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Glette M, Stiles TC, Woodhouse A, Nilsen TIL, Landmark T. Chronic fatigue in the general population: Prevalence, natural course and associations with chronic pain (the HUNT pain study). Eur J Pain 2024. [PMID: 38940382 DOI: 10.1002/ejp.2307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 06/10/2024] [Accepted: 06/12/2024] [Indexed: 06/29/2024]
Abstract
BACKGROUND Fatigue and pain are both prevalent and frequently co-occur. No standard measure of fatigue exists, but most definitions include a continuum between high levels of energy and fatigue. There is limited knowledge about the course of fatigue in the general population and its association with functioning and other health outcomes. Our main aim was to identify trajectories of energy and fatigue in the general population and to investigate whether chronic pain is related to a negative prognosis of chronic fatigue. METHODS Longitudinal latent class analysis was performed to classify 4771 individuals into trajectory groups based on five quarterly repeated measures. RESULTS A five-cluster solution was identified: 'much energy' (n = 1471, [31%]), 'varying energy' (n = 1445, [30%]), 'some energy' (n = 921, [19%]), 'low energy' [chronic moderate fatigue] (n = 852, [18%]) and 'no energy' [chronic severe fatigue] (n = 82, [2%]). Individuals with chronic moderate fatigue who reported chronic pain had reduced probability of improvement over the following 3 years (OR = 0.67, 95% CI [0.52, 0.88]). CONCLUSIONS Chronic fatigue is highly prevalent in the general population and a small proportion have chronic severe fatigue. When chronic pain co-occurs with chronic fatigue, improvement of chronic fatigue is less likely, indicating that these symptoms may perpetuate each other. SIGNIFICANCE STATEMENT Understanding the close relationship between chronic pain and chronic fatigue is important as they both contribute to suffering and loss of functioning, may be related to the same underlying diseases, or in the absence of disease, may share common mechanisms. This study highlights the important role of chronic pain in relation to chronic fatigue, both by showing a strong association between the prevalence of the two conditions, and by showing that chronic pain is associated with a negative prognosis of chronic fatigue.
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Affiliation(s)
- Mari Glette
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Anesthesiology and Intensive Care Medicine, St. Olav's University Hospital, Trondheim, Norway
| | - Tore Charles Stiles
- Department of Psychology, Faculty of Social and Educational Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Astrid Woodhouse
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Anesthesiology and Intensive Care Medicine, St. Olav's University Hospital, Trondheim, Norway
| | - Tom Ivar Lund Nilsen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Tormod Landmark
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Anesthesiology and Intensive Care Medicine, St. Olav's University Hospital, Trondheim, Norway
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González-Devesa D, Varela S, Sanchez-Lastra MA, Ayán C. Nordic Walking as a Non-Pharmacological Intervention for Chronic Pain and Fatigue: Systematic Review. Healthcare (Basel) 2024; 12:1167. [PMID: 38921282 PMCID: PMC11203355 DOI: 10.3390/healthcare12121167] [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: 04/30/2024] [Revised: 05/31/2024] [Accepted: 06/05/2024] [Indexed: 06/27/2024] Open
Abstract
OBJECTIVE We aimed to analyze and summarize the available scientific evidence on the benefits of Nordic walking for people with chronic pain and fatigue. LITERATURE SURVEY This systematic review adhered to PRISMA guidelines and conducted a comprehensive search across five databases using the PICO strategy. METHODOLOGY Inclusion criteria encompassed randomized trials evaluating Nordic walking for pain and fatigue. Two authors independently screened studies, extracted data, and assessed methodological quality using the PEDro scale. SYNTHESIS A total of 14 studies were included, with sample sizes ranging from 20 to 136 participants. The methodological quality of the included studies varied from fair (five studies) to good (nine studies). The interventions consisted of supervised Nordic walking sessions lasting 6 to 24 weeks, with a frequency of 2 to 4 days per week and duration of 25 to 75 min. The results of this review suggest that Nordic walking had beneficial effects in six of the eight studies that analyzed participant fatigue. However, Nordic walking did not show greater beneficial effects on fatigue than walking (two studies) or than not performing physical activity (one study). Additionally, six of the nine studies that examined the effects of Nordic walking on participants' perceptions of pain showed beneficial results. However, five studies that compared Nordic walking with control groups did not find any significant inter-group differences on pain. CONCLUSIONS Based on our findings, Nordic walking exercise programs provide a potentially efficient method for alleviating pain and fatigue in people with chronic conditions. Its straightforwardness and ease of learning make it accessible to a broad spectrum of participants, which can result in higher adherence rates and lasting positive effects.
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Affiliation(s)
- Daniel González-Devesa
- Well-Move Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36310 Vigo, Spain; (D.G.-D.); (M.A.S.-L.); (C.A.)
| | - Silvia Varela
- Well-Move Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36310 Vigo, Spain; (D.G.-D.); (M.A.S.-L.); (C.A.)
- Department of Special Didactics, University of Vigo, 36005 Pontevedra, Spain
| | - Miguel Adriano Sanchez-Lastra
- Well-Move Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36310 Vigo, Spain; (D.G.-D.); (M.A.S.-L.); (C.A.)
- Department of Special Didactics, University of Vigo, 36005 Pontevedra, Spain
| | - Carlos Ayán
- Well-Move Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36310 Vigo, Spain; (D.G.-D.); (M.A.S.-L.); (C.A.)
- Department of Special Didactics, University of Vigo, 36005 Pontevedra, Spain
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Ali SMA, Sherman-Morris K, Meng Q, Ambinakudige S. Longitudinal disparities in social determinants of health and COVID-19 incidence and mortality in the United States from the three largest waves of the pandemic. Spat Spatiotemporal Epidemiol 2023; 46:100604. [PMID: 37500229 DOI: 10.1016/j.sste.2023.100604] [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: 08/08/2022] [Revised: 06/01/2023] [Accepted: 07/14/2023] [Indexed: 07/29/2023]
Abstract
The United States experienced at least five COVID-19 waves linked with different mutated SARS-CoV-2 variants including Alpha, Delta and Omicron. In addition to the variants, the intensity, geographical distribution, and risk factors related to those waves also vary within socio-demographic characteristics and timeframes. In this project, we have examined the spatial and temporal pattern of COVID-19 in the USA and its associations with Social Determinants of Health (SDoH) by utilizing the County Health Rankings & Roadmaps (CHRR) dataset. Our epidemiologic investigation at the county level showed that the burden of COVID-19 cases and deaths is higher in counties with high percentages of smoking, number of preventable hospital stays, primary care physician rate, the average daily density of PM2.5 and percentages of high proportions of Hispanic residents. In addition, the analysis also demonstrated that COVID-19 incidence and mortality had distinct characteristics in their association with SDoH variables. For example, the percentages of the population 65 and older had negative associations with incidence while a significant positive association with mortality. In addition to the elderly population, median household income, unemployment, and number of drug overdose deaths showed a mixed association with COVID-19 incidence and mortality. Our findings validate several influential factors found in the existing social epidemiology literature and highlight temporal associations between SDoH variables and COVID-19 incidence and mortality not yet frequently studied.
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Affiliation(s)
- S M Asger Ali
- Polis Center, Indiana University Purdue University Indianapolis (IUPUI), Indianapolis, USA.
| | | | - Qingmin Meng
- Department of Geosciences, Mississippi State University, Starkville, USA.
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Løke D, Løvstad M, Andelic N, Andersson S, Ystrom E, Vassend O. The role of pain and psychological distress in fatigue: a co-twin and within-person analysis of confounding and causal relations. Health Psychol Behav Med 2022; 10:160-179. [PMID: 35173998 PMCID: PMC8843118 DOI: 10.1080/21642850.2022.2033121] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Daniel Løke
- Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen-Bjornemyr, Norway
| | - Marianne Løvstad
- Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen-Bjornemyr, Norway
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | - Nada Andelic
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Center for Habilitation and Rehabilitation Models and Services (CHARM), University of Oslo, Oslo, Norway
| | - Stein Andersson
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
- Psychosomatic and CL Psychiatry, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Eivind Ystrom
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Olav Vassend
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
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Bilgin A, Kesik G, Özdemir L. Biopsychosocial Factors Predicting Pain Among Individuals Experiencing the Novel Coronavirus Disease (COVID-19). Pain Manag Nurs 2022; 23:79-86. [PMID: 34893431 PMCID: PMC8595472 DOI: 10.1016/j.pmn.2021.11.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 09/27/2021] [Accepted: 11/08/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Pain is one of the most common symptoms of novel coronavirus disease (COVID-19). Being both a physical and a psychological experience, pain is affected by many factors, including biological, psychological, and social rather than a single variable. AIMS To determine the effects of biological, psychological, and social factors on pain level among participants experiencing with the COVID-19. DESIGN A web-based, retrospective, and descriptive study SETTING: Social media sources such as Facebook, WhatsApp, Instagram, and E-mail PARTICIPANTS: One hundred forty-nine participants were included. METHODS Data were collected based on the biopsychosocial model. Pain level was evaluated using the visual analog scale (VAS). The data were analyzed using descriptive, correlational statistics, and structural equation modeling. RESULTS The mean age of participants was 32.87 (SD = 11.32) years. The VAS scores were associated with gender (Z = -2.103, p = .035), and chronic disease status (Z = 3.001, p = .003), and the Chalder Fatigue Scale total score (β = 0.718, p < .001) associated with biological factors. The Coronavirus Anxiety Scale scores among psychological factors showed a direct impact on the VAS scores (β = 0.583, p < .001). The Patterns of Activity Measure-Pain total score examined within social factors directly affected the VAS score. The VAS score did not correlate with age, smoking status, hospitalization status, respiratory support, marital status, education level, employment, and income status. CONCLUSIONS The pain level in COVID-19 participants was determined by biological, psychological, and social factors. Females and participants with chronic illness, anxiety, fatigue, and low physical activity were found to experience high levels of pain. Education and counseling programs for pain management should be comprehensively structured and include anxiety reduction programs, and fatigue management.
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Affiliation(s)
- Aylin Bilgin
- Hacettepe University, Faculty of Nursing, Internal Medicine Nursing Department, Ankara, Turkey.
| | - Gulsah Kesik
- Hacettepe University, Faculty of Nursing, Internal Medicine Nursing Department, Ankara, Turkey
| | - Leyla Özdemir
- Hacettepe University, Faculty of Nursing, Internal Medicine Nursing Department, Ankara, Turkey
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Dehhaghi M, Panahi HKS, Kavyani B, Heng B, Tan V, Braidy N, Guillemin GJ. The Role of Kynurenine Pathway and NAD + Metabolism in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Aging Dis 2022; 13:698-711. [PMID: 35656104 PMCID: PMC9116917 DOI: 10.14336/ad.2021.0824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 08/24/2021] [Indexed: 11/18/2022] Open
Abstract
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a serious, complex, and highly debilitating long-term illness. People with ME/CFS are typically unable to carry out their routine activities. Key hallmarks of the disease are neurological and gastrointestinal impairments accompanied by pervasive malaise that is exacerbated after physical and/or mental activity. Currently, there is no validated cure of biomarker signature for this illness. Impaired tryptophan (TRYP) metabolism is thought to play significant role in the pathobiology of ME/CFS. TRYP is an important precursor for serotonin and the essential pyridine nucleotide nicotinamide adenine dinucleotide (NAD+). TRYP has been associated with the development of some parts of the brain responsible for behavioural functions. The main catabolic route for TRYP is the kynurenine pathway (KP). The KP produces NAD+ and several neuroactive metabolites with neuroprotective (i.e., kynurenic acid (KYNA)) and neurotoxic (i.e., quinolinic acid (QUIN)) activities. Hyperactivation of the KP, whether compensatory or a driving mechanism of degeneration can limit the availability of NAD+ and exacerbate the symptoms of ME/CFS. This review discusses the potential association of altered KP metabolism in ME/CFS. The review also evaluates the role of the patient’s gut microbiota on TRYP availability and KP activation. We propose that strategies aimed at raising the levels of NAD+ (e.g., using nicotinamide mononucleotide and nicotinamide riboside) may be a promising intervention to overcome symptoms of fatigue and to improve the quality of life in patients with ME/CFS. Future clinical trials should further assess the potential benefits of NAD+ supplements for reducing some of the clinical features of ME/CFS.
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Affiliation(s)
- Mona Dehhaghi
- Neuroinflammation Group, Faculty of Medicine and Health Sciences, Macquarie University, NSW, Australia.
- PANDIS.org, Australia.
| | | | - Bahar Kavyani
- Neuroinflammation Group, Faculty of Medicine and Health Sciences, Macquarie University, NSW, Australia.
| | - Benjamin Heng
- Neuroinflammation Group, Faculty of Medicine and Health Sciences, Macquarie University, NSW, Australia.
- PANDIS.org, Australia.
| | - Vanessa Tan
- Neuroinflammation Group, Faculty of Medicine and Health Sciences, Macquarie University, NSW, Australia.
- PANDIS.org, Australia.
| | - Nady Braidy
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia.
| | - Gilles J. Guillemin
- Neuroinflammation Group, Faculty of Medicine and Health Sciences, Macquarie University, NSW, Australia.
- PANDIS.org, Australia.
- Correspondence should be addressed to: Dr. Gilles J. Guillemin, Neuroinflammation Group, Faculty of Medicine and Health Sciences, Macquarie University, NSW, Australia. .
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7
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Segerstrom SC, Monroe AD, Crofford LJ. Pain, Goal Engagement, and Eudaemonic Well-Being: Moderation by Autonomous Motivation. J Gerontol B Psychol Sci Soc Sci 2021; 77:493-498. [PMID: 34129029 DOI: 10.1093/geronb/gbab105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Pain may decrease well-being in older adults by limiting social and leisure activities. However, some activities can exacerbate pain. We hypothesized that autonomously motivated goal engagement could ameliorate negative effects of pain on goal engagement and amplify positive effects of goal engagement on eudaemonic well-being (EWB). METHOD Midlife and older women (N=200) were oversampled for chronic pain. Daily diaries (n=10,697) including goal lists and ratings, pain, and EWB were completed for 7 days every 3 months for 2 years. RESULTS Pain was not a correlate of goal engagement. More engagement was associated with higher EWB when motivation was autonomous. However, more goal engagement correlated with lower EWB the next day and, when not autonomously motivated, higher pain. DISCUSSION Goal engagement can benefit people with or without physical pain, but the motivation behind goal engagement is equally if not more important. Goals motivated by autonomous sources increase EWB and may protect against maladaptive patterns of activity associated with pain.
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Affiliation(s)
| | | | - Leslie J Crofford
- Department of Internal Medicine, Vanderbilt University School of Medicine
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8
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Glette M, Stiles TC, Jensen MP, Nilsen TIL, Borchgrevink PC, Landmark T. Impact of pain and catastrophizing on the long-term course of depression in the general population: the HUNT pain study. Pain 2021; 162:1650-1658. [PMID: 33416223 DOI: 10.1097/j.pain.0000000000002168] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 12/07/2020] [Indexed: 12/30/2022]
Abstract
ABSTRACT Pain and depression are episodic conditions that might take a chronic course. They are clearly related, but information on how they influence each other in the process of chronification is limited. Pain catastrophizing is hypothesized to play a role in the development of depression and chronic pain, but few longitudinal studies have investigated their association over a longer term. In this study, a random cohort from the general population (n = 4764) answered questions about pain, catastrophizing, and depression at 5 assessments in yearly intervals. Linear mixed models showed that within persons, increases in pain intensity and catastrophizing were independently associated with increases in depressive symptoms {mean change = -1.12, 95% confidence interval (CI) [-1.32 to -0.91] and -1.29, 95% CI [-1.52 to -1.05], respectively}. In prospective analyses restricted to individuals without depression above cutoff at baseline, chronic pain increased the risk of endorsing depression over the following 4 years (odds ratio = 2.01, 95% CI [1.71-2.37]). Seven percent showed a chronic course of depression, as indicated by scores above cutoff on at least 3 of 5 assessments. The number of years lived with chronic pain was associated with a chronic course of depression, with odds ratios increasing from 1.55 (95% CI [0.87-2.91]) to 14.19 (95% CI [8.99-22.41]) when reporting chronic pain on 2 vs 5 assessments compared with none. The results suggest that when pain intensity or catastrophizing change, depressive symptoms change in the same direction. When pain and catastrophizing become chronic, they seem to be mutually reinforcing determinants for chronic depression.
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Affiliation(s)
- Mari Glette
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- National Competence Centre for Complex Symptom Disorders, Clinic of Anesthesia and Intensive Care, St. Olav's University Hospital, Trondheim, Norway
| | - Tore C Stiles
- National Competence Centre for Complex Symptom Disorders, Clinic of Anesthesia and Intensive Care, St. Olav's University Hospital, Trondheim, Norway
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Mark P Jensen
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA, United States
| | - Tom Ivar Lund Nilsen
- National Competence Centre for Complex Symptom Disorders, Clinic of Anesthesia and Intensive Care, St. Olav's University Hospital, Trondheim, Norway
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Petter C Borchgrevink
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- National Competence Centre for Complex Symptom Disorders, Clinic of Anesthesia and Intensive Care, St. Olav's University Hospital, Trondheim, Norway
| | - Tormod Landmark
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- National Competence Centre for Complex Symptom Disorders, Clinic of Anesthesia and Intensive Care, St. Olav's University Hospital, Trondheim, Norway
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Anxiety and depression in diabetes care: longitudinal associations with health-related quality of life. Sci Rep 2020; 10:8307. [PMID: 32433470 PMCID: PMC7239869 DOI: 10.1038/s41598-020-57647-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Accepted: 12/09/2019] [Indexed: 12/13/2022] Open
Abstract
Anxiety and depression are commonly found in patients with diabetes, but little is known about how the anxiety and depression symptoms of diabetes patients and the health-related quality of life (HRQoL) over time influence each other. Therefore, we conducted a survey among patients with diabetes (T1) and repeated the survey after 3 months (T2). Linear regression models and cross-lagged structural equation models were used to analyze the associations between anxiety and depression symptoms and HRQoL within and across time intervals. Correcting for baseline index and potential confounders, the HRQoL index at T2 reflected the change in anxiety/depression between T1 and T2 more than anxiety/depression at T1 (P < 0.05). Similarly, anxiety and depression at T2 reflected the change in the EQ-5D index over time more than the index at baseline (P < 0.05). Our longitudinal data fitted well in a cross-lagged model with bi-directional pathways of associations between anxiety and HRQoL, as well as depression and HRQoL, among adult patients with diabetes (x2/df = 1.102, P = 0.256; CFI = 1.000, RMSEA = 0.030). Our findings support early detection of anxiety and depression, as well as comprehensive efforts improving HRQoL for patients with diabetes.
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Miaskowski C, Blyth F, Nicosia F, Haan M, Keefe F, Smith A, Ritchie C. A Biopsychosocial Model of Chronic Pain for Older Adults. PAIN MEDICINE 2019; 21:1793-1805. [DOI: 10.1093/pm/pnz329] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Abstract
Population
Comprehensive evaluation of chronic pain in older adults is multifaceted.
Objective and Methods
Research on chronic pain in older adults needs to be guided by sound conceptual models. The purpose of this paper is to describe an adaptation of the Biopsychosocial Model (BPS) of Chronic Pain for older adults. The extant literature was reviewed, and selected research findings that provide the empiric foundation for this adaptation of the BPS model of chronic pain are summarized. The paper concludes with a discussion of specific recommendations for how this adapted model can be used to guide future research.
Conclusions
This adaptation of the BPS model of chronic pain for older adults provides a comprehensive framework to guide future research in this vulnerable population.
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Affiliation(s)
| | - Fiona Blyth
- School of Medicine, The University of Sydney, Sydney, Australia
| | - Francesca Nicosia
- School of Medicine, University of California, San Francisco, California
| | - Mary Haan
- School of Medicine, University of California, San Francisco, California
| | - Frances Keefe
- School of Medicine, Duke University, Durham, North Carolina, USA
| | - Alexander Smith
- School of Medicine, University of California, San Francisco, California
| | - Christine Ritchie
- School of Medicine, University of California, San Francisco, California
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Impacts of Fatigue, Stress, and Perceived Health Status on Women With Rheumatic Diseases: A Comparison Study. J Nurs Res 2019; 28:e89. [PMID: 31688342 DOI: 10.1097/jnr.0000000000000354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Rheumatic conditions, which increase in prevalence as populations age, are a growing public health problem that disproportionately affects women. Understanding the influences of rheumatic diseases (RDs) on fatigue, stress, and perceived health status is deemed important to the improvement of physical and mental health for women with RDs. PURPOSE This study was designed to compare the fatigue, stress, and perceived physical and mental health status of women with RDs (RD group) with those of peers who did not have chronic illnesses (comparison group). METHODS A cross-sectional, purposive sample and comparative design was used. Four hundred forty-three women with a mean age of 46.2 years participated in this study. Those with physician-diagnosed RDs (n = 212) were enrolled in the RD group, and those without chronic disease were enrolled in the comparison group (n = 231). Measures used included a demographic datasheet, Fatigue Severity Scale, Perceived Stress Scale, and Short Form-12 Items Health Survey. Analysis of covariance was used to examine the intergroup differences for major variables based on demographic covariates. RESULTS The RD group reported significantly more fatigue and stress than the comparison group. Moreover, the RD group reported significantly poorer perceived physical health status, significantly poorer physical functioning and general health, and greater bodily pain compared with the comparison group. Conversely, the RD group reported significantly better perceived mental health status, significantly lower vitality, and better role emotional status than the comparison group. CONCLUSIONS/IMPLICATIONS FOR PRACTICE The findings support the theory that RDs have a negative impact on perceived stress and fatigue in women. Physical function, bodily pain, and general health may be the most significantly affected domains of perceived physical health in women with RDs. Of note, with the exception of the vitality subscale, RDs did not adversely affect the perceived mental health of participants with RD in this study. Healthcare professionals should cooperate with clinical rheumatologists, psychologists, and physiotherapists to provide comprehensive care that includes long-term education to help patients with RD self-manage stress, restore vitality, relieve pain, and increase physical function.
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Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Comprehensive Review. Diagnostics (Basel) 2019; 9:diagnostics9030091. [PMID: 31394725 PMCID: PMC6787585 DOI: 10.3390/diagnostics9030091] [Citation(s) in RCA: 128] [Impact Index Per Article: 25.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 07/09/2019] [Accepted: 07/15/2019] [Indexed: 12/21/2022] Open
Abstract
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating chronic disease of unknown aetiology that is recognized by the World Health Organization (WHO) and the United States Center for Disease Control and Prevention (US CDC) as a disorder of the brain. The disease predominantly affects adults, with a peak age of onset of between 20 and 45 years with a female to male ratio of 3:1. Although the clinical features of the disease have been well established within diagnostic criteria, the diagnosis of ME/CFS is still of exclusion, meaning that other medical conditions must be ruled out. The pathophysiological mechanisms are unclear but the neuro-immuno-endocrinological pattern of CFS patients gleaned from various studies indicates that these three pillars may be the key point to understand the complexity of the disease. At the moment, there are no specific pharmacological therapies to treat the disease, but several studies' aims and therapeutic approaches have been described in order to benefit patients' prognosis, symptomatology relief, and the recovery of pre-existing function. This review presents a pathophysiological approach to understanding the essential concepts of ME/CFS, with an emphasis on the population, clinical, and genetic concepts associated with ME/CFS.
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Vassend O, Røysamb E, Nielsen CS, Czajkowski NO. Fatigue symptoms in relation to neuroticism, anxiety-depression, and musculoskeletal pain. A longitudinal twin study. PLoS One 2018; 13:e0198594. [PMID: 29879175 PMCID: PMC5991664 DOI: 10.1371/journal.pone.0198594] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 05/22/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The nature of the relationship between fatigue and its risk factors is poorly understood. In the present study the genetic and environmental association between anxiety-depression, musculoskeletal (MS) pain and fatigue was examined, and the role of neuroticism as a shared risk factor that may possibly explain the co-occurrence between these phenotypes was investigated in a combined cross-sectional and longitudinal twin design. METHODS The sample consisted of 746 monozygotic (MZ) and 770 dizygotic (DZ) twins in the age group of 50-65 (mean = 57.11 years, SD = 4.5). Continuous measures of fatigue symptoms and the other phenotypes were employed. Using Cholesky modeling, genetic and environmental influences on the phenotypes, and the associations among them, were determined. Analyses were performed using measures of neuroticism obtained concurrently and 13-19 years earlier. RESULTS Results from multiple regression analyses showed that neuroticism, anxiety-depression symptoms, and MS pain were all significantly associated with fatigue, controlling for sex, education, and general health indices. The best-fitting biometric models included additive genetic and individual-specific environmental effects. Heritabilities in the 0.40-0.53 range were demonstrated. Furthermore, while there was a considerable overlap in genetic risk factors between the four phenotypes, a substantial proportion of the genetic risk shared between anxiety-depression and fatigue, and between MS pain and fatigue, was independent of neuroticism. CONCLUSION Evidence for a common underlying susceptibility to report fatigue symptoms, genetically linked to neuroticism, anxiety-depression, and MS pain, was found. Both unique and pleiotropic effects appear to be involved in the genetic architecture of the phenotypes.
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Affiliation(s)
- Olav Vassend
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Espen Røysamb
- Department of Psychology, University of Oslo, Oslo, Norway
- Norwegian Institute of Public Health, Oslo, Norway
| | - Christopher Sivert Nielsen
- Norwegian Institute of Public Health, Oslo, Norway
- Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
| | - Nikolai Olavi Czajkowski
- Department of Psychology, University of Oslo, Oslo, Norway
- Norwegian Institute of Public Health, Oslo, Norway
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Scherber RM, Kosiorek HE, Senyak Z, Dueck AC, Clark MM, Boxer MA, Geyer HL, McCallister A, Cotter M, Van Husen B, Harrison CN, Mesa RA. Comprehensively understanding fatigue in patients with myeloproliferative neoplasms. Cancer 2015; 122:477-85. [DOI: 10.1002/cncr.29753] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 08/25/2015] [Accepted: 09/04/2015] [Indexed: 11/10/2022]
Affiliation(s)
- Robyn M. Scherber
- Division of Hematology and Medical Oncology, Mayo Clinic; Scottsdale Arizona
- Department of Hematology and Oncology; Oregon Health and Science University; Portland Oregon
| | | | - Zhenya Senyak
- MPN Forum, MPN Research Foundation; Chicago Illinois
| | | | - Matthew M. Clark
- Department of Psychiatry and Psychology; Mayo Clinic; Rochester Minnesota
| | | | - Holly L. Geyer
- Division of Hematology and Medical Oncology, Mayo Clinic; Scottsdale Arizona
| | | | - Mary Cotter
- MPN Forum, MPN Research Foundation; Chicago Illinois
| | | | - Claire N. Harrison
- Guy's and St Thomas' NHS Foundation Trust; London United Kingdom
- MPN Voice; London United Kingdom
| | - Ruben A. Mesa
- Division of Hematology and Medical Oncology, Mayo Clinic; Scottsdale Arizona
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15
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Anderson LA, James G, Duncombe AS, Mesa R, Scherber R, Dueck AC, de Vocht F, Clarke M, McMullin MF. Myeloproliferative neoplasm patient symptom burden and quality of life: evidence of significant impairment compared to controls. Am J Hematol 2015; 90:864-70. [PMID: 26113113 DOI: 10.1002/ajh.24098] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Accepted: 06/22/2015] [Indexed: 01/14/2023]
Abstract
The myeloproliferative neoplasms (MPN) including polycythaemia vera (PV), essential thrombocythaemia and primary myelofibrosis (PMF) are rare diseases contributing to significant morbidity. Symptom management is a prime treatment objective but current symptom assessment tools have not been validated compared to the general population. The MPN-symptom assessment form (MPN-SAF), a reliable and validated clinical tool to assess MPN symptom burden, was administered to MPN patients (n = 106) and, for the first time, population controls (n = 124) as part of a UK case-control study. Mean symptom scores were compared between patients and controls adjusting for potential confounders. Mean patient scores were compared to data collected by the Mayo Clinic, USA on 1,446 international MPN patients to determine patient group representativeness. MPN patients had significantly higher mean scores than controls for 25 of the 26 symptoms measured (P < 0.05); fatigue was the most common symptom (92.4% and 78.1%, respectively). Female MPN patients suffered worse symptom burden than male patients (P < 0.001) and substantially worse burden than female controls (P < 0.001). Compared to the Mayo clinic patients, MPN-UK patients reported similar symptom burden but lower satiety (P = 0.046). Patients with PMF reported the worst symptom burden (88.3%); significantly higher than PV patients (P < 0.001). For the first time we report quality of life was worse in MPN-UK patients compared with controls (P < 0.001).
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Affiliation(s)
- Lesley A. Anderson
- Centre for Public Health; Queen's University Belfast; Belfast Northern Ireland
| | - Glen James
- Centre for Public Health; Queen's University Belfast; Belfast Northern Ireland
| | - Andrew S. Duncombe
- Department of Haematology; University Hospitals Southampton NHS Foundation Trust; Hampshire United Kingdom
| | - Ruben Mesa
- Mayo Clinic Cancer Centre; Scottsdale Arizona
| | | | | | - Frank de Vocht
- School of Social and Community Medicine; University of Bristol; Bristol United Kingdom
| | - Mike Clarke
- Centre for Public Health; Queen's University Belfast; Belfast Northern Ireland
| | - Mary F. McMullin
- Centre for Cancer Research and Cell Biology; Queen's University Belfast; Belfast Northern Ireland
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Druce KL, Jones GT, Macfarlane GJ, Basu N. Patients receiving anti-TNF therapies experience clinically important improvements in RA-related fatigue: results from the British Society for Rheumatology Biologics Register for Rheumatoid Arthritis. Rheumatology (Oxford) 2014; 54:964-71. [DOI: 10.1093/rheumatology/keu390] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Indexed: 11/14/2022] Open
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Landmark T, Romundstad P, Dale O, Borchgrevink PC, Vatten L, Kaasa S. Chronic pain: One year prevalence and associated characteristics (the HUNT pain study). Scand J Pain 2013; 4:182-187. [DOI: 10.1016/j.sjpain.2013.07.022] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Accepted: 07/18/2013] [Indexed: 11/29/2022]
Abstract
Abstract
Background
The reported prevalence of chronic pain ranges from 11% to 64%, and although consistently high, the calculated economic burden estimates also vary widely between studies. There is no standard way of classifying chronic pain. We have repeated measurements of pain in a longitudinal population study to improve validity ofthe case ascertainment. In this paper, associations between chronic pain and demographic characteristics, self reported health and functioning, work Incapacity and health care use were investigated in a sample from the general Norwegian population.
Methods
A random sample of 6419 participants from a population study (the HUNT 3 Study) was invited to report pain every three months during a 12 month period. Chronic pain was defined as moderate pain or more (on the SF-8 verbal rating scale) in at least three out of five consecutive measurements. Self reported health and functioning was measured by seven of the eight subscales on the SF-8 health survey (bodily pain was excluded). Health care utilisation during the past 12 months was measured by self report, and included seeing a general practitioner, seeing a medical specialist and seeing other therapists. The survey data was combined with information on income, education, disability pension awards and unemployment by Statistics Norway, which provided data from the National Education database (NUDB) and the Norwegian Labour and Welfare Administration (NAV).
Results
The total prevalence of chronic pain was 36% (95% CI34-38) among women and 25% (95% CI 22–26) among men. The prevalence increased with age, was higher among people with high BMI, and in people with low income and low educational level. Smoking was also associated with a higher prevalence of chronic pain. Subjects in the chronic pain group had a self-reported health and functioning in the range of 1–2.5 standard deviations below that of those without chronic pain. Among the chronic pain group 52% (95% CI 49–55), of participants reported having seen a medical specialist during the 12 month study period and 49%(95% CI 46–52) had seen other health professionals. The corresponding proportions for the group without chronic pain were 32% (95% CI 29–34) and 22% (95% CI 20–25), respectively. Work incapacity was strongly associated with chronic pain: compared with those not having chronic pain, the probability of being a receiver of disability pension was four times higher for those with chronic pain and the probability of being unemployed was twice has high for those with chronic pain. The population attributable fraction (PAF) suggested that 49% (95% CI 42–54) of the disability pension awards and 20% (13–27) of the unemployment were attributable to chronic pain.
Conclusion and implications
Chronic pain is a major challenge for authorities and health care providers both on a national, regional and local level and it is an open question how the problem can best be dealt with. However, a better integration of the various treatments and an adequate availability of multidisciplinary treatment seem to be important.
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Affiliation(s)
- Tormod Landmark
- Department of Cancer Research and Molecular Medicine, Faculty of Medicine , Norwegian University of Science and Technology , Trondheim , Norway
- National Competence Centre for Complex Symptom Disorders , St. Olav’s University Hospital , Trondheim , Norway
| | - Pål Romundstad
- Department of Public Health, Faculty of Medicine , Norwegian University of Science and Technology , Trondheim , Norway
| | - Ola Dale
- Department of Circulation and Medical Imaging, Faculty of Medicine , Norwegian University of Science and Technology , Trondheim , Norway
- Department of Anaesthesia and Emergency Medicine , St. Olav’s University Hospital , Trondheim , Norway
| | - Petter C. Borchgrevink
- National Competence Centre for Complex Symptom Disorders , St. Olav’s University Hospital , Trondheim , Norway
- Department of Circulation and Medical Imaging, Faculty of Medicine , Norwegian University of Science and Technology , Trondheim , Norway
| | - Lars Vatten
- Department of Public Health, Faculty of Medicine , Norwegian University of Science and Technology , Trondheim , Norway
| | - Stein Kaasa
- National Competence Centre for Complex Symptom Disorders , St. Olav’s University Hospital , Trondheim , Norway
- Department of Oncology , St. Olav’s University Hospital , Trondheim , Norway
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van Dartel SAA, Repping-Wuts JWJ, van Hoogmoed D, Bleijenberg G, van Riel PLCM, Fransen J. Association between fatigue and pain in rheumatoid arthritis: does pain precede fatigue or does fatigue precede pain? Arthritis Care Res (Hoboken) 2013; 65:862-9. [PMID: 23729241 DOI: 10.1002/acr.21932] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Accepted: 12/11/2012] [Indexed: 01/30/2023]
Abstract
OBJECTIVE Fatigue and pain are important symptoms for patients with rheumatoid arthritis (RA), but their temporal association is unknown. Therefore, the objective of this study was to investigate the longitudinal relationship between fatigue and pain in patients with RA using time-lag models. METHODS Consecutive RA outpatients (n = 228) were enrolled for this 1-year study. Fatigue was assessed monthly with the Checklist Individual Strength (CIS; range 8-56) and pain was assessed monthly with the bodily pain subscale (inverted, range 0-100) of the Short Form 36. The association between monthly changes in fatigue and pain was analyzed using longitudinal regression (mixed models), using the same months and with a 1-month time lag. RESULTS A total of 198 patients were included in the analyses. At baseline, the mean ± SD pain score was 35.23 ± 19.82 and the mean ± SD CIS fatigue score was 31.0 ± 12.4. Severe fatigue at baseline (CIS score ≥35) was present in 42% of the patients. The mean ± SD patient-averaged CIS fatigue score over 1 year was 30.9 ± 6.0 and the mean ± SD patient-averaged pain score over 1 year was 36.4 ± 18.3. The longitudinal regression analysis showed a significant positive relationship between fatigue and pain during the same month (β = 2.04; 95% confidence interval 1.82, 2.27). The models using a time lag showed no significant association between changes in pain and changes in fatigue. CONCLUSION In established RA, pain and fatigue show monthly fluctuations that are synchronous rather than showing a temporal relationship with a time lag; within this timeframe, the results do not indicate that one precedes the other.
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Affiliation(s)
- S A A van Dartel
- Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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Does Sleep Differ Among Patients with Common Musculoskeletal Pain Disorders? Curr Rheumatol Rep 2011; 13:535-42. [DOI: 10.1007/s11926-011-0209-3] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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