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Ryan N, Bruno P. The clinical utility of the prone hip extension test in the diagnosis of motor control impairments associated with low back pain: A cross-sectional study using motion capture and electromyography. Clin Biomech (Bristol, Avon) 2024; 118:106317. [PMID: 39079204 DOI: 10.1016/j.clinbiomech.2024.106317] [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: 05/10/2024] [Revised: 07/05/2024] [Accepted: 07/23/2024] [Indexed: 08/18/2024]
Abstract
BACKGROUND The prone hip extension test is used as a clinical tool to diagnose specific motor control impairments that have been identified in individuals with chronic low back pain. However, conventional protocols for performing the test are subjective and lack evidence for their effectiveness. The objective of the current study was to quantify lumbopelvic motion and muscle activation during this test and identify which motor control patterns best distinguish individuals with low back pain from asymptomatic controls. METHODS 18 individuals with sub-acute or chronic low back pain and 32 asymptomatic controls performed the prone hip extension test while a 3D motion capture system measured lumbar and pelvic movement patterns and an electromyography system measured the muscle activation patterns of the paraspinal, gluteus maximus, and hamstring muscles. A three-stage statistical analysis was performed, the final stage being a stepwise logistic regression analysis aimed at identifying the movement and muscle activation pattern variables that best distinguished the two groups. FINDINGS The final regression model included three lumbar kinematic variables and several electromyographic amplitude variables for the gluteus maximus and hamstring muscles during right-sided prone hip extension. The final model correctly classified 86.7 % of the control group and 83.3 % of the low back pain group. INTERPRETATION The subject of asymmetrical gluteus maximus and hamstring muscle activation appears to be a potentially interesting area for future research on the utility of the prone hip extension test as a clinical tool in diagnosing motor control impairments associated with low back pain.
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Affiliation(s)
- Nicholas Ryan
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, Saskatchewan, Canada
| | - Paul Bruno
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, Saskatchewan, Canada.
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De La Rosa JS, Brady BR, Herder KE, Wallace JS, Ibrahim MM, Allen AM, Meyerson BE, Suhr KA, Vanderah TW. The unmet mental health needs of U.S. adults living with chronic pain. Pain 2024:00006396-990000000-00671. [PMID: 39073375 DOI: 10.1097/j.pain.0000000000003340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 05/13/2024] [Indexed: 07/30/2024]
Abstract
ABSTRACT Previous research suggests that individuals with mental health needs and chronic pain may be less likely to use mental health treatment compared with those with mental health needs only. Yet, few studies have investigated the existence of population-level differences in mental health treatment use. We analyzed data from the National Health Interview Survey (n = 31,997) to address this question. We found that chronic pain was associated with end-to-end disparities in the mental health journeys of U.S. adults: (1) Those living with chronic pain are overrepresented among U.S. adults with mental health needs; (2) among U.S. adults with mental health needs, those living with chronic pain had a lower prevalence of mental health treatment use; (3) among U.S. adults who used mental health treatment, those living with chronic pain had a higher prevalence of screening positive for unremitted anxiety or depression; (4) among U.S. adults living with both chronic pain and mental health needs, suboptimal mental health experiences were more common than otherwise-just 44.4% of those living with mental health needs and co-occurring chronic pain reported use of mental health treatment and screened negative for unremitted anxiety and depression, compared with 71.5% among those with mental health needs only. Overall, our results suggest that U.S. adults with chronic pain constitute an underrecognized majority of those living with unremitted anxiety/depression symptoms and that the U.S. healthcare system is not yet adequately equipped to educate, screen, navigate to care, and successfully address their unmet mental health needs.
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Affiliation(s)
- Jennifer S De La Rosa
- Comprehensive Center for Pain and Addiction, University of Arizona Health Sciences, Tucson, AZ, United States
- Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ, United States
| | - Benjamin R Brady
- Comprehensive Center for Pain and Addiction, University of Arizona Health Sciences, Tucson, AZ, United States
- School of Interdisciplinary Health Programs, College of Health and Human Services, Western Michigan University, Kalamazoo, MI, United States
| | - Katherine E Herder
- Comprehensive Center for Pain and Addiction, University of Arizona Health Sciences, Tucson, AZ, United States
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
| | - Jessica S Wallace
- Comprehensive Center for Pain and Addiction, University of Arizona Health Sciences, Tucson, AZ, United States
- Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ, United States
| | - Mohab M Ibrahim
- Comprehensive Center for Pain and Addiction, University of Arizona Health Sciences, Tucson, AZ, United States
- Departments of Anesthesiology
| | - Alicia M Allen
- Comprehensive Center for Pain and Addiction, University of Arizona Health Sciences, Tucson, AZ, United States
- Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ, United States
| | - Beth E Meyerson
- Comprehensive Center for Pain and Addiction, University of Arizona Health Sciences, Tucson, AZ, United States
- Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ, United States
| | - Kyle A Suhr
- Comprehensive Center for Pain and Addiction, University of Arizona Health Sciences, Tucson, AZ, United States
- Psychiatry, and
| | - Todd W Vanderah
- Comprehensive Center for Pain and Addiction, University of Arizona Health Sciences, Tucson, AZ, United States
- Department of Pharmacology, College of Medicine, University of Arizona, Tucson, AZ, United States
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Uvelli A, Ribaudo C, Gualtieri G, Coluccia A, Ferretti F. The association between violence against women and chronic pain: a systematic review and meta-analysis. BMC Womens Health 2024; 24:321. [PMID: 38834977 DOI: 10.1186/s12905-024-03097-w] [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: 05/25/2023] [Accepted: 04/16/2024] [Indexed: 06/06/2024] Open
Abstract
Violence against women is a phenomenon that involves at least 35% of women worldwide. Violence can be sexual, physical, and/or psychological, perpetrated by the partner, another family member, or a stranger. Violence is a public health problem because its consequences include higher morbidity, higher mortality, and short and long-term physical and psychological health diseases. Most studies prove an association between any type of violence and some chronic pain diagnoses but no one has done a complete collection of this evidence. This systematic review and meta-analysis aimed to evaluate whether this association is statistically significant, including the largest number of studies. Through the inclusion of 37 articles, the association has been demonstrated. Compared with no history of violence, women who did experience violence showed 2 times greater odds of developing chronic pain. The impact of violence was significant also on fibromyalgia separately, but not on pelvic pain.PROSPERO registrationPROSPERO CRD42023425477.
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Affiliation(s)
- Allison Uvelli
- Department of Medical Science, Surgery and Neurosciences, University of Siena, Viale Bracci, Siena, 53100, Italy.
| | - Carola Ribaudo
- AOUC Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla, Florence, 50134, Italy
| | - Giacomo Gualtieri
- Department of Medical Science, Surgery and Neurosciences, University of Siena, Viale Bracci, Siena, 53100, Italy
- AOUS Azienda Ospedaliero-Universitaria Senese, Viale Bracci, Siena, 53100, Italy
| | - Anna Coluccia
- Department of Medical Science, Surgery and Neurosciences, University of Siena, Viale Bracci, Siena, 53100, Italy
| | - Fabio Ferretti
- Department of Medical Science, Surgery and Neurosciences, University of Siena, Viale Bracci, Siena, 53100, Italy
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Vieira WF, Coelho DRA, Litwiler ST, McEachern KM, Clancy JA, Morales-Quezada L, Cassano P. Neuropathic pain, mood, and stress-related disorders: A literature review of comorbidity and co-pathogenesis. Neurosci Biobehav Rev 2024; 161:105673. [PMID: 38614452 DOI: 10.1016/j.neubiorev.2024.105673] [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: 01/30/2024] [Revised: 04/02/2024] [Accepted: 04/10/2024] [Indexed: 04/15/2024]
Abstract
Neuropathic pain can be caused by multiple factors, and its prevalence can reach 10% of the global population. It is becoming increasingly evident that limited or short-lasting response to treatments for neuropathic pain is associated with psychological factors, which include psychiatric comorbidities known to affect quality of life. It is estimated that 60% of patients with neuropathic pain also experience depression, anxiety, and stress symptoms. Altered mood, including stress, can be a consequence of several painful conditions but can also favor pain chronicization when preexisting. Despite the apparent tight connection between clinical pain and mood/stress disorders, the exact physiological mechanisms remain unclear. This review aims to provide an overview of state-of-the-art research on the mechanisms of pain related to the pathophysiology of depression, anxiety, and stress disorders.
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Affiliation(s)
- Willians Fernando Vieira
- Division of Neuropsychiatry and Neuromodulation, Massachusetts General Hospital (MGH), Boston, USA; Department of Psychiatry, Harvard Medical School (HMS), Boston, USA; Department of Anatomy, Institute of Biomedical Sciences (ICB), University of São Paulo (USP), São Paulo, Brazil.
| | - David Richer Araujo Coelho
- Division of Neuropsychiatry and Neuromodulation, Massachusetts General Hospital (MGH), Boston, USA; Department of Psychiatry, Harvard Medical School (HMS), Boston, USA; Harvard T. H. Chan School of Public Health (HSPH), Boston, USA
| | - Scott Thomas Litwiler
- Center for Computational and Integrative Biology (CCIB), Massachusetts General Hospital (MGH), Boston, USA
| | - Kayla Marie McEachern
- Division of Neuropsychiatry and Neuromodulation, Massachusetts General Hospital (MGH), Boston, USA
| | - Julie A Clancy
- Division of Neuropsychiatry and Neuromodulation, Massachusetts General Hospital (MGH), Boston, USA
| | - Leon Morales-Quezada
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, USA
| | - Paolo Cassano
- Division of Neuropsychiatry and Neuromodulation, Massachusetts General Hospital (MGH), Boston, USA; Department of Psychiatry, Harvard Medical School (HMS), Boston, USA
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Daher M, Alsoof D, Balmaceno-Criss M, Kuharski MJ, Criddle SL, Diebo BG, Daniels AH. Preoperative Resilience and Improvement in Patient-Reported Outcomes After Lumbar Spinal Fusion. World Neurosurg 2024; 186:e531-e538. [PMID: 38583559 DOI: 10.1016/j.wneu.2024.03.168] [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: 03/14/2024] [Accepted: 03/29/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND It is incompletely understood how preoperative resilience affects 1-year postoperative outcomes after lumbar spinal fusion. METHODS Patients undergoing open lumbar spinal fusion at a single-center institution were identified between November 2019 and September 2022. Preoperative resilience was assessed using the Brief Resilience Scale. Demographic data at baseline including age, gender, comorbidities, and body mass index (BMI) were extracted. Patient-reported outcome measures including Oswestry Disability Index, PROMIS (Patient-Reported Outcomes Measurement Information System) Global Physical Health, PROMIS Global Mental Health (GMH), and EuroQol5 scores were collected before the surgery and at 3 months and 1 year postoperatively. Bivariate correlation was conducted between Brief Resilience Scale scores and outcome measures at 3 months and 1 year postoperatively. RESULTS Ninety-three patients had baseline and 1 year outcome data. Compared with patients with high resilience, patients in the low-resilience group had a higher percentage of females (69.4% vs. 43.9%; P = 0.02), a higher BMI (32.7 vs. 30.1; P = 0.03), and lower preoperative Global Physical Health (35.8 vs. 38.9; P = 0.045), GMH (42.2 vs. 49.2; P < 0.001), and EuroQol scores (0.56 vs. 0.61; P = 0.01). At 3 months postoperatively, resilience was moderately correlated with GMH (r = 0.39) and EuroQol (r = 0.32). Similarly, at 1 year postoperatively, resilience was moderately correlated with GMH (r = 0.33) and EuroQol (r = 0.34). Comparable results were seen in multivariable regression analysis controlling for age, gender, number of levels fused, BMI, Charlson Comorbidity Index, procedure, anxiety/depression, and complications. CONCLUSIONS Low preoperative resilience can negatively affect patient-reported outcomes 1 year after lumbar spinal fusion. Resiliency is a potentially modifiable risk factor, and surgeons should consider targeted interventions for at-risk patient groups.
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Affiliation(s)
- Mohammad Daher
- Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Daniel Alsoof
- Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Mariah Balmaceno-Criss
- Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Michael J Kuharski
- Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Sarah L Criddle
- Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Bassel G Diebo
- Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Alan H Daniels
- Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
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Yıldız NG, Aydin HZ, Sambo G, Aydın K, Yıldız H, Santri IN, Wardani Y, Mwamulima B, Isni K, Phiri YVA. The mediating role of depressive symptoms among Turkish population related to gender and low back pain: evidence from a national health survey. BMC Public Health 2024; 24:1136. [PMID: 38654220 DOI: 10.1186/s12889-024-18612-9] [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: 05/09/2023] [Accepted: 04/15/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Low back pain (LBP), though non-life-threatening, burdens healthcare with treatment expenses and work hours lost. Globally, 70-84% experience it, with risk factors tied to societal structure, income, and living conditions, making it a leading cause of disability. METHODS This study utilized data from the 2019 Türkiye Health Survey, which consisted of 17,084 individuals aged 15 and above. Our study focused on investigating the factors related to low back pain through a cross-sectional analysis. To analyze these factors, we employed binary multivariate logistic regression. Additionally, we conducted post-hoc analyses to assess the potential mediating effect of depressive symptoms on the relationship between low back pain and gender. RESULTS We found that 31.9% of the population experienced low back pain, with women being 58% more likely [aOR = 1.58; 95% CI (1.45-1.73)] than men to report symptoms. Individuals aged 55 + years old had a 90% [aOR = 1.90; 95% CI (1.61-2.23)] chance of experiencing low back pain, indicating an age-related increase. In the general population, having depressive symptoms was 2.49 [95% CI (2.23-2.78)] times more likely associated with low back pain. Our mediation analysis showed that gender (i.e., women vs. men), indicated by direct effects with β-estimates e = 0.78, predicted the likelihood of low back pain. Additionally, the relationship between gender and low back pain, mediated through a history of depressive symptoms, had a significant total indirect effect (i.e., β-estimate given as e = 0.49). Specifically, a history of depressive symptoms accounted for 17.86% [95% CI (9.67-20.10)] of the association between women having a higher likelihood of low back pain compared to men. CONCLUSION We observed that a higher likelihood of low back pain associated with gender and aging. Additionally, BMI served as a significant predictor, particularly in adults. Depression mediated the association between gender and low back pain. Acknowledging these associations may help identify and address contributing factors to LBP, potentially increasing awareness and alleviating the burden. Policymakers and healthcare professionals may consider these findings when developing prevention and treatment programs for low back pain.
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Affiliation(s)
- Nadire Gülçin Yıldız
- Faculty of Education, Department of Guidance and Counseling, Istanbul Medipol University, Istanbul, Turkey
| | - Halide Z Aydin
- Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Grace Sambo
- Chang Gung Medical Education Research Centre (CG-MERC), Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Kemal Aydın
- Faculty of Economics and Administrative Sciences, Amasya University, Amasya, Turkey
| | - Hatice Yıldız
- Health Sciences Institute, Istanbul Medipol University, Istanbul, Turkey
| | | | - Yuniar Wardani
- Faculty of Public Health, Universitas Ahmad Dahlan, Yogyakarta, Indonesia
| | - Bwanalori Mwamulima
- Directorate of Health and Social Services, Rumphi District Council, Rumphi, Malawi
| | - Khoiriyah Isni
- Faculty of Public Health, Universitas Ahmad Dahlan, Yogyakarta, Indonesia
| | - Yohane V A Phiri
- Department of Epidemiology and Environmental Health (EEH), University at Buffalo, Buffalo, NY, USA.
- Charis Professional and Academic Research Consultants (CPARC), C/O, Mchinji, P.O. Box 132, Malawi.
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Sansatan R, Kanlayanaphotporn R, Jensen MP, Correia H, Janwantanakul P. Cross-cultural adaptation and psychometric properties of the Thai version of the patient-reported outcomes measurement information system short form- depression 8a in individuals with chronic low back pain. J Patient Rep Outcomes 2024; 8:27. [PMID: 38436802 PMCID: PMC10912068 DOI: 10.1186/s41687-024-00702-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 02/15/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND The study aimed to cross-culturally adapt the Patient-Reported Outcomes Measurement Information System Short Form v1.0 - Depression 8a (PROMIS SF v1.0 - Depression 8a) into Thai and evaluate its psychometric properties in individuals with chronic low back pain (CLBP). METHODS The PROMIS SF v1.0- Depression 8a was translated and cross-culturally adapted into Thai using the Functional Assessment of Chronic Illness Therapy translation methodology. Two hundred and sixty-nine individuals with CLBP completed the Thai version of PROMIS SF v1.0- Depression 8a (T-PROMIS-D-8a) scale and a set of measures assessing validity criterion domains. Structural validity, internal consistency, and test-retest reliability at a 7-day interval of the T-PROMIS-D-8a scale were computed and its construct validity was evaluated by computing correlations with the Thai version of Patient Health Questionnaire-9 (T-PHQ-9), Numeric Rating Scale of pain intensity (T-NRS), and Fear Avoidance Beliefs Questionnaire (T-FABQ). RESULTS Data from 269 participants were analyzed. Most participants were women (70%), and the sample had a mean age of 42.5 (SD 16.6) years. The findings supported the unidimensionality, internal consistency (Cronbach's alpha = 0.94), and test-retest reliability (ICC [2,1] = 0.86) of the T-PROMIS-D-8a. A floor effect was observed for 16% of the sample. Associations with the T-PHQ-9, T-NRS, and T-FABQ supported the construct validity of the T-PROMIS-D-8a. CONCLUSIONS The T-PROMIS-D-8a was successfully translated and culturally adapted. The findings indicated that the scale is reliable and valid for assessing depression in Thai individuals with CLBP.
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Affiliation(s)
- Ruetaichanok Sansatan
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Rotsalai Kanlayanaphotporn
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Mark P Jensen
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Harborview Medical Center, Seattle, Washington, USA
| | - Helena Correia
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Prawit Janwantanakul
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand.
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De La Rosa JS, Brady BR, Ibrahim MM, Herder KE, Wallace JS, Padilla AR, Vanderah TW. Co-occurrence of chronic pain and anxiety/depression symptoms in U.S. adults: prevalence, functional impacts, and opportunities. Pain 2024; 165:666-673. [PMID: 37733475 PMCID: PMC10859853 DOI: 10.1097/j.pain.0000000000003056] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 08/08/2023] [Accepted: 08/09/2023] [Indexed: 09/23/2023]
Abstract
ABSTRACT Co-occurrence of chronic pain and clinically significant symptoms of anxiety and/or depression is regularly noted in the literature. Yet, little is known empirically about population prevalence of co-occurring symptoms, nor whether people with co-occurring symptoms constitute a distinct subpopulation within US adults living with chronic pain or US adults living with anxiety and/or depression symptoms (A/D). To address this gap, this study analyzes data from the 2019 National Health Interview Survey, a representative annual survey of self-reported health status and treatment use in the United States (n = 31,997). Approximately 12 million US adults, or 4.9% of the adult population, have co-occurring chronic pain and A/D symptoms. Unremitted A/D symptoms co-occurred in 23.9% of US adults with chronic pain, compared with an A/D prevalence of 4.9% among those without chronic pain. Conversely, chronic pain co-occurred in the majority (55.6%) of US adults with unremitted A/D symptoms, compared with a chronic pain prevalence of 17.1% among those without A/D symptoms. The likelihood of experiencing functional limitations in daily life was highest among those experiencing co-occurring symptoms, compared with those experiencing chronic pain alone or A/D symptoms alone. Among those with co-occurring symptoms, 69.4% reported that work was limited due to a health problem, 43.7% reported difficulty doing errands alone, and 55.7% reported difficulty participating in social activities. These data point to the need for targeted investment in improving functional outcomes for the nearly 1 in 20 US adults living with co-occurring chronic pain and clinically significant A/D symptoms.
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Affiliation(s)
- Jennifer S. De La Rosa
- Comprehensive Pain and Addiction Center, University of Arizona Health Sciences, Tucson, AZ, United States
| | - Benjamin R. Brady
- Comprehensive Pain and Addiction Center, University of Arizona Health Sciences, Tucson, AZ, United States
- Arizona Center for Rural Health, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
- School of Interdisciplinary Health Programs, College of Health and Human Services, Western Michigan University, Kalamazoo, MI, United States
| | - Mohab M. Ibrahim
- Comprehensive Pain and Addiction Center, University of Arizona Health Sciences, Tucson, AZ, United States
- Department of Anesthesiology, College of Medicine, University of Arizona, Tucson, AZ, United States
| | - Katherine E. Herder
- Comprehensive Pain and Addiction Center, University of Arizona Health Sciences, Tucson, AZ, United States
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
| | - Jessica S. Wallace
- Comprehensive Pain and Addiction Center, University of Arizona Health Sciences, Tucson, AZ, United States
- Departments of Family and Community Medicine and
| | - Alyssa R. Padilla
- Comprehensive Pain and Addiction Center, University of Arizona Health Sciences, Tucson, AZ, United States
| | - Todd W. Vanderah
- Comprehensive Pain and Addiction Center, University of Arizona Health Sciences, Tucson, AZ, United States
- Pharmacology, College of Medicine, University of Arizona, Tucson, AZ, United States
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9
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Zhang T, Li X, Zhou X, Zhan L, Wu F, Huang Z, Sun Y, Feng Y, Du Q. Virtual Reality Therapy for the Management of Chronic Spinal Pain: Systematic Review and Meta-Analysis. JMIR Serious Games 2024; 12:e50089. [PMID: 38345832 PMCID: PMC10897798 DOI: 10.2196/50089] [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] [Received: 06/19/2023] [Revised: 12/01/2023] [Accepted: 01/07/2024] [Indexed: 03/01/2024] Open
Abstract
BACKGROUND The effectiveness of virtual reality (VR) therapy in adults with chronic spinal pain (CSP) is unclear. OBJECTIVE This study was conducted to compare the effectiveness of VR therapy and other therapies in adults with CSP, especially patients with inflammation-related pain. METHODS PubMed, Web of Science, Cochrane Library, Embase, and CINAHL databases were searched up to November 11, 2023. Randomized controlled trials (RCTs) comparing adults with CSP receiving VR therapy with those receiving other therapies were included. The trial registration platform as well as the reference lists of included studies and previous systematic reviews and meta-analyses were manually searched. Two independent reviewers performed study selection, data extraction, risk-of-bias assessment, and evaluation of the quality of the evidence. The weighted mean difference (WMD) was used as the effect size used to synthesize the outcome measure. RESULTS In total, 16 RCTs involving 800 participants were included in this meta-analysis. The pooled data from 15 (94%) RCTs including 776 (97%) participants showed that VR therapy was superior in improving pain intensity (WMD=-1.63, 95% CI -2.11 to -1.16, P<.001, I2=90%) and reducing inflammatory markers, including C-reactive protein (WMD=-0.89, 95% CI -1.07 to -0.70, P<.001, I2=0%), tumor necrosis factor-alpha (WMD=-6.60, 95% CI -8.56 to -4.64, P<.001, I2=98%), and interleukin-6 (WMD=-2.76, 95% CI -2.98 to -2.53, P<.001, I2=0%). However, no significant differences were found in terms of the spinal range of motion (ROM), disability level, or fear of movement. In addition, 10 (63%) of the included RCTs had a high risk of bias. CONCLUSIONS VR therapy may be an effective and safe intervention for reducing symptoms in patients with CSP, as it is shown to exert significant analgesic effects and beneficial improvements in inflammatory factor levels. However, this approach may not have significant effects on the spinal ROM, disability level, or fear of movement. Notably, the quality of the evidence from the RCTs included in this study ranged from moderate to low. Therefore, we recommend that readers interpret the results of this study with caution. TRIAL REGISTRATION PROSPERO CRD42022382331; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=382331.
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Affiliation(s)
- Tongtong Zhang
- Department of Rehabilitation, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Xin Li
- Department of Rehabilitation, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Xuan Zhou
- Department of Rehabilitation, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lixia Zhan
- The Second People's Hospital of Beihai, Beihai, China
| | - Fan Wu
- Department of Rehabilitation, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zefan Huang
- Department of Rehabilitation, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuxun Sun
- College of Rehabilitation Sciences, Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Yufei Feng
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Qing Du
- Department of Rehabilitation, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Chongming Hospital, Shanghai University of Medicine & Health Sciences, Shanghai, China
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Chen Y, Sun Y, Wang L, Xu K, Wang DW. Genetic insights into associations of multisite chronic pain with common diseases and biomarkers using data from the UK Biobank. Br J Anaesth 2024; 132:372-382. [PMID: 38104003 DOI: 10.1016/j.bja.2023.11.007] [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: 08/09/2023] [Revised: 10/17/2023] [Accepted: 11/06/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND Chronic pain is a common, complex, and challenging condition, for which specialised healthcare is required. We investigated the relationship between multisite chronic pain (MCP) and different disease traits identify safe biomarker interventions that can prevent MCP. METHODS Univariable and multivariable Mendelian randomisation (MR) analysis were conducted to investigate associations between MCP and 36 common diseases in the UK Biobank. Subsequently, we estimated the potential effect of expression of 4774 proteins on MCP utilising existing plasma protein quantitative trait locus data. For the significant biomarkers, we performed phenome-wide MR (Phe-MR) with 1658 outcomes to predict potential safety profiles linked to biomarker intervention. RESULTS Multisite chronic pain had a substantial impact on psychiatric and neurodevelopmental traits (major depression and attention deficit hyperactivity disorder), cardiovascular diseases (myocardial infarction, coronary artery disease, and heart failure), respiratory outcomes (asthma, chronic obstructive pulmonary disease, and sleep apnoea), arthropathies, type 2 diabetes mellitus, and cholelithiasis. Higher genetically predicted levels of S100A6, DOCK9, ferritin, and ferritin light chain were associated with a risk of MCP, whereas PTN9 and NEUG were linked to decreased MCP risk. Phe-MR results suggested that genetic inhibition of DOCK9 increased the risk of 21 types of disease, whereas the other biomarker interventions were relatively safe. CONCLUSIONS We established that MCP has an effect on health conditions covering various physiological systems and identified six novel biomarkers for intervention. In particular, S100A6, PTN9, NEUG, and ferritin light chain represent promising targets for MCP prevention, as no significant side-effects were predicted in our study.
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Affiliation(s)
- Yanghui Chen
- Division of Cardiology, Department of Internal Medicine and Hubei Key Laboratory of Genetics and Molecular Mechanism of Cardiologic Disorders, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR of China
| | - Yang Sun
- Division of Cardiology, Department of Internal Medicine and Hubei Key Laboratory of Genetics and Molecular Mechanism of Cardiologic Disorders, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR of China
| | - Linlin Wang
- Division of Cardiology, Department of Internal Medicine and Hubei Key Laboratory of Genetics and Molecular Mechanism of Cardiologic Disorders, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR of China
| | - Ke Xu
- Division of Cardiology, Department of Internal Medicine and Hubei Key Laboratory of Genetics and Molecular Mechanism of Cardiologic Disorders, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR of China
| | - Dao Wen Wang
- Division of Cardiology, Department of Internal Medicine and Hubei Key Laboratory of Genetics and Molecular Mechanism of Cardiologic Disorders, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR of China.
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11
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Heikkala E, Oura P, Paananen M, Ho E, Ferreira P, Tanguay-Sabourin C, Karppinen J. Chronic disease clusters are associated with prolonged, bothersome, and multisite musculoskeletal pain: a population-based study on Northern Finns. Ann Med 2023; 55:592-602. [PMID: 36773018 PMCID: PMC9930817 DOI: 10.1080/07853890.2023.2177723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
Abstract
BACKGROUND Chronic diseases often accumulate with musculoskeletal (MSK) pain. However, less evidence is available on idiosyncratic patterns of chronic diseases and their relationships with the severity of MSK pain in general MSK pain populations. MATERIAL AND METHODS Questionnaire-based data on physician-diagnosed chronic diseases, MSK pain and its dimensions (frequency, intensity, bothersomeness, and the number of pain sites), and confounders were collected from the Northern Finland Birth Cohort 1966 at the age of 46. Latent Class Analysis (LCA) was used to identify chronic disease clusters among individuals who reported any MSK pain within the previous year (n = 6105). The associations between chronic disease clusters, pain dimensions, and severe MSK pain, which was defined as prolonged (over 30 d within the preceding year), bothersome (Numerical Rating Scale >5), and multisite (two or more pain sites) pain, were analyzed using logistic regression and general linear regression models, adjusted for sex and educational level (n for the full sample = 4768). RESULTS LCA resulted in three clusters: Metabolic (10.8% of the full sample), Psychiatric (2.9%), and Relatively Healthy (86.3%). Compared to the Relatively Healthy cluster, the Metabolic and Psychiatric clusters had higher odds for daily pain and higher mean pain intensity, bothersomeness, and the number of pain sites. Similarly, the odds for severe MSK pain were up to 75% (95% confidence interval: 44%-113%) and 155% (81%-259%) higher in the Metabolic and Psychiatric clusters, respectively, after adjustments for sex and educational level. CONCLUSIONS Distinct patterns of chronic disease accumulation can be identified in the general MSK pain population. It seems that mental and metabolic health are at interplay with severe MSK pain. These findings suggest a potential need to screen for psychiatric and metabolic entities of health when treating working-aged people with MSK pain.Key messagesThis large study on middle-aged people with musculoskeletal pain aimed to examine the idiosyncratic patterns of chronic diseases and their relationships with the severity of musculoskeletal pain. Latent class cluster analysis identified three chronic disease clusters: Psychiatric, Metabolic, and Relatively Healthy. People with accumulated mental (Psychiatric cluster) or metabolic diseases (Metabolic cluster) experienced more severe pain than people who were relatively healthy (Relatively Healthy cluster). These findings suggest a potential need to screen for psychiatric and metabolic entities of health when treating working-aged people with MSK pain.
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Affiliation(s)
- Eveliina Heikkala
- Research Unit of Population Health, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.,Rovaniemi Health Center, Rovaniemi, Finland
| | - Petteri Oura
- Research Unit of Population Health, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Markus Paananen
- Research Unit of Population Health, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.,Western Uusimaa Wellbeing Services County, Social and Health Care Services, Espoo, Finland
| | - Emma Ho
- Sydney Musculoskeletal Health, School of Health Sciences, Charles Perkins Centre, University of Sydney, Sydney, Australia.,Sydney Musculoskeletal Health, The Kolling Institute, School of Health Sciences, University of Sydney, Sydney, Australia
| | - Paulo Ferreira
- Sydney Musculoskeletal Health, School of Health Sciences, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Christophe Tanguay-Sabourin
- Alan Edwards Pain Centre for Research on Pain, McGill University, Montreal, Canada.,Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Jaro Karppinen
- Research Unit of Population Health, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.,Rehabilitation Services of South Karelia Social and Health Care District, Lappeenranta, Finland
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12
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Endrighi R, Borrelli B. Pain-Related Smoking Expectancies and Smoking Behavior Among U.S. Adult Cigarette Smokers with Chronic Pain. Int J Behav Med 2023:10.1007/s12529-023-10239-1. [PMID: 37935908 DOI: 10.1007/s12529-023-10239-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2023] [Indexed: 11/09/2023]
Abstract
BACKGROUND This study investigated the factor structure of a measure of pain-smoking interrelations and expectancies (pain and smoking inventory (PSI)) and examined associations with risk factors for smoking maintenance among smokers with chronic pain (CP). METHOD Participants (n = 504; M age = 46 ± 13 years; 58% female) completed an online survey about health-related factors and smoking characteristics. Data were analyzed using Horn's parallel analysis (PA) and multiple linear regression. RESULTS PA indicated that a single-dimension structure was the best fit for the PSI. Our regression model accounted for 34% of the variance in PSI score. The PSI was associated with younger age, higher education, poorer physical functioning, greater pain severity and pain intensity, higher psychological distress, greater nicotine dependence, lower self-efficacy and greater perceived difficulty quitting, and lifetime use of behavioral treatment for quitting smoking. CONCLUSION This research is the first step in identifying potential targets for smoking cessation approaches tailored to smokers with CP.
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Affiliation(s)
- Romano Endrighi
- Center for Behavioral Science Research, Department of Health Policy and Health Services Research, Boston University, Henry M. Goldman School of Dental Medicine, 560 Harrison Ave, Boston, MA, 02118, USA.
| | - Belinda Borrelli
- Center for Behavioral Science Research, Department of Health Policy and Health Services Research, Boston University, Henry M. Goldman School of Dental Medicine, 560 Harrison Ave, Boston, MA, 02118, USA
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13
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Uvelli A, Duranti C, Salvo G, Coluccia A, Gualtieri G, Ferretti F. The Risk Factors of Chronic Pain in Victims of Violence: A Scoping Review. Healthcare (Basel) 2023; 11:2421. [PMID: 37685455 PMCID: PMC10486711 DOI: 10.3390/healthcare11172421] [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: 07/18/2023] [Revised: 08/01/2023] [Accepted: 08/03/2023] [Indexed: 09/10/2023] Open
Abstract
Violent situations are unfortunately very frequent in women and children all over the world. These experiences have long-term consequences for adult physical and psychological health. One of the most reported is chronic pain, defined in various sub-diagnoses and present in all types of violence. Unfortunately, the etiology of this condition is not clear and neither are the predisposing factors. The aim of this scoping review is to examine the literature trends about the probable risk factors of chronic pain in violence victims. Considering a bio-psycho-social model, it is possible to hypothesize the presence of all these aspects. The results will be discussed in the present article.
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Affiliation(s)
- Allison Uvelli
- Department of Medical Science, Surgery, and Neurosciences, University of Siena, Viale Bracci, 53100 Siena, Italy
| | - Cristina Duranti
- Department of Medical Science, Surgery, and Neurosciences, University of Siena, Viale Bracci, 53100 Siena, Italy
| | - Giulia Salvo
- Department of Medical Science, Surgery, and Neurosciences, University of Siena, Viale Bracci, 53100 Siena, Italy
| | - Anna Coluccia
- Department of Medical Science, Surgery, and Neurosciences, University of Siena, Viale Bracci, 53100 Siena, Italy
| | - Giacomo Gualtieri
- Azienda Ospedaliero-Universitaria Senese (AOUS), Viale Bracci, 53100 Siena, Italy
| | - Fabio Ferretti
- Department of Medical Science, Surgery, and Neurosciences, University of Siena, Viale Bracci, 53100 Siena, Italy
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14
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Frede N, Hiestand S, Endres D, van Elst LT, Finzel S, Chevalier N, Schramm MA, Rump IC, Thiel J, Voll R, Herget G, Venhoff N. Burden of disease and impact on quality of life in chronic back pain - a comparative cross-sectional study of 150 axial spondyloarthritis and 150 orthopedic back pain patients. Front Med (Lausanne) 2023; 10:1221087. [PMID: 37663655 PMCID: PMC10469952 DOI: 10.3389/fmed.2023.1221087] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 07/31/2023] [Indexed: 09/05/2023] Open
Abstract
Objective Chronic back pain (CBP) constitutes one of the most common complaints in primary care and a leading cause of disability worldwide. CBP may be of mechanical or inflammatory character and may lead to functional impairment and reduced quality of life. In this study, we aimed to assess and compare burden of disease, functional capacity, quality of life and depressive symptoms in axial spondyloarthritis (axSpA) patients with orthopedic chronic back pain patients (OBP). We further aimed to identify factors associated with quality of life. Methods Cross-sectional survey of a cohort of 300 CBP patients including 150 patients from a University Hospital Orthopedic Back Pain Outpatient Clinic with OBP and 150 patients with confirmed axSpA from a University Hospital Rheumatology Outpatient Clinic. Questionnaire-based assessment of pain character (Inflammatory Back Pain, MAIL-Scale), functional status (FFbH, BASFI), quality of life (WHOQOL-Bref) and depressive symptoms (Phq9) and retrospective medical chart analysis. Results Both, OBP and axSpA patients reported on average intermediate pain levels of mostly mixed pain character. Both groups demonstrated a reduced health-related quality of life and the presence of depressive symptoms. However, axSpA patients reported a significantly better subjective quality of life, more satisfaction with their health status and better functional capacity compared to OBP patients (all p < 0.001). In a multivariate regression model, depressive symptoms, mechanical back pain, pain level and age were negative predictors of subjective quality of life, whereas functional capacity was a positive predictor. Conclusion Chronic back pain was associated with a high morbidity and reduced quality of life regardless of pain character. We identified multiple factors associated with reduced quality of life. Awareness and addressing of these factors may help to overcome unmet needs and improve quality of life for these patients.
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Affiliation(s)
- Natalie Frede
- Department of Rheumatology and Clinical Immunology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Sonja Hiestand
- Department of Rheumatology and Clinical Immunology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Dominique Endres
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ludger Tebartz van Elst
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Stephanie Finzel
- Department of Rheumatology and Clinical Immunology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Nina Chevalier
- Department of Rheumatology and Clinical Immunology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Markus A. Schramm
- Department of Rheumatology and Clinical Immunology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ina C. Rump
- Department of Rheumatology and Clinical Immunology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Jens Thiel
- Department of Rheumatology and Clinical Immunology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Division of Rheumatology and Clinical Immunology, Medical University Graz, Graz, Austria
| | - Reinhard Voll
- Department of Rheumatology and Clinical Immunology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Georg Herget
- Department of Orthopedics and Trauma Surgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Nils Venhoff
- Department of Rheumatology and Clinical Immunology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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15
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Wang J, Yang L, Tibbo P, Simon P, Bullerwell M. The Health and Psychosocial Profiles of Adults Who Sought Mental Health and Addiction Specialty Services Through a Centralized Intake Process in Nova Scotia in 2020 and 2021. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2023; 68:613-622. [PMID: 36855805 PMCID: PMC10411361 DOI: 10.1177/07067437231159768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
OBJECTIVES (1) To calculate the proportions of people who sought mental health and addiction (MHA) specialty services in Nova Scotia, overall and by sex and age. (2) To describe the health and psychosocial profiles of the MHA Intake clients. (3) To identify factors associated with acceptance for MHA services. METHODS The data of the Nova Scotia MHA Intake clients aged 19 to 64 years old in 2020 (N = 10,178) and in 2021 (N = 12,322) were used. The proportions of unique clients in the general population were calculated based on 2021 census data. The percentages of primary presenting concerns, the presence and frequency of psychiatric symptoms in the past month, suicide risk levels, current or past provisional psychiatric diagnosis, medical problems, and psychosocial stressors were calculated. Logistic regression was conducted to identify factors associated with the acceptance of MHA services after the assessment. RESULTS It was found that 1.48% and 2.33% of Nova Scotians aged 19 to 64 contacted the MHA Intake in 2020 and 2021. Over 66% were self-referrals, followed by physician referrals (28.34%). Mood (28.3%), anxiety (25.17%), and substance use (19.81%) were the top three presenting concerns for the contact. Many clients had a current or past provisional psychiatric diagnosis (58.7% in 2020, 61.8% in 2021). Among the clients, 74.67% and 68.29% reported at least 1 psychosocial stressor in 2020 and 2021, respectively. The clients with a current or past psychiatric diagnosis, suicide risk, and 2 or more psychosocial stressors, those who lived outside of Central Zone, and who had employee assistance program benefits/private insurance, were more likely to be qualified and accepted for MHA services than others. CONCLUSIONS The Intake clients have complex health and psychosocial profiles. Future studies are needed to monitor the trajectories of the clients to reduce inequities in receiving MHA services and improve client outcomes.
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Affiliation(s)
- JianLi Wang
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Halifax, Canada
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Halifax, Canada
| | - Lu Yang
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Halifax, Canada
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Phil Tibbo
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Halifax, Canada
- Early Psychosis Intervention Nova Scotia, Nova Scotia Health, Halifax, Nova Scotia, Halifax, Canada
| | - Patryk Simon
- Mental Health and Addiction Program, Nova Scotia Health, Halifax, Nova Scotia, Halifax, Canada
| | - Michele Bullerwell
- Mental Health and Addiction Program, Nova Scotia Health, Halifax, Nova Scotia, Halifax, Canada
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16
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James RJE, Ferguson E. Depression, Cognition, and Pain: Exploring Individual, Cultural and Country-Level Effects Across Europe. THE JOURNAL OF PAIN 2023; 24:1104-1115. [PMID: 36966946 DOI: 10.1016/j.jpain.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 03/08/2023] [Accepted: 03/14/2023] [Indexed: 04/08/2023]
Abstract
The aim of this paper was to investigate the role of economic (eg, GDP per capita), political (eg, healthcare spending), cultural (country-level aggregates norms) and individual correlates (eg, depression) of pain in a secondary analysis of a sample of 76,000 adults in 19 countries across Europe. The sample was aggregated from 2 waves of the Study of Health, Ageing and Retirement in Europe cohort, using multilevel models with cross-level interactions between individual and country-level effects. While there has been extensive focus on individual risk factors (eg, depression, cognition, BMI), the role of social, political and cultural contextual factors has been relatively underexplored. In addition to replicating well-established individual risk factors (eg, increased depression), we demonstrate that higher levels of depression, chronic pain diagnosis, and collectivism, aggregated at the country-level, are also associated with increased pain severity. There was evidence that these country-level effects moderate the effect of individual correlates of pain. These results contribute to the literature by identifying the importance of broader cultural factors alongside individual psychological indices of pain reporting. PERSPECTIVE: In this study we model how individual, political and cultural factors influence pain in a large cross-national sample. In addition to replicating established individual effects, it shows how cultural (ie, collectivism) and political (eg, GDP, healthcare spending) factors affect individual expressions of pain, and how the cultural and individual factors interact with each other.
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Affiliation(s)
- Richard J E James
- School of Psychology, University of Nottingham, Nottinghamshire, UK; Versus Arthritis Pain Centre, University of Nottingham, Nottinghamshire, UK.
| | - Eamonn Ferguson
- School of Psychology, University of Nottingham, Nottinghamshire, UK
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17
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Roberts-West L, Gravatt A, Guest N, Hunt A, Siddique L, Serbic D. A Comparison of Social Exclusion Towards People with Depression or Chronic Back Pain. Br J Pain 2023; 17:267-280. [PMID: 37342396 PMCID: PMC10278445 DOI: 10.1177/20494637221148337] [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] [Indexed: 09/20/2023] Open
Abstract
Objectives Research comparing mental and physical health stigma is scarce. The aim of this study was to compare social exclusion towards hypothetical males and females with depression or chronic back pain. Furthermore, the study investigated whether social exclusion is associated with participant's empathy and personality traits, while controlling for their sex, age and personal exposure to mental/physical chronic health conditions. Design This study employed a cross-sectional questionnaire design. Methods Participants (N = 253) completed an online vignette-based questionnaire and were randomly allocated to either a depression or chronic back pain study condition. Measures of social exclusion through respondents' willingness to interact with hypothetical individuals, empathy and the Big Five personality traits were completed. Results Willingness to interact scores did not significantly differ depending on the diagnosis or sex of the hypothetical person in the vignette. For depression, higher levels of conscientiousness significantly predicted less willingness to interact. Whilst being a female participant and having higher empathy significantly predicted greater willingness to interact. For chronic back pain, higher empathy significantly predicted greater willingness to interact, with no significant predictors found from the Big Five personality traits. Conclusion Findings indicate that females and males with depression or chronic back pain face similar levels of social exclusion, with empathy being a core variable driving social exclusion behaviours. These findings enhance our understanding of potential variables driving social exclusion, in-turn informing campaign development to reduce public stigma towards depression and chronic back pain.
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Affiliation(s)
- Lucy Roberts-West
- Department of Psychology, Royal Holloway University of London, Egham, SRY, UK
| | - Amy Gravatt
- Department of Psychology, Royal Holloway University of London, Egham, SRY, UK
| | - Natasha Guest
- Department of Psychology, Royal Holloway University of London, Egham, SRY, UK
| | - Ashley Hunt
- Department of Psychology, Royal Holloway University of London, Egham, SRY, UK
| | - Laraib Siddique
- Department of Psychology, Royal Holloway University of London, Egham, SRY, UK
| | - Danijela Serbic
- Department of Psychology, Royal Holloway University of London, Egham, SRY, UK
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18
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Dickson C, Zhou A, MacIntyre E, Hyppönen E. Do Chronic Low Back Pain and Chronic Widespread Pain differ in their association with Depression Symptoms in the 1958 British Cohort? PAIN MEDICINE (MALDEN, MASS.) 2023; 24:644-651. [PMID: 36331329 PMCID: PMC10233498 DOI: 10.1093/pm/pnac170] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 11/01/2022] [Accepted: 11/01/2022] [Indexed: 11/25/2023]
Abstract
OBJECTIVE Depression frequently coexists with chronic pain. Contemporary models suggest that these conditions share pathobiological mechanisms, prompting a need to investigate their temporal association. This investigation aimed to explore two distinctly different chronic pain conditions, and their cross-sectional and prospective associations with depression. METHODS Self-reported information was available on chronic widespread pain (CWP), chronic low back pain (CLBP) (45 years), and depression symptoms (45 and 50 years) from up to 9,377 participants in the 1958 British cohort. Depression symptom outcomes were derived by "Clinical Interview Schedule-Revised" (45 years) and "Short Form-36" (50 years). Relationships between both chronic pain conditions and depression symptoms were investigated by fitting four separate logistic regression models, each with varying levels of covariate adjustment, including depression at baseline. RESULTS CWP was associated with depression symptoms cross-sectionally (odds ratio [OR] = 2.04, 95% confidence interval [CI] 1.65, 2.52; P < 0.001, n = 7,629), and prospectively when fully adjusted for baseline, sociodemographic, lifestyle, and health covariates (OR = 1.45, 95% CI 1.17, 1.80; P = < 0.001, n = 6,275). CLBP was associated with depression symptoms prospectively (full model: OR = 1.28, 95% CI 1.01, 1.61; P = 0.04, n = 6,288). In fully adjusted models the prospective association of CWP with depression symptoms was more heavily influenced by our covariates than CLBP with depression symptoms. CONCLUSION Pain may be a stressor from which depression can arise. Development of depression may be differentially dependant upon the type of pain experienced. Screening for depression symptoms among individuals with both chronic pain conditions is indicated and should be repeated over time.
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Affiliation(s)
- Cameron Dickson
- School of Allied Health Science and Practice, The University of Adelaide, Adelaide, Australia
| | - Ang Zhou
- ACPreH, Unit of Clinical and Health Sciences, University of South Australia, Adelaide, Australia
| | - Erin MacIntyre
- IIMPACT in Health, Allied Health & Human Performance, University of South Australia, Adelaide, Australia
| | - Elina Hyppönen
- ACPreH, Unit of Clinical and Health Sciences, University of South Australia, Adelaide, Australia
- South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
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19
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Muñoz Laguna J, Puhan MA, Rodríguez Artalejo F, De Pauw R, Wyper GMA, Devleesschauwer B, Santos JV, Hincapié CA. Certainty of the Global Burden of Disease 2019 Modelled Prevalence Estimates for Musculoskeletal Conditions: A Meta-Epidemiological Study. Int J Public Health 2023; 68:1605763. [PMID: 37325175 PMCID: PMC10266422 DOI: 10.3389/ijph.2023.1605763] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 04/27/2023] [Indexed: 06/17/2023] Open
Abstract
Objectives: To describe and assess the risk of bias of the primary input studies that underpinned the Global Burden of Disease Study (GBD) 2019 modelled prevalence estimates of low back pain (LBP), neck pain (NP), and knee osteoarthritis (OA), from Australia, Brazil, Canada, Spain, and Switzerland. To evaluate the certainty of the GBD modelled prevalence evidence. Methods: Primary studies were identified using the GBD Data Input Sources Tool and their risk of bias was assessed using a validated tool. We rated the certainty of modelled prevalence estimates based on the GRADE Guidelines 30-the GRADE approach for modelled evidence. Results: Seventy-two primary studies (LBP: 67, NP: 2, knee OA: 3) underpinned the GBD estimates. Most studies had limited representativeness of their study populations, used suboptimal case definitions and applied assessment instruments with unknown psychometric properties. The certainty of modelled prevalence estimates was low, mainly due to risk of bias and indirectness. Conclusion: Beyond the risk of bias of primary input studies for LBP, NP, and knee OA in GBD 2019, the certainty of country-specific modelled prevalence estimates still have room for improvement.
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Affiliation(s)
- Javier Muñoz Laguna
- Department of Preventive Medicine, Public Health and Microbiology, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
- University Spine Centre Zurich (UWZH), Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- EBPI-UWZH Musculoskeletal Epidemiology Research Group, University of Zurich and Balgrist University Hospital, Zurich, Switzerland
| | - Milo A. Puhan
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Fernando Rodríguez Artalejo
- Department of Preventive Medicine, Public Health and Microbiology, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- IMDEA Food Institute, CEI UAM + CSIC, Madrid, Spain
| | - Robby De Pauw
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Grant M. A. Wyper
- School of Health & Wellbeing, University of Glasgow, Glasgow, United Kingdom
- Place and Wellbeing Directorate, Public Health Scotland, Glasgow, United Kingdom
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Translational Physiology, Infectiology and Public Health, Ghent University, Merelbeke, Belgium
| | - João V. Santos
- MEDCIDS—Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS—Centre for Health Technology and Services Research, Porto, Portugal
- Public Health Unit, ACES Grande Porto V – Porto Ocidental, ARS Norte, Porto, Portugal
| | - Cesar A. Hincapié
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
- University Spine Centre Zurich (UWZH), Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- EBPI-UWZH Musculoskeletal Epidemiology Research Group, University of Zurich and Balgrist University Hospital, Zurich, Switzerland
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Uebelacker LA, Pinkston MM, Busch AM, Baker JV, Anderson B, Caviness CM, Herman DS, Weisberg RB, Abrantes AM, Stein MD. HIV-PASS (Pain and Sadness Support): Randomized Controlled Trial of a Behavioral Health Intervention for Interference Due to Pain in People Living With HIV, Chronic Pain, and Depression. Psychosom Med 2023; 85:250-259. [PMID: 36799731 PMCID: PMC10073275 DOI: 10.1097/psy.0000000000001172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
OBJECTIVE This study aimed to determine whether HIV-Pain and Sadness Support (HIV-PASS), a collaborative behavioral health intervention based on behavioral activation, is associated with decreased pain-related interference with daily activities, depression, and other outcomes in people living with HIV. METHODS We conducted a three-site clinical trial ( n = 187) in which we randomly assigned participants to receive either HIV-PASS or health education control condition. In both conditions, participants received seven intervention sessions, comprising an initial in-person joint meeting with the participant, their HIV primary care provider and a behavioral health specialist, and six, primarily telephone-based, meetings with the behavioral health specialist and participant. The intervention period lasted 3 months, and follow-up assessments were conducted for an additional 9 months. RESULTS Compared with health education, HIV-PASS was associated with significantly lower pain-related interference with daily activities at the end of month 3 (our primary outcome; b = -1.31, 95% confidence interval = -2.28 to -0.34). We did not observe other differences between groups at 3 months in secondary outcomes that included worst or average pain in the past week, depression symptoms, anxiety, and perceived overall mental and physical health. There were no differences between groups on any outcomes at 12 months after enrollment. CONCLUSIONS A targeted intervention can have positive effects on pain interference. At the end of intervention, effects we found were in a clinically significant range. However, effects diminished once the intervention period ended. TRIAL REGISTRATION ClinicalTrials.gov NCT02766751.
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Affiliation(s)
- Lisa A Uebelacker
- From the Departments of Psychiatry and Human Behavior (Uebelacker, Pinkston, Caviness, Herman, Abrantes) and Family Medicine (Uebelacker, Weisberg), Alpert Medical School of Brown University; Behavioral Medicine and Addictions Research (Uebelacker, Anderson, Caviness, Herman, Abrantes, Stein), Butler Hospital; Department of Medicine (Pinkston), Alpert Medical School of Brown University; Lifespan Physicians Group (Pinkston), The Miriam Hospital, Providence, Rhode Island; Department of Medicine (Busch, Baker), Hennepin Healthcare; Department of Medicine (Busch, Baker), University of Minnesota, Minneapolis, Minnesota; VA Boston Healthcare System (Weisberg); Department of Psychiatry (Weisberg), Boston University School of Medicine; and Department of Health Law, Policy and Management(Stein), Boston University School of Public Health, Boston, Massachusetts
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21
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Hammett PJ, Eliacin J, Makris UE, Allen KD, Kerns RD, Heapy A, Goldsmith ES, Meis LA, Taylor BC, Saenger M, Cross LJS, Do T, Branson M, Burgess DJ. An Analysis of the Role of Mental Health in a Randomized Trial of a Walking Intervention for Black Veterans With Chronic Pain. THE JOURNAL OF PAIN 2023; 24:55-67. [PMID: 36162790 DOI: 10.1016/j.jpain.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 05/03/2022] [Accepted: 07/15/2022] [Indexed: 02/08/2023]
Abstract
Black patients and those with co-occurring mental health disorders are disproportionately affected by chronic pain, but few interventions target these populations. This is a secondary analysis of a randomized trial of a walking-focused proactive counseling intervention for Black Veterans with chronic musculoskeletal pain (ACTION). The primary aim was to examine intervention effectiveness among Veterans with an electronic health record-documented mental health diagnosis [depressive disorder, anxiety disorder, substance use disorder, post-traumatic stress disorder or serious mental illness (n = 205)] and those without a diagnosis (n = 175). About 380 Black Veterans receiving care at the Atlanta VA Health Care System were enrolled from 2016 to 2019 and randomized to the intervention or usual care (UC) (1:1). The intervention featured 6 telephone coaching sessions over 8-14 weeks to encourage walking. Participants with a mental health disorder were more likely to complete all counseling sessions (56% vs 38%) and reported improvements in global perceptions of pain and pain intensity/interference (secondary outcomes) at 3-months vs UC. Among participants without a mental health disorder, the intervention was associated with an improvement in pain-related disability at 6-months (primary outcome). Black chronic pain patients with co-occurring mental health disorders may require more intensive treatment to affect improvement in pain-related disability. PERSPECTIVE: This study examines the effectiveness of a walking intervention for chronic pain among Black Veterans with a mental health disorder. These patients were more engaged with the intervention than those without a mental health disorder. However, they did not experience reductions in pain-related disability, suggesting more intensive treatment is needed.
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Affiliation(s)
- Patrick J Hammett
- Center for Care Delivery and Outcomes Research, Veterans Affairs Medical Center, Minneapolis, Minnesota; Department of Medicine, University of Minnesota, Minneapolis, Minnesota.
| | - Johanne Eliacin
- Center for Health Information and Communication, Roudebush VA Medical Center, Indianapolis, Indiana; Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana; Health Services Research, Regenstrief Institute, Indianapolis, Indiana
| | - Una E Makris
- Department of Internal Medicine, UT Southwestern (UTSW) Medical Center, Dallas, Texas; Department of Population and Data Sciences, UTSW, Dallas, Texas; Department of Medicine, VA North Texas Health Care System, Dallas, Texas; Department of Internal Medicine, Division of Rheumatic Diseases, VA North Texas Health Care System, Dallas, Texas
| | - Kelli D Allen
- Center of Innovation to Accelerate Discovery and Practice Transformation, Veterans Affairs (a VA HSR&D Center of Excellence), Veterans Affairs Medical Center, Durham, North Carolina; Department of Medicine and Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Robert D Kerns
- Departments of Psychiatry, Yale School of Medicine, New Haven, Connecticut; Pain Research, Informatics, Multi-morbidities and Education (PRIME) Center of Innovation, VA Connecticut Health Care System, West Haven, Connecticut
| | - Alicia Heapy
- Departments of Psychiatry, Yale School of Medicine, New Haven, Connecticut; Pain Research, Informatics, Multi-morbidities and Education (PRIME) Center of Innovation, VA Connecticut Health Care System, West Haven, Connecticut
| | - Elizabeth S Goldsmith
- Center for Care Delivery and Outcomes Research, Veterans Affairs Medical Center, Minneapolis, Minnesota; Department of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Laura A Meis
- Center for Care Delivery and Outcomes Research, Veterans Affairs Medical Center, Minneapolis, Minnesota; Department of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Brent C Taylor
- Center for Care Delivery and Outcomes Research, Veterans Affairs Medical Center, Minneapolis, Minnesota; Department of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Michael Saenger
- Atlanta Veterans Affairs Health Care System, Atlanta, Georgia; Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Lee J S Cross
- Center for Care Delivery and Outcomes Research, Veterans Affairs Medical Center, Minneapolis, Minnesota
| | - Tam Do
- Center for Care Delivery and Outcomes Research, Veterans Affairs Medical Center, Minneapolis, Minnesota
| | - Mariah Branson
- Center for Care Delivery and Outcomes Research, Veterans Affairs Medical Center, Minneapolis, Minnesota
| | - Diana J Burgess
- Center for Care Delivery and Outcomes Research, Veterans Affairs Medical Center, Minneapolis, Minnesota; Department of Medicine, University of Minnesota, Minneapolis, Minnesota
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22
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Han JJ, Graham JH, Snyder DI, Alfieri T. Long-term Use of Wearable Health Technology by Chronic Pain Patients. Clin J Pain 2022; 38:701-710. [PMID: 36198095 PMCID: PMC9645546 DOI: 10.1097/ajp.0000000000001076] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 09/16/2022] [Accepted: 09/26/2022] [Indexed: 01/26/2023]
Abstract
OBJECTIVES People living with chronic pain may use wearable health technology (WHT) in conjunction with an expert-directed pain management program for up to 1 year. WHT use may be associated with improvements in key patient outcomes. METHODS A 12-month study of WHT use among people with chronic pain was conducted, consisting of iPhone and Apple Watch applications to measure movement, sleep, and self-reported pain. Clinical outcomes among 105 patients enrolled in a multidisciplinary pain program that included WHT use were compared with 146 patients in the same program but without WHT, and to 161 patients receiving medical pain management without WHT. RESULTS Participants used the WHT on average 143.0 (SD: 117.6) out of 365 days. Mixed-effects models revealed participants who used WHT had decreases in depression scores (-7.83, P <0.01) and prescribed morphine milligram equivalents (-21.55, P =0.04) over 1 year. Control groups also showed decreases in depression scores (-5.08, P =0.01; -5.68, P <0.01) and morphine milligram equivalents (-18.67, P =0.01; -10.99, ns). The estimated slope of change among the WHT was not statistically different than control groups. DISCUSSION Patients who used WHT as part of their pain management program demonstrated a willingness to do so for extended periods of time despite living with chronic pain and other comorbidities. Data trends suggest that WHT use may positively impact depression and prescribed medication. Additional research is warranted to investigate the potential of WHT to improve the negative consequences of chronic pain.
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Affiliation(s)
- John J. Han
- Department of Pain Medicine, Geisinger Danville, PA
| | - Jove H. Graham
- Center for Pharmacy Innovation and Outcomes Geisinger, Danville, PA
| | | | - Thomas Alfieri
- Medical Affairs Strategic Research, Purdue Pharma L.P., Stamford, CT
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23
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Kruger-Steyn WM, Lubbe J, Louw KA, Asmal L. Depressive symptoms and quality of life prior to metabolic surgery in Cape Town, South Africa. S Afr J Psychiatr 2022; 28:1783. [PMID: 36263154 PMCID: PMC9575344 DOI: 10.4102/sajpsychiatry.v28i0.1783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 06/14/2022] [Indexed: 11/01/2022] Open
Abstract
Background Depression has been shown to have a negative impact on the outcomes of metabolic surgery and quality of life (QOL). Currently, there are limited data on mental distress and QOL in metabolic surgery candidates in South Africa. Aim This study aimed to determine the prevalence of depressive symptoms at the time of presurgical assessment in participants undergoing metabolic surgery. Setting The Obesity and Metabolic Surgery Initiative at Tygerberg Hospital. Methods We conducted pre-operatively a retrospective cross-sectional study on patients who underwent metabolic surgery from September 2017 to September 2019. Participants were profiled in terms of metabolic parameters, depressive symptoms and QOL. Results Of the 157 participants assessed, 88% were female with a body mass index in the super obese range. Twenty-two percent of participants had depressive symptoms. Metabolic surgery candidates with depressive symptoms had a significantly poorer overall QOL score compared with those without depressive symptoms. When controlling for all other variables, an increase in QOL score was shown to decrease the odds of current depressive symptoms, whilst back pain on non-narcotic medication and having had a stroke were found to increase the odds of current depressive symptoms. Conclusion This study highlights the complex interplay between metabolic, clinical and psychiatric factors in patients undergoing metabolic surgery. The study highlights the vital role of a psychiatrist as part of a multidisciplinary team pre- and post-operatively in the early identification of depressive symptoms. Psychiatrists may have an important role to play as part of the multidisciplinary team in metabolic surgery, including screening for mental health problems pre- and post-operatively, providing psychoeducation and relevant pharmacological treatment and psychotherapy where needed. Contribution This study expands our limited knowledge of psychiatric comorbidity (in particular depressive symptoms and associated factors) in people undergoing metabolic surgery in low- and middle-income countries.
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Affiliation(s)
- Wilma M. Kruger-Steyn
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Jeanne Lubbe
- Division of Surgery, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Kerry-Ann Louw
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Laila Asmal
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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24
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Tang R, Kapellusch JM, Hegmann KT, Thiese MS, Wang I, Merryweather AS. Evaluating Different Measures of Low Back Pain Among U.S. Manual Materials Handling Workers: Comparisons of Demographic, Psychosocial, and Job Physical Exposure. HUMAN FACTORS 2022; 64:973-996. [PMID: 33300376 DOI: 10.1177/0018720820971101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To examine differences in demographic, psychosocial, and job physical exposure risk factors between multiple low back pain (LBP) outcomes in a prospective cohort of industrial workers. BACKGROUND LBP remains a leading cause of lost industrial productivity. Different case definitions involving pain (general LBP), medication use (M-LBP), seeking healthcare (H-LBP), and lost time (L-LBP) are often used to study LBP outcomes. However, the relationship between these outcomes remains unclear. METHOD Demographic, health status, psychosocial, and job physical exposure risk factors were quantified for 635 incident-eligible industrial workers. Incident cases of LBP outcomes and pain symptoms were quantified and compared across the four outcomes. RESULTS Differences in age, gender, medical history, and LBP history were found between the four outcomes. Most incident-eligible workers (67%) suffered an LBP outcome during follow-up. Cases decreased from 420 for LBP (25.4 cases/100 person-years) to 303 for M-LBP (22.0 cases/100 person-years), to 151 for H-LBP (15.6 cases/100 person-years), and finally to 56 for L-LBP (8.7 cases/100 person-years). Conversely, pain intensity and duration increased from LBP to H-LBP. However, pain duration was relatively lower for L-LBP than for H-LBP. CONCLUSION Patterns of cases, pain intensity, and pain duration suggest the influence of the four outcomes. However, few differences in apparent risk factors were observed between the outcomes. Further research is needed to establish consistent case definitions. APPLICATION Knowledge of patterns between different LBP outcomes can improve interpretation of research and guide future research and intervention studies in industry.
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Affiliation(s)
- Ruoliang Tang
- 12530 Sichuan University-Pittsburgh Institute, Chengdu, China
- 14751 University of Wisconsin-Milwaukee, USA
| | | | | | | | - Inga Wang
- 14751 University of Wisconsin-Milwaukee, USA
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25
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Bergman BP, Demou E, Lewsey J, Macdonald E. A comparison of routine and case-managed pathways for recovery from musculoskeletal disorders in people in employment. Disabil Rehabil 2022; 44:4648-4655. [PMID: 33896322 PMCID: PMC7613959 DOI: 10.1080/09638288.2021.1912837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 03/26/2021] [Accepted: 03/31/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE To compare outcomes in employed people from an enhanced routine management pathway for musculoskeletal disorders within National Health Service Scotland with an existing active case-management system, Working Health Services Scotland. MATERIALS AND METHODS The study comprised a service evaluation using anonymised routinely collected data from all currently employed callers presenting with musculoskeletal disorder to the two services. Baseline demographic and clinical data were collected. EuroQol EQ-5DTM scores at the start and end of treatment were compared for both groups, overall and by age, sex, socio-economic status, and anatomical site, and the impact of mental health status at baseline was evaluated. RESULTS Active case-management resulted in greater improvement than enhanced routine care. Case-managed service users entered the programme earlier in the recovery pathway; there was evidence of spontaneous improvement during the longer waiting time of routine service clients but only if they had good baseline mental health. Those most disadvantaged through mental health co-morbidity showed the greatest benefit. CONCLUSIONS People with musculoskeletal disorders who have poor baseline mental health status derive greatest benefit from active case-management. Case-management therefore contributes to reducing health inequalities and can help to minimise long-term sickness absence. Shorter waiting times contributed to better outcomes in the case-managed service. Implications for RehabilitationMusculoskeletal disorders are a major cause of inability to work.Case-management is effective in helping people with musculoskeletal disorders to return to work.People who have the poorest mental health are likely to gain the greatest benefit from case-management of their musculoskeletal disorders.
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Affiliation(s)
| | - Evangelia Demou
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - James Lewsey
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Ewan Macdonald
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Stapp EK, Cui L, Guo W, Paksarian D, Merikangas KR. Comorbidity and familial aggregation of back/neck pain in the NIMH Family Study of Affective Spectrum Disorders. J Psychosom Res 2022; 158:110927. [PMID: 35526400 DOI: 10.1016/j.jpsychores.2022.110927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 04/26/2022] [Accepted: 04/26/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Back pain is associated with substantial Global Burden of Disease and is highly comorbid with mood and anxiety symptoms and syndromes. However, mechanisms underlying this association have not been well-elucidated. Here we apply data from the NIMH Family Study of Affective Spectrum Disorders to investigate the comorbidity, familial aggregation, and cross-aggregation of back/neck pain with mood disorder subtypes. METHODS The sample includes 519 probands and 560 interviewed first-degree relatives. Lifetime DSM-IV Bipolar I, Bipolar II, and Major Depressive Disorder [MDD] were derived from semi-structured diagnostic interviews. Lifetime history of back or neck pain and its age of onset were self-reported retrospectively. Familial aggregation and cross-aggregation were estimated via mixed effects models in probands and interviewed first-degree relatives, while heritability and co-heritability (endophenotypic ranking value [ERV]) were estimated using full pedigrees. RESULTS Over 45% of participants endorsed a history of back/neck pain. Back/neck pain was familial (adjusted odds ratio [aOR] 1.5, p = 0.04; h2 = 0.24, p = 0.009). Back/neck pain in probands was associated with MDD in relatives (aOR 1.5, p = 0.04; ERV = 0.17, p = 0.024), but not with bipolar disorder. Onset of back/neck pain occurred earlier in those with bipolar disorder compared to controls. CONCLUSION Findings suggest common familial risk factors underlying back/neck pain with MDD, whereas there was within-individual comorbidity of bipolar with back/neck pain. Future studies that identify common factors that lead to either back/neck pain or MDD can inform prevention and interventions.
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Affiliation(s)
- Emma K Stapp
- Genetic Epidemiology Branch, Intramural Research Program, NIMH, Bethesda, MD, USA
| | - Lihong Cui
- Genetic Epidemiology Branch, Intramural Research Program, NIMH, Bethesda, MD, USA
| | - Wei Guo
- Genetic Epidemiology Branch, Intramural Research Program, NIMH, Bethesda, MD, USA
| | - Diana Paksarian
- Genetic Epidemiology Branch, Intramural Research Program, NIMH, Bethesda, MD, USA
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27
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Goodall J, Brown T. Patients' experiences of occupational therapy within a multidisciplinary pain management programme: A qualitative study. Br J Pain 2022; 16:290-302. [PMID: 35646343 PMCID: PMC9136995 DOI: 10.1177/20494637211054697] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Occupational problems are common for adults experiencing chronic pain, but occupational therapists are not always accessed as part of the multidisciplinary team. Despite evidence of benefit for work-focused interventions, there is limited evidence for broader benefit from occupational therapy interventions within the context of multidisciplinary pain management. The aim of this study was to explore the experiences of programme attendees who received structured intervention from an occupational therapist as part of a multidisciplinary pain management programme, and gain an understanding as to how they felt it influenced changes they made to occupational participation. METHOD A qualitative approach was undertaken with 9 individual patients recruited from a group pain management programme for adults with chronic low back pain. Semi-structured interviews were carried out, recorded and transcribed. Thematic analysis was used to identify themes in the data. RESULTS Three key themes were identified: 1) the helpfulness of activity pacing techniques 2) the value of participating in a therapeutic activity-based session and 3) an increased understanding of the importance of leisure and creative activities in the context of their lives. CONCLUSION Participants perceived the specific occupational therapy content of the programme to be helpful in a number of different ways. The findings suggest that occupational therapy can be important in facilitating patients to apply theoretical techniques in the real world, thereby increasing the likelihood of long term benefit.
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28
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Sullivan MJL, Wideman TH, Gauthier N, Thibault P, Ellis T, Adams H. Risk-targeted behavioral activation for the management of work disability associated with comorbid pain and depression: a feasibility study. Pilot Feasibility Stud 2022; 8:90. [PMID: 35461255 PMCID: PMC9034524 DOI: 10.1186/s40814-022-01040-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 03/30/2022] [Indexed: 11/12/2022] Open
Abstract
Purpose The purpose of the present study was to conduct a preliminary evaluation of the feasibility and impact of a risk-targeted behavioral activation intervention for work-disabled individuals with comorbid pain and depression. Methods The design of the study was a single-arm non-randomized trial. The sample consisted of 66 work-disabled individuals with comorbid pain and depression. The treatment program consisted of a 10-week standardized behavioral activation intervention supplemented by techniques to target two psychosocial risk factors for delayed recovery, namely, catastrophic thinking and perceptions of injustice. Measures of pain severity, depression, catastrophic thinking, perceived injustice, and self-reported disability were completed pre-, mid-, and post-treatment. Satisfaction with treatment was assessed at post-treatment. Return to work was assessed at 6-month follow-up. Results The drop-out rate was 18%. At treatment termination, 91% of participants indicated that they were “very” or “completely” satisfied with their involvement in the treatment program. Significant reductions in pain (Cohen’s d = 0.71), depression (d = 0.86), catastrophic thinking (d = 1.1), and perceived injustice (d = 1.0) were observed through the course of treatment. In multivariate analyses, treatment-related reductions in depression, catastrophic thinking, and perceived injustice, but not pain, contributed significant unique variance to the prediction of return-to-work outcomes. Conclusions Risk-targeted behavioral activation was found to be an acceptable and effective intervention for work-disabled individuals with comorbid pain and depression. The findings suggest that interventions targeting psychosocial risk factors for pain and depression might contribute to more positive recovery outcomes in work-disabled individuals with comorbid pain and depression. Trial registration ClinicalTrials.gov: NCT0517442. Retrospectively registered.
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Affiliation(s)
| | - Timothy H Wideman
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Nathalie Gauthier
- Clinique de Consultation Conjugale et Familiale Poitras-Wright, Coté, Longueuil, QC, Canada
| | - Pascal Thibault
- Department of Psychology, McGill University, Montreal, QC, H3A 1G1, Canada
| | - Tamra Ellis
- Centre for Rehabilitation and Health, Toronto, ON, Canada
| | - Heather Adams
- University Centre for Research and Disability, Halifax, Nova Scotia, Canada
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Thériault FL, Momoli F, Hawes RA, Garber BG, Gardner W, Colman I. Spinal pain and major depression in a military cohort: bias analysis of dependent misclassification in electronic medical records. Soc Psychiatry Psychiatr Epidemiol 2022; 57:575-581. [PMID: 34374826 DOI: 10.1007/s00127-021-02160-3] [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: 03/30/2021] [Accepted: 07/30/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Spinal pain and major depression are prevalent conditions in adult populations and are particularly impactful in the military. However, the temporal relationship between these two conditions remains poorly understood. METHODS Using data extracted from electronic medical records, we assessed the association between incident diagnoses of spinal pain and major depression in a cohort of 48,007 Canadian Armed Forces personnel followed from January 2017 to August 2018. We used multivariate Poisson regression to measure the association between the period prevalence of these two conditions. We used probabilistic bias modelling to correct our estimates for misclassification of spinal pain and major depression. RESULTS After correcting for misclassification with probabilistic bias modelling, subjects newly diagnosed with spinal pain during the study period were 1.41 times (95% interval 1.25, 1.59) more likely also to be diagnosed with incident major depression, and personnel newly diagnosed with major depression were 1.28 times (95% interval 1.17, 1.39) more likely also to be diagnosed with spinal pain, compared to undiagnosed counterparts of the same age and sex. Without bias corrections, we would have overestimated the magnitude of the association between major depression and spinal pain by a factor of approximately 2.0. CONCLUSION Our results highlight a moderate and bi-directional association between two of the most prevalent disorders in military populations. Our results also highlight the importance of correcting for misclassification in electronic medical record data research.
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Affiliation(s)
- François L Thériault
- Canadian Forces Health Services Group, Department of National Defence, Ottawa, Canada.
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada.
| | - Franco Momoli
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Robert A Hawes
- Canadian Forces Health Services Group, Department of National Defence, Ottawa, Canada
| | - Bryan G Garber
- Canadian Forces Health Services Group, Department of National Defence, Ottawa, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - William Gardner
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | - Ian Colman
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
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Kovačević I, Majerić Kogler V, Krikšić V, Ilić B, Friganović A, Ozimec Vulinec Š, Pavić J, Milošević M, Kovačević P, Petek D. Non-Medical Factors Associated with the Outcome of Treatment of Chronic Non-Malignant Pain: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:2881. [PMID: 35270575 PMCID: PMC8910574 DOI: 10.3390/ijerph19052881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 02/25/2022] [Accepted: 02/28/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Chronic pain is a global public health issue with increasing prevalence. Chronic pain causes sleep disorder, reactive anxiety, and depression, impairs the quality of life; it burdens the individual and society as a whole. The aim of this study was to examine non-medical factors related to the outcome of the treatment of chronic non-malignant pain. METHODS A cross-sectional study with two groups of patients was conducted using a questionnaire with biological, psychological, and social characteristics of patients. Since this study was cross-sectional, it was not possible to determine whether some factors were the cause or the consequence of unsuccessful treatment outcome, which is at the same time one of the disadvantages of cross-sectional studies. RESULTS The poor outcome of the treatment of chronic non-malignant pain in a multivariate binary logistic regression model was statistically significantly associated with the lower quality of life (OR = 0.95 (95% CI: 0.91-0.99; p = 0.009), and higher depression level OR = 1.08 (95% CI: 1.02-1.14; p = 0.009). The outcome of the treatment was not directly related to social support measured by the multivariate binary logistic regression model (OR = 1.04, 95% CI: 0.95-1.15, p = 0.395), but solitary life (without partner) was (OR = 2.16 (95% CI: 1.03-4.53; p = 0.043). CONCLUSION The typical patient with a poor pain management outcome is retired, presents depressive behavior; their pain disturbs general activity and sleeping. Moreover, they have a physically disturbed quality of life and require self-treatment due to the inaccessibility of doctors and therapies. The principle of treatment of patients with chronic, non-malignant pain should take into account a biopsychosocial approach with individually adjusted procedures.
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Affiliation(s)
- Irena Kovačević
- Department of Nursing, University of Applied Health Sciences, Mlinarska 38, 10000 Zagreb, Croatia; (V.K.); (B.I.); (A.F.); (Š.O.V.); (J.P.)
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Poljanski nasip 58, 1000 Ljubljana, Slovenia;
| | | | - Valentina Krikšić
- Department of Nursing, University of Applied Health Sciences, Mlinarska 38, 10000 Zagreb, Croatia; (V.K.); (B.I.); (A.F.); (Š.O.V.); (J.P.)
- Institution for Home Healthcare Domnius, 10000 Zagreb, Croatia
| | - Boris Ilić
- Department of Nursing, University of Applied Health Sciences, Mlinarska 38, 10000 Zagreb, Croatia; (V.K.); (B.I.); (A.F.); (Š.O.V.); (J.P.)
| | - Adriano Friganović
- Department of Nursing, University of Applied Health Sciences, Mlinarska 38, 10000 Zagreb, Croatia; (V.K.); (B.I.); (A.F.); (Š.O.V.); (J.P.)
- Department of Anaesthesiology and Intensive Medicine, University Hospital Centre Zagreb, Kišpaticeva 12, 10000 Zagreb, Croatia
| | - Štefanija Ozimec Vulinec
- Department of Nursing, University of Applied Health Sciences, Mlinarska 38, 10000 Zagreb, Croatia; (V.K.); (B.I.); (A.F.); (Š.O.V.); (J.P.)
| | - Jadranka Pavić
- Department of Nursing, University of Applied Health Sciences, Mlinarska 38, 10000 Zagreb, Croatia; (V.K.); (B.I.); (A.F.); (Š.O.V.); (J.P.)
| | - Milan Milošević
- Andrija Štampar School of Public Health, University of Zagreb School of Medicine, 10000 Zagreb, Croatia;
| | - Petra Kovačević
- Department of Rheumatology, Physical and Rehabilitation Medicine, University Hospital Centre “Sestre Milosrdnice”, 10000 Zagreb, Croatia;
| | - Davorina Petek
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Poljanski nasip 58, 1000 Ljubljana, Slovenia;
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The interplay between multisite pain and insomnia on the risk of anxiety and depression: the HUNT study. BMC Psychiatry 2022; 22:124. [PMID: 35172768 PMCID: PMC8851694 DOI: 10.1186/s12888-022-03762-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 01/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chronic musculoskeletal pain and insomnia frequently co-occur and are known independent risk factors for anxiety and depression. However, the interplay between these two conditions on the risk of anxiety and depression has not been explored. METHODS A population-based prospective study of 18,301 adults in the Norwegian HUNT Study without anxiety or depression at baseline (2006-2008). We calculated adjusted risk ratios (RRs) with 95% confidence intervals (CIs) for anxiety and/or depression at follow-up (2017-2019), associated with i) number of chronic pain sites, and ii) chronic pain and insomnia symptoms jointly. RESULTS At follow-up, 2155 (11.8%) participants reported anxiety and/or depression. The number of pain sites was positively associated with risk of anxiety and/or depression (Ptrend, < 0.001). Compared to people without chronic pain and insomnia symptoms, people with ≥5 pain sites and no insomnia symptoms had a RR of 1.52 (95% CI: 1.28 to 1.81) for anxiety and/or depression, those with no chronic pain but with insomnia had a RR of 1.78 (95% CI: 1.33 to 2.38), whereas the RR among people with both ≥5 pain sites and insomnia was 2.42 (95% CI: 1.85 to 3.16). We observed no synergistic effect above additivity for the combination of ≥5 pain sites and insomnia on risk of anxiety and/or depression. CONCLUSIONS This study shows that people with multisite chronic pain who also suffer from insomnia are at a particularly high risk for anxiety and/or depression, suggesting that insomnia symptoms are important contributors to the association between multisite pain and common mental health problems.
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Groessl EJ, Casteel D, McKinnon S, McCarthy A, Schmalzl L, Chang DE, Fowler IM, Park CL. Comparing Types of Yoga for Chronic Low Back and Neck Pain in Military Personnel: A Feasibility Randomized Controlled Trial. Glob Adv Health Med 2022; 11:2164957X221094596. [PMID: 35734420 PMCID: PMC9208032 DOI: 10.1177/2164957x221094596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 03/04/2022] [Accepted: 03/22/2022] [Indexed: 11/17/2022] Open
Abstract
Background Chronic low back pain (cLBP) and chronic neck pain (cNP) are highly prevalent conditions and common reasons for disability among military personnel. Yoga and other mind-body interventions have been shown to safely decrease pain and disability in persons with cLBP and/or cNP but have not been adequately studied in active duty military personnel. The objective of this study was to examine the feasibility and acceptability of delivering 2 types of yoga (hatha and restorative) to a sample of active-duty military personnel with cLBP/cNP. Methods Military personnel with cLBP and/or cNP (n = 49; 59% men) were randomized to either hatha or restorative yoga interventions. Interventions consisted of in-person yoga 1-2x weekly for 12 weeks. Feasibility and acceptability were measured by rates of recruitment, intervention attendance, attrition, adverse events, and satisfaction ratings. Health outcomes including pain and disability were measured at baseline, 12 weeks, and 6 months. Means and effect sizes are presented. Results Recruitment was completed ahead of projections. Over 90% of participants agreed or strongly agreed that they enjoyed participation, liked the instructor, and would like to continue yoga. Retention rates were 86% and 80% at 12 week and 6 month assessments, respectively. Intervention attendance was adequate but lower than expected. There were small to moderate reductions in back-pain related disability, pain severity and pain interference, and improvements in quality of life, grip strength, and balance. In general, effects were larger for those who attended at least 50% of intervention classes. Participants with cNP tended to have smaller outcome improvements, but conclusions remain tentative given small sample sizes. Conclusions Results demonstrate feasibility for conducting a randomized controlled comparative effectiveness trial of yoga for cLBP and cNP among active duty military personnel. Acceptability was also established. Ongoing work will enhance the intervention for cNP and establish feasibility at another military facility in preparation for a fully-powered comparative effectiveness trial.ClinicalTrials #NCT03504085; registered April 20, 2018.
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Affiliation(s)
- Erik J Groessl
- Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, CA
- HSR&D, VA San Diego Healthcare System, San Diego, CA
- Erik J Groessl, PhD, University of California San Diego, 9500 Gilman Dr #0994, La Jolla, CA 92093, USA.
| | - Danielle Casteel
- Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, CA
- HSR&D, VA San Diego Healthcare System, San Diego, CA
| | - Symone McKinnon
- Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, CA
| | - Adhana McCarthy
- Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, CA
- HSR&D, VA San Diego Healthcare System, San Diego, CA
- US Army, 187th Med Student Detachment
| | - Laura Schmalzl
- College of Science and Integrative Health, Southern California University of Health Sciences, Whittier, CA, USA
| | - Douglas E Chang
- Physical Medicine and Rehabilitation, Dept. of Orthopedic Surgery, University of California San Diego, La Jolla, CA
| | - Ian M Fowler
- Naval Medical Center San Diego, United States Navy
| | - Crystal L Park
- University of Connecticut, Department of Clinical Psychology, Storrs, CT
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Tarabeih N, Kalinkovich A, Shalata A, Cherny SS, Livshits G. Deciphering the Causal Relationships Between Low Back Pain Complications, Metabolic Factors, and Comorbidities. J Pain Res 2022; 15:215-227. [PMID: 35125889 PMCID: PMC8809521 DOI: 10.2147/jpr.s349251] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 12/23/2021] [Indexed: 01/09/2023] Open
Affiliation(s)
- Nader Tarabeih
- Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Maale HaCarmel Mental Health Center, Affiliated to Rappaport Faculty of Medicine Technion, Israel Institute of Technology, Haifa, Israel
| | - Alexander Kalinkovich
- Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Adel Shalata
- The Simon Winter Institute for Human Genetics, Bnai Zion Medical Center, The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Stacey S Cherny
- Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Gregory Livshits
- Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Adelson School of Medicine, Ariel University, Ariel, Israel
- Correspondence: Gregory Livshits, Department of Morphological Studies, Adelson School of Medicine, Ariel University, Ariel, 40700, Israel, Tel +972-3-6409494, Fax +972-3-6408287, Email
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Usefulness of the Brief Scale for Psychiatric Problems in Orthopaedic Patients (BS-POP) for Predicting Poor Outcomes in Patients Undergoing Lumbar Decompression Surgery. Pain Res Manag 2022; 2021:2589865. [PMID: 34970359 PMCID: PMC8714325 DOI: 10.1155/2021/2589865] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 11/07/2021] [Accepted: 12/02/2021] [Indexed: 11/17/2022]
Abstract
Background The Brief Scale for Psychiatric Problems in Orthopaedic Patients (BS-POP) is an original questionnaire that evaluates psychosocial problems in orthopaedic patients. The purpose of this study was to clarify the relationship between BS-POP scores and surgical outcomes in patients with lumbar spinal stenosis (LSS). Methods From our database, a total of 157 patients with LSS who had undergone decompression surgery and completed a 1-year follow-up were retrospectively observed. The primary outcome was the numerical rating scale (NRS) score for satisfaction with surgery (from 0: not satisfied to 10: completely satisfied). Patients with an NRS score ≥8 were classified into the satisfied group. The secondary outcomes were NRS scores for low back pain, leg pain, and leg numbness and scores on the Roland–Morris Disability Questionnaire (RDQ). BS-POP was used to detect psychiatric problems before surgery. A BS-POP score ≥11 on the physician version or a combination of 10 on the physician version and ≥15 on the patient version was considered to indicate the presence of psychiatric problems. The patients were classified into two groups and compared based on preoperative BS-POP scores at the 1-year follow-up. Results Preoperatively, 22 and 135 patients showed high and low BS-POP scores, respectively. No significant differences in preoperative symptoms were found between the two groups. At 1 year after surgery, patients with high BS-POP scores showed significantly lower satisfaction with surgery, higher NRS scores for low back pain, leg pain, and leg numbness, and lower RDQ deviation scores than did the low BS-POP group (p < 0.05). The results of the multivariable analysis indicated that preoperative high BS-POP scores were independently associated with low satisfaction with surgery (odds ratio: 5.2, 95% confidence interval: 1.9–15.1). Conclusion High preoperative BS-POP scores were associated with poor outcomes for decompression surgery in patients with LSS at 1 year after surgery. These results suggest that BS-POP is a useful tool for predicting surgical outcomes in patients with LSS.
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Phiri YVA, Aydın K, Yıldız NG, Motsa MPS, Nkoka O, Aydin HZ, Chao HJ. Individual-level determinants of depressive symptoms and associated diseases history in Turkish persons aged 15 years and older: A population-based study. Front Psychiatry 2022; 13:983817. [PMID: 36532187 PMCID: PMC9751320 DOI: 10.3389/fpsyt.2022.983817] [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: 07/01/2022] [Accepted: 11/14/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Depressive symptoms are associated with both long-lasting and short-term repetitive mood disorders and affect a person's ability to function and lead a rewarding life. In addition to predisposing genetic causes, other factors such as socioeconomic and demographic factors, and chronic diseases have also been reported to associate with depression. In this study, we analyzed the association between history of chronic diseases and presentation of depressive symptoms amongst Turkish individuals. METHODS We employed the 2019 Turkey health survey to analyze data of 11,993 individuals aged 15+ years. Depressive symptoms were assessed using the eight-item Patient Health Questionnaire (PHQ-8) coded with a binary measure, a score of <10 as less depressed and >10 as moderate-severely depressed. A number of sociodemographic characteristics were adjusted for in the analyses. Logistic regression models were used to test the association between chronic diseases and depressive symptoms in the study sample. RESULTS Our analysis revealed that 6.24% of the 11,993 participants had reported an episode of depressive symptoms. The prevalence of depressive symptoms in men was 1.85% and in women, it was 2.34 times higher. Participants who had previously reported experiencing coronary heart diseases (AOR = 7.79, 95% CI [4.96-12.23]), urinary incontinences (AOR = 7.90, 95% CI [4.93-12.66]), and liver cirrhosis (AOR = 7.50, 95% CI [4.90-10.42]) were approximately eight times likely to have depressive symptoms. Similarly, participants with Alzheimer's disease (AOR = 6.83, 95% CI [5.11-8.42]), kidney problems (AOR = 6.63, 95% CI [4.05-10.85]), and history of allergies (AOR = 6.35, 95% CI [4.28-9.23]) had approximately seven-fold odds of reporting episodes of depressive symptoms. The odds of presenting with depressive symptoms amongst participants aged ≥ 50 were higher than in individuals aged ≤ 49 years. CONCLUSION At individual level, gender and general health status were associated with increased odds of depression. Furthermore, a history of any of the chronic diseases, irrespective of age, was a positive predictor of depression in our study population. Our findings could help to serve as a reference for monitoring depression amongst individuals with chronic conditions, planning health resources and developing preventive and screening strategies targeting those exposed to predisposing factors.
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Affiliation(s)
- Yohane V A Phiri
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan.,Institute for Health Research and Communication, Lilongwe, Malawi
| | - Kemal Aydın
- Faculty of Economics and Administrative Sciences, Amasya University, Amasya, Turkey
| | - Nadire Gülçin Yıldız
- Department of Guidance and Counseling, Faculty of Education, Istanbul Medipol University, Istanbul, Turkey
| | - Mfundi President Sebenele Motsa
- Global Health and Health Security, College of Public Health, Taipei Medical University, Taipei, Taiwan.,Behavioural Research and Innovations Unit, Educational Youth Empowerment, Manzini, Eswatini
| | - Owen Nkoka
- Institute for Health Research and Communication, Lilongwe, Malawi.,Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Halide Z Aydin
- Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Hsing Jasmine Chao
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan.,Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan
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Masselin-Dubois A, Enert-Barbero N, Gazagne A. Adaptation des pratiques psychologiques en clinique de la douleur durant la pandémie de la COVID-19. PRAT PSYCHOL 2022. [PMCID: PMC8784648 DOI: 10.1016/j.prps.2022.01.001] [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] [Indexed: 11/25/2022]
Abstract
Introduction La pratique clinique auprès de patients douloureux chroniques, ébranlée par la réorganisation du champ sanitaire, a nécessité de repenser la prise en charge psychologique de la douleur. Afin de poursuivre l’accompagnement psychologique des patients, des consultations individuelles ou des ateliers de groupes à distance se sont développés. Un groupe d’échange de pratiques rassemblant des psychologues et psychothérapeutes a partagé ses expériences cliniques et son vécu de la crise. Objectifs Les objectifs de cette étude sont d’explorer l’adaptation des pratiques cliniques pour les sujets douloureux chroniques, le vécu des professionnels, et de proposer des recommandations issues des réflexions collectives. Méthode La méthodologie de recherche clinique a suivi celle d’un focus group. Trois réunions en visioconférence de deux heures ont eu lieu de septembre 2020 à mai 2021. Une analyse thématique des retranscriptions a été réalisée avec le logiciel d’analyse qualitative NVivo. Résultats Au total, 9 psychologues et psychothérapeutes ont participé au focus group. L’analyse thématique a révélé trois grands thèmes, à savoir : (1) impact de la crise sanitaire liée à la COVID-19 ; (2) adaptation des pratiques ; (3) processus de changement des pratiques cliniques. Conclusion Les professionnels rapportent que l’usage des outils numériques a permis de limiter l’impact psychologique de la crise sanitaire sur les patients et de maintenir le lien. Des recommandations issues des réflexions collectives suggèrent de maintenir les soins en distanciel et de s’appuyer sur le soutien des équipes, de la hiérarchie, et des groupes d’échanges entre pairs.
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Harris JI, Hanson D, Leskela J, Billig J, Padilla-Martinez V, Boyd J, Nienow T. Reconsidering research exclusion for serious mental illness: Ethical principles, current status, and recommendations. J Psychiatr Res 2021; 143:138-143. [PMID: 34487990 DOI: 10.1016/j.jpsychires.2021.09.016] [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: 03/03/2021] [Revised: 07/19/2021] [Accepted: 09/01/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Historically, individuals managing serious mental illness (SMI) have often been excluded from research, typically because of concern that these individuals may not be able to understand and provide truly informed consent. As treatment has improved, the assumption that individuals managing SMI may not be capable of consent needs to be re-examined. Systematic exclusion from research may limit empirically tested treatments available for people managing SMI, and may contribute to the health care disparities seen in this population. OBJECTIVES This article examines this issue by documenting current rates of research exclusion for high disease burden conditions, based on empirical review of studies in ClinicalTrials.gov. RESEARCH DESIGN Current rates of exclusion from studies for psychiatric conditions were assessed through systematic review of relevant clinical trials on ClinicalTrials.gov. SUBJECTS Subjects in this inquiry are either articles accessed in the literature reviews, or descriptions of studies in public data on ClinicalTrials.gov. MEASURES The primary measure was a previously published coding system to document the extent and types of research exclusion related to psychiatric status. RESULTS Among studies of interventions for substance use disorders and chronic pain, individuals managing SMI were more likely to be excluded than those with other psychiatric disorders at statistically significant levels. This was not the case among studies of interventions for ischemic heart disease. In studies of substance use disorders, 9% explicitly excluded SMI and 83% could exclude people with SMI based on broader exclusion criteria. In studies of chronic pain these two categories of exclusion were 16% and 55%, and in studies of ischemic heart disease, these two categories of exclusion were 1% and 20%. CONCLUSIONS Evidence indicates that it is ethically and scientifically more appropriate to exclude based on capacity to consent than membership in the group of individuals managing SMI. The discussion outlines techniques researchers can use for more equitable and generalizable sampling.
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Affiliation(s)
- J Irene Harris
- VA Bedford Healthcare System, Bedford, MA, USA; University of Minnesota, Minneapolis, MN, USA.
| | | | - Jennie Leskela
- University of Minnesota, Minneapolis, MN, USA; ABPP Minneapolis VA Health Care System, Minneapolis, MN, USA
| | - John Billig
- ABPP, National Center for Ethics in Health Care, Veterans Health Administration, Washington, DC, USA
| | | | - Jennifer Boyd
- San Francisco VA Health Care System, San Francisco, CA, USA; University of California San Francisco, San Francisco, CA, USA
| | - Tasha Nienow
- Minneapolis VA Health Care System, Minneapolis, MN, USA
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Feijó FR, Pearce N, Faria NMX, Carvalho MP, Szortyka ALSC, Oliveira PAB, Fassa AG. The Role of Workplace Bullying in Low Back Pain: A Study With Civil Servants From a Middle-Income Country. THE JOURNAL OF PAIN 2021; 23:459-471. [PMID: 34678472 DOI: 10.1016/j.jpain.2021.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 08/15/2021] [Accepted: 09/14/2021] [Indexed: 11/25/2022]
Abstract
This is a cross-sectional study that analysed the association between workplace bullying and LBP. The participants were 894 judicial civil servants from Porto Alegre, southern Brazil. Workplace Bullying was measured by the Negative Acts Questionnaire (NAQ-r) and Low Back Pain by the Nordic Questionnaire for Musculoskeletal Symptoms (NQMS). Logistic Regression was used to analyse data and test hypotheses. The prevalence of LBP in the last 7 days was 50.1%, while the overall prevalence of Chronic LBP was 19.3%. Some psychosocial factors at work were strongly associated with both outcomes. Workplace bullying was strongly associated with LBP, even after adjustment for several covariates. The odds of LBP in the last 7 days among bullied workers was 1.89 (95% CI: 1.31-2.71) times higher, compared to non-bullied. Workplace bullying was also associated with chronic LBP after adjustment for sociodemographic, behavioural and some occupational factors (OR = 1.60; 95% CI: 1.05-2.44). Psychosocial factors at work, and particularly workplace bullying, were strong risk factors for LBP, in contrast to most individual factors, and dose-response patterns were showed. Positive associations between bullying and LBP raise hypotheses on causation, and the role of psychosocial factors at work are discussed. Further longitudinal studies should address these hypotheses, investigating causal paths, mechanisms and possible mediation. Perspectives: As a psychosocial risk, workplace bullying may play a role in low back pain and can be focus of interventions to prevent LBP. Dose-response patterns on the association between workplace bullying and low back pain are discussed and hypotheses are raised. The paper addresses different ways of measuring and categorising bullying at work, in order to study the relationship between bullying and pain.
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Affiliation(s)
- Fernando Ribas Feijó
- Postgraduate Programme in Epidemiology, Department of Social Medicine (F.R.F., N.M.X.F., M.P.C., A.L.S.C.S., A.G.F.), Federal University of Pelotas, Pelotas, Brazil; Postgraduate Programme in Health, Environment and Work (F.R.F.), Department of Preventive and Social Medicine, Federal University of Bahia, Salvador, Brazil.
| | - Neil Pearce
- Department of Medical Statistics, Faculty of Epidemiology and Population Health (N.P.), London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Neice Müller Xavier Faria
- Postgraduate Programme in Epidemiology, Department of Social Medicine (F.R.F., N.M.X.F., M.P.C., A.L.S.C.S., A.G.F.), Federal University of Pelotas, Pelotas, Brazil
| | - Maitê Peres Carvalho
- Postgraduate Programme in Epidemiology, Department of Social Medicine (F.R.F., N.M.X.F., M.P.C., A.L.S.C.S., A.G.F.), Federal University of Pelotas, Pelotas, Brazil
| | - Ana Laura Sica Cruzeiro Szortyka
- Postgraduate Programme in Epidemiology, Department of Social Medicine (F.R.F., N.M.X.F., M.P.C., A.L.S.C.S., A.G.F.), Federal University of Pelotas, Pelotas, Brazil
| | | | - Anaclaudia Gastal Fassa
- Postgraduate Programme in Epidemiology, Department of Social Medicine (F.R.F., N.M.X.F., M.P.C., A.L.S.C.S., A.G.F.), Federal University of Pelotas, Pelotas, Brazil
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Luo Y. The Association of Delayed Care With Depression Among US Middle-Aged and Older Adults During the COVID-19 Pandemic: Cross-sectional Analysis. JMIR Aging 2021; 4:e29953. [PMID: 34524964 PMCID: PMC8494067 DOI: 10.2196/29953] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/17/2021] [Accepted: 07/31/2021] [Indexed: 12/24/2022] Open
Abstract
Background During the COVID-19 pandemic, the depression level among US adults has significantly increased. Age disparity in depression during the pandemic has been reported in recent studies. Delay or avoidance of medical care is one of the collateral damages associated with the COVID-19 pandemic, and it can lead to increased morbidity and mortality. Objective This study aimed to assess the prevalence of depression and delayed care among US middle-aged adults and older adults during the pandemic, as well as investigate the association of delayed care with depression among those 2 age groups. Methods This cross-sectional study used data from the 2020 Health and Retirement Study (HRS) COVID-19 Project (Early, Version 1.0). Univariate analyses, bivariate analyses, and binary logistic regression were applied. US adults older than 46 years were included. Depression was measured by the Composite International Diagnostic Interview-Short Form (CIDI-SF). Delayed care was measured by the following 4 items: delayed surgery, delayed seeing a doctor, delayed dental care, and other delayed care. Results A total of 3246 participants were identified. More than half of the participants were older than 65 years (n=1890, 58.2%), and 274 (8.8%) participants had depression during the pandemic. Delayed dental care was positively associated with depression among both middle-aged adults (OR 2.05, 95% CI 1.04-4.03; P=.04) and older adults (OR 3.08, 95% CI 1.07-8.87; P=.04). Delayed surgery was positively associated with depression among older adults (OR 3.69, 95% CI 1.06-12.90; P=.04). Self-reported pain was positively related to depression among both age groups. Middle-aged adults who reported higher education levels (some college or above) or worse self-reported health had a higher likelihood of having depression. While perceived more loneliness was positively associated with depression among older adults, financial difficulty was positively associated with depression among middle-aged adults. Conclusions This study found that depression was prevalent among middle-aged and older adults during the pandemic. The study highlighted the collateral damage of the COVID-19 pandemic by identifying the association of delayed surgery and dental care with depression during the pandemic. Although surgery and dental care cannot be delivered by telehealth, telehealth services can still be provided to address patients’ concerns on delayed surgery and dental care. Moreover, the implementation of telemental health services is needed to address mental health symptoms among US middle-aged and older adults during the pandemic. Future research that uses more comprehensive measurements for delayed care is needed to decipher the path through which delayed care is associated with depression.
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Affiliation(s)
- Yan Luo
- The University of Alabama, Tuscaloosa, AL, United States
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Acute and chronic back pain in adults and elderly in southern Brazil. SCIENTIA MEDICA 2021. [DOI: 10.15448/1980-6108.2021.1.39824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Aims: to determine the prevalence of acute and chronic back pain and associated factors and identify the consequences of this pain in adults and the elderly in southern Brazil.Methods: cross-sectional study conducted in 2019, in Criciúma, Santa Catarina, in individuals aged 18 and over. Acute back pain was pain in the cervical, thoracic, or lumbar regions not exceeding 3 months and chronic pain as pain for 3 months or more. Bivariate analyzes and multinomial logistic regression were performed.Results: among the 820 participants, the prevalence of back pain was 67.0%, acute pain 39.3% (95% CI: 35.5% to 43.3%) and chronic pain 27.4% (95% CI: 24.5% to 30.4%). Acute back pain was associated with women, overweight, obesity, and with WMSD/RSI, while chronic pain chronic pain was found mostly in women, being related to leisure inactivity ...were female, leisure inactivity, falls, Work-related musculoskeletal disorder/repetitive strain injury, and arthritis/rheumatism.Conclusions: acute pain was greater among overweight/obese and chronic pain contribute to absenteeism and demand for health services.
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Rogers AH, Garey L, Bakhshaie J, Viana AG, Ditre JW, Zvolensky MJ. Anxiety, Depression, and Opioid Misuse Among Adults With Chronic Pain: The Role of Anxiety Sensitivity. Clin J Pain 2021; 36:862-867. [PMID: 32769415 DOI: 10.1097/ajp.0000000000000870] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVES The opioid epidemic is a significant public health problem largely driven by opioid prescriptions for chronic pain. Among those with chronic pain, anxiety and depressive symptoms have been linked to opioid misuse, and individual differences in anxiety and depressive symptoms among adults with chronic pain may be important for better understanding pain. Yet, little work has examined mechanisms that may link anxiety and depressive symptoms to opioid misuse among adults with chronic pain. Anxiety sensitivity (AS), or the fear of anxiety-related physical sensations, may be one candidate construct that has been linked independently to anxiety and depressive symptoms as well as opioid misuse. METHODS The current survey-based study examined the indirect association of AS in the relation between anxiety and depressive symptoms and opioid misuse among 429 adults with chronic pain currently using prescription opioid medication (73.9% female, Mage=38.32 y, SD=11.07). RESULTS Using structural equation modeling, it appears that AS is a potential construct in the interrelation between anxiety and depressive symptoms and opioid misuse. However, an alternative model found equally strong empirical support, as mental health symptoms may serve as an explanatory factor between AS and opioid misuse. DISCUSSION Bi-directional effects are apt to be involved among the studied variables. Prospective research is needed to replicate the study results and isolate the temporal patterning between the studied constructs. Nonetheless, the data overall highlight the importance of both AS and anxiety and depressive symptoms in terms of understanding opioid misuse among adults with chronic pain.
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Affiliation(s)
| | | | | | | | - Joseph W Ditre
- Department of Psychology, Syracuse University, Syracuse, NY
| | - Michael J Zvolensky
- Department of Psychology.,HEALTH Institute, University of Houston.,Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX
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Fear Avoidance Predicts Persistent Pain in Young Adults With Low Back Pain: A Prospective Study. J Orthop Sports Phys Ther 2021; 51:383-391. [PMID: 33998262 PMCID: PMC8328870 DOI: 10.2519/jospt.2021.9828] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To (1) quantify relationships between low back pain (LBP) symptoms, physical activity, and psychosocial characteristics in young adults and (2) identify subclasses of young adults with distinct pain trajectories. DESIGN Prospective cohort study with 12-month follow-up. METHODS One hundred twenty adults (mean ± SD age, 20.8 ± 2.6 years; 99 women) participated. Participants completed a baseline survey that measured anxiety, depression, fear avoidance, quality of life, and history and impact of any LBP. Participants completed follow-up surveys every 3 months for 1 year. Subclasses based on pain trajectories over time were identified using latent class analysis, and predictors of class membership at baseline were assessed. RESULTS Individuals with LBP at baseline had lower physical quality-of-life scores than back-healthy participants (P = .01). Subclass 1 (25% of individuals with LBP) had persistent moderate-to-high pain intensity over the 1-year study period. Subclass 2 (75% of individuals with LBP) had significantly improving pain over the 1-year study period. Higher fear avoidance (physical activity subscale) and pain interference at baseline were associated with greater odds of membership in subclass 1 (odds ratio = 1.2; 95% confidence interval: 1.0, 1.3 and odds ratio = 1.4; 95% confidence interval: 1.1, 1.6, respectively). CONCLUSION Most young adults with LBP had symptoms that improved over time. Levels of fear avoidance and pain interference may help to identify individuals at risk of persistent pain early in the lifespan. J Orthop Sports Phys Ther 2021;51(8):383-391. Epub 15 May 2021. doi:10.2519/jospt.2021.9828.
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Yu L, Kioskli K, McCracken LM. The Psychological Functioning in the COVID-19 Pandemic and Its Association With Psychological Flexibility and Broader Functioning in People With Chronic Pain. THE JOURNAL OF PAIN 2021; 22:926-939. [PMID: 33677112 PMCID: PMC7930808 DOI: 10.1016/j.jpain.2021.02.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 02/08/2021] [Accepted: 02/18/2021] [Indexed: 12/30/2022]
Abstract
AIMS People with chronic pain may be particularly vulnerable to the impact of the pandemic COVID-19, and psychological flexibility may protect them. This study investigates psychological functioning in the context of COVID-19, including fear and avoidance in the context of COVID-19, specifically its association with daily functioning, and the role of psychological flexibility, among people with chronic pain. METHODS Responses from 555 adults with chronic pain were collected through a cross-sectional online survey and analyzed. RESULTS Eight out of 10 participants reported significant depression and nearly 9 out of 10 reported significant functional impairment. COVID-19-related fear and avoidance significantly correlated with pain, pain-related disability, depression, and work and social adjustment (r = 18-.32), as well as psychological flexibility processes, including pain acceptance, self-as-context, and committed action, |r|=.13-.30. COVID-19-related fear and avoidance and COVID-19-related interference were significant predictors of some measures of daily functioning beyond demographics and pain, β = .09-.14. However, these associations weakened when psychological flexibility processes were factored into the models, with fear of COVID-19 no longer being a significant predictor of pain-related disability or depression, and COVID-19 avoidance no longer a significant predictor of depression. CONCLUSIONS The psychological functioning in the context of COVID-19 appears to be negatively associated with daily functioning in people with chronic pain, and is statistically significant in this regard. Psychological flexibility may have a role in these associations for people with chronic pain in the pandemic. PERSPECTIVE This article demonstrates the psychological implication of COVID-19 and its association with broader emotional and daily functioning in people with chronic pain. It also demonstrates that Psychological flexibility may have a role in these associations for people with chronic pain in the pandemic.
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Affiliation(s)
- Lin Yu
- Middlesex University, Department of Psychology, UK.
| | - Kitty Kioskli
- City, University of London, Department of Computer Science, UK; Maggioli S.p.A, Research and Development Lab, Greece
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44
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Seward J, Stavrinos D, Moore D, Attridge N, Trost Z. When driving hurts: characterizing the experience and impact of driving with back pain. Scand J Pain 2021; 21:445-456. [PMID: 33641275 DOI: 10.1515/sjpain-2020-0108] [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: 06/29/2020] [Accepted: 12/07/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Driving is one of the most widespread aspects of daily living to people in the United States and is an active process that requires various cognitive functions, such as attention. Chronic low back pain (CLBP) is one of the more prevalent and costly health conditions in the world, with individuals who report CLBP also reporting significant impairment across different domains of daily life both physically and cognitively. However, despite the prevalence of these two constructs, research detailing the experience of driving in pain remains largely underrepresented. This cross-sectional study sought to characterize the driving experience of people who experience CLBP, focusing on the psychological constructs related to chronic pain like pain catastrophizing, affective responses (irritability, anxiety, fear), and self-reported driving behaviors and outcomes. METHODS This study distributed an online questionnaire measuring pain, disability, and other psychological constructs commonly associated with CLBP like pain catastrophizing through M-turk to 307 U.S. participants with recurring CLBP and regular driving activity. Participants also answered questions regarding driving in pain, affective responses to driving in pain (i.e., irritability, anxiety, and fear), driving behaviors and violations, driving avoidance habits as a result of pain, opioid use, using pain medication while driving, and recent vehicle collisions within the past three years. Bivariate correlations were used to compare study variables, and one-way ANOVA's were used to compare means between participants with and without a collision history within the past three years. RESULTS Findings demonstrated significant positive associations not only between the psychological factors commonly associated with chronic pain, such as pain intensity, pain disability, pain catastrophizing, and the cognitive intrusion by pain, but also statistically significant relationships between these measures and pain intensity while driving, affective responses to driving in pain, driving violations, and driving avoidance habits. Additionally, in comparison to participants with no collision history within the past three years, participants who had been driving during a vehicle collision reported greater pain catastrophizing and cognitive intrusion by pain scores. CONCLUSIONS To our knowledge, the current study is the first to characterize driving experience specifically among individuals with CLBP, with attention to the relationship among key sensory, affective, and cognitive psychological metrics as well as self-reported driving history and behavior. The current findings reinforce multiple associations between pain and cognitive-affective variables that have been observed in literature outside the driving context, including pain intensity, anger, inattention, and behavioral disruption. Given that driving is a pervasive, potentially risky behavior that requires some form of cognitive focus and control, the current findings point to a continued need to examine these associations within this specific life context. We believe we have laid a groundwork for research considering the role of psychological pain variables in a driving performance. However, the nature of our analyses prevents any sort of causality from being inferred, and that future experimental research is warranted to better understand and explain these mechanisms underlying driving in pain while accounting for participant bias and subject interpretation.
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Affiliation(s)
- Joshua Seward
- Department of Psychology, University of Alabama, Birmingham, AL, USA
| | - Despina Stavrinos
- Department of Psychology, University of Alabama, Birmingham, AL, USA
| | - David Moore
- School of Natural Sciences and Psychology, Liverpool John Moores University, Liverpool, UK.,Research Centre for Brain and Behaviour, Liverpool John Moores University, Liverpool, UK
| | - Nina Attridge
- School of Science, Loughborough University, Loughborough, UK
| | - Zina Trost
- Virginia Commonwealth University, Richmond, USA
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Miller-Matero LR, Hecht LM, Miller MK, Autio K, Pester BD, Tobin ET, Patel S, Braciszewski JM, Maye M, Ahmedani BK. A Brief Psychological Intervention for Chronic Pain in Primary Care: A Pilot Randomized Controlled Trial. PAIN MEDICINE 2021; 22:1603-1611. [PMID: 33616190 DOI: 10.1093/pm/pnaa444] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Although evidence-based psychological interventions improve chronic pain, many patients do not engage in behavioral health services. Offering a brief intervention in a medical setting may provide benefits to patients with chronic pain. The purpose of this study was to examine preliminary outcomes of a brief psychological intervention for chronic pain delivered in primary care. DESIGN Pilot randomized controlled trial. SETTING Primary care clinic. SUBJECTS Sixty participants with chronic pain were randomized to a 5-session psychological intervention or treatment-as-usual control group. METHODS Participants completed pre- and post-intervention measures assessing pain severity, pain interference, pain catastrophizing, depression, and anxiety. RESULTS Most participants (76.7%) randomized to the intervention completed all sessions. Compared to the control group, those in the intervention had decreases in pain severity (P = .048), pain catastrophizing (P = .04), and depression (P = .01) from pre- to post-intervention. Within the intervention group, there was a significant improvement in pain interference scores (P = 0.02). Within the intervention group, effect sizes were medium to large for changes in pain severity, pain interference, pain catastrophizing, and depression scores. There were no significant changes in anxiety scores. CONCLUSION Results suggest that delivery of a brief psychological intervention for chronic pain in primary care appears to offer improvements in pain severity, pain interference, pain catastrophizing, and depression. Findings suggest that shorter-term psychological interventions may offer similar benefits as longer-term ones. Furthermore, offering a brief intervention in primary care may increase access and engagement in behavioral pain management services. Future research should examine this through a fully-powered trial with longer-term outcomes.
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Affiliation(s)
- Lisa R Miller-Matero
- Behavioral Health, Henry Ford Health System, Detroit, Michigan, USA.,Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, Michigan, USA
| | - Leah M Hecht
- Behavioral Health, Henry Ford Health System, Detroit, Michigan, USA.,Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, Michigan, USA
| | - Mary Kate Miller
- Behavioral Health, Henry Ford Health System, Detroit, Michigan, USA.,Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, Michigan, USA
| | - Kirsti Autio
- Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, Michigan, USA
| | - Bethany D Pester
- Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, Michigan, USA
| | - Erin T Tobin
- Behavioral Health, Henry Ford Health System, Detroit, Michigan, USA.,Internal Medicine, Henry Ford Health System, Detroit, Michigan, USA
| | - Shivali Patel
- Behavioral Health, Henry Ford Health System, Detroit, Michigan, USA
| | - Jordan M Braciszewski
- Behavioral Health, Henry Ford Health System, Detroit, Michigan, USA.,Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, Michigan, USA
| | - Melissa Maye
- Behavioral Health, Henry Ford Health System, Detroit, Michigan, USA.,Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, Michigan, USA
| | - Brian K Ahmedani
- Behavioral Health, Henry Ford Health System, Detroit, Michigan, USA.,Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, Michigan, USA
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Jacob L, Rathmann W, Koyanagi A, Haro JM, Kostev K. Association between type 2 diabetes and chronic low back pain in general practices in Germany. BMJ Open Diabetes Res Care 2021; 9:9/1/e002426. [PMID: 34266855 PMCID: PMC8286747 DOI: 10.1136/bmjdrc-2021-002426] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 06/30/2021] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION There are conflicting results on the association between type 2 diabetes and chronic low back pain (CLBP). Therefore, the goal was to investigate the relationship between type 2 diabetes and CLBP in individuals followed in general practices in Germany. RESEARCH DESIGN AND METHODS Adults diagnosed for the first time with type 2 diabetes in 809 general practices in Germany between 2005 and 2018 (index date) were included. Adults without type 2 diabetes were matched (1:1) to those with type 2 diabetes by sex, age, index year, and the annual number of medical consultations (index date: a randomly selected visit date). The association between type 2 diabetes and the 10-year incidence of CLBP was analyzed in conditional Cox regression models adjusted for a wide range of comorbidities, including hypertension, lipid metabolism disorders, and obesity. RESULTS There were 139 002 individuals included in this study (women: 58.0%; mean (SD) age 62.5 (13.4) years). There was a positive association between type 2 diabetes and the incidence of CLBP in the overall sample (HR=1.23, 95% CI: 1.13 to 1.35). Sex-stratified analyses showed a higher risk of CLBP in women (HR=1.68, 95% CI: 1.43 to 1.90) and a lower risk in men with than in their counterparts without type 2 diabetes (HR=0.83, 95% CI: 0.71 to 0.97). CONCLUSIONS Newly diagnosed type 2 diabetes was associated with an increased risk of CLBP. There were important sex differences in the type 2 diabetes-CLBP relationship, and more research is warranted to investigate the underlying factors explaining these differences.
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Affiliation(s)
- Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Wolfgang Rathmann
- German Diabetes Center, Institute for Biometrics and Epidemiology, Leibniz Institute for Diabetes Research at Heinrich Heine University, Duesseldorf, Germany
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
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Mehl-Madrona L, McFarlane P, Mainguy B. Effects of a Life Story Interview on the Physician-Patient Relationship with Chronic Pain Patients in a Primary Care Setting. J Altern Complement Med 2021; 27:688-696. [PMID: 34185546 DOI: 10.1089/acm.2020.0449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction: Within family medicine it is generally accepted that the more we know about patients' lives, the better the care we provide. Few studies have sought to quantify this historical assumption. We wondered if knowing their chronic pain, patients' life stories would improve the physician-patient relationship in a family medicine residency training program clinic. Methods: We selected patients in chronic pain with depression and/or anxiety who were considered difficult. After a lead in period to establish stability of ratings, we obtained a life story interview for 125 such patients after administering the doctor-patient relationship questionnaire to them and their physicians. Patients completed the McGill Pain Inventory (MPQ), the Zung Anxiety Inventory, and the Center for Epidemiological Studies Depression Scale. Physicians completed the Jefferson Physicians Empathy Scale. Questionnaires were repeated every 4 months. Results: The quality of the physician-patient relationship increased significantly over the course of the year for patients (increase of 0.60, standard deviation [SD] = 0.13, 95% confidence interval [CI] = 0.57 to 0.63, p < 0.001) and for doctors (increase of 0.77, SD = 0.20, 95% CI = 0.72 to 0.81, p < 0.001). The perceived level of pain on the MPQ decreased significantly on the sensory component (71.2 ± 7.6 to 11.7 + 9.4, 95% CI = 0.589 to 9.411, p = 0.0270 and the affective component (4.2 + 3.4 to 2.1 + 4.3, 95% CI = 0.131 to 4.069, p = 0.037). Anxiety and depression ratings did not change. Physicians' empathy ratings increased significantly over the course of the year from a mean of 117.2 (SD = 10.2) to 125.1 (SD = 16.1) for a difference of 7.90, which was significant at p = 0.0273 with a 95% CI of -14.85 to -0.915. Discussion: Knowing the patient's life story improves the physician-patient relationship for both patients and physicians. When the physician-patient relationship improves, the perceived level of pain decreases. Physicians' empathy ratings increase. While the interview requires 90-120 min, it is billable, and can be done by medical students, medical assistants, social workers, or behavioral health. Conclusions: Obtaining life stories of chronic pain patients is a cost-effective way to reduce pain while simultaneously improving the physician-patient relationship and increasing physician empathy.
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Affiliation(s)
- Lewis Mehl-Madrona
- Family Medicine Residency, Northern Light Eastern Maine Medical Center, Orono, ME, USA.,Department of Family Medicine, University of New England College of Osteopathic Medicine, Biddeford and Bangor, ME, USA.,Department of Psychiatry, University of Vermont College of Medicine, Burlington, VT, USA.,Coyote Institute, Orono, ME, USA.,Medical Arts and Humanities Program, University of Maine, Orono, ME, USA.,Wabanaki Health and Wellness, Bangor, ME, USA.,Acadia Hospital, Bangor, ME, USA
| | - Patrick McFarlane
- Family Medicine Residency, Northern Light Eastern Maine Medical Center, Orono, ME, USA.,Department of Family Medicine, University of New England College of Osteopathic Medicine, Biddeford and Bangor, ME, USA.,Medical Arts and Humanities Program, University of Maine, Orono, ME, USA
| | - Barbara Mainguy
- Coyote Institute, Orono, ME, USA.,Wabanaki Health and Wellness, Bangor, ME, USA
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Men F, Fischer B, Urquia ML, Tarasuk V. Food insecurity, chronic pain, and use of prescription opioids. SSM Popul Health 2021; 14:100768. [PMID: 33763516 PMCID: PMC7974024 DOI: 10.1016/j.ssmph.2021.100768] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 02/19/2021] [Accepted: 03/02/2021] [Indexed: 02/06/2023] Open
Abstract
Chronic pain has been on the rise in recent decades in Canada. Accordingly, the use of prescription opioids (PO) in Canada increased drastically between 2005 and 2014, only starting to decrease in 2015. Both pain and PO use have serious public health repercussions, disproporionately affecting select socially disadvantaged populations. Food insecurity is a strong risk factor for mental disorders and suicidal outcomes, yet its relationship to chronic pain and PO use is largely unknown. Using two recent cycles from the population representative Canadian Community Health Survey (CCHS), we examined the association of household food insecurity status with chronic pain and PO use among Canadians 12 years and older, adjusting for health and sociodemographic characteristics. Compared to food-secure individuals, marginally, moderately, and severely food-insecure individuals had 1.31 (95% confidence interval [CI] 1.15-1.48), 1.89 (95% CI 1.71-2.08), and 3.29 (95% CI 2.90-3.74) times higher odds of experiencing chronic pain and 1.55 (95% CI 1.30-1.85), 1.77 (95% CI 1.54-2.04), and 2.65 (95% CI 2.27-3.09) times higher odds of using PO in the past year, respectively. The graded association with food insecurity severity was also found in severe pain experience and pain-induced activity limitations among chronic pain patients and, less consistently, in intensive, excess, and alternative use of PO and its acquisition through means other than medical prescription among past-year PO users. Food insecurity was a much more powerful predictor of chronic pain and PO use than other well-established social determinants of health like income and education. Policies reducing food insecurity may lower incidence of chronic pain and help contain the opioid crisis.
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Affiliation(s)
- Fei Men
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
- Department of Consumer Sciences, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Benedikt Fischer
- Schools of Population Health and Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Centre for Applied Research in Mental Health & Addiction, Simon Fraser University, Vancouver, British Columbia, Canada
- Department of Psychiatry, Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - Marcelo L. Urquia
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
| | - Valerie Tarasuk
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
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Hanke A, Schoch W, Keller M, Kurz E, Richter R. [Function-based tests to determine the return-to-activity state in patients with non-specific low back pain]. SPORTVERLETZUNG-SPORTSCHADEN 2021; 36:80-91. [PMID: 33979841 DOI: 10.1055/a-1272-9781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Most people with back pain suffer from non-specific low back pain, for which no specific reasons can be found. Two out of three have recurrent pain episodes. To reduce the likelihood of recurrence and long-lasting pain, functional tests are increasingly used to determine the current functional status. This literature study evaluates evidence of functional tests in patients with non-specific low back pain and their validity related to the return-to-activity (RTA) status. The objective of this analysis is to give recommendations for specific activities and to assess the risk of chronification and recurrent pain. METHODS PubMed-based literature search. Narrative review focusing on data from the past ten years. RESULTS A total of twelve studies were included in the analysis. Overall, 33 different tests were identified for which positive statements regarding reliability, validity and relevance for the assessment of the RTA status in non-specific back pain could be made. The tests identified may be able to provide useful information when assessing the RTA status and to recognise yellow and blue flags in patients with non-specific low back pain. The ability to walk, the behaviour when lifting and carrying objects, motor control, muscle strength and mobility play a particular role. CONCLUSION The determination of the RTA status in patients with non-specific low back pain should be patient-specific and based on biopsychosocial aspects rather than relying exclusively on movement-related tests. Exact statements regarding the point in time when patients can resume everyday activities and work without an increased risk of recurrence or chronicity do not seem possible with functional tests alone. The major influence of psychological and social factors on disease development, course and prognosis are limiting factors. Movement and strain-related tests can still be used to evaluate activities related to everyday life, to design therapy programs and to give patients confidence.
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Affiliation(s)
| | - Wolfgang Schoch
- PULZ im Rieselfeld, Germany.,OSINSTITUT, ortho & sport, München, Germany
| | | | - Eduard Kurz
- OSINSTITUT, ortho & sport, München, Germany.,Department für Orthopädie, Unfall- und Wiederherstellungschirurgie, Martin-Luther-Universität Halle-Wittenberg, Germany
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50
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Abe T, Okuyama K, Hamano T, Takeda M, Yamasaki M, Isomura M, Nakano K, Sundquist K, Nabika T. Assessing the Impact of a Hilly Environment on Depressive Symptoms among Community-Dwelling Older Adults in Japan: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094520. [PMID: 33923194 PMCID: PMC8123156 DOI: 10.3390/ijerph18094520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 04/22/2021] [Accepted: 04/22/2021] [Indexed: 11/16/2022]
Abstract
Although some neighborhood environmental factors have been found to affect depressive symptoms, few studies have focused on the impact of living in a hilly environment, i.e., land slope, on depressive symptoms among rural older adults. This cross-sectional study aimed to investigate whether a land slope is associated with depressive symptoms among older adults living in rural areas. Data were collected from 935 participants, aged 65 years and older, who lived in Shimane prefecture, Japan. Depressive symptoms were assessed using the Zung Self-Rating Depression Scale (SDS) and defined on the basis of an SDS score ≥ 40. Land slopes within a 400 m network buffer were assessed using geographic information systems. Odds ratios (ORs) with 95% confidence intervals (CIs) of depressive symptoms were estimated using logistic regression. A total of 215 (23.0%) participants reported depressive symptoms. The land slope was positively associated with depressive symptoms (OR = 1.04; 95% CI = 1.01-1.08) after adjusting for all confounders. In a rural setting, living in a hillier environment was associated with depressive symptoms among community-dwelling older adults in Japan.
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Affiliation(s)
- Takafumi Abe
- Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University, Shimane 693-8501, Japan; (K.O.); (T.H.); (M.T.); (M.Y.); (M.I.); (K.N.); (K.S.)
- Correspondence: ; Tel.: +81-853-20-2586
| | - Kenta Okuyama
- Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University, Shimane 693-8501, Japan; (K.O.); (T.H.); (M.T.); (M.Y.); (M.I.); (K.N.); (K.S.)
- Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, 20502 Malmö, Sweden
| | - Tsuyoshi Hamano
- Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University, Shimane 693-8501, Japan; (K.O.); (T.H.); (M.T.); (M.Y.); (M.I.); (K.N.); (K.S.)
- Department of Sports Sociology and Health Sciences, Faculty of Sociology, Kyoto Sangyo University, Kyoto 603-8555, Japan
| | - Miwako Takeda
- Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University, Shimane 693-8501, Japan; (K.O.); (T.H.); (M.T.); (M.Y.); (M.I.); (K.N.); (K.S.)
| | - Masayuki Yamasaki
- Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University, Shimane 693-8501, Japan; (K.O.); (T.H.); (M.T.); (M.Y.); (M.I.); (K.N.); (K.S.)
- Faculty of Human Sciences, Shimane University, Shimane 690-8504, Japan
| | - Minoru Isomura
- Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University, Shimane 693-8501, Japan; (K.O.); (T.H.); (M.T.); (M.Y.); (M.I.); (K.N.); (K.S.)
- Faculty of Human Sciences, Shimane University, Shimane 690-8504, Japan
| | - Kunihiko Nakano
- Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University, Shimane 693-8501, Japan; (K.O.); (T.H.); (M.T.); (M.Y.); (M.I.); (K.N.); (K.S.)
| | - Kristina Sundquist
- Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University, Shimane 693-8501, Japan; (K.O.); (T.H.); (M.T.); (M.Y.); (M.I.); (K.N.); (K.S.)
- Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, 20502 Malmö, Sweden
- Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY 10029-5674, USA
| | - Toru Nabika
- Department of Functional Pathology, Faculty of Medicine, Shimane University, Shimane 693-8501, Japan;
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