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Critch AL, Snow NJ, Alcock LR, Chaves AR, Buragadda S, Ploughman M. Multiple sclerosis-related heat sensitivity linked to absence of DMT prescription and subjective hand impairment but not autonomic or corticospinal dysfunction. Mult Scler Relat Disord 2023; 70:104514. [PMID: 36669245 DOI: 10.1016/j.msard.2023.104514] [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: 09/13/2022] [Revised: 12/28/2022] [Accepted: 01/12/2023] [Indexed: 01/15/2023]
Abstract
OBJECTIVES Heat sensitivity (HS) describes a temporary worsening of multiple sclerosis (MS) symptoms with increased body temperature. The pathophysiology may relate to central nervous system conduction deficits and autonomic dysfunction. We conducted deep clinical phenotyping of a cohort of persons with MS to identify predictors of HS. METHODS We recruited 59 MS participants with HS or No HS. Participants self-reported symptom severity (Hospital Anxiety and Depression Scale, Multiple Sclerosis Impact Scale, and fatigue visual analog scale) and underwent maximal exercise and transcranial magnetic stimulation testing to characterize autonomic and corticospinal function. We examined associations with HS using binomial logistic regression. RESULTS People with HS (36/59) had significantly greater disability, depression, fatigue, and physical and psychological functional effects of MS. They also had significantly lower corticospinal excitability but not conduction. After controlling for disease-modifying therapy (DMT), disability, and disease type, self-reported difficulty using hands in everyday tasks was significantly associated with a large increase in the odds of HS. Autonomic and corticospinal dysfunction were not associated with HS. Lack of DMT use alone was also associated with a large increase in the odds of HS. DISCUSSION Following a comprehensive assessment of plausible contributors to HS, HS was most strongly associated with lack of a DMT prescription and self-reported hand dysfunction. Surprisingly, objective measurement of autonomic and corticospinal integrity did not contribute to HS.
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Affiliation(s)
- Amber L Critch
- Recovery & Performance Laboratory, Faculty of Medicine, Leonard A Miller Centre, Memorial University of Newfoundland, Rm. 400, 100 Forest Road, St. John's, Newfoundland and Labrador A1A 1E5, Canada
| | - Nicholas J Snow
- Recovery & Performance Laboratory, Faculty of Medicine, Leonard A Miller Centre, Memorial University of Newfoundland, Rm. 400, 100 Forest Road, St. John's, Newfoundland and Labrador A1A 1E5, Canada
| | - Lynsey R Alcock
- Recovery & Performance Laboratory, Faculty of Medicine, Leonard A Miller Centre, Memorial University of Newfoundland, Rm. 400, 100 Forest Road, St. John's, Newfoundland and Labrador A1A 1E5, Canada
| | - Arthur R Chaves
- Recovery & Performance Laboratory, Faculty of Medicine, Leonard A Miller Centre, Memorial University of Newfoundland, Rm. 400, 100 Forest Road, St. John's, Newfoundland and Labrador A1A 1E5, Canada
| | - Syamala Buragadda
- Recovery & Performance Laboratory, Faculty of Medicine, Leonard A Miller Centre, Memorial University of Newfoundland, Rm. 400, 100 Forest Road, St. John's, Newfoundland and Labrador A1A 1E5, Canada
| | - Michelle Ploughman
- Recovery & Performance Laboratory, Faculty of Medicine, Leonard A Miller Centre, Memorial University of Newfoundland, Rm. 400, 100 Forest Road, St. John's, Newfoundland and Labrador A1A 1E5, Canada.
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Novak AM, Lev-Ari S. Resilience, Stress, Well-Being, and Sleep Quality in Multiple Sclerosis. J Clin Med 2023; 12:jcm12020716. [PMID: 36675644 PMCID: PMC9864697 DOI: 10.3390/jcm12020716] [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: 12/01/2022] [Revised: 01/05/2023] [Accepted: 01/09/2023] [Indexed: 01/19/2023] Open
Abstract
(1) Background: Multiple Sclerosis (MS) is a chronic, progressive, immune-mediated disorder that affects the Central Nervous System and is the most common cause of non-traumatic neurological disability in young adults. The study aimed to assess the levels of stress, resilience, well-being, sleep quality, and fatigue in Israeli people with MS (PwMS), and to examine the associations between these factors and the sociodemographic and clinical characteristics. These factors had never before been studied in conjunction in PwMS, nor had they been systematically addressed in Israel, the unique geopolitical situation of which may pose unique challenges. (2) Methods: This was a survey-based, cross-sectional study conducted through an Internet platform. (3) Results: Israeli PwMS who participated in the study were experiencing relatively high levels of stress and low resilience, poor sleep quality, and severe fatigue. The analysis revealed significant associations between resilience and stress, well-being, and anxiety, as well as stress and well-being, resilience, sleep quality, fatigue, and Clinically Isolated Syndrome (CIS). (4) Conclusions: the Israeli PwMS who participated in the study were experiencing higher levels of stress, lower resilience and worse sleep quality than PwMS in other countries, as compared to results previously reported in literature. The findings of this study ought to serve as a call to action for the MS care providers in Israel and warrant further research into the possible causes of the phenomenon and strategies to address it.
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Zarotti N, Eccles F, Broyd A, Longinotti C, Mobley A, Simpson J. Third wave cognitive behavioural therapies for people with multiple sclerosis: a scoping review. Disabil Rehabil 2022; 45:1720-1735. [PMID: 35514235 DOI: 10.1080/09638288.2022.2069292] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE Multiple sclerosis (MS) is a chronic condition linked to a wide range of psychological difficulties. While traditional cognitive behavioural therapy has been studied extensively with people with MS, much less is known about more recent "third wave" approaches. METHODS A scoping review was carried out by performing a systematic search across MEDLINE Complete, PsycINFO, CINAHL, Academic Search Ultimate, and Cochrane Library up to January 2022. RESULTS From an initial return of 8306 citations, 35 studies were included, 20 of which were randomised controlled trials (RCTs). These showed that four third wave approaches have been investigated with people with MS to date: acceptance and commitment therapy (ACT), dialectical behaviour therapy (DBT), mindfulness-based stress reduction (MBSR), and mindfulness-based cognitive therapy (MBCT). MBSR and MBCT may be helpful to address a range of psychological difficulties up to three months post-intervention. However, MS-specific adaptations may be required, and more evidence is needed on longer-term effectiveness. Limited evidence is also available for DBT and ACT, but additional research is warranted before any recommendation can be made. CONCLUSIONS As third wave approaches keep being refined, further more rigorous investigations are needed to implement them to the benefit of people with MS. Implications for RehabilitationMultiple sclerosis is linked to a wide range of psychological difficulties in adults.Little is currently known on third wave psychotherapies for people with MS.Mindfulness-based stress reduction and mindfulness-based cognitive therapy may be helpful to address a wide range of difficulties in MS.Specific adaptations may be needed to deliver suitable therapies to people with MS.Additional research is warranted to build on preliminary findings for DBT and ACT.
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Affiliation(s)
- Nicolò Zarotti
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Fiona Eccles
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Annabel Broyd
- University College London Hospitals NHS Trust, London, UK
| | | | - Amanda Mobley
- Worcestershire Health and Care NHS Trust, Worcester, UK
| | - Jane Simpson
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
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4
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Szcześniak M, Potemkowski A, Brola W, Kroplewski Z, Szałachowski RR, Zak M, Wilski M, Sobolewski P, Bartosik-Psujek H, Kapica-Topczewska K, Tarasiuk J, Czarnowska A, Kułakowska A, Zakrzewska-Pniewska B, Kubicka-Bączyk K, Morawiec N, Adamczyk-Sowa M, Stępień A, Zaborski J, Ratajczak A, Ratajczak M. The Big Five Personality Traits and Positive Orientation in Polish Adults with Multiple Sclerosis: The Role of Meaning in Life. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095426. [PMID: 35564821 PMCID: PMC9099940 DOI: 10.3390/ijerph19095426] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/25/2022] [Accepted: 04/27/2022] [Indexed: 02/05/2023]
Abstract
Scientific achievements concerning the direct relation between personality traits and positive orientation among patients with multiple sclerosis do not explain the role of potential mediators. In fact, some researchers argue that the traits–positivity association is much more complex than it seems to be. For this reason, we made an attempt to analyze the indirect relationship between the above-mentioned variables, including meaning in life as a mediator. In total, 618 patients with MS took part in the study. The NEO Five-Factor Inventory, the Positive Orientation Scale, and the Meaning in Life Questionnaire were used. The results showed that positive orientation/the presence of meaning/searching for meaning correlated positively with extraversion, openness to experience, agreeableness, and conscientiousness, and were negatively associated with neuroticism. Moreover, meaning in life in both its dimensions acted as a mediator in 9 of 10 models. It can be assumed that a propensity to establish interpersonal relationships (extraversion), use active imagination (openness), inspire confidence among others (agreeableness), and take responsibility (conscientiousness) can have an impact on someone’s positive attitude toward oneself and the surrounding world (positive orientation) when people have meaning in life and when they are seeking it.
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Affiliation(s)
- Małgorzata Szcześniak
- Institute of Psychology, University of Szczecin, 71-017 Szczecin, Poland; (A.P.); (Z.K.); (R.R.S.)
- Correspondence:
| | - Andrzej Potemkowski
- Institute of Psychology, University of Szczecin, 71-017 Szczecin, Poland; (A.P.); (Z.K.); (R.R.S.)
| | - Waldemar Brola
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (W.B.); (M.Z.); (P.S.)
| | - Zdzisław Kroplewski
- Institute of Psychology, University of Szczecin, 71-017 Szczecin, Poland; (A.P.); (Z.K.); (R.R.S.)
| | | | - Marek Zak
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (W.B.); (M.Z.); (P.S.)
| | - Maciej Wilski
- Department of Adapted Physical Activity, Poznan University of Physical Education, 61-871 Poznań, Poland;
| | - Piotr Sobolewski
- Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (W.B.); (M.Z.); (P.S.)
| | - Halina Bartosik-Psujek
- Department of Neurology, Institute of Medical Sciences, Medical College of Rzeszów University, 35-959 Rzeszów, Poland;
| | - Katarzyna Kapica-Topczewska
- Department of Neurology, Medical University of Białystok, 15-276 Białystok, Poland; (K.K.-T.); (J.T.); (A.C.); (A.K.)
| | - Joanna Tarasiuk
- Department of Neurology, Medical University of Białystok, 15-276 Białystok, Poland; (K.K.-T.); (J.T.); (A.C.); (A.K.)
| | - Agata Czarnowska
- Department of Neurology, Medical University of Białystok, 15-276 Białystok, Poland; (K.K.-T.); (J.T.); (A.C.); (A.K.)
| | - Alina Kułakowska
- Department of Neurology, Medical University of Białystok, 15-276 Białystok, Poland; (K.K.-T.); (J.T.); (A.C.); (A.K.)
| | | | - Katarzyna Kubicka-Bączyk
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland; (K.K.-B.); (N.M.); (M.A.-S.)
| | - Natalia Morawiec
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland; (K.K.-B.); (N.M.); (M.A.-S.)
| | - Monika Adamczyk-Sowa
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland; (K.K.-B.); (N.M.); (M.A.-S.)
| | - Adam Stępień
- Department of Neurology, Military Institute of Medicine, 01-755 Warszawa, Poland;
| | - Jacek Zaborski
- Department of Neurology and Neurological Rehabilitation and Stroke Sub-Division, Specialist Hospital in Międzylesie, 04-749 Warszawa, Poland;
| | - Anna Ratajczak
- Postgraduate Study, Pomeranian Medical University, 70-204 Szczecin, Poland;
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Zarrabi-Ajami S, Zamanian H, Amini-Tehrani M, Farhadidanaloo Z, Razavi RJ, Abbasi A, Darbandi S, Chenari P. Short quality of life scale: A cross-cultural validation in Iranian patients with multiple sclerosis. Mult Scler Relat Disord 2022; 58:103411. [PMID: 35216776 DOI: 10.1016/j.msard.2021.103411] [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: 04/08/2021] [Revised: 11/07/2021] [Accepted: 11/14/2021] [Indexed: 02/03/2023]
Abstract
Health-related quality of life (HRQoL) is the prioritized measure in multiple sclerosis (MS) patients. The short quality of life scale (SQoL) developed by Devy et al. (2013) is an MS-specific and abbreviated scale with ten items suitable for routine medical care settings. The current study reported the cross-cultural validation of the scale in the Persian language. A total of 455 convenient MS patients with a mean age of 38.39 (9.28) ranged from 18 to 64 filled out the primary measure and the validating measures, including hospital anxiety and depression scale, visual analogue scale - quality of life, and a single index of the number of past-year MS relapse. The confirmatory factor analysis on original structure indicated an acceptable model fit. However, a modestly modified structure composing of physical-functional dimension (items #1-3), mental dimension (items #5-8), and pain & energy dimension (items 4 & 9,10) was also exposed with a sound fit and a meaningful structure. The overall internal consistency reliability was sound (0.88), and the concurrent validity was confirmed. The Persian short quality of life scale (P-SQoL) is the first translated and validated version of the scale, surfacing significant implications. Further cross-cultural investigations are recommended to re-examine current findings. The classic and recent suggestions concerning the close interplay between the immunity system and the psychological system and the implications based on Iran's context are discussed.
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Affiliation(s)
| | - Hadi Zamanian
- Department of Health Education and Promotion, School of Health, Qom University of Medical Sciences, Qom, Iran
| | - Mohammadali Amini-Tehrani
- Health Psychology and Behavior Medicine Research Group, Students' Scientific Research Center, Tehran University of Medical Sciences, Vesal St., Tehran, Iran; Department of Psychology, Faculty of Psychology and Education, University of Tehran, Tehran, Iran.
| | - Zahra Farhadidanaloo
- Department of Psychology, Roudehen Branch, Islamic Azad University, Tehran, Iran
| | | | - Azam Abbasi
- Department of Psychology, Karaj Branch, Islamic Azad University, Karaj, Iran
| | - Saeideh Darbandi
- Department of Psychology, Karaj Branch, Islamic Azad University, Karaj, Iran
| | - Pegah Chenari
- Department of Psychology, Karaj Branch, Islamic Azad University, Karaj, Iran
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Alphonsus KB, D’Arcy C. Is There an Association Between Social Support and Pain Among Individuals Living With Multiple Sclerosis? J Evid Based Integr Med 2021; 26:2515690X21991995. [PMID: 33535805 PMCID: PMC7868479 DOI: 10.1177/2515690x21991995] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 12/13/2020] [Accepted: 01/09/2021] [Indexed: 12/04/2022] Open
Abstract
CONTEXT Pain is one of the most common symptoms reported by patients living with Multiple Sclerosis (MS). Risk factors associated with pain may include individual's cognitive thinking process, emotional and behavioural response to pain and amount of social support. There is a lack of research on the influence on the amount of social support and its association to pain outcomes. OBJECTIVE The primary objective of this study was to determine the association between amount and of social support and its association with odds of pain among individuals with MS. METHODS The Survey on Living with Neurological Conditions in Canada (SLNCC) 2011-2012 linked to the Canadian Community Health Survey (CCHS) 2010-2011 was used to carry out a logistic regression model for this analysis (N = 78,623). MAIN OUTCOME MEASURES The factors that were assessed were psychological factors, problems with sleeping, self-perceived general health, self-perceived level of stress, number of years living with MS, as well as social factors. The outcome variable was pain. RESULTS The amount of social support was found to be significant in that individuals who had 3 or fewer types of social support were 3.02 times more likely (95% CI 1.06 to 8.59) to report being in pain as opposed to individuals who had 4 types of support. The results indicate the importance of self efficacy in overcoming symptoms of MS and the need for more home care services.
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Affiliation(s)
- Khrisha B. Alphonsus
- School of Public Health, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Carl D’Arcy
- Applied Research, Department of Psychiatry, Royal University Hospital, Saskatoon, Saskatchewan, Canada
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Szcześniak M, Świątek AH, Cieślak M, Świdurska D. Disease Acceptance and Eudemonic Well-Being Among Adults With Physical Disabilities: The Mediator Effect of Meaning in Life. Front Psychol 2020; 11:525560. [PMID: 33192766 PMCID: PMC7643024 DOI: 10.3389/fpsyg.2020.525560] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 08/26/2020] [Indexed: 12/15/2022] Open
Abstract
The acceptance of disability is recognized as one of the most frequently mentioned factors that plays a particularly significant role in subjective well-being. However, so far, only a very small amount of research has been undertaken to clarify how and why acceptance of illness relates to eudemonic well-being. Hence, comprehension of the direct and indirect effects underlying this relationship seems essential for interventions that increase the recovery of people with impairments and enhance their quality of life. The current research was aimed at investigating the association between acceptance of illness, meaning in life, and eudemonic well-being, as well as the possible mediatory effect of meaning in life on the relationship between acceptance of illness and well-being. The sample consisted of 102 participants (71% women) aged between 20 and 64 years. The respondents had a range of different impairments (e.g., cerebral palsy, neurological disorders, spinal muscular atrophy, and sight defects). The Acceptance of Illness Scale, the Meaning in Life Questionnaire, and the Ryff Scales of Psychological Well-Being were used. It was confirmed that acceptance of illness correlated positively and significantly with the presence of meaning, self-acceptance, positive relations, environmental mastery, personal growth, general well-being, cohesion, flexibility, communication, and family satisfaction. The presence of meaning mediated the relationship between acceptance of illness and general well-being with its four other dimensions: self-acceptance, environmental mastery, purpose in life, and personal growth. Conversely, the search for meaning did not have any mediatory effect on this relationship.
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Affiliation(s)
| | - Agata H Świątek
- Institute of Psychology, University of Szczecin, Szczecin, Poland
| | | | - Daria Świdurska
- Institute of Psychology, University of Szczecin, Szczecin, Poland
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8
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Bassi M, Cilia S, Falautano M, Grobberio M, Niccolai C, Pattini M, Pietrolongo E, Quartuccio ME, Viterbo RG, Allegri B, Amato MP, Benin M, De Luca G, Gasperini C, Minacapelli E, Patti F, Trojano M, Delle Fave A. Illness perceptions and psychological adjustment among persons with multiple sclerosis: the mediating role of coping strategies and social support. Disabil Rehabil 2019; 42:3780-3792. [DOI: 10.1080/09638288.2019.1610511] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Marta Bassi
- Department of Biomedical and Clinical Sciences L. Sacco, University of Milan, Milan, Italy
| | - Sabina Cilia
- Multiple Sclerosis Center, University Polyclinic Hospital G. Rodolico, Catania, Italy
| | | | - Monica Grobberio
- Lab of Clinical Neuropsychology – Psychology Unit, ASST Lariana, Como, Italy
| | | | - Marianna Pattini
- Multiple Sclerosis Center – Neurology Unit, Hospital of Vaio, Fidenza, Italy
| | - Erika Pietrolongo
- Department of Neurosciences, Imaging and Clinical Sciences, University G. d’Annunzio, Chieti, Italy
| | | | - Rosa Gemma Viterbo
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, Bari, Italy
| | - Beatrice Allegri
- Multiple Sclerosis Center – Neurology Unit, Hospital of Vaio, Fidenza, Italy
| | - Maria Pia Amato
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
- Department of NEUROFARBA – Section of Neurosciences, University of Florence, Florence, Italy
| | - Miriam Benin
- Lab of Clinical Neuropsychology – Psychology Unit, ASST Lariana, Como, Italy
| | - Giovanna De Luca
- Department of Neurosciences, Imaging and Clinical Sciences, University G. d’Annunzio, Chieti, Italy
| | - Claudio Gasperini
- Department of Neuroscience, San Camillo-Forlanini Hospital, Rome, Italy
| | | | - Francesco Patti
- Multiple Sclerosis Center, University Polyclinic Hospital G. Rodolico, Catania, Italy
| | - Maria Trojano
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, Bari, Italy
| | - Antonella Delle Fave
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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The tide does turn: Predictors of remission from suicidal ideation and attempt among Canadians who previously attempted suicide. Psychiatry Res 2019; 274:313-321. [PMID: 30836277 DOI: 10.1016/j.psychres.2019.02.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 02/12/2019] [Accepted: 02/13/2019] [Indexed: 12/27/2022]
Abstract
The objectives of this study were to identify factors that contribute to (1) remission from suicidal ideation, and (2) remission from suicide attempt, among Canadians with a lifetime history of suicide attempt. Data for this study came from Statistics Canada's nationally representative 2012 Canadian Community Health Survey-Mental Health. A sample of 769 adult respondents who had ever attempted suicide was analyzed with remission from past year suicidal ideation and remission from past year suicide attempt as outcome variables. Of the 769 respondents who had ever attempted suicide, more than two-thirds (69%) were free from suicidal ideation within the past year, and approximately 87% were free from suicide attempts within the past year. Compared to men, odds were 2.66 times greater for women to be free of suicide attempt and 2.65 times greater to be free of suicidal ideation in the past year. Older age, being free of sleep problems and major depressive episode, having no history of chronic childhood physical abuse, and having two or fewer previous suicide attempts were associated with higher odds of remission from both suicide attempt and ideation in the past year.
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10
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Subjective Happiness, Health and Quality of Life and Their Sociocultural Correlates among Younger Population in Malawi. SOCIAL SCIENCES 2019. [DOI: 10.3390/socsci8020055] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Public health research and policy in sub-Saharan Africa are generally disease-oriented, with the focus being largely confined within the biological determinants of health. So far, little attention has been given to developing a more health-oriented approach by emphasising the psychosocial dimensions of health, especially among the younger population. To this regard, we conducted the present study to assess the prevalence and sociocultural correlates of perceived happiness, health, and life satisfaction among the adolescent and young (15–24 years) population in Malawi. We analysed cross-sectional data on 12,610 men and women based on a Malawi multiple indicator cluster survey conducted in 2013–2014. Data were analysed using descriptive and multivariable regression methods. According to the findings, more than 80% of the men and women reported being satisfied about happiness, health, and life. Multivariate analysis showed an inverse relationship between being currently or formerly married and perceived happiness. Ethnic disparities in perceived health and happiness were more pronounced in men, whereas that of life satisfaction was more pronounced in women. Living in households of the highest wealth quintile was positively associated with health and life satisfaction, but not with happiness. These findings highlight the need for prioritising the psychosocial needs of the adolescent and youth populations in designing health and social policy in Malawi. The findings need to be interpreted in light of the factors specific to the sociocultural environment in Malawi.
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Vescovelli F, Sarti D, Ruini C. Subjective and psychological well-being in Parkinson's Disease: A systematic review. Acta Neurol Scand 2018; 138:12-23. [PMID: 29696627 DOI: 10.1111/ane.12946] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The aim of this review is to summarize studies investigating subjective and psychological well-being in patients with Parkinson's disease (PD). MATERIALS AND METHODS A systematic and integrative review according to PRISMA criteria was performed with a literature search from inception up to September 2017 in multidisciplinary databases (PubMED, Scopus, Web of Knowledge) by combining together key words related to PD and well-being. Studies were included if: their full-text was available; they involved PD patients; focused on the selected positive dimensions; written in English. Case studies, conference proceedings, abstract, dissertations, book chapters, validation studies and reviews were excluded. Data extracted from the studies included sample characteristics, the positive dimension investigated, type of measure, study aims, design and results. One reviewer extracted details and commented results with other reviewers. The studies' quality was assessed following Kmet, Lee, and Cook. RESULTS Out of 1425 studies extracted, 12 studies (9 quantitative, 2 qualitative, 1 mixed methods) involving 2204 patients with PD were included. Most of the studies had a cross-sectional design and/or evaluated the effect of physical rehabilitation on well-being. Articles documented that the illness could impair well-being for its progressive impact on patients' motor autonomy. Preserving motor and musculoskeletal functioning facilitate patients' experience of well-being, social contribution and the maintenance of their job. CONCLUSIONS Research on positive resources in PD is still scarce compared to other chronic illnesses. The few available investigations suggest the need of preserving motor abilities by proper rehabilitation programs for maintaining and/or promoting patients' well-being and life engagement.
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Affiliation(s)
- F. Vescovelli
- Department of Psychology; University of Bologna; Bologna Italy
| | - D. Sarti
- Riminiterme Center of Rehabilitation; Rimini Italy
| | - C. Ruini
- Department of Psychology; University of Bologna; Bologna Italy
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12
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Delle Fave A, Bassi M, Allegri B, Cilia S, Falautano M, Goretti B, Grobberio M, Minacapelli E, Pattini M, Pietrolongo E, Valsecchi M, Amato MP, Lugaresi A, Patti F. Beyond Disease: Happiness, Goals, and Meanings among Persons with Multiple Sclerosis and Their Caregivers. Front Psychol 2017; 8:2216. [PMID: 29326635 PMCID: PMC5742493 DOI: 10.3389/fpsyg.2017.02216] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Accepted: 12/07/2017] [Indexed: 01/07/2023] Open
Abstract
The experience of persons with multiple sclerosis (MS) and their caregivers is usually investigated in terms of emotional distress and health-related quality of life, while well-being indicators remain largely underexplored. In addition, findings are often interpreted from the clinical perspective, neglecting socio-cultural aspects that may crucially contribute to individuals' functioning. At the methodological level, most studies rely on scaled instruments, not allowing participants to freely express their needs and resources. Based on the bio-psycho-social perspective endorsed by the International Classification of Functioning, well-being indicators were investigated among 62 persons with MS (PwMS), their 62 caregivers and two control groups, matched by age and gender. Participants completed the Positive Affect Negative Affect Schedule (PANAS), the Satisfaction with Life Scale (SWLS), and the Eudaimonic and Hedonic Happiness Investigation instrument (EHHI). EHHI provides information on participants' happiness, goals and meanings through scaled and open-ended questions, contextualized within major life domains. No relevant differences emerged among PwMS and caregivers, compared with the respective control groups, as concerns life domains associated with happiness, goals and meaning. Participants across groups prominently mentioned family, highlighting its intrinsic value and its relevance as a sharing context; health did not represent a major theme for PwMS; community, society and religion/spirituality issues were substantially neglected by all participants. PwMS and caregivers reported lower levels of positive affect than their control groups, while no substantial differences emerged for negative affect, happiness and meaningfulness levels in life and across most domains. Results suggest that the experience of MS is associated with well-being in relevant life domains, such as family and close relationships. Although PwMS and caregivers identified a lower number of goals and meaning-related opportunities compared to control groups, they showed a positive adjustment to disease through the development of personal and family resources. These assets are often undervalued by health professionals and social institutions, while they could be fruitfully exploited through the active involvement of PwMS and their families as expert and exemplary informants in initiatives aimed at promoting the well-being of individuals and communities
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Affiliation(s)
- Antonella Delle Fave
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Marta Bassi
- Department of Biomedical and Clinical Sciences "L.Sacco", Università degli Studi di Milano, Milan, Italy
| | - Beatrice Allegri
- Neurology Unit, Multiple Sclerosis Centre, Ospedale di Vaio-Fidenza, Fidenza, Italy
| | - Sabina Cilia
- Ospedale Policlinico Universitario G. Rodolico, Catania, Italy
| | - Monica Falautano
- Neurological Department, San Raffaele Hospital (IRCCS), Milan, Italy
| | | | - Monica Grobberio
- Laboratory of Clinical Neuropsychology, ASST Lariana, Como, Italy
| | | | - Marianna Pattini
- Neurology Unit, Multiple Sclerosis Centre, Ospedale di Vaio-Fidenza, Fidenza, Italy
| | - Erika Pietrolongo
- Department of Neurosciences, Imaging and Clinical Science, Università degli Studi 'G. d'Annunzio' Chieti - Pescara, Chieti, Italy
| | | | - Maria Pia Amato
- Department of NEUROFARBA, University of Florence, Florence, Italy
| | - Alessandra Lugaresi
- Department of Biomedical and Neuromotor Sciences, Università di Bologna, Bologna, Italy
| | - Francesco Patti
- Ospedale Policlinico Universitario G. Rodolico, Catania, Italy
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Baiden P, Fuller-Thomson E. Factors Associated with Achieving Complete Mental Health among Individuals with Lifetime Suicidal Ideation. Suicide Life Threat Behav 2016; 46:427-46. [PMID: 26811142 DOI: 10.1111/sltb.12230] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2015] [Accepted: 09/23/2015] [Indexed: 01/24/2023]
Abstract
The objective of this study was to identify factors associated with complete mental health among Canadians who had ever seriously considered suicide. Data for this study were obtained from Statistics Canada's 2012 Canadian Community Health Survey-Mental Health (N = 2,844). The outcome variable examined in this study was complete mental health and was analyzed using binary logistic regression. Of the 2,844 respondents with lifetime suicidal ideation, 1,088 (38.2%) had complete mental health (i.e., had flourishing mental health, no mental illness, and no suicidal ideation in the past 12 months). Those who had a confidant were seven times more likely to have complete mental health. Other factors associated with achieving complete mental health among formerly suicidal respondents include being older, being a woman, having higher income, use of religious coping, and never previously having a mental illness. Considering the importance of these protective factors in formulating public health policies will allow for a more wide-reaching approach to suicide prevention.
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Affiliation(s)
- Philip Baiden
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Esme Fuller-Thomson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
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Dehnavi SR, Heidarian F, Ashtari F, Shaygannejad V. Psychological well-being in people with multiple sclerosis in an Iranian population. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2015; 20:535-9. [PMID: 26600827 PMCID: PMC4621646 DOI: 10.4103/1735-1995.165942] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND To date, few results on well-being in individuals with neurological disease have been published, while several studies in other groups have indicated that well-being may not be the only absence of psychological distress, but also positive psychological function. The aim of the present study was to compare the psychological well-being (PWB) between the people with Multiple sclerosis (MS) and normal individuals and identify correlated demographic factors to PWB in people with MS disorder. MATERIALS AND METHODS A case-control study was performed in July 2012 on 55 people with MS who were referred to MS clinic (located at the Kashani Hospital), Isfahan Neurosciences Research Centre and 83 normal individuals with matched mean of age, level of education, and gender. The participants filled up the 18-item Ryff's PWB and demographic profile. The data were analyzed by SPSS software based on the independent t-test, and ANOVA. RESULTS There is significant different in all PWB dimensions between people with MS and normal groups. There were no significant differences in PWB in people with MS in relation to gender and marital status, but individuals with higher level of education scored higher in total PWB, positive relationship with others and purpose in life. CONCLUSION People with MS are at risk of lower level of PWB. Interventional programs for improving PWB are strongly recommended.
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Affiliation(s)
| | - Fatemeh Heidarian
- Department of Counseling and Psychology, Payame Noor University, Tehran, Iran
| | - Fereshteh Ashtari
- Department of Neurology, Isfahan Neurosciences Research Centre, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Vahid Shaygannejad
- Department of Neurology, Isfahan Neurosciences Research Centre, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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15
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Bassi M, Falautano M, Cilia S, Goretti B, Grobberio M, Pattini M, Pietrolongo E, Viterbo RG, Amato MP, Benin M, Lugaresi A, Minacapelli E, Montanari E, Patti F, Trojano M, Delle Fave A. Illness Perception and Well-Being Among Persons with Multiple Sclerosis and Their Caregivers. J Clin Psychol Med Settings 2015. [DOI: 10.1007/s10880-015-9425-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Lugaresi A, Rottoli MR, Patti F. Fostering adherence to injectable disease-modifying therapies in multiple sclerosis. Expert Rev Neurother 2014; 14:1029-42. [PMID: 25109614 DOI: 10.1586/14737175.2014.945523] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Multiple sclerosis requires long-term management, often with disease-modifying therapies. Poor medication adherence, especially to injectables, can increase relapse and hospitalisation rates and consume healthcare resources. We discuss adherence definitions and terminology and its prevalence in multiple sclerosis (MS). Typical causes of poor adherence in patients with MS include: insufficient efficacy or tolerability, concurrent disorders, and consequences of MS (e.g., forgetfulness, depression, fatigue and poor motor skills). Ways to improve adherence rates are reviewed, focusing on interdisciplinary healthcare teams, good communication between healthcare workers and patients (and their families), ongoing support and digital tools to promote adherence. We consider open communication and continuing education to be key, and that MS nurses have a pivotal role in ensuring patients' adherence to MS medicines.
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Affiliation(s)
- Alessandra Lugaresi
- Department of Neuroscience, Imaging and Clinical Sciences, Multiple Sclerosis Center, University "G. d'Annunzio", Ospedale Clinicizzato "SS Annunziata", VII livello, Corpo A, Via dei Vestini snc, 66100 Chieti, Italy
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The coexistence of well- and ill-being in persons with multiple sclerosis, their caregivers and health professionals. J Neurol Sci 2014; 337:67-73. [DOI: 10.1016/j.jns.2013.11.018] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Revised: 10/21/2013] [Accepted: 11/12/2013] [Indexed: 11/20/2022]
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19
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Votruba KL, Rapport LJ, Whitman RD, Johnson A, Langenecker S. Personality differences among patients with chronic aphasia predict improvement in speech-language therapy. Top Stroke Rehabil 2013; 20:421-31. [PMID: 24091284 DOI: 10.1310/tsr2005-421] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Negative affectivity and neurocognitive deficits including executive dysfunction have been shown to be detrimental to rehabilitation therapies. However, research on the relationship between neuropsychological deficits and improvement in speech-language therapy (SLT) for aphasia is sparse. OBJECTIVE To examine the relationships among neurocognitive and psychological functioning and improvement in SLT following aphasia due to stroke. METHODS Fifty patients who were ≥ 9 months post stroke and enrolled in outpatient SLT to treat aphasia participated. Using standard language assessment measures, the authors evaluated language functioning at initiation of the study and after participants completed various SLT protocols. Executive functioning, visuospatial skills, attention, and memory also were assessed to provide indices of convergent and discriminant validity. Participants' mood and affectivity were evaluated by self-report, and their functional abilities and recovery of function since stroke were assessed via caregiver report. RESULTS A multiple regression model testing the combined powers of neurocognitive and psychological variables was significant (P = .004, R2 = 0.33), with psychological and neurocognitive functioning accounting for 15% of the variance in relative language change beyond that accounted for by stroke severity and gross cognitive functioning. Negative affectivity expressed on the Positive and Negative Affectivity Scale made unique contributions to the model. CONCLUSIONS Improvement in SLT is substantially related to neurocognitive and psychological functioning, particularly affectivity. Assessment of these characteristics may assist in identifying patients who are likely to improve and in tailoring treatment programs to yield optimal outcomes.
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Tinghög P, Hillert J, Kjeldgård L, Wiberg M, Glaser A, Alexanderson K. High prevalence of sickness absence and disability pension among multiple sclerosis patients: a nationwide population-based study. Mult Scler 2013; 19:1923-30. [PMID: 23652218 DOI: 10.1177/1352458513488234] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
INTRODUCTION Although multiple sclerosis (MS) often implies substantial disability, there is little knowledge about sick leave and disability pension among MS patients. OBJECTIVES The purpose of this study was to estimate the prevalence rates of sick leave and disability pension among MS patients and to explore how socio-demographics are associated with such rates. METHODS The register data of all people who lived in Sweden in 2005 and were 16-64 years old was used to identify 9721 MS patients and matched controls. Adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were calculated and effect modifications were evaluated with Wald X(2) tests. RESULTS In 2005, 61.7% of the MS patients were on partial or full disability pension compared to 14.2% among the controls. Of the others, 36.8% had ≥ 1 sick-leave spell for >14 days during that year. Socio-demographics were similarly associated with sick leave and disability pension among MS patients and controls, with the noteworthy exceptions that female gender and immigration status were less potent risk factors in the MS population (p<0.05). CONCLUSION In spite of widespread access to modern health care including disease-modifying drugs, the majority of MS patients of working ages were on a disability pension. Strategies enabling MS patients to retain their footing in the labour market are needed.
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Affiliation(s)
- Petter Tinghög
- Department of Insurance Medicine, Karolinska Institutet, Sweden
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21
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Vianna D, Claro L, Mendes A, da Silva A, Bucci D, de Sá P, Rocha V, Pincer J, de Barros I, Silva P. Infusion of Life: patient perceptions of expressive therapy during chemotherapy sessions. Eur J Cancer Care (Engl) 2013; 22:377-88. [DOI: 10.1111/ecc.12041] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2012] [Indexed: 11/29/2022]
Affiliation(s)
| | - L.L. Claro
- Department of Health and Society; Fluminense Federal University; Niterói; Rio de Janeiro
| | - A.A. Mendes
- Department of Health and Society; Fluminense Federal University; Niterói; Rio de Janeiro
| | - A.N. da Silva
- Department of Health and Society; Fluminense Federal University; Niterói; Rio de Janeiro
| | - D.A. Bucci
- Fluminense Federal University; Niterói; Rio de Janeiro; Brazil
| | - P.T. de Sá
- Fluminense Federal University; Niterói; Rio de Janeiro; Brazil
| | - V.S. Rocha
- Fluminense Federal University; Niterói; Rio de Janeiro; Brazil
| | - J.S. Pincer
- Fluminense Federal University; Niterói; Rio de Janeiro; Brazil
| | | | - P.R. Silva
- Fluminense Federal University; Niterói; Rio de Janeiro; Brazil
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Costa DC, Sá MJ, Calheiros JM. The effect of social support on the quality of life of patients with multiple sclerosis. ARQUIVOS DE NEURO-PSIQUIATRIA 2012; 70:108-13. [PMID: 22311214 DOI: 10.1590/s0004-282x2012000200007] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Accepted: 10/11/2011] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To determine the predictive value of social support on health related quality of life (HRQoL) in multiple sclerosis (MS) patients. METHODS The sample is composed by 150 MS consecutive patients. We used the Medical Outcomes Study Social Support Survey to assess social support and the Health Status Questionnaire to assess HRQoL. For inferential analysis, we used the Multiple Linear Regression with stepwise selection of variables. RESULTS The age, basic education, psychological support and disability explains 41.6% of the variance in physical function, 29.4% in physical performance and 30.6% in emotional performance. Age and psychological support explains 23.1% of the variance in physical function and 29.4% in vitality. CONCLUSION This study demonstrated that social support is a predictor with a significant effect on HRQoL in MS.
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García Jalón EG, Lennon S, Peoples L, Murphy S, Lowe-Strong A. Energy conservation for fatigue management in multiple sclerosis: a pilot randomized controlled trial. Clin Rehabil 2012; 27:63-74. [DOI: 10.1177/0269215512446495] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: To develop and test the feasibility of an energy conservation programme to manage fatigue in multiple sclerosis. Design: A pilot randomized controlled trial. Setting: Community setting. Subjects: People with multiple sclerosis reporting fatigue. Interventions: An energy conservation programme was compared to a peer support group. Both interventions were delivered in group format with 2-hour sessions once a week for five weeks. Patients’ views about the interventions were sought in discussion groups one week post intervention. Main measures: The primary feasibility outcomes were recruitment and adherence. Other outcome measures were the Fatigue Impact Scale, Fatigue Severity Scale, MS-Impact Scale-29, MS Self-efficacy Scale, Beck’s Depression Scale-Fast Screen and Epworth Sleepiness Scale. Outcomes were administered at baseline, post intervention, 6-week and 3-month follow-up. Results: Almost 30% of the people approached to take part in the study did not commit to participation because of transport/time issues. Twenty-three patients took part in the study. Three patients dropped out, one reporting adverse effects. A power calculation indicated that a sample of 56 (28 per group) would be required for a main randomized controlled trial. Patients valued peer support and those in the energy conservation group described the programme as useful, but reported difficulties completing some practice activities. Conclusion: An energy conservation programme in the community is feasible and welcomed by people with multiple sclerosis. However, future research needs to consider longer follow-ups and practical issues to improve recruitment rate by accommodating to patients’ needs.
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Affiliation(s)
- E Guiomar García Jalón
- Northern Ireland Cerebral Palsy Register, School of Nursing and Midwifery, Queen’s University Belfast, Belfast, UK
| | - Sheila Lennon
- Physiotherapy, School of Medicine, Flinders University, Adelaide, South Australia
| | - Louise Peoples
- School of Psychology, University of Ulster, Londonderry, UK
| | - Sam Murphy
- School of Psychology, University of Ulster, Londonderry, UK
| | - Andrea Lowe-Strong
- Health and Rehabilitation Sciences Research Institute and School of Health Sciences, University of Ulster, Belfast, UK
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A brief overview of the Patient Competency Rating Scale: updates and additions to the COMBI. J Head Trauma Rehabil 2012; 27:83-5. [PMID: 22218203 DOI: 10.1097/htr.0b013e31823645db] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Pakenham KI, Fleming M. Relations between acceptance of multiple sclerosis and positive and negative adjustments. Psychol Health 2011; 26:1292-309. [PMID: 21623545 DOI: 10.1080/08870446.2010.517838] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study examines relations between acceptance as defined in Acceptance and Commitment Therapy (ACT) and adjustment to multiple sclerosis (MS). A first step in this investigation was the development of a measure of acceptance of MS called the MS Acceptance Questionnaire (MSAQ). Consistent with prior findings and theoretical propositions, it was predicted that acceptance would be associated with better adjustment to MS (lower distress and higher positive affect, life satisfaction and marital adjustment and better health). A total of 128 persons with MS completed measures of demographics, illness and adjustment at Time 1 and measures of acceptance and adjustment 12 months later (Time 2). Factor analyses of the MSAQ revealed two factors, action and willingness. Associations between the MSAQ and other validated acceptance measures supported convergent validity. As predicted, after controlling for the effects of initial adjustment and relevant demographic and illness variables, greater acceptance was related to better adjustment, although the action factor emerged as the strongest predictor of better adjustment. This is the first study to examine the role of acceptance (as defined in ACT) in adjusting to MS over time and as such provides a first step for further investigation of acceptance in MS.
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Morrow SA, Drake A, Zivadinov R, Munschauer F, Weinstock-Guttman B, Benedict RHB. Predicting loss of employment over three years in multiple sclerosis: clinically meaningful cognitive decline. Clin Neuropsychol 2010; 24:1131-45. [PMID: 20830649 DOI: 10.1080/13854046.2010.511272] [Citation(s) in RCA: 181] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Cognitive dysfunction is common in multiple sclerosis (MS), yet the magnitude of change on objective neuropsychological (NP) tests that is clinically meaningful is unclear. We endeavored to determine NP markers of the transition from employment to work disability in MS, as indicated by degree of decline on individual tests. Participants were 97 employed MS patients followed over 41.3 ± 17.6 months with a NP battery covering six domains of cognitive function. Deterioration at follow-up was designated as documented and paid disability benefits (conservative definition) or a reduction in hours/work responsibilities (liberal definition). Using the conservative definition, 28.9% reported deteriorated employment status and for the liberal definition, 45.4%. The Symbol Digit Modalities Test (SDMT) and California Verbal Learning Test, Total Learning (CVLT2-TL) measures distinguished employed and disabled patients at follow-up. Controlling for demographic and MS characteristics, the odds ratio of a deterioration based on a change of 2.0 on the CVLT2-TL was 3.7 (95% CI 1.2-11.4 and SDMT by 4.0 was 4.2 (95% CI 1.2-14.8), accounting for 86.7% of the area under the ROC curve. We conclude that decline on NP testing over time is predictive of deterioration in vocational status, establishing a magnitude of decline on NP tests that is clinically meaningful.
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Affiliation(s)
- Sarah A Morrow
- The Jacobs Neurological Institute, State University of New York at Buffalo, NY 14203, USA
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Demakis GJ, Buchanan RJ. Rated cognition in nursing home residents with multiple sclerosis: cross-sectional and longitudinal analyses. Disabil Rehabil 2010; 32:1438-46. [PMID: 20462388 DOI: 10.3109/09638281003596840] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To examine cognitive change in nursing home residents with multiple sclerosis (MS) over the first year of a nursing home stay and to predict cognition functioning in these residents at admission and the 1-year annual assessment. METHOD In the first part of this study, the cognitive functioning of nursing home residents with MS (n = 1890) and without MS (n = 22,985) were compared. In the second part, demographic and other variables were used to predict cognition at the admission and 1-year annual assessment for MS residents. RESULTS Nursing home residents with MS had better cognitive functioning than residents without MS at admission and 1 year later. Regression analyses demonstrated that higher education and pain predicted higher Minimum Data Set Cognition Scale (MDS-Cog) at admission and at 1 year later, but poorer activities of daily living predicted worse MDS-Cog at admission and 1 year later. For the longitudinal analysis, MDS-Cog at the admission assessment was an independent predictor of MDS-Cog scores at the 1-year annual assessment. CONCLUSIONS Nursing home residents with MS have significantly better cognitive functioning than non-MS residents and, over the first year of a nursing home stay, higher education and pain, but lower activities of daily living, predict poorer cognitive functioning.
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Affiliation(s)
- George J Demakis
- Department of Psychology, University of North Carolina at Charlotte, NC 28223-0001, USA.
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Demakis GJ, Buchanan R, Dewald L. A longitudinal study of cognition in nursing home residents with multiple sclerosis. Disabil Rehabil 2010; 31:1734-41. [PMID: 19479556 DOI: 10.1080/09638280902738664] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE Examine cognitive change in nursing home residents with multiple sclerosis (MS) over the first 4 years of their nursing home stay. METHOD Nine hundred and twenty-four individuals with MS in nursing homes were longitudinally studied. Of these, 121 had MS but no psychiatric or neurological co-morbidities, 169 had MS plus another neurological disorder (MS-Neuro), 269 had MS plus a psychiatric disorder (MS-Psych) and 365 had MS plus both psychiatric and neurological disorders (MS-Comb). Data were obtained from a large government data-set, the minimum data set (MDS), and cognition was rated on the MDS-Cognition Scale. RESULTS Data were analysed using a mixed-model ANOVA with a repeated factor of time and a fixed factor Group. We found a significant time effect with declines in cognition between each assessment, except 2000 and 2001, and a significant group effect so that the MS-Neuro and the MS-Comb groups had worse cognition than the MS-Psyc and the MS groups. A significant time x group interaction indicated differences in how the groups declined over time. CONCLUSIONS Over the first 4 years of a nursing home stay, cognition deteriorates in individuals with MS. Though there are not different rates of decline, residents with MS-Neuro and MS-Comb perform worse than residents with MS or MS-Psyc.
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Affiliation(s)
- George J Demakis
- Psychology Department, University of North Carolina at Charlotte, Charlotte, North Carolina 28223-0001, USA.
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Créange A, Labauge P. [Social handicap at the onset of the multiple sclerosis]. Rev Neurol (Paris) 2009; 165 Suppl 4:S167-72. [PMID: 19361683 DOI: 10.1016/s0035-3787(09)72130-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Multiple sclerosis is the most frequent cause of handicap in young adults. Because of the young age of patients, the chronic relapsing course, the multifocal consequences of lesions, and the frequent progressive chronic course, multiple sclerosis has multiple consequences including individuals, familial, social and professional, that induces, in the early stage, a wide social handicap overflowing consequences of the neurological deficit. Since the onset of the disease, social events are very frequent: jobless and decrease of salaries (50% of the cases), divorce (10%), daily help (12%).
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Affiliation(s)
- A Créange
- Service de Neurologie, CHU Albert Chenevier/Henri Mondor, AP-HP, Université Paris XII et Réseau SINDEFI-SEP, Créteil, France.
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Dancey CP, Attree EA, Stuart G, Wilson C, Sonnet A. Words fail me: the verbal IQ deficit in inflammatory bowel disease and irritable bowel syndrome. Inflamm Bowel Dis 2009; 15:852-7. [PMID: 19130620 DOI: 10.1002/ibd.20837] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
BACKGROUND Many chronic illnesses are accompanied by impaired cognitive functioning. In people with Inflammatory Bowel Disease (IBD), there is some research to suggest a decrement in verbal IQ (VIQ), when compared to people with Irritable Bowel Syndrome (IBS) and healthy controls. Although this is an important finding, it is necessary to ensure that such deficits are not due to methodological problems such as the failure to take into account pre-morbid functioning. METHODS A total of 88 people (IBD, N = 29; IBS, N = 29; Controls, N = 30) completed the Wechsler Abbreviated Scale of Intelligence (WASI), the Wechsler Test of Adult Reading (WATR), the Trait Rumination Questionnaire (TRQ), the Center for Epidemiologic Studies Depression Scale (CES-D), and the General Health Questionnaire (GHQ-12). RESULTS We found evidence of a VIQ decrement in both IBD and IBS groups when measured against both healthy controls and against their own pre-morbid IQ scores (WTAR-Predicted WAIS-III IQ measures). However, the decrement was larger (and of clinical significance) in the IBD group but not in the IBS group. CONCLUSION Some tentative evidence is presented which suggests that poor VIQ performance may be due in part to interference from excessive rumination.
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31
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Waldron-Perrine B, Rapport LJ, Ryan KA, Harper KT. Predictors of life satisfaction among caregivers of individuals with multiple sclerosis. Clin Neuropsychol 2009; 23:462-78. [DOI: 10.1080/13854040802279683] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Ryan KA, Rapport LJ, Telmet Harper K, Fuerst D, Bieliauskas L, Khan O, Lisak R. Fitness to drive in multiple sclerosis: Awareness of deficit moderates risk. J Clin Exp Neuropsychol 2008; 31:126-39. [DOI: 10.1080/13803390802119922] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
| | | | | | | | | | - Omar Khan
- c Multiple Sclerosis Center, Department of Neurology , Wayne State University School of Medicine , Detroit, MI, USA
| | - Robert Lisak
- c Multiple Sclerosis Center, Department of Neurology , Wayne State University School of Medicine , Detroit, MI, USA
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Alshubaili AF, Ohaeri JU, Awadalla AW, Mabrouk AA. Quality of life in multiple sclerosis: a Kuwaiti MSQOL-54 experience. Acta Neurol Scand 2008; 117:384-92. [PMID: 18028242 DOI: 10.1111/j.1600-0404.2007.00960.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES We compared the quality of life (QOL) self-ratings of relapsing-remitting multiple sclerosis (RRMS) and progressive multiple sclerosis (PMS) patients with those of the general population; and assessed the association of demographic, clinical, and caregiver variables with patients' QOL. METHODS Consecutive clinic attendees were assessed with MSQOL-54, Beck's Depression Inventory, and Expanded Disability Status Scale. Caregivers rated their impression of patients' QOL and attitudes to patients' illness. RESULTS Of 170 patients (35.5% M, 64.5% F), 85.3% had RRMS and 14.7% PMS. RRMS had higher QOL domain scores (P < 0.001). Patients had lower QOL than controls (P < 0.001). Depression was the commonest significant covariate of QOL domains. After controlling for depression and disability, differences between the MS groups were less significant. Predictors of overall QOL were caregiver impression of patient's QOL, depression, and treatment side effects. CONCLUSION Programs that address depression, disability, the impact of treatment side effects, caregiver attitudes and education should enhance QOL outcomes.
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Affiliation(s)
- A F Alshubaili
- Department of Neurology, Ibn Sina Hospital, Safat, Kuwait
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Executive dysfunction and neuropsychiatric symptoms predict lower health status in essential tremor. Cogn Behav Neurol 2008; 21:28-33. [PMID: 18327020 DOI: 10.1097/wnn.0b013e3181684414] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To evaluate the hypothesis that increased neuropsychiatric distress and cognitive impairment are associated with lower perceived health status in essential tremor (ET). BACKGROUND Many patients with ET experience nonmotor complications, including lower perceived health status and poor health-related quality of life, which are associated with tremor severity, age, and personality factors. No studies, however, have examined the potential contribution of neuropsychiatric symptoms and cognitive deficits to health status in ET. METHOD Forty-five patients with ET underwent comprehensive neurologic and neuropsychologic evaluations, including self-report measures of physical and psychosocial health status (ie, the Sickness Impact Profile) and neuropsychiatric distress (ie, the Profile of Mood States). RESULTS A series of hierarchical multiple regressions showed that after considering the effects of ET disease severity, lower vigor, and deficits in executive functions were independently predictive of poorer physical health status, whereas increased symptoms of depression were uniquely associated with lower psychosocial health status. CONCLUSIONS Findings indicate that reduced vigor (ie, apathy), executive deficits, and depression are important predictors of poorer perceived health status in ET. Given the prevalence of such nonmotor symptoms, these data highlight the potential value of considering neuropsychiatric and neurocognitive assessments in the management of patients with ET.
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Alshubaili AF, Awadalla AW, Ohaeri JU, Mabrouk AA. Relationship of depression, disability, and family caregiver attitudes to the quality of life of Kuwaiti persons with multiple sclerosis: a controlled study. BMC Neurol 2007; 7:31. [PMID: 17877820 PMCID: PMC2041952 DOI: 10.1186/1471-2377-7-31] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2007] [Accepted: 09/18/2007] [Indexed: 11/26/2022] Open
Abstract
Background Assessment of subjective quality of life (QOL) of persons with multiple sclerosis (MS) could facilitate the detection of psychosocial aspects of disease that may otherwise go unrecognized. The objectives of the study were to (i) compare the QOL ratings of relapsing remitting (RRMS) and progressive (PMS) types of MS with those of a general population group and the impression of their family caregivers; and (ii) assess the association of demographic, clinical, treatment, depression, and caregiver variables with patients' QOL. Methods Consecutive clinic attendees at the national neurology hospital were assessed with the 26 -item WHOQOL Instrument, Beck's Depression Inventory and Expanded Disability Scale. Caregivers rated their impression of patients' QOL and attitudes to patients' illness. Results The 170 patients (60 m, 109 f) consisted of 145(85.3%) with RRMS and 25 with PMS, aged 32.4(SD 8.8), age at onset 27.1(7.7), EDSS score 2.9 (1.8), and 76% were employed. The patients were predominantly dissatisfied with their life circumstances. The RRMS group had higher QOL domain scores (P < 0.001), and lower depression(P > 0.05) and disability (P < 0.0001) scores than the PMS group. Patients had significantly lower QOL scores than the control group (P < 0.001). Caregiver impression was significantly correlated with patients' ratings. Depression was the commonest significant covariate of QOL domains. When we controlled for depression and disability scores, differences between the two MS groups became significant for only one (out of 6) QOL domains. Patients who were younger, better educated, employed, felt less sick and with lesser side effects, had higher QOL. The predictors of patients' overall QOL were disability score, caregiver impression of patients' QOL, and caregiver fear of having MS. Conclusion Our data indicate that MS patients in stable condition and with social support can hope to have better QOL, if clinicians pay attention to depression, disability, the impact of side effects of treatment and family caregiver anxieties about the illness. The findings call for a regular program of psychosocial intervention in the clinical setting, to address these issues and provide caregiver education and supports, in order to enhance the quality of care.
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Affiliation(s)
| | - Abdel W Awadalla
- Department of Psychiatry, Faculty of Medicine, Kuwait University, PO Box 24923, Safat, 13110, Kuwait
| | - Jude U Ohaeri
- Department of Psychiatry, Psychological Medicine Hospital, Gamal Abdul Naser Road, PO Box 4081, Safat, 13041, Kuwait
| | - Asser A Mabrouk
- Department of Neurology, Ibn Sina Hospital, PO Box 2547, Safat, 13115, Kuwait
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Abstract
The present study examined awareness of deficits among individuals with multiple sclerosis (MS). A total of 74 pairs of persons with MS and their significant others participated. Awareness of cognitive deficit was measured by discrepancy scores between patient reports of their cognitive abilities and objective test results. Awareness of functional deficit was measured by the discrepancy between the patient and significant other reports of the functional abilities of the patient. Results suggest that about one third of MS patients have diminished awareness of their cognitive and/or functional deficits. Unawareness of deficit was more common among patients with secondary-progressive MS than among those with relapse-remitting MS. Executive dysfunction was strongly associated with unawareness of cognitive deficits but not unawareness of functional deficits. Unawareness of cognitive deficits and unawareness of functional deficits appear to be tapping different aspects of unawareness of deficit.
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Affiliation(s)
- Tanya E Sherman
- Department of Rehabilitation Psychology and Neuropsychology, The Rehabilitation Institute of Michigan, Rm 555, 261 Mack Blvd, Detroit, MI 48201, USA.
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