: This was a cross- sectional, questionnaire survey of 200 elderly aged 65 or above and were members of 12 Open Care Centers for the Elderly (OCCE) or residents in 2 nursing homes located in the rural region of Epirus, in Greece. Data collection took place in the form of structured individual interviews. For the identification of independent factors associated with the existence of depressive symptoms, stepwise logistic regression analysis was performed. Results: A total of 81 (40.5%) seniors experienced depressive symptoms, though only 39 of them (19.5%) had been diagnosed for depression. Depression rates were higher for those with more chronic diseases (p=0.01) and at divorced, widowed and single seniors compared to married ones (50.5% vs. 28.1% respectively, p=0.002). The prevalence of depression was higher among the elderly who lived in nursing homes compared to the participants who were registered members of the OCCE (50% vs. 35.6% respectively, p=0.049), while elderly who often participated in the social activities of OCCE, had significantly lower rates of depressive symptoms compared to those who scarcely were involved in these activities (23% vs. 46.2% respectively, p=0.019). Participants who suffered from osteoporosis were more likely of displaying depressive symptoms compared to those who didn’t; OR (95% Confidence Interval) = 2.61 (1.28-5.33), p=0.009. Conclusions: The existence of an action plan that includes education and training of health professionals on mental health of the elderly and the satisfactory operation of public facilities to promote the wellbeing of seniors and offer more incentives for activity participation, may reduce depression rates and the under-diagnosis of the disease.
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Affiliation(s)
- Katerina Kouvatsou
- Department of Nursing, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Tripoli, Greece
| | - Maria Iliadou
- Department of Nursing, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Tripoli, Greece.,Department of Midwifery, Faculty of Health and Care Sciences, University of West Attica, Aigaleo, Athens, Greece
| | - Panagiota Kalatzi
- Department of Nursing, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Tripoli, Greece
| | - Sakellari Evanthia
- Department of Public and Community Health, Faculty of Public Health University of West Attica, Athens, Greece
| | - Prapas Christos
- Department of Public and Community Health, Faculty of Public Health University of West Attica, Athens, Greece
| | - Kalafati Maria
- Faculty of Nursing, National and Kapodistrian University of Athens, Athens, Greece
| | - Styliani Tziaferi
- Department of Nursing, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Tripoli, Greece
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Ray-Griffith SL, Morrison B, Stowe ZN. Chronic Pain Prevalence and Exposures during Pregnancy. Pain Res Manag 2019; 2019:6985164. [PMID: 31485284 PMCID: PMC6702808 DOI: 10.1155/2019/6985164] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 07/15/2019] [Indexed: 11/18/2022]
Abstract
Pregnant women with chronic pain present a unique clinical challenge for both chronic pain and obstetrical providers, and clinical guidelines do not exist. The present study describes the prevalence and management of chronic pain during pregnancy in a perinatal mood disorder clinic. A retrospective chart review of pregnant women who presented to the Women's Mental Health Program at the University of Arkansas for Medical Sciences (UAMS) for an initial evaluation from July 2013 to June 2016 was conducted to obtain demographic and medical information, including pharmacological exposures. Data are described using the mean and standard deviation for continuous data and frequency for categorical data. Pain complaints and medications are presented as counts and percentages. Differences between women with and without chronic pain were assessed by t-tests for continuous variables and chi-square analysis for categorical variables. Of the 156 pregnant women, chronic pain conditions were reported by 44 (28.2%). The most common chronic pain complaints included neck and/or back pain (34.1%) and headaches (31.8%). Of subjects with chronic pain, 95.5% were taking at least one prescription medication (mean = 2.6 ± 2.1, range of 0-10). Acetaminophen (43.2%) and opioids (43.2%) were the most common. The complexity of managing maternal benefits of treatment with the risks of fetal exposures presents a uniquely challenging clinical scenario for healthcare providers.
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Affiliation(s)
- Shona L. Ray-Griffith
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Department of Obstetrics & Gynecology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Bethany Morrison
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Zachary N. Stowe
- Department of Psychiatry, University of Wisconsin at Madison, Madison, WI, USA
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24
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Samper Bernal D, Alvarado Bonilla A, Cánovas L, Carregal A, Fernández Sánchez SP, González Mesa JM, Guillén Astete C, Loscos López A, Lozano Martínez AJ, Pérez-Castejón JM, Romero-Cullerés G, Salido de Andrés E. [Consensus statement on the use of acetaminophen/tramadol in patients with moderate-severe pain]. Semergen 2019; 45:52-62. [PMID: 30686297 DOI: 10.1016/j.semerg.2018.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 05/03/2018] [Accepted: 08/01/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES To present recommendations on the use of the paracetamol/tramadol (P/T) combination in patients with moderate-intense pain based on best evidence and experience. METHODS The method of nominal groups and Delphi was followed, and supported by a systematic literature review (SLR). A multidisciplinary panel of 12 experts in pain management was selected. In the first nominal group meeting, the aim, scope, users, and sections of the consensus document, were defined, along with the preliminary general recommendations. For the SLR, the inclusion and exclusion criteria, as well as the search strategies, were defined. Two reviewers selected and analysed the articles. This evidence was discussed in a second nominal group meeting, and definitive recommendations were developed. For each recommendation, the evidence levels and grade of recommendation grades were classified according to the Oxford model, and the grade according to the Delphi technique. It was defined as an agreement if at least 70% of the participants scored ≥7 for each recommendation (1=total disagreement to 10=total agreement). RESULTS A total of 20 recommendations were produced, which covered general aspects, such as the assessment of pain, and those specific to P/T management. These latter included the indications of the P/T combination (patient profile, dosing, prescription, formulations), risk management (contraindications, precautions, interactions, concomitant use with other medications, follow-up, special situations), and patient education. CONCLUSIONS These recommendations attempt to resolve any of the routine clinical questions, and help in the making of decisions on the use of the P/T combination in patients with moderate-intense pain.
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Affiliation(s)
- D Samper Bernal
- Servicio Anestesia, Clínica del Dolor, Hospital Germans Trias i Pujol, Badalona, Barcelona, España.
| | - A Alvarado Bonilla
- Servicio de Traumatología y Cirugía Ortopédica, Hospital Jerez de la Frontera, Jerez de la Frontera, Cádiz, España
| | - L Cánovas
- Unidad del Dolor, Servicio de Anestesia, Complexo Hospitalario Universitario de Ourense, Orense, España
| | - A Carregal
- Unidad del Dolor, Servicio de Anestesia, Complexo Hospitalario Universitario de Vigo, Vigo, España
| | | | - J M González Mesa
- Unidad del Dolor, Hospital Clínico Virgen de la Victoria, Málaga, España
| | - C Guillén Astete
- Servicio de Reumatología, Hospital Universitario Ramón y Cajal, Madrid, España
| | - A Loscos López
- Servicio de Urgencias, Hospital Arnau de Vilanova, Valencia, España
| | - A J Lozano Martínez
- Servicio de Oncología Radioterápica, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | - J M Pérez-Castejón
- Servicio de Geriatría y Cuidados Paliativos de Badalona Servicios Asistenciales (BSA). Centro Sociosanitario El Carme, Badalona, Barcelona, España
| | - G Romero-Cullerés
- Servicio de Medicina Física y Rehabilitación, Hospital Universitario Fundación Althaia. Universitat de Vic-Universitat Central de Catalunya (UVIC-UCC) y Universitat Internacional de Catalunya (UIC), Manresa, Barcelona, España
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25
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Rodríguez-Sánchez I, García-Esquinas E, Mesas AE, Martín-Moreno JM, Rodríguez-Mañas L, Rodríguez-Artalejo F. Frequency, intensity and localization of pain as risk factors for frailty in older adults. Age Ageing 2019; 48:74-80. [PMID: 30307470 DOI: 10.1093/ageing/afy163] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Indexed: 01/10/2023] Open
Abstract
Background the association between pain characteristics and frailty risk is uncertain. Objective to investigate the separate impact of the frequency, intensity and location of pain on frailty risk and its possible mechanisms. Methods prospective cohort of 1505 individuals ≥63 years followed between 2012 and 2015 in Spain. In 2012, pain was classified into: lowest pain (Score 0), middle pain (Score 1-4) and highest pain (Score 5-6). Incident frailty was assessed in 2015 as having ≥3 Fried criteria or a Frailty Index (FI) ≥0.30. Results in multivariate analyses, the risk of frailty (measured with the Fried criteria or the FI) increased progressively with the frequency of pain, its intensity and the number of pain locations. Compared with those having the lowest pain score, the odds ratio (95% confidence interval) of Fried-based frailty was 1.24 (0.56-2.75) in the middle score and 2.39 (1.34-4.27; P-trend <0.01) in the highest score. Corresponding values for frailty as FI ≥0.30 were 1.39 (0.80-2.42) and 2.77 (1.81-4.24; P-trend <0.01). Odds ratios did not change after adjustment for alcohol intake, Mediterranean diet adherence or sedentary time, but were reduced with adjustment for pain-associated chronic diseases (cardiovascular disease, diabetes, chronic lung disease, osteomuscular disease and depression). A higher pain score was linked to higher risk of exhaustion and low physical activity (two out of five Fried criteria) and to a worse score in all FI domains. Conclusion frequency, intensity and location of pain were associated with higher risk of frailty. Study associations were partly explained by pain-associated morbidity.
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Affiliation(s)
- Isabel Rodríguez-Sánchez
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPaz, Madrid, Spain
- Department of Geriatric Medicine, Hospital Universitario La Paz/IdiPaz, Madrid, Spain
| | - Esther García-Esquinas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPaz, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Arthur E Mesas
- Department of Public Health, Universidade Estadual de Londrina, Londrina, Brazil
| | - José María Martín-Moreno
- Preventive Medicine and Public Health and University Clinical Hospital INCLIVA, University of Valencia, Valencia, Spain
| | - Leocadio Rodríguez-Mañas
- Department of Geriatric Medicine, Hospital Universitario de Getafe and CIBERFES (CIBER of Frailty and Healthy Ageing), Getafe, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPaz, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
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26
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Portellano-Ortiz C, Garre-Olmo J, Calvó-Perxas L, Conde-Sala JL. Factor structure of depressive symptoms using the EURO-D scale in the over-50s in Europe. Findings from the SHARE project. Aging Ment Health 2018; 22:1477-1485. [PMID: 28856915 DOI: 10.1080/13607863.2017.1370688] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The aims of this study are: to analyze the factor structure of the EURO-D depression scale; to explore the variables associated with depressive symptoms in the total sample and in the EURO-D factors; and to compare the presence of depressive symptoms and the factor distribution in 15 European countries. METHOD 62,182 participants in Wave 5 (2013) of the Survey of Health, Aging and Retirement in Europe (SHARE) were included. INSTRUMENTS The SHARE study and the EURO-D scale. Factor, bivariate and multilevel analyses were performed. RESULTS Higher levels of depressive symptoms were associated with a poorer self-perception of physical health (η2 = 0.22) and economic difficulties (η2 = 0.07). Factor analysis of the EURO-D identified two factors: Suffering and Motivation. Higher levels of depressive symptoms were associated with female gender and younger age (≤60) in the Suffering factor, and with less activity and exercise, older age (≥71), widowhood and lower educational level in the Motivation factor. Poorer self-perception of physical health and economic difficulties were associated with higher depressive symptomatology in both factors. CONCLUSIONS Poorer self-perception of physical health, female gender, economic difficulties, widowhood, lower levels of activity and exercise and lower educational level were associated with higher depressive symptomatology. In the countries of southern Europe, the Motivation factor predominated.
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Affiliation(s)
- Cristina Portellano-Ortiz
- a Department of Cognition, Development and Educational Psychology, Faculty of Psychology , University of Barcelona , Barcelona , Spain
| | - Josep Garre-Olmo
- b Research Unit , Girona Biomedical Research Institute (IDIBGI) , Institut d'Assistència Sanitària , Salt , Spain.,c Department of Medical Sciences , University of Girona , Girona , Spain
| | - Laia Calvó-Perxas
- b Research Unit , Girona Biomedical Research Institute (IDIBGI) , Institut d'Assistència Sanitària , Salt , Spain
| | - Josep Lluís Conde-Sala
- a Department of Cognition, Development and Educational Psychology, Faculty of Psychology , University of Barcelona , Barcelona , Spain.,b Research Unit , Girona Biomedical Research Institute (IDIBGI) , Institut d'Assistència Sanitària , Salt , Spain
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Khan H, Amin S, Patel S. Targeting BDNF modulation by plant glycosides as a novel therapeutic strategy in the treatment of depression. Life Sci 2018; 196:18-27. [DOI: 10.1016/j.lfs.2018.01.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Revised: 01/06/2018] [Accepted: 01/12/2018] [Indexed: 12/19/2022]
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28
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Cimas M, Ayala A, Sanz B, Agulló-Tomás MS, Escobar A, Forjaz MJ. Chronic musculoskeletal pain in European older adults: Cross-national and gender differences. Eur J Pain 2017; 22:333-345. [PMID: 29235193 DOI: 10.1002/ejp.1123] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2017] [Indexed: 11/08/2022]
Abstract
BACKGROUND In an ageing Europe, chronic pain is a major public health problem, but robust epidemiological data are scarce. This study aimed to analyse the prevalence of and factors associated with chronic musculoskeletal pain by gender in older adults of 14 European countries. METHODS A cross-sectional study was performed from wave 5 of the Survey of Health, Ageing and Retirement in Europe (SHARE). The study included people ≥50 years residing in Austria, Belgium, Czech Republic, Denmark, Estonia, France, Germany, Italy, Luxembourg, the Netherlands, Slovenia, Spain, Sweden and Switzerland. Chronic pain was defined as being bothered by joint and/or back pain for the previous 6 months. Multivariable Poisson regression models with robust variance were performed to analyse prevalence ratio by covariates, stratified by sex. RESULTS A total of 61,157 participants were included. Overall prevalence of chronic musculoskeletal pain was 35.7% (28.8-31.7), ranging from 18.6% (17.1-20.1) for Switzerland to 45.6% (43.3-47.8) for France. Prevalence was higher in women than in men: 41.3% (40.2-42.4) versus 29.1% (28.0-30.3). Chronic musculoskeletal pain was lower in men aged >75 years (PR = 0.82; 0.72-0.92) than the younger (50-59) group. Separated/divorced status presented opposite effects among men (PR = 0.85; 0.76-0.96) and women (PR = 1.12; 1.03-1.21) compared with married, and unemployment was a significant factor in men (PR = 1.21; 95% CI 1.02-1.43) compared with employed. CONCLUSIONS Musculoskeletal pain in older European adults is very frequent, especially in women, with large differences depending on the country of residence. Health policy makers should prioritize strategies aimed at improving the prevention and management of chronic musculoskeletal pain in Europe. SIGNIFICANCE This study provides epidemiological data of chronic musculoskeletal pain in older adults. Reported differences contribute to highlight the relevance of considering a gender perspective in chronic musculoskeletal pain research. Cross-national comparison also offers a map of differences that improves the knowledge of this chronic condition in Europe.
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Affiliation(s)
- M Cimas
- National School of Health, Institute of Health Carlos III, Madrid, Spain
| | - A Ayala
- National School of Health, Institute of Health Carlos III, Madrid, Spain.,Red de Investigación en Servicios, Red de Servicios de Salud Orientados a Enfermedades Crónicas (REDISECC), Madrid, Spain
| | - B Sanz
- National School of Health, Institute of Health Carlos III, Madrid, Spain
| | - M S Agulló-Tomás
- Instituto Universitario de Estudios de Género y Departamento de Análisis Social, Universidad Carlos III, Madrid, Spain
| | - A Escobar
- Red de Investigación en Servicios, Red de Servicios de Salud Orientados a Enfermedades Crónicas (REDISECC), Madrid, Spain
| | - M J Forjaz
- National School of Health, Institute of Health Carlos III, Madrid, Spain.,Red de Investigación en Servicios, Red de Servicios de Salud Orientados a Enfermedades Crónicas (REDISECC), Madrid, Spain
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29
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Gender and the Association between Long-Term Prescription Opioid Use and New-Onset Depression. THE JOURNAL OF PAIN 2017; 19:88-98. [PMID: 29030323 DOI: 10.1016/j.jpain.2017.09.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 08/28/2017] [Accepted: 09/19/2017] [Indexed: 10/18/2022]
Abstract
Women have a higher prevalence of chronic noncancer pain conditions and report more severe pain, yet, it is not known if the association between long-term opioid analgesic use (OAU) and risk of a new depression episode (NDE) differs according to gender. We analyzed patient data from the Veterans Health Administration (VHA; 2000-2012; n = 70,997) and a large private-sector health care organization (2003-2012; n = 22,981) to determine whether long-term OAU and risk of NDE differed according to gender. Patients were free of depression and OAU for 2 years before baseline. OAU duration was defined as 1 to 30, 31 to 90 and more than 90 days, and NDE was defined according to International Classification of Diseases, Ninth Revision codes. Gender-stratified Cox proportional hazard models were used to estimate hazard ratios (HRs). Propensity scores and subsequent inverse probability of treatment weighting controlled for confounding. In the VHA, more than 90 compared with 1- to 30-day OAU was more strongly associated with NDE among female than male patients (female: HR = 1.79 [95% confidence interval (CI), 1.45-2.22] vs male HR = 1.25 [95% CI, 1.16-1.34], P = .002). In private sector patients, there was no gender difference in the association between more than 90-day OAU and NDE (female HR = 1.97 [95% CI, 1.64-2.37] vs male HR = 1.99 [95% CI, 1.44-2.74]). Risk of NDE after long-term OAU is similar in men and women in private sector patients but may differ for VHA patients. Future prospective studies are needed to identify mechanisms for the association between longer OAU and NDE. PERSPECTIVE Existing research is mixed regarding gender differences in outcomes after long-term prescription opioid use. This study found both genders have increased risk of an NDE after more than 90 days of opioid use. Women and men may benefit from closer monitoring of mood associated with chronic opioid use.
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30
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Liew HP. Health and well-being of middle age Indonesians: An application of seemingly unrelated regression (SUR) models. HEALTH POLICY AND TECHNOLOGY 2017. [DOI: 10.1016/j.hlpt.2017.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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31
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Diz JBM, de Souza Moreira B, Felício DC, Teixeira LF, de Jesus-Moraleida FR, de Queiroz BZ, Pereira DS, Pereira LSM. Brain-derived neurotrophic factor plasma levels are increased in older women after an acute episode of low back pain. Arch Gerontol Geriatr 2017; 71:75-82. [PMID: 28376368 DOI: 10.1016/j.archger.2017.03.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 03/08/2017] [Accepted: 03/17/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Low back pain (LBP) is a growing public health problem in old age, and it is associated with disabling pain and depressive disorders. We compared brain-derived neurotrophic factor (BDNF) plasma levels, a key neurotrophin in pain modulation, between older women after an acute episode of LBP and age-matched pain-free controls, and investigated potential differences in BDNF levels between controls and LBP subgroups based on pain severity, presence of depressive symptoms and use of analgesic and antidepressant drugs. METHODS A total of 221 participants (154 with LBP and 67 pain-free) were studied. A comprehensive assessment of sociodemographic and clinical variables was conducted including pain severity (11-point NRS), depressive symptoms (GDS-15), age, body mass index, physical activity and total number of comorbidities and medications in use. RESULTS BDNF levels in LBP group were significantly higher than controls (7515.9±3021.2; Md=7116.0 vs 6331.8±3364.0; Md=5897.5pg/mL, P=0.005). LBP subgroups exhibited higher BDNF levels than controls, regardless of pain severity, presence of depressive symptoms and use of analgesic drugs. BDNF levels were significantly higher in LBP subgroup without use of antidepressant drugs compared to both controls and LBP subgroup with use of antidepressant drugs. DISCUSSION This study provides evidence that older women with acute low back pain exhibit higher BDNF plasma levels compared to pain-free controls. Subgroup comparisons suggest that use of pain-relief drugs may influence BDNF levels. The study results offer a novel target for research on mechanisms of back pain in older adults.
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Affiliation(s)
- Juliano Bergamaschine Mata Diz
- Department of Physical Therapy, Postgraduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, 6627 Antônio Carlos Avenue, 31270-901, Belo Horizonte, Minas Gerais, Brazil.
| | - Bruno de Souza Moreira
- Department of Physical Therapy, Postgraduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, 6627 Antônio Carlos Avenue, 31270-901, Belo Horizonte, Minas Gerais, Brazil.
| | - Diogo Carvalho Felício
- Department of Physical Therapy, Universidade Federal de Juiz de Fora, s/n Eugênio do Nascimento Avenue, 36038-330, Juiz de Fora, Minas Gerais, Brazil.
| | - Luiza Faria Teixeira
- Department of Physical Therapy, Universidade do Vale do Sapucaí, 320 Coronel Alfredo Custódio de Paula Avenue, 37550-000, Pouso Alegre, Minas Gerais, Brazil.
| | - Fabianna Resende de Jesus-Moraleida
- Department of Physical Therapy, Faculty of Medicine, Universidade Federal do Ceará, 949 Alexandre Barúna Street, 60430-160, Fortaleza, Ceará, Brazil.
| | - Bárbara Zille de Queiroz
- Department of Physical Therapy, Postgraduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, 6627 Antônio Carlos Avenue, 31270-901, Belo Horizonte, Minas Gerais, Brazil.
| | - Daniele Sirineu Pereira
- Department of Physical Therapy, Universidade Federal de Alfenas, 2600 Jovino Fernandes Sales Avenue, 31270-901, Alfenas, Minas Gerais, Brazil.
| | - Leani Souza Máximo Pereira
- Department of Physical Therapy, Postgraduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, 6627 Antônio Carlos Avenue, 31270-901, Belo Horizonte, Minas Gerais, Brazil.
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Hayek SS, Ko YA, Awad M, Del Mar Soto A, Ahmed H, Patel K, Yuan M, Maddox S, Gray B, Hajjari J, Sperling L, Shah A, Vaccarino V, Quyyumi AA. Depression and chest pain in patients with coronary artery disease. Int J Cardiol 2017; 230:420-426. [PMID: 28041701 PMCID: PMC5881400 DOI: 10.1016/j.ijcard.2016.12.091] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 11/15/2016] [Accepted: 12/16/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND Depression is common in patients with coronary artery disease (CAD) and is associated with more frequent chest pain. It is however unclear whether this is due to differences in underlying CAD severity. We sought to determine [1] whether depressive symptoms are associated with chest pain independently of CAD severity, [2] whether improvement in depressive symptoms over time is associated with improvement in chest pain and [3] whether the impact of revascularization on chest pain differs between patients with and without depression. METHODS AND RESULTS 5158 patients (mean age 63±12years, 65% male, 20% African American) undergoing cardiac catheterization completed the Seattle Angina Questionnaire (SAQ) and Patient Health Questionnaire-8 (PHQ-8) to assess angina severity and screen for depression, respectively, both at baseline and between 6 and 24months of follow-up. We found significant correlations between PHQ-8 scores and angina frequency (SAQ-AF, r=-0.28), physical limitation (SAQ-PL, r=-0.32) and disease perception (SAQ-DS r=-0.37, all P<0.001), which remained significant after adjustment for clinical characteristics, CAD severity, and anti-depressant use. Improvement in depressive symptoms at follow-up was associated with improvement in angina subscales (SAQ-AF β 1.34, P<0.001), SAQ-PL β 1.85, P<0.001), and SAQ-DS (β 2.12, P<0.001), independently of CAD severity or revascularization. Patients with depression who underwent revascularization had less improvement in chest pain frequency than those without depressive symptoms. CONCLUSIONS Depression is associated with angina, independently of CAD severity. Patients with depression may not derive as adequate symptomatic benefit from revascularization as those without. Whether treatment of underlying depression improves chest pain needs to be further studied.
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Affiliation(s)
- Salim S Hayek
- Division of Cardiology, Emory University School of Medicine, Atlanta, GA, United States
| | - Yi-An Ko
- Division of Cardiology, Emory University School of Medicine, Atlanta, GA, United States; Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Mosaab Awad
- Division of Cardiology, Emory University School of Medicine, Atlanta, GA, United States
| | - Andrea Del Mar Soto
- Division of Cardiology, Emory University School of Medicine, Atlanta, GA, United States
| | - Hina Ahmed
- Division of Cardiology, Emory University School of Medicine, Atlanta, GA, United States
| | - Keyur Patel
- Division of Cardiology, Emory University School of Medicine, Atlanta, GA, United States
| | - Michael Yuan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Spencer Maddox
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States
| | - Brandon Gray
- Division of Cardiology, Emory University School of Medicine, Atlanta, GA, United States
| | - Jamal Hajjari
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States
| | - Laurence Sperling
- Division of Cardiology, Emory University School of Medicine, Atlanta, GA, United States
| | - Amit Shah
- Division of Cardiology, Emory University School of Medicine, Atlanta, GA, United States; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Viola Vaccarino
- Division of Cardiology, Emory University School of Medicine, Atlanta, GA, United States; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Arshed A Quyyumi
- Division of Cardiology, Emory University School of Medicine, Atlanta, GA, United States.
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Perviz S, Khan H, Pervaiz A. Plant Alkaloids as an Emerging Therapeutic Alternative for the Treatment of Depression. Front Pharmacol 2016; 7:28. [PMID: 26913004 PMCID: PMC4753303 DOI: 10.3389/fphar.2016.00028] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 01/31/2016] [Indexed: 11/13/2022] Open
Abstract
Depression is a heterogeneous mood disorder that has been classified and treated in a variety of ways. Although, a number of synthetic drugs are being used as standard treatment for clinically depressed patients, but they have adverse effects that can compromise the therapeutic treatments and patient's compliance. Unlike, synthetic medications, herbal medicines are widely used across the globe due to their wide applicability and therapeutic efficacy associated with least side effects, which in turn has initiated the scientific research regarding the antidepressant activity. This review is mostly based on the literature of the last decade, aimed at exploring the preclinical profile of plant-based alkaloids (the abundant secondary metabolite) as an emerging therapy for depression.
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Affiliation(s)
- Sadia Perviz
- Department of Pharmacy, Abdul Wali Khan University Mardan Mardan, Pakistan
| | - Haroon Khan
- Department of Pharmacy, Abdul Wali Khan University Mardan Mardan, Pakistan
| | - Aini Pervaiz
- Department of Pharmacy, Abdul Wali Khan University Mardan Mardan, Pakistan
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