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Sabo MT, Walker A, Elmi Assadzadeh G, Hildebrand KA. Rotator cuff outcomes and mental health indices: Correlation or causation? Shoulder Elbow 2023; 15:108-118. [PMID: 37974603 PMCID: PMC10649477 DOI: 10.1177/17585732221076027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 10/12/2021] [Accepted: 12/22/2021] [Indexed: 11/19/2023]
Abstract
Background Psychological factors such as catastrophizing, anxiety, and depression influence clinical outcomes in many conditions. Our purpose was to examine trends and associations between these and outcomes of rotator cuff surgery. Methods 148 patients (76 W:72 M, 55.1 ± 8.2 years) with unilateral symptomatic rotator cuff syndrome were followed for 1 year after surgery. The Western Ontario Rotator Cuff Score (WORC), the Pain Catastrophizing Score (PCS), and the Hospital Anxiety and Depression Score (HADS) were administered. Evolution and associations of WORC, HADS and PCS scores were examined using uni- and multivariate analyzes. Results At 1 year, PCS, HADS-A, and HADS-D scores negatively correlated with WORC score (R = -0.6, -0.61, -0.69). The strength of correlation was lower between baseline PCS, HADS-A, and HADS-D scores and 1-year WORC score (R = -0.38, -0.43, -0.42). Prior anxiety diagnosis was associated with higher HADS-A scores at 2- and 6- weeks post-op (p = 0.013, 0.011). 106 participants experienced an improving HADS-D over the year of follow-up. Worse pre-op pain, WORC, PCS, HADS-A, HADS-D, cardiovascular disease and current smoking were associated with non-improving HADS-D. Discussion Patient-reported outcomes of rotator cuff surgery are associated with patient-reported anxiety, depression, and pain catastrophizing. In many, all outcome scores improved over time suggesting a two-way association between shoulder condition and psychological parameters. Level of evidence II.
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Affiliation(s)
- MT Sabo
- SCRUBS Research Unit, University of Calgary, Calgary, AB, Canada
| | - A Walker
- Department of Anaesthesia, University of Calgary, Calgary, AB, Canada
| | | | - KA Hildebrand
- Department of Surgery, University of Calgary, Calgary, AB, Canada
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2
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Muacevic A, Adler JR, Alharthi EK, Alhossaini ZA, Alkurayzi AH, Alharthi N, Filfilan NN. LifeStyle and Exercise Relation to Neck and Back Pain in Saudi Arabia. Cureus 2022; 14:e32979. [PMID: 36582417 PMCID: PMC9794101 DOI: 10.7759/cureus.32979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Personal anguish, incapacity, and a decline in work and life quality are all associated with neck and low back pain, making it a significant socioeconomic burden for individuals and society. It is well known that engaging in regular physical exercise has considerable health benefits. OBJECTIVE The purpose of this research was to investigate the factors contributing to the high rates of musculoskeletal pain experienced by the Saudi Arabian population. METHODS This population-based, cross-sectional study was done in Saudi Arabia with 2,717 participants aged 18 to 60. A questionnaire was provided online to assess neck, shoulder, and lower back discomfort, time spent in general or aerobic physical activity, time spent sitting, sleep problems, general health, work satisfaction, and nutrition. Using logistic regression, we observed potential risk factors for musculoskeletal pain. RESULTS The prevalence of neck pain, shoulder pain, and lower back pain (LBP) were found to be 48.1%, 47.6%, and 63.8%, respectively. It was found that being a female (OR=1.78 [1.41-2.25], p<0.001), married (OR=1.58 [1.34-1.86], p<0.001), and having poor general health status (OR=3.78 [2.2-6.49], p<0.001), sleep disturbances (OR=2.46 [2.04-2.97], p<0.001) and poor job satisfaction (OR=1.29 [1.05-1.60], p=0.016) were independently associated with the prevalence of musculoskeletal pain. The diet of the individuals did not significantly influence the prevalence of MSPs. CONCLUSION Good general health, good sleep, and good job satisfaction were associated with a reduced risk of experiencing neck or shoulder pain, but there was no association between physical activity and MSPs Longitudinal studies are required to acquire a better understanding of the relationship between MSP, aerobic activity, sleep, and diet.
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Kruger-Steyn WM, Lubbe J, Louw KA, Asmal L. Depressive symptoms and quality of life prior to metabolic surgery in Cape Town, South Africa. S Afr J Psychiatr 2022; 28:1783. [PMID: 36263154 PMCID: PMC9575344 DOI: 10.4102/sajpsychiatry.v28i0.1783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 06/14/2022] [Indexed: 11/01/2022] Open
Abstract
Background Depression has been shown to have a negative impact on the outcomes of metabolic surgery and quality of life (QOL). Currently, there are limited data on mental distress and QOL in metabolic surgery candidates in South Africa. Aim This study aimed to determine the prevalence of depressive symptoms at the time of presurgical assessment in participants undergoing metabolic surgery. Setting The Obesity and Metabolic Surgery Initiative at Tygerberg Hospital. Methods We conducted pre-operatively a retrospective cross-sectional study on patients who underwent metabolic surgery from September 2017 to September 2019. Participants were profiled in terms of metabolic parameters, depressive symptoms and QOL. Results Of the 157 participants assessed, 88% were female with a body mass index in the super obese range. Twenty-two percent of participants had depressive symptoms. Metabolic surgery candidates with depressive symptoms had a significantly poorer overall QOL score compared with those without depressive symptoms. When controlling for all other variables, an increase in QOL score was shown to decrease the odds of current depressive symptoms, whilst back pain on non-narcotic medication and having had a stroke were found to increase the odds of current depressive symptoms. Conclusion This study highlights the complex interplay between metabolic, clinical and psychiatric factors in patients undergoing metabolic surgery. The study highlights the vital role of a psychiatrist as part of a multidisciplinary team pre- and post-operatively in the early identification of depressive symptoms. Psychiatrists may have an important role to play as part of the multidisciplinary team in metabolic surgery, including screening for mental health problems pre- and post-operatively, providing psychoeducation and relevant pharmacological treatment and psychotherapy where needed. Contribution This study expands our limited knowledge of psychiatric comorbidity (in particular depressive symptoms and associated factors) in people undergoing metabolic surgery in low- and middle-income countries.
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Affiliation(s)
- Wilma M. Kruger-Steyn
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Jeanne Lubbe
- Division of Surgery, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Kerry-Ann Louw
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Laila Asmal
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Liu L, Li X, Xue P, Wu M, Zeng S, Dai Y, Zhou J. Subjective Sleep Disruption and Mood Disorders are Associated with the Risk of Chronic Pain in Patients with Obstructive Sleep Apnea. Nat Sci Sleep 2022; 14:2023-2032. [PMID: 36394066 PMCID: PMC9651032 DOI: 10.2147/nss.s378246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 10/27/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE This study aimed to determine the prevalence of chronic pain and its risk factors in patients with obstructive sleep apnea (OSA). METHODS A total of 145 patients diagnosed with OSA were consecutively recruited from the Sleep Medicine Center in West China Hospital. All patients were divided into two groups including OSA with and without chronic pain. They were assessed the subjective sleep (Pittsburgh Sleep Quality Index, Insomnia Severity Index), objective sleep (polysomnography), mood symptoms (Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale), and pain characteristics (Short-Form McGill Pain Questionnaire). Demographic, clinical, subjective and objective sleep parameters were compared between OSA patients with and without chronic pain. Binary logistic regression models and linear regression models were used to examine the risk factors of chronic pain in OSA. RESULTS Fifty-five (37.9%) patients with OSA were diagnosed with chronic pain. There were more severe subjective sleep disruption and symptoms of anxiety and depression in patients with chronic pain compared to those without chronic pain. After controlling for potential confounders, poor subjective sleep quality and severe insomnia and mood disorders (all ps < 0.05), but not objective sleep fragmentation or nocturnal hypoxemia (all ps > 0.05) were associated with the increased risk of pain and pain intensity, respectively. CONCLUSION More than one-third of patients with OSA had chronic pain. Subjective sleep disruption and mood disorders are the risk factors of chronic pain in OSA. Our findings suggest that subjective sleep quality should be valued highly in the relationship between OSA and pain.
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Affiliation(s)
- Liu Liu
- Department of Anesthesiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, People's Republic of China
| | - Xiao Li
- Department of Psychology, Sleep Research Clinic and Laboratory, the University of Hong Kong, Hong Kong Special Administrative Regions, People's Republic of China.,State Key Laboratory of Brain and Cognitive Sciences, the University of Hong Kong, Hong Kong Special Administrative Regions, People's Republic of China
| | - Pei Xue
- Sleep Medicine Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Min Wu
- Sleep Medicine Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Si Zeng
- Department of Anesthesiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, People's Republic of China
| | - Yuee Dai
- Department of Anesthesiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, People's Republic of China
| | - Junying Zhou
- Sleep Medicine Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China.,Department of Neurology, West China Hospital, Sichuan University, Chengdu, People's Republic of China
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Gibson E, LeBlanc J, Sabo MT. Prior mood disorder diagnoses do not relate to current mood disorder symptoms or patient-reported disease severity in rotator cuff patients. Shoulder Elbow 2021; 13:683-690. [PMID: 34804218 PMCID: PMC8600670 DOI: 10.1177/1758573220947025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 07/13/2020] [Accepted: 07/13/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Surgery for rotator cuff syndrome does not always produce symptom improvement. Biological factors may explain some symptoms, but mood disorder symptoms may also contribute. The purpose of this study is to examine the interaction between disease severity, prevalence of mood disorder diagnoses, and current mood disorder symptoms in preoperative rotator cuff patients. METHODS A prospective cohort of patients aged 35-75 years with unilateral rotator cuff disease awaiting surgery participated. Demographics, psychiatric history, the Hospital Anxiety & Depression Scale, and the Western Ontario Rotator Cuff index were collected. Descriptive and univariate statistical testing was performed. RESULTS Of 140 participants (75M:65W) aged 55 ± 8 years, 34 reported a prior diagnosis of a mood disorder. There was a moderate positive relationship between disease severity and current depression and anxiety scores. Women were more likely to carry a diagnosis of a mood disorder, but there were no differences in current symptom levels between genders. No differences were found in patient-reported outcome measure scores between patients with and without a mood disorder diagnosis. DISCUSSION Current mood disorder symptoms were associated with greater disease severity, whereas the presence of a past mood disorder diagnosis was not. Awareness of this relationship may reduce bias about past mood disorder diagnoses during decision-making.
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Affiliation(s)
- Eric Gibson
- Sport Injury Prevention Research Centre,
University of Calgary, Calgary, Canada,South Campus Research Unit for Bone and
Soft Tissue, University of Calgary, Calgary, Canada,Eric Gibson, Sport Injury Prevention
Research Centre, 2500 University Drive NW, Calgary, Alberta, Canada T2N 1N4.
| | - Justin LeBlanc
- South Campus Research Unit for Bone and
Soft Tissue, University of Calgary, Calgary, Canada,Section of Orthopaedic Surgery, Cumming
School of Medicine, University of Calgary, Calgary, Canada
| | - Marlis T Sabo
- South Campus Research Unit for Bone and
Soft Tissue, University of Calgary, Calgary, Canada,Section of Orthopaedic Surgery, Cumming
School of Medicine, University of Calgary, Calgary, Canada
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Pasco JA, Sui SX, West EC, Holloway‐Kew KL, Hyde NK, Stuart AL, Gaston J, Williams LJ. Operational definitions of sarcopenia should consider depressive symptoms. JCSM CLINICAL REPORTS 2021. [DOI: 10.1002/crt2.32] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Julie A. Pasco
- Deakin University, IMPACT ‐ Institute for Mental and Physical Health and Clinical Translation Geelong VIC 3220 Australia
- Department of Medicine‐Western Health The University of Melbourne St Albans VIC Australia
- Barwon Health Geelong VIC Australia
- Department of Epidemiology and Preventive Medicine Monash University Melbourne VIC Australia
| | - Sophia X. Sui
- Deakin University, IMPACT ‐ Institute for Mental and Physical Health and Clinical Translation Geelong VIC 3220 Australia
| | - Emma C. West
- Deakin University, IMPACT ‐ Institute for Mental and Physical Health and Clinical Translation Geelong VIC 3220 Australia
| | - Kara L. Holloway‐Kew
- Deakin University, IMPACT ‐ Institute for Mental and Physical Health and Clinical Translation Geelong VIC 3220 Australia
| | - Natalie K. Hyde
- Deakin University, IMPACT ‐ Institute for Mental and Physical Health and Clinical Translation Geelong VIC 3220 Australia
| | - Amanda L. Stuart
- Deakin University, IMPACT ‐ Institute for Mental and Physical Health and Clinical Translation Geelong VIC 3220 Australia
| | - James Gaston
- Deakin University, IMPACT ‐ Institute for Mental and Physical Health and Clinical Translation Geelong VIC 3220 Australia
| | - Lana J. Williams
- Deakin University, IMPACT ‐ Institute for Mental and Physical Health and Clinical Translation Geelong VIC 3220 Australia
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Antioch I, Ilie OD, Ciobica A, Doroftei B, Fornaro M. Preclinical Considerations about Affective Disorders and Pain: A Broadly Intertwined, yet Often Under-Explored, Relationship Having Major Clinical Implications. MEDICINA (KAUNAS, LITHUANIA) 2020; 56:E504. [PMID: 32992963 PMCID: PMC7600172 DOI: 10.3390/medicina56100504] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 09/16/2020] [Accepted: 09/23/2020] [Indexed: 12/11/2022]
Abstract
Background: Pain, a distinctive undesirable experience, encompasses several different and fluctuating presentations across varying mood disorders. Therefore, the present narrative review aimed to shed further light on the matter, accounting for both experimental animal models and clinical observations about major depressive disorder (MDD) pathology. Method: Major databases were inquired from inception until April 2016 for records about MDD and pain. Results: Pain and MDD are tightly associated with each other in a bi-directional fashion. Several cross-sectional and retrospective studies indicated a high presence of pain in the context of mood disorders, including MDD (up to 65%), but also increased prevalence rates in the case of mood disorders documented among people with a primary diagnosis of either psychological or somatic pain (prevalence rates exceeding 45%). The clinical implications of these observations suggest the need to account for mood and pain manifestations as a whole rather than distinct entities in order to deliver more effective interventions. Limitations: Narrative review, lack of systematic control groups (e.g., people with the primary diagnosis at review, but not the associated comorbidity as a study) to allow reliable comparisons. Prevalence rates and clinical features associated with pain varied across different studies as corresponding operational definitions did. Conclusions: Pain may have a detrimental effect on the course of mood disorders-the opposite holds. Promoting a timely recognition and management of such an often neglected comorbidity would therefore represent a primary goal toward the delivery of effective, multi-disciplinary care.
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Affiliation(s)
- Iulia Antioch
- Department of Research, Faculty of Biology, “Alexandru Ioan Cuza” University, Carol I Avenue, no 11, 700505 Iasi, Romania; (I.A.); (O.-D.I.)
| | - Ovidiu-Dumitru Ilie
- Department of Research, Faculty of Biology, “Alexandru Ioan Cuza” University, Carol I Avenue, no 11, 700505 Iasi, Romania; (I.A.); (O.-D.I.)
| | - Alin Ciobica
- Department of Research, Faculty of Biology, “Alexandru Ioan Cuza” University, Carol I Avenue, no 11, 700505 Iasi, Romania; (I.A.); (O.-D.I.)
| | - Bogdan Doroftei
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street, no 16, 700115 Iasi, Romania
| | - Michele Fornaro
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY 10027, USA;
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8
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Sui SX, Holloway-Kew KL, Hyde NK, Williams LJ, Tembo MC, Mohebbi M, Gojanovic M, Leach S, Pasco JA. Handgrip strength and muscle quality in Australian women: cross-sectional data from the Geelong Osteoporosis Study. J Cachexia Sarcopenia Muscle 2020; 11:690-697. [PMID: 32061063 PMCID: PMC7296267 DOI: 10.1002/jcsm.12544] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 12/05/2019] [Accepted: 01/07/2020] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Low handgrip strength (HGS) is a measure of poor skeletal muscle performance and a marker of ill health and frailty. Muscle quality (MQ) is a measure of muscle strength relative to muscle mass. We aimed to develop normative data for HGS and MQ, report age-related prevalence of low HGS and MQ, and determine the relationship with age, anthropometry, and body composition for women in Australia. METHODS This cross-sectional analysis included data from 792 women (ages 28-95 years) assessed by the Geelong Osteoporosis Study. Duplicate measures of HGS were performed for each hand with a dynamometer (Jamar) and the mean of maximum values used for analyses. Dual energy X-ray absorptiometry-derived lean mass for the arms was used to calculate MQ as HGS/lean mass (kg/kg). Body mass index (BMI) was categorized as normal (BMI < 25.0 kg/m2 ), overweight (25.0-29.9 kg/m2 ), and obese (>30.0 kg/m2 ). Fat mass index (FMI) was calculated as whole body fat/height2 (kg/m2 ) and appendicular lean mass index (ALMI) as lean mass of arms and legs/height2 (kg/m2 ). RESULTS Mean (±SD) of HGS values for normal BMI, overweight, and obese groups were 25 (±7), 24 (±7), and 24 (±7) kg, P = 0.09, and for MQ, 12 (±3), 11 (±3), and 10 (±3) kg/kg, P < 0.001. Our data indicated a quadratic relationship between age and HGS or MQ. Mean HGS and MQ remained stable until the fifth age decade then declined steadily with increasing age; therefore, we used data for women (n = 283) aged 28-49 years as the young adult reference group, with mean (SD) values for HGS 28 (±6) kg and MQ 12 (±3) kg/kg. The prevalence of low (T-score < -2) HGS and MQ for women 80 years and older was 52.2% and 39.6%, respectively. In multivariable models, age-adjusted HGS was associated with FMI (B = -0.13, P = 0.004) and ALMI (1.03, <0.001) while age-adjusted MQ was associated with BMI (-0.15, <0.001) but not with FMI. In a sensitivity analysis, the same pattern remained after the removal of 129 women who reported hand and/or arm pain. CONCLUSIONS Mean HGS and MQ declined with advancing age in older women. Our data suggest that while mean HGS increased with appendicular lean mass and decreased with body fat mass, there was no association with BMI. By contrast, MQ decreased with increasing BMI, but not with increasing adiposity.
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Affiliation(s)
- Sophia X Sui
- School of Medicine, Deakin University, Geelong, VIC, Australia
| | | | - Natalie K Hyde
- School of Medicine, Deakin University, Geelong, VIC, Australia
| | - Lana J Williams
- School of Medicine, Deakin University, Geelong, VIC, Australia
| | - Monica C Tembo
- School of Medicine, Deakin University, Geelong, VIC, Australia
| | - Mohammadreza Mohebbi
- Biostatistics Unit, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | | | | | - Julie A Pasco
- School of Medicine, Deakin University, Geelong, VIC, Australia.,Department of Medicine-Western Campus, The University of Melbourne, St Albans, VIC, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia.,Barwon Health, University Hospital Geelong, Geelong, VIC, Australia
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Fuentecilla JL, Huo M, Birditt KS, Charles ST, Fingerman KL. Interpersonal Tensions and Pain Among Older Adults: The Mediating Role of Negative Mood. Res Aging 2020; 42:105-114. [PMID: 31709931 PMCID: PMC7944576 DOI: 10.1177/0164027519884765] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To examine whether (a) negative social encounters and physical pain are linked throughout the day, (b) negative mood mediates these associations, and (c) these associations vary by closeness with social partners. METHOD Adults aged 65+ (n = 313) completed ecological momentary assessments and reported their negative social encounters, physical pain, and mood every 3 hr throughout the day for 5-6 days. RESULTS Multilevel models revealed that negative social encounters were associated with greater pain at each 3-hr interval and that this association was mediated by negative mood during the same interval. Negative encounters with less close partners were associated with pain, but negative encounters with close partners were not. DISCUSSION Regulating older adults' negative emotions may be crucial to improving their daily pain. Further, interventions focusing on negative encounters with less close partners in daily life may help mitigate older adults' experiences of pain throughout the day.
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Affiliation(s)
| | - Meng Huo
- Department of Human Ecology, University of California, Davis, CA, USA
| | - Kira S. Birditt
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Susan T. Charles
- Department of Psychology and Social Behavior, University of California, Irvine, CA, USA
| | - Karen L. Fingerman
- Department of Human Development and Family Sciences, The University of Texas at Austin, TX, USA
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10
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The Complex Interplay of Pain, Depression, and Anxiety Symptoms in Patients With Chronic Pain. Clin J Pain 2019; 36:249-259. [DOI: 10.1097/ajp.0000000000000797] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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A Systematic Review of Atypical Antipsychotics in Chronic Pain Management: Olanzapine Demonstrates Potential in Central Sensitization, Fibromyalgia, and Headache/Migraine. Clin J Pain 2019; 34:585-591. [PMID: 29077621 DOI: 10.1097/ajp.0000000000000567] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Many psychopharmacologic agents are used as primary or adjuncts in pain management. Atypical antipsychotics (AAs) have also been used as adjuncts in pain management regimens in a variety of manners; however, their efficacy in this capacity is unclear. METHODS A systematic review of all studies examining AA use for pain was conducted. Three literature databases were utilized to search for word combinations of "pain" and a variety of commonly prescribed AAs ie, (olanzapine, quetiapine, risperidone, aripiprazole, ziprasidone, clozapine, paliperidone, iloperidone, lurasidone). Articles chosen for review included retrospective analyses, randomized control trials, and case series/reports. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses diagram illustrates the study selection process. RESULTS Olanzapine, quetiapine, risperidone, aripiprazole, and ziprasidone are the only AAs with published studies in pain management. Among these, olanzapine and quetiapine have the most studies (11 and 6, respectively). Olanzapine shows preliminary and consistent efficacy in fibromyalgia and headache/migraine, although only 1 study was a randomized controlled trial with level I evidence of efficacy. Other AAs eg, (quetiapine) fail to demonstrate efficacy in pain syndromes and/or lack robust study designs. CONCLUSIONS Few studies have been conducted to evaluate the analgesic effects of AAs. The collective findings of multiple studies evaluating olanzapine in pain syndromes suggest a high, yet preliminary level of evidence of efficacy, warranting prospective studies in various pain syndrome contexts. Pharmacological mechanisms of AA action are elaborated, and the findings of this review are discussed. Risk and benefits of using AAs in chronic pain are described, and investigational implications and future directions are explored.
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Kessing LV, Rytgaard HC, Gerds TA, Berk M, Ekstrøm CT, Andersen PK. New drug candidates for bipolar disorder-A nation-wide population-based study. Bipolar Disord 2019; 21:410-418. [PMID: 30873730 DOI: 10.1111/bdi.12772] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVE Drug repurposing is an increasingly promising idea in many fields of medicine. We systematically used Danish nation-wide population-based registers to investigate whether continued use of non-aspirin non-steroidal anti-inflammatory drugs (NSAIDs), low-dose aspirin, high-dose aspirin, statins, allopurinol, and angiotensin agents decrease the rate of incident mania/bipolar disorder. METHODS A nation-wide population-based longitudinal study using Poisson regression analyses including all persons in Denmark who purchased the exposure medication of interest and a random sample of 30% of the Danish population. The follow-up period comprised a 10 years period from 2005 to 2015. Two different outcome measures were included, (1) a diagnosis of mania/bipolar disorder at a psychiatric hospital contact as inpatient or outpatient and (2) a combined measure of a diagnosis of mania/bipolar disorder or initiation of lithium use. RESULTS A total of 1,605,365 subjects were exposed to one of the six drugs of interest during the exposure period from 2005 to 2015, median age 57 years [quartiles: 43;69], and female proportion of 53.1%. Continued use of low-dose aspirin, statins, and angiotensin agents were associated with decreased rates of incident mania/bipolar disorder on both outcome measures. Continued uses of non-aspirin NSAIDs as well as high-dose aspirin were associated with an increased rate of incident bipolar disorder. There were no statistically significant associations for allopurinol. CONCLUSIONS The study supports the potential of agents acting on inflammation and the stress response system in bipolar disorder and illustrates that population-based registers can be used to systematically identify drugs with repurposing potentials.
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Affiliation(s)
- Lars V Kessing
- Psychiatric Center Copenhagen, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Helene C Rytgaard
- Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Thomas A Gerds
- Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Michael Berk
- School of Medicine, Deakin University, Melbourne, Australia.,Orygen, The National Centre of Excellence in Youth Mental Health, Department of Psychiatry, Florey Institute for Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
| | - Claus T Ekstrøm
- Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Per K Andersen
- Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark
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Peng W, Meng J, Lou Y, Li X, Lei Y, Yan D. Reduced empathic pain processing in patients with somatoform pain disorder: Evidence from behavioral and neurophysiological measures. Int J Psychophysiol 2019; 139:40-47. [DOI: 10.1016/j.ijpsycho.2019.03.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 03/12/2019] [Accepted: 03/12/2019] [Indexed: 01/09/2023]
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Gil JA, Gunaseelan V, DeFroda SF, Brummett CM, Bedi A, Waljee JF. Risk of Prolonged Opioid Use Among Opioid-Naïve Patients After Common Shoulder Arthroscopy Procedures. Am J Sports Med 2019; 47:1043-1050. [PMID: 30735622 PMCID: PMC7303922 DOI: 10.1177/0363546518819780] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Opioid-related morbidity and mortality are major public health concerns, and the risk of long-term opioid use after shoulder arthroscopy is not well defined. HYPOTHESIS Substance abuse disorders, pain disorders, and psychiatric conditions increase the risk for prolonged opioid use. STUDY DESIGN Case-control study, Level of evidence, 3. METHODS Insurance claims data from the Truven Health MarketScan Research Databases was used to identify patients who underwent shoulder arthroscopy between January 1, 2010, and March 31, 2015. Opioid-naïve patients were included. New prolonged opioid use was defined as continued opioid use between 91 and 180 days after the index procedure. The authors used a multivariable logistic regression model to identify patient factors associated with the risk of new prolonged opioid use. RESULTS In this cohort of 104,154 opioid-naïve adult patients, 8686 (8.3%) developed new prolonged opioid use as defined in this study. A total of 31,768 (30.5%) filled an opioid prescription in the 30 days before surgery. Patients who had limited debridement had the highest prolonged use rate (9.0%), followed by rotator cuff repair (8.5%), anterior labrum lesion repair (8.5%), and extensive debridement (8.2%). Patient characteristics associated with the highest odds ratios (ORs) of prolonged opioid use included those who had a total opioid dose during the perioperative period that was ≥743 oral morphine equivalents (ie, at least 149 tablets of 5-mg hydrocodone) (OR, 2.0; 95% CI, 1.9-2.1), followed by patients with a suicide and self-harm disorder (OR, 2.0; 95% CI, 1.1-3.4), a history of alcohol dependence or abuse (OR, 1.6; 95% CI, 1.3-1.9), a mood disorder (OR, 1.3; 95% CI, 1.2-1.4), an opioid prescription filled in the 30 days before surgery (OR, 1.3; 95% CI, 1.2-1.4), female sex (OR, 1.3; 95% CI, 1.2-1.3), an anxiety disorder (OR, 1.2; 95% CI, 1.1-1.3), and a history of a pain diagnosis (OR, 1.2; 95% CI, 1.1-1.2). CONCLUSION The risk of prolonged opioid use after arthroscopic shoulder procedures is 8.3%, and it is higher among women and among those with greater opioid use in the early postoperative period, mental health conditions, substance dependence and abuse, and preexisting pain disorders. Patients at high risk warrant close surveillance after surgery for early recognition and management.
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Affiliation(s)
- Joseph A Gil
- Department of Orthopaedic Surgery, Brown University, Providence, Rhode Island, USA
| | - Vidhya Gunaseelan
- Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Steven F DeFroda
- Department of Orthopaedic Surgery, Brown University, Providence, Rhode Island, USA
| | - Chad M Brummett
- Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Asheesh Bedi
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Jennifer F Waljee
- Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA
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Pain LAM, Baker R, Sohail QZ, Hebert D, Zabjek K, Richardson D, Agur AMR. The three-dimensional shoulder pain alignment (3D-SPA) mobilization improves pain-free shoulder range, functional reach and sleep following stroke: a pilot randomized control trial. Disabil Rehabil 2019; 42:3072-3083. [PMID: 30907155 DOI: 10.1080/09638288.2019.1585487] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background and purpose: Following a stroke, three-dimensional clavicular/scapular/humeral joint rotations may become restricted and contribute to post-stroke shoulder pain. This study examined whether a treatment group provided with current standard treatment plus the proposed "Three-dimensional Shoulder Pain Alignment" mobilization protocol demonstrated improved pain-free shoulder range, functional reach and sleep compared to a control group provided with standard treatment alone.Methods: In this double-blinded parallel-group randomized control trial, treatment and control subjects with moderate/severe post-stroke upper extremity impairment and shoulder pain were treated 3x/week for 4 weeks. Outcome measures included changes in pain-free three-dimensional clavicular/scapular/humeral range (using computerized digitization), pain during sleep and functional reach (using the Pain Intensity-Numerical Rating Scale), and pain location/prognostic indicators (using the Chedoke-McMaster Stroke Assessment-Shoulder Pain Inventory).Results: Compared to controls (n = 10) the treatment group (n = 10) demonstrated significantly improved three-dimensional clavicular/scapular/humeral pain-free range during shoulder flexion and abduction (p < 0.05; Hedges g > 0.80), large effect sizes for decreased pain during sleep and functional reach to the head and back (OR range: 5.44-21.00), and moderate effect size for improved pain/prognostic indicators (OR = 3.86).Conclusions: The Three-Dimensional Shoulder Pain Alignment mobilization protocol significantly improved pain-free range of motion, functional reach and pain during sleep in shoulders with moderate/severe post-stroke upper-extremity impairment.Implications for rehabilitationAlthough three-dimensional clavicular/scapular/humeral rotations are an essential component of normal pain-free shoulder range of motion, current guidelines for treatment of post-stroke shoulder pain only includes uni-dimensional mobilizations for joint alignment and pain management.The Three-Dimensional Shoulder Pain Alignment (3D-SPA) mobilization protocol incorporates multi-dimensional mobilizations in various planes of shoulder movement.The current study results demonstrate proof-of-concept regarding the 3D-SPA mobilization, and this approach should be considered as an alternative to the uni-dimensional mobilizations currently used in clinical treatment guidelines for post-stroke shoulder pain.
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Affiliation(s)
- Liza A M Pain
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.,Senior Services, Credit Valley Hospital-Trillium Health Partners, Mississauga, Canada.,Department of Medicine, University of Toronto, Toronto, Canada
| | - Ross Baker
- Department of Medicine, University of Toronto, Toronto, Canada
| | | | - Debbie Hebert
- Toronto Rehabilitation Institute (University Centre), University Health Network, Toronto, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Karl Zabjek
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.,Toronto Rehabilitation Institute (University Centre), University Health Network, Toronto, Canada.,Department of Physical Therapy, University of Toronto, Toronto, Canada
| | - Denyse Richardson
- Department of Medicine, University of Toronto, Toronto, Canada.,Department of Neuro-rehabilitation, Toronto Rehabilitation Institute-University Health Network, Toronto, Canada
| | - Anne M R Agur
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.,Department of Medicine, University of Toronto, Toronto, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
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16
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Kessing LV, Rytgaard HC, Gerds TA, Berk M, Ekstrøm CT, Andersen PK. New drug candidates for depression - a nationwide population-based study. Acta Psychiatr Scand 2019; 139:68-77. [PMID: 30182363 DOI: 10.1111/acps.12957] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/15/2018] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To investigate whether continued use of non-aspirin NSAID, low-dose aspirin, high-dose aspirin, statins, allopurinol and angiotensin agents decreases the rate of incident depression using Danish nationwide population-based registers. METHODS All persons in Denmark who purchased the exposure medications of interest between 1995 and 2015 and a random sample of 30% of the Danish population was included in the study. Two different outcome measures were included, (i) a diagnosis of depressive disorder at a psychiatric hospital as in-patient or out-patient and (ii) a combined measure of a diagnosis of depression or use of antidepressants. RESULTS A total of 1 576 253 subjects were exposed to one of the six drugs of interest during the exposure period from 2005 to 2015. Continued use of low-dose aspirin, statins, allopurinol and angiotensin agents was associated with a decreased rate of incident depression according to both outcome measures. Continued uses of non-aspirin NSAIDs as well as high-dose aspirin were associated with an increased rate of incident depression. CONCLUSION The findings support the potential of agents acting on inflammation and the stress response system in depression as well as the potential of population-based registers to systematically identify drugs with repurposing potential.
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Affiliation(s)
- L V Kessing
- Copenhagen Affective Disorder reaserch Center (CADIC), Psychiatric Center Copenhagen, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - H C Rytgaard
- Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - T A Gerds
- Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - M Berk
- School of Medicine, Deakin University, Geelong, Vic, Australia.,Orygen, The National Centre of Excellence in Youth Mental Health, the Department of Psychiatry, and the Florey Institute for Neuroscience and Mental Health, University of Melbourne, Melbourne, Vic, Australia
| | - C T Ekstrøm
- Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - P K Andersen
- Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark
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17
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Lamarca GDA, Vettore MV, Monteiro da Silva AM. The Influence of Stress and Anxiety on the Expectation, Perception and Memory of Dental Pain in Schoolchildren. Dent J (Basel) 2018; 6:dj6040060. [PMID: 30360395 PMCID: PMC6313345 DOI: 10.3390/dj6040060] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 09/14/2018] [Accepted: 10/11/2018] [Indexed: 01/06/2023] Open
Abstract
The aim of this study was to investigate the association of stress and anxiety with the expectation, perception and memory of dental pain among schoolchildren. A follow-up study involving 46 children aged 9 to 12 years was conducted in a public school in the city of Petropolis (RJ), Brazil. Demographic characteristics, stress (children's stress scale), and state and trait anxiety (state⁻trait anxiety inventory) were recorded before a dental procedure to restore the occlusal surface of a permanent first molar under local anaesthetic. Dental pain was assessed using the faces pain scale before (dental pain expectation), immediately after (dental pain perception) and six weeks after (memory of dental pain) the dental procedure. Dental pain expectation scores were significantly higher than dental pain perception, independent of the levels of stress, state anxiety and trait anxiety. Children with high scores of stress (OR 1.05 95%CI 1.02⁻1.09), state anxiety (OR 1.15 95%CI 1.05⁻1.27) and trait anxiety (OR 1.18 95%CI 1.07⁻1.30) were more likely to report greater scores of dental pain expectation. Children anticipated more dental pain than what was actually perceived after the dental restoration. Children with greater levels of stress and anxiety have a distorted evaluation of expected dental pain before the dental procedure.
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Affiliation(s)
- Gabriela de A Lamarca
- Centre of Studies, Policies and Information on Social Determinants of Health, National School of Public Health, Oswaldo Cruz, Foundation, Rio de Janeiro 21041-210, Brazil.
| | - Mario V Vettore
- Academic Unit of Oral Health, Dentistry and Society, University of Sheffield, Sheffield S10 2TA, UK.
| | - Angela M Monteiro da Silva
- Academia Brasileira de Ciências e Artes Orientais, Av Nossa Senhora de Copacabana, 928, 5º andar, Copacabana, Rio de Janeiro 22060-002, Brazil.
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18
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Simonton AJ, Young CC, Brown RA. Physical Activity Preferences and Attitudes of Individuals With Substance Use Disorders: A Review of the Literature. Issues Ment Health Nurs 2018; 39:657-666. [PMID: 29505733 DOI: 10.1080/01612840.2018.1429510] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Substance use disorders (SUDs) are prevalent in the United States and costly to society. SUDs contribute significantly to decreased quality of life and overdose deaths. Physical activity (PA) interventions may be one efficacious method to improve recovery and long-term abstinence from substance use; although PA interventions have resulted in positive physical and psychological outcomes, their adherence and attrition rates have been problematic. To address lack of adherence and high attrition rates, it is important to understand the preferences and attitudes for PA among patients in SUD treatment. We, therefore, conducted a literature review to examine preferences and attitudes for PA among adults with SUDs. Five articles met inclusion and exclusion criteria. The findings from this small sample of studies suggest that adults with SUDs are interested in PA. Walking, strength training, and cycling were the activities preferred most frequently. Participants said that they would like to engage in these activities either alone or with small groups and would prefer their exercise options to be located at facilities they already frequented, such as treatment clinics. Nurses are well positioned to assess patient preferences and attitudes and to enhance recovery efforts in this population. Further exploration of this population's unique preferences and attitudes regarding PA may lay the groundwork for efficacious PA interventions with improved adherence and attrition rates, which may lead to improved recovery outcomes.
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Affiliation(s)
- Amanda J Simonton
- a School of Nursing , The University of Texas at Austin , Austin , Texas , USA
| | - Cara C Young
- a School of Nursing , The University of Texas at Austin , Austin , Texas , USA
| | - Richard A Brown
- a School of Nursing , The University of Texas at Austin , Austin , Texas , USA
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19
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Rambod M, Sharif F, Molazem Z, Khair K, von Mackensen S. Health-Related Quality of Life and Psychological Aspects of Adults With Hemophilia in Iran. Clin Appl Thromb Hemost 2018; 24:1073-1081. [PMID: 29575928 PMCID: PMC6714756 DOI: 10.1177/1076029618758954] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Hemophilia causes bleeding that may affect patients’ psychological aspects and quality of life. This study aims to evaluate the impact of psychological aspects and pain on health-related quality of life (HRQoL) in adult patients with hemophilia. This cross-sectional study was conducted on 103 patients with hemophilia. Data were collected using hemophilia-specific quality of life, Depression Anxiety Stress Scales, and pain visual analogue scales. Data were analyzed using correlation coefficients, analysis of covariance, and regression analysis. The results showed that 71.7% of patients with hemophilia experienced pain on the study day. The mean score of HRQoL of patients with hemophilia was 51.09 (standard deviation = 19.37). Moreover, 57.4%, 64.6%, and 44.6% of the patients had mild to severe depression, anxiety, and stress, respectively. In addition, a significant association was observed between HRQoL and depression, anxiety, and severity of pain. In the regression model, 48% of changes in HRQOL were explained by the study variables, with the severity of pain and depression being significant predictors. Therefore, attention should be paid to these aspects to improve patients’ quality of life and psychosocial health.
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Affiliation(s)
- Masoume Rambod
- 1 Department of Medical Surgical Nursing, Community-Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farkhondeh Sharif
- 2 Department of Mental Health and Psychiatric Nursing, Community-Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Molazem
- 1 Department of Medical Surgical Nursing, Community-Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kate Khair
- 3 Haemophilia Centre, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.,4 London South Bank University, London, UK
| | - Sylvia von Mackensen
- 5 Institute of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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20
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Ortego G, Villafañe JH, Doménech-García V, Berjano P, Bertozzi L, Herrero P. Is there a relationship between psychological stress or anxiety and chronic nonspecific neck-arm pain in adults? A systematic review and meta-analysis. J Psychosom Res 2016; 90:70-81. [PMID: 27772562 DOI: 10.1016/j.jpsychores.2016.09.006] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 07/28/2016] [Accepted: 09/08/2016] [Indexed: 11/20/2022]
Abstract
PURPOSE To systematically review and analyze the research evidence linking stress or anxiety to chronic nonspecific neck-arm pain (NSNAP) in adults. SUBJECTS AND METHODS Data were obtained from Pubmed, Scopus, PsycInfo, Web of Science, Physiotherapy Evidence Database (PEDro) and The Cochrane library database from their inception to July 2015. Two authors independently conducted the searches, extracted data, and completed methodological quality assessments. The methodological quality of the cohort and case-control studies was evaluated using the Newcastle-Ottawa scale, whilst the quality of the Randomized Controlled Trial (RCT) was evaluated using the PEDro scale. RESULTS Twenty-eight studies involving 39,166 participants met the inclusion criteria. Four studies, including 5 pair-wise comparisons, were included in the meta-analysis: Three were cohort studies and 1 was a cross-sectional study. The meta-analysis outcome demonstrated a relationship between chronic NSNAP and psychological stress. The estimate odds ratio for all studies combined was 2.33 (95% CI, 1.04-5.18; p=0.039). A high heterogeneity of the findings appeared (Q=28.94, I2=86% p=0.00). CONCLUSION This study shows that there is a strong relationship between stress and chronic NSNAP. Despite this finding, we cannot support that stress is a risk factor for chronic NSNAP due to the low quality of the results according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE). It was not possible to make a quantitative analysis comparing the relationship between anxiety and chronic NSNAP. However, according to the qualitative analysis there is a strong relationship between anxiety and chronic NSNAP.
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Affiliation(s)
- Gorka Ortego
- iPhysio Research Group, Universidad San Jorge, Campus Universitario, Autov A23 km 299, 50830, Villanueva de Gállego Zaragoza, Spain.
| | | | - Victor Doménech-García
- iPhysio Research Group, Universidad San Jorge, Campus Universitario, Autov A23 km 299, 50830, Villanueva de Gállego Zaragoza, Spain
| | | | | | - Pablo Herrero
- iPhysio Research Group, Universidad San Jorge, Campus Universitario, Autov A23 km 299, 50830, Villanueva de Gállego Zaragoza, Spain
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21
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Butterworth PA, Menz HB, Urquhart DM, Cicuttini FM, Landorf KB, Pasco JA, Brennan SL, Wluka AE. Fat Mass Is Associated with Foot Pain in Men: The Geelong Osteoporosis Study. J Rheumatol 2015; 43:138-43. [PMID: 26628606 DOI: 10.3899/jrheum.141331] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2015] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Foot pain is a common complaint in adults. Evidence suggests that body composition is involved in the development of foot pain. However, whether this is the case in men remains unclear because previous studies mainly examined women. The aim of this cross-sectional study was to determine the relationship between body composition and foot pain in men while accounting for important risk factors. METHODS Among 978 men (median age 60 yrs, range 24-98) from the Geelong Osteoporosis Study who participated in a followup study in 2006 to 2011, 796 provided responses to questions on health status and foot pain. Foot pain was determined using the Manchester Foot Pain and Disability Index, and body composition was measured using dual-energy x-ray absorptiometry. RESULTS Of the 796 respondents, 177 (22%) had foot pain. Risk factors for foot pain were age (OR 1.03, 95% CI 1.02-1.04), self-reported depression (OR 2.05, 95% CI 1.30-3.20), decreased mobility (OR 1.54, 95% CI 1.05-2.24), and lower education (OR 1.47, 95% CI 1.03-2.09). Foot pain was associated with body mass index (OR 1.05, 95% CI 1.00-1.10), fat mass (OR 1.02, 95% CI 1.03-1.05), and fat mass index (OR 1.08, 95% CI 1.01-1.15), but not fat-free mass (OR 1.01, 95% CI 0.98-1.04) or fat-free mass index (OR 1.05, 95% CI 0.95-1.15) after appropriate adjustments were made. CONCLUSION Fat mass is associated with foot pain in men. These findings complement those in studies that have mainly examined women, and provide further evidence for the relationship between obesity and foot pain.
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Affiliation(s)
- Paul A Butterworth
- From the Discipline of Podiatry, and Lower Extremity and Gait Studies Program, La Trobe University, Bundoora; School of Health and Human Sciences, Southern Cross University, Bilinga; Department of Epidemiology and Preventive Medicine (DEPM), School of Public Health and Preventive Medicine, Monash University; North-West Academic Centre, University of Melbourne; Australian Institute of Musculoskeletal Sciences, Melbourne; School of Medicine, Deakin University, Geelong, Australia.P.A. Butterworth, MPod, PhD candidate, La Trobe University; H.B. Menz, PhD, Professor, Director, Lower Extremity and Gait Studies Program, La Trobe University; D.M. Urquhart, PhD, Research Fellow, Monash University; F.M. Cicuttini, PhD, Professor, Musculoskeletal Unit, DEPM, Head Rheumatology Unit, Alfred Hospital; K.B. Landorf, PhD, Associate Professor, Research Coordinator, Discipline of Podiatry, La Trobe University; J.A. Pasco, PhD, Professor, Director, Epi-Centre for Healthy Ageing, Innovation in Mental and Physical Health and Clinical Treatment, Strategic Research Centre, Deakin University; S.L. Brennan, PhD, Research Fellow, Deakin University; A.E. Wluka, PhD, Associate Professor, Senior Research Fellow, Monash University
| | - Hylton B Menz
- From the Discipline of Podiatry, and Lower Extremity and Gait Studies Program, La Trobe University, Bundoora; School of Health and Human Sciences, Southern Cross University, Bilinga; Department of Epidemiology and Preventive Medicine (DEPM), School of Public Health and Preventive Medicine, Monash University; North-West Academic Centre, University of Melbourne; Australian Institute of Musculoskeletal Sciences, Melbourne; School of Medicine, Deakin University, Geelong, Australia.P.A. Butterworth, MPod, PhD candidate, La Trobe University; H.B. Menz, PhD, Professor, Director, Lower Extremity and Gait Studies Program, La Trobe University; D.M. Urquhart, PhD, Research Fellow, Monash University; F.M. Cicuttini, PhD, Professor, Musculoskeletal Unit, DEPM, Head Rheumatology Unit, Alfred Hospital; K.B. Landorf, PhD, Associate Professor, Research Coordinator, Discipline of Podiatry, La Trobe University; J.A. Pasco, PhD, Professor, Director, Epi-Centre for Healthy Ageing, Innovation in Mental and Physical Health and Clinical Treatment, Strategic Research Centre, Deakin University; S.L. Brennan, PhD, Research Fellow, Deakin University; A.E. Wluka, PhD, Associate Professor, Senior Research Fellow, Monash University
| | - Donna M Urquhart
- From the Discipline of Podiatry, and Lower Extremity and Gait Studies Program, La Trobe University, Bundoora; School of Health and Human Sciences, Southern Cross University, Bilinga; Department of Epidemiology and Preventive Medicine (DEPM), School of Public Health and Preventive Medicine, Monash University; North-West Academic Centre, University of Melbourne; Australian Institute of Musculoskeletal Sciences, Melbourne; School of Medicine, Deakin University, Geelong, Australia.P.A. Butterworth, MPod, PhD candidate, La Trobe University; H.B. Menz, PhD, Professor, Director, Lower Extremity and Gait Studies Program, La Trobe University; D.M. Urquhart, PhD, Research Fellow, Monash University; F.M. Cicuttini, PhD, Professor, Musculoskeletal Unit, DEPM, Head Rheumatology Unit, Alfred Hospital; K.B. Landorf, PhD, Associate Professor, Research Coordinator, Discipline of Podiatry, La Trobe University; J.A. Pasco, PhD, Professor, Director, Epi-Centre for Healthy Ageing, Innovation in Mental and Physical Health and Clinical Treatment, Strategic Research Centre, Deakin University; S.L. Brennan, PhD, Research Fellow, Deakin University; A.E. Wluka, PhD, Associate Professor, Senior Research Fellow, Monash University
| | - Flavia M Cicuttini
- From the Discipline of Podiatry, and Lower Extremity and Gait Studies Program, La Trobe University, Bundoora; School of Health and Human Sciences, Southern Cross University, Bilinga; Department of Epidemiology and Preventive Medicine (DEPM), School of Public Health and Preventive Medicine, Monash University; North-West Academic Centre, University of Melbourne; Australian Institute of Musculoskeletal Sciences, Melbourne; School of Medicine, Deakin University, Geelong, Australia.P.A. Butterworth, MPod, PhD candidate, La Trobe University; H.B. Menz, PhD, Professor, Director, Lower Extremity and Gait Studies Program, La Trobe University; D.M. Urquhart, PhD, Research Fellow, Monash University; F.M. Cicuttini, PhD, Professor, Musculoskeletal Unit, DEPM, Head Rheumatology Unit, Alfred Hospital; K.B. Landorf, PhD, Associate Professor, Research Coordinator, Discipline of Podiatry, La Trobe University; J.A. Pasco, PhD, Professor, Director, Epi-Centre for Healthy Ageing, Innovation in Mental and Physical Health and Clinical Treatment, Strategic Research Centre, Deakin University; S.L. Brennan, PhD, Research Fellow, Deakin University; A.E. Wluka, PhD, Associate Professor, Senior Research Fellow, Monash University
| | - Karl B Landorf
- From the Discipline of Podiatry, and Lower Extremity and Gait Studies Program, La Trobe University, Bundoora; School of Health and Human Sciences, Southern Cross University, Bilinga; Department of Epidemiology and Preventive Medicine (DEPM), School of Public Health and Preventive Medicine, Monash University; North-West Academic Centre, University of Melbourne; Australian Institute of Musculoskeletal Sciences, Melbourne; School of Medicine, Deakin University, Geelong, Australia.P.A. Butterworth, MPod, PhD candidate, La Trobe University; H.B. Menz, PhD, Professor, Director, Lower Extremity and Gait Studies Program, La Trobe University; D.M. Urquhart, PhD, Research Fellow, Monash University; F.M. Cicuttini, PhD, Professor, Musculoskeletal Unit, DEPM, Head Rheumatology Unit, Alfred Hospital; K.B. Landorf, PhD, Associate Professor, Research Coordinator, Discipline of Podiatry, La Trobe University; J.A. Pasco, PhD, Professor, Director, Epi-Centre for Healthy Ageing, Innovation in Mental and Physical Health and Clinical Treatment, Strategic Research Centre, Deakin University; S.L. Brennan, PhD, Research Fellow, Deakin University; A.E. Wluka, PhD, Associate Professor, Senior Research Fellow, Monash University
| | - Julie A Pasco
- From the Discipline of Podiatry, and Lower Extremity and Gait Studies Program, La Trobe University, Bundoora; School of Health and Human Sciences, Southern Cross University, Bilinga; Department of Epidemiology and Preventive Medicine (DEPM), School of Public Health and Preventive Medicine, Monash University; North-West Academic Centre, University of Melbourne; Australian Institute of Musculoskeletal Sciences, Melbourne; School of Medicine, Deakin University, Geelong, Australia.P.A. Butterworth, MPod, PhD candidate, La Trobe University; H.B. Menz, PhD, Professor, Director, Lower Extremity and Gait Studies Program, La Trobe University; D.M. Urquhart, PhD, Research Fellow, Monash University; F.M. Cicuttini, PhD, Professor, Musculoskeletal Unit, DEPM, Head Rheumatology Unit, Alfred Hospital; K.B. Landorf, PhD, Associate Professor, Research Coordinator, Discipline of Podiatry, La Trobe University; J.A. Pasco, PhD, Professor, Director, Epi-Centre for Healthy Ageing, Innovation in Mental and Physical Health and Clinical Treatment, Strategic Research Centre, Deakin University; S.L. Brennan, PhD, Research Fellow, Deakin University; A.E. Wluka, PhD, Associate Professor, Senior Research Fellow, Monash University
| | - Sharon L Brennan
- From the Discipline of Podiatry, and Lower Extremity and Gait Studies Program, La Trobe University, Bundoora; School of Health and Human Sciences, Southern Cross University, Bilinga; Department of Epidemiology and Preventive Medicine (DEPM), School of Public Health and Preventive Medicine, Monash University; North-West Academic Centre, University of Melbourne; Australian Institute of Musculoskeletal Sciences, Melbourne; School of Medicine, Deakin University, Geelong, Australia.P.A. Butterworth, MPod, PhD candidate, La Trobe University; H.B. Menz, PhD, Professor, Director, Lower Extremity and Gait Studies Program, La Trobe University; D.M. Urquhart, PhD, Research Fellow, Monash University; F.M. Cicuttini, PhD, Professor, Musculoskeletal Unit, DEPM, Head Rheumatology Unit, Alfred Hospital; K.B. Landorf, PhD, Associate Professor, Research Coordinator, Discipline of Podiatry, La Trobe University; J.A. Pasco, PhD, Professor, Director, Epi-Centre for Healthy Ageing, Innovation in Mental and Physical Health and Clinical Treatment, Strategic Research Centre, Deakin University; S.L. Brennan, PhD, Research Fellow, Deakin University; A.E. Wluka, PhD, Associate Professor, Senior Research Fellow, Monash University
| | - Anita E Wluka
- From the Discipline of Podiatry, and Lower Extremity and Gait Studies Program, La Trobe University, Bundoora; School of Health and Human Sciences, Southern Cross University, Bilinga; Department of Epidemiology and Preventive Medicine (DEPM), School of Public Health and Preventive Medicine, Monash University; North-West Academic Centre, University of Melbourne; Australian Institute of Musculoskeletal Sciences, Melbourne; School of Medicine, Deakin University, Geelong, Australia.P.A. Butterworth, MPod, PhD candidate, La Trobe University; H.B. Menz, PhD, Professor, Director, Lower Extremity and Gait Studies Program, La Trobe University; D.M. Urquhart, PhD, Research Fellow, Monash University; F.M. Cicuttini, PhD, Professor, Musculoskeletal Unit, DEPM, Head Rheumatology Unit, Alfred Hospital; K.B. Landorf, PhD, Associate Professor, Research Coordinator, Discipline of Podiatry, La Trobe University; J.A. Pasco, PhD, Professor, Director, Epi-Centre for Healthy Ageing, Innovation in Mental and Physical Health and Clinical Treatment, Strategic Research Centre, Deakin University; S.L. Brennan, PhD, Research Fellow, Deakin University; A.E. Wluka, PhD, Associate Professor, Senior Research Fellow, Monash University.
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Gerrits MMJG, van Marwijk HWJ, van Oppen P, van der Horst H, Penninx BWJH. Longitudinal association between pain, and depression and anxiety over four years. J Psychosom Res 2015; 78:64-70. [PMID: 25466385 DOI: 10.1016/j.jpsychores.2014.10.011] [Citation(s) in RCA: 96] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Revised: 10/16/2014] [Accepted: 10/20/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Many patients with depression and/or anxiety (D/A) persistently report pain. However, it is not clear how the course of D/A is associated with pain over time. The present study assessed longitudinal associations between D/A and pain, and compared pain over time between D/A and healthy controls. METHODS 2676 participants of the Netherlands Study of Depression and Anxiety were followed-up for four years. At three waves (baseline, 2, 4years) we assessed depressive and anxiety symptom severity. Using DSM-IV criteria, we also assessed four different D/A disorder courses over time (n=2093): incident, remitted, chronic, and no D/A (reference group). Pain was assessed at the three waves by severity and number of locations. RESULTS Change in D/A symptoms was positively associated with change in pain symptoms. Compared to healthy controls (n=519), D/A subjects - incident (n=333), remitted (n=548) or chronic (n=693) - reported more severe pain (b=0.4-0.7, p<0.001) and more pain locations (b=0.8-1.4, p<.001) at all waves, with the highest ratings in chronic D/A. Remission of D/A during follow-up was associated with a significant decline in pain (severity; p=0.002, number of locations; p<.001), but pain levels remained significantly higher compared to healthy controls. Findings were similar for separate depression or anxiety course. CONCLUSIONS This study largely confirms synchrony of change between depression, anxiety and pain. However, even after depression and anxiety remission, subjects report higher pain ratings over time. Individuals with D/A (history) seem to be at increased risk of chronic pain.
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Affiliation(s)
- Marloes M J G Gerrits
- Department of Psychiatry, EMGO Institute for Health and Care Research, VU University Medical Center and Academic Outpatient Clinic for Affective Disorders, GGZ inGeest, Amsterdam, The Netherlands; Department of General Practice and Elderly Care Medicine, EMGO institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
| | - Harm W J van Marwijk
- Department of Psychiatry, EMGO Institute for Health and Care Research, VU University Medical Center and Academic Outpatient Clinic for Affective Disorders, GGZ inGeest, Amsterdam, The Netherlands; Department of General Practice and Elderly Care Medicine, EMGO institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Patricia van Oppen
- Department of Psychiatry, EMGO Institute for Health and Care Research, VU University Medical Center and Academic Outpatient Clinic for Affective Disorders, GGZ inGeest, Amsterdam, The Netherlands; Department of General Practice and Elderly Care Medicine, EMGO institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Henriëtte van der Horst
- Department of General Practice and Elderly Care Medicine, EMGO institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry, EMGO Institute for Health and Care Research, VU University Medical Center and Academic Outpatient Clinic for Affective Disorders, GGZ inGeest, Amsterdam, The Netherlands
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Abstract
OBJECTIVES Children and adolescents diagnosed as having Crohn disease (CD), a type of inflammatory bowel disease (IBD), have increased vulnerability for anxiety symptoms that may be related to disease-related processes. The aims of this article are 3-fold: to report the proportion of pediatric patients with CD whose self-reported anxiety symptoms are indicative of distress, to describe the constellation of anxiety symptoms, and to examine the relation between anxiety and disease symptoms. METHODS Retrospective medical chart review was performed for 93 youths with CD (ages 9-18 years) who had completed the Screen for Child Anxiety Related Disorders during their gastroenterology visit. Medical records were reviewed for demographic and disease characteristics. the Harvey-Bradshaw Index (HBI) was used as a measure of CD activity. RESULTS Thirty percent of the youths reported experiencing elevated anxiety symptoms (Screen for Child Anxiety Related Disorder score >20), and 50% had scored above the cutoff in 1 or more anxiety domains, with school anxiety, general anxiety, and separation anxiety symptoms reported most frequently. Youth rated with moderate/severe disease activity on the HBI (n = 4) self-reported more anxiety symptoms compared with youth with inactive disease (n = 78, P = 0.03). Greater school anxiety was significantly associated with decreased well-being (P = 0.003), more abdominal pain (P < 0.001), and the number of loose stools (P = 0.01). Having extraintestinal symptoms was significantly associated with higher somatic/panic anxiety (P = 0.01). CONCLUSIONS Implementing a brief anxiety screen in tertiary pediatric settings may be one approach to identify young patients with CD in distress. Health care providers should consider periodic assessment of school anxiety among youth with CD.
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RUS MAKOVEC M, VINTAR N, MAKOVEC S. Self - Reported Depression, Anxiety and Evaluation of Own Pain in Clinical Sample of Patients with Different Location of Chronic Pain. Zdr Varst 2014; 54:1-10. [PMID: 27646616 PMCID: PMC4820143 DOI: 10.1515/sjph-2015-0001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 09/18/2014] [Indexed: 12/18/2022] Open
Abstract
Background Depression, anxiety and chronic pain are frequent co-occurrent disorders. Patients with these mental disorders experience more intense pain that lasts for a longer time. Method Questionnaire with 228 variables was applied to 109 randomly chosen patients that were treated at an outpatient clinic for treatment of chronic pain of the University Clinical Centre Ljubljana from March to June 2013. 87 patients responded to the questionnaire (79.8%). Location of pain considering diagnosis was the criterion in the discriminant analysis (soft tissue disorders; headache; symptoms not elsewhere classified; back pain) and following summative scores as predictors: level of depression and anxiety (The Zung Self-Rating Depression/Anxiety Scale), evaluation of pain and perceptions of being threatened in social relations. Results Average age of participants was M = 52.7 years (SD 13.9), with 70.9% female, 29.1% male participants. 63% of respondents achieved clinically important level of depression and 54% clinically important level of anxiety. On univariate level, the highest level of depression and anxiety was found for back pain and the lowest for headache. No significant difference was found in evaluation of pain and perceptions of being threatened in social relations regarding location of pain. Self-evaluation of depression has, in the framework of discriminant analysis, the largest weight for prediction of differentiation between different locations of pain. Conclusion Different locations of pain have different connections with mood levels. The results of research on a preliminary level indicate the need to consider mental experience in the treatment of chronic pain.
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Affiliation(s)
- Maja RUS MAKOVEC
- University Psychiatric Hospital Ljubljana, Center for Mental Health, Poljanski nasip 58, 1000 Ljubljana, Slovenia
- Corresponding author: Tel: +386 1 300 34 75; E-mail:
| | - Neli VINTAR
- University Medical Centre Ljubljana, Clinical Department of Anesteziology, Zaloška 7, 1000 Ljubljana, Slovenia
| | - Samo MAKOVEC
- University of Ljubljana, Medical Faculty, Vrazov trg 2, 1000 Ljubljana, Slovenia
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Goli Z, Asghari A, Moradi A. Effects of Mood Induction on the Pain Responses in Patients with Migraine and the Role of Pain Catastrophizing. Clin Psychol Psychother 2014; 23:66-76. [PMID: 25523303 DOI: 10.1002/cpp.1939] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Revised: 11/25/2014] [Accepted: 11/27/2014] [Indexed: 11/09/2022]
Abstract
UNLABELLED Migraine has close associations with depression and anxiety. Catastrophizing, an alarmist reaction to pain, has been proposed as one of the mediators in the relationship between headache and emotional distress. However, much experimental evidence is needed to make such a view more validated. The aims of this study are to examine the effects of mood induction on the pain responses and to investigate the role of pain catastrophizing in the relationship between pain and mood amongst a sample of patients with migraine. For this purpose, 60 patients with migraine were recruited from a headache clinic in Tehran-Iran and were randomly assigned into one of three groups: negative mood induced group, positive mood induced group and control group. The following instruments and measures were used in this study: mood induction by presenting different types of films (positive, negative), a computerized cognitive task to elicit pain, Beck Depression Inventory and Pain Catastrophizing Scale. The results showed that while the induction of depressed mood increased the pain intensity, the induction of positive mood reduced it significantly (p < 0.05). Further analyses revealed that catastrophizing is as a confounding factor in the relationship between pain and mood. Once catastrophizing scores were entered into the analyses as a covariate, the significant effect of mood on the pain intensity reduced. In conclusion, both mood and catastrophizing are important factors in understanding the migraine pain. Clinical implications of these findings are discussed in the paper. Copyright © 2014 John Wiley & Sons, Ltd. KEY PRACTITIONER MESSAGE Pain-related catastrophizing and mood induction are important factors in understanding pain intensity amongst patients with migraine pain. Catastrophizing as a confounding factor in the relationship between pain and mood may partially mediate the relationship between mood and pain. Therapeutic interventions should focus on the reduction of depression and catastrophizing.
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Affiliation(s)
- Zahra Goli
- Kharazmi University, Psychology Department, Tehran, Islamic Republic of Iran
| | - Ali Asghari
- Shahed University, Department of Psychology, Tehran, Islamic Republic of Iran
| | - Alireza Moradi
- Shahed University, Department of Psychology, Tehran, Islamic Republic of Iran
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Leichtfried V, Matteucci Gothe R, Kantner-Rumplmair W, Mair-Raggautz M, Bartenbach C, Guggenbichler H, Gehmacher D, Jonas L, Aigner M, Winkler D, Schobersberger W. Short-Term Effects of Bright Light Therapy in Adults with Chronic Nonspecific Back Pain: A Randomized Controlled Trial. PAIN MEDICINE 2014; 15:2003-12. [DOI: 10.1111/pme.12503] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Khan A, Brown WJ, Burton NW. What physical activity contexts do adults with psychological distress prefer? J Sci Med Sport 2013. [DOI: 10.1016/j.jsams.2012.10.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abate M, Vanni D, Pantalone A, Salini V. Cigarette smoking and musculoskeletal disorders. Muscles Ligaments Tendons J 2013; 3:63-9. [PMID: 23888288 DOI: 10.11138/mltj/2013.3.2.063] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Cigarette smoking has deleterious effects on the musculo-skeletal system. The loss of bone mineral content and increased incidence of fractures are the best known negative consequences. The pathogenesis is complex, due to direct toxic effects on osteoblasts/osteoclasts activity of nicotine, and indirect actions on sex and adrenocortical hormones, vitamin D, intestinal calcium absorption, vessels and oxygen supply. Smoking may favour the onset or aggravate the progression of rheumatoid arthritis and back pain. Negative influences have been observed on muscle and on tendons. Moreover, smoking habit is associated to a number of short term post-operative complications and higher resource consumption. Smoking cessation is highly advisable with positive effects on the bone metabolism on the long term. More positive and immediate results can be obtained in patients submitted to orthopedic surgery: the healing process is improved, the frequency of complications is reduced, and the length of hospital stay is shortened.
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Affiliation(s)
- Michele Abate
- Department of Medicine and Science of Aging, University of Study "G. D'Annunzio" Chieti - Pescara, Italy
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Yoshino A, Okamoto Y, Yoshimura S, Shishida K, Toki S, Doi M, Machino A, Fukumoto T, Yamashita H, Yamawaki S. Distinctive neural responses to pain stimuli during induced sadness in patients with somatoform pain disorder: An fMRI study. NEUROIMAGE-CLINICAL 2013; 2:782-9. [PMID: 24179828 PMCID: PMC3777689 DOI: 10.1016/j.nicl.2013.06.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Revised: 05/25/2013] [Accepted: 06/03/2013] [Indexed: 12/13/2022]
Abstract
Pain is a multidimensional phenomenon. Patients with somatoform pain disorder suffer from long-lasting pain, with the pathology being closely associated with cognitive–emotional components. Differences between these patients and controls in cerebral responses to pain stimuli have been reported. However, to our knowledge, no studies of somatoform pain disorder have evaluated altered pain-related brain activation as modulated by emotional dysregulation. We examined the distinct neural mechanism that is engaged in response to two different pain intensities in a sad emotional condition, performing functional magnetic resonance imaging (fMRI) on a group of 11 somatoform pain patients and an age-matched control group. Our results showed that the ratio for low-pain intensity ratings between the sad and neutral conditions in patients was higher than in controls. They also showed significant increased activation in the anterior/posterior insula in the low pain sadness condition. Furthermore, there was specific functional connectivity between the anterior insula and the parahippocampus in patients during presentation of low-pain stimuli in the sad context. These findings suggest that a negative emotional context such as sadness contributes to dysfunctional pain processing in somatoform pain disorder. Greater sensitivity to low levels of pain in an emotional context of sadness might be an important aspect of the psychopathology of somatoform pain disorder. Patients show higher pain sensitivities for low pain under sadness. The insula to low-pain stimuli are particularly changeable in patients. There was strong connectivity between the insula and the parahippocampus in patients. We suggest potential importance of emotional context in somatoform pain disorder.
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Affiliation(s)
- Atsuo Yoshino
- Department of Psychiatry and Neurosciences, Division of Frontier Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
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Williams AE, Hill LA, Nester CJ. Foot orthoses for the management of low back pain: a qualitative approach capturing the patient's perspective. J Foot Ankle Res 2013; 6:17. [PMID: 23651579 PMCID: PMC3653791 DOI: 10.1186/1757-1146-6-17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Accepted: 05/06/2013] [Indexed: 08/30/2023] Open
Abstract
BACKGROUND The onset of non specific low back pain is associated with heavy lifting, age, female gender, and poor general health, with psychological factors being predictors of it becoming chronic. Additionally, it is thought that altered lower limb biomechanics are a contributory factor, with foot orthoses increasingly being considered as an appropriate intervention by physiotherapists and podiatrists. However, research into the effect of foot orthoses is inconclusive, primarily focusing on the biomechanical effect and not the symptomatic relief from the patient's perspective. The aim of this study was to explore the breadth of patients' experiences of being provided with foot orthoses and to evaluate any changes in their back pain following this experience. METHOD Following ethical approval, participants (n = 25) with non-specific low back pain associated with altered lower limb biomechanics were provided with customised foot orthoses. At 16 weeks after being provided with the foot orthoses, conversational style interviews were carried out with each patient. An interpretivistic phenomenological approach was adopted for the data collection and analysis. RESULTS For these participants, foot orthoses appeared to be effective. However, the main influence on this outcome was the consultation process and a patient focussed approach. The consultation was an opportunity for fostering mutual understanding, with verbal and visual explanation reassuring the patient and this influenced the patient's beliefs, their engagement with the foot orthoses (physical) and their experience of low back pain (psychological). CONCLUSION Clinicians need to adopt 'psychologically informed practice' in relation to the provision of foot orthoses. Likewise, researchers should consider all the influencing factors found in this study, both in relation to their study protocol and the outcomes they plan to measure.
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Affiliation(s)
- Anita E Williams
- Orthotics and Podiatry, Brian Blatchford Building, University of Salford, Salford, M6 6PU, UK
| | - Lindsay A Hill
- (Foot & Ankle) Royal Bolton Hospital NHS Foundation Trust, Elective Orthopaedics Service, Bolton, UK
| | - Christopher J Nester
- School of Health Sciences, University of Salford, Frederick Road, Salford, M6 6PU, UK
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Sanna L, Stuart AL, Pasco JA, Kotowicz MA, Berk M, Girardi P, Brennan SL, Williams LJ. Physical comorbidities in men with mood and anxiety disorders: a population-based study. BMC Med 2013; 11:110. [PMID: 23618390 PMCID: PMC3648485 DOI: 10.1186/1741-7015-11-110] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2012] [Accepted: 04/04/2013] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND The mind-body nexus has been a topic of growing interest. Further data are however required to understand the specific relationship between mood and anxiety disorders and individual physical health conditions, and to verify whether these psychiatric disorders are linked to overall medical burden. METHODS This study examined data collected from 942 men, 20 to 97 years old, participating in the Geelong Osteoporosis Study. A lifetime history of mood and anxiety disorders was identified using the Structured Clinical Interview for DSM-IV-TR Research Version, Non-patient edition (SCID-I/NP). The presence of medical conditions (lifetime) was self-reported and confirmed by medical records, medication use or clinical data. Anthropometric measurements and socioeconomic status (SES) were determined and information on medication use and lifestyle was obtained via questionnaire. Logistic regression models were used to test the associations. RESULTS After adjustment for age, socioeconomic status, and health risk factors (body mass index, physical activity and smoking), mood disorders were associated with gastro oesophageal reflux disease (GORD), recurrent headaches, blackouts and/or epilepsy, liver disorders and pulmonary disease in older people, whilst anxiety disorders were significantly associated with thyroid, GORD and other gastrointestinal disorders, and psoriasis. Increased odds of high medical burden were associated with both mood and anxiety disorders. CONCLUSIONS Our study provides further population-based evidence supporting the link between mental and physical illness in men. Understanding these associations is not only necessary for individual management, but also to inform the delivery of health promotion messages and health care.
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Affiliation(s)
- Livia Sanna
- Unit of Psychiatry, Neurosciences, Mental Health and Sensory Organs Department (NeSMOS), Faculty of Medicine and Psychology, Sant’Andrea Hospital, Sapienza University of Rome, Via di Grottarossa 1035–1037 00189 Rome, Italy
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Marques CA, Stefanello B, Mendonça CND, Furlanetto LM. Associação entre depressão, níveis de dor e falta de apoio social em pacientes internados em enfermarias de clínica médica. JORNAL BRASILEIRO DE PSIQUIATRIA 2013. [DOI: 10.1590/s0047-20852013000100001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJETIVO: Verificar a associação entre depressão, níveis de dor e falta de apoio social em pacientes clínicos internados. MÉTODOS: Em um estudo transversal, 1.147 adultos admitidos nas enfermarias de clínica médica de um hospital universitário foram selecionados por randomização e avaliados durante a primeira semana de internação. Foram utilizados: Subescala Cognitivo-afetiva do Inventário Beck de Depressão (BDI-13), Índice Charlson de Comorbidade Física e escalas numéricas para avaliar dor e percepção de gravidade física. Foram considerados deprimidos os pacientes que pontuaram acima de 10 no BDI-13. Investigou-se apoio social por meio da pergunta direta: "Com quantos parentes ou amigos você se sente à vontade e pode falar sobre tudo ou quase tudo?". Foram considerados como tendo falta de apoio social os pacientes que relataram ter menos que quatro parentes ou amigos confidentes. Foram utilizados os testes T de Student, Qui-quadrado e Regressão Logística. RESULTADOS: Dos 1.147 pacientes, 25,3% apresentavam depressão. Escolaridade [odds ratio (OR): 0,96; intervalo de confiança (IC): 0,89-0,96; p < 0,001], renda familiar (OR: 0,92; IC: 0,86-0,99; p = 0,018), maior intensidade de dor (OR: 1,04; IC: 1,00-1,08; p = 0,036), falta de apoio social (OR: 2,02; IC: 1,49-2,72; p < 0,001) e percepção de maior gravidade física (OR: 1,07; IC: 1,02-1,13; p = 0,008) se associaram independentemente à depressão. CONCLUSÃO: Pacientes clínicos deprimidos relatam mais falta de apoio social e dor, mesmo após controlar para variáveis confundidoras sociodemográficas e clínicas.
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