1
|
Sousa H, Ribeiro O, Figueiredo D. Development process, clinical utility, and preliminary psychometric evidence of a new tool for screening psychological distress in renal care settings: the Hemodialysis Distress Thermometer (HD-DT). Psychol Health 2024:1-27. [PMID: 38679920 DOI: 10.1080/08870446.2024.2347662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 04/21/2024] [Indexed: 05/01/2024]
Abstract
OBJECTIVE This study aimed to develop, evaluate the clinical utility, and test the psychometric properties of a new tool - the Hemodialysis Distress Thermometer (HD-DT) - designed to screen self-reported psychological distress and its sources in adults receiving hemodialysis. METHODS AND MEASURES Phase 1 focused on the process of developing and evaluating the content validity and clinical utility of the HD-DT using a stepwise mixed-methods approach; in Phase 2, the measurement properties of the European Portuguese version of the HD-DT were tested against reference measures in a cross-sectional study (n = 134 people on hemodialysis); while in Phase 3 the HD-DT was translated and culturally adapted into American English using forward-backward translation and review by a panel of experts. RESULTS Qualitative findings suggested that the HD-DT was perceived by feedback panels as practical and useful for rapidly screening psychological distress in nephrology centers. The European Portuguese version of this new tool showed good test-retest reliability and high diagnostic accuracy using a cutoff point of ≥ 6 for total distress. High convergent validity was found with reference measures that assess psychological health, and symptoms of anxiety and depression. CONCLUSION This study highlights the potential clinical utility of the HD-DT as an acceptable, reliable, and valid measure that can be used by health psychologists in clinical practice and research in renal care settings. Data collection to validate the American English version of the HD-DT is currently underway.
Collapse
Affiliation(s)
- Helena Sousa
- CINTESIS@RISE, Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Oscar Ribeiro
- CINTESIS@RISE, Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Daniela Figueiredo
- CINTESIS@RISE, School of Health Sciences, University of Aveiro, Aveiro, Portugal
| |
Collapse
|
2
|
Kobayashi N, Shimada K, Ishii A, Osaka R, Nishiyama T, Shigeta M, Yanagisawa H, Oka N, Kondo K. Identification of a strong genetic risk factor for major depressive disorder in the human virome. iScience 2024; 27:109203. [PMID: 38414857 PMCID: PMC10897923 DOI: 10.1016/j.isci.2024.109203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 11/07/2023] [Accepted: 02/07/2024] [Indexed: 02/29/2024] Open
Abstract
The heritability of major depressive disorder (MDD) is reportedly 30-50%. However, the genetic basis of its heritability remains unknown. Within SITH-1, a risk factor for MDD in human herpesvirus 6B (HHV-6B), we discovered a gene polymorphism with a large odds ratio for an association with MDD. It was a sequence whose number of repeats was inversely correlated with SITH-1 expression. This number was significantly lower in MDD patients. Rates for 17 or fewer repeats of the sequence were 67.9% for MDD and 28.6% for normal controls, with an odds ratio of 5.28. For patients with 17 or less repeats, the rate for presence of another MDD patient in their families was 47.4%, whereas there were no MDD patients in the families of patients with more than 17 repeats. Since HHV-6B is transmitted primarily mother to child and within families and persists for life, this gene polymorphism could potentially influence heritability of MDD.
Collapse
Affiliation(s)
- Nobuyuki Kobayashi
- Department of Virology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Kazuya Shimada
- Department of Virology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Azusa Ishii
- Department of Virology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Rui Osaka
- Department of Virology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Toshiko Nishiyama
- Department of Public Health & Environmental Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Masahiro Shigeta
- Department of Psychiatry, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Hiroyuki Yanagisawa
- Department of Public Health & Environmental Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Naomi Oka
- Department of Virology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Kazuhiro Kondo
- Department of Virology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo 105-8461, Japan
| |
Collapse
|
3
|
Bala A, Olejnik A, Dziedzic T, Piwowarska J, Podgórska A, Marchel A. What helps patients to prepare for and cope during awake craniotomy? A prospective qualitative study. J Neuropsychol 2024; 18:30-46. [PMID: 37036087 DOI: 10.1111/jnp.12311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 03/09/2023] [Indexed: 04/11/2023]
Abstract
There is growing interest in awake craniotomies, but some clinicians are concerned that such procedures are poorly tolerated by patients. Therefore, we conducted a study to assess this phenomenon. In this prospective qualitative study, 68 patients who qualified for awake craniotomy were asked to complete the Hospital Anxiety and Depression Scale (HADS)-two days before the surgery and visual analogue scales (VAS) for pain and stress, two days before the surgery and again about two days after. In addition, after their surgery, they took part in a structured interview about what helped them prepare for and cope with the surgery. Most patients tolerated the awake surgery well, scoring low on stress and pain scales. They reported a lower level of stress during the surgery (when questioned afterwards) than before it. Intensity of stress before the surgery correlated negatively with age, positively with HADS anxiety score and positively with stress subsequently experienced during surgery. The level of stress during surgery was associated with stress experienced before the surgery, pain and HADS anxiety and depression scores. Severity of pain during the surgery was positively correlated with stress during surgery and HADS depression and anxiety scores before the surgery. There was no correlation between stress, pain, anxiety and depression and the location of the lesion. Patients have a high tolerance for awake craniotomy. Various factors have an impact on how well patients cope with the operation. Extensive preoperative preparation should be considered a key part of the procedure.
Collapse
Affiliation(s)
| | | | - Tomasz Dziedzic
- Department of Neurosurgery, Medical University of Warsaw, Warsaw, Poland
| | - Jolanta Piwowarska
- Department of Anaesthesiology and Intensive Care, Medical University of Warsaw, Warsaw, Poland
| | - Anna Podgórska
- Department of Neurosurgery, Medical University of Warsaw, Warsaw, Poland
| | - Andrzej Marchel
- Department of Neurosurgery, Medical University of Warsaw, Warsaw, Poland
| |
Collapse
|
4
|
Alhazmi AI, Alghamdi AM, Alghamdi FS, Alhumam MN, Alghamdi MKN, Alghamdi GA, Jathmi SAS. Association of Hyperparathyroidism with Depression and Anxiety Among Chronic Hemodialysis Patients in the Al Baha Region, Kingdom of Saudi Arabia. Cureus 2024; 16:e57210. [PMID: 38681457 PMCID: PMC11056225 DOI: 10.7759/cureus.57210] [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: 03/29/2024] [Indexed: 05/01/2024] Open
Abstract
Introduction Anxiety and depression are prevalent psychological issues among hemodialysis patients, adversely affecting their well-being and treatment response. The study aims to identify the relationship between these mental health concerns and hyperparathyroidism in chronic hemodialysis patients from the Al Baha Region, Kingdom of Saudi Arabia. Methods This retrospective study included 143 chronic hemodialysis patients aged 18-85 years. Monthly laboratory records for parathyroid hormone (PTH) levels and the Hospital Anxiety and Depression Scale (HADS) for mental health assessment were utilized. Demographic information and the primary causes of end-stage renal disease were obtained through patient interviews. Statistical analyses, including chi-square tests, odds ratio, and significance tests, were performed to assess associations. Results Elevated PTH levels were associated with increased anxiety and depression in hemodialysis patients. Patients with PTH levels >400 pg/ml exhibited higher rates of abnormal HADS scores for anxiety and depression than those with PTH levels <400 pg/ml. Gender differences were evident, with women showing a higher predisposition to anxiety disorders and men having depression. Additionally, patients with PTH levels <150 pg/ml had a significantly higher proportion of the "normal" depression score than those with PTH levels >800 pg/ml. Conclusion The study underscores the association between hyperparathyroidism and adverse mental health outcomes in chronic hemodialysis patients. Maintaining optimal PTH levels plays a crucial role in mitigating anxiety and depression. Gender differences in mental health outcomes highlight the need for tailored interventions. Routine mental health assessments, utilizing tools such as the HADS, are important in the comprehensive care of hemodialysis patients.
Collapse
Affiliation(s)
- Areej I Alhazmi
- Internal Medicine/Nephrology, Al Baha University, Al Baha, SAU
| | | | | | | | | | | | | |
Collapse
|
5
|
Mohamed NA, Eraslan A, Kose S. The impact of anxiety and depression on the quality of life of hemodialysis patients in a sample from Somalia. BMC Psychiatry 2023; 23:825. [PMID: 37950178 PMCID: PMC10636891 DOI: 10.1186/s12888-023-05312-8] [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] [Received: 02/10/2023] [Accepted: 10/26/2023] [Indexed: 11/12/2023] Open
Abstract
OBJECTIVE The main objective of the present study was to determine the quality of life (QoL), depression, and anxiety levels in kidney failure patients undergoing hemodialysis (HD) treatment and examine the impact of depression and anxiety on the QoL of these patients in a sample from Somalia. METHODS A sample of 200 patients with kidney failure who were undergoing HD treatment approximately two to three times a week was included. All participants were administered a sociodemographic data form, the Patient Health Questionnaire-9 (PHQ-9), the Hospital Anxiety and Depression Scale (HADS), and the World Health Organization Quality of Life (WHO-QOL-BREF). Subjects on HD for less than 3 months prior to the study date were excluded. RESULTS Of the kidney failure patients, 200 patients, aged 18-86 years (median: 50.0; IQR: 25.0), consented and participated in the study. 58.5% of the participants were men; 64% had a kidney failure duration of 1-5 years, and 52.6% had a HD duration of 1-5 years. Mild symptoms of depression were found in 48%, while moderate-to-severe depressive symptoms were found in 13.5% of HD patients. Depression and anxiety were found to be significantly correlated with overall QoL, physical health, psychological health, social relationships, and environmental well-being. There were similar predictors of overall QoL, physical health, psychological well-being, social relationships, and environmental well-being relating to socio-demographic factors such as age, gender, family income, anxiety, and depression. CONCLUSIONS This study emphasizes the important role that anxiety, depression, and family income have in HD patients' QoL in Somalia. It highlights the significance of regular emotional assessment and efficient management in order to increase patient satisfaction. Future studies with larger samples are necessary for more accurate statistical analysis. To optimize patient care, a multidisciplinary healthcare team is recommended.
Collapse
Affiliation(s)
- Nur Adam Mohamed
- Department of Psychiatry and Behavioral Sciences, Mogadishu Somalia Türkiye Recep Tayyip Erdogan Research and Training Hospital, Mogadishu, Somalia.
| | - Asir Eraslan
- Department of Urology, Mogadishu Somalia Türkiye Recep Tayyip Erdogan Research and Training Hospital, Mogadishu, Somalia
| | - Samet Kose
- Department of Psychiatry and Behavioral Sciences, Mogadishu Somalia Türkiye Recep Tayyip Erdogan Research and Training Hospital, Mogadishu, Somalia
| |
Collapse
|
6
|
Szabados M, Kolumbán E, Agócs G, Kiss-Dala S, Engh MA, Hernádfői M, Takács K, Tuboly E, Párniczky A, Hegyi P, Garami M. Association of tumor location with anxiety and depression in childhood brain cancer survivors: a systematic review and meta-analysis. Child Adolesc Psychiatry Ment Health 2023; 17:124. [PMID: 37891679 PMCID: PMC10612250 DOI: 10.1186/s13034-023-00665-0] [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: 06/26/2023] [Accepted: 09/29/2023] [Indexed: 10/29/2023] Open
Abstract
OBJECTIVE This study aimed to evaluate the association between the location (supratentorial or infratentorial) of brain tumors and the development of depression and anxiety in childhood cancer survivors. Understanding the risk factors for the development of depression and anxiety disordersin these patients is crucial for early diagnosis and successful treatment. METHODS The meta-analysis included articles that listed patients diagnosed with an intracranial tumor before the age of 18 years, provided the location of the tumor, had exact data on the prevalence of anxiety and depression, or measured these disorders using different assessment tools. The search was conducted in five different databases (MEDLINE, Embase, Web of Science, Scopus, and Cochrane Library). Risk of bias was assessed using QUIPS-2. Outcome measures used were prevalences and standardized means. RESULTS The analysis included 42 eligible articles with a total number of 1071 patients. Relevant articles were cohort studies, cross-sectional studies, and case series. Based on the available data infratentorial brain tumor survivors had significantly higher scores on various assessment tools measuring anxiety (MRAW (raw mean scores): 36.24 [CI (confidence interval): 28.81-43.67]; versus MRAW: 23.21 (CI 0.91-45.51); p = 0.02, and depression (MRAW: 27.57 (CI 14.35-40.78) versus MRAW: 13.84 (CI 11.43-16.26); p < 0.01. CONCLUSION Childhood infratentorial cancer survivors have more impairments in terms of depression and anxiety; these children and adults should be monitored more frequently and may require closer follow-up on their mental health. The main limitation of our study originates from the lack of data on follow-up times used by different studies.
Collapse
Affiliation(s)
- Márton Szabados
- Pediatric Center, Semmelweis University, 7-9 Tűzoltó Street, Budapest, 1094, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Erika Kolumbán
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- András Pető Faculty, Semmelweis University, Budapest, Hungary
| | - Gergely Agócs
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Biophysics and Radiation Biology, Semmelweis University, Budapest, Hungary
| | - Szilvia Kiss-Dala
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Marie Anne Engh
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Márk Hernádfői
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Bethesda Children's Hospital, Budapest, Hungary
| | - Kata Takács
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Eszter Tuboly
- Hungarian Pediatric Oncology Network, Budapest, Hungary
| | - Andrea Párniczky
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Heim Pál National Pediatric Institute, Budapest, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Miklós Garami
- Pediatric Center, Semmelweis University, 7-9 Tűzoltó Street, Budapest, 1094, Hungary.
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.
| |
Collapse
|
7
|
Tian M, Qian Z, Long Y, Yu F, Yuan J, Zha Y. Decreased Intracellular to Total Body Water Ratio and Depressive Symptoms in Patients with Maintenance Hemodialysis. Psychol Res Behav Manag 2023; 16:4367-4376. [PMID: 37908680 PMCID: PMC10615096 DOI: 10.2147/prbm.s436574] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 10/11/2023] [Indexed: 11/02/2023] Open
Abstract
Objective Depression is a common psychiatric disorder and related to poor outcomes in patients undergoing maintenance hemodialysis (MHD). Previous studies have reported some associations between sarcopenia and depressive symptoms. Recently, intracellular water (ICW) and total body water (TBW) have been found to reflect muscle function and muscle mass. ICW/TBW ratio is a marker of sarcopenia that is simple to assess. However, the relationship between ICW/TBW ratio and depression has not been explored in MHD patients. Methods In our cross-sectional and multi-center study, 3300 adult MHD patients were included from June 1, 2021, to August 30, 2021. Depressive symptoms were evaluated using the Beck Depression Inventory-II (BDI-II). TBW and ICW were measured by Body Composition Monitor (BCM). Multivariable logistic regression, stratified analyses, and interactive analyses were conducted to assess the relationship between ICW/TBW ratio and depression. Results About 16.5% of the 3300 MHD patients were found to have depressive symptoms. The prevalence of depression increased with decreasing quartiles of ICW/TBW ratios, and decreased ICW/TBW ratio was independently associated with depression after adjusting for potential confounders. Patients in Quartile 1 of ICW/TBW ratios were more likely to have depressive symptoms (odds ratio 1.55, 95% confidence interval 1.07-2.22; p=0.002) than those in Quartile 4. History of diabetes and education status had interactive roles in the relationship between depression and ICW/TBW ratios (p < 0.05). The association of ICW/TBW ratios and depression existed in patients of both genders and different education levels, but only in non-diabetic patients. Conclusion In MHD patients, the decreased ratio of ICW/TBW was independently related to high depression rates.
Collapse
Affiliation(s)
- Maolu Tian
- Department of Nephrology, Guizhou Provincial People’s Hospital, Guiyang, Guizhou, People’s Republic of China
- NHC Key Laboratory of Pulmonary Immunological Disease, Guizhou Provincial People’s Hospital, Guiyang, Guizhou, People’s Republic of China
- Medical College, Guizhou University, Guiyang, Guizhou, People’s Republic of China
| | - Zuping Qian
- Clinical Medical College, Zunyi Medical University, Zunyi, Guizhou, People’s Republic of China
| | - Yanjun Long
- Department of Nephrology, Guizhou Provincial People’s Hospital, Guiyang, Guizhou, People’s Republic of China
- NHC Key Laboratory of Pulmonary Immunological Disease, Guizhou Provincial People’s Hospital, Guiyang, Guizhou, People’s Republic of China
| | - Fangfang Yu
- Department of Nephrology, Guizhou Provincial People’s Hospital, Guiyang, Guizhou, People’s Republic of China
| | - Jing Yuan
- Department of Nephrology, Guizhou Provincial People’s Hospital, Guiyang, Guizhou, People’s Republic of China
| | - Yan Zha
- Department of Nephrology, Guizhou Provincial People’s Hospital, Guiyang, Guizhou, People’s Republic of China
- NHC Key Laboratory of Pulmonary Immunological Disease, Guizhou Provincial People’s Hospital, Guiyang, Guizhou, People’s Republic of China
| |
Collapse
|
8
|
Turoń-Skrzypińska A, Tomska N, Mosiejczuk H, Rył A, Szylińska A, Marchelek-Myśliwiec M, Ciechanowski K, Nagay R, Rotter I. Impact of virtual reality exercises on anxiety and depression in hemodialysis. Sci Rep 2023; 13:12435. [PMID: 37528161 PMCID: PMC10394078 DOI: 10.1038/s41598-023-39709-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 07/29/2023] [Indexed: 08/03/2023] Open
Abstract
Renal replacement therapy is associated with reduced physical activity. The aim of the study was to assess the relationship between regular physical activity performed with the use of virtual reality and the occurrence of symptoms of anxiety and depression in hemodialysis patients. The study involved 85 patients from the dialysis station at the Department of Nephrology, Transplantology and Internal Medicine PUM. The examined patients were randomly divided into study group and control group. The study group consisted of patients undergoing renal replacement therapy by hemodialysis, whose task was to perform VR exercises using the prototype of the NefroVR system for 20 min during hemodialysis. The control group consisted of patients undergoing renal replacement therapy by hemodialysis who were not assigned an intervention. An intragroup analysis was performed for the Beck and GAD scales. After the end of the exercise cycle in the study group there was a decrease in the score while in the control group there was an increase in comparison to the first result. The research showed that after a 3-month exercises on a bicycle with the use of low-intensity virtual reality, a decrease in depression symptoms measured by the Beck Depression Inventory was observed. The research showed that regular physical activity using virtual reality may be associated with a reduction in the occurrence of anxiety and depression symptoms in patients included in the chronic hemodialysis program.
Collapse
Affiliation(s)
- Agnieszka Turoń-Skrzypińska
- Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Natalia Tomska
- Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University in Szczecin, Szczecin, Poland.
| | - Hanna Mosiejczuk
- Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Aleksandra Rył
- Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Aleksandra Szylińska
- Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Małgorzata Marchelek-Myśliwiec
- Clinical Department of Nephrology, Transplantology, and Internal Medicine, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Kazimierz Ciechanowski
- Clinical Department of Nephrology, Transplantology, and Internal Medicine, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Radosław Nagay
- Department of Visual Communication, Faculty of Design, Academy of Art in Szczecin, Szczecin, Poland
| | - Iwona Rotter
- Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University in Szczecin, Szczecin, Poland
| |
Collapse
|
9
|
Kim H, Ha J, Park HY, Choung YH, Jang JH. Efficacy and Safety of Co-Administered St. John's Wort and Ginkgo biloba Extracts in Patients with Subjective Tinnitus: A Preliminary Prospective Randomized Controlled Trial. J Clin Med 2023; 12:jcm12093261. [PMID: 37176699 PMCID: PMC10179387 DOI: 10.3390/jcm12093261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 04/12/2023] [Accepted: 05/01/2023] [Indexed: 05/15/2023] Open
Abstract
It is widely accepted that extracts of St. John's wort (Hypericum perforatum) improve depressive symptoms, and tinnitus patients commonly presented with either mild depression or anxiety. We investigated whether co-administration of St. John's wort and Ginkgo biloba extracts can suppress tinnitus. Participants with subjective tinnitus aged 30-70 years were randomly assigned to the experimental (co-administration of St. John's wort and Ginkgo biloba extract; n = 20) or control (Ginkgo biloba extract only; n = 26) group for 12 weeks. Participants were blinded to the group assignments. After 12 weeks of treatment, no significant change in the minimum masking level on the tinnitogram was observed in either group. In the co-administration group, the Tinnitus Handicap Inventory (THI) score decreased from 34.7 (SD, 15.9) to 29.6 (16.0) (p = 0.102). However, the control group showed a significant decrease in THI score, from 30.5 (16.7) to 25.6 (17.1) (p = 0.046). Regarding the Short Form-36 Health Survey (SF-36), only the "Social Functioning" domain score changed significantly after extract co-administration, from 74.5 (21.5) to 83.9 (20.5) (p = 0.047). Co-administration of St. John's wort and Ginkgo biloba extracts did not improve the symptoms of subjective tinnitus compared to administration of Ginkgo biloba extract alone.
Collapse
Affiliation(s)
- Hantai Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Konyang University College of Medicine, Daejeon 35365, Republic of Korea
| | - Jungho Ha
- Department of Otolaryngology, Ajou University School of Medicine, Suwon 16499, Republic of Korea
| | - Hun Yi Park
- Department of Otolaryngology, Ajou University School of Medicine, Suwon 16499, Republic of Korea
| | - Yun-Hoon Choung
- Department of Otolaryngology, Ajou University School of Medicine, Suwon 16499, Republic of Korea
| | - Jeong Hun Jang
- Department of Otolaryngology, Ajou University School of Medicine, Suwon 16499, Republic of Korea
| |
Collapse
|
10
|
Khoury R, Ghantous Z, Ibrahim R, Ghossoub E, Madaghjian P, Karam E, Karam G, Fares N, Karam S. Anxiety, depression and post-traumatic stress disorder in patients on hemodialysis in the setting of the pandemic, inflation, and the Beirut blast: a cross-sectional study. BMC Psychiatry 2023; 23:284. [PMID: 37087412 PMCID: PMC10122541 DOI: 10.1186/s12888-023-04798-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 04/18/2023] [Indexed: 04/24/2023] Open
Abstract
BACKGROUND In 2020, Lebanon has witnessed its worst economic crisis, exacerbated by the COVID-19 pandemic and a massive explosion of its capital. Amidst these stressors, this study aims at assessing the prevalence of depression, anxiety, suicidality, post-traumatic stress disorder (PTSD) and cognitive impairment in patients undergoing hemodialysis in an academic hospital destroyed by the explosion. METHODS This cross-sectional study conducted 6 months after the blast included adults on hemodialysis, with no previous diagnoses of dementia or intellectual disability. It explores prevalence rates of psychiatric disorders, in addition to other medical and psychosocial variables such as frailty, malnutrition, sarcopenia, quality of life and religiosity. RESULTS Forty two patients (mean age 66.1; SD: 11.2 years) undergoing hemodialysis for 6.12 years (SD:7.22 years) were included. Anxiety and depression rates reached 54.8% and 57.1% using cut-offs of 6 and 7 respectively on the Hospital Anxiety and Depression rating Scale. 9.5% of the patients reported being in the hospital at the time of the blast and 7.1% reported being injured. 33.3% screened positively for PTSD using a cut-off of 23 on the PCL-5. 26.2% had passive death wishes and 7.1% had suicide plans, however no one had attempted it. 23.8% were found cognitively impaired as shown by the Mini-Cog (<3). Around two-third of participants were moderately to severely malnourished per the GLIM criteria. One third suffered from frailty, according to the FRAIL screening tool. Around 60% suffered from sarcopenia, based on handgrip strength measures. These findings contrast with "acceptable to good" quality of life subjectively reported by participants on the Short Form 36 (SF-36) Health Survey. While one-third of participants participated in organizational religious activities, 88% reported significant subjective meaning of religion in their heart. CONCLUSIONS Rates of depression, anxiety, PTSD, suicidality, and cognitive impairment were found to be alarming in the setting of an urban dialysis unit following a major explosion. Psychiatric disorders were found to be compounded with increased prevalence of malnutrition, frailty, and sarcopenia. These findings urge healthcare providers to implement early diagnostic and intervention strategies to improve both mental and physical wellbeing of this vulnerable population, in similar settings.
Collapse
Affiliation(s)
- Rita Khoury
- Department of Psychiatry, American University of Beirut, PO Box: 11-0236, Beirut, 1107, Riad El Solh, Lebanon.
| | - Ziad Ghantous
- Department of Psychiatry, Washington University in St. Louis, Clayton, Missouri, United States
| | - Roy Ibrahim
- Department of Psychiatry and Clinical Psychology, Saint Georges Hospital University Medical center, Beirut, Lebanon
| | - Elias Ghossoub
- Department of Psychiatry, American University of Beirut, PO Box: 11-0236, Beirut, 1107, Riad El Solh, Lebanon
| | - Patille Madaghjian
- Department of Nutrition, Saint Georges Hospital University Medical center, Beirut, Lebanon
| | - Elie Karam
- Department of Psychiatry and Clinical Psychology, Saint Georges Hospital University Medical center, Beirut, Lebanon
| | - Georges Karam
- Department of Psychiatry and Clinical Psychology, Saint Georges Hospital University Medical center, Beirut, Lebanon
| | - Najat Fares
- Department of Internal Medicine, Division of Nephrology, Saint Georges Hospital University Medical center, Beirut, Lebanon
| | - Sabine Karam
- Division of Nephrology and Hypertension, University of Minnesota, Minneapolis, United States
| |
Collapse
|
11
|
Loban K, Horton A, Robert JT, Hales L, Parajuli S, McAdams-DeMarco M, Sandal S. Perspectives and experiences of kidney transplant recipients with graft failure: A systematic review and meta-synthesis. Transplant Rev (Orlando) 2023; 37:100761. [PMID: 37120965 DOI: 10.1016/j.trre.2023.100761] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 04/10/2023] [Accepted: 04/11/2023] [Indexed: 05/02/2023]
Abstract
BACKGROUND Kidney transplant recipients with graft failure are a rapidly rising cohort of patients who experience high morbidity, mortality, and fragmented transitions of care between transplant and dialysis teams. Current approaches to improving care focus on medical and surgical interventions, increasing re-transplantation, and improving coordination between treating teams with little understanding of patient needs and perspectives. METHODS We undertook a systematic literature review of personal experiences of patients with graft failure. Six electronic and five grey literature databases were searched systematically. Of 4664 records screened 43 met the inclusion criteria. Six empirical qualitative studies and case studies were included in the final analysis. Thematic synthesis was used to combine data that included the perspectives of 31 patients with graft failure and 9 caregivers. RESULTS Using the Transition Model, we isolated three interconnected phases as patients transition through graft failure: shattering of lifestyle and plans associated with a successful transplant; physical and psychological turbulence; and re-alignment by learning adaptive strategies to move forward. Critical factors affecting coping included multi-disciplinary healthcare approaches, social support, and individual-level factors. While clinical transplant care was evaluated positively, participants identified gaps in the provision of information and psychosocial support related to graft failure. Graft failure had a profound impact on caregivers especially when they were living donors. CONCLUSIONS Our review reports patient-identified priorities for improving care and can help inform research and guideline development that strives to improve the care of patients with graft failure.
Collapse
Affiliation(s)
- Katya Loban
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada; Division of Experimental Medicine, Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Anna Horton
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Jorane-Tiana Robert
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Lindsay Hales
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Sandesh Parajuli
- Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Mara McAdams-DeMarco
- Department of Surgery, NYU Grossman School of Medicine and NYU Langone Health, New York, NY, USA
| | - Shaifali Sandal
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada; Division of Experimental Medicine, Department of Medicine, McGill University, Montreal, Quebec, Canada; Division of Nephrology, Department of Medicine, McGill University, Montreal, Quebec, Canada.
| |
Collapse
|
12
|
Tommel J, Evers AWM, van Hamersvelt HW, Jordens R, van Dijk S, Hilbrands LB, Hermans MMH, Hollander DAMJ, van de Kerkhof JJ, Ten Dam MAGJ, van Middendorp H. "What matters to you?": The relevance of patient priorities in dialysis care for assessment and clinical practice. Semin Dial 2023; 36:131-141. [PMID: 35388533 DOI: 10.1111/sdi.13080] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 02/25/2022] [Accepted: 03/21/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Dialysis patients are confronted with numerous, complex problems, which make it difficult to identify individual patient's most prominent problems. The objectives of this study were to (1) identify dialysis patients' most prominent problems from a patient perspective and (2) to calculate disease-specific norms for questionnaires measuring these problems. METHODS One hundred seventy-five patients treated with hemodialysis or peritoneal dialysis completed a priority list on several domains of functioning (e.g., physical health, mental health, social functioning, and daily activities) and a set of matching questionnaires assessing patient functioning on these domains. Patient priorities were assessed by calculating the importance ranking of each domain on the priority list. Subsequently, disease-specific norm scores were calculated for all questionnaires, both for the overall sample and stratified by patient characteristics. RESULTS Fatigue was listed as patients' most prominent problem. Priorities differed between male and female patients, younger and older patients, and home and center dialysis patients, which was also reflected in their scores on the corresponding domains of functioning. Therefore, next to general norm scores, we calculated corrections to the general norms to take account of patient characteristics (i.e., sex, age, and dialysis type). CONCLUSIONS Results highlight the importance of having attention for the specific priorities and needs of each individual patient. Adequate disease-specific, norm-based assessment is not only necessary for diagnostic procedures but is an essential element of patient-centered care: It will help to better understand and respect individual patient needs and tailor treatment accordingly.
Collapse
Affiliation(s)
- Judith Tommel
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Faculty of Social and Behavioural Sciences, Leiden University, Leiden, The Netherlands
| | - Andrea W M Evers
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Faculty of Social and Behavioural Sciences, Leiden University, Leiden, The Netherlands.,Medical Delta, Leiden University, TU Delft and Erasmus University, The Netherlands
| | - Henk W van Hamersvelt
- Department of Nephrology, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Rien Jordens
- Department of Nephrology, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Sandra van Dijk
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Faculty of Social and Behavioural Sciences, Leiden University, Leiden, The Netherlands
| | - Luuk B Hilbrands
- Department of Nephrology, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Marc M H Hermans
- Department of Internal Medicine, Division of Nephrology, VieCuri Medical Center, Venlo, The Netherlands
| | - Daan A M J Hollander
- Department of Nephrology, Ravenstein Dialysis Centre, Ravenstein, The Netherlands
| | | | - Marc A G J Ten Dam
- Department of Internal Medicine, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Henriët van Middendorp
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Faculty of Social and Behavioural Sciences, Leiden University, Leiden, The Netherlands
| |
Collapse
|
13
|
Firat M, Vardar-Yagli N, Saglam M, Yildirim T, Erdem Y. Quality of life and physical activity level in patients with chronic kidney disease during COVID-19 pandemic. PSYCHOL HEALTH MED 2023; 28:640-647. [PMID: 36128610 DOI: 10.1080/13548506.2022.2119481] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
The COVID-19 pandemic process may affect the physical and psychosocial health in patients with chronic kidney disease (CKD). The aim of this study was to compare the quality of life, physical activity, fear of COVID-19 and mental health in CKD patients and healthy individualsand compare the aforementioned parameters in end-stage renal disease (ESRD) and renal transplantation (RTx) patients during the pandemic. Eighty-two patients (33 ESRD, 49 RTx) and age-gender matched 108 healthy individuals were included. Quality of life (Short Form 36 Health Survey Questionnaire-SF-36), physical activity (short form of the International Physical Activity Questionnaire -IPAQ-SF), fear of COVID-19 (Fear of COVID-19 Scale-FCV-19S) and mental health (Hospital Anxiety and Depression Scale-HADS) were evaluated. Physical activity levels and all SF-36 scores except mental health in CKD patients were significantly lower than healthy individuals (p < 0.05). FCV-19S and HADS scores were similar between the groups (p > 0.05). ESRD patients' pain and general health perceptions scores of SF-36 were lower than RTx patients' (p < 0.05). Quality of life and physical activity levels were worse in CKD patients compared to healthy individuals during the pandemic. The participants had fear of COVID-19, poor mental health and low physical activity. For these reasons, psychosocial and physical activity interventions for the both groups may be beneficial for the affected outcomes during COVID-19 pandemic.
Collapse
Affiliation(s)
- Merve Firat
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Naciye Vardar-Yagli
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Melda Saglam
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Tolga Yildirim
- Faculty of Medicine, Department of Internal Medicine, Division of Nephrology, Hacettepe University, Ankara, Turkey
| | - Yunus Erdem
- Faculty of Medicine, Department of Internal Medicine, Division of Nephrology, Hacettepe University, Ankara, Turkey
| |
Collapse
|
14
|
Bürker BS, Hardersen RI, Lappegård KT. Symptoms of Depression, Anxiety, and Posttraumatic Stress among Patients with Cardiac Pacemakers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16838. [PMID: 36554718 PMCID: PMC9778963 DOI: 10.3390/ijerph192416838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/11/2022] [Accepted: 12/12/2022] [Indexed: 06/17/2023]
Abstract
Despite being a prerequisite for tailoring specific therapeutic interventions, knowledge of pattern and prevalence of clinically significant psychiatric symptomatology among patients with cardiac pacemakers (PMs), especially of symptoms of posttraumatic stress, is limited. We studied symptoms of depression, anxiety, and posttraumatic stress among PM patients (PM due to syncope or presyncope) compared to participants of (i) a cardiac, (ii) a chronic disease, and (iii) a healthy control group. Symptoms of depression, anxiety and posttraumatic stress were measured by validated self-report scales at least 6 months after implantation of the PM (PM group; n = 38), percutaneous coronary intervention (PCI; PCI control group; n = 23), and first dialysis (Dialysis control group; n = 17). Blood donors constituted the Healthy control group (n = 42). Both PM, PCI, and dialysis patients reported depressive symptoms above clinical cut-off more frequently than the healthy controls (16.2, 26.1, 41.2, and 0%, respectively; p < 0.001). Self-report of symptoms of anxiety and posttraumatic stress did not differ significantly across study groups. However, a non-negligible proportion of PM patients reported on symptoms of posttraumatic stress of anticipated clinical relevance. Identification and treatment of depression deserves attention in clinical routine in all three patient populations. Further study of posttraumatic stress in PM patients seems advisable.
Collapse
Affiliation(s)
- Britta S. Bürker
- Department of Psychiatry, Nordland Hospital Trust Bodø, 8092 Bodø, Norway
- Norwegian National Unit for Sensory Loss and Mental Health, Oslo University Hospital, 0424 Oslo, Norway
| | - Randolf I. Hardersen
- Department of Nephrology, Nordland Hospital Trust Bodø, 8092 Bodø, Norway
- Department of Clinical Medicine, UiT The Arctic University of Norway, 9037 Tromsø, Norway
| | - Knut Tore Lappegård
- Department of Clinical Medicine, UiT The Arctic University of Norway, 9037 Tromsø, Norway
- Division of Medicine, Department of Cardiology, Nordland Hospital Trust Bodø, 8092 Bodø, Norway
| |
Collapse
|
15
|
Alshogran OY, Altawalbeh SM, Khalil AA. Comparison of two self-report scales to assess anxiety and depressive symptoms in hemodialysis patients. Arch Psychiatr Nurs 2022; 41:208-213. [PMID: 36428051 DOI: 10.1016/j.apnu.2022.08.004] [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: 03/01/2022] [Revised: 08/12/2022] [Accepted: 08/21/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Psychiatric illness is prevalent among hemodialysis (HD) patients. This study compared the assessment of anxiety and depressive symptoms among HD patients using two self-administered scales; hospital anxiety and depression scale (HADS) and brief symptom inventory (BSI). METHODS A cross-sectional study was conducted among a convenience sample of HD patients (n = 352) from different dialysis centers in Jordan. Patients were interviewed in dialysis units, and demographics, clinical status, disease, and dialysis history data were collected. Symptoms of anxiety (HADS-A ≥ 8 and BSI-A ≥ 0.82) and depression (HADS-D ≥ 8 and BSI-D ≥ 0.82) were also measured. RESULTS The mean age of participants was 52.2 ± 15.6 years. The majority had been receiving HD three times daily and for >2 years. A significant moderate-strong correlation was observed between HADS-A and BSI-A (r = 0.753, p < 0.0001) as well as HADS-D and BSI-D (r = 0.588, p < 0.0001). Anxiety prevalence was 43.7 % using HADS-A ≥ 8 and 80.7 % using BSI-A ≥ 0.82, while depression prevalence was 53.1 % using HADS-D ≥ 8 and 51.7 % using BSI-D ≥ 0.82. When HADS was used as a standard, the operating characteristics reveal that a higher cut-off for BSI-A is recommended (≥1.58) for better anxiety screening. DISCUSSION Specific and suitable cut-off points need to be further explored and validated for HADS and BSI scales among patients undergoing dialysis.
Collapse
Affiliation(s)
- Osama Y Alshogran
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan.
| | - Shoroq M Altawalbeh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Amani A Khalil
- Department of Clinical Nursing, School of Nursing, The University of Jordan, Amman 11942, Jordan
| |
Collapse
|
16
|
Nadort E, van Geenen NJK, Schouten RW, Boeschoten RE, Chandie Shaw P, Vleming LJ, Schouten M, Farhat K, Dekker FW, van Oppen P, Siegert CEH, Broekman BFP. Validation of Two Screening Tools for Anxiety in Hemodialysis Patients. J Pers Med 2022; 12:jpm12071077. [PMID: 35887577 PMCID: PMC9318791 DOI: 10.3390/jpm12071077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 06/16/2022] [Accepted: 06/27/2022] [Indexed: 11/29/2022] Open
Abstract
Background: Symptoms of anxiety are often unrecognized and untreated in dialysis patients. We investigated the diagnostic accuracy of two widely used screening tools for anxiety in hemodialysis patients. Methods: For this cross-sectional validation study, chronic hemodialysis patients from eight dialysis centers in the Netherlands were included. The Beck Anxiety Inventory (BAI) and Hospital Anxiety and Depression Scale—Anxiety subscale (HADS-A) were validated by the Mini International Neuropsychiatric Inventory (MINI) diagnostic interview. Receiver operating characteristic curves were used to determine the optimal cut-off values. Results: Of 65 participants, 13 (20%) were diagnosed with one or more anxiety disorders on the MINI, of which 5 were included in the analysis. ROC curves showed a good diagnostic accuracy of the BAI and HADS-A. The optimal cut-off value for the BAI was ≥13 (sensitivity 100%, specificity 85%) and for the HADS-A was ≥10 (sensitivity 80%, specificity 100%). Conclusions: Based on our limited data, both the BAI and the HADS-A seem to be valid screening instruments for anxiety in hemodialysis patients that can be used in routine dialysis care. The HADS-A consists of fewer items and showed fewer false-positive results than the BAI, which might make it more useful in clinical practice.
Collapse
Affiliation(s)
- Els Nadort
- Department of Psychiatry, OLVG Hospital, Jan Tooropstraat 164, 1061 AE Amsterdam, The Netherlands; (N.J.K.v.G.); (B.F.P.B.)
- Department of Psychiatry, Amsterdam University Medical Centre and GGZ inGeest, Oldenaller 1, 1081 HJ Amsterdam, The Netherlands; (R.E.B.); (P.v.O.)
- Correspondence:
| | - Noëlle J. K. van Geenen
- Department of Psychiatry, OLVG Hospital, Jan Tooropstraat 164, 1061 AE Amsterdam, The Netherlands; (N.J.K.v.G.); (B.F.P.B.)
| | - Robbert W. Schouten
- Department of Nephrology, OLVG Hospital, Jan Tooropstraat 164, 1061 AE Amsterdam, The Netherlands; (R.W.S.); (C.E.H.S.)
| | - Rosa E. Boeschoten
- Department of Psychiatry, Amsterdam University Medical Centre and GGZ inGeest, Oldenaller 1, 1081 HJ Amsterdam, The Netherlands; (R.E.B.); (P.v.O.)
| | - Prataap Chandie Shaw
- Department of Nephrology, Haaglanden Medisch Centrum, Lijnbaan 32, 2512 VA The Hague, The Netherlands;
| | - Louis Jean Vleming
- Department of Nephrology, HagaZiekenhuis, Els Borst-Eilersplein 275, 2545 AA The Hague, The Netherlands;
| | - Marcel Schouten
- Department of Nephrology, Tergooi Ziekenhuis, Van Riebeeckweg 212, 1213 XZ Hilversum, The Netherlands;
| | - Karima Farhat
- Department of Nephrology, Spaarne Gasthuis, Boerhaavelaan 22, 2035 RC Haarlem, The Netherlands;
| | - Friedo W. Dekker
- Department of Clinical Epidemiology, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA Leiden, The Netherlands;
| | - Patricia van Oppen
- Department of Psychiatry, Amsterdam University Medical Centre and GGZ inGeest, Oldenaller 1, 1081 HJ Amsterdam, The Netherlands; (R.E.B.); (P.v.O.)
| | - Carl E. H. Siegert
- Department of Nephrology, OLVG Hospital, Jan Tooropstraat 164, 1061 AE Amsterdam, The Netherlands; (R.W.S.); (C.E.H.S.)
| | - Birit F. P. Broekman
- Department of Psychiatry, OLVG Hospital, Jan Tooropstraat 164, 1061 AE Amsterdam, The Netherlands; (N.J.K.v.G.); (B.F.P.B.)
- Department of Psychiatry, Amsterdam University Medical Centre and GGZ inGeest, Oldenaller 1, 1081 HJ Amsterdam, The Netherlands; (R.E.B.); (P.v.O.)
| |
Collapse
|
17
|
Kobayashi N, Shinagawa S, Nagata T, Shigeta M, Kondo K. Suppressors of Cytokine Signaling Are Decreased in Major Depressive Disorder Patients. J Pers Med 2022; 12:jpm12071040. [PMID: 35887537 PMCID: PMC9315526 DOI: 10.3390/jpm12071040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 06/23/2022] [Accepted: 06/24/2022] [Indexed: 12/01/2022] Open
Abstract
There is strong evidence for an association between major depressive disorder (MDD) and inflammation. However, some studies have not observed an increase in inflammatory cytokines in MDD, and the mechanism behind this is unknown. In the present study, we evaluated MDD severity using the Montgomery–Åsberg Depression Rating Scale (MADRS) and quantified mRNA levels of the blood inflammatory cytokines interleukin (IL) 1β, IL-6 and tumor necrosis factor alpha (TNF-α), as well as negative regulators of cytokine signaling—comprising IL-10, IL-1RA, SOCS1, SOCS2 and SOCS3—in MDD patients (n = 36), with a focus on mild MDD, and normal controls (NC, n = 30). We also measured the serum levels of IL-1β and IL-6. Neither the blood mRNA nor the protein levels of inflammatory cytokines were significantly elevated in the MDD group compared with the NC group. However, we observed significant decreases in SOCS1, SOCS2 and SOCS3 mRNA in the MDD group compared to the NC group. A significant finding was a decrease in SOCS3 mRNA after remission from MDD, suggesting that SOCS3 is a trait marker in depressive symptoms. We consider that our findings would be useful in elucidating the pathophysiological mechanism of depression.
Collapse
Affiliation(s)
- Nobuyuki Kobayashi
- Department of Virology, The Jikei University School of Medicine, Tokyo 105-8461, Japan;
- Department of Psychiatry, The Jikei University School of Medicine, Tokyo 105-8461, Japan; (S.S.); (T.N.); (M.S.)
- Correspondence: ; Tel.: +81-3-3433-1111; Fax: +81-3-5400-1305
| | - Shunichiro Shinagawa
- Department of Psychiatry, The Jikei University School of Medicine, Tokyo 105-8461, Japan; (S.S.); (T.N.); (M.S.)
| | - Tomoyuki Nagata
- Department of Psychiatry, The Jikei University School of Medicine, Tokyo 105-8461, Japan; (S.S.); (T.N.); (M.S.)
| | - Masahiro Shigeta
- Department of Psychiatry, The Jikei University School of Medicine, Tokyo 105-8461, Japan; (S.S.); (T.N.); (M.S.)
| | - Kazuhiro Kondo
- Department of Virology, The Jikei University School of Medicine, Tokyo 105-8461, Japan;
| |
Collapse
|
18
|
Pain, Anxiety, and Depression in Patients Undergoing Chronic Hemodialysis Treatment: A Multicentre Cohort Study. Pain Manag Nurs 2022; 23:632-639. [DOI: 10.1016/j.pmn.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 02/22/2022] [Accepted: 03/08/2022] [Indexed: 11/21/2022]
|
19
|
Marthoenis M, Syukri M, Abdullah A, Tandi TMR, Putra N, Laura H, Setiawan A, Sofyan H, Schouler-Ocak M. Quality of life, depression, and anxiety of patients undergoing hemodialysis: Significant role of acceptance of the illness. Int J Psychiatry Med 2021; 56:40-50. [PMID: 32216494 DOI: 10.1177/0091217420913382] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Routine dialysis is stressful. It has the possibility of leading to depression and anxiety and also reducing patients' quality of life. Despite these significant consequences, these comorbidities have been rarely studied among Indonesian patients. This study aims to examine the rate of depression, anxiety, and the role of acceptance of their illness on patients' quality of life. METHOD A total of 213 patients undergoing hemodialysis in three general hospitals in Aceh, Indonesia, were included in the study. The presence of depression, anxiety, and the quality of life of each patient was assessed using the hospital anxiety and depression scale and WHO quality of life-BREF questionnaires. RESULTS The prevalence of depression and anxiety was 46% and 30.5%, respectively. Depression was only associated with the presence of anxiety and the duration of hemodialysis. Anxiety was negatively associated with quality of life but positively associated with depression and the prescription of an anxiolytic. Overall quality of life was associated with age, body mass index, the presence of anxiety, and acceptance of the illness. Acceptance of the illness was also independently associated with almost every domain of patients' quality of life. CONCLUSIONS The rates of depression and anxiety among patients undergoing hemodialysis in the current study setting are relatively similar to the rates in other settings. Patients' acceptance of their illnesses is significantly associated with the occurrence of anxiety and quality of life. Therefore, health practitioners should help patients accept their illnesses and the administration of regular hemodialysis.
Collapse
Affiliation(s)
- Marthoenis Marthoenis
- Department of Psychiatry and Mental Health Nursing, Syiah Kuala University, Banda Aceh, Indonesia
| | - Maimun Syukri
- Department of Internal Medicine, Syiah Kuala University, Banda Aceh, Indonesia
| | - Abdullah Abdullah
- Department of Internal Medicine, Zoenal Abidin Hospital, Banda Aceh, Indonesia
| | - Teuku M Reza Tandi
- Department of Internal Medicine, Syiah Kuala University, Banda Aceh, Indonesia
| | - Nadisyah Putra
- Department of Internal Medicine, Syiah Kuala University, Banda Aceh, Indonesia
| | - Hasna Laura
- Department of Internal Medicine, Syiah Kuala University, Banda Aceh, Indonesia
| | - Arie Setiawan
- Department of Internal Medicine, Syiah Kuala University, Banda Aceh, Indonesia
| | - Hizir Sofyan
- Department of Statistics, Syiah Kuala University, Banda Aceh, Indonesia
| | - Meryam Schouler-Ocak
- University Psychiatric Clinic of Charité at St. Hedwig's Hospital, Berlin, Germany
| |
Collapse
|
20
|
Chen X, Huang W, Wei D, Ding DG, Jiao Y, Pan HL, Jin YT, Zheng YW, Zhang YJ, Zhang YR, Liu YR, Zhou ZY. Clinical effect of catgut implantation at acupoints for the treatment of simple obesity: A multicentre randomized controlled trial. Medicine (Baltimore) 2020; 99:e23390. [PMID: 33235115 PMCID: PMC7710253 DOI: 10.1097/md.0000000000023390] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 10/29/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Catgut implantation at acupoints (CIA) is a subtype of acupuncture that has been widely used to treat simple obesity, but evidence for its effectiveness remains scarce. The aim of this study is to evaluate the efficacy and safety of treating simple obesity with CIA. OBJECTIVE This clinical trial aims to evaluate the effectiveness and safety of CIA used for treatment of simple obesity. METHODS This is a multicentre, randomized, parallel, sham-controlled clinical trial. A total of 216 patients with simple obesity will be recruited. They will be randomly assigned in a 1:1 ratio to either the CIA group or the sham control group. All treatments will be given once every 2 weeks. The primary outcome measure is the rate of waistline reduction. Secondary outcome measures are the rates of reduction of body measurements, including weight, body mass index (BMI), hipline, waist-hip-ratio (WHR) and body fat percentage (BFP), the changes in scores on scales, including the Impact of Weight on Quality of Life Questionnaire (IWQOL-Lite), Short Form 36 (SF-36), the Hospital Anxiety and Depression Scale (HAD) and the Self-Esteem Scale (SES), Outcomes will be evaluated at baseline and at weeks 4, 8, 12, 16, 28, and 40, respectively. All adverse events that occur during this study will be recorded. If any participant withdraws from the trial, an intention-to-treat analysis (ITT) will be performed. CONCLUSION This is a randomized, sham-controlled trial of CIA treatment for simple obesity. The results of this trial will provide more evidence on whether CIA is efficacious and safe for treating obesity. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02936973. Registered on October 18, 2016.
Collapse
Affiliation(s)
- Xia Chen
- Department of Acupuncture, Hubei Provincial Hospital of Traditional Chinese Medicine
- Hubei Province Academy of Traditional Chinese Medicine
| | - Wei Huang
- Department of Acupuncture, Hubei Provincial Hospital of Traditional Chinese Medicine
- Hubei Province Academy of Traditional Chinese Medicine
- Hubei University of Chinese Medicine/The Co-innovation Center for Preventive Treatment of Disease of Acupuncture-moxibustion in Hubei Province, Wuhan, China
| | - Dan Wei
- Department of Acupuncture, Hubei Provincial Hospital of Traditional Chinese Medicine
- Hubei Province Academy of Traditional Chinese Medicine
| | - De-Guang Ding
- Department of Acupuncture, Hubei Provincial Hospital of Traditional Chinese Medicine
- Hubei Province Academy of Traditional Chinese Medicine
| | - Yang Jiao
- Department of Acupuncture, Hubei Provincial Hospital of Traditional Chinese Medicine
- Hubei Province Academy of Traditional Chinese Medicine
| | - Hong-Ling Pan
- Department of Acupuncture, Hubei Provincial Hospital of Traditional Chinese Medicine
- Hubei Province Academy of Traditional Chinese Medicine
| | - Yi-Ting Jin
- Hubei University of Chinese Medicine/The Co-innovation Center for Preventive Treatment of Disease of Acupuncture-moxibustion in Hubei Province, Wuhan, China
| | - Yi-Wei Zheng
- Department of Acupuncture, Hubei Provincial Hospital of Traditional Chinese Medicine
- Hubei Province Academy of Traditional Chinese Medicine
| | - Yan-Ji Zhang
- Hubei University of Chinese Medicine/The Co-innovation Center for Preventive Treatment of Disease of Acupuncture-moxibustion in Hubei Province, Wuhan, China
| | - Ying-Rong Zhang
- Hubei University of Chinese Medicine/The Co-innovation Center for Preventive Treatment of Disease of Acupuncture-moxibustion in Hubei Province, Wuhan, China
| | - Yi-Ran Liu
- Department of Acupuncture, Hubei Provincial Hospital of Traditional Chinese Medicine
- Hubei Province Academy of Traditional Chinese Medicine
| | - Zhong-Yu Zhou
- Department of Acupuncture, Hubei Provincial Hospital of Traditional Chinese Medicine
- Hubei Province Academy of Traditional Chinese Medicine
| |
Collapse
|
21
|
Kondo K, Antick JR, Ayers CK, Kansagara D, Chopra P. Depression Screening Tools for Patients with Kidney Failure: A Systematic Review. Clin J Am Soc Nephrol 2020; 15:1785-1795. [PMID: 33203736 PMCID: PMC7769028 DOI: 10.2215/cjn.05540420] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 10/19/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Patients with kidney failure experience depression at rates higher than the general population. Despite the Centers for Medicare and Medicaid Services' ESRD Quality Incentive Program requirements for routine depression screening for patients with kidney failure, no clear guidance exists. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS For this systematic review, we searched MEDLINE, PsycINFO, and other databases from inception to June 2020. Two investigators screened all abstracts and full text. We included studies assessing patients with kidney failure and compared a tool to a clinical interview or another validated tool (e.g., Beck Depression Inventory II). We abstracted data related to sensitivity and specificity, positive and negative predictive value, and the area under the curve. We evaluated the risk of bias using the Quality Assessment of Diagnostic Accuracy Studies 2. RESULTS A total of 16 studies evaluated the performance characteristics of depression assessment tools for patients with kidney failure. The Beck Depression Inventory II was by far the best studied. A wide range of thresholds were reported. Shorter tools in the public domain such as the Patient Health Questionnaire 9 and Geriatric Depression Scale 15 (adults over 60) performed well but were not well studied. Short tools such as the Beck Depression Inventory-Fast Screen may be a good option for an initial screen. CONCLUSIONS There is limited research evaluating the diagnostic accuracy of most screening tools for depression in patients with kidney failure, and existing studies may not be generalizable to US populations. Studies suffer from limitations related to methodology quality and/or reporting. Future research should target widely used, free tools such as the Patient Health Questionnaire 2 and the Patient Health Questionnaire 9. CLINICAL TRIAL REGISTRY NAME AND REGISTRATION NUMBER Systematic Review Registration: PROSPERO CRD42020140227.
Collapse
Affiliation(s)
- Karli Kondo
- Evidence Synthesis Program, Veterans Affairs Portland Health Care System, Portland, Oregon .,Research Integrity Office, Oregon Health & Science University, Portland, Oregon
| | - Jennifer R Antick
- School of Graduate Psychology, Pacific University, Hillsboro, Oregon.,Legacy Good Samaritan Medical Center, Portland, Oregon
| | - Chelsea K Ayers
- Evidence Synthesis Program, Veterans Affairs Portland Health Care System, Portland, Oregon
| | - Devan Kansagara
- Evidence Synthesis Program, Veterans Affairs Portland Health Care System, Portland, Oregon.,Department of Medicine, Oregon Health & Science University, Portland, Oregon.,Center to Improve Veteran Involvement in Care, Veterans Affairs Portland Health Care System, Portland, Oregon
| | - Pavan Chopra
- Department of Medicine, Oregon Health & Science University, Portland, Oregon
| |
Collapse
|
22
|
Graier T, Fink-Puches R, Porkert S, Lang R, Pöchlauer S, Ratzinger G, Tanew A, Selhofer S, Sator PG, Hofer A, Gruber-Wackernagel A, Legat FJ, Vieyra-Garcia PA, Quehenberger F, Wolf P. Quality of Life, Anxiety, and Depression in Patients With Early-Stage Mycosis Fungoides and the Effect of Oral Psoralen Plus UV-A (PUVA) Photochemotherapy on it. Front Med (Lausanne) 2020; 7:330. [PMID: 32850876 PMCID: PMC7419471 DOI: 10.3389/fmed.2020.00330] [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: 05/11/2020] [Accepted: 06/04/2020] [Indexed: 12/17/2022] Open
Abstract
Background: Little is known about psychological discomfort and quality of life (QoL) in early stage mycosis fungoides (MF) and the effect of psoralen plus UV-A (PUVA) on it. Objective: To evaluate QoL, anxiety, and depression with validated instruments in early stage MF patients and whether PUVA treatment improves it. Methods: Patients with stage IA to IIA MF were treated with PUVA twice weekly for 12–24 weeks, followed by maintenance treatment or not, in a prospective randomized clinical trial. Patients completed a questionnaire on DLQI as well as the Hospital Anxiety and Depression Scale (HADS) prior to therapy, after their last PUVA exposure, and after the PUVA maintenance or observance phase. Results: For 24 patients with early stage MF, completed questionnaires were available and analyzed. Prior to treatment, 17% reported strong (DLQI > 10) and 29% moderate impairment (DLQI 6–10) in QoL; 33% of patients reported HADS scores indicating anxiety, and 21% reported scores indicating depression. PUVA significantly improved overall QoL by reducing mean DLQI scores by 58.6% (p = 0.003), HADS-A by 30% (p = 0.045), and HADS-D by 44% (p = 0.002). Improvements in QoL and psychological well-being seemed to be sustained, irrespective of maintenance treatment or not. Limitations: Small sample size. Conclusions: PUVA sustainably improves QoL and psychological well-being in patients with early stage MF. Clinical trial registration:ClinicalTrials.gov identifier: NCT01686594.
Collapse
Affiliation(s)
- Thomas Graier
- Research Unit for Photodermatology, Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - Regina Fink-Puches
- Research Unit for Photodermatology, Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - Stephanie Porkert
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Roland Lang
- Department of Dermatology and Allergology, Paracelsus Medical University, Salzburg, Austria
| | | | - Gudrun Ratzinger
- Department of Dermatology Venereology and Allergology, Medical University of Innsbruck, Innsbruck, Austria
| | - Adrian Tanew
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Sylvia Selhofer
- Department of Dermatology and Allergology, Paracelsus Medical University, Salzburg, Austria
| | | | - Angelika Hofer
- Research Unit for Photodermatology, Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - Alexandra Gruber-Wackernagel
- Research Unit for Photodermatology, Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - Franz J Legat
- Research Unit for Photodermatology, Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - Pablo Augusto Vieyra-Garcia
- Research Unit for Photodermatology, Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - Franz Quehenberger
- Institute for Medical Informatics, Statistics, and Documentation, Medical University of Graz, Graz, Austria
| | - Peter Wolf
- Research Unit for Photodermatology, Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| |
Collapse
|
23
|
Colomo N, Olveira C, Hernández-Pedrosa J, Bergero T, Fábrega-Ruz J, Porras N, Girón MV, de Rota LF, Olveira G. Validity of Self-rating Screening Scales for the Diagnosis of Depression and Anxiety in Adult Patients With Bronchiectasis. Arch Bronconeumol 2020; 57:179-185. [PMID: 32143909 DOI: 10.1016/j.arbres.2020.01.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 01/08/2020] [Accepted: 01/12/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND There are no previous studies aimed at assessing the validity of the screening scales for depression and anxiety in adult patients with bronchiectasis. AIMS To analyze the psychometric properties of Hospital Anxiety and Depression Scale (HADS), Beck Depression Inventory (BDI) and Hamilton Anxiety Scale and to evaluate the concordance for the diagnosis of depression and anxiety between these screening scales and the structured clinical interview in adult patients with bronchiectasis. METHOD Cross sectional study. 52 patients with bronchiectasis completed HADS, BDI and Hamilton Anxiety Scale; afterwards, were individually interviewed by a mental health care professional using the structured Mini International Neuropsychiatric Interview (MINI), which evaluates for depression and anxiety according to DSM-IV criteria. RESULTS Based on MINI, 18 subjects (34.6%) had a diagnosis of depression and 25 (48.1%) had anxiety. Optimal cut-off values to detect depression were ≥9 for the HADS-D (sensitivity 0.833, specificity 0.971, AUC 0.962 [95% CI 0.918-1]), and 17 for BDI (sensitivity 0.889, specificity 0.912, AUC 0.978 [95% CI 0.945-1]). Optimal cut-off values to detect anxiety were ≥4 for the HADS-A (sensitivity 0.960, specificity 0.593, AUC 0.833 [95% CI 0.723-0.943]), and 17 for Hamilton Anxiety Scale (sensitivity 0.800, specificity 0.852, AUC 0.876 [95% CI 0.781-0.970]). CONCLUSION The self-rating screening scales HADS, BDI and Hamilton Anxiety Scale are reliable tools to screen for depression and anxiety in adult patients with bronchiectasis. However, the use of specific cut-off values may improve the diagnostic accuracy of the previous scales in this specific group of patients.
Collapse
Affiliation(s)
- Natalia Colomo
- Endocrinology and Nutrition Department, Hospital Regional Universitario de Málaga/Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain; CIBER of Diabetes and Metabolic Diseases (CIBERDEM), Madrid, Spain
| | - Casilda Olveira
- Pneumology Department, Hospital Regional Universitario de Málaga/Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.
| | - Javier Hernández-Pedrosa
- Mental Health Department, Hospital Regional Universitario de Málaga/Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Trinidad Bergero
- Mental Health Department, Hospital Regional Universitario de Málaga/Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Julia Fábrega-Ruz
- Mental Health Department, Hospital Regional Universitario de Málaga/Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Nuria Porras
- Endocrinology and Nutrition Department, Hospital Regional Universitario de Málaga/Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - María Victoria Girón
- Pneumology Department, Hospital Regional Universitario de Málaga/Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | | | - Gabriel Olveira
- Endocrinology and Nutrition Department, Hospital Regional Universitario de Málaga/Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain; CIBER of Diabetes and Metabolic Diseases (CIBERDEM), Madrid, Spain
| |
Collapse
|
24
|
Nochaiwong S, Ruengorn C, Noppakun K, Panyathong S, Dandecha P, Sood MM, Saenjum C, Awiphan R, Sirilun S, Mongkhon P, Chongruksut W, Thavorn K. Comparative Effectiveness of Local Application of Chlorhexidine Gluconate, Mupirocin Ointment, and Normal Saline for the Prevention of Peritoneal Dialysis-related Infections (COSMO-PD Trial): a multicenter randomized, double-blind, controlled protocol. Trials 2019; 20:754. [PMID: 31856900 PMCID: PMC6924023 DOI: 10.1186/s13063-019-3953-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 12/03/2019] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Current international guidelines recommend the use of a daily topical exit-site antimicrobial to prevent peritoneal dialysis (PD)-related infections. Although nonantibiotic-based therapies are appealing because they may limit antimicrobial resistance, no controlled trials have been conducted to compare topical antimicrobial agents with usual exit-site care for the prevention of PD-related infections among the Thai PD population. We propose a controlled three-arm trial to examine the efficacy and safety of a daily chlorhexidine gluconate-impregnated patch versus mupirocin ointment versus usual exit-site care with normal saline for the prevention of PD-related infections. METHODS/DESIGNS This study is a randomized, double-blind, multicenter, active-controlled, clinical trial. Adult patients aged 18 years or older who have end-stage kidney disease and are undergoing PD will be enrolled at three PD Centers in Thailand. A total of 354 PD patients will be randomly assigned to either the 2% chlorhexidine gluconate-impregnated patch, mupirocin ointment, or usual exit-site care with normal saline dressing according to a computer-generated random allocation sequence. Participants will be followed until discontinuation of PD or completion of 24 months. The primary study outcomes are time to first PD-related infection (exit-site/tunnel infection or peritonitis) event and the overall difference in PD-related infection rates between study arms. Secondary study outcomes will include (i) the rate of infection-related catheter removal and PD technique failure, (ii) rate of nasal and exit-site Staphylococcus aureus colonization, (iii) healthcare costs, and (iv) skin reactions and adverse events. We plan to conduct a cost-utility analysis alongside the trial from the perspectives of patients and society. A Markov simulation model will be used to estimate the total cost and health outcome in terms of quality-adjusted life years (QALYs) over a 20-year time horizon. An incremental cost-effectiveness ratio in Thai Baht and U.S. dollars per QALYs gained will be illustrated. A series of probabilistic sensitivity analyses will be conducted to assess the robustness of the cost-utility analysis findings. DISCUSSION The results from this study will provide new clinical and cost-effectiveness evidence to support the best strategy for the prevention of PD-related infections among the Thai PD population. TRIAL REGISTRATION ClinicalTrials.gov, NCT02547103. Registered on September 11, 2015.
Collapse
Affiliation(s)
- Surapon Nochaiwong
- Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, 50200, Thailand. .,Pharmacoepidemiology and Statistics Research Center (PESRC), Chiang Mai University, Chiang Mai, 50200, Thailand.
| | - Chidchanok Ruengorn
- Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, 50200, Thailand.,Pharmacoepidemiology and Statistics Research Center (PESRC), Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Kajohnsak Noppakun
- Pharmacoepidemiology and Statistics Research Center (PESRC), Chiang Mai University, Chiang Mai, 50200, Thailand.,Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Setthapon Panyathong
- Pharmacoepidemiology and Statistics Research Center (PESRC), Chiang Mai University, Chiang Mai, 50200, Thailand.,Kidney Center, Nakornping Hospital, Chiang Mai, 50180, Thailand
| | - Phongsak Dandecha
- Division of Nephrology, Department of Internal Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110, Thailand
| | - Manish M Sood
- Ottawa Hospital Research Institute, Ottawa Hospital, Ottawa, Ontario, K1H 8L6, Canada.,Division of Nephrology, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Chalermpong Saenjum
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Ratanaporn Awiphan
- Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, 50200, Thailand.,Pharmacoepidemiology and Statistics Research Center (PESRC), Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Sasithorn Sirilun
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Pajaree Mongkhon
- Pharmacoepidemiology and Statistics Research Center (PESRC), Chiang Mai University, Chiang Mai, 50200, Thailand.,School of Pharmaceutical Sciences, University of Phayao, Muang, Phayao, 56000, Thailand
| | - Wilaiwan Chongruksut
- Pharmacoepidemiology and Statistics Research Center (PESRC), Chiang Mai University, Chiang Mai, 50200, Thailand.,Depertment of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Kednapa Thavorn
- Pharmacoepidemiology and Statistics Research Center (PESRC), Chiang Mai University, Chiang Mai, 50200, Thailand.,Ottawa Hospital Research Institute, Ottawa Hospital, Ottawa, Ontario, K1H 8L6, Canada.,School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, K1G 5Z3, Canada.,Institute of Clinical and Evaluative Sciences, ICES uOttawa, Ottawa, Ontario, K1Y 4E9, Canada
| | | |
Collapse
|
25
|
van Zwieten A, Wong G, Ruospo M, Palmer SC, Teixeira-Pinto A, Barulli MR, Iurillo A, Saglimbene V, Natale P, Gargano L, Murgo M, Loy CT, Tortelli R, Craig JC, Johnson DW, Tonelli M, Hegbrant J, Wollheim C, Logroscino G, Strippoli GF, Cagnazzo A, Antinoro R, Sambati M, Donatelli C, Dambrosio N, Saturno C, Marangelli A, Pedone F, Matera G, Benevento M, Papagni S, Alicino F, Latassa G, Molino A, Grippaldi F, Bertino D, Montalto G, Messina S, Campo S, Nasisi P, Failla A, Bua A, Pagano S, Marino G, Sanfilippo N, Rallo D, Maniscalco A, Capostagno C, Randazzo G, Fici M, Lupo A, Fichera R, D'angelo A, Di Toro Mammarella R, Meconizzi M, Boccia E, Mantuano M, Flammini A, Moscardelli L. Associations of Cognitive Function and Education Level With All-Cause Mortality in Adults on Hemodialysis: Findings From the COGNITIVE-HD Study. Am J Kidney Dis 2019; 74:452-462. [DOI: 10.1053/j.ajkd.2019.03.424] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 03/08/2019] [Indexed: 12/24/2022]
|
26
|
Alshogran OY, Al-Eitan LN, Altawalbeh SM, Khalil AA, Alqudah MAY, Oweis AO, Aman HA, Alhawari HH. Investigating the Contribution of NPSR1, IL-6 and BDNF Polymorphisms to Depressive and Anxiety Symptoms in Hemodialysis Patients. Prog Neuropsychopharmacol Biol Psychiatry 2019; 94:109657. [PMID: 31132388 DOI: 10.1016/j.pnpbp.2019.109657] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 05/21/2019] [Accepted: 05/22/2019] [Indexed: 12/20/2022]
Abstract
AIMS Psychological symptoms are prevalent in hemodialysis (HD) patients. Previous investigations showed that brain-derived neurotrophic factor (BDNF) and interleukin-6 (IL-6) as well as the interaction with neuropeptide S receptor 1 (NPSR1) are linked to the development of psychological distress. This study examined the association of polymorphisms of genes encoding these proteins with depression and anxiety in a representative group of Jordanian HD patients. METHODS A total of 302 HD patients were involved in the study and categorized into three groups based on the Hospital Anxiety and Depression Scale, HADS-D or HADS-A scores as follows: normal (<7), mild (8-10) and moderate-severe (11-21). Single nucleotide polymorphism (SNP) of NPSR1 Asn107Ile (rs324981), IL-6 G174C (rs1800795), and BDNF Val66Met (rs6265) was genotyped using blood samples. RESULTS The frequency of Ile-allele of NPSR1 Asn107Ile was significantly higher in patients with moderate-severe HADS-A scores versus normal (53% vs. 40.8%, p = .035). Using ordinal regression analysis, Asn-allele of NPSR1 polymorphism was nominally significantly associated with a lower risk of anxiety (OR = 0.57, CI: 0.33-0.97, p = .038) after adjusting for other covariates. A marginally significant difference in genotype distribution of IL-6 G174C was observed among patients according to HADS-D scores (p = .05). Furthermore, carriers of IL-6174 CC genotype showed lower median IL-6 serum concentration versus carriers of GG genotype (5.2 vs. 1.35 pg/mL, p < .05). CONCLUSIONS The results support the genetic role of NPSR1 in the pathogenesis of anxiety and suggest that carriers of NPSR1 Ile-allele are at increased risk of anxiety in HD patients. Neither BDNF Val66Met nor IL-6 G174C were linked to psychological symptoms. Future studies among other ethnicities are necessary to verify the observations.
Collapse
Affiliation(s)
- Osama Y Alshogran
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid 22110, Jordan.
| | - Laith N Al-Eitan
- Department of Applied Biological Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan; Department of Biotechnology and Genetic Engineering, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Shoroq M Altawalbeh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Amani A Khalil
- Department of Clinical Nursing, School of Nursing, The University of Jordan, Amman 11942, Jordan
| | - Mohammad A Y Alqudah
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Ashraf O Oweis
- Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Hatem A Aman
- Department of Applied Biological Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Hussein H Alhawari
- Department of Internal Medicine, Faculty of Medicine, The University of Jordan, Amman 11942, Jordan
| |
Collapse
|
27
|
Khan A, Khan AH, Adnan AS, Sulaiman SAS, Mushtaq S. Prevalence and predictors of depression among hemodialysis patients: a prospective follow-up study. BMC Public Health 2019; 19:531. [PMID: 31072378 PMCID: PMC6507067 DOI: 10.1186/s12889-019-6796-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Accepted: 04/10/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Even though depression is one of the most common psychiatric disorders, it is under-recognized in hemodialysis (HD) patients. Existing literature does not provide enough information on evaluation of predictors of depression among HD patients. The objective of the current study was to determine the prevalence and predictors of depression among HD patients. METHODS A multicenter prospective follow-up study. All eligible confirmed hypertensive HD patients who were consecutively enrolled for treatment at the study sites were included in the current study. HADS questionnaire was used to assess the depression level among study participants. Patients with physical and/or cognitive limitations that prevent them from being able to answer questions were excluded. RESULTS Two hundred twenty patients were judged eligible and completed questionnaire at the baseline visit. Subsequently, 216 and 213 patients completed questionnaire on second and final follow up respectively. The prevalence of depression among patients at baseline, 2nd visit and final visit was 71.3, 78.2 and 84.9% respectively. The results of regression analysis showed that treatment given to patients at non-governmental organizations (NGO's) running HD centers (OR = 0.347, p-value = 0.039) had statistically significant association with prevalence of depression at final visit. CONCLUSIONS Depression was prevalent in the current study participants. Negative association observed between depression and hemodialysis therapy at NGO's running centers signifies patients' satisfaction and better depression management practices at these centers.
Collapse
Affiliation(s)
- Amjad Khan
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Penang, Malaysia
- Chronic Kidney Disease Resource Centre, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan Malaysia
- Department of Pharmacy, Quaid-i-Azam University, Islamabad, 45320 Pakistan
| | - Amer Hayat Khan
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Penang, Malaysia
- Chronic Kidney Disease Resource Centre, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan Malaysia
| | - Azreen Syazril Adnan
- Chronic Kidney Disease Resource Centre, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan Malaysia
- Management Science University, University Drive, Off Persiaran Olahraga, Section 13, 40100 Shah Alam, Selangor Malaysia
| | - Syed Azhar Syed Sulaiman
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Penang, Malaysia
| | - Saima Mushtaq
- Health Care Biotechnology Department, Atta ur Rahman School of Applied Biosciences, National University of Science & Technology, Islamabad, 44000 Pakistan
| |
Collapse
|
28
|
Schouten RW, Haverkamp GL, Loosman WL, Chandie Shaw PK, van Ittersum FJ, Smets YFC, Vleming LJ, Dekker FW, Honig A, Siegert CEH. Anxiety Symptoms, Mortality, and Hospitalization in Patients Receiving Maintenance Dialysis: A Cohort Study. Am J Kidney Dis 2019; 74:158-166. [PMID: 31027882 DOI: 10.1053/j.ajkd.2019.02.017] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 02/09/2019] [Indexed: 11/11/2022]
Abstract
RATIONALE & OBJECTIVE Anxiety symptoms are common in dialysis patients and have a large impact on quality of life. The association of anxiety symptoms with adverse clinical outcomes in dialysis patients is largely unknown. This study examined the association of anxiety symptoms with hospitalization and mortality in patients receiving maintenance dialysis. STUDY DESIGN Prospective cohort study. SETTING & PARTICIPANTS Maintenance dialysis patients treated at 10 dialysis centers in the Netherlands between 2012 and 2016. EXPOSURES Time-varying symptoms of anxiety and depression using the Beck Anxiety Inventory and Beck Depression Inventory. OUTCOMES All-cause mortality, 1-year hospitalization rate, and hospital length of stay. ANALYTICAL APPROACH Cox proportional hazards and Poisson regression models adjusted for sociodemographic and clinical variables. Sensitivity analyses included multiple imputation of missing data and restriction to incident patients only. RESULTS 687 patients were included, composed of 433 prevalent and 242 incident dialysis patients. Median follow-up time was 3.1 (IQR, 3.0-3.5) years, during which 172 deaths occurred. 22% of patients had anxiety symptoms and 42% had depressive symptoms. Anxiety symptoms were associated with all-cause mortality and 1-year hospitalization rate and length of stay in all multivariable models. Anxiety symptoms showed a clear dose-response relationship with mortality. LIMITATIONS Depression and anxiety often coexist and share symptoms. The observational design of this study limits inferences about causal mechanisms between anxiety and clinical outcomes. CONCLUSIONS Anxiety symptoms are independently associated with increased risk for mortality and 1-year hospitalization. Anxiety symptoms are a clinically relevant risk factor for morbidity and mortality in dialysis patients and warrant further research on effective treatment.
Collapse
Affiliation(s)
- Robbert W Schouten
- Department of Nephrology, OLVG, Amsterdam, the Netherlands; Department of Psychiatry, OLVG, Amsterdam, the Netherlands.
| | - Gertrud L Haverkamp
- Department of Nephrology, OLVG, Amsterdam, the Netherlands; Department of Psychiatry, OLVG, Amsterdam, the Netherlands
| | - Wim L Loosman
- Department of Nephrology, OLVG, Amsterdam, the Netherlands; Department of Psychiatry, OLVG, Amsterdam, the Netherlands
| | | | | | - Yves F C Smets
- Department of Nephrology, OLVG, Amsterdam, the Netherlands
| | - Louis-Jean Vleming
- Department of Nephrology, Haga Teaching Hospital, The Hague, the Netherlands
| | - Friedo W Dekker
- Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, the Netherlands
| | - Adriaan Honig
- Department of Psychiatry, OLVG, Amsterdam, the Netherlands
| | | |
Collapse
|
29
|
Drangsholt SH, Cappelen UW, von der Lippe N, Høieggen A, Os I, Brekke FB. Beliefs about medicines in dialysis patients and after renal transplantation. Hemodial Int 2019; 23:117-125. [DOI: 10.1111/hdi.12717] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 10/03/2018] [Accepted: 10/15/2018] [Indexed: 12/22/2022]
Affiliation(s)
| | | | - Nanna von der Lippe
- Faculty of Medicine; University of Oslo; Oslo Norway
- Department of Nephrology; Oslo University Hospital Ullevål; Oslo Norway
| | - Aud Høieggen
- Faculty of Medicine; University of Oslo; Oslo Norway
- Department of Nephrology; Oslo University Hospital Ullevål; Oslo Norway
| | - Ingrid Os
- Faculty of Medicine; University of Oslo; Oslo Norway
- Department of Nephrology; Oslo University Hospital Ullevål; Oslo Norway
| | - Fredrik B. Brekke
- Sanitary Battalion; Brigade North, Norwegian Armed Forces; Setermoen Norway
| |
Collapse
|
30
|
Collister D, Rodrigues JC, Mazzetti A, Salisbury K, Morosin L, Rabbat C, Brimble KS, Walsh M. Single Questions for the Screening of Anxiety and Depression in Hemodialysis. Can J Kidney Health Dis 2019; 6:2054358118825441. [PMID: 30719321 PMCID: PMC6348566 DOI: 10.1177/2054358118825441] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 12/07/2018] [Indexed: 11/17/2022] Open
Abstract
Background: Depression and anxiety are common and underrecognized in end-stage renal
disease (ESRD), are associated with poor outcomes and reduced health-related
quality of life, and are potentially treatable. Simple, accurate screening
tools are needed. Objective: We examined the operating characteristics of single questions for anxiety and
depression from the Edmonton Symptom Assessment System (ESAS) in
hemodialysis. Design: Cross-sectional study. Setting: Two outpatient hemodialysis units (1 tertiary, 1 community) in Hamilton,
Canada. Patients: Adult prevalent hemodialysis patients. Measurements: ESAS and Hospital Anxiety and Depression Scale (HADS). Methods: Participants were asked the degree to which they experienced anxiety and
depression using the ESAS. ESAS single questions for anxiety and depression
were compared with the reference standard of the HADS using dialysis
population specific cutoffs (HADS anxiety subscale ≥6 and HADS depression
subscale ≥7). Logistic regression was used to create receiver operating
characteristics (ROC) curves. Results: We recruited 50 participants with a mean age of 64 (SD = 12.4) years, of whom
52% were male and 96% were on ≥3× weekly hemodialysis. Using the reference
standards, 28 (56%) had a diagnosis of anxiety and 27 (54%) had a diagnosis
of depression. Areas under the ROC curves were 0.83 for anxiety and 0.81 for
depression using ESAS scores of ≥2. Limitations: Sample size and the lack of a reference gold standard. Conclusions: The ESAS single questions for anxiety and depression have reasonable
discrimination in a hemodialysis population. The use of more complex and
time-consuming screening instruments could be reduced by adopting the ESAS
questions for anxiety and depression in hemodialysis.
Collapse
Affiliation(s)
- David Collister
- Department of Medicine, McMaster University, Hamilton, ON, Canada.,St. Joseph's Healthcare Hamilton, ON, Canada.,Population Health Research Institute, Hamilton, ON, Canada.,Department of Health Research Methods, Evaluation and Impact, McMaster University, Hamilton, ON, Canada
| | - Jennifer C Rodrigues
- Department of Medicine, McMaster University, Hamilton, ON, Canada.,St. Joseph's Healthcare Hamilton, ON, Canada.,Population Health Research Institute, Hamilton, ON, Canada.,Department of Health Research Methods, Evaluation and Impact, McMaster University, Hamilton, ON, Canada
| | | | | | | | - Christian Rabbat
- Department of Medicine, McMaster University, Hamilton, ON, Canada.,St. Joseph's Healthcare Hamilton, ON, Canada
| | - K Scott Brimble
- Department of Medicine, McMaster University, Hamilton, ON, Canada.,St. Joseph's Healthcare Hamilton, ON, Canada
| | - Michael Walsh
- Department of Medicine, McMaster University, Hamilton, ON, Canada.,St. Joseph's Healthcare Hamilton, ON, Canada.,Population Health Research Institute, Hamilton, ON, Canada.,Department of Health Research Methods, Evaluation and Impact, McMaster University, Hamilton, ON, Canada
| |
Collapse
|
31
|
Abstract
Pain is one of the most common symptoms among patients with end-stage renal disease (ESRD), and is often under recognized and not adequately managed in hemodialysis (HD) patients. Barriers to adequate pain management include poor awareness of the problem, insufficient medical education, fears of possible drug-related side effects, and common misconceptions about the inevitability of pain in elderly and HD patients. Caregivers working in HD should be aware of the possible consequences of inadequate pain assessment and management. Common pain syndromes in HD patients include musculoskeletal diseases and metabolic neuropathies, associated with typical intradialytic pain. Evaluating the etiology, nature, and intensity of pain is crucial for choosing the correct analgesic. A mechanism-based approach to pain management may result in a better outcome. Pharmacokinetic considerations on clearance alterations and possible toxicity in patients with ESRD should drive the right analgesic prescription. Comorbidities and polymedications may increase the risk of drug-drug interactions, therefore drug metabolism should be taken into account when selecting analgesic drugs. Automedication is common among HD patients but should be avoided to reduce the risk of hazardous drug administration. Further research is warranted to define the efficacy and safety of analgesic drugs and techniques in the context of patients with ESRD as generalizing information from studies conducted in the general population could be inappropriate and potentially dangerous. A multidisciplinary approach is recommended for the management of complex pain syndromes in frail patients, such as those suffering from ESRD.
Collapse
Affiliation(s)
- Flaminia Coluzzi
- Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino, Corso della Repubblica 79, 04100, Latina, Italy.
| |
Collapse
|
32
|
Relationship between anxiety/depression and oral health-related quality of life in inpatients of convalescent hospitals. Odontology 2018; 107:254-260. [PMID: 30317463 DOI: 10.1007/s10266-018-0394-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 09/10/2018] [Indexed: 10/28/2022]
Abstract
The aim of this study is to examin the association between anxiety/depressive tendency and oral health-related quality of life in inpatients of convalescent wards. This cross-sectional study included inpatients of convalescent wards (age range 34-100 years). Data on age, sex, functional independence measure, number of teeth, odontotherapy status, and primary disease for which hospitalization was required were collected. The Hospital Anxiety and Depression Scale (HADS) was used to assess emotional distress. The oral health-related quality of life was evaluated by the Geriatric Oral Health Assessment Index (GOHAI). Oral hygiene level was assessed by the Oral Health Assessment Tool (OHAT). We performed a multiple regression analysis to assess relationships among HADS, GOHAI, and OHAT. Following the analysis, causal connections of these factors were evaluated with structural equations modeling. The scores of GOHAI and OHAT in the caseness cohort (HADS score > 11) were significantly worse than those in the non-caseness cohort (HADS score < 7). Multiple regression analysis revealed that GOHAI was a statistically significant predictor of HADS score (p = 0.012), and that HADS and OHAT scores were predictors of GOHAI (p = 0.012 and < 0.001, respectively), adjusted by sex and age. We found that a model connected from OHAT to HADS through GOHAI was a good fit for the data of inpatients. Oral health-related quality of life, affected by oral hygiene status, was strongly associated with emotional distress in inpatients of convalescent wards. Daily oral care and assessment by healthcare professionals can reduce the emotional distress of inpatients in convalescent wards.
Collapse
|
33
|
Wang YY, Zhang WW, Feng L, Gao D, Liu C, Zhong L, Ren JW, Wu YZ, Huang L, Fu LL, He YN. Development and Preliminary Validation of a Depression Assessment Tool for Maintenance Hemodialysis Patients. Ther Apher Dial 2018; 23:49-58. [PMID: 30239119 DOI: 10.1111/1744-9987.12749] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 06/11/2018] [Accepted: 07/19/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Yun-yan Wang
- Department of Nephrology, Daping Hospital; Third Military Medical University; Chongqing China
| | - Wei-wei Zhang
- Department of Nephrology, Daping Hospital; Third Military Medical University; Chongqing China
| | - Lei Feng
- Department of Nephrology, Daping Hospital; Third Military Medical University; Chongqing China
| | - Dong Gao
- Department of Sleep and Psychology, Institute of Surgery Research, Daping Hospital; Third Military Medical University; Chongqing China
| | - Chun Liu
- Department of Nephrology; The Third People's Hospital of Chongqing; Chongqing China
| | - Ling Zhong
- Department of Nephrology, The Second Affiliated Hospital; Chongqing Medical University; Chongqing China
| | - Jiang-wen Ren
- Department of Nephrology; The First People's Hospital of Jiulongpo District; Chongqing China
| | - Ya-zhou Wu
- Department of Statistics, Preventive Medicine; Third Military Medical University; Chongqing China
| | - Long Huang
- Department of Nephrology, Daping Hospital; Third Military Medical University; Chongqing China
| | - Li-li Fu
- Department of Nephrology, Daping Hospital; Third Military Medical University; Chongqing China
| | - Ya-ni He
- Department of Nephrology, Daping Hospital; Third Military Medical University; Chongqing China
| |
Collapse
|
34
|
Semaan V, Noureddine S, Farhood L. Prevalence of depression and anxiety in end-stage renal disease: A survey of patients undergoing hemodialysis. Appl Nurs Res 2018; 43:80-85. [PMID: 30220369 DOI: 10.1016/j.apnr.2018.07.009] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Accepted: 07/25/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND Dialysis is a lifelong treatment required by end stage renal disease patients who are not able to undergo renal transplantation. Dialysis impacts the patients' quality of life drastically, increasing the risk of mortality. Depression and anxiety are commonly reported among dialysis patients, but their prevalence and correlates vary by sociocultural context. OBJECTIVE The aim of this study is to examine the prevalence of anxiety and depression and associated factors among patients receiving hemodialysis at a major tertiary referral medical center in Lebanon that receives patients from all over the country. DESIGN A cross-sectional, descriptive design was used. METHODS Ninety patients receiving hemodialysis were targeted using convenience sampling, with a final sample size of 83 patients. The patients were interviewed while undergoing their dialysis session using the Hospital Anxiety and Depression Scale, and asked demographic and clinical questions. RESULTS The majority of participants were married men over 60 years of age; 48% achieved high school education. Depression was prevalent in 40.8% and anxiety in 39.6%, with 20 patients (24.1%) having both conditions. Although 24.1% self-reported anxiety symptoms, only 2.4% were taking anxiolytics. Illiterate patients had significantly higher depression scores than those with higher levels of education (p = 0.021). Patients who were living with their family had higher anxiety scores than those living alone (p = 0.014). CONCLUSION Anxiety and depression are underdiagnosed and undertreated in Lebanese dialysis patients. Screening and appropriate referral to mental health specialists are needed.
Collapse
Affiliation(s)
- Victoria Semaan
- American University of Beirut Medical Center, Cairo Street, Beirut 1107 2020, Lebanon.
| | - Samar Noureddine
- American University of Beirut, Hariri School of Nursing, Beirut 1107 2020, Lebanon
| | - Laila Farhood
- American University of Beirut, Hariri School of Nursing, Beirut 1107 2020, Lebanon
| |
Collapse
|
35
|
Valenzuela PL, de Alba A, Pedrero-Chamizo R, Morales JS, Cobo F, Botella A, González-Gross M, Pérez M, Lucia A, Marín-López MT. Intradialytic Exercise: One Size Doesn't Fit All. Front Physiol 2018; 9:844. [PMID: 30026703 PMCID: PMC6041401 DOI: 10.3389/fphys.2018.00844] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 06/14/2018] [Indexed: 01/29/2023] Open
Abstract
Purpose: Hemodialysis patients commonly have impaired physical performance and mental health. We studied the effects of an intradialytic exercise program on these variables. Methods: 27 patients (33% women; 68 ± 13 years) were enrolled in a 14-week intradialytic endurance-resistance training program (‘exercise’ group, 40 programmed sessions per patient); 40 hemodialysis patients (28% women; 68 ± 11 years) performing no exercise during the same time length were used as controls. Endpoints included physical performance (6-min walk test [6MWT], 10-repetition sit to stand [STS-10] and handgrip strength), emotional status (Beck’s depression inventory and State-Trait Anxiety Inventory), and mental and physical component scores of the short-from (SF)-12 Health Survey. Results: There were no differences (p> 0.05) between groups at baseline for sex distribution, or mean age, body mass index and time spent on dialysis. Exercise benefits were observed for 6MWT (11 and −3% for the exercise and control groups, respectively; p < 0.001), STS-10 performance time (-22 and 6%; p < 0.001) and handgrip strength (4 and −4%; p < 0.02). No significant benefits (p> 0.05) were observed for emotional status endpoints or SF-12 component scores. Despite significant benefits on physical performance, the proportion of clinically meaningful responders was low (<50%). Responsiveness was dependent on baseline physical performance (p < 0.05) but not on age or sex (p > 0.05). Conclusion: A 14-week intradialytic training program induced significant improvements on physical performance. However, the rate of clinically meaningful responders observed in the present study was low, being the level of responsiveness dependent on baseline physical status. Efforts to individualize exercise prescription are needed in clinical practice.
Collapse
Affiliation(s)
- Pedro L Valenzuela
- Department of Systems Biology, Universidad de Alcalá, Madrid, Spain.,Department of Sport and Health, Spanish Agency for Health Protection in Sport (AEPSAD), Madrid, Spain
| | - Ana de Alba
- Fundación Renal Íñigo Álvarez de Toledo, Madrid, Spain
| | - Raquel Pedrero-Chamizo
- Faculty of Physical Activity and Sport Sciences, Technical University of Madrid, Madrid, Spain
| | - Javier S Morales
- Faculty of Sport Sciences, European University of Madrid, Madrid, Spain
| | - Fernando Cobo
- Fundación Renal Íñigo Álvarez de Toledo, Madrid, Spain
| | - Ana Botella
- Fundación Renal Íñigo Álvarez de Toledo, Madrid, Spain
| | - Marcela González-Gross
- Faculty of Physical Activity and Sport Sciences, Technical University of Madrid, Madrid, Spain
| | - Margarita Pérez
- Faculty of Sport Sciences, European University of Madrid, Madrid, Spain
| | - Alejandro Lucia
- Faculty of Sport Sciences, European University of Madrid, Madrid, Spain.,Research Institute i+12 and CIBER de Envejecimiento y Fragilidad (CIBERFES), Madrid, Spain
| | | |
Collapse
|
36
|
Alshogran OY, Khalil AA, Oweis AO, Altawalbeh SM, Alqudah MAY. Association of brain-derived neurotrophic factor and interleukin-6 serum levels with depressive and anxiety symptoms in hemodialysis patients. Gen Hosp Psychiatry 2018; 53:25-31. [PMID: 29727764 DOI: 10.1016/j.genhosppsych.2018.04.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 04/14/2018] [Accepted: 04/22/2018] [Indexed: 02/05/2023]
Abstract
OBJECTIVE This study assessed the possible association of serum brain-derived neurotrophic factor (BDNF) and interleukin-6 (IL-6) with depressive and anxiety symptoms in hemodialysis (HD) patients. METHOD An analytical cross-sectional study was conducted over 274 HD patients from March to October 2017. The Hospital Anxiety and Depression Scale (HADS) was utilized to evaluate depressive (HADS-D) and anxiety (HADS-A) symptoms. The HADS-D/A is a self-report instrument that has a maximum score of 21. Serum BDNF and IL-6 were measured using enzyme-linked immunosorbant assay (ELISA). RESULTS Serum IL-6 was significantly higher in patients with depressive symptoms compared to normal (20.47 ± 4.27 pg/mL for HADS-D ≥11 versus 9.26 ± 1.59 pg/mL for HADS-D <7, p = 0.014). Multivariable regression analysis revealed that IL-6, education level, hypertension, and dialysis duration were significant predictors of HADS-D. Also, gender, education level, hypertension, and the number of dialysis sessions/week were significant predictors of HADS-A. Significant positive correlation was shown between HADS-D and IL-6 (r = 0.1729, p = 0.004). CONCLUSION Collectively, HD patients with depressive symptoms showed higher levels of IL-6, supporting previous findings that the circulating inflammatory mediator IL-6 can be used as a biomarker for prediction of depressive symptoms in HD patients. Further longitudinal or interventional studies are needed to further validate this association.
Collapse
Affiliation(s)
- Osama Y Alshogran
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan.
| | - Amani A Khalil
- Department of Clinical Nursing, Faculty of Nursing, The University of Jordan, Amman, Jordan
| | - Ashraf O Oweis
- Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Shoroq M Altawalbeh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohammad A Y Alqudah
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| |
Collapse
|
37
|
Bautovich A, Katz I, Loo CK, Harvey SB. Beck Depression Inventory as a screening tool for depression in chronic haemodialysis patients. Australas Psychiatry 2018; 26:281-284. [PMID: 29457471 DOI: 10.1177/1039856218758582] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVES To evaluate the psychometric properties of the Beck Depression Inventory (BDI) and Cognitive Depression Index (CDI) as a potential screening tool for major depression in haemodialysis (HD) patients. METHODS Forty-five HD patients completed both the BDI/CDI and diagnostic interview. The interview was conducted by two experienced clinicians and was based on DSM-IV criteria. The sensitivity, specificity and positive (PPV) and negative (NPV) predictive values were then calculated. RESULTS A diagnosis of depression was found in 6 of the 45 participants (13.3%). Optimal cut-offs were ≥18 for the BDI (sensitivity 1.0, specificity 0.90, PPV 0.60, NPV 1.0) and ≥11 for the CDI (sensitivity 1.0, specificity 0.92, PPV 0.67, NPV 1.0). CONCLUSIONS Both the BDI and CDI were shown to be acceptable screening tools for depression in this population of chronic HD patients. The recommended cut-off scores for both scales are higher than those suggested for the general population and slightly higher than previously found in the chronic kidney disease literature, suggesting that altered thresholds are required when using these screening tools amongst HD patients.
Collapse
Affiliation(s)
- Alison Bautovich
- Consultant Psychiatrist, School of Psychiatry, University of New South Wales, Sydney, NSW, and; NSW Institute of Psychiatry, Westmead, NSW, and; St George Hospital, Kogarah, Australia; Prince of Wales Hospital, Randwick, NSW, Australia
| | - Ivor Katz
- Associate Professor, St George Hospital, Kogarah, NSW, and; Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Colleen Ken Loo
- Professor, School of Psychiatry, University of New South Wales, Sydney, NSW, and; St George Hospital, Kogarah, NSW, and; Black Dog Institute, Sydney, NSW, Australia
| | - Samuel B Harvey
- Associate Professor, School of Psychiatry, University of New South Wales, Sydney, NSW, and; St George Hospital, Kogarah, NSW, and; Black Dog Institute, Sydney, NSW, Australia
| |
Collapse
|
38
|
van Zwieten A, Wong G, Ruospo M, Palmer SC, Barulli MR, Iurillo A, Saglimbene V, Natale P, Gargano L, Murgo M, Loy CT, Tortelli R, Craig JC, Johnson DW, Tonelli M, Hegbrant J, Wollheim C, Logroscino G, Strippoli GFM. Prevalence and patterns of cognitive impairment in adult hemodialysis patients: the COGNITIVE-HD study. Nephrol Dial Transplant 2017; 33:1197-1206. [DOI: 10.1093/ndt/gfx314] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Accepted: 10/08/2017] [Indexed: 12/20/2022] Open
Affiliation(s)
- Anita van Zwieten
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
- Centre for Kidney Research, Children’s Hospital at Westmead, Westmead, New South Wales, Australia
| | - Germaine Wong
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
- Centre for Kidney Research, Children’s Hospital at Westmead, Westmead, New South Wales, Australia
- Department of Renal Medicine, Westmead Hospital, Westmead, New South Wales, Australia
| | - Marinella Ruospo
- Diaverum Medical-Scientific Office, Lund, Sweden
- Division of Nephrology and Transplantation, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy
| | - Suetonia C Palmer
- Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand
| | - Maria Rosaria Barulli
- Neurodegenerative Diseases Unit, Department of Clinical Research in Neurology, University of Bari ‘A. Moro’, ‘Pia Fondazione Cardinale G. Panico’, Tricase, Lecce, Italy
| | - Annalisa Iurillo
- Neurodegenerative Diseases Unit, Department of Clinical Research in Neurology, University of Bari ‘A. Moro’, ‘Pia Fondazione Cardinale G. Panico’, Tricase, Lecce, Italy
| | - Valeria Saglimbene
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
- Diaverum Medical-Scientific Office, Lund, Sweden
| | | | | | - Marco Murgo
- Diaverum Medical-Scientific Office, Lund, Sweden
| | - Clement T Loy
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
- Huntington Disease Service, Westmead Hospital, Westmead, New South Wales, Australia
| | - Rosanna Tortelli
- Neurodegenerative Diseases Unit, Department of Clinical Research in Neurology, University of Bari ‘A. Moro’, ‘Pia Fondazione Cardinale G. Panico’, Tricase, Lecce, Italy
| | - Jonathan C Craig
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
- Centre for Kidney Research, Children’s Hospital at Westmead, Westmead, New South Wales, Australia
- Department of Nephrology, Children’s Hospital at Westmead, Westmead, New South Wales, Australia
| | - David W Johnson
- Department of Nephrology, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
- Translational Research Institute, University of Queensland, Woolloongabba, Queensland, Australia
| | - Marcello Tonelli
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | | | | | - Giancarlo Logroscino
- Neurodegenerative Diseases Unit, Department of Clinical Research in Neurology, University of Bari ‘A. Moro’, ‘Pia Fondazione Cardinale G. Panico’, Tricase, Lecce, Italy
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari ‘A. Moro’, Bari, Italy
| | - Giovanni F M Strippoli
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
- Diaverum Medical-Scientific Office, Lund, Sweden
- Department of Emergency and Organ Transplantation, University of Bari, Piazza Giulio Cesare, Bari, Italy
| | | |
Collapse
|
39
|
Pop-Jordanova N, Polenakovic M. Are Depression and Anxiety Common in Hemodialyzed Patients? BANTAO JOURNAL 2017. [DOI: 10.1515/bj-2016-0020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Researchers confirmed that depression and anxiety are two common comorbid disorders in chronic kidney patients. The aim of our study was to screen the level of depression and anxiety in a group of end-stage kidney diseases treated with hemodialysis. The evaluated sample comprised 230 participants; 110 females (mean age 55.5±13.5 years), and 120 males (mean age 54.5±14.3 years). The mean duration of maintenance dialysis was 8.3±5.8 years (from 0.5 to 24 years). Patients were selected randomly from three dialysis centers in R. Macedonia. As psychometric instruments Beck Depression Inventory (BDI) and scores from Minnesota Multiphasic Personality Inventory (MMPI-201) were used. Our study confirmed that majority of evaluated dialyzed patients are depressed and anxious in different level, but unfortunately the mental problems are frequently unrecognized. We suggested some response measures for management of these conditions in order to avoid risks for complications as well of suicide.
Collapse
Affiliation(s)
- Nada Pop-Jordanova
- Macedonian Academy of Sciences and Arts, Bul. Krste Misirkov 2, 1000 Skopje , R. Macedonia
| | - Momir Polenakovic
- Macedonian Academy of Sciences and Arts, Skopje , Republic of Macedonia
| |
Collapse
|
40
|
Nochaiwong S, Ruengorn C, Awiphan R, Panyathong S, Noppakun K, Chongruksut W, Chiewchanvit S. Development of a multidimensional assessment tool for uraemic pruritus: Uraemic Pruritus in Dialysis Patients (UP-Dial). Br J Dermatol 2017; 176:1516-1524. [PMID: 28012182 DOI: 10.1111/bjd.15268] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Dialysis patients with uraemic pruritus (UP) have significantly impaired quality of life. To assess the therapeutic effect of UP treatments, a well-validated comprehensive and multidimensional instrument needed to be established. OBJECTIVES To develop and validate a multidimensional scale assessing UP in patients on dialysis: the Uraemic Pruritus in Dialysis Patients (UP-Dial). METHODS The development and validation of the UP-Dial instrument were conducted in four phases: (i) item generation, (ii) development of a pilot questionnaire, (iii) refinement of the questionnaire with patient recruitment and (iv) psychometric validation. Participants completed the UP-Dial, the visual analogue scale (VAS) of UP, the Dermatology Life Quality Index (DLQI), the Kidney Disease Quality of Life-36 (KDQOL-36), the Pittsburgh Sleep Quality Index (PSQI) and the Beck Depression Inventory (BDI) between 15 May 2012 and 30 November 2015. RESULTS The 27-item pilot UP-Dial was generated, with 168 participants completing the pilot scale. After factor analysis was performed, the final 14-item UP-Dial encompassed three domains: signs and symptoms, psychosocial, and sleep. Face and content validity were satisfied through the item generation process and expert review. Psychometric analysis demonstrated that the UP-Dial had good convergent and discriminant validity. The UP-Dial was significantly correlated [Spearman rank coefficient, 95% confidence interval (CI)] with the VAS-UP (0·76, 0·69-0·83), DLQI (0·78, 0·71-0·85), KDQOL-36 (-0·86, -0·91 to -0·81), PSQI (0·85, 0·80-0·89) and BDI (0·70, 0·61-0·79). The UP-Dial revealed excellent internal consistency (Cronbach's α 0·90, 95% CI 0·87-0·92) and reproducibility (intraclass correlation 0·95, 95% CI 0·90-0·98). CONCLUSIONS The UP-Dial is valid and reliable for assessing UP among patients on dialysis. Future research should focus on the cross-cultural adaptation and translation of the scale to other languages.
Collapse
Affiliation(s)
- S Nochaiwong
- Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, 50200, Thailand.,Pharmacoepidemiology and Statistics Clinic, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - C Ruengorn
- Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, 50200, Thailand.,Pharmacoepidemiology and Statistics Clinic, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - R Awiphan
- Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - S Panyathong
- Kidney Center, Nakornping Hospital, Chiang Mai, 50180, Thailand
| | - K Noppakun
- Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - W Chongruksut
- Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - S Chiewchanvit
- Division of Dermatology, Department of Internal Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| |
Collapse
|
41
|
Rebollo Rubio A, Morales Asencio JM, Eugenia Pons Raventos M. Depression, anxiety and health-related quality of life amongst patients who are starting dialysis treatment. J Ren Care 2017; 43:73-82. [PMID: 28239953 DOI: 10.1111/jorc.12195] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Chronic kidney disease (CKD) has a severe impact on patients' health-related quality of life (HRQL). The start of renal replacement therapy (RRT) significantly influences psychological, physical and social aspects of life. OBJECTIVES To analyse the HRQL and psychological status (anxiety and depression) at the start of RRT. METHODS We undertook an observational descriptive cross-sectional study. A total of 152 patients starting RRT were recruited for the study. HRQL was measured by the Kidney Disease and Quality of Life Short Form questionnaire. Levels of anxiety and depression were assessed by the Hospital Anxiety and Depression Scale questionnaire. Comorbidities and sociodemographic and clinical factors were also evaluated. FINDINGS HRQL in patients with end-stage kidney disease (ESKD) is significantly affected by the initiation of RRT in all respects. States of anxiety and depression were present in 26.6% and 27% of patients, respectively. These states are significantly related to the emotional component of the quality of life. CONCLUSION The initiation of RRT has a strong impact on HRQL in comparison with a reference population and with other stages of CKD. The early detection of an altered psychological state is important, as this condition should be treated from the first stages of the disease, as it can significantly affect the subsequent development of RRT and the patient's quality of life.
Collapse
Affiliation(s)
- Ana Rebollo Rubio
- Department of Nephrology, Carlos Haya Regional University Hospital and University of Málaga, Málaga, Spain
| | | | | |
Collapse
|
42
|
King-Wing Ma T, Kam-Tao Li P. Depression in dialysis patients. Nephrology (Carlton) 2017; 21:639-46. [PMID: 26860073 DOI: 10.1111/nep.12742] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 12/23/2015] [Accepted: 02/05/2016] [Indexed: 11/30/2022]
Abstract
Depression is the most common psychiatric illness in patients with end-stage renal disease (ESRD). The reported prevalence of depression in dialysis population varied from 22.8% (interview-based diagnosis) to 39.3% (self- or clinician-administered rating scales). Such differences were attributed to the overlapping symptoms of uraemia and depression. Systemic review and meta-analysis of observational studies showed that depression was a significant predictor of mortality in dialysis population. The optimal screening tool for depression in dialysis patients remains uncertain. The Beck Depression Inventory (BDI), Patient Health Questionnaire (PHQ) and Center for Epidemiologic Studies Depression Scale (CESD) have been validated for screening purposes. Patients who scored ≥14 using BDI should be referred to a psychiatrist for early evaluation. Structured Clinical Interview for DSM disorders (SCID) remains the gold standard for diagnosis. Non-pharmacological treatment options include cognitive behavioural therapy and exercise training programs. Although frequent haemodialysis may have beneficial effects on patients' physical and mental well-being, it cannot and should not be viewed as a treatment of depression. Selective serotonin reuptake inhibitors (SSRIs) are generally effective and safe in ESRD patients, but most studies were small, non-randomized and uncontrolled. The European Renal Best Practice (ERBP) guideline suggests a trial of SSRI for 8 to 12 weeks in dialysis patients who have moderate-major depression. The treatment effect should be re-evaluated after 12 weeks to avoid prolonging ineffective medication. This review will discuss the current understanding in the diagnosis and management of depression in dialysis patients.
Collapse
Affiliation(s)
- Terry King-Wing Ma
- Division of Nephrology, Carol and Richard Yu PD Research Centre, Department of Medicine and Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong
| | - Philip Kam-Tao Li
- Division of Nephrology, Carol and Richard Yu PD Research Centre, Department of Medicine and Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong
| |
Collapse
|
43
|
Brekke FB, Waldum-Grevbo B, von der Lippe N, Os I. The effect of renal transplantation on quality of sleep in former dialysis patients. Transpl Int 2016; 30:49-56. [PMID: 27696543 DOI: 10.1111/tri.12866] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 07/29/2016] [Accepted: 09/26/2016] [Indexed: 01/08/2023]
Abstract
Data on sleep quality in renal transplanted (RTX) patients are scarce, and longitudinal studies are lacking. The purpose of this study was to assess the prevalence of sleep complaints in RTX patients and identify variables associated with improvement in sleep quality. In a longitudinal study, 301 dialysis patients were followed for up to 5.5 years, during which time 142 were transplanted. Out of the transplanted patients, a total of 110 were eligible for inclusion. Sleep quality and depression were assessed with the validated questionnaires Pittsburgh Sleep Quality Index (PSQI) and Beck Depression Inventory (BDI), and data were collected during dialysis and after RTX. Based on PSQI scores, 59% were characterized as poor sleepers after RTX compared to 75% when in dialysis (P = 0.016). A total of 46% experienced a clinical relevant improvement in overall sleep quality, while 21% experienced a clinical relevant deterioration. In multivariable analyses, clinical meaningful change in sleep quality was not associated with either depressive symptoms assessed with BDI or other clinical variables. Sleep quality improved after RTX in nearly half of the patients, but poor sleep quality was prevalent in RTX patients. Therefore, sleep quality should routinely be assessed in RTX patients.
Collapse
Affiliation(s)
- Fredrik B Brekke
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Bård Waldum-Grevbo
- Department of Nephrology, Oslo University Hospital Ullevål, Oslo, Norway
| | - Nanna von der Lippe
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Os
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Nephrology, Oslo University Hospital Ullevål, Oslo, Norway
| |
Collapse
|
44
|
von der Lippe N, Waldum-Grevbo B, Varberg Reisæter A, Os I. Is HRQOL in dialysis associated with patient survival or graft function after kidney transplantation? BMC Nephrol 2016; 17:94. [PMID: 27456506 PMCID: PMC4960875 DOI: 10.1186/s12882-016-0316-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 07/19/2016] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Health related quality of life (HRQOL) is patient-reported, and an important treatment outcome for patients undergoing renal replacement therapy. Whether HRQOL in dialysis can affect mortality or graft survival after renal transplantation (RTX) is not determined. The aims of the present study were to investigate whether pretransplant HRQOL is associated with post-RTX patient survival or graft function, and to assess whether improvement in HRQOL from dialysis to RTX is associated with patient survival. METHODS In a longitudinal prospective study, HRQOL was measured in 142 prevalent dialysis patients (67 % males, mean age 51 ± 15.5 years) who subsequent underwent renal transplantation. HRQOL could be repeated in 110 transplant patients 41 (IQR 34-51) months after RTX using the self-administered Kidney Disease and Quality of Life Short Form (KDQOL-SF) measure. Kaplan-Meier plots were utilized for survival analyses, and linear regression models were used to address HRQOL and effect on graft function. RESULTS Follow-up time was 102 (IQR 97-108) months after RTX. Survival after RTX was higher in patients who perceived good physical function (PF) in dialysis compared to patients with poorer PF (p = 0.019). Low scores in the domain mental health measured in dialysis was associated with accelerated decline in graft function (p = 0.048). Improvements in the kidney-specific domains "symptoms" and "effect of kidney disease" in the trajectory from dialysis to RTX were associated with a survival benefit (p = 0.007 and p = 0.02, respectively). CONCLUSION HRQOL measured in dialysis patients was associated with survival and graft function after RTX. These findings may be useful in clinical pretransplant evaluations. Improvements in some of the kidney-specific HRQOL domains from dialysis to RTX were associated with lower mortality. Prospective and interventional studies are warranted.
Collapse
Affiliation(s)
| | - Bård Waldum-Grevbo
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Nephrology, Oslo University Hospital, Oslo, Norway
| | - Anna Varberg Reisæter
- Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway
- The Norwegian Renal Registry, Oslo, Norway
| | - Ingrid Os
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Nephrology, Oslo University Hospital, Oslo, Norway
| |
Collapse
|
45
|
Barros A, Costa BED, Mottin CC, d'Avila DO. Depression, quality of life, and body composition in patients with end-stage renal disease: a cohort study. ACTA ACUST UNITED AC 2016; 38:301-306. [PMID: 26870913 PMCID: PMC7111352 DOI: 10.1590/1516-4446-2015-1681] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 05/28/2015] [Indexed: 01/09/2023]
Abstract
Objective: To prospectively evaluate depressive symptoms, nutritional status, and quality of life (QoL) and search for possible associations in patients with end-stage renal disease undergoing hemodialysis. Methods: A cohort study of 104 adult patients with end-stage renal disease undergoing hemodialysis was conducted. Anthropometric, clinical, and biochemical variables were evaluated after a midweek hemodialysis session. The participants’ body composition was assessed by direct segmental multi-frequency bioimpedance analysis. The WHOQOL-Bref questionnaire was used to evaluate QoL. Participants were separated into two groups - depressive symptoms and no depressive symptoms - at inclusion and evaluated annually for 2 years thereafter using the Beck Depression Inventory. Survival analysis used the Kaplan-Meier method and Cox regression analysis for the goodness of fit of associated factors. All-cause mortality was the outcome of interest. Results: Participants’ mean age was 55.3±15.6 years, 60% were male, and the median time on hemodialysis was 17.5 (8.0-36.8) months. Thirty-two patients had depressive symptoms and a significantly lower QoL compared with the 72 patients in the no depressive symptoms group. The fitted outcome model showed that lean body mass had a protective effect against all-cause mortality (hazard ratio [HR] = 0.89; 95%CI 0.80-0.99; p = 0.038). Conclusion: Depressive symptoms were highly prevalent in the cohort, and correlated with the physical and psychological components of the QoL life questionnaire, as well as with C-reactive protein and phosphorus levels. Lean body mass was protective for the assessed outcome.
Collapse
Affiliation(s)
- Annerose Barros
- Programa de Pós-Graduação em Medicina e Ciências da Saúde (Nefrologia), Faculdade de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Bartira E da Costa
- Programa de Pós-Graduação em Medicina e Ciências da Saúde (Nefrologia), Faculdade de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Claudio C Mottin
- Programa de Pós-Graduação em Medicina e Ciências da Saúde (Cirurgia), Faculdade de Medicina, PUCRS, Porto Alegre, RS, Brazil
| | - Domingos O d'Avila
- Programa de Pós-Graduação em Medicina e Ciências da Saúde (Nefrologia), Faculdade de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| |
Collapse
|
46
|
Griva K, Kang AWC, Yu ZL, Lee VYW, Zarogianis S, Chan MC, Foo M. Predicting technique and patient survival over 12 months in peritoneal dialysis: the role of anxiety and depression. Int Urol Nephrol 2016; 48:791-6. [DOI: 10.1007/s11255-015-1191-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 12/16/2015] [Indexed: 12/01/2022]
|
47
|
Palmer SC, Ruospo M, Barulli MR, Iurillo A, Saglimbene V, Natale P, Gargano L, Murgo AM, Loy C, van Zwieten A, Wong G, Tortelli R, Craig JC, Johnson DW, Tonelli M, Hegbrant J, Wollheim C, Logroscino G, Strippoli GFM. COGNITIVE-HD study: protocol of an observational study of neurocognitive functioning and association with clinical outcomes in adults with end-stage kidney disease treated with haemodialysis. BMJ Open 2015; 5:e009328. [PMID: 26656022 PMCID: PMC4679889 DOI: 10.1136/bmjopen-2015-009328] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION The prevalence of cognitive impairment may be increased in adults with end-stage kidney disease compared with the general population. However, the specific patterns of cognitive impairment and association of cognitive dysfunction with activities of daily living and clinical outcomes (including withdrawal from treatment) among haemodialysis patients remain incompletely understood. The COGNITIVE impairment in adults with end-stage kidney disease treated with HemoDialysis (COGNITIVE-HD) study aims to characterise the age-adjusted and education-adjusted patterns of cognitive impairment (using comprehensive testing for executive function, perceptual-motor function, language, learning and memory, and complex attention) in patients on haemodialysis and association with clinical outcomes. METHODS AND ANALYSIS A prospective, longitudinal, cohort study of 750 adults with end-stage kidney disease treated with long-term haemodialysis has been recruited within haemodialysis centres in Italy (July 2013 to April 2014). Testing for neurocognitive function was carried out by a trained psychologist at baseline to assess cognitive functioning. The primary study factor is cognitive impairment and secondary study factors will be specific domains of cognitive function. The primary outcome will be total mortality. Secondary outcomes will be cause-specific mortality, major cardiovascular events, fatal and non-fatal myocardial infarction and stroke, institutionalisation, and withdrawal from treatment at 12 months. ETHICS AND DISSEMINATION This protocol was approved before study conduct by the following responsible ethics committees: Catania (approval reference 186/BE; 26/09/2013), Agrigento (protocol numbers 61-62; 28/6/2013), USL Roma C (CE 39217; 24/6/2013), USL Roma F (protocol number 0041708; 23/7/2013), USL Latina (protocol number 20090/A001/2011; 12/7/2013), Trapani (protocol number 3413; 16/7/2013) and Brindisi (protocol number 40259; 6/6/2013). All participants have provided written and informed consent and can withdraw from the study at any time. The findings of the study will be disseminated through peer-reviewed journals and national and international conference presentations and to the participants through communication within the dialysis network in which this study is conducted.
Collapse
Affiliation(s)
- Suetonia C Palmer
- Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand
| | - Marinella Ruospo
- Diaverum Medical Scientific Office, Lund, Sweden Division of Nephrology and Transplantation, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy
| | - Maria Rosaria Barulli
- Neurodegenerative Diseases Unit, Department of Clinical Research in Neurology, University of Bari "A. Moro", Tricase, Lecce, Italy
| | - Annalisa Iurillo
- Neurodegenerative Diseases Unit, Department of Clinical Research in Neurology, University of Bari "A. Moro", Tricase, Lecce, Italy
| | | | | | | | | | - Clement Loy
- Huntington Disease Service, Westmead Hospital, Westmead, NSW, Australia
| | - Anita van Zwieten
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Germaine Wong
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Rosanna Tortelli
- Neurodegenerative Diseases Unit, Department of Clinical Research in Neurology, University of Bari "A. Moro", Tricase, Lecce, Italy
| | - Jonathan C Craig
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - David W Johnson
- Department of Nephrology, Princess Alexandra Hospital, Woolloongabba, Australia
| | - Marcello Tonelli
- Cumming School of Medicine, Health Services, University of Calgary, Calgary, Alberta, Canada
| | | | | | - Giancarlo Logroscino
- Neurodegenerative Diseases Unit, Department of Clinical Research in Neurology, University of Bari "A. Moro", Tricase, Lecce, Italy Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari "A. Moro", Bari, Italy
| | - G F M Strippoli
- Diaverum Medical Scientific Office, Lund, Sweden Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia Department of Emergency and Organ Transplantation, University of Bari, Piazza Giulio Cesare, Bari, Italy Diaverum Academy, Bari, Italy
| |
Collapse
|
48
|
The Effect of Breathing, Movement, and Meditation on Psychological and Physical Symptoms and Inflammatory Biomarkers in Inflammatory Bowel Disease: A Randomized Controlled Trial. Inflamm Bowel Dis 2015; 21:2886-96. [PMID: 26426148 DOI: 10.1097/mib.0000000000000568] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND This study evaluated the effects of the Breath-Body-Mind Workshop (BBMW) (breathing, movement, and meditation) on psychological and physical symptoms and inflammatory biomarkers in inflammatory bowel disease (IBD). METHODS Twenty-nine IBD patients from the Jill Roberts IBD Center were randomized to BBMW or an educational seminar. Beck Anxiety Inventory, Beck Depression Inventory, Brief Symptom Inventory 18, IBD Questionnaire, Perceived Disability Scale, Perceived Stress Questionnaire, Digestive Disease Acceptance Questionnaire, Brief Illness Perception Questionnaire, fecal calprotectin, C-reactive protein, and physiological measures were obtained at baseline and weeks 6 and 26. RESULTS The BBMW group significantly improved between baseline and week 6 on Brief Symptom Inventory 18 (P = 0.02), Beck Anxiety Inventory (P = 0.02), and IBD Questionnaire (P = 0.01) and between baseline and week 26 on Brief Symptom Inventory 18 (P = 0.04), Beck Anxiety Inventory (P = 0.03), Beck Depression Inventory (P = 0.01), IBD Questionnaire (P = 0.01), Perceived Disability Scale (P = 0.001), and Perceived Stress Questionnaire (P = 0.01) by paired t tests. No significant changes occurred in the educational seminar group at week 6 or 26. By week 26, median C-reactive protein values decreased significantly in the BBMW group (P = 0.01 by Wilcoxon signed-rank test) versus no significant change in the educational seminar group. CONCLUSIONS In patients with IBD, participation in the BBMW was associated with significant improvements in psychological and physical symptoms, quality of life, and C-reactive protein. Mind-body interventions, such as BBMW, which emphasize Voluntarily Regulated Breathing Practices, may have significant long-lasting benefits for IBD symptoms, anxiety, depression, quality of life, and inflammation. BBMW, a promising adjunctive treatment for IBD, warrants further study.
Collapse
|
49
|
Moss AH, Davison SN. How the ESRD quality incentive program could potentially improve quality of life for patients on dialysis. Clin J Am Soc Nephrol 2015; 10:888-93. [PMID: 25739850 PMCID: PMC4422237 DOI: 10.2215/cjn.07410714] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
For over 20 years, the quality of medical care of the Medicare ESRD Program has been a concern. The Centers for Medicare and Medicaid Services have implemented the ESRD Quality Incentive Program, which uses the principles of value-based purchasing; dialysis providers are paid for performance on predefined quality measures, with a goal of improving patient outcomes and the quality of patient care. The ESRD Quality Incentive Program measures have been criticized, because they are largely disease oriented and use easy-to-obtain laboratory-based indicators, such as Kt/V and hemoglobin, that do not reflect outcomes that are most important to patients and have had a minimal effect on survival or quality of life. A key goal of improving quality of care is to enhance quality of life, a patient-important quality measure that matters more to many patients than even survival. None of the ESRD Quality Incentive Program measures assess patient-reported quality of life. As outlined in the National Quality Strategy, the Centers for Medicare and Medicaid Services are holding providers accountable in six priority domains, in which quality measures have been and are being developed for value-based purchasing. Three measures-patient experience and engagement, clinical care, and care coordination-are particularly relevant to quality care in the ESRD Program; the 2014 ESRD Quality Incentive Program includes six measures, none of which provide data from a patient-centered perspective. Value-based purchasing is a well intentioned step to improve care of patients on dialysis. However, the Centers for Medicare and Medicaid Services need to implement significant change in what is measured for the ESRD Quality Incentive Program to be patient centered and aligned with patients' values, preferences, and needs. This paper provides examples of potential quality measures for patient experience and engagement, clinical care, and care coordination, which if implemented, would be much more likely to enhance quality of life for patients with ESRD than present ESRD Quality Incentive Program measures.
Collapse
Affiliation(s)
- Alvin H Moss
- Section of Nephrology, West Virginia University School of Medicine, Morgantown, West Virginia; and
| | - Sara N Davison
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| |
Collapse
|
50
|
Stasiewski E, Christoph M, Christoph A, Bittner A, Weidner K, Julius U. Mental symptoms and quality of life in lipoprotein apheresis patients in comparison to hemodialysis patients, platelet donors and normal population. ATHEROSCLEROSIS SUPP 2015; 18:233-40. [DOI: 10.1016/j.atherosclerosissup.2015.02.035] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
|