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Health, Psychological and Demographic Predictors of Depression in People with Fibromyalgia and Osteoarthritis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063413. [PMID: 35329109 PMCID: PMC8950397 DOI: 10.3390/ijerph19063413] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 03/09/2022] [Accepted: 03/10/2022] [Indexed: 02/04/2023]
Abstract
Depression is common in people with fibromyalgia (FM) and osteoarthritis (OA) and has been linked to adverse health outcomes in these conditions. The purpose of this study was to examine differences in predictors of depression among individuals with FM and OA using a range of health, demographic, and psychological variables. Of the total 963 participants, 600 were diagnosed with FM, and 363 with OA. The Quality of Well-Being Scale (QWB) was used to assess health status. The Fibromyalgia Impact Questionnaire (FIQ) and the Arthritis Impact Measurement Scale (AIMS) were used to measure disease-specific impact. Additionally, participants completed self-efficacy and helplessness assessments. Depression was measured using the Center for Epidemiological Studies Scale (CES-D). The results of a moderated linear regression showed that higher depression scores were associated with lower health status and a greater condition impact, especially in the FM group. Self-efficacy and helplessness predicted depression in both groups, but more strongly in FM. White participants with OA were more depressed than their non-White counterparts, while the opposite was true for FM. These findings indicate that improving health status and psychological well-being might alleviate depression in both FM and OA.
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Jin Y, Si H, Qiao X, Tian X, Liu X, Xue QL, Wang C. Relationship Between Frailty and Depression Among Community-Dwelling Older Adults: The Mediating and Moderating Role of Social Support. THE GERONTOLOGIST 2021; 60:1466-1475. [PMID: 32556208 DOI: 10.1093/geront/gnaa072] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Frailty is associated with depression in older adults and reduces their social support. However, the mechanism underlying such relationship remains unclear. We aim to examine whether social support acts as a mediator or moderator in the relationship between frailty and depression. RESEARCH DESIGN AND METHODS This cross-sectional study was conducted among 1,779 community-dwelling older adults aged 60 and older. Frailty, social support, and depressive symptoms were measured by the Physical Frailty Phenotype, Social Support Rating Scale, and five-item Geriatric Depression Scale, respectively. Data were also collected on age, gender, years of schooling, monthly income, cognitive function, number of chronic diseases, physical function, and pain. RESULTS Linear regression models showed that subjective support and support utilization, but not objective support, mediated and moderated the relationship between frailty and depressive symptoms. The Johnson-Neyman technique determined a threshold of 30 for subjective support, but not for support utilization, beyond which the detrimental effect of frailty on depressive symptoms was offset. DISCUSSION AND IMPLICATIONS Social support underlies the association of frailty with depression, and its protective role varies by type. Interventions on depression should address improving perceptions and utilization of social support among frail older adults rather than simply providing them with objective support.
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Affiliation(s)
- Yaru Jin
- School of Nursing, Peking University, Beijing, China
| | - Huaxin Si
- School of Nursing, Peking University, Beijing, China
| | - Xiaoxia Qiao
- School of Nursing, Peking University, Beijing, China
| | - Xiaoyu Tian
- School of Nursing, Shandong University, Jinan Shandong, China
| | - Xinyi Liu
- School of Nursing, Shandong University, Jinan Shandong, China
| | - Qian-Li Xue
- School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Cuili Wang
- School of Nursing, Peking University, Beijing, China
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Ejdemyr I, Hedström F, Gruber M, Nordin S. Somatic symptoms of helplessness and hopelessness. Scand J Psychol 2021; 62:393-400. [PMID: 33615490 DOI: 10.1111/sjop.12713] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 01/04/2021] [Indexed: 01/01/2023]
Abstract
Helplessness and hopelessness are transdiagnostic and aggravating factors of mental ill health, but their relation with somatization is not well documented. The main objectives were to identify somatic symptoms that are particularly associated with helplessness, referred to as somatic symptoms of helplessness (SS-He), and hopelessness, referred to as somatic symptoms of hopelessness (SS-Ho), determine increased risk of helplessness and hopelessness if having these symptoms and a certain number of these symptoms, and determine sensitivity and specificity in identifying helplessness and hopelessness based on number of these symptoms in a general Swedish sample. Population-based data from validated questionnaire instruments were used from 3,210 participants who constituted case groups of helplessness and hopelessness, and corresponding reference groups. Among 15 common somatic symptoms, five SS-He (e.g., feeling tired/having low energy) and five SS-Ho (e.g., dizziness) were identified, showing increased risk of helplessness and hopelessness that ranged from the factor 1.73 to 2.58 and from 1.44 to 1.92, respectively, which decreased considerably when controlled for depression and anxiety. The risk of helplessness increased by the factor 1.49 for each additional SS-He, and by 1.38 for each SS-Ho. A cutoff of two/three or more SS-He showed a sensitivity of 81.7/63.7% and a specificity of 40.6/61.4% in identifying helplessness, and 77.4/54.6% and 40.4/66.1%, respectively, in identifying hopelessness based on two/three or more SS-Ho. Primary care clinicians may consider further investigation of helplessness and hopelessness as well as depression and anxiety if presenting with these symptoms.
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Affiliation(s)
- Ivan Ejdemyr
- Department of Psychology, Umeå University, Umeå, Sweden
| | | | | | - Steven Nordin
- Department of Psychology, Umeå University, Umeå, Sweden
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Sahar K, Thomas SA, Clarke SP. Adjustment to fibromyalgia: The role of domain‐specific self‐efficacy and acceptance. AUSTRALIAN JOURNAL OF PSYCHOLOGY 2020. [DOI: 10.1111/ajpy.12089] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Karan Sahar
- Division of Rehabilitation and Ageing, University of Nottingham, Nottingham, UK,
| | - Shirley A. Thomas
- Division of Rehabilitation and Ageing, University of Nottingham, Nottingham, UK,
| | - Simon P. Clarke
- Division of Rehabilitation and Ageing, University of Nottingham, Nottingham, UK,
- Arthritis Research UK Pain Centre, University of Nottingham, Nottingham, UK,
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Feingold D, Brill S, Goor-Aryeh I, Delayahu Y, Lev-Ran S. The association between severity of depression and prescription opioid misuse among chronic pain patients with and without anxiety: A cross-sectional study. J Affect Disord 2018; 235:293-302. [PMID: 29660645 DOI: 10.1016/j.jad.2018.04.058] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 03/08/2018] [Accepted: 04/05/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND In light of the increased rates of Prescription Opioid (PO) misuse and associated mortality in several developed countries in recent years, efforts have been made to identify populations who may be at increased risk for misuse of POs. Though the association between depression and PO misuse among pain patients is well documented, little is known regarding the effects of severity of depression on rates of misuse. In this study we explored rates of PO misuse among chronic pain patients screening positive for depression according to level of severity. METHODS Participants included chronic pain patients receiving POs (N = 554). All participants were screened for depression using the Patient Health Questionnaire (PHQ-9; cut-off scores of 5, 10, 15, and 20 for mild, moderate, moderate-severe and severe depression, respectively) and for opioid misuse using the Current Opioid Misuse Measure (COMM). Logistic regression analyses controlling for additional sociodemographic and clinical factors were conducted. RESULTS Participants who screened positive for depression were at significantly increased odds to screen positive for opioid misuse (Adjusted Odds Ratio (AOR) = 3.63; 95% Confidence Interval (CI) = 1.71-7.7) compared to those without depression. Severity of depression was significantly associated with increased odds for opioid misuse for moderate (AOR = 3.71; 95% CI = 1.01-13.76), moderate-severe (AOR = 6.28; 95% CI = 1.6-24.57) and severe (AOR = 14.66; 95% CI = 3.28-65.52) depression but not among those who screened positive for mild depression (AOR = 1.49; 95% CI = 0.39-5.68). LIMITATIONS Cross-sectional study. CONCLUSIONS Our results highlight the need to properly asses and address level of severity of co-morbid depression among chronic pain patients receiving POs.
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Affiliation(s)
- Daniel Feingold
- Ariel University, Ariel, Israel; Dual Diagnosis Clinic, Lev-Hasharon Medical Center, Pardesiya, Israel.
| | - Silviu Brill
- Pain Center, Sourasky Medical Center, Tel Aviv, Israel
| | | | - Yael Delayahu
- Department of Dual Diagnosis, Abarbanel Mental Health Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shaul Lev-Ran
- Dual Diagnosis Clinic, Lev-Hasharon Medical Center, Pardesiya, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Mills SD, Azizoddin D, Gholizadeh S, Racaza GZ, Nicassio PM. The mediational role of helplessness in psychological outcomes in systemic lupus erythematosus. Lupus 2018; 27:1185-1189. [PMID: 29320976 DOI: 10.1177/0961203317751046] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can result in disability and psychological distress. Although pain has been associated with depressive symptomatology and stress in SLE, a paucity of theoretical models have been used to explain the relationship between pain and psychological distress in this population. Thus, the present study examined helplessness as a mediator of the relationship between pain and psychological distress among patients with SLE. Methods Multiple mediation analysis was used to examine the hypothesis that learned helplessness mediates the relationship between pain and symptoms of anxiety, depression, and stress in a sample of patients with SLE ( N = 136) receiving medical care at Cedars Sinai Medical Center. Results The mean score on the Helplessness subscale was 14.5 ( SD = 5.4). Helplessness fully mediated the relationship between pain vitality and symptoms of anxiety (BCa 95% CI (-0.073, -0.015)), depression (BCa 95% CI (-0.502, -0.212)), and stress (BCa 95% CI (-0.063, -0.027)). Conclusion Participants reported a high level of perceived inability to control one's disease. Helplessness fully mediated the relationship between pain and measures of anxiety, depression, and perceived stress among patients with SLE.
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Affiliation(s)
- S D Mills
- 1 464916 San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology , San Diego, CA, USA
| | - D Azizoddin
- 2 Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, CA, USA
| | - S Gholizadeh
- 1 464916 San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology , San Diego, CA, USA
| | - G Z Racaza
- 3 University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - P M Nicassio
- 4 Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, Los Angeles, CA, USA
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Association between pain and frailty among Chinese community-dwelling older adults: depression as a mediator and its interaction with pain. Pain 2017; 159:306-313. [DOI: 10.1097/j.pain.0000000000001105] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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McBain H, Mulligan K, Newman SP. Nonpharmacologic pain management. Rheumatology (Oxford) 2015. [DOI: 10.1016/b978-0-323-09138-1.00050-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Commonalities in grief responding across bereavement and non-bereavement losses. J Affect Disord 2014; 161:136-43. [PMID: 24751321 DOI: 10.1016/j.jad.2014.03.018] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Accepted: 03/07/2014] [Indexed: 11/20/2022]
Abstract
BACKGROUND Despite implications for theory and treatment, commonality in responding to non-bereavement and bereavement losses are not well explicated. METHOD This study identified the factor structure of the three most common responses to bereavement, prolonged grief, posttraumatic stress, and major depression in a bereaved community sample (n=151, 59% female, 68% white) from the U.S. recruited from Amazon's MTurk using a cross-sectional survey design, then cross-validated the structure in samples where people had lost other potentially self-defining roles; one's employment (n=157, 47% female, 69% white) and one's marriage (n=116, 62% female, 80% white). RESULTS Results indicated that symptoms of prolonged grief, posttraumatic stress, and major depression were distinct factors in the bereaved sample, the three-factor solution was a good fit for the job-loss and divorce samples, and levels of grief in each sample appeared to be best predicted by time since loss and centrality of the loss to one's identity. LIMITATIONS Limitations include potential sample bias due to convenience sampling, and the cross-sectional design did not allow examination of the stability of factors over time. CONCLUSIONS These results suggest that grief is not a unique response to loss of loved one but instead may be a common phenomenology across types of loss. This implies that facilitating meaningful engagement in self-defining activities that compensate for the disrupting loss might be efficacious in promoting grief resolution without the need for working through individuals' emotional attachment to a specific individual or processing one's emotional responses to the loss.
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Fahland R, Kohlmann T, Hasenbring M, Feng YS, Schmidt C. Welcher Weg führt von chronischen Rückenschmerzen zur Depressivität? Schmerz 2012; 26:685-91. [DOI: 10.1007/s00482-012-1233-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Will it hurt less if I believe I can control it? Influence of actual and perceived control on perceived pain intensity in healthy male individuals: a randomized controlled study. J Behav Med 2011; 35:529-37. [PMID: 21972179 DOI: 10.1007/s10865-011-9382-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2011] [Accepted: 09/20/2011] [Indexed: 10/17/2022]
Abstract
We explored the effects of uncontrollability and subjective helplessness (SHL) on perceived pain intensity (PPI) in 64 healthy men randomly assigned to groups receiving controllable (C) or uncontrollable (UC) painful electric skin stimuli. SHL (d = 1.43), perceived unpleasantness (d = 1.03), and PPI (d = 0.58) were more pronounced in the UC group than in the C group. Multiple regression and bootstrap analyses for testing mediation showed a direct relationship between stressor uncontrollability and PPI (r = 0.28; P < .05), which disappeared when adjusted for the SHL increase (β = 0.49, P < .001). SHL changes were associated with objective uncontrollability (r = 0.59, P < .001). PPI and unpleasantness were positively correlated (r = 0.37, P < .01). The study suggests that the effect of objective controllability on pain intensity ratings is mediated mainly by ratings of SHL.
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Müller MJ. Helplessness and perceived pain intensity: relations to cortisol concentrations after electrocutaneous stimulation in healthy young men. Biopsychosoc Med 2011; 5:8. [PMID: 21718526 PMCID: PMC3141369 DOI: 10.1186/1751-0759-5-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2011] [Accepted: 06/30/2011] [Indexed: 01/24/2023] Open
Abstract
Background Uncontrollable aversive events are associated with feelings of helplessness and cortisol elevation and are suitable as a model of depression. The high comorbidity of depression and pain symptoms and the importance of controllability in both conditions are clinically well-known but empirical studies are scarce. The study investigated the relationship of pain experience, helplessness, and cortisol secretion after controllable vs. uncontrollable electric skin stimulation in healthy male individuals. Methods Sixty-four male volunteers were randomly assigned to receive 30 controllable (self-administered) or uncontrollable (experimenter-administered) painful electric skin stimuli. Perceived pain intensity (PPI), subjective helplessness ratings, and salivary cortisol concentrations were assessed. PPI was assessed after stress exposure. For salivary cortisol concentrations and subjective helplessness ratings, areas under the response curve (AUC) were calculated. Results After uncontrollable vs. controllable stress exposure significantly higher PPI ratings (P = 0.023), higher subjective helplessness AUC (P < 0.0005) and higher salivary cortisol AUC (P = 0.004, t-tests) were found. Correlation analyses revealed a significant correlation between subjective helplessness AUC and PPI (r = 0.500, P < 0.0005), subjective helplessness AUC and salivary cortisol AUC (r = 0.304, P = 0.015) and between PPI and salivary cortisol AUC (r = 0.298, P = 0.017). Conclusions The results confirm the impact of uncontrollability on stress responses in humans; the relationship of PPI with subjective helplessness and salivary cortisol suggests a cognitive-affective sensitization of pain perception, particularly under uncontrollable conditions.
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Affiliation(s)
- Matthias J Müller
- Vitos Clinical Centre Giessen-Marburg Clinic for Psychiatry, Psychosomatic Medicine and Psychotherapy Giessen Academic Hospital, University of Giessen, Licher Straße 106, 35394 Giessen, Germany.
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Miró E, Martínez MP, Sánchez AI, Prados G, Medina A. When is pain related to emotional distress and daily functioning in fibromyalgia syndrome? The mediating roles of self-efficacy and sleep quality. Br J Health Psychol 2011; 16:799-814. [DOI: 10.1111/j.2044-8287.2011.02016.x] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Non-pharmacologic pain management. Rheumatology (Oxford) 2011. [DOI: 10.1016/b978-0-323-06551-1.00048-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Mehta S, MacDermid J, Tremblay M. The implications of chronic pain models for rehabilitation of distal radius fracture. HAND THERAPY 2010. [DOI: 10.1258/ht.2010.010022] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Distal radius fracture (DRF) is the most common fracture and usually occurs as a result of a fall. Most patients recover following DRF with minimal residual pain or disability; however, a small subset of patients continue to experience pain and disability even one year after the injury. Currently, there are no practice guidelines for early identification and treatment of patients who are potentially at greater risk of developing these adverse outcomes. As a result, hand therapy management of patients following DRF does not incorporate screening of these at-risk patients. The objective of this paper is to apply constructs from learned helplessness and cognitive-behavioural models of chronic pain in assessing the psychosocial risk profile of patients following DRF. We have also integrated key findings derived from studies addressing personal and life-style factors in assessing this risk profile. This framework is proposed as a basis to categorize patients as higher or lower psychosocial risk for developing chronic pain and disability following DRF. We outline a model depicting the RACE approach (Reducing pain, Activating, Cognitive reshaping, Empowering) towards the management of patients following DRF. The model suggests that patients with minimal psychosocial risk factors are managed based on their injury profile and those with higher psychosocial risk are treated with the risk-based RACE approach. Using a biopsychosocial RACE approach to prognosis and treatment, hand therapy intervention can be customized for patients recovering from DRF. In future, researchers can conduct clinical trials to compare the RACE-based treatment approach to routine hand therapy in mitigating the risk of chronic pain and disability in patients with elevated risk profile for adverse outcomes following DRF.
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Affiliation(s)
- Saurabh Mehta
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Joy MacDermid
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
- Hand and Upper Limb Centre Clinical Research Laboratory, St Joseph's Health Centre, London, Ontario, Canada
| | - Mary Tremblay
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
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van Koulil S, van Lankveld W, Kraaimaat FW, van Riel PLCM, Evers AWM. Risk factors for longer term psychological distress in well-functioning fibromyalgia patients: a prospective study into prognostic factors. PATIENT EDUCATION AND COUNSELING 2010; 80:126-129. [PMID: 19744816 DOI: 10.1016/j.pec.2009.08.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2008] [Revised: 08/04/2009] [Accepted: 08/06/2009] [Indexed: 05/28/2023]
Abstract
OBJECTIVE Psychological distress is a key risk factor for long-term complaints in fibromyalgia (FM). Prognostic factors for psychological distress might facilitate an early identification of patients at risk to help prevent long-term dysfunction, especially for the relatively well-functioning patients showing little distress who are usually not considered for treatment. This study hence examines potential prognostic factors in this subgroup. METHODS Psychological distress, physical functioning, illness cognitions (helplessness, acceptance), pain-avoidance factors (passive pain-coping, fear of pain, hypervigilance), and social factors (social support, social reinforcement) was assessed in 78 low-distress FM patients at baseline and after a mean of 9 months (SD=3.3). RESULTS Baseline physical functioning did not predict changes in psychological distress, whereas a higher level of hypervigilance, less acceptance, and less perceived social support predicted an increase in psychological distress at follow-up. CONCLUSION Illness cognitions, pain-avoidance factors, and social support can be considered as prognostic factors predicting changes in psychological distress in FM. More research is needed to investigate additional factors that could also be implicated (e.g. personality factors, stressful events). PRACTICE IMPLICATIONS Timely assessment of illness cognitions, pain-avoidance factors, and social support may help identify subgroups of relatively well-functioning FM patients at risk of longer term aggravated psychological distress.
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Affiliation(s)
- Saskia van Koulil
- Radboud University Nijmegen Medical Center, Department of Medical Psychology, Nijmegen, The Netherlands.
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Chan R, Brooks R, Gallagher M, Erlich J, Snelling P, Chow J, Suranyi M. Measuring kidney disease-related loss in samples of predialysis and dialysis patients: validating the kidney disease loss scale. Clin J Am Soc Nephrol 2010; 5:1249-54. [PMID: 20498243 DOI: 10.2215/cjn.08361109] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Kidney disease-related loss is clinically significant in patients with ESRD and is related to depression and quality of life. The Kidney Disease Loss Scale (KDLS) was recently developed for long-term dialysis patients as a means of studying loss and applying it to clinical practice; however, its validity and usability in the other developmental stages of ESRD-predialysis and early dialysis-remain unknown. This study examined the validity and reliability of the KDLS in the long-term dialysis, early dialysis, and predialysis populations. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Four groups of participants were recruited from four large university teaching hospitals in the Sydney metropolitan area. Participants were long-term dialysis (n=151), early dialysis (n=163), and predialysis (n=111) patients. An additional independent group of dialysis (n=50) patients were recruited to measure the test-retest reliability. Multisample confirmatory factor analysis and correlational analysis were used. RESULTS Results demonstrated good internal consistency and test-retest reliability for KDLS. Multisample confirmatory factor analysis indicated that the factor structure of KDLS was invariant across samples and thus supported its construct validity. The convergent and discriminant validities of KDLS were supported by its correlations with scales that measure health-related quality of life, depression, and positive affect in the expected directions and magnitudes. The KDLS was sensitive to the developmental stages of ESRD. CONCLUSIONS These findings demonstrated that the concept of loss exists in dialysis patients. The KDLS is a reliable measure of loss in ESRD and valid in the developmental stages of ESRD.
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Affiliation(s)
- Ramony Chan
- Consultation Liaison Psychiatry, Renal Unit, Centre for Population mental Health Research, Liverpool Hospital, Locked Bag 7103, Liverpool BC, NSW 1871, Australia.
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Abstract
OBJECTIVES The goal of this study was to identify factors associated with decreased disability and lower pain scores 6 months after a multimodal treatment program for fibromyalgia (FM). METHODS Forty-six patients with FM were assessed after having participated in a 3-month outpatient program integrating physiotherapy, occupational therapy, nursing, and cognitive-behavior therapy. A physician examined the patients before treatment and patients who completed a battery of psychosocial questionnaires at baseline, during treatment, at the end of treatment, and 3 and 6 months after the end of treatment. Two separate multivariable linear regression models were built to identify predictors of improvements in disability and pain. RESULTS Two predictors for improvement in disability were found: an increase in self-efficacy for pain during treatment and better general adherence during treatment. Similarly, one predictor for improvement in pain intensity was found: an increase in self-efficacy for pain during treatment. DISCUSSION Self-efficacy and adherence are 2 modifiable factors that influence disability and pain intensity in FM. These psychosocial factors need to be addressed in FM treatment programs to assist patients in maintaining posttreatment improvements.
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Govender C, Cassimjee N, Schoeman J, Meyer H. Psychological characteristics of FMS patients. Scand J Caring Sci 2009; 23:76-83. [DOI: 10.1111/j.1471-6712.2007.00592.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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The Deficit of Pain Inhibition in Fibromyalgia Is More Pronounced in Patients With Comorbid Depressive Symptoms. Clin J Pain 2009; 25:123-7. [DOI: 10.1097/ajp.0b013e318183cfa4] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Hassett AL, Simonelli LE, Radvanski DC, Buyske S, Savage SV, Sigal LH. The relationship between affect balance style and clinical outcomes in fibromyalgia. ACTA ACUST UNITED AC 2008; 59:833-40. [PMID: 18512724 DOI: 10.1002/art.23708] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Affective balance, relative levels of negative affect (NA) and positive affect (PA), better describes emotional functioning than NA or PA alone. Affect balance styles and their relationship to clinical outcomes were compared between patients with fibromyalgia (FM) and controls. METHODS FM patients (n = 79) were compared with patients with other medical conditions (controls; n = 92). Patients underwent a physical examination, completed questionnaires, and were screened for clinical disorders such as depression, with diagnoses confirmed by structured interview. Affect balance style categories were calculated as follows: healthy (high PA/low NA), low (low PA/low NA), reactive (high PA/high NA), and depressive (low PA/high NA). RESULTS Compared with controls, FM patients had lower levels of PA (P = 0.0031; P values are adjusted for multiple testing), higher levels of NA (P = 0.0061), lower levels of functioning (P < 0.0001), and more clinical disorders (P = 0.0031). Groups differed regarding affect balance style (P = 0.0061), with FM patients being more likely than controls to be categorized as depressive (odds ratio 5.60) and reactive (odds ratio 3.81). FM patients and controls with reactive and depressive affect balance styles reported poorer functioning (P < 0.0001) compared with patients with healthy affect balance style. Finally, there was an association between affect balance style and psychiatric comorbidity (P < 0.0001), with patients with depressive and reactive affect balance styles having a 9.00 and 4.75 odds ratio, respectively, of having psychiatric comorbidity compared with patients with healthy affect balance style. CONCLUSION Depressive (low PA, high NA) and reactive (high PA, high NA) affect balance styles were predominant in FM patients and related to poor functioning and psychiatric comorbidity.
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Affiliation(s)
- Afton L Hassett
- Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, Division of Rheumatology and Connective Tissue Research, New Brunswick, NJ 80903-0019, USA.
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Abstract
There are mounting data supporting comorbidity of fibromyalgia syndrome (FMS) and psychiatric conditions. These include depression, panic disorders, anxiety, and post-traumatic stress disorder (PTSD). The nature of the relationship between depression and FMS is not fully understood, and it was hypothesized that chronic pain causes depression, or vice versa, and that chronic pain syndromes are variants of depression. A link between PTSD symptoms and FMS has been reported, and both conditions share similar symptomatology and pathogenetic mechanisms. Assessment of comorbid psychiatric disorders in FMS patients has clinical implications because treatment in these patients should focus both on physical and emotional dimensions of dysfunction.
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Affiliation(s)
- Dan Buskila
- Department of Medicine H, Soroka Medical Center, POB 151, Beer Sheva 84101, Israel.
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