1
|
Golovchanova N, Zhao X, Flink I, Owiredua C, Boersma K. Recurrent pain in older age: A cross-sectional network analysis of biopsychosocial-existential interactions. J Psychosom Res 2024; 189:112016. [PMID: 39705900 DOI: 10.1016/j.jpsychores.2024.112016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2024] [Revised: 12/12/2024] [Accepted: 12/14/2024] [Indexed: 12/23/2024]
Abstract
OBJECTIVE Chronic pain is a prevalent condition in older adults, associated with substantial distress. For many older people, chronic pain interferes with their daily life which is reflected in various life domains. This study aimed to investigate whether interactions among self-reported indicators of biological, psychological, social, and existential life domains differ for older adults with no pain, with non-interfering pain, and with interfering pain. METHOD The study was based on the cross-sectional 65+ and Safe Study data (N = 622; age range 64-106 years; 60.6 % women). Network analysis was used to assess the inter-variable associations for older adults reporting no pain, non-interfering pain, and interfering pain separately. Network visualization and centrality tests were performed. Permutation-based analyses were conducted to investigate the connections among variables in three subgroups. RESULTS We identified a structural difference between the networks of older adults with no pain and interfering pain, suggesting differences in connectivity among the life domains. The strength centrality metrics showed the central role of presence of meaning in the networks of older adults with no pain and with non-interfering pain, while for older adults with interfering pain, anxiety appeared to be dominant. CONCLUSION The findings illuminated that anxiety regulation and meaning-enhancement are potentially important intervention targets for older adults with recurrent pain. Overall, the study highlighted the value of a holistic biopsychosocial-existential approach for understanding and managing pain in older adults.
Collapse
Affiliation(s)
- Nadezhda Golovchanova
- Center for Health and Medical Psychology, School of Behavioral, Social and Legal Sciences, Örebro University, Fakultetsgatan 1, 701 82 Örebro, Sweden.
| | - Xiang Zhao
- Center for Health and Medical Psychology, School of Behavioral, Social and Legal Sciences, Örebro University, Fakultetsgatan 1, 701 82 Örebro, Sweden; Institute of Psychology, Klagenfurt University, Universitätsstraße 65-67, 9020 Klagenfurt am Wörthersee, Austria.
| | - Ida Flink
- Center for Health and Medical Psychology, School of Behavioral, Social and Legal Sciences, Örebro University, Fakultetsgatan 1, 701 82 Örebro, Sweden; Department of Social and Psychological Studies, Karlstad University, Universitetsgatan 2, 651 88 Karlstad, Sweden.
| | - Christiana Owiredua
- Center for Health and Medical Psychology, School of Behavioral, Social and Legal Sciences, Örebro University, Fakultetsgatan 1, 701 82 Örebro, Sweden.
| | - Katja Boersma
- Center for Health and Medical Psychology, School of Behavioral, Social and Legal Sciences, Örebro University, Fakultetsgatan 1, 701 82 Örebro, Sweden.
| |
Collapse
|
2
|
Wettstein M, Tesarz J. Increasing pain prevalence and intensity among middle-aged and older adults: Evidence from the German Ageing Survey. J Psychosom Res 2023; 168:111233. [PMID: 36958227 DOI: 10.1016/j.jpsychores.2023.111233] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 03/11/2023] [Accepted: 03/12/2023] [Indexed: 03/25/2023]
Abstract
OBJECTIVE Pain is a very common chronic condition in late life that is associated with poorer quality of life and greater functional restrictions. Little is known regarding temporal trends in pain prevalence and pain intensity. Therefore, we estimated trends in pain prevalence and intensity over time among German middle-aged and older adults. METHODS We used two independent samples drawn in different years from the German Ageing Survey, which is a nationwide population-representative study with a cohort-sequential design. Specifically, a sample of individuals aged 40-85 years who were assessed in 2008 (n = 5961) was compared with a sample of individuals with the same age range who were assessed in 2014 (n = 5809). Individuals were asked if and to what extent they had experienced constant or recurrent pain within the past four weeks. χ2 tests and regression analyses were computed. RESULTS In 2008, about 44% of all individuals reported suffering from at least very mild pain. In 2014, this proportion was higher by about 7%. Controlling for chronological age, gender, education, region of residence (West vs. East Germany), depressive symptoms, chronic diseases, BMI, and physical activity, the difference in pain prevalence and pain intensity between the samples remained statistically significant. CONCLUSION Our data suggest an increase in the prevalence and intensity of pain among middle-aged and older German adults between 2008 and 2014, which remained statistically significant when controlling for socio-demographic and health-related indicators. Further research is needed to identify the factors underlying this increasing pain prevalence and pain intensity in order to counteract this negative temporal trend.
Collapse
Affiliation(s)
- Markus Wettstein
- Department of Psychology, Humboldt-University Berlin, Germany; Heidelberg University, Germany.
| | - Jonas Tesarz
- Department of General Internal Medicine and Psychosomatics, Medical Hospital, University of Heidelberg, Germany
| |
Collapse
|
3
|
Pellerin N, Raufaste E, Corman M, Teissedre F, Dambrun M. Psychological resources and flexibility predict resilient mental health trajectories during the French covid-19 lockdown. Sci Rep 2022; 12:10674. [PMID: 35739290 PMCID: PMC9219392 DOI: 10.1038/s41598-022-14572-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 05/04/2022] [Indexed: 11/09/2022] Open
Abstract
The implementation of lockdowns and the Covid-19 pandemic situation have negatively impacted mental health (anxiety, depression). However, little is known about individual differences in the longitudinal reactions to lockdown. We designed a longitudinal study (a) to identify the various trajectories of symptoms of depression and anxiety in the general population during and after lockdown; (b) to determine which positive psychological resources prevent individuals from falling into groups with the most severe trajectories; (c) to test the mediating role of psychological flexibility. We collected and analysed longitudinal data on a sample of French participants (N = 1399, Mage = 43.4; SDage = 12; 87.8% women) during the end of the first lockdown. Participants were asked to report their psychological resources and (in)flexibility at baseline and symptoms of anxiety and depression at each measurment occasion (five weekly observations from 17 March to 11 May 2020, including baseline). Using growth mixture modelling, seven dynamic profiles of symptoms were identified: four for depression and three for anxiety. Resilience emerged as the most frequent trajectory. Wisdom, optimism, hope, self-efficacy and peaceful disengagement significantly prevented individuals from belonging to the symptomatic groups. Moreover, psychological flexibility emerged as a significant mediator of these effects. This study highlights the importance of cultivating protective factors and psychological flexibility to prevent mental health damage during potentially traumatic events (PTE) and to favour resilience trajectories.
Collapse
Affiliation(s)
- Nicolas Pellerin
- CLLE, CNRS UMR 5263, Universite Toulouse 2 Jean Jaures (UT2J), 5 Allees A. Machado, 31058, Toulouse Cedex, France.
| | - Eric Raufaste
- CLLE, CNRS UMR 5263, Universite Toulouse 2 Jean Jaures (UT2J), 5 Allees A. Machado, 31058, Toulouse Cedex, France
| | - Maya Corman
- LAPSCO, CNRS UMR 6024, Universite Clermont Auvergne, Clermont-Ferrand, France
| | | | - Michael Dambrun
- LAPSCO, CNRS UMR 6024, Universite Clermont Auvergne, Clermont-Ferrand, France
| |
Collapse
|
4
|
Zainal NH, Newman MG. Curiosity helps: Growth in need for cognition bidirectionally predicts future reduction in anxiety and depression symptoms across 10 years. J Affect Disord 2022; 296:642-652. [PMID: 34627855 PMCID: PMC8759714 DOI: 10.1016/j.jad.2021.10.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/30/2021] [Accepted: 10/03/2021] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Decreased motivational tendency to seek out, engage in, and enjoy investing in complex cognitive processes in a sustained manner (need for cognition; NFC) may be a predictor and consequence of heightened anxiety and depression symptoms (ADS). However, the majority of investigations on this topic have been cross-sectional, which hinders causal inferences. METHODS The current study thus determined the within-person relations between NFC and ADS by using random intercept cross-lagged panel model (RI-CLPM) and bivariate dual latent change score (BLCS) approaches to separate between- and within-person effects. RI-CLPM and BLCS also present with advantages of adjusting for regression to the mean, baseline scores, autoregressive and lagged effects, and minimizing measurement error. Community-dwelling adults (n = 6750) completed the Mental Health Inventory-5 and trait-level NFC scales approximately every one year across 10 years. RESULTS RI-CLPM showed that within persons, lower level of NFC predicted higher future level of ADS, and vice versa (d = -0.852 to -0.498). Likewise, BLCS demonstrated that within persons, smaller change in NFC forecasted larger subsequent increase in ADS, and conversely (d = -0.631 to -0.519). Findings remained after adjusting for socio-demographic covariates. CONCLUSION Consistent with theories, findings suggested that the within-person level-to-future level and change-to-future change relations among NFC and ADS were bi-directional and negative, with moderate-to-large effect sizes. Targeting NFC may treat or prevent the emergence of depression and anxiety disorders. Such efforts may include augmenting or personalizing evidence-based cognitive-behavioral therapeutic strategies for individuals with or at-risk for heightened ADS.
Collapse
Affiliation(s)
- Nur Hani Zainal
- Harvard Medical School - Massachusetts General Hospital, The Pennsylvania State University, National University of Singapore.
| | | |
Collapse
|
5
|
Cheng Y, Thorpe L, Kabir R, Lim HJ. Latent class growth modeling of depression and anxiety in older adults: an 8-year follow-up of a population-based study. BMC Geriatr 2021; 21:550. [PMID: 34645416 PMCID: PMC8515663 DOI: 10.1186/s12877-021-02501-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 09/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Depression and anxiety are common mental health conditions in the older adult population. Understanding the trajectories of these will help implement treatments and interventions. AIMS This study aims to identify depression and anxiety trajectories in older adults, evaluate the interrelationship of these conditions, and recognize trajectory-predicting characteristics. METHODS Group-based dual trajectory modeling (GBDTM) was applied to the data of 3983 individuals, aged 65 years or older who participated in the Korean Health Panel Study between 2008 and 2015. Logistic regression was used to identify the association between characteristics and trajectory groups. RESULTS Four trajectory groups from GBDTM were identified within both depression and anxiety outcomes. Depression outcome fell into "low-flat (87.0%)", "low-to-middle (8.8%)", "low-to-high (1.3%)" and "high-stable (2.8%)" trajectory groups. Anxiety outcome fell into "low-flat (92.5%)", "low-to-middle (4.7%)", "high-to-low (2.2%)" and "high-curve (0.6%)" trajectory groups. Interrelationships between depression and anxiety were identified. Members of the high-stable depression group were more likely to have "high-to-low" or "high-curved" anxiety trajectories. Female sex, the presence of more than three chronic diseases, and being engaged in income-generating activity were significant predictors for depression and anxiety. CONCLUSIONS Dual trajectory analysis of depression and anxiety in older adults shows that when one condition is present, the probability of the other is increased. Sex, having more than three chronic diseases, and not being involved in income-generating activity might increase risks for both depression and anxiety. Health policy decision-makers may use our findings to develop strategies for preventing both depression and anxiety in older adults.
Collapse
Affiliation(s)
- Yanzhao Cheng
- Collaborative Biostatistics Program, School of Public Health, University of Saskatchewan, Saskatoon, Canada
| | - Lilian Thorpe
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK, S7N2Z4, Canada
| | - Rasel Kabir
- Collaborative Biostatistics Program, School of Public Health, University of Saskatchewan, Saskatoon, Canada
| | - Hyun Ja Lim
- Collaborative Biostatistics Program, School of Public Health, University of Saskatchewan, Saskatoon, Canada. .,Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK, S7N2Z4, Canada.
| |
Collapse
|
6
|
Morrissey AM, O’Neill A, O’Sullivan K, Robinson K. Complementary and alternative medicine use among older adults with musculoskeletal pain: findings from the European Social Survey (2014) special module on the social determinants of health. Br J Pain 2021; 16:109-118. [PMID: 35111319 PMCID: PMC8801684 DOI: 10.1177/20494637211023293] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background: This study describes the use of complementary and alternative medicine (CAM) among older adults who report being hampered in daily activities due to musculoskeletal pain. The characteristics of older adults with debilitating musculoskeletal pain who report CAM use is also examined. Methods: Cross-sectional European Social Survey Round 7 data from 21 countries were examined for participants aged 55 years and older, who reported musculoskeletal pain that hampered daily activities in the past 12 months. Results: Of the 4950 older adult participants reporting musculoskeletal pain that hampered daily activities, the majority (63.5%) were from the West of Europe, reported secondary education or less (78.2%), and reported at least one other health-related problem (74.6%). In total, 1657 (33.5%) reported using at least one CAM treatment in the previous year. Manual body-based therapies (MBBTs) were most used, including massage therapy (17.9%) and osteopathy (7.0%). Alternative medicinal systems (AMSs) were also popular with 6.5% using homoeopathy and 5.3% reporting herbal treatments. A general trend of higher CAM use in younger participants was noted. CAM use was associated with physiotherapy use, female gender, higher levels of education, being in employment and living in West Europe. Those reporting multiple health problems were more likely to use all CAM treatments, except MBBT. Conclusion: A third of older Europeans with musculoskeletal pain report CAM use in the previous 12 months. Certain subgroups with higher rates of CAM use could be identified. Clinicians should comprehensively and routinely assess CAM use among older adults with musculoskeletal pain.
Collapse
Affiliation(s)
- Ann-Marie Morrissey
- School of Allied Health, Health Research Institute, Ageing Research Centre, University of Limerick, Limerick, Ireland
| | - Aoife O’Neill
- School of Allied Health, Health Research Institute, Ageing Research Centre, University of Limerick, Limerick, Ireland
| | - Kieran O’Sullivan
- School of Allied Health, Health Research Institute, Ageing Research Centre, University of Limerick, Limerick, Ireland
| | - Katie Robinson
- School of Allied Health, Health Research Institute, Ageing Research Centre, University of Limerick, Limerick, Ireland
| |
Collapse
|
7
|
Latent Class Growth Analysis of Gout Flare Trajectories: A Three‐Year Prospective Cohort Study in Primary Care. Arthritis Rheumatol 2020; 72:1928-1935. [DOI: 10.1002/art.41476] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 07/30/2020] [Indexed: 01/22/2023]
|
8
|
Jeong H, Lee Y. Sex-Based Differences in the Quality of Life of Elderly Koreans with Chronic Musculoskeletal Pain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E743. [PMID: 31979306 PMCID: PMC7038106 DOI: 10.3390/ijerph17030743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 01/16/2020] [Accepted: 01/18/2020] [Indexed: 11/18/2022]
Abstract
In this study, we constructed a structural equation model (SEM) for predicting the quality of life (QOL) in elderly Koreans with chronic musculoskeletal pain (CMP) and examined the differences between sexes. Data were earlier collected in a prior study of 307 participants (101 men and 206 women) with CMP, aged 65 years and above, who used geriatric welfare centers located in two cities. The effects of pain, functional limitation, perceived health status, pain coping, and social support on the QOL were estimated with a multigroup SEM. For both men and women, the results show sequential causality from pain to functional limitation, perceived health status, and QOL. However, the relationships among pain, pain coping, functional limitation, and QOL differ between men and women. The multigroup SEM provides a better understanding of the sex differences in the QOL of elderly with CMP. The results suggest that in order to improve QOL among the elderly with CMP, a customized strategy should be applied that takes into account differences between the sexes.
Collapse
Affiliation(s)
- Hyesun Jeong
- Department of Nursing, Graduate School, Pusan National University, Yangsan 50612, Korea;
| | - Yoonju Lee
- College of Nursing, Pusan National University, Yangsan 50612, Korea
| |
Collapse
|
9
|
Hohls JK, König HH, van den Bussche H, Eisele M, Wiese B, Oey A, Weyerer S, Werle J, Fuchs A, Pentzek M, Stein J, Röhr S, Mösch E, Bickel H, Heser K, Miebach L, Scherer M, Maier W, Riedel-Heller SG, Hajek A. Association of anxiety symptoms with health care use and costs in people aged 85 and over. Int J Geriatr Psychiatry 2019; 34:765-776. [PMID: 30821399 DOI: 10.1002/gps.5089] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 11/29/2018] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To analyze the association of anxiety symptoms with health care use and costs in people aged 85 and older. METHODS Baseline data from AgeQualiDe (N = 856), a multicenter prospective cohort study of primary care patients aged 85 and older, were analyzed. Anxiety symptoms (Geriatric Anxiety Inventory-Short Form) and health care use were assessed via questionnaires. Health care use was monetarily valued using German unit costs to obtain sectoral (inpatient, outpatient, nursing care, medical supplies, and medication) and total costs. Health care use and costs were analyzed in regression models as a function of anxiety symptoms, as well as relevant covariates (predisposing, enabling, and other need characteristics based on the Behavioral Model of Health Care Use). RESULTS On a descriptive level, people with increased anxiety symptoms (12% of the sample) incurred on average € 10 909 (SD: 16 023) in the last 6 months, 31% more than those without increased anxiety (€ 8303, SD: 11 175; P = 0.12). Adjusting for predisposing, enabling, and other need characteristics, anxiety symptoms were not significantly associated with health care use or costs. Specifically, need characteristics (morbidity, cognitive decline, and functional impairment) were associated with total or sectoral costs, depending on the cost category analyzed. CONCLUSION In a sample of people of the oldest-old age group, the severity of anxiety symptoms was not associated with health care use or costs, when adjusting for relevant covariates. A longitudinal analysis could assess whether a change in anxiety symptom severity is associated with health care use or costs in old age.
Collapse
Affiliation(s)
- Johanna Katharina Hohls
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hendrik van den Bussche
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marion Eisele
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Birgitt Wiese
- Institute of General Practice, Hannover Medical School, Hannover, Germany
| | - Anke Oey
- Institute of General Practice, Hannover Medical School, Hannover, Germany
| | - Siegfried Weyerer
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Jochen Werle
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Angela Fuchs
- Institute of General Practice (ifam), Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Michael Pentzek
- Institute of General Practice (ifam), Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Janine Stein
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Susanne Röhr
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Edelgard Mösch
- Department of Psychiatry, Technical University of Munich, Munich, Germany
| | - Horst Bickel
- Department of Psychiatry, Technical University of Munich, Munich, Germany
| | - Kathrin Heser
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Bonn, Germany
| | - Lisa Miebach
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Bonn, Germany
| | - Martin Scherer
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Wolfgang Maier
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Bonn, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| |
Collapse
|
10
|
Rogers AH, Bakhshaie J, Ditre JW, Manning K, Mayorga NA, Viana AG, Zvolensky MJ. Worry and rumination: Explanatory roles in the relation between pain and anxiety and depressive symptoms among college students with pain. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2019; 67:275-282. [PMID: 29979938 DOI: 10.1080/07448481.2018.1481071] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 04/09/2018] [Accepted: 05/18/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Pain affects a significant proportion of college students in the United States and has been linked to anxiety and depressive symptoms. Rumination and worry, two transdiagnostic factors linked to comorbidity, may explain the relationship between pain and mental health symptoms. Current Study: The current study examined worry and rumination as explanatory factors in the relationship between pain and anxiety and depressive symptoms in a sample of college students with pain (n = 1,577; 79.9% female). RESULTS Results indicated that both rumination and worry explained the relationship between pain and depressive and social anxiety symptoms, while rumination alone explained the relationship between pain and anxious arousal symptoms. CONCLUSION The current study provides novel empirical evidence that worry and rumination each help explain the relationship between pain and anxiety and depressive symptoms among college students with current pain, and college students in pain may benefit from targeted psychosocial strategies aimed at decreasing worry and ruminative responses.
Collapse
Affiliation(s)
- Andrew H Rogers
- a Department of Psychology , University of Houston , Houston , Texas , USA
| | - Jafar Bakhshaie
- a Department of Psychology , University of Houston , Houston , Texas , USA
| | - Joseph W Ditre
- b Department of Psychology , Syracuse University , Syracuse , New York , USA
| | - Kara Manning
- a Department of Psychology , University of Houston , Houston , Texas , USA
| | - Nubia A Mayorga
- a Department of Psychology , University of Houston , Houston , Texas , USA
| | - Andres G Viana
- a Department of Psychology , University of Houston , Houston , Texas , USA
| | - Michael J Zvolensky
- a Department of Psychology , University of Houston , Houston , Texas , USA
- c Department of Behavioral Sciences , University of Texas MD Anderson Cancer Center , Houston , Texas , USA
| |
Collapse
|
11
|
Edwards RA, Bonfanti G, Grugni R, Manca L, Parsons B, Alexander J. Predicting Responses to Pregabalin for Painful Diabetic Peripheral Neuropathy Based on Trajectory-Focused Patient Profiles Derived from the First 4 Weeks of Treatment. Adv Ther 2018; 35:1585-1597. [PMID: 30206821 PMCID: PMC6182642 DOI: 10.1007/s12325-018-0780-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Prediction of final clinical outcomes based on early weeks of treatment can enable more effective patient care for chronic pain. Our goal was to predict, with at least 90% accuracy, 12- to 13-week outcomes for pregabalin-treated painful diabetic peripheral neuropathy (pDPN) patients based on 4 weeks of pain and pain-related sleep interference data. METHODS We utilized active treatment data from six placebo-controlled randomized controlled trials (n = 939) designed to evaluate efficacy of pregabalin for reducing pain in patients with pDPN. We implemented a three-step, trajectory-focused analytics approach based upon patient responses collected during the first 4 weeks using monotonicity, path length, frequency domain (FD), and k-nearest neighbor (kNN) methods. The first two steps were based on combinations of baseline pain, pain at 4 weeks, weekly monotonicity and path length during the first 4 weeks, and assignment of patients to one of four responder groups (based on presence/absence of 50% or 30% reduction from baseline pain at 4 and at 12/13 weeks). The third step included agreement between prediction of logistic regression of daily FD amplitudes and assignment made from kNN analyses. RESULTS Step 1 correctly assigned 520/939 patients from the six studies to a responder group using a 3-metric combination approach based on unique assignment to a 50% responder group. Step 2 (applied to the remaining 419 patients) predicted an additional 121 patients, using a blend of 50% and 30% responder thresholds. Step 3 (using a combination of FD and kNN analyses) predicted 204 of the remaining 298 patients using the 50% responder threshold. Our approach correctly predicted 90.0% of all patients. CONCLUSION By correctly predicting 12- to 13-week responder outcomes with 90% accuracy based on responses from the first month of treatment, we demonstrated the value of trajectory measures in predicting pDPN patient response to pregabalin. TRIAL REGISTRATION www.clinicaltrials.gov identifiers, NCT00156078/NCT00159679/NCT00143156/NCT00553475. FUNDING Pfizer. Plain language summary available for this article.
Collapse
Affiliation(s)
- Roger A Edwards
- Health Services Consulting Corporation, 169 Summer Road, Boxborough, MA, 01719, USA
| | - Gianluca Bonfanti
- Fair Dynamics Consulting, srl, Via Carlo Farini 5, 20154, Milan, Italy
| | - Roberto Grugni
- Fair Dynamics Consulting, srl, Via Carlo Farini 5, 20154, Milan, Italy
| | - Luigi Manca
- Fair Dynamics Consulting, srl, Via Carlo Farini 5, 20154, Milan, Italy
| | | | - Joe Alexander
- Pfizer Inc, 235 E 42nd St, New York, NY, 10017, USA.
| |
Collapse
|
12
|
Musculoskeletal Disorders: Prevalence and Associated Factors among District Hospital Nurses in Haiphong, Vietnam. BIOMED RESEARCH INTERNATIONAL 2018; 2018:3162564. [PMID: 30225248 PMCID: PMC6129332 DOI: 10.1155/2018/3162564] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 08/07/2018] [Indexed: 02/03/2023]
Abstract
Background Musculoskeletal disorders (MSDs) are a major occupational health problematic among healthcare workers, and the prevalence is especially high among nurses. In high income countries, the prevention of MSDs is an occupational health priority. But in Vietnam, there is no data available among health professionals. Objectives To determine the prevalence and associated factors of musculoskeletal disorders among district hospital nurses in Haiphong city. Material and Methods A cross-sectional study was conducted on 1179 nurses working in 15 district hospitals using the Standardized Nordic Questionnaire. Results A very high prevalence of MSDs in the past 12 months (74.7%) and during the last 7 days (41.1%), with the two most common sites being the low back (44.4%) and neck (44.1%), was found; 37.8% complained that MSDs symptoms limit their work. When analyzing factors related to MSDs, the results showed that women were 2.1 times more likely to develop MSDs than men; people with a previous history of MSDs were more likely to develop MSDs symptoms in the past 12 months than those with no history (OR = 7.1); nurses with symptoms of psychological distress and frequent absenteeism in the workplace had a higher prevalence of MSDs compared to the rest (p<0.001). Conclusions Due to the high prevalence of MSDs among nurses in district hospitals in Haiphong, preventive actions are needed to improve the working conditions and to raise the awareness of nurses about MSDs prevention.
Collapse
|
13
|
Lu N, Xu L, Lou VWQ, Chi I. Intergenerational relationships and the trajectory of depressive symptoms among older Chinese adults in rural migrant families. Aging Ment Health 2018; 22:389-396. [PMID: 27922265 DOI: 10.1080/13607863.2016.1262821] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES This study examined the trajectory patterns of depressive symptoms of older rural Chinese adults in migrant families and the role of intergenerational relationships in predicting trajectory class memberships. METHOD Data were derived from the 2001, 2003, 2006, and 2009 waves of a longitudinal survey titled The Well-being of Older People in Anhui Province. The sample featured 486 respondents who had at least one migrant adult children at all four waves. Growth mixture modeling was used to investigate the trajectory classifications of depressive symptoms from 2001 to 2009 and antecedents in differentiating among class memberships. RESULTS The findings suggested a two-class model to interpret depressive symptom trajectory patterns: persistently high symptoms and low but increasing symptoms. Older adults who had better intergenerational relationships at baseline were more likely to have low but increasing depressive symptoms after controlling for other covariates. DISCUSSION The findings suggest that intergenerational relationships have long-term impacts on depressive symptom trajectory classes. Policy and intervention implications are discussed.
Collapse
Affiliation(s)
- Nan Lu
- a Department of Social Work, School of Sociology and Population Studies , Renmin University of China , Beijing , China
| | - Ling Xu
- b School of Social Work, University of Texas at Arlington , Arlington , TX , USA
| | - Vivian W Q Lou
- c Department of Social Work & Social Administration , The University of Hong Kong , Pokfulam, Hong Kong
| | - Iris Chi
- d Suzanne Dworak-Peck School of Social Work , University of Southern California , Los Angeles , CA , USA
| |
Collapse
|
14
|
Whitworth SR, Bruce DG, Starkstein SE, Davis WA, Davis TME, Skinner TC, Bucks RS. Depression symptoms are persistent in Type 2 diabetes: risk factors and outcomes of 5-year depression trajectories using latent class growth analysis. Diabet Med 2017; 34:1108-1115. [PMID: 28453875 DOI: 10.1111/dme.13372] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/25/2017] [Indexed: 11/27/2022]
Abstract
AIMS To describe the long-term trajectories of depression symptom severity in people with Type 2 diabetes, and to identify predictors and associates of these trajectories. METHODS A community-dwelling cohort of 1201 individuals with Type 2 diabetes from the Fremantle Diabetes Study Phase II was followed for 5 years. The nine-item version of the Patient Health Questionnaire was administered annually to assess depression symptoms, and biomedical and psychosocial measures were assessed at baseline and biennially. Latent class growth analysis was used to identify classes of depression severity trajectories and associated outcomes, and logistic regression models were used to determine predictors of class membership. RESULTS Three trajectories of depression symptoms were identified: continuously low depression symptoms (85.2%); gradually worsening symptoms that then began to improve (persistent depression - low-start; 7.3%); and gradually improving symptoms which later worsened (persistent depression - high-start; 7.5%). Younger age, being a woman, and a lifetime history of major depressive disorder, were associated with greater risk of persistent depression symptoms. Persistent depression was associated with consistently higher BMI over time, but not with changes in HbA1c or self-monitoring of blood glucose. CONCLUSIONS A subset of individuals with Type 2 diabetes is at risk of depression symptoms that remain elevated over time. Younger, overweight individuals with a history of depression may benefit from early and intensive depression management and ongoing follow-up as part of routine Type 2 diabetes care.
Collapse
Affiliation(s)
- S R Whitworth
- School of Psychological Science, University of Western Australia, Crawley, Western Australia
| | - D G Bruce
- School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia
| | - S E Starkstein
- School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, Western Australia
| | - W A Davis
- School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia
| | - T M E Davis
- School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia
| | - T C Skinner
- School of Psychological and Clinical Sciences, Charles Darwin University, Darwin, Northern Territory, Australia
| | - R S Bucks
- School of Psychological Science, University of Western Australia, Crawley, Western Australia
| |
Collapse
|
15
|
Müller F, Tuinman MA, Janse M, Almansa J, Sprangers MAG, Smink A, Ranchor AV, Fleer J, Hagedoorn M. Clinically distinct trajectories of fatigue and their longitudinal relationship with the disturbance of personal goals following a cancer diagnosis. Br J Health Psychol 2017. [DOI: 10.1111/bjhp.12253] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Fabiola Müller
- Department of Health Psychology; University Medical Center Groningen; University of Groningen; The Netherlands
| | - Marrit A. Tuinman
- Department of Health Psychology; University Medical Center Groningen; University of Groningen; The Netherlands
| | - Moniek Janse
- Department of Health Psychology; University Medical Center Groningen; University of Groningen; The Netherlands
| | - Josué Almansa
- Division of Community and Occupational Medicine; Department of Health Sciences; University Medical Center Groningen; University of Groningen; The Netherlands
| | - Mirjam A. G. Sprangers
- Department of Medical Psychology; Academic Medical Center; University of Amsterdam; The Netherlands
| | - Ans Smink
- Department of Health Psychology; University Medical Center Groningen; University of Groningen; The Netherlands
| | - Adelita V. Ranchor
- Department of Health Psychology; University Medical Center Groningen; University of Groningen; The Netherlands
| | - Joke Fleer
- Department of Health Psychology; University Medical Center Groningen; University of Groningen; The Netherlands
| | - Mariët Hagedoorn
- Department of Health Psychology; University Medical Center Groningen; University of Groningen; The Netherlands
| |
Collapse
|
16
|
Trick L, Watkins E, Windeatt S, Dickens C. The association of perseverative negative thinking with depression, anxiety and emotional distress in people with long term conditions: A systematic review. J Psychosom Res 2016; 91:89-101. [PMID: 27894469 DOI: 10.1016/j.jpsychores.2016.11.004] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 11/08/2016] [Accepted: 11/10/2016] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Depression is common in people with long term conditions, and is associated with worse medical outcomes. Previous research shows perseverative negative thinking (e.g. worry, rumination) predicts subsequent depression and worse medical outcomes, suggesting interventions targeting perseverative negative thinking could improve depression and medical outcomes. Previous studies recruited healthy individuals, however. This review aimed to determine the temporal relationship and strength of prospective association of perseverative negative thinking with depression, anxiety and emotional distress in people with long term conditions. METHOD Four electronic databases were searched for studies including standardised measures of perseverative negative thinking and depression, anxiety or emotional distress, and which presented prospective associations. Findings were narratively synthesized. RESULTS Thirty studies were identified in a range of long term conditions. Perseverative negative thinking and subsequent depression, anxiety or emotional distress were significantly correlated in the majority of studies (bivariate r=0.23 to r=0.73). 25 studies controlled for confounders, and in 15 perseverative negative thinking predicted subsequent depression, anxiety or emotional distress. Results varied according to condition and study quality. Six of 7 studies found bivariate associations between depression, anxiety or emotional distress and subsequent perseverative negative thinking, though 2 studies controlling for key covariates found no association. Few studies assessed the impact of perseverative negative thinking on medical outcomes. CONCLUSION Strongest evidence supported perseverative negative thinking predicting subsequent depression, anxiety and emotional distress in people with long term conditions. Further prospective research is warranted to clarify the association of perseverative negative thinking with subsequent poor medical outcomes.
Collapse
Affiliation(s)
- Leanne Trick
- University of Exeter Medical School, College House, St Lukes Campus, Heavitree Road, Exeter EX1 2LU, United Kingdom.
| | - Edward Watkins
- University of Exeter Medical School, College House, St Lukes Campus, Heavitree Road, Exeter EX1 2LU, United Kingdom
| | - Stacey Windeatt
- University of Exeter Medical School, College House, St Lukes Campus, Heavitree Road, Exeter EX1 2LU, United Kingdom
| | - Chris Dickens
- University of Exeter Medical School, College House, St Lukes Campus, Heavitree Road, Exeter EX1 2LU, United Kingdom
| |
Collapse
|
17
|
Park SJ, Lee R, Yoon DM, Yoon KB, Kim K, Kim SH. Factors associated with increased risk for pain catastrophizing in patients with chronic neck pain: A retrospective cross-sectional study. Medicine (Baltimore) 2016; 95:e4698. [PMID: 27631217 PMCID: PMC5402560 DOI: 10.1097/md.0000000000004698] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Pain catastrophizing is becoming increasingly recognized as a clinically important psychological factor in chronic musculoskeletal pain. In this retrospective cross-sectional study, we have identified factors associated with an increased risk for pain catastrophizing in chronic neck pain (CNP) patients. We obtained data from our medical database on 331 patients who were treated for neck pain as their chief complaint at our clinic. The Pain Catastrophizing Scale (PCS) was used to define a high pain catastrophizing state (PCS score ≥21) in this study. Patient demographics, pain-related factors, and psychological factors were evaluated with logistic regression analysis to identify risk factors of high pain catastrophizing among patients with CNP. A total of 256 patients with CNP satisfied the study inclusion criteria and were included in the analyses. The median PCS score was 16 (range, 0-45), and 86 of 256 patients (33.5%) reported a PCS score ≥21. In multivariate analysis, high pain intensity, clinical insomnia, and a high level of depression/anxiety were strongly associated with high pain catastrophizing in patients with CNP. Depression was the strongest predictor of high pain catastrophizing, with an odds ratio of 7.35 (95% confidence interval 2.23-24.22). High pain catastrophizing was not significantly related to age, gender, comorbidities, or neck pain-related physical symptoms. In conclusion, poor psychological states should be addressed as an important part of pain management in CNP patients who are susceptible to high pain catastrophizing.
Collapse
Affiliation(s)
| | | | | | | | | | - Shin Hyung Kim
- Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
- Correspondence: Shin Hyung Kim, Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea (e-mail: )
| |
Collapse
|
18
|
McKillop AB, Carroll LJ, Jones CA, Battié MC. The relation of social support and depression in patients with chronic low back pain. Disabil Rehabil 2016; 39:1482-1488. [PMID: 27415131 DOI: 10.1080/09638288.2016.1202335] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE Depression is a common condition in adults with low back pain (LBP), and is associated with poorer patient outcomes. Social support is a modifiable factor that may influence depressive symptoms in people with LBP and, if so, could be a consideration in LBP management when depression is an issue. The aim of this study was to examine social support as a prognostic factor for depressive symptoms and recovery from depression in patients with LBP. METHOD Patients with LBP (n = 483), recruited from four imaging centers in Canada, completed an initial survey following imaging and a follow-up survey one year later, including the Medical Outcomes Study (MOS) Social Support Survey and the Center for Epidemiologic Studies Depression Scale. Multivariable regression analyses were used to examine the relationship between social support and depression. RESULTS More social support (overall functional social support) at baseline was associated with recovery from depression (OR = 0.24; 95% CI 0.10, 0.55) and less depressive symptoms (β = 1.68; 95% CI = 0.36, 3.00) at one-year follow-up. In addition, associations were found between specific aspects (subscales) of social support and the two depression outcomes. CONCLUSIONS Functional social support as a prognostic factor for depression and possible target of LBP management warrants further investigation. Implications for Rehabilitation Depression is a common condition in adults with low back pain (LBP), and is associated with poorer patient outcomes. This study provides evidence for social support as a prognostic factor for depressive symptoms and recovery from depression in patients with LBP problems. Management of pain conditions may be enhanced by a better understanding of modifiable risk factors for depression, such as social support.
Collapse
Affiliation(s)
- Ashley B McKillop
- a Faculty of Rehabilitation Medicine , University of Alberta , Edmonton , Alberta , Canada
| | - Linda J Carroll
- b Department of Public Health Sciences , School of Public Health, University of Alberta , Edmonton , Alberta , Canada
| | - C Allyson Jones
- c Department of Physical Therapy, Faculty of Rehabilitation Medicine , University of Alberta , Edmonton , Alberta , Canada
| | - Michele C Battié
- c Department of Physical Therapy, Faculty of Rehabilitation Medicine , University of Alberta , Edmonton , Alberta , Canada
| |
Collapse
|
19
|
Stephens HE, Lehman E, Raheja D, Yang C, Walsh S, Simmons Z. The role of mental health and self-efficacy in the pain experience of patients with amyotrophic lateral sclerosis. Amyotroph Lateral Scler Frontotemporal Degener 2016; 17:206-12. [PMID: 26878392 DOI: 10.3109/21678421.2015.1131832] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Complex interactions between pain, depression, and anxiety impact quality of life in patients with ALS. Psychological approaches to pain control may be useful. This study explored the role of self-efficacy in mitigating pain. Individuals registered with the Agency for Toxic Substances and Disease Registry National ALS Registry and who experienced pain were invited to participate in an online survey. Subjects completed the Brief Pain Inventory-Short Form, Hospital Anxiety and Depression Scale, and Chronic Pain Self-Efficacy Scale. Correlations between variables were determined. Multiple linear regression models assessed relationships between depression, anxiety and self-efficacy predictions, and pain severity, interference, and relief. Results recorded that there were 197 participants (58% males, mean age 59 ± 10 years). Cases or borderline cases of depression or anxiety were common. Mean levels of pain were moderate. Higher pain self-efficacy scores predicted lower pain severity, lower pain interference, and higher pain relief with treatment. As depression scores increased, pain interference with daily life was higher. In conclusion, anxiety and depression are common in patients with ALS and pain. Self-efficacy appears to mitigate pain. A multifactorial approach to pain management should be considered in these patients, addressing mental health and self-efficacy to augment pharmacologic pain treatments.
Collapse
Affiliation(s)
- Helen E Stephens
- a Department of Neurology The Pennsylvania State University College of Medicine, Hershey Pennsylvania
| | - Erik Lehman
- b Department of Public Health Sciences , The Pennsylvania State University College of Medicine, Hershey Pennsylvania
| | - Divisha Raheja
- a Department of Neurology The Pennsylvania State University College of Medicine, Hershey Pennsylvania
| | - Chengwu Yang
- c Department of Public Health Sciences & Office for Scholarship in Learning and Education Research , The Pennsylvania State University College of Medicine, Hershey Pennsylvania
| | - Susan Walsh
- d ALS Association Greater Philadelphia Chapter, Ambler Pennsylvania , and
| | - Zachary Simmons
- e Department of Neurology and Humanities , The Pennsylvania State University College of Medicine, Hershey Pennsylvania , USA
| |
Collapse
|